I'm actually using my notes for this post. It was an exhausting night Sunday night. I slept from 10 until 11:45, and then we were up until 1. The slept until 2:15 and catnapped until 3:30 when we (Bill) was up for good. Cody, the nurse, was very quiet and I hardly knew when he came in the room. I made sure the blinds in the door and all the windows were closed and the only light in the room, besides white shows through the blinds, was the nightlight. Cody didn't even need to leave the door open to work, just the light that came in.

Bill only had to have the Seroquel and Respiradol to sleep. Cody asked me on one of my trips down the hall to the bathroom is he needed his Xanax and I told him no. He was awake, but not agitated. He only got agitated around 6.

He was very junky sounding and needed suctioned 3 times during the night and he has a hard time recovering from any movement or anything done to him. His sats will drop into the upper 70s, low 80s and it may take 15 minutes or so to get them back to the upper 80s, low 90s. They also have to bump his oxygen up. It seems like right now he breathes best at a 65% concentration, 65% pure oxygen. Sometimes they take it to 98% to get him up faster. I also think some of the low readings are from him worrying with the oximeter on his finger. He keeps trying to untape it, and after so long on the same finger, it will stop reading. 

Even though he was needing suctioned, and the stuff he's getting up, and he's coughing a lot of it up and out, is the thick gluey stuff that's not really yellow looking like infection, but a yellowish brown. It has the consistency of, well I don't really know what. It's thicker than egg whites, or regular if you pardon the expression snot, but I don't really know how to describe it. Anyway, Dr. Williams said he didn't sound that bad and decided not to bronch him again. He had not looked at his chest x-ray and he said they hadn't changed much from one to the next in several days. As he was walking out of the room, he said that Restorative Care had agreed to take him as a patient and that if a bed opened up he could be moved this week! That's in direct contradiction to what Dr. Edwards has been saying, so I wonder who will win the argument this time!

I tied a knot in one end of the fastener to the trach collar after I watched Bill try to take it off. It's just a shoe lace and one end has a snap on it to attach to the mask. The other end the lace just pulls through to be tightened. So, I gave it just a little slack and then tied a knot so that it can't go back through the hole. Hopefully it held last night.

The other big news from yesterday, and it hadn't been done before I left, was to switch the foley catheter to a condom catheter. And, that is exactly what it sounds like. There is a tube that is attached to the end of a condom that he will wear that will drain into a bag, just like a regular one. The only difference is that it is external and he will actually have to pee. It won't automatically drain like the foley. Hopefully, he still has that sensation and won't have any problem. They were going to do it before the end of shift and I left around 5. 

They did get him put into the chair again yesterday, and as soon as he was moved, he had to poop. We found out Sunday night that he hadn't gone for a few days and when Yolanda looked in the computer, his last time was Friday. So she called Dr. Edwards who prescribed something to help. He had gone once before he was moved, and although he thought he had filled the bedpan, it was empty and it was all still attached to him (gross I know and TMI). But, it was very solid, compared to the mostly liquid ones from earlier. Well, Yolanda gave him the medicine Dr. Edwards prescribed through his feeding tube port after he was situated in the chair. Between me, Ed and Caleb, we got him on the bedpan. The men lifted him and I slid the bedpan in. Getting him off was a little harder. They enlisted the help of Austin and 2 lifted while the third wiped. Again, if was mostly on him and still pretty thick. I imagine it was not an easy night once that medicine really started to work. Bill is usually very regular and had been up to this point. So, I looked and constipation is a side effect of the seroquel. I don't know now if he will have to have a daily stool softener or what they will do. I guess I will find out today!

I put a note on my chair before I left not to remove it from the room. Hopefully I'll have it again today. Caleb thought that was a good idea. Bill asked me if I was taking him home with me when I went and it breaks my heart to tell him know. But, I remind him that I can't take care of him right now and he does know that. I told him when he moves he will get stronger and will be able to come home sooner. I told him maybe by his birthday which is the end of February. That of course depends on how soon they get him moved and how he does with rehab and everything else. But, it seemed like a good milestone to start with.

We did not see therapy of any kind at all yesterday, although they were all over the unit. I know that's a problem that Dr. Edwards has, the lack of consistent therapy for all of "his" patients. And, as I said before, the ones who are able to walk can walk with their nurse or the aides, but the bedridden ones, and there are several, aren't even getting much in the way of range of motion exercises, but then they're told by the therapists that if they don't move their limbs, they will lose the use of them. Well, since you're a therapist, and I'm not, make sure it's being done.

When I was leaving Bill told me to be careful going home because he knew how tired I was. He also said he was going home with Caleb because he knew he was having a party! He was probably going to nap some as he had been awake all day, from 3:30. It was a rougher trip home last night. I did pretty well until I was about 15 miles from home and then started yawning. I got him, fed all the animals and me and was in bed a little after 8 and slept until 4:30 this morning. Woke a few times, but went right back to sleep. I'm still a little groggy this morning, but it always hits me the 2nd day after a sleepless night.

So, I think I've covered everything. I talked to the secretary in the step-down unit yesterday (she's a fellow crafter so we compare what we've made) and she said "you'll both have lots more room up on 4", so I guess I need to plan on going up to see if I can have a little tour as it seems like it's going to happen sooner rather than later now. It will be nice to be able to walk around furniture without having to dodge so much equipment. Bill's room is one of the smallest in the unit and he's still got a lot of equipment, IV poles, feeding pole, vent for backup, plus the recliner and all of the trash, linen, nursing equipment. I'll be satisfied with just having a bathroom that's not down the hall!

I think I've covered everything. And, it's almost time for me to start heading out. But, I don't think I should drive in my pajamas and robe so need to get dressed and gather my things for the day. Not going to take the laptop today, but I had to rearrange my backpack to bring my meds home so need to repack it. So, see you either tonight or in the morning!