It's 2:16 am, and I'm sitting in Bill's hospital room, listening to all the beeps and buzzes, and watching him sleep. What started as a momentous day yesterday, ended with a crash.

Yesterday when I got to the hospital, he was awake and alert and responding. He asked me to take off the vent and I told him I couldn't do that or he would die...and he said OK, to let him die! I told him if that was what he really wanted, we would do that, but he wouldn't be able to change his mind, so he decided to think about it.

When Dr. Okpor the pulmonologist came he, he looked at all his numbers, nodded his head and told respiratory to put him in CPAP mode! And, Dr. Sharma told her that if he did well for 4-6 hours, to put him on trach collar! So, from 8:33 until 12:33 he was on CPAP and then he spent the rest of the day on trach collar! He did quite well. His initial sats were in the upper 80s, which is the lower end of his acceptable range. I only had to remind him a couple of times to take a deep breath when he would drop. He hadn't even been on it an hour when Travis came in for physical therapy and he did really well, only dropped to the upper 70s once and rebounded quickly. So we were quite pleased with that. 

We had a favorite nurse, Diane, yesterday and she was quite concerned with the blood in his urine, and the amount. It has increased considerably and it looked like it was all blood, and lots of it in his brief. She called Dr Edwards and he requested a urology consult and complete urinalysis done. 

They also came to do an abdominal ultrasound since the x-ray was inconclusive. The also checked his lower left leg as it was quite swollen from the knee down. I also told her that I had noticed that he now had a belly and told her she would see what I meant when she came to bathe him.

When they removed his gown she told me she saw what I meant and said that looked like his bladder area. She palpated it and he said that it hurt and she said it was very tense, so after his bath she got a bladder scanner and he was full. So, they had to insert a Foley catheter to drain it.

This may get a little too graphic for some of you. If you remember, I had been telling them for about 3 weeks that there was blood in his urine, every doctor, nurse, nurse practitioner, anyone who would listen. What they drained from his bladder didn't look like urine in any way, shape, or form. It looks like almost pure blood, complete with clots of various sizes. When I got back into the room after the Foley was placed, they told me they had already drained over a liter and he was still putting out. When I left the hospital, they had charted 1423 cc, and the collection bag was again half full. You could also see a significant difference in his belly size! I don't know if he was holding the urine because, after 77 years, it's very hard to learn to just go, especially while you are cognizant.

I left the hospital a little after 6 and he was still awake and aware. I told him I would see him in the morning and he reached up and caressed my cheek with one finger, down to my chin and then up the other cheek. I've missed that!

Now, the reason I'm writing this at 2 am. The hospital called at 12:30 and said that he had crashed, his heart rate had dropped to the 40s again and his blood pressure got dangerously low. He was initially unresponsive, but they were able to get him to respond. They called Dr. Edwards and he ordered some drugs, one to keep his blood pressure up, one to keep his heart rate up, and some albumin to give him some blood volume. That worked for a bit and his heart rate dropped again. The drug was increased and he stabilized. They do have a diffibulator attached, just in case he goes into cardiac arrest, but they haven't had to use it. He is back on the vent, but he was going to go back on anyway for the night. He was at 100% oxygen for awhile, but it's been cut back to either 60 or 70% now. I don't remember which he said, and since he's working on him, I don't want to get up and walk around the bed to look.

Cole, the nurse said that the abdominal ultrasound showed some cysts on his gall bladder. It also showed the cyst on his kidney, so my theory of it rupturing and causing the blood. The ultrasound of the leg did not show any clots, so we're unsure of what was causing the swelling. But, it's not swollen now, or not as much. Cole didn't think it would have been because of the bladder being so full, unless it was the kidneys filtering and it not having anywhere to go.

His potassium level is high and Cole is now trying to draw some blood to do a full electrolyte panel, but he's having a hard time. Because of the IVs and the importance of the drugs he's getting, he's reluctant to stop the meds to use the midline. But, every time he finds a vein it blows almost as soon as he gets the needle in.

I'm OK, did a lot of praying on the way down, mainly to let him still be alive when I got here, and that prayer was answered. I'm still at peace with our decision to let him go, and if that time is now, so be it. At least we had a good day yesterday. I made it here in less than an hour. I won't say just how fast I was driving, but I don't think I ever hit 100. I did look at my watch and I left the house at 12:44, less than 20 minutes after Cole called, and I got on the elevator at 1:42.

So, what was supposed to be a happy post, has now turned to a serious one, and the outcome again doesn't look good. But, he has surprised us before. I'll update during the day today so keep checking back. Keep the prayers coming.