Pain and Fever

Late last night Cathy had a fever (101+ F). Because she had the G tube procedure that day, the doctors and nurses were scrambling a bit to get it under control. Cathy spent most of the night with ice packs placed over her body.

There were two different 'theories' being floated around last night. One theory was that Cathy may have an infection and the Tylenol in the vicodin that she had been taking for pain has been holding the fever down. The vicodin was discontinued sometime on Friday. The other possibility is that the G tube site is already infected. The infectious disease attending physician was in to assess Cathy a little while ago. It sounds like he may be ordering an ultra sound to investigate the G tube site. (The surgeon that placed the G tube also stopped by this morning).

The fever was pretty much gone by this morning. Samples of bodily fluids (blood, mucous, urine) have been taken for cultures.

The pain at the G tube site is still pretty much unbearable for Cathy. A different approach to her pain management is being tried. She is receiving IV injections of dilaudid every four hours and injections of another drug every twelve hours.

A Day of Two Faces

Today started out very nice. Cathy' face was bright and full of smiles this morning. She was a little anxious about the procedure for the G tube, but was handling it well. The procedure went smooth. Cathy's face is free of tubes and hoses for the first time since the end of June.

All was well until the local anesthesia started to wear off. Cathy has been experiencing severe pain since this afternoon. The drugs she has received for the pain (oxycodone & morphine) has brought on nausia. Dealing with the nausia and the potiential for vomiting with the trach is very 'unsettling' for Cathy. Tonight Cathy's face is overshadowed with pain and distress. [It's going to be a long night].

You Don't Put Gravy On A Hot Dog

Cathy is scheduled to have her NG tube removed tomorrow and a G Tube 'installed' (interpret: the tube removed from her nose and one put into her abdomen). The nurses have started to record every calorie Cathy consumes. The nutritionist has worked with Cathy to come up with the pureed foods that are the most attractive and tasty to Cathy. Tonight Cathy was looking forward to a pureed hot dog (uhmmm gooood). When the tray arrived this evening with her grilled hot dog, the chef had put gravy all over it (yuk).

During physical therapy today, Cathy walked using portable oxygen. This allowed her to stroll outside of her room to the window at the end of the hallway. Eye-balling it, this looks to be over 100 feet one-way. How about that!!!

Last night and today, while Cathy has been on the trach collar, I have been blessed to hear her voice again. It takes a lot out of her to talk. She covers the end of the trach tube with her finger and then she can talk (this forces air through her voice box). It is only a few words at a time, but what precious words they are.

Now that there is portable oxygen available to Cathy, Dr. Saggar said that we may be able to take wheelchair strolls out of the room this weekend (patio privileges - yippee!!). Since Cathy is having the procedure to have the G tube placed, and will be sedated, this is not likely to happen until Sunday or even Monday.

Meeting Interrupted

Dr. Saggar (the other one) stopped by this afternoon and spoke with Cathy about today's transplant committee meeting. Apparently an emergency arose before they had the opportunity to discuss Cathy's case. [Oh well, maybe next time.]

Cathy has been on a version of the trach collar since around 8:30 am this morning. She is receiving an oxygen rich flow of air (50%) without the cool mist for humidification.

The physical therapist came by today and was able to walk Cathy about the room.

Plenty of Rest, A Proper Diet And Exercise

The resident physician stopped by early this morning and provided us with the results of yesterday's bronkoscopy. There are signs of irritation at the back of Cathy's trachea (wind pipe). They believe that this is the source of the bleeding. It was likely caused by to much suctioning. The nurses and respiratory therapists are being asked to suction Cathy only when needed, not per a set schedule in addition to as-needed.

It was a 'groggy' day for Cathy. She was still feeling the effects of yesterday's sedation.

The physical therapist stopped by to work out with Cathy earlier in the day. Cathy was eating her lunch at the time so she left saying she would be back later. She never came back. Today's exercise routine has been bedside stretches and journeys in and out of bed to use the cammode. (Ooops, is that to much information?)

Cathy is being encouraged to eat more of her pureed diet. The nutritionist wants Cathy to be able to eat three quarters of the hospital diet before the feeding tube is removed.

Cathy Has Been Bronked

Cathy had the bronkscopy performed around 1:30 this afternoon. As of this evening we have not heard any results. According to the nurse, the doctors should have the results before their morning rounds.

