Back-Up Support

The highlight of Cathy's day was dealing with problems with the Bi-Pap machine. This afternoon when I walked into Cathy room there were two Bi-pap machines set up.

This evening she went on the trach collar long enough to eat some egg salad and cottage cheese, about 20 minutes.

That about sums up her day. Just waiting for that 'call'.

No Further Discharges

Today was a pretty good day for Cathy. For physical therapy she was able to walk outside of her room and up and down the hallway. She is still only able to tolerate the trach collar for around 30 minutes at a time.

Cathy's biopsy wound stopped bleeding today, or "no further discharges" in nurse speak.

Wednesday Evening Treatments

No physical therapy for Cathy today. Cathy actually looked a little disappointed as she told me this. I think Cathy gets as much out of the visits with Lawanda (the physical therapist) and she does from the physical therapy itself.

Cathy went on the trach collar for a short time this afternoon to eat lunch and again this evening for about 15 minutes to receive an aerosol antibiotic treatment that cannot be given while she is on the Bi-pap. Cathy takes a while to recover from these treatments so she did not want to go on the trach collar this evening to eat supper. She will be receiving this treatment every Wednesday until the doctors decide to DC it.

Negative Bone Marrow Biopsy

I don't know if I am happy or alarmed, but today we learned that the bone marrow biopsy was negative for any infections. This is good news on the infection front. However, it indicates that Cathy's recent deterioration of lung function may be due to active rejection.

Two days in a row now Cathy has worked with the physical therapist. She is still only able tolerate being off of respiratory support for 30 to 45 minutes (and 45 minutes is pushing it). So these workouts are brief. But, God bless her, she is still trying.

The Blank Stares Have Been DC'd

Cathy managed a bit of exercise this morning and a little supper this evening. This evening she is alert and upbeat.

The blood given to her yesterday was successful, it raised the numbers that the doctors wanted raised. We have not received any updates on the bone marrow biopsy. The biopsy wound is still bleeding. A couple of Cathy's medications that have the potential to thin blood have been temporarily discontinued (DC'd to use the term I hear around here).

That's about it for this evening.

Back Where It Should Be

Cathy just finished receiving one unit of blood. Around 5 this afternoon she went onto the trach collar to eat some very late lunch or early supper. She did pretty good, she ate about one-fourth of a tilapia fillet and about half a portion of plain bow-tie pasta (she sure digs that bow-tie pasta).

For most of the day Cathy has been alert and interactive. Her friend Dianna and her daughters were here for a visit this afternoon. I think this stimulation helped keep her alert.

It looks like the added support has put Cathy's mental status back to where it should be (to use the phrase the doctor used on Friday). Now to determine if the requirement for added respiratory support is due to infection or rejection. Better yet.... a transplant.

Twinkle Twilkle Little Eyes

As I was waking up this morning I looked over and noticed that Cathy was staring in my direction. After I worked the creeks out of my bones and put on my glasses, I realized it was not the blank stare from last night. This stare had a set of twinkling eyes and a smile behind it. What a gift!

The respiratory support from the Bi-Pap that has brought Cathy out of her "reduced mental state" is the same as what the ventilator was providing her back in early July. I don't know if there is any significance to this, it just caught my attention. I will ask one of the pulmonologist about this when I get the opportunity.

With all the frequent blood draws and the bleeding from her wounds, Cathy is in the need of another blood transfusion. They haven't told us how many units. In the past it has typically been two units at a time. I've lost count, I think we are somewhere north of twelve units (one of these days I'll go back and read all the blogs and add them up).

The doctors want Cathy on the Bi-Pap continually except to eat and exercise. This morning Cathy went on the Bi-pap for a bit and ate some french toast and fruit. Within 45 minutes she was struggling and was 'going blank'. She is now back on the Bi-pap and smiling again.

Messing With Karma

The support that the Bi-Pap is giving Cathy was increased twice today. She was a little more alert this afternoon, however by this evening she is becoming 'blank' again.

