The internet has been zipping right along this morning. And now that I've said it, it will probably slow down, or stop working altogether!

Yesterday Bill did not feel well. He said his stomach hurt and he was nauseous and it was hard to breathe. His sats were down to the minimum acceptable levels and his heart rate was up. He also thought he might throw up.

He was rather agitated and Crystal from respiratory came by just to say hi. But, he was junky and trying to cough so she went ahead and gowned up and came in to help. Mike was tied up with the patient next door, so Crystal said that if he scanned his breathing treatments, she would give them. She also suctioned him a lot and just when she thought they got it all, he would cough more. She also changed his cannula and all of his tubing and filters. His sats did come up a little, but he was still agitated.

Molly gave him some Zofran and he finally went to sleep, but his numbers stayed off. His oxygen stayed in the mid 80s for about 2 hours. He also had some episodes of V Tach which is where his heart beats too fast. And then, all of a sudden, his heart rate dropped to normal and his sats went to the mid 90s and I could tell that he was really resting. He slept all day, but Zofran does that to him.

Molly told me that they were going to go ahead and do the scope of his bladder, even though his urine had stayed clear all night, and was still clear. She said it was scheduled for between 12:30 and 1. Later she came in and said that it was going to be at 1:30. At 3:30 she brought me the consent forms, even though she said there were no orders yet for the procedure, but she wanted me to sign them in case I left. I told her I was planning on staying until it was done so that I would know what they found. At 5:30 she came in and said she didn't know why they didn't say anything in the morning, but he had to be Covid-19 tested before they would do it. She said they would use the quick test but that takes about 2 hours to get results and she said it would most like be 4 hours. We decided that they probably would postpone the procedure then anyway, so I decided to go home. She called while I was on my way home and said that Dr. Threlkeld had over-ridden the order for the test and the procedure would be done at 7:30. I decided not to turn around and go back. He would have been taken to the OR by the time I got there. I knew I would get a call if something went wrong and I would get the results today anyway.

So, that was yesterday. Not one mention of discharge, not a phone call from the social worker, nothing. Just business as usual. I do know that the unit is full and that may be a reason. I know they moved a patient from step-down back for surgery. I talked to his wife this morning. He had a pocket of fluid that was pushing on a lung.

This morning the first thing I noticed was that there was no catheter hanging on the edge of the bed. That didn't make much sense, even for after the procedure because he hasn't felt the sensation to go on his own for a long time now. I did notice that the oxygen level on the vent was at 100% which was odd, but figured it just wasn't changed back after the procedure. His numbers looked pretty good except for his blood pressure which was a little low.

Stacy came in to re-insert a catheter and he is so swollen "down there" and he said it hurt, she decided she didn't want to do it. So she called the urology nurse practitioner. Dr. Greenberger isn't on call this week-end, but the nurse said she would call him anyway. It turns out they did not do the procedure. They decided to do it bedside and they got the camera inserted but it malfunctioned. So, it will have to be repeated, but I don't know when. Still waiting on a decision from urology. I do know that he has not voided at all. A bladder scan was done and there was about 400 whatevers (the amount they measure urine) and at 500 they will do an in and out catheter. You've seen those advertised on TV, they go in, drain the urine and take it right back out.

I asked Mike if he knew why the oxygen was so high and he said he didn't get anything in report about it. Dr. Okpor came in, looked at the settings, listened to him, said good morning and left. But he did tell Mike to start lowering the level. He's at 60% right now and doing well. He's still junky, but he's coughing it up. He's had his mouth suctioned and he's coughing it into his tubing. Mikaila has suctioned him some and he's getting a lot of stuff out.

Mikaila said that he started to de-sat in the night, dropping back into the mid 80s so Dr. Yaranov said to put him on the 100% to give him a boost.

His sodium was a little low and his potassium was a little high, so he again got the Kexelate to make him poop a lot. That's the fastest way to regulate it. He's been passing a lot of gas so maybe it will work pretty fast. Mikaila is also checking to see if they have a latex-free catheter they can use. He doesn't generally have a latex allergy, but with repeated use it can cause one. That may help with the scrotal swelling.

He's been interacting with Mikaila, answering questions. Me, not too much, but that's OK. He's snoozing right now. The docs are all coming early today but I think the ones who can get out after seeing patients are wanting to go and enjoy the nice week-end we're supposed to have. It's supposed to be in the low 80s and it's a beautiful clear blue sky.

So, you are all caught up for the last 2 days. I'm hoping the internet will stay up good enough for me to get some bills paid. There may be another post later today, once I know what it going on. The only thing I'm sure of is that about noon he's going to get in his chair. Mikaila wanted to wait until the catheter situation was taken care of, and hoping he would be finished pooping. Just keep checking!