Yesterday was a little scary and disturbing. Bill was put back on the vent overnight to let him rest. We breathe without thinking but for Bill to remember to do it on his own is hard work. I glad he did as good as he did. When I got to the hospital, he wasn't awake and his numbers were a little off. His heart rate was erratic and high, his sats were ok but on the low end and his respirations were a little high. I don't remember what his blood pressure was.

We just kept the lights off and I didn't turn on the TV. It was pouring rain and that was the only sound in the room other than the vent. When he did wake up he was aware and acknowledged that I was there, but still a little sleepy.

Dr. Sharma came in early and, for the first time, did not mention going to Restorative Care. So I think someone pulled rank, either Dr. Edwards or Dr. Mullinax. Anyway, he put him in SIMV mode, which is the mode that will only breathe for him if he doesn't take a breath and it will not deliver a breath right after a natural one. He said when he can be on CPAP with no problems for 13-14 hours straight, they will leave it overnight.

Bill went back to sleep and I noticed that he was really laboring to breathe. I went over to the bed to talk him down a little, usually just takes me rubbing his shoulder and telling him to slow down. He was really sweaty, not clammy, just sweaty enough that his pillowcase was damp. He didn't wake up, but his breathing did slow a bit. 

 When his blood pressure took again, in was 198 over something so it started alarming. His heart rate was high and very erratic and his respirations showed in the 70s. His oxygen was still staying in the low 90s.

His nurse came in and checked his pressure 2 more times and it was in the 180 range, so she called Dr. Edwards. We also couldn't get him to wake up. She said the night nurse said he had a hard time waking him at times in the night, too. She used the flashlight on her phone to check his pupils and they reacted and, she didn't see it as she was getting ready to call Dr. Edwards, but I watched him slowly blink twice then.

Dr. Edwards wanted her to manually check his pressure so she did that and it was still high, but much lower than the automatic one, in the 160s. He did not have a fever. His temp was 97.6, which is perfectly normal for him. Since his pressure was coming down, Dr. Edwards just ordered her to have it checked every 15 minutes and he didn't order anything to help lower it. And it did come down.

And then, all of a sudden, he opened his eyes, and his heart rate dropped to a normal rhythm, his pressure was a normal number, his respirations went way down and his oxygen level went up a little...just like nothing had happened!

When Mike came in to do his breathing treatment, he switched him to CPAP from SIMV and everything went back to normal. His breathing slowed down and he went to sleep, a nice easy sleep.

Caleb and Horace came in a tag teamed him for a bath and he didn't wake up much during that process. Caleb is going to be off for the next 6 days and Horace is moving to ICU from step-down to help out.

Dr. Threlkeld said that Bill's white count was still going down, which is good. I think Dr. Edwards was thinking another infection was taking hold as he asked Tyler if Dr. T was on or one of his nurses.

The rest of the day was pretty dull and boring. Bill slept until about 2:30 and then woke up very chatty, asking for something to drink and eat. He knows he can't have either, but that doesn't stop him from asking.

The strangest part of the day came about 3:30. Jennifer, the nurse manager for transplant and Sara, one of the charge nurses, came to the door and asked to talk to me. They said that they were now going to limit visitors to only patients in isolation. They said they made sure it was known that Bill doesn't do well without me there and said that even if the guideline changed again, because I followed the rules of the isolation gown and gloves and didn't come and go from the hospital except at night, they would do their best to see that I could always be with him. I told them I was prepared to stay in the hospital if necessary and they said no, I needed to get my rest at home. They are also limiting it to only 1 visitor and if I can't be there, I can't send a substitute. It's me or no-one. They also addressed if something should "happen" with Bill, they would do what they could so that others could come at that time.

I do feel sorry for the other patients and their families. The man in the next room just came off the vent yesterday and when his wife, daughter and granddaughter left, they were all in tears. But, at the same time, I'm grateful that Bill is in isolation and already on the vent.

I don't know what the procedure will be this morning when I get to the hospital, and the nurses didn't know either. They said it hadn't been addressed in their meeting on how they were going to know that Bill is actually in isolation and that I am authorized to be there. They were going to call when they found out, but I haven't heard anything. I'm hoping there will be a list at the front door and they will then not only check my temp as they have been doing, but my ID. I guess I'll find out when I get there.

Memphis is basically a ghost town with not much traffic. Even the interstates are eerily empty, mostly trucks. Lots of campers heading north, so it is snowbirds going home. I'm keeping a box of gloves in the car for pumping gas now. There's been a lot of chatter online about gas pumps so it just makes sense. It may look strange, but I can toss them into the trash bin before I get back into the car. I'm also going to keep one, or pick one up in the lobby for pushing the elevator buttons at the hospital.

So, another new normal for the time being. I also noticed that the waiting room for ICU, where many family member sleep, is missing 2/3s of the recliners that are usually there...social distancing. The hospital is doing all it can to protect patients, staff and guests. It will be interesting to see if they again change the cafeteria.

I've been taking this with me all week, but so far the internet hasn't cooperated. Maybe with fewer people using it, it will connect. I'm starting to feel like a correspondent on the front lines of the war!