For a short while this afternoon, while she was alert, Cathy was put on the trach collar so she could try and eat some real food. I managed to get her to eat about half a portion of plain bow-tie pasta and a little under a half a portion of couscous. The amount of nutrition she is receiving by the tube was decreased in an attempt to have her build an appetite.

Just before 6 pm, a blood sample was taken to test for her blood gas levels. The results of this sample were so bad, a resident from the ICU came up to Cathy's room to conduct an assessment in preparation of a possible transfer back down there. An additional blood sample will be drawn around midnight. I am packing thinks up tonight to avoid the middle of the night rush and confusion like we experienced during the last transfer to the ICU. Of course, since I have gone to the trouble of packing things up, she probably will not be transferred. (This is my hope, doing the old reverse psychology thing on karma).

A different type of dressing was applied to Cathy's pressure sore this afternoon. This one is a thick silicone pad that is meant to stay in place for several days. The location of the sore puts the dressing in the way of conducting proper 'sanitary procedures', so the dressing will likely need to be changed frequently anyway. We'll see how this works out. This sore stopped bleeding today. The bone marrow biopsy wound is a different story. This would is bleeding so much the dressings are being changed several times a day.

Guessing Games

The amount of respiratory support Cathy is receiving from the Bi-Pap was increased yesterday. It is getting harder and harder for Cathy's respiratory system to remove CO2. As a result (in the words of the resident from the pulmonary team) "Cathy's mental status isn't quite where it should be". I thought that it may have just been my paranoia over the past few days, but I thought that Cathy had become a little 'mentally distant'. She had a blank stare most of the time. This was one of the issues I wanted to discuss with a doctor today. This resident brought up this issue before I had the chance to ask. The theory is that the increased respiratory support will help remove the CO2 which will in turn improve Cathy's 'mental status'.

I also spoke with the attending physician responsible for treating infectious diseases. He stated that nothing has shown up on any of the latest cultures, even the mold that has always shown up in the past. It is to early for any results from the bone marrow biopsy. This doctor had a different twist on the reason for Cathy's 'mental status'. He thinks it could be due to the dialudid she has been taking for pain. Four months of dialudid, every four to six hours, may be taking its toll. He followed up this comment with a statement about pain management being the priority.

The one issue that I cannot even get a theory on, is how they are going to address Cathy's pressure sore. This sore was close to being healed when two days ago it became an open, bleeding, wound. Apply dressing, rotate positions, give antibiotics, and treat the pain is the approach that they are using. However, this is the same approach that has been used since August. I don't think it is working. When I question this, all I get are quiet looks and "yeah.......yeah......I know....... yeah....." and shrugged shoulders. Over the next couple days I will be working my way up the food chain with this question.

On the topic of pain, with the pressure sore now an open wound, Cathy's ever-present chronic headaches, and now a biopsy wound (within inches of her pressure sore if you can believe that), Cathy is continually fighting pain.

Cathy is under the care of a very persistent physical therapist. Today this therapist insisted on getting Cathy up out of bed for some marching in place (she cannot go far connected to the Bi-Pap) and leg exercises while sitting in a chair. Cathy had tears in her eyes, and at one point she begged me to help her convince the therapist that she was in to much pain. It tore me up to take the side of the therapist. After it was over, I think Cathy was glad she endured and exercised. It is needed for so many reasons.

A List Of Questions

Sorry for the late post this evening.

Today was an uneventful day for Cathy - no physical therapy, no eating, and no further set backs.

I have not spoken with a doctor in over a week. Tomorrow I am taking the day off work and camping out here until I have that opportunity. Sometimes Cathy's 'lip-speak' is a little tough to translate. So tomorrow I want to get some answers to question that I have been holding onto for several days.

Penne Pasta

This afternoon Cathy was on the trach collar just long enough to go for a short walk and eat some pasta, a little over an hour. As a result, she has a little more energy this evening.

