Bill was agitated when I got to the hospital yesterday morning. Said he hadn't slept well, they kept coming in and rearranging the room. I noticed that the nursing computer station had been moved, but it was also plugged in, so it needed charging. He also said that he had to sign some military paperwork and they didn't give him a copy of it. I actually thought he was dreaming, or a little confused, but then I saw the man we usually see in ER who deals with paperwork. He may have had him sign the paper for Tricare so that they will pick up the 20% Medicare doesn't pay.

I didn't see Dr. Threlkeld except in passing later in the day but, since IVs were still being hung, he's still on antibiotics. I need to question today what antibiotics he's getting. I think one of them is Cefipime again, but I don't know if that's the only one.

Cindy did come in and I did hold my tongue about the I told you so aspect. She said he sounded a little short of breath and I told her he was agitated. He told her he hadn't slept well because they kept bothering him so she was going to see if he could be moved to step-down where it's a little quieter at night.

When Dr. Yaranov came in he said that he and Dr. Williams had put their heads together and decided that Bill would pass the swallow study. They think now that it is chronic, spontaneous aspiration. This means that it's happening without him even knowing. As Amber the speech therapist explained it Friday, the pills may go down but some water may be seeping past. Part of this is caused by him being on the vent and having the trach, not just last year but after the transplant. Those muscles are all weaker, which also leads to a weaker cough and a harder time clearing his throat. So, they are going to just do intense speech therapy and swallowing exercises. He agreed that his numbers were stable enough to move to step-down and said the antibiotics are working, his white count was coming down, but he needed to get much stronger. He wasn't happy that none of the other therapies had come in yet.

He did have a different nurse yesterday and he let him use the bedside commode instead of a bedpan. He moved it close enough to the bed that all Bill had to do was stand, pivot and sit. He was surprised at how steady he was standing. Bill did let him clean him up and I don't think his sats dropped too low, I don't remember a lot of monitor beeping. That's a drawback for me in step-down. All of his monitoring is done out of the room and they only come in every 4 hours for blood pressure and O2 sats. So I may bring our oximeter and check it some myself if I feel like he's low.

I left about 5 and he still hadn't been moved. The rain had stopped but it was dreary and very windy. I wanted to get home as close to dark as possible. Bill called when I was about 20 miles from home and said he had been moved and gave me his room number. And just as I got out of the car the hospital called and it was his nurse. Bill's phone was messed up and they neither one could get it to work. I tried talking Bill through it but either he didn't understand where I was telling him to press, or the phone is dead. And since I couldn't see what screen it was on, it was hard to visualize it. He also couldn't reach his room phone so he's incommunicado until I get there. Hopefully, if I can't get it, taking the batter out will work, but I won't know until I see it. I can rearrange the room a little to make it easier for him to reach the room phone.

It's supposed to be really foggy this morning, although it doesn't look like it is, at least in town. But, I'm going to wait until daylight again to leave. I need to stop at Walmart before I go. I was too tired to do it last night.

So, there you have it. I think Emily and a friend (unless Bryan and the girls want to come) are going to come this afternoon after church. She's made Bill a water bottle so that he will drink more. He's on a higher dose of Lasix now and he's not drinking enough. I also think he needs to have his prostate checked. He's using his urinal every 20 minutes or so, but getting very little output.

Until tomorrow's update...