3/23

We had a homecoming last night; not in an alarming way. John was transferred from the MICU (medical ICU) to the BMT (bone marrow transplant unit). BMT will be able to support all of John's needs - blood pressure support, continuous dialysis, ventilator - and his care plan will be created by the team of bone marrow transplant doctors and nurses now. This floor really is designed more for long term care than an ICU so it seems to be a win-win for everyone. Many thanks to the great ICU teams (surgical and medical) that have taken such good care of John up till now for getting him to this point. And, so happy to be reunited with all of our great BMT team. John had another rough spell last evening in the ICU of high heart rate, elevating temperature and respirations, high blood pressure. Maybe getting jostled around in the move helped... once he was settled in BMT, his heart rate, blood pressure, respirations, and temperature all came down to good ranges. The nurses were able to take John off his pressor and even begin to slowly withdraw some fluid; he did need a couple of doses of pain meds, especially when they were trying to start an IV to get more places to deliver all the meds and blood products John needs. It wasn't possible to get the IV started so there will be some discussion about whether a second picc line is possible. At least then, he wouldn't need to be stuck; he is leaking a fair amount from his new punctures. He is getting a cat scan now to see if there are any changes in the pneumonia. John is frequently awake for brief periods now. He can open his eyes and focus, he recognizes us including all of the BMT nurses, staff and doctors we came to know so well in John's previous stays. He had a pretty emotional reunion with Sherene this morning; last time we were here he insisted she and her son (violinist) attend John's nephew's next Philadelphia concert and he will want to make sure they do. John can also nod his head, blink and he even was able to squeeze our hands just a little bit this morning. Toe wiggling and sticking out his tongue are the next milestones. Once he is able to stick out his tongue on command, we might begin to see a lot of that action - even when we are not asking for it. For the immediate future, he won't be able to talk and it may take a while to regain the strength to use the alphabet board for communication. John is still extremely critical with lots of problems that are difficult to resolve and that, if resolvable, will require extensive recuperation. I am hopeful he will get his wish to spend some time on the deck this summer - maybe even in the hammock. Please keep up the prayers, good wishes, incantations, long distance hugs and whatever else your spirit moves you to offer on his behalf.