Cathy has been awake on-and-off since I arrived this afternoon. She is still feeling the effects of the sedation.

Becky came down with Miles this evening. This is the first chance Cathy has been able to see Miles since she came into the hospital.

To Be Bronked Or Not To Be Bronked

We have been told that Cathy has a bronkoscopy scheduled for 11 am tomorrow. (We've heard that one before). Unfortunately I cannot take another day off of work to be here with Cathy. Cathy says she will be OK, and after the day she had today, I believe her. She just went 'back to bed' a little over an hour ago. She spent over 14 hours out of bed, several of those breathing room air. Simply Amazing!!!

Another change we learned about today is that Cathy's PICC line will not be coming out. (I guess doctors are allowed to change their minds).

Cathy's View

Cathy spent several hours on room air, sitting in a chair today. Earlier this afternoon, the physical therapist dropped by and had Cathy attempt to walk a little bit. Well, we know Cathy, a little bit is just not in her. She did a couple laps around the room and even managed to walk herself out of the room and into the hall.

On Cathy's first lap around the room, she stopped at the window and admired her view for several minutes. Then, after 'dancing a few bumps' with the RT, she continued her tour.

I thought I'd share Cathy's view with everyone.

Left Hand to Right Hand: What Are We Doing?

Apparently there was some confusion about the bronkoscopy procedure that was 'scheduled' for today. It was not scheduled for today. The medical observation team thought is was scheduled, the transplant team says they were reading some old notes in Cathy's chart.

The doctors (transplant team) want Cathy to begin taking her medication and more food by mouth. They want to remove the feeding tube from her nose (NG-tube). This is a possible source of infection. Cathy's PICC line (a small catheter that was placed through one of Cathy's veins several weeks ago) is also going to be removed today or tomorrow. This is another possible source of infection. Cathy spiked a small fever yesterday afternoon (I did not hear about it until this morning). There is no fever so far today. The doctors want to reduce the possible routes of infection. If Cathy is unable to take her medications by mouth, or take enough nourishment by mouth, they will consider placing a tube through her abdomen into her stomach (a G-tube).

According to the transplant team, "a bronkoscopy will be performed this week, within the next 72-hours, probably tomorrow or Thursday" (how's that for committing to a schedule?). According to the medical observation team, they will review Cathy's chart and see what the transplant team wants. [---- I think I may be sensing a little miscommunication between the teams ----].

Cathy has been setting up in in a chair for a little over an hour now. She is breathing room air if you can believe that! The inner cannula (small tube) was removed from her trach to make it easier for her to draw air in the push it out. Every few minutes Cathy will place the Bi-Pap hose up to her trach opening and give herself a 'shot or two" of oxygen saturated air. What a visual juxtaposition between looking at Cathy today versus eight weeks ago in the ICU.

Day 57

I left the hospital this morning to tend to some chores at home and visit with the Miles and the girls. Cathy tells me that she had an uneventful day. She was out of bed, sitting in the chair for a few hours. When I left this morning, she was wide awake, the effects of the sedation appeared to be gone.

The respiratory therapist (and Cathy) says that there was only a small amount blood coming from Cathy's lungs today. I hope the bronkoscopy tomorrow answers the doctor's questions regarding the cause/source of this blood.

David

Two Votes

Cathy had a Cat Scan of her neck and chest this morning. The results were "good". No deterioration from her previous Cat Scan and no evidence of active infections were observed. They were not able to determine the source of the bleeding (which has been a little worse today). On Monday they are going to perform the bronkoscopy. They are going to de-trach Cathy and perform the procedure through her mouth. This will allow them to inspect the trach site as well as the back of her throat. They are also going to take some fluid and tissue samples from within her lungs.

Dr. Saggar (no, not that Dr Saggar, the other Dr Saggar, his brother) and another doctor from the transplant team stopped by Cathy's room this afternoon. Dr. Saggar said that the transplant team is going to meet this Thursday and discuss Cathy's case again. He and his brother both feel Cathy is ready for another transplant. He did mention that it is acknowledged that he and his brother are a little biased about re-listing Cathy. So, it is up to Cathy to convince the other doctors on the team that she is strong enough to make it through another transplant operation. This Tuesday or Wednesday another doctor from the transplant team and the transplant surgeon will be dropping by to assess Cathy. Dr. Saggar wants them to see Cathy to get out of bed, stand and hopefully walk a few steps. If this occurs on Tuesday it may be difficult for Cathy. She may still be recovering from the sedation from the bronkoscopy.

