I'm really tired tonight and the last 2 days have been pretty eventful. I'll try to get it all down, without making it really long, yet try not to skip anything. That will be hard to do!

The decision was made yesterday morning to go ahead and do the tracheostomy. It was done about 11 and everything went find. Because they used a combination of drugs to paralyze Bill during the procedure, they did not try to lift the sedation too soon. It was probably about 4 when they started to wake him up.

It took quite awhile before he finally focused on my voice and tracked to where I was. He was still in and out most of the evening until we left for dinner. I say we because his daughter Aimee and her husband Lee arrived in the morning. We checked into the hotel later that afternoon and then met Ryan, Amanda and Daemon, Emily and Bryan, and Mary-Rose, Jack, William, and Petra. We tried to just order pizza and eat in the lobby of the hotel, but found that no place would deliver to the hotel. They will deliver across the street to the hospital, but not the hotel. There is a Wendy's within walking distance so we went there for dinner. Afterwards we met back in the lobby for a mini family meeting.  The main issue we needed to talk about was changing from the nasal gastric feeding tube to the peg tube that goes directly to the stomach. He had one of those after the transplant and hated it. The dr. Aimee and I talked to went over all of the risks and the fact that if there was a problem, he is too weak to undergo a surgery to correct any problem. We think he will probably need to have it, but we want to see if he can be weaned from the vent first. (More on this later). We also nixed the idea of hospice, unless it was absolutely necessary, and we won't know that until he wakes up completely. We then talked about the culpability of the nursing home and the contribution it made to the deterioration of his condition in a matter of 2 days. After agreement all around, the local families headed home, and I took Mary-Rose, Jack and the kids to the hospital as they hadn't been there yet. Bill was still awake, but had been given some pain medication, so wasn't quite as aware of us being there as he had been before.

This morning I went to the hospital fairly early and was there when Dr. Threlkeld got there. He was very surprised to see Bill awake and following with his eyes. He still thinks we are on the right track with the antibiotics and thinks that the trach will definitely help in his recovery. I also noticed that all of the maintenance drugs, the Isoprel for his heart rate and the Propofol for sedation had been removed. He now only gets an IV for some of his meds and of course the antibiotics. I got a huge gift from him today...a wink! He usually reserves his winks for everyone but me. I get the glares and cut away eyes, but not today.

Physical therapy came in and did some range of motion exercises with him. They were pleased at his responses to commands to wiggle and squeeze. The maneuvered his bed into a position that almost resembled a recliner, yet he was sitting almost straight up. He stayed in that position all morning and was able to hold his head up some and it also let him cough some to try to clear the secretions. He continued to track and look around and he would try to get my attention by opening his eyes really wide and raise his eyebrows. He wanted to talk a lot but his mouth is still really swollen from the biter bar and of course he doesn't have his teeth in, so it's hard to lip read. But, he's been swallowing, which is going to be a determining factor for the feeding tube.

The GI dr. came in again and we came to the decision to wait until Monday before doing the peg. We're going to let him get through the week-end and let his lungs recover some before doing it. Mary Rose asked him very plainly if it was OK if we did this, explaining why, and he very emphatically, in front of the dr., nodded his head. The dr. had said it wasn't an emergency situation to get it done tomorrow, so waiting to see if he could be weaned from the vent in the next few days seemed like the thing to do.

Dr. Williams came in and listened and watched and then said that tomorrow they can start the breathing trials again. It should be easier on him this time. So, I'll be going early again, but I'm picking Mary Rose up on the way to the hospital. 

I came home later than usual, but earlier than I had planned. I'm glad I did because once I was home, I really got tired. It was rainy on the way home, and of course dark and those are my least favorite conditions to drive in.  

So, I think I've covered everything. Progress has been made and I think, as before, Bill is going to surprise everyone again. I'll update again after tomorrow's breathing test. Until then, I'm going to bed!