I'm sooo tired this morning! We had a night of thunderstorms and the cats got spooked and then started fighting on the bed because they both wanted to be as close to me as possible. The sound of the rain changed with the last storm and I believe we got some hail, but it's still to dark to see if there's any damage to the car. It all started with an alert from my alarm system that the power was out when I was on my way home. I checked with the neighbors thinking it was the day we were getting our new meter, but there's was out too, and it turned out most of our end of town was out. But, after a while I started the generator before it got dark so that I could fix something to eat and the power came back on just before the first storm hit.

Bill didn't have as good a day as Tuesday. He was awake and talking but all he said was help me. He was cock-eyed in the bed and laying on one arm and shoulder. All the board said next to his name for nurse was SBP. So, I went to the desk to see who it was and it was Stacy B. (there are 2 Stacys) with a new nurse. She's not a student, just a very new one with not a lot of confidence yet. They finally came in and got him moved so that he was more comfortable.

The swelling has gone down considerably after stopping the extra fluids. He's still getting Lasix twice a day which is pulling more fluids off. His belly is leaking again and his left arm is weeping so much now, and has a little skin tear, so there's a little blood mixed in with it. His urine is still bloody, but still getting flushed out. The color didn't come and go as much as it has been, it stayed pretty bloody all day. When Londyn came in to change the bandage on his PICC line, she didn't like the way it looked. It was bloody and shouldn't be and it looked like it had been changed. It may have been if it had gotten went from all the weeping and leaking from various places.

He was put onto CPAP early and then switched to trach collar again about mid-morning. But, he didn't do near as well as the day before. I think part of it was the way they had him positioned. The mask couldn't get fully to the trach so he wasn't getting the full amount of oxygen. His numbers stayed low so after a couple of hours he was put back to CPAP mode and he went right to sleep.

Crystal didn't fully inflate his cuff so he was able to talk and at one point, when he had been telling the nurses to leave him alone during his bath, he finally just said "Do what you want". He did get a nice bath and a shave. 

Dr. Edwards was back and was pleased with him. He was going to review everything that he had missed. He did say that the ART line may come out today. They usually only stay in for a week, and it was a week yesterday. Dr. Morris said that his kidney function was much improved. Dr. Threlkeld popped in for just a minute to see how he was and said that Janet would be by later. She did come in and checked him over. Today is supposed to be the last day on the antibiotics.
Dr. Sheikh said that his x-ray did not show any active pneumonia, just the usual junk that's in there. He said if Bill couldn't ever come off the vent that was OK, and if he could only tolerate it for shorter periods of time, that was OK too. He would like to keep trying so that he would benefit more from therapy and maybe, just maybe, be able to eat something again. Bill didn't hear him say that though, he was already back out.

He did cough a lot this time, even though when they listened to him they all said he sounded better than he usually does. But, he was coughing it all the way to the end of the trach. They did suction a lot of stuff out and it was white, which is good. But, it's the first that has been suctioned out in a long time. There hasn't been much stuff when he would  be suctioned before.

The plan now is to keep trying the trach collar for a few hours if he can do it, otherwise CPAP during the day and vent at night to let him rest. We don't think about breathing, but Bill has to be reminded that he is doing all the breathing on CPAP and trach collar and the machine isn't doing any at all. The vent did keep alarming when he was put back on, and it was showing that he wasn't exhaling deeply enough, so he was retaining CO2 again. That's what got him into trouble last week. So we'll see how the night went, I didn't get any calls.

That's it. I need to get dressed and I'm almost too tired to move. It's going to be a long drive this morning being tired. Maybe I'll perk up after I finish my cup of coffee.