Cathy has spent all day sleeping off the sedation from this morning's Cat Scan. (Cathy has to be sedated before she can lay flat on her back). She slept through Dr. Saggar's visit and encouraging outlook.

Rock Star

Cathy had another good day today. She has gained enough strength to get herself in and out of bed on her own. (She thinks she is soooo cool....). Cathy did not spend any time on the trach collar, but she did spend most of the day sitting up in a chair. The doctors have ordered Cathy to be on ventilation (Bi-Pap) 24/7. They are going to try to have her to start walking while on the Bi-Pap.

Tomorrow Cathy will be going in for a Cat-Scan of her neck and chest. I believe that they are going to attempt to identify the source of the bleeding with this procedure instead of a bronkoscopy. The bleeding is minimal one day and quite substantial the next.

Cathy had an emotional surprise this morning. Cathy's nurse for today was one that she had become very close to during previous hospital 'visits', Isabel. They both cried when Isabel walked into the room this morning. They had a pleasant day which will repeat tomorrow since Cathy will have her for a nurse again. After her shift was over, Isabel stayed in the room and visited with us for quite a while. During her visit Isabel shared an interesting perspective on Cathy's health. Isabel told us that of all the rejection patients she has seen who had to be intibated, she has never seen one extibated and last (live) very long. She has also never seen a rejection patient regain enough strength to be considered for another transplant. Although Cathy has not been re-listed, Isabel said that the doctor's notes on her chart make it clear that it is definately being considered. The doctors want Cathy stronger. Cathy is a "Rock Star" she kept saying. After hearing this, it is a little easier for me to accept the doctor's caution about re-listing Cathy.

A Day of Mixed Emotions

Cathy had a very good day today. Although she did not spend any time on the trach collar, Cathy spent over 12 hours sitting up in a chair. Cathy was relaxed and in good spirits for most of the day.

The transplant team met today and discussed Cathy's case. It was decided to not re-list Cathy at this time. Apparently there have been reports put in Cathy's 'chart' from some of the ICU nurses stating that Cathy has not been trying. (Boy am I ever happy that Cathy is out of the ICU!!!!). Dr. Saggar told Cathy that he stood up for her in the meeting, telling the other doctors that he did not believe this was the case. The bottom line for today is that Cathy is still not on the transplant list. Dr. Saggar had told Cathy that he would be back this evening to discuss the situation with both of us. I have delayed posting tonight's update hoping to have more information from Dr. Saggar. (No visit by this message's post time).

Cathy was happy to learn tonight that she weighs more now than what she has weighted since well before she came to the hospital. I know it is not polite for me to share her weight, so let's just say her weight is displayed in three digits (no, I am not counting the digits after the decimal point). Cathy says this is because of the good liquid diet she has been 'eating'.

Pay No Attention To The Man Behind The Curtain

Cathy was sleeping soundly when I arrived at her room this evening. This was particularly calming for me after I learned about her day.

During the day there were some 'difficulties' with the Bi-Pap machine. Cathy started to have trouble getting flow from the machine and felt she was heading into trouble, so she pressed the 'call button'. However, since Cathy did not answer the attendant when he queried her over the intercom, no one came to Cathy's assistance. (Of course Cathy did not answer, she cannot speak. What an idiot!!!!) Cathy's blood oxygen levels dropped below the alarm limits. It was not until after the alarm was going off for several minutes that someone responded. The nurses and attendants are conditioned to ignore the blood oxygen sensor alarms because they give a lot of false alarms. Cathy attempted to inform the nurse that she felt the machine was not correct. The nurse attributed the situation (low oxygen levels) on anxieties. By the time it was determined that there were indeed issues with the machine, they were 'bagging' Cathy. [The preceding is a compilation of the story as described by Cathy and the evening nurse who was not on duty at the time].

This was the exact situation Cathy was afraid of before leaving the ICU. I have been told that there is now a notice posted at the monitoring station, stating that Cathy does not have to respond to intercom queries (I sure hope it is more than a post-it with a scribbled instruction). The attendant is to simply inform Cathy that someone is on their way. Additionally, Cathy's nurse and 'care partner' are to physically check on Cathy hourly. Therefore someone should be sticking their head into the room about every 30 minutes.

