Again, we're getting into days that may seem to be nothing, but things do happen.

Bill slept most of yesterday again, but he did apparently sleep at night too. Maybe he just isn't resting. When I got to his room, it was pretty much in shambles! It was also dangerous for Bill. His bed was raised and in a locked position and all the rails were up. Using all 4 rails is illegal, it is considered to be restraint. I don't mind that the rails were up, we went through that in Florida in the nursing home when I begged for rails to be put on his bed, but to have the bed up so high, had Bill been so inclined to get out of bed, he would have broken several bones! His tray table was pushed clear across the room and his night stand was by the bed. That was explained by his nurse, who put it there, when he asked to call me. She said she just couldn't tell him no. But, the rest is a mystery to all, including the nurse. She said there was nothing in report that explained it and the only thing we could think of, since one of his urinals was gone, was that he had had a bowel movement and the PCA had cleaned him and then didn't lower the bed.

The vent was turned down to 6 and he was doing fine with his sats, staying mostly in the high 90s and hitting 100% when he was sleeping. The plan was to replace the inner trach collar yesterday, but as of 4:30 when I left it still hadn't been done and the respiratory tech thought that it would be done today now. Once that is done, he won't be able to talk, they hope. It wouldn't surprise me if he didn't find a way.

When they can turn the vent to 4, which should be today, they will then put it in CPAP mode, where he is doing all the breathing but the machine is keeping the airway open. And after that, he will come off the vent completely and go back to the trach collar and regular oxygen. So, that led me to wonder, if that's going to happen in the next couple of days, why do the trach replacement? Seems like that just puts him through some trauma that may not need to happen. But, then it could take longer to get him off, and in this case, I'm not a dr. and have to defer to them.

He did both physical and occupational therapy. I saw the speech therapist a couple of times in the hall, looking toward the room, but she didn't come in. I do know that the x-ray did show a new pneumonia in the lower right lobe so I'm wondering if he is aspirating the ice chips some, which is why she didn't come in. He didn't want to do the OT since she came late in the day and I had to get tough with him. I told him if he ever wanted to come home with me, he had to do it, even if he didn't feel like it. So he grudgingly said he would try. She had him move plastic rings from one side of an arch to the other and back, alternating arms. He did fine with that and actually started trying to cheat by moving them in 2s and 3s! Then he was able to get to bed, which is what he wanted all along. But by that time he had been up almost 4 hours.

I left after that and didn't get any calls. And now it's time for me to get dressed and hit the road. We'll see if he can talk or not when I get there. Later, everybody!