Early post today. It was not a good day and I ended up coming home early. Bill has slept all day, at least up until I left at 2:15. His numbers were also not good this morning, sats low and heart rate up. They tried to put him on trach collar and he couldn't do it, so they put him back on CPAP, thinking that when he woke up they would swap him over, or when he got in his chair. Well, he got into his chair, under protest, and slept the entire time.

I think the problem was the inner trach had gotten crooked again and when Shea from the lung group checked it, even after it had been repositioned once, it was almost out. So she fixed it which didn't make Bill happy since it hurts him when that's done. She asked why he had the longer one and I explained that it was because he kept talking around the shorter one. But, we talked about doing the shorter one again since he's going to be on trach collar and using the speech valve. She said she would check with respiratory to see if they had what she would need to change it and be back, and apparently they didn't because she didn't come back! It probably had to be ordered. I don't remember if Stephanie said that she would be back Wednesday or Thursday, so maybe it will be changed out tomorrow.

Since the trach was out of position, and I suspect it was out of position all night, I think that he was just worn out from trying to breathe. When he got back into bed, 2 of the 3 therapies came in and he said he didn't want to do them. Physical therapy could hardly rouse him. I explained to them what had been going on. Lisa from speech was OK with just starting tomorrow. I told Laurie from PT that he had been in his chair for more than 2 hours and she was OK with that, so hopefully he'll feel more like it tomorrow. I usually don't let him get away with turning down therapy, but I did today.

I hate that he missed a full day on trach collar after doing 16 hours yesterday. But, there was definitely something off with him today. He had a low grade fever first thing this morning, 99, but it went down on it's own later. I also noticed that his urine output was off. He gets plenty of water flushed through his feeding tube so it wasn't that he wasn't getting any fluids. His nurse, Magin, also said when I was leaving that he apparently just wasn't feeling good and letting him rest was the best thing. She's had him before so she knows how he usually is. He even told her and Janice to leave him alone when they were getting him back into bed. He told them he was just going to go home but he got the old I can't take care of you from me.

Since he was sleeping, but not in any distress anymore, and the weather was atrocious, I left early as I said. It was not a pleasant drive and tomorrow is supposed to be just as bad. So, the extra 2 hours of down time will do me good, I'm sure.

So, that's how the day was. We all wish it could have been better, but he hadn't had a bad day in a while, so I guess it was time for one. I'll let you know how tomorrow goes!