After all this excitement today, Cathy did not spend any time on the trach collar or out of bed and in the chair.

Take A Stand

It appears that our stay on the 7th floor was almost a short one. When planning for the bronkoscopy, the doctors were intending to perform the procedure at Cathy's bedside in the ICU. Therefore a procedure room was not reserved. The doctors had not anticipated a room opening up last night (why would they, Cathy has been waiting for days). To avoid having to re-admit Cathy back into the ICU for the bronkoscopy, and then wait for another room to open up, the doctors have postponed the bronkoscopy until a procedure room can be reserved. The bleeding has subsided today, so the doctor said that there is no urgent need to perform the procedure.

Cathy has been sitting up in a chair since 7 am. The physical therapist stopped by just before 10 to work with Cathy. One of the 'exercises' she had Cathy perform was to just stand. The goal was to stand for thirty seconds to one minute. I watched as the seconds ticked by and the one minute mark approached and passed. Cathy looked up and shot me a mischievous grin. If they wanted one minute, she was going to give them two. By the time another 60 seconds passed, Cathy was starting to tremble but she sat back down with a smile that that highlighted magnitude of her accomplishment. A little while later, while I was standing and admiring the view from Cathy's new room (it is a pretty view), I was struck by the thought of how the seemingly simple act of standing can be easily taken for granted.

Same Management, New Location

Cathy has been moved out of the ICU and into an observation room. We have moved from the fourth floor up to the seventh floor of the hospital (the same floor she was on way back on June 30th).

Cathy has the bronkoscopy scheduled for tomorrow (I guess its today now), so they must have been able to obtain a small scope. I do not know the time for the procedure. However, this room has a couch so I am here until the procedure is complete and Cathy has recovered.

Pray For More Days Like Today

Cathy is having a very good day today. She was sitting up in a chair from around 1 pm until after 7:30 this evening. She has been on the trach collar since 2 pm. They will be putting her back on respiratory support sometime between 9 and 10 this evening. She ate some pureed cream of chicken soup and pureed roast beef (yuk) for supper tonight.

Becky has been here visiting with her mom since around 2 this afternoon. Earlier in the day, Norma, her good friend and transplant buddy, stopped by for a visit as well. Cathy said that these visits helped to brighten her day.

Cathy says that the pain in her shoulder is almost gone. Her range of motion is almost back to normal.

The transplant team wants to perform a bronkoscopy to determine the source/cause of the bleeding in Cathy's lungs (look down into Cathy lungs with a camera). If they can obtain a "child-size" scope that will fit through the tracheotomy tube, they will perform this procedure tomorrow. If a "child-size" scope cannot be obtained, they may have to close off the tracheotomy, re-intibate Cathy, and perform the bronkoscopy through the intibation tube like they did the last time. We will not know until after midnight if they were able to obtain the small scope and schedule the bronkoscopy.

Pass The Pop

Cathy did not attempt any time on the trach collar today (but who knows, the day is not over yet). Today has been a day of relaxing and visiting. Jessica was down for a little while again this afternoon.

Cathy's nurse taught her how to remove herself from the Bi-Pap machine long enough to take a drink of soda (or pop as Cathy would call it). If she were to take a drink while connected to the machine, the machine could possibly suck the pop down into her lungs. I am not too comfortable with Cathy doing this herself, and she has allowed me to assist her whenever she has attempted it. It does make me feel better knowing that Cathy can reconnect herself to the machine should she become disconnected accidentally. This has happened several times during the past weeks. Even when the hose is connected and secured with a rubber band, it will occasionally slip off. This was one of the reasons Cathy was concerned about being leaving the ICU and being in an observation room. If she is a little more independent, maybe not having a nurse just outside her door all the time will be a little easier to handle.

Cathy would like me to tell everyone that she loves them and thanks them for all their support, thoughts and prayers.

Cathy & David

Not Pushing it

Cathy spent just under three hours on the trach collar this morning. She was put back on the respiratory support on the doctor's orders. Cathy wanted to go longer but the doctor does not want Cathy to push herself and go through another set-back.

Cathy said she slept very well last night. She was awake and 'chipper' for most of the day. She just started napping a few moments ago.

Donna and Floyd came down from Oxnard this afternoon and visited with Cathy. Jessica was also here this afternoon. Having visits from these guests today has brightened Cathy's spirits.

