For those of you who have been looking for a new post for a couple of days now, sorry it's so late tonight. But, as there is no set time for me to do them, just keep checking in. Before I get you caught up, or try to get you caught up, I'm extremely tired tonight, and I even had Emily take over staying at the hospital this afternoon (she was already in Memphis and I was supposed to meet the chimney sweep this afternoon). But, I really want to turn all the lights out and go to bed.

Yesterday did not start out well. When I got to the hospital I noticed that Bill's urinal looked like it had some mildew in it. I did not inspect it, just figured that they would throw it away when they came in. But, he said he needed to use the commode and he didn't think he could hold it. The nurses came right in when he called and he had diahrrea and then he said he was going to throw up so I grabbed his basin and dumped everything out just in time. It took awhile to then get him cleaned up and his feeding tube got caught in all of the mess. But, his nurse cleaned and sterilized it. When I looked at the urinal again, he had vomited in it at some point and just didn't tell anyone.

He then said that his right arm hurt from his shoulder to his fingertips and since that is the one with the DVT I called his nurse. She felt his arm and it was very warm compared to his left one, so a STAT ultrasound was ordered. It showed that the DVT was still in his armpit and hadn't changed and there was nothing else found. The pain went away and the warmth left. He was running a slight temp, but Tylenol took care of that and Zofran took care of the nausea. He even felt well enough to eat lunch.

We found out that Dr. Shirwany deferred to Dr. Edwards and when I told the nurse for the umpteenth time why we did not want Edwards, she said we would probably get Yaranov, which is fine, we like him!

One of the case managers came in and we discussed home health and he's already working on getting PT and nursing for awhile. They were supposed to set it up the last time but it didn't happen.

The lung drs. (and I'm sketchy on this) said it wasn't feasible to do another bronchoscopy at this time. (More on this later).

PT finally came and got him into his chair. The entire room had to be rearranged. They will not increase the length of oxygen tubing because it is high-flow, so they won't go longer than 7 feet. But, we got the chair next to the bed and the tubing is long enough, so he sat in the chair for at least an hour before I left. I don't know how much longer he stayed in it.

His insulin has been increased and a long acting one has been added. Dr. Oktied said that when he's ready to be discharged, we will talk about what ones to use at home. He said that his A1C was 8.8 and they want it under 6.5 so he will probably continue to use insulin, even if he is able to get off the steroids.

A nurse from our lung group came in and I really like him. He said he was going to have a new x-ray done and they he and the doctor, that we haven't seen, would get together and review everything. He did say that a bronch was not off the table yet since he still sounds pretty junky. We talked about some different therapies, including a sleep study and a cough assist device. No-one from the other lung group ever mentioned things like this.

This morning a nurse from pulmonology came in and was surprised that he hadn't been taken for his Thallium test. Turns out that she had the patients confused! She's not the only one, since nothing had been said about any testing.

His board showed his goal for today was a down arrow SOB. I couldn't figure out what that was so I asked his nurse and she it was "decrease shortness of breath". Makes perfect sense when you know the shorthand!

Dr. Threlkeld said that he's responded well to the antibiotic. They all seem to think that's he's still aspirating some. He did say that we all do it, and I guess the difference is that most people have a strong enough immune system that it can fight it off, but since Bill's is compromised, he just can't. He also said that it could be sinus drainage that is sneaking through while he's sleeping.

Tom, the pulmonary nurse I like so much, said that his x-ray actually looks worse than it had in the past. Since Bill is not able to cough up the secretions, they may bring in a vibrating vest to shake him up some. When I talked to Bill tonight, it had not been done.

After I left pulmonary did come in and Emily also missed them. But she talked to Cindy, the cardiology nurse and she checked the computer and said it looked like they were going to hold off on the bronch for now, but if he got the least little bit worse they would do one. 

After he had his bath this morning he walked the 4 steps to his chair and I checked his oxygen and it was only 69. That's pass out level. But, he wasn't in distress, his nailbeds were not turning blue, it was just breathing a little harder and his heart rate was up. His O2 was increased to 7 again from 5 before it reached 90. So, until they can get him stabilized with his oxygen level, and keep his sats from dropping so low, he'll stay where he is. Maybe something will get figured out.

While I was waiting for the chimney sweep, who I think I already said didn't show up until after I had to go to the bank before it closed, I had planned to do some research on some things they've talked about. But, I wasn't able to do that, and I'm too tired to do that now. I think I'm going to take my laptop with me tomorrow. The wifi at the hospital stinks, but I can always turn my phone into a hotspot and pair them to get a better signal.

I think that covers most of the last 2 days. My brain doesn't want to work anymore tonight. I should be able to get back onto a more normal schedule tomorrow, but for now I'm calling it a night. The cats and I are going to bed!