This morning I was met in the hallway by the Stacy, one of the charge nurses and taken to the conference room. That is usually not a good sign. She said they had taken Bill for a CT and since his room is so small, they asked that it stay empty until they got him back in and settled. It's quite the operation when they move patients with IVs and vents and all the other stuff that goes with it.

After he got back to the room, his night nurse came in and said that around 5 this morning his blood pressure dropped and he became slightly unresponsive and twitchy. They drew some blood gases and his pH was low so they gave him some bicarb and then restarted the Levo for his blood pressure. They said he perked up a little after that and Dr. Edwards ordered the CT. They did one from skull to pelvis. The respiratory tech told me that he did wake up and respond to her while they were transporting and in CT.

Dr. Edwards wanted an ART line (arterial) put in to check his blood gases frequently since he's such a hard stick. They can also monitor his arterial blood pressure with this. When Dr. Edwards came in he said he thought the mental status was from being dry, so he ordered fluids. He did increase the vent from 12 to 20. Dr. Aswan did not like that and told me that from his standpoint, and the blood gases, they did not need to be changed. He said the fluids would also help his BUN and creatinine levels.

When Dr. Nara, the GI doctor came in, she looked to see if the scans were ready and she said the lung showed a pneumonia and the abdominal one showed some fluid in the stomach. She stopped his tube feeds and started him on some IV nutrition. She wants to do an EDG to see what is causing the vomiting and the fluid in the stomach, but she wants him more alert to do that. 

Dr. Threlkeld doesn't agree with the other drs. that the infection he had in his blood has caused the pneumonia. He's more sure that Bill did aspirate some when he vomited. Both he and Dr. Nara said that his belly is very tense, probably from not having a bowel movement since Saturday. He's already on good antibiotics and he's not going to change them unless something grows that they aren't expecting.

Dr. Morris didn't say anything about dialysis today. He said his numbers are staying about the same so we'll just stay the course we're on now. 

At one point Dr. Edwards did not like the numbers he was seeing, so he wanted him bronched. That was done and there were no mucus plugs and they got very little greenish-yellow gunk from the bottom of his lungs. So, there is some infection there, especially since his white count is up again.

His urine almost back to a normal color and he's got good output. And...he finally had a bowel movement! They were going to give him a stronger laxative but she hadn't gotten it to him yet before he went on his own. I don't know how much he went, but at least he went some.

I'm still at the hospital. I want to see if Dr. Edwards comes around before midnight. I've already arranged for the cats to be taken care of tonight and just need to text Emily if I need her to do them in the morning in case I stay. But, I want to be sure he's stable before I go home, or if I get too tired, I'll go ahead and stay.

So, that's been our day. Bill has woken up from the bronch sedation and told me hi. I asked if he was going to stay awake and he said no, and he meant it! He's back snoozing away! Since he's sleeping it wouldn't matter if I was here or not, but for my peace of mind, I'll stick around a little longer anyway.