Cathy's shoulder is moving through a much wider range of motion today. Cathy only comments about the pain when I press aginst it. (I guess I'll have stop pressing against it).

Increased Support

Cathy was on respiratory support all day. After observing Cathy struggling to breathe early this morning, the ICU attending physican had the respiratory therapist increase the amount of respiratory assistance Cathy is receiving (three units of increased pressure support). She also told Cathy to rest all day today.

Cathy is able to move her shoulder a little more this evening. She says the pain is about the same.

Sorry for the brief update, there isn't much more to say at this time.

Move That Joint

Cathy is in good spirits this afternoon (even after the late night MRI adventure). She was only able to tolerate being on the trach collar for about an hour today.

We were able to speak with a rheumatologist about some preliminary results from the MRI. The good new is that there are no muscle or tendon tears and no infections were noted. There is some excess fluid in the joint and some swelling in the tissue of two of the muscles. This 'injury' was likely caused from overexertion (either during physical therapy or rough handling). The doctor expressed concern about not moving the joint. If the joint does not get moved periodically it may become locked in place. If this occurs, it would require surgery to free the joint back up. Cathy and I are going to implement a nightly 'workout routine' to move this shoulder joint and exercise her legs. (The physical therapist did not show up today).

An Early Morning MRI

I called down to the hospital a little while ago to check on Cathy and get a feel for the likelihood of the MRI occurring this afternoon. Wouldn't you know it, shortly after I left the hospital this morning, Cathy was taken in for the MRI. No Results are available. I will be heading back down in about an hour from now (give or take a few shakes). The results should be available by the time I get back to the hospital.

A Day of Waiting

The nurse just informed me that the MRI will not happen tonight. We are back to the "the machine is broken" reason. Who knows?...........

Cathy is sleeping soundly. Hopefully this day of rest (she did do a little physical therapy) and respiratory support will give her the energy to get out of bed tomorrow and spend some time on the trach collar.

The transplant team meets on Thursdays. It is likely that they will be considering re-listing Cathy for a transplant tomorrow . Lets pray for God's guidance and his will at this meeting.

Still Waiting

We have been given a few reasons for the delays in having the MRI. The more recent reason is that stroke patients are priority patients, and there have been several stroke patients come in to the emergency room today. Cathy has been on the 'priority' end of having a procedure performed in the past (bumping others) so we will accept the situation and be patient.

Cathy appears to have a bit more energy this afternoon. She just asked to be put on the trach collar so she could eat some of her pureed turkey dinner.

Theories

We are still waiting for the MRI to be performed. We have been told that it will happen "soon".

Cathy was only able to make it 45 minutes on the trach collar this morning. When the respiratory therapist was putting Cathy back on the Bi-Pap machine, she noticed some water buildup in the supply hose. Immediately after clearing this water Cathy's eyes opened wide and a look of relief rushed over her face. Cathy commented that she was able to breathe so much easier. Apparently for the past day (plus) Cathy has had to work extra hard to overcome this blockage while on respiratory support. This may explain why she has been tired and unable to last long on the trach collar (my theory).

The doctors have a new theory of their own. This morning we were told that Cathy's rotator cuff (in her shoulder) may have been injured. This could explain the pain an immobility in her arm. Until the results of the MRI are available this will remain a theory.

MRI Down

Change in plans. I was just advised the the MRI is down and will not be repaired until tomorrow. The earliest that they will be able to perform the MRI on Cathy's arm is tomorrow afternoon.

I am heading home to catch some sleep on a familiar pillow.

Late Night MRI

The doctors have ordered an MRI of Cathy's arm. The pain in Cathy's arm has not subsided any more from yesterday, her mobility is still limited, and Cathy has now spiked a little fever. This has raised the suspicion of an infection in the arm. The MRI will help the doctors determine if there is an infection present somewhere in the arm. Of course they will not give us a time for this MRI procedure. The closest thing to a time that we can get is "sometime tonight", so I have a feeling it is going to be a long night.

Cathy's energy level was also very low today (another indication that there may be an infection). She has been sleeping almost constantly since I arrived just before 5 pm. She spent only a few hours on the trach collar today.

Jessica and Becky spent the day with Cathy, I am sure this helped with her energy and spirits.

I am going to chase down some coffee and stick around for the MRI. I will post an update after the procedure is complete.