There are no updates on the infection theories. Still waiting on test results.

Where's Waldo

Cathy was only able to tolerate the trach collar for a little over three hours again today. However, during that three hours a lot was accomplished. Cathy went through a procedure by the speech therapist to test her ability to swallow, she passed. Now she can officially eat. She also went for a cruise with the physical therapist up and down the hallway outside of her room (about 100 feet, give or take several feet). By the time she made it back to her room and ordered something to eat, she was starting to struggle to breath and wanted to go back on the Bi-pap. No food tonight.

Today Cathy was given another opinion regarding why she appears to be loosing energy and the ability to tolerate the trach collar. The latest theory is that there is an infection hiding out in her bone marrow. Sometime within the next day or so Cathy will undergo a procedure where they take samples of her bone marrow. These samples will be cultured and tested for evidence of an infection. At this time we do not know the full ramifications of a bone marrow infection or how it would be treated.

Lasting Longer Off Of The Bi-Pap

Cathy was not able to tolerate being on the trach collar long enough yesterday for us to attempt a stroll. She was only on the trach collar for three hours.

This afternoon she was on the trach collar for about six hours. A blood sample was drawn just before she went back on the Bi-Pap to test for blood gas levels. As of this blog posting we have not heard the results. I suspect that the CO2 is going to be a bit high and the pH a bit low. Just before being put back on the Bi-Pap, Cathy was struggling to breath and was beginning to 'be a little hard to communicate with'. She is sleeping soundly now.

Oh So Close

Dr. Saggar (the brother) stopped by Cathy's room this afternoon. During his assessment he expressed concern about Cathy's increasing need to be on the Bi-Pap. He said there is still concern for an infection but this increased dependence may also be due to chronic rejection. Every time she has a mucous blockage, more rejection may be occurring. For the first time a doctor has vocalized what Cathy has felt for weeks now. The gravity of what he said was lost at that moment due to what he said next.....

....."During the past several days there have been at least three offers of lungs for Cathy".....

These offers had to be turned down because they were not satisfactory lungs. Dr. Saggar emphasized that it is very important for Cathy to eat and stay strong. We are close, oh so close.

Cathy has been on the trach collar for one hour at the time of this blog posting. She is enjoying another California Roll without having to disconnect herself from respiratory support. If we can round up a walker or wheelchair, we are going to attempt a cruise down the hallway this afternoon.

No Walk In The Park

The highlight of Cathy's day today was a visit from Jessica (fresh from her first ever, and fruitful, visit to the Chumash Casino).

Cathy has not regained enough strength to do much. It has been a couple weeks since she has been out of bed for anything other than 'personal chores'. She has told me that tomorrow she would like to try.

The Nomadic Patient

Cathy was transferred out of the fourth floor ICU and into the seventh floor medical observation unit this morning. This is her ninth 'address' since being admitted last June. One of these days she is bound to put down some roots.

Tonight she is very tired. I think the move, and all the commotion that goes along with it, kept her awake all day.

New Feeding Schedule

Cathy was incrementally better again today. She did have an episode of low blood sugars this morning. It seems that the IV insulin is to much during the day when the tube feedings are off and not quite enough when she is receiving the feedings at night. The doctors adjusted her feeding schedule. Cathy is now receiving tube feeding around the clock. [If you want numbers: 50 ml per hour of Osmolite at 1.5 calories per ml, providing Cathy with 1800 calories per day by the tube.]

Last night the California roll went over so well that we went for it again tonight. That's gotta be another 150 to 200 calories.

Cathy is still waiting for a room to open up on the 7th floor. We hear that several others in this ICU are also waiting.

California Roll

Cathy spent the entire day on the Bi-Pap. We have been told that the doctors have written an order to move Cathy back up to the 7th floor. They must believe she is improving.

