I hope the flash I saw as I switched to the page for new posts was just the page changing and not lightning, but I'm not really hopeful. It's been raining for a few hours now and is supposed to rain most of the day, with storms ramping up this afternoon and evening. The drives won't be fun today!

Bill was already on trach collar when I got there at 7:30 yesterday and the plan was to leave him on it, if he was doing OK for the entire day shift, 12 hours. He was still on it when I left at 4:30 and doing fine.

He did get a unit of blood yesterday. Dr. Muir came in and said that his hematocrit had been steadily dropping for the past 3 days and yesterday it was 23.5. As far as we know there's no active bleed anywhere (his urine was totally clear yesterday) so he must just not be making as much blood. That does sometimes happen with older people, according to Dr. Muir, who is a hematologist. So, we'll see how he is today. The blood usually perks him right up.

His PEG drainage is now the big thing. Within the first 30 minutes that I was there the pads and his gown had to be changed, along with his blanket. The night nurse had taken a picture of it and sent it to Dr. Edwards, and Dr. Threlkeld said that he and "Todd" had looked at it and they neither one think that it's infection. He also said he's been on so many antibiotics, and just came off of them again, that there shouldn't be any infection. It looks like bile, yellow, but it is sticky and there was some gray to it as Molly was cleaning it. Bill said it is really sore, and it is really red around it. I think, no I know, that his skin is really irritated and they are having to use a special cream on it. It's an antibiotic cream, but it's also a barrier cream. Molly said she will just look at it every time she comes in the room and if they have to keep changing his gown they will. She did put one of the diapers over it and got it tucked down pretty good without resorting to taping it. And, when she checked it after about 3 hours, it and the drain sponges were totally dry! Just as fast as it was pouring out, it stopped! Dr. Threlkeld said he would get the GI docs back on it.

Dr. Sheikh was very pleased with his progress from the day before. He woke Bill up and asked him to shake his hand and how he was feeling. He said that if he keeps progressing he will reduce the size of the cannula from the 8 he has now to a 6. Don't ask me the difference because I don't know. But, the Passey-Muir speaking valve fits on the end of the 6 better so that he can talk easier. He also said the smaller one won't press against the sides of the trachea and more air will be able to get around it for his vocal cords to work. He did put the valve on and had Bill say something, but when he asked him who I was, he said I was his daughter! I could tell that his eyes weren't really focused, and with the mask on, he probably thought that I was Mary Rose. The doctor wasn't alarmed about that, and neither was I since I could tell with his eyes, and later in the afternoon when he was fully awake, we did talk.

Dr. Sheikh also said that if he can maintain the 12 hours on the trach collar, he will schedule a swallow study so that maybe he could start eating a little, not full meals, but have a little ice cream, or maybe his coffee again. Bill did not hear him say that, and when I told him later in the afternoon, Bill wasn't sure he would be able to eat. I told him he wasn't going to eat a steak, but maybe some applesauce, and he was OK with that.

So, lots of progress going on right now for a man who was supposed to die a month ago. And, no, I'm not getting my hopes up that he's going to get well and everything is going to be OK again. I'm glad to see he's making progress again, but I know that it can change at any moment. And there will be days, and this could be one of them, that he can't tolerate the trach collar. As I said before, breathing is hard work.

I did ask Molly what the parameters were for when his sats dropped below 88, meaning how low will they allow them to drop and for how long before they intervene and put him back on the vent. If you remember, we needed to see if he could work through the episode himself. We decided on the upper 70s for 15 minutes before intervening. He did drop into the mid 80s during a couple of coughing spells, but once he stopped and could take a few deep breaths, he rebounded nicely.

He told me he would try to behave himself when I left, and I told him to sleep at night but he said they wouldn't let him. I told him to tell them to turn off all the lights and the TV and shut the door so that he could sleep and he said he would.

This is the first Easter we've spent in the hospital so I'm going to see what the offerings are in the cafeteria. I've been bringing my lunch the last couple of days. And if they aren't having a holiday meal like they do for Christmas and Thanksgiving, there's always a hamburger or chicken strips, or a hot dog. 

I figured up yesterday that I drive about 167 mles a day, depending on how I come home. So, since November 15, I've put between 23,000 and 26,000 miles on my car. That's what most people put on in 2 years, not 5 months!

And, now I'm hearing a few rumbles of thunder so it's going to be lovely this morning. I think I'll go fix me a bacon, egg, cheese sandwich for breakfast to eat in the car and get myself going. I need to repack my go bag. I usually take my rolling backpack, but I'm going to switch to a waterproof beach bag that should hold everything I need, or think I need anyway!

Happy Easter everyone! The Lord is Risen!