Happy New Year! The cats and I partied hard until 8:30 last night and then gave up for the night, or at least I did! Of course at midnight, the gunfire started, but it sounded farther away than usual and didn't last as long as it usually does.

I'm not sure if yesterday was a good day or not, but I'm a little more optimistic this morning. They did discontinue the condom catheter and went to a urinal. I had said in the last post that I was concerned that there was a lot of blood in his urine, but I don't think that is the case now. We're just not sure what is going on. It was more the color of cranberry juice, but when I left late in the afternoon, it had become more normal looking, although still a little dark. But today, it's back to being extremely dark, looking almost deep brown. Still, no one seems to be concerned except for me.

They did increase his tube feeds from 30 mL/hour to 50. So he's getting a little more nutrition. I asked about his weight and Kelsey said she would check to see what it had been trending, but she didn't get back to me on it.

They said he had not had a good night (Monday) and he dozed most of the morning. But, I did clean his dentures and he put those in so that when speech came in, he would be ready. That did not go well. Actually she didn't get started at all. She did cover his trach with her finger and told him to say ahh, which he did, but then his sats dropped into the low 80s and she didn't want to put the valve on, or try to evaluate his swallow. The valve does make it harder to breathe until you get used to it, from what I understand, and since he was already low, she didn't want to stress him too much.

Occupational therapy was supposed to come in and sit him on the side of the bed, but that didn't happen. I think she came (someone did and looked in the room from the nurses station), but that was when speech was in, so the other one left.

He was bronched again late in the afternoon and they put a different delivery system on for the trach. He originally had like a regular oxygen mask on, but now it's tubing that attaches to the trach. It also has a longer piece of tubing on the other side and he can be connected to the vent if necessary. They did bring one in, as a precaution, they said. Dr. El Hadad ordered that he be vented if his sats dropped during the night. That's why I'm not sure it was a good day or not. It seemed like he's taken a step or two back again, but maybe that's just me reading too much into it. I worried all night that I would come in this morning and he would be on it.

Dr. El Hadad thinks he might have to bronch him daily for awhile. I asked him why he was making such thick secretions so quickly, and it's a result of the bronchiectasis and COPD. He explained that most of us have a strong enough cough to get the gunk up, but his cough is so weak right now, he just can't move it. The only problem with bronching him every day, and it's not with the frequency, Dr. El Hadad has said that they would be in the late afternoon. The last 2 have both been at 4:30. That makes it later for me to leave and I don't like driving in the dark. Although, I drive in the dark every morning. My car thinks that the lights are supposed to be on all the time, no matter what time in the afternoon I leave. I just don't like getting home so late since I have so little time in the evenings anyway before getting to bed. And, I suppose I could leave before, but I would worry that things didn't go well, and Bill always asks for me after it's over. So, kind of a catch 22.

This morning when I got here he was being suctioned and his sats were only in the 70s. His nurse had called respiratory to have them vent him, but I was able to talk him into just breathing slowly. He was having a little panic attack. He has now been suctioned several times, and his numbers are staying near perfect, upper 90s to 100. But, he's on 98% oxygen at 15 liters. Hopefully, they'll be able to start reducing those numbers. So, my fears have been put to rest, at least for a bit.

His nurse has said she may suction him frequently since he has such a hard time coughing. And he has admitted that it's hard to cough with this new setup. His nurse is buzzing around the room, rearranging things, and she caught that one of his meds was not supposed to be crushed and put through his tube. But, it's not a capsule that she can open and put under his tongue like his other transplant med. She said the only other way to get it was IV, but I told her that when he was in skilled nursing they had a liquid one that could go through the tube. So, she called pharmacy and sure enough, they have a suspension one. She's still waiting on it to come up and then he will have gotten all of his morning meds. And as much as the nurse has done this morning, she's one of my least favorite. She rather brusque with him. But, we don't have a choice on who we get and some of the better ones have been assigned to the 3 patients who are really critical.

He's awake and aware and a little talkative this morning and said he slept all night. But, I think they may have "helped" him sleep a little. Since the bronch was done so late, he was still pretty loopy when I left.

So, I think that's it for yesterday and this morning. There may be another update later today, when I know if he's going to be bronched again. Maybe they will just do an xray, if they haven't and decide to let him go an extra day.