For those of you who usually get multiple text updates, or phone calls, I did none of those things  as you know. I sent no texts, and was very selective on which phone calls I answered, and made none. There was no certain reason for that other than I didn't do it. It was a busy/not busy day, you'll understand that shortly. So, I just took lots of notes and this update may just be me copying them instead of trying to get them into some kind of coherent order. So, today, and maybe for the next few days, be patient with me. I'm going to do whatever is most convenient for me.

He's still critical, but stable. Austin was suctioning his vent when I got there and he was getting so much junk out that he thought they might do another bronchoscopy since he was already intubated. Another favorite nurse, Stacy, was his nurse for the morning, and when she suctioned his ng tube, the contents were almost burgundy, which indicates there was some blood. So a GI consult was set up. Dr. Williams ordered IV protonics twice a day to prevent any acid reflux, which could explain some of the aspiration. They are going to start some tube feedings just so he gets some nutrition, so the tube will stay in place for the time being. He also is not going to be taken off the vent, but allowed to just rest. He's still overbreathing it.

He was awake when I got there but they raised the sedation because he is still reaching for the vent and ng tube. He is also very agitated and reaching for the catheter. It wouldn't surprise me if he isn't restrained more when I get there today since I wasn't there throughout the night.

His right hand and leg are swollen and Stacy assured me that it is only because of the fluids he's getting. His urine output is good (and there goes the helicopter this morning, bless all the occupants, Lord, patient and flight crew) and the ultrasound of the kidneys was normal except for a cyst on his right one that we've known about for years.

His "crit", which is blood level, was 31 on admission and 25 yesterday morning. The standing order had been that if it was under 25 they would give a unit of blood, but he had not received any. His creatinine, kidney numbers, were 2.1 on discharge, which is a little high, but acceptable for him, 4.79 on admission which is extreme, and 3.17 yesterday. So it is coming down. Urine output is good and it wasn't as dark today as it was Sunday.

Respiratory came in a lavaged his lungs, which means she introduced some water into them and then suctioned it back out, along with other secretions. After she did that, and suctioned his mouth, he calmed down and did not need suctioned again while I was there.

Some of his meds have been switched to IV, some are being crushed and pushed through the ng tube and some have been held. He's still getting normal saline drips, Isuprel which is the drug that keeps his heart rate up, Levaphed which keeps his blood pressure up (this one they tweak and try to get him off once he stays at a stable rate. It was at 3 when I left and Noel was going to try to turn it down after I left.), Propofol for sedation and different antibiotics. I know one is Zyvox which he's had before and there is another one but I didn't get the name of it. He can also have some dilaudid to help with extra sedation if needed.

Dr. Duncan from the gastro group came in and he flushed a lot of water through the ng tube and tried to recreate what Stacy suctioned. He only got water and stomach acid back, so he thinks that what she pulled was some blood from when the tube was placed. It may have irritated the stomach wall. But, he ordered another hematocrit level just to be sure. Those results had not come back before I left. He said if there was continued blood loss they would consider an EGD to look into his stomach, especially since he was already intubated to see if there was a little bleeding ulcer or something. And since he had complained that his stomach and back hurt before all this happens, that could make sense.

All of the nursing staff has been so solicitous of how I'm doing, it's a little unnerving. It makes me feel like we're on death watch, but since they haven't sent a chaplain or said to call in family, they just are making sure they are caring for me as much as for Bill. There were some tears again yesterday as it did get overwhelming at times, but just a rub on the back or a touch of a shoulder helped. Caleb, the aide, checked on me so many times. The last time he peeked in to ask if I was good I told him that since I was knitting, I was relaxed. (I didn't tell him I had ripped it out 3 times and it's only a 4 row pattern).

One of the most disturbing aspects of the day was with the social worker. She asked what my thoughts were on the nursing center he was at, and I told her that even though a nurse friend of Emily's gave it 2 thumbs up, and our nurse practitioner has placed her father there, we gave it 4 thumbs down.  She later came back with a 2 page list of skilled nursing centers in and around Jonesboro and said she would be back today for my decision on which ones to call for placement! Now, I know that lately I've been Super Woman as my neighbor called me, but I haven't figured out how to be in several places at once! We are not going to go in blind this time and Bill is nowhere near ready for discharge. So, after discussing this with Emily, Ryan, and Mary Rose (along with input from my sister who worked in nursing homes), I am going to tell her that until we know what condition Bill will be in at discharge and what his wishes will be, we will not make a decision on placement and only then will we visit the different locations. Some are rated from much above average to below average. The below average ones won't even be considered...been there done that! I think they are pushing that to cover themselves with Medicare because he was readmitted so soon after discharge for the same diagnosis and that makes their numbers look bad, so if he comes back because the family didn't like placement, then it falls on us. So, that is my plan for our meeting today. And if necessary, Emily is ready to come down and take charge of that aspect. She said that my job and focus is Bill and only him right now. I don't need to be thinking of this.

I think that covers everything. I'm not leaving super early this morning. There's no real reason to. The ICU nurses will give me any and all info from the drs. if I miss any. They will also update me on meds and if blood was needed and anything I ask about. I've pulled a muscle in my shoulder and need to go to Walmart to get an Icy Hot pain patch. It's right where I can't reach it to rub regular Icy Hot. I used my long handled bath scrubby this morning. Note to self...buy a new long handled bath brush now for bathing. Using the old one could make for an interesting shower! But, since he will probably still be sedated, it's not like we can have breakfast together. And if necessary they will call and I'll head out.

I'm taking meds and a small "go bag" in case I get too tired to drive home, or need to stay. There is a Hampton Inn on the campus so I won't have to sleep in the waiting room (been there done that) and I would still be 5 minutes away if needed. Brianna can feed the animals if I decide to stay. But, if I'm not too tired and just want that 1 1/2 hour drive to think or not think, I'll still come home.

OK, we're caught up as far as I know. I also don't know again today if I will send texts and make/receive phone calls. It will depend on what's going on at the time with Bill, and in my head. So, don't get upset if you don't hear. This area will always be updated daily.