I've debated with myself on how to write this update. Do I just put down the facts from the 3 pages of notes I took yesterday, or do I put my honest feelings down? I've had several imaginary conversations with various medical people, where I am concerned about Bill's condition, or assertive with how I want his treatment to be. So, this is going to be a hard one to write, and maybe a hard one for you to read.

I know that it hasn't been quite a week since he was moved to Restorative Care, and we lost the entire first day with the problem he had with his heart rate going so high and his agitation. But, he's only seen physical therapy once and speech therapy once and no occupational therapy at all.

The physical therapist, who is the head therapist, will only allow Bill to be moved by using the sling system. This means that he has already, in just 5 days, lost the little progress of sitting on the edge of the bed and standing and taking shuffling steps, that he had made in ICU. I've noticed that he doesn't even want to reach for something. He just smacks on his tray table to get my attention and then points to his urinal. I told him he can reach it and then he does get it. But, that is not progress.

He is also now, it seems to me, dependent on the vent. They have tried twice to wean him down from a setting of 14, which is the vent does 14 breaths a minute of however many he takes. Every time they turn it to 12, he says after a little bit he can't breathe and he starts breathing really fast. I have to stand right in front of him, and tell him to slow his breathing down. I finally told him that when they turn it down, he has to do more of the breathing than the machine does. Dr. Bart wanted him at 10 yesterday and he was put on 12, but raised back to 14 at the first complaint that he couldn't breathe. They need to talk to him about what is going on. He can understand, it just takes a bit longer for him to process it. So, depending on which therapist we have today, I'm hoping it's Walt or Bettie, maybe we can get them to let him work through the agitation. You know they were letting him work through his low sats in ICU before using the vent, and he could get himself out of it most of the time. 

He's also doing a lot of sundowning, which is getting agitated in the late afternoon. Of course part of that is due to me leaving. One of the doctors, and I don't know which one, finally ordered a mild anti-anxiety med. I told his nurse to give it to him as soon as I left yesterday. Hopefully she did. A really good nurse will be back today, and hopefully we will get her again. She and I work well together. The 2 he's had the last 2 days are good, but we rarely saw either of them. 

The infectious disease nurse said that the antibiotics are going to be stopped after the weekend and then they will re-evaluate. He's gotten all of the ones this strain of pseudomonas is susceptible to. His white count is hovering around 15, which is high for a normal person, but he's also on 30 mg of prednisone a day which accounts for some of it. So, it's still just a guessing game.

The cardiology nurse said he sounded "flappy" when she listened, but he was also getting a breathing treatment that blows in spurts instead of continuously so that was probably what she was hearing more than a problem. The pulmonologist and nurse were both pleased with how he sounded. They may have to replace the inner cannula again as it has already moved so that he can talk. She said they can use a longer one that can't be dislodged as easily.

He also seems to be getting more dependent on me than he already was. He gets very upset when I leave, even though he knows I have to. I think he's losing some sense of time, which is understandable. And I only got that impression from a comment he made yesterday about where I had been all day when I got there.

So, this post is not a very happy one. You can probably tell I'm tired, it's been a long week and I got to bed later each night than I usually get there, and didn't sleep well a couple of nights. The cats are also being bad from being left alone so much now. Even though I tell them I'm just going to go see Dad and that I'll be back, I haven't been as consistent with my time of arrival as I had been. But, one of them, and I don't know which one yet, has started using my plants as a little box, only for urine, but y'all know what cat pee smells like! Not a pleasant odor to come home to. It also doesn't help that it has rained all week and for 2 days it was heavy fog and rain both commutes. Tomorrow's drive will also be interesting. VP Pence is going to be in Memphis speaking at a black church to celebrate MLK day. Memphis always has a week-end of service on this week-end. So, some roads will be closed. I haven't seen which ones yet, but it may affect which way I can go. But, on a more positive note, my hip is better! I'm only using my cane walking from the parking lot to the hospital/car. It seems like the first steps out of the car are the worst, probably from being in the same position. But, it's better and the pain can now be controlled with Ibuprofen instead of the pain pills. And, oh my, the wind is howling! Fun times!