A Shot In The Arm

Cathy spent only a few hours on the trach collar today. It appears that we are in a pattern of one day with a high energy level and being able to tolerate long hours on the trach collar, followed by a day spent rebuilding her energy. Cathy did not have physical therapy today and she remained in bed the entire day.

Cathy is experiencing an adverse side-effect of one of her medications. Cathy has been receiving Lovenox to prevent blood clots. This medication is administered through a shot into the fleshy part of her abdomen. Apparently a nurse yesterday (or the day before) gave Cathy this shot into the fleshy part of her arm. This morning Cathy was unable to move her arm and was experiencing a bit of pain. There is a good sized bruise with a knot in the middle where the shot was given. This evening Cathy has started to regain some ability to move this arm and the pain is subsiding.

A Quiet Sunday

Cathy has been on the trach collar since 8am this morning. Her appetite also increased a bit today. She had a good portion of mashed potatoes for lunch and a pureed hamburger and chocolate pudding for supper. A little extra time on respiratory support yesterday appears to have helped her energy level.

Cathy is still bleeding from somewhere within her throat/lungs. A few days ago the doctors thought it was bleeding from the tracheotomy. The latest school of thought is that she has had too much suctioning. (Sterile water is routinely 'squirted' down her trach. This water is then suctioned back out by sticking a tube through the trach down into her lungs. This is done to remove the secretions and fluids in her lungs). The frequent suctioning may have caused irritation and bleeding. One of the problems with the bleeding is that blood clots are frequently blocking the trach and making it difficult for Cathy to breathe.

She Took A Pass On The Room

There is not much to update on this evening. Cathy has not been on the trach collar for very long today, just a couple hours this morning and a few more this evening. She is very tired.

Apparently a room did open up around 3 am last night. However, at that time Cathy was sleeping soundly and the charge nurse did not want to disturb her. The charge nurse knows how worried Cathy is about being out of the ICU and in a room where she is not visible to the nurses 24/7. Waking her up in the middle of the night and moving her to a floor where she is 'out-of-sight' would have only increased Cathy's anxieties.

I commented a couple day ago about Cathy pulse rate dropping below 100. The past two days her pulse has been increasing a little bit again. This evening it has been holding between 110 and 120 when she is resting. I don't know what this means, I have not seen a doctor today (or yesterday).

Date Night

Cathy and I are anxiously awaiting the start of the Olympic events this evening.... a relaxing evening at 'home' watching the tube.

Cathy was on respiratory support for less than six hours this morning. Her lungs are getting stronger every day.

Today the physical therapist added some leg kicks to Cathy's workout. Squats, walking and leg kicks: Cathy is training for the triathlon.

The nurse mentioned the possibility of moving to a regular room tonight!!! So, who knows, this date night may end in a strange room...... sssshhhhhh.

A County Fair Treat

Cathy stayed on the trach collar for 29 hours yesterday. An arterial blood sample was not drawn this morning so we do not know how her body did with its CO2 levels. Cathy did say that she was alert when she was put back on respiratory support, so the CO2 could not have been too high.

After being on the trach collar so long yesterday, Cathy is exhausted today. She still found the drive to do some physical therapy and go back on the trach collar at 1 pm. The respiratory therapist said he will be putting Cathy back on respiratory support between 10 and midnight tonight.

One of the attending physicians from the transplant team stopped by to examine Cathy this afternoon. This doctor expressed some concern that Cathy's trach is still bleeding internally. I will follow up with one of the doctors the next opportunity I get (I was not at the hospital when the doctor was examining Cathy).

Jessica is taking Miles to the County fair this evening. I have asked her to pick up a few 'fair foods' that we could puree and bring in for Cathy. Maybe this will add a little variety to Cathy's pureed diet and bring a little of home here for her.

David

Perseverance And Faith

If Cathy was looking good yesterday, today she is looking terrific! She is fully awake and alert, and chatty with the nurses (as chatty as one can be without a voice).

Cathy was put on the trach collar at 5 am this morning and will be on it until 10 or 11 pm tonight. She has been sitting up in a chair since around 10 am. She will probably stay in the chair until she is put back on respiratory support. Before being put in the chair, she had a nice workout with the physical therapist. She did some more squats and walked four laps between her bed and the door to her ICU room.

