3/26

Today is my(Lynn's) birthday. Not putting a narcissistic spin on the blog; just letting you all know I received the best possible gift today. I'm with John and it has been a remarkable day for him. I might remember more if I do this in some kind of order, so we'll go from top to bottom. John is off some of the antibiotics and isn't having any fevers. He is still on amphotericin and posiconazole for the pneumonia. The doctors considered replacing the pociconazole with voriconazole but were able to add some higher fat content to John's tube feedings (which is necessary to absorb the pociconazole) so that med change is not required. His feedings are back up to 75 ml/hr; he is tolerating and absorbing them well. This is important because he needs good nutrition to assist healing. The nurse was able to use ice water and suction to moisten John's mouth for the first time today. Up until today, they were using a moistening lotion which they still use for mouth care about every 2 hours but the ice water has to feel better than lotion on the tongue a lips. And he can now stick his tongue out on command (but isn't sticking it out at us all the time). His lungs sound a little better; there are lung sounds in the lower lobes. For now, they are crackles but that is better than nothing. John has been on the assist control setting of the ventilator meaning the ventilator is doing all the work of breathing (except when John overbreathes it). Yesterday, they put John on pressure assist for several hours; on this setting, the ventilator provides a small amount of pressure but John controls the rate and most of the work of breaths. This morning, John was on the trach collar for almost 6 hours. That means he was completely off the ventilator breathing humidified air with 50% oxygen all on his own without any help from the ventilator! This is remarkable progress. Each day they will increase the time John is off the vent; so if all continues to go well, he has begun the process of weaning. For the vent techs out there, his O2 setting is 45% and the peep is 5. The continuous dialysis is still working and John's kidneys are working a little better on their own. Some of the extra fluid has been pulled off; that combined with the reduction in pre and post treatment fluids have noticeably decreased the edema. He is still leaking through his arms but it is a bit less. John's liver enzymes show that his liver is working better too. The bedsore is pretty bad; it is being debrided with a medication. The wound care nurse recommended the addition of some wet and dry dressings to pull the drainage out better so that will be added to the list of procedures 2x/day. The leg ulcers are getting special dressings, they're not too bad, and at least one is getting better. The nurses are working on getting softer booties that fit better to help prevent drop foot and keep John's legs properly aligned. Consults are in for PT and OT; anything they can do will be just great. John is wide awake and fully cognizant of everything going on. He has been off pain meds for most of the day. I'm sure I'm forgetting something but you get the idea that tremendous improvements have occurred in the last 24 hours. Honey badger indeed! (Check out the you tube video if you haven't seen it yet and decide for yourself what traits they have in common.)