Cathy's hunger was back again this evening. Once again the opportunity to eat and the desire to eat are not occurring simultaneously. However, Cathy has been on the Bi-Pap enough to know how to disconnect and reconnect herself. She has been doing this to take drinks of water (and pop). She will disconnect the Bi-Pap at the trach, take her drink, swallow, then reconnect the hose to the trach. If she doesn't disconnect herself from the Bi-Pap there is a chance that she could aspirate the drink down into her lungs. Of course all this is without the approval of the nurses. Tonight she wanted to attempt this with food. I fetched a California Roll from the cafeteria and tonight Cathy ate the soft inside portions (crab and avocado) of an entire California Roll (Ummmm sushi).

Cathy is more alert tonight compared to last night. Looking back over the past several days, I'd say today was a good day.

No Comfort Food

Cathy was put on the trach collar this morning. Unfortunately she was only able to tolerate it for about an hour and a half. No time to satisfy her hunger pains.


When she is awake, she is upbeat and responsive. However, all afternoon she has only been awake in 10 to 15 minute increments.


There is not much else to update this evening.

Let Her Eat Cake

After several days of even the thought of food making Cathy nauseous, tonight Cathy has a desire to eat, something, anything, she is hungry. Unfortunately, Cathy cannot eat while on the ventilator. The current plan is to have her on the ventilator until tomorrow. If her blood gasses are OK in the morning, she will be put on the trach collar. Then she can eat. Hopefully she will still want to eat.

This morning Cathy had an ultrasound-type of procedure on her heart. We're not sure what they were looking for and the results have not been discussed with us yet.

Overall Cathy is doing better than yesterday, and a whole-lot better than Saturday. Her friend, Dianna, stopped by for a little while this morning. Cathy has been awake for most of the day.

Yesterday I mentioned the differing opinions that the doctors have about whether or not Cathy has a pneumonia. Cathy has shared with me her own opinion and told me that it was OK if I shared this opinion with everyone. Cathy believes that her body has resumed the rejection of her lungs. She mentioned this feeling to the attending physician yesterday. The attending said that it is a possibility but did not think that there is active rejection occurring. The only way to tell for sure would be to perform a biopsy. This biopsy would be performed by going inside her lung with a bronchyscope and taking a tissue sample from an area without scar tissue. She felt there was to much risk for this procedure to be performed at this time. Cathy and I are fearful that this latest set back is rejection related. Cathy knows her body and knows how she felt during the active rejection in the past.

Opinions

The attending physicians in the ICU rotated today. The new attending physician for Cathy's care stopped by to introduce herself and discuss her plans for treatment. During her discussion she stated her opinion that Cathy has "a touch of pneumonia". She believes that there is an infection hiding out somewhere in Cathy's lung (possibly in the upper lobe of the right lung). She did not think this will effect Cathy status on the transplant list, that determination will be up to the pumonary team (transplant team).

Cathy was kept on the ventilator. The settings were changed to a 'pressure support only' mode. This mode is pretty much the same as the support given by the bi-pap.

Two units of blood have been ordered for Cathy. I kinda thought this was going to happen. They have been drawing a lot of blood the past few days.

Morning Greetings

As I approached Cathy's ICU room this morning the curtains were pulled back and I could see her sitting up in bed. When she saw me approaching I was greeted with a huge smile. The doctors and nurses didn't have to say anything, I knew, she is much better than last night.

Cathy was kept on the ventilator overnight. Her blood gasses and pH have returned to her baseline values. In an hour or so from now she will be taken off of the ventilator. The doctors are still discussing whether the change will be to the trach collar or to the Bi-Pap.

Cathy does have a fever this morning and her headaches are hitting her with a vengeance. Its not a perfect day, but we'll take it.......

Resting On A Ventilator

Just before 5 this afternoon, we were told that Cathy's room was ready on the 7th floor. When the nurse attempted to wake Cathy up to prep her for the move, Cathy was unresponsive. She would wake up and just give a blank stare. A quick test of Cathy's arterial blood gasses and it was determined that her CO2 was back up to a dangerous level (over 100). Cathy was briefly put on the Bi-Pap (she had been on the trach collar since 9 am). The ICU doctors felt that a ventilator would be a better approach to quickly reducing the CO2 (and increase her blood's pH). Cathy was switched to a ventilator. By 7:30 this evening she was responding to questions and breathing easier (with the assistance of the ventilator).

