And the pattern continues...Bill had not slept much and he's starting to sundown some. They said he became agitated just after I left. That's why they give him his sleep medicine so early in the evening. But, after explaining for the millionth time why he can't go home yet, he settled down and had a good day.

He was already back on CPAP when I got there and only periodically did he say that it was hard to breathe. But, again, we told him that it's because he was doing all the breathing himself and it was hard using those muscles that hadn't been used for so long. The goal was to keep him on CPAP for 8 hours and then back on the vent at night, again at a very low rate. He made it until 4 and unless she had just switched him before I got there between 7:30 and 8 and was just going by 8, he was on for 9 hours. Even after he was switched over he said it was hard to breathe, but the way he was gesturing, he was feeling the vent breathe for him, and he didn't like it. The vent is only set on 4, so it only breathes 4 breaths per minute and he does the rest.

He stood for nearly 2 minutes in therapy and sat on the edge of the bed in between, and then sat in his chair for 2 hours. He started to complain, but I told him he just had to watch Gunsmoke twice and when it was time for me to get lunch, he could get back into bed. He did have to use the bathroom right after he got in the chair and the PCAs decided to stand him really quick and slide the bedpan under him and that worked really well. But, after that he worked his puzzle books and watched Gunsmoke and was fine.


The afternoon was quiet with drs. and nurse practitioners popping in and out. Dr. Munday is pleased with his progress, and cardiology said he sounds better. He didn't need suctioned much, but he did get one deep suctioning that got some stuff out. The secretions aren't thick like they were, at least to me, they are clear and somewhat foamy. 

Ashley, from Dr. Threlkeld's office, said that his white count has spiked again, going from normal to 19,000 and since he's got mostly liquid stools, they are wanting a stool sample to check for c.diff. But, that has a very distinct, horrible odor, and his does not. It's not pleasant to smell, but I've smelled worse. So, I don't think it's that, but who knows. I don't know if they are running any tests on the sputum that's collecting in his little jar, and I know they've done some blood tests, as usual, so we'll see what pops up. He's been without antibiotics since Sunday so who knows what was still lurking.

When I left yesterday I made sure I shut his blinds to darken the room some and I had stayed later to see if that helped with the sundowning. But, I had been up since about 3:30 with the cats and was tired. It was a good thing I had only eaten about half my lunch, so I had dinner ready. And, I couldn't eat it. I'm finding that beef (barbecued brisket, which was wonderful) doesn't want to go down easily. But, I had eaten enough and the episode didn't last long. 

I was in bed by 8:30 and slept well, but Mouse started in at 3. I finally got up about  4:15. I still feel tired so it will probably be another early to bed night for me again.

So, that's it. Today should be a trach collar day. I don't know how long they will plan to leave it on him, probably depends on if he can keep his saturation high enough. I'll let you know!