Progression

After being observed throughout the night it was discovered that Jerry was not sleeping so the last couple of nights he's been receiving a medication to help him sleep. I think the sleep has helped his brain rest, he seems to be more alert and more responsive now that he's had some rest. This morning at 6:30 we had a bit of a scare his trach tube became clogged, his oxygen dropped to 0 and heart rate dropped to 40, his face was white as a ghost, the nurse ran for help and about 5 people came rushing in. Someone began bagging him as a couple others quickly worked to change the tube. The emergency start to finish only lasted maybe 2 minutes but felt like forever. Once the tube was changed all his vitals returned to normal fairly quickly.

Jerry was supposed to have the PEG tube procedure done yesterday however I was able to get it postponed to Monday which gives me until Wednesday to try and get him into Valley Med. Valley Med is reconsidering but is requiring more information, they need a Physical Therapist evaluation among other things. The PT was so wonderful and helpful, she stayed after hours to do a last minute eval and report. I'm hoping that by late Monday early Tuesday we will know if he's been accepted into VM. I did find another facility that looks phenomenal in Roseville, the case manager is also submitting all the requirements to try and get him in there as a back up should VM deny the case. I had some issues with the case manager on how he was handling some things, I was upset that he took it upon himself without my consent to submit to the facility in Marin, even after I told him I didn't want Jerry there. I've spoken with another family member who has a loved one in the ICU and she also had problems with the case manager. Apparently he has only been here a short time, I requested a meeting with the case manager and someone new showed up. Interestingly the person I was working with is no longer employed here, he resigned. The new case worker seems great, she's really advocating to get Jer to VM and got on it right away to submit to Roseville as a back up plan.

Jerry is even more responsive today then yesterday, it seems as if parts of his brain may be reconnecting. You can get him to nod his head yes or no if you ask him to but oddly enough he won't use that skill to answer questions. He's now following commands pretty consistently and seems to have some understanding. When asked he will lift his head, open and close his mouth for thermometer, stick out his tongue, try and move his arm, nod his head yes or no. It also seems that Jerry is trying to mouth words, he does not form the words completely so it's hard to try and read his lips. A speech therapist came to insert a special valve on Jerry's trach tube which would allow him to talk. There is a cuff in the trachea that blocks the air way so that air does not flow up out the mouth and nose, it will only flow through the trach tube. When the talk valve is put on the cuff is deflated so air can circulate around it. When he breaths in the air comes through the valve in the trach tube, when he breaths out the valve closes and the air has to get around the cuff and out the mouth which allows the air to pass the vocal cords to make a voice. Jerry did not tolerate the valve well, his respiratory rate accelerated fairly quickly. It was to much work for him to try and push the air around all the obstructions in the trachea. Maybe tomorrow he will tolerate it better.

Since Jerry seems so much more responsive and aware today I had an idea that maybe he would remember how to use his computer and could possible communicate by typing. I had Janea bring his computer and chin mouse to test if he would remember what to do with it. I didn't have much luck getting him to use it, it's to soon, maybe tomorrow he will remember how to use it ...we'll try again.

Happy mothers day to all you moms including my own :)

Katie