The bottom line for the day is that she is staying in the ICU for now.

Results

The resident from the 7th floor medical team stopped by Cathy's ICU room a little while ago. He too was initially unaware of the reasons for Cathy's move.

He finally gave us the results from the CatScan: No new pulmonary invasions were observed (interpret: this is GOOD news). He also stated that all cultures taken during the past three days have grown nothing, also good news. His assumptions about the cause for this latest set-back was that Cathy was beginning to develop another mucuous blockage. Cathy also needs to be on respiratory support for a few hours during the day as well as during the night to keep her CO2 levels down.

No pneumonia!!! If I wasn't so tired from being woken up in the middle of the night I'd dance a jig (and if I knew how).

When They Speak, Everyone Jumps

It was shortly after 4:30 am. From a sound sleep Cathy and I were woken by the sudden flash of all the lights in the room being turned on and a transport nurse declaring "Good morning Mrs. Two-O-Mala, we are taking you to the ICU". Then, noticing me waking up from the couch, he declares "Good Morning Mr. Two-O-Mala". (I had given up months ago explaining the family politics and have accepted the fact that while at UCLA I am Cathy's other half and go by her surname. And my apologies to Jessica and Matt, I also gave up on trying to give the correct pronunciation of the last name).

"We need to get her down to the ICU". There was a tremendous sense of urgency. My only thought was that some doctor must have finally received the CatScan results and set things in motion with an urgency that you do not normally see. "This must be bad" were my thoughts. They barely moved this fast during Cathy's code blue.

As the sleep cleared from my eyes and I was completing the shoving of personal items in a bag, I noticed a mess on the floor on the opposite side of Cathy's bed. The respiratory therapist was wiping the floor with a towel under one foot while he was preparing the Bi-Pap for transporting (multitasking). He looked at me and said "yeah, a ceiling tile fell last night, I don't know how you two slept through it". (We were both exhausted from zero sleep the previous night). At that time, looking up, I noticed a wet spot on another ceiling tile and a spot where a fresh tile had been placed. (Evidently I slept through the repair also).

Within a few minutes we were dashing through the corridor on the way to the elevator and the fourth floor ICU (Oh no! Not the fourth floor ICU!). When we arrived at the ICU, a nurse that we both recognized asked me to give her a few moments while she settles Cathy in. "No problem", I said, "I'll go get a cup of coffee". Duh, we've been here before, this hospital does not have coffee available before 7:30 am on weekends. So off I go to find one of my favorite quite spots and wait.

Returning to Cathy's new address, I found her sleeping soundly. This gave me a small amount of relief, at least Cathy wasn't becomming anxious over being sent to the ICU. I found a comfortable corner in an uncomfortable chair with the intention of grabbing the first doctor I saw and get some answers. The nurse came into the room to tend to a beeping IV pump. I thought I would try my best communication skills and get some information from her. "So, the CatScan was that bad", in as casual a voice as I could muster. Her response: "I don't know anything about a CatScan". Not giving up I continued with an explanation about how we were told that if they found something on the CatScan Cathy would be transferred to the ICU. With the urgency with which she was transfered they must have found something serious. "Oh, no", she replied, "she was transferred out of the room because facility maintenance needed to get into the room to repair the ceiling. She came to this ICU because we are familiar with her. After the repairs are completed she will go back to the same room".

I guess we now know who has the stick around here.... Facility Maintenance.

The Ivy Forest

We have not heard anything about the results from the CatScan, and Cathy has not been moved to an ICU. If there had been evidence of a pneumonia found in the CatScan, I believe Cathy would have been transferred to an ICU. We will have to wait until morning rounds to confirm or disprove my beliefs.

