Bill was awake when I got there this morning and when I asked him if he felt better he nodded and said "a little". He stayed awake all day and he watched TV for the first time in I don't know how long. 

Dr. Threlkeld asked him for a thumbs up and he looked at him and shook his head no! So they shook hands, and then he gave him a thumbs up.

After I left yesterday, he apparently got a bag of fluids and some albumin, which could account for his awareness today. Austin, his nurse for the day, was repeating his labs as his hematocrit had dropped from 24 to 19, which is quite dramatic. When the new labs came back, it had dropped, but only a little, so Dr. Edwards just wanted to keep an eye on things.

Dr. Morris was not happy to see that his urine was bloody again. He said that his kidney numbers had improved, but he's concerned that he's staying too dry. It's been a real balancing act to get the right amount of fluids in without causing him to swell like before. So, he was going to increase the amount of flush he gets with his feeding, which was restarted today. He also said that he might want an additional bag of fluid hung.

Dr. Gessller, I never did check the spelling, came and asked a lot of questions about the tube. He wanted to know if the tube feeds were just supplementing his nutrition, and I told him it was his total nutrition. The x-ray showed the dye went through the tube and into the stomach, so the tube is in place. So back to square one with the drainage. It was draining again, but not as much as yesterday. He looked at it, and it was also oozing blood from around the peg site. It was very painful for Bill for him to be prodding and he, the doctor, said that it shouldn't be painful. I told him I thought the pain was coming more from the erosion of the skin from all the acidity of whatever was draining. He wanted it cultured, so after he got finished, Austin came in and took a sample of it, which hurt Bill again.

Shortly after that Austin said that Dr. Edwards changed his mind and wanted him to get a unit of blood, and that was hung just before I left. Bill was starting to get sleepy then, so it was a good time for me to leave and he said it was OK.

Dr. Okpor, the pulmonologist, came by in the morning, looked at the vent settings, said that one of his colleagues would be by later and asked if I had any questions. Since I didn't have any idea of what his plans were, there was nothing to ask. I also didn't see anyone else as far as pulmonology goes.

All in all it was a good day, compared to the last 5 days. Let's hope that tomorrow is just as good, if not better!