Cathy's 'numbers' are also showing continued improvement. Since being admitted, Cathy's heart rate has been elevated, sometimes very elevated. I believe the doctors have referred to this as tachycardia. Today her heart rate dropped below 100 beats per minute. It has been holding between 97 and 103 all evening. Just yesterday evening the lowest I observed was in the 120's.

Cathy said that she was able to do all this today through perseverance and faith, even though she has felt tired all day. As always, Cathy thanks everyone for their continued love, thoughts and prayers.

Grandma's Remedy

Knock on wood.... Tonight Cathy looks better than I've seen her since being in the hospital. She has been on the trach collar steady since 5 am this morning. The plan is for her to stay on the collar until after 10 tonight. She was sitting up in the chair for most of the day and the nurse said she ate more food during lunch than what she has eaten since being here.

Tonight Cathy had a good helping of cream of chicken soup with her dinner and she said that she slept very well last night. What more would a grandma prescribe?

Still no word on a change of rooms. The doctors say that 'they' are still looking. (It must be the same 'They' that always says everything).

David

Squats And Blessings

I arrived at Cathy's ICU room this afternoon just in time to see her finish up with her physical therapy: Ten Squats!!!! How about that!!!!! (Cathy says that they were wimpy squats). She was on the trach collar for four and a half hours this morning, and she just went back on it about an hour ago so she could eat some dinner.

The nurse said that the preliminary results from yesterday's lung secretion cultures are mostly negative. The preliminary report did indicate some yeast growth. This may be the aspargillis that Cathy has had since her transplant in 2004. I have not had the opportunity to discuss this with any of the doctors.

Cathy wanted me to tell everyone that she is touched to see how many people are following her progress. She appreciates all the good thoughts and prayers. She sends her love and Gods good blessings.

Cathy & David

Some Good Days and Some Bad Days

Cathy was on the trach collar for a little over 8 hours today. During the past couple days, the time Cathy has been spending on the trach collar has been decreasing. Dr. Saggar consoled Cathy and let her know that this was OK, she is going to have some good days and some bad days.

During their rounds, doctors said that Cathy's lungs have been secreting more fluids during the past couple days. The doctors also said that Cathy has become anemic again. The anemia may explain Cathy's lack of energy. However, they are concerned that the increased secretions from her lungs may indicate the presence of an infection.

Cathy will be receiving another unit of blood this afternoon (her seventh (?) since being admitted to the hospital). The doctors are also reducing the frequency and amount of blood draws that Cathy must endure. This will reduce the burden on her body to produce more blood. Of course, no sooner did they say this when a nurse came into the room for a blood draw to cross-match for the blood transfusion. Samples of her lung secretions were also drawn and sent to the lab for cultures. The initial results of these cultures will be available by tomorrow.

The resident physician spent a few minutes discussing Cathy's treatment program with us. She 'warned' Cathy that the anabolic steroids she has been receiving may have a few unwanted side effects. One of the side effects could be the growth of facial hair. I guess I'd better go out and get Cathy an electric razor.

A Slow End To Week Five

I've waited as long as I can for today's update. It has been a very slow day with not much to talk about.

Cathy was on the trach collar from 5:30 am to around noon. She went back onto the trach collar around 4pm and she is going to try to stay on it until 10 pm. She has been very tired today, but has not slept very much. It seems that there has been someone coming in the room for one reason or another all day.

Becky is down this evening to visit with her mom.

Olympic Disqualification

Cathy was on the trach collar for over twenty seven hours yesterday. The CO2 concentration in her blood was 68 (still improving). However, she was very exhausted after this length of time on the collar. She was not able to sleep very well through the night. After that much time on the trach collar, breathing is a conscious effort for her. She keeps herself awake out of fear she will stop breathing.

When Cathy was taken off the trach collar this morning, they put her on the Bi-Pap machine instead of the ventilator.

Dr. Saggar dropped by to check on Cathy and to give a few words of encouragement. Among these were "You are getting better". He also told Cathy that she needs to be rested nightly. Pushing herself to stay on the trach collar only makes her overly tired. This will limit the amount of effort she can direct towards building her strength. He wants Cathy to be rested on the Bi-Pap machine for several hours every night. Cathy has been resisting being rested on the ventilator. She does not like the feeling of the ventilator breathing for her.

Dr. Saggar also put Cathy on an anabolic steroid. This will build some lean muscle mass for Cathy and help her develop some strength. On the down-side, this will disqualify Cathy for the Beijing Olympics.