This evening Cathy is doing much better than last night. A few moments ago I got the biggest and brightest smile that I have seen in at least three days. Her breathing is also a little less labored than this afternoon. She is still very week. It is hard for her to get in and out of bed or even reposition herself in bed.

Another IV pole was brought into the room this afternoon. For now, this pole is fitted with two more pumps and IV medications. Cathy has been switched to 24 hour a day IV insulin along with the panel of antibiotics and anti fungal medications.

A Run Home And A Home Run

I had to leave the hospital for a few hours this morning (a plumbing emergency at home and a task at work that needed to be completed). When I returned a little while ago I walked into Cathy's room to find her sitting up in bed and watching the tube. Her struggles for each breath were still very obvious, but she was awake and alert.

A Cat Scan was performed this morning. I am sure that as soon as the doctors have these results they will let us know.

While I was out, Cathy's friend Denise M. stopped by with some potato pancakes. Cathy loves potato pancakes. Cathy actually managed to eat a few bites. This is the first food she has taken by mouth in several days. Thank you Denise, home run.

A Question

A little over an hour ago, Cathy briefly woke up and acknowledged me. She mouthed a few words - "why are you here?" - and went back to sleep.

Squeeze My Finger

The CO2 in Cathy's blood stabilized and came down a bit during the night. She is responding to commands but still is not communicating well. For now she is not going to the ICU. We are back to waiting on the results from the Cat scan for that decision.

I Cannot Think Of A Title

Cathy is once again retaining CO2 in her blood. Within the past hour she started to become non-responsive. A doctor from the ICU team was just in to perform an assessment and make a couple recommendations. The ICU team is ready to accept her tonight if that is the decision. Another blood gas test will be performed in an hour and a decision will likely be made after those results are available.

The P Word

Cathy had a very rough night. It sounds like the nurses and respiratory therapists were working on Cathy through most of the night to get her blood gasses lined out. Cathy is running a low grade fever again and the nausea is as bad as it has ever been.

I had a long conversation with the medical team attending physician this evening (the longest conversation that I've had with any doctor since Cathy was first admitted). Tonight there was no poker face. "There is a chance that Cathy has the beginnings of another pneumonia". My head is still spinning from hearing these words come from his mouth. I am trying to hold it together while I'm with Cathy. I can tell Cathy is trying to hold herself together also.

Tomorrow they are going to perform a CatScan (the X-rays do not provide enough detail). Cathy may also be transferred back to the ICU tomorrow. Several medications (antibiotics and anti fungal) are hanging from the IV pole this evening. We have not seen this many meds hanging from an IV pole since Cathy's first stay in the ICU. There is a sense of seriousness with anyone who walks into the room. The doctor said that they are not going to take any chances, they are going to act very aggressively.

Poker Night At UCLA

Shortly after I walked into Cathy's room this afternoon she began to have 'issues'. Besides an elevated blood pressure and pulse, she became very short of breath. After a thorough suctioning of her lungs, a dosage of a sedative, and a shot of grape juice, Cathy returned to 'normal'. It appears that this incident may have been triggered by low blood sugars.

For the past four years, whenever Cathy has been hospitalized she would acquire a form of 'transient diabetes' caused by the steroids they give her. Counter balancing the high blood sugars caused by the steroids is an event that occurs every four hours, around the clock. Until yesterday, this hospital visit had not been any different. Yesterday Cathy began experiencing low blood sugars. Something has shifted in her metabolism to cause her body to react differently to the steroids and insulin she is receiving. [Now what? More over-steering?] The attending physician on the medical team stopped by for a brief moment this evening. He did not appear to concerned. (These attending physicians would all make pretty good poker players. They have no tells. It is easy to read concern, and sometimes panic, in the residents. The fellows are a bit harder to read. It must be a prerequisite to becoming an attending - the poker face.)

Day 101

You are receiving today's update second hand. Becky and Jessica were heading down to visit with their mother this evening so I decided to stay home and catch up on some chores (like 101 days of mail, thank God for on-line bill paying).

