Bill was bright eyed and bushy-tailed yesterday morning. He had slept well, been bathed and shaved and was ready to go.

When therapy came in they asked if he would sit on the edge of the bed and he agreed. They arranged all of the tubes and lines and told him to move his legs to the edge. Usually he'll move them once and they have to help to get them the rest of the way. But, this time he moved them all the way over, grabbed the railing of the bed and pulled himself up! This was a first for him! He sat upright with no support. Since he had done so well, they asked if he wanted to try to stand and he nodded, so they got the Sara Steady, which is a stander/mover that can just be used for someone to stand or parts can be moved to make a seat and patients can then be rolled around a little. They locked it down and he grabbed the bar and pulled himself up! He stood, with back straight and head held up for 30 seconds. He then sat for awhile and did it again for 15 seconds, sat and rested, then stood for another 30 seconds. All in all, when he said he wanted to lay down, he sat on the edge of the bed for 10 minutes and stood for 1 minute and 15 seconds! He didn't want to get into the chair so I told them I would see if the nurses would put him in later in the afternoon.

The speech therapist came by to tell us that Dr. Edwards wanted to hold off on speech unless it was just exercises, no swallowing with ice, until he was on trach collar. I don't think he gave a reason, and she was rather confused. I think he's trying to avoid him aspirating right now since it all becomes pneumonia. But, we may not see much of her for a bit.

While I was at lunch they turned the vent off and put him on CPAP. He complained most of the afternoon that he couldn't breathe, although his numbers were excellent. We think it's just because the machine was not helping and he was not inflating his lungs far enough himself. But, he started having a small panic attack and his heart rate and respiration rate went up, so about 4:30 he was put back on the vent. Diane told me that was the plan anyway. I thought that when he went to CPAP he would stay on it until he went to trach collar unless, of course, he had a big problem, but she said no, it's still a weaning process. So a 4 hour start was good.

He was also coughing a lot of foamy secretions yesterday and had to be suctioned more than he had the last few days. I mentioned that this was the longest he had gone without being bronched and Diane and the student therapists wanted to know how often they were doing it and were very surprised when I told them every 2-3 days. I would have to go back over notes and here to be sure, but it was frequently.

He was resting better when I left and it was almost time for his meds. Since he had such a busy day, I hope he did sleep last night. If his new pattern held, he did not and today won't be such a good day, but since he was more active, hopefully he was tired enough. He did not nap any during the day.

That's about it. The response time for the staff was a little lax yesterday. Bill asked for a bedpan and finally another PCA came in and he had already gone. Another time another nurse brought it in and got him on and a different nurse got him off. He still had more on him than in the pan from the way he was positioned. But, patients were moved all around yesterday and maintenance was up and down the hallway and there were students everywhere. Still no excuse and I'll watch again today. When he asks for the bedpan it should tell them that he can tell when he has to go, and I'm specific when I call them. I may see if there's an alternative to the diapers, something that he can wear and still be able to use the urinal, yet can be pulled apart easily if he does mess them. Surely they exist, even if I have to bring them in myself.

I did stop in and visit with the nurses in ICU. They had all been wondering how he was and of course they made me cry. I told them to come and visit him and they said they wanted to see him walk into the unit to see them! So, something to shoot for.

It's time for me to start getting moving. It's cold this morning and frosty and now I really wish I had stopped for gas on my way home last night instead of waiting until this morning. But, it's not raining! That drive yesterday was brutal in the wind and rain! See you tomorrow, or tonight if I'm not too tired!