Becky & Jessica tell me that their mother is doing good this evening. Cathy spent most of today on respiratory support. This evening she is on the trach collar so she can eat some food. However, that task is not going so well as she is dealing with nausea again today.

One-hundred and one days in the hospital....... It seems like we should be hearing bands playing and cannons sounding. It is quite a milestone no matter how you measure it. For me it has been one hundred more days that I had with Cathy that I did not think I would have one-hundred and one days ago.

I'm A Believer

The doctors had Cathy on the Bi-Pap all day. They let her go on the trach collar for a couple hours so she can eat. Her friend, Denise M. from Palm Desert, stopped by to visit and brought in some 'deli' food.

After spending the extra time on respiratory support, the effects are very apparent: much more energy. I think Cathy is becoming a believer. She has already told me that she wants to go back on the Bi-Pap tonight.

There's rest, Then There's Rest

Cathy has spent most of the day sleeping. I think she needs to rest on the Bi-Pap tonight. (My opinion not the doctor's, and definitely not Cathy's). Over the past couple days her energy level appears to be slipping again. Cathy doesn't like the Bi-Pap because it is uncomfortable when she is first put on it, and uncomfortable to breathe again on her own when taken back off. She also sees going on the Bi-Pap as a step backwards.

Cathy's temperature was normal today, no low grade fever. We will take that as the Up for the day.

My Heart Will Go On

Cathy spent a pleasant day visiting with Jessica. This evening the three of us are just kickin' it watching Titanic (It seems like that movie is always on).

Cathy began running a low grade fever again yesterday evening. Tonight her temperature is still a bit elevated (~99.4). Samples of bodily fluids (and some things not so fluid) were taken for cultures. Now we wait... again....

Just One Of Those Days

Once again, there isn't much to update about this evening. Cathy's nausea was a bit better today and her headaches were a bit worse (or maybe a lot worse). No physical therapy, I will see if I can't get her to take a stroll along the promanade with me tomorrow.

Outwit, Outlast, Outplay And Survive

Cathy was rested on the Bi-Pap again last night. As a result, tonight she has enough energy to stay up and watch survivor with me. (The survivors on the TV show have nothing on the survivor sitting next to me tonight).

Today was another day focused on headaches and nausea. I did not get here in time this evening to bring Cathy something from the cafeteria. I may run out and grab her a snack in a bit, after tribal council. (I will be spending the night here tonight).

Night And Day

Last night the doctor did not give Cathy the option to stay off of the Bi-Pap. Cathy was put on respiratory support for several hours to rest her lungs. As a result, when I walked into Cathy's room this afternoon she was refreshed and awake. Yesterday afternoon, Cathy was awake in ten to twenty minute spurts. Tonight she did not even start to dose off until after 7 pm.

The nausea was bothering her less today also. Tonight I brought Cathy a serving of penne pasta with lots of butter and parmesan cheese. She eat almost the entire serving.

Cathy's energy level was back up to where she was able to walk around the unit with the physical therapist again today. The difference between yesterday and today is like night and day.

A PICC line was placed in Cathy's left arm today. She had a PICC line back in July/August, but it was taken out to eliminate a possible source of infection. I guess the risk of infection has been trumped by the need to continually replace Cathy's IV. Cathy is a 'hard stick' when it comes to putting in IV's and drawing blood. Also, her IV's never last as long as the doctors and nurses would like them to: they 'blow-out". The PICC line is similar to an IV. It enters a vein (or maybe its an artery) just below her left bicep. The catheter runs inside the vein, up the arm into a main vein (or artery, I'm crappy at biology) at her neck. The catheter extends down this main vein to a point close to her heart. This PICC line can be left in for extended periods of time (several weeks or a few months). It can be used to introduce medications and to draw blood samples. This will mean a lot less needle sticks for Cathy, and a lot less bruises from all the needle sticks.