When Misty arrived this morning around 9:30 AM, the pulmonary team was gathered outside his room developing their plan for the day. Perry was very awake, bathed & had his hair washed (1st time since surgery) by the time Misty arrived. After deliberation, Dr. Akindipe came in & held Perry's hand as he revealed what was discussed & the plan for the immediate future. Today, the goal was to do some light physical therapy to begin rebuilding strength, get out of bed & sit up in a chair for awhile, take some time off of the vent (did about 2 hours unassisted) and tomorrow he will go to the Bronchoscopy Suite to assess the anastomoses sites (where the lungs were connected), check secretions & also to assess how his diaphragm is functioning as sometimes the nerves that control the diaphragm can become damaged with the surgery. Everything went according to plan & then some. Dr. Ajit Moghekar completed an ultrasound of the diaphragms with news shared that neither of Perry's diaphragms are presently working so therefore the difficulty with tolerating extubation.
He was apprehensive/nervous being taken off the major drugs Propofol & Fentanyl before going into the chair. He really has not had much complaint about pain other than back pain from being bedridden & is receiving crushed/dissolved meds via NG tube as needed now. His creatinine levels continue to decrease and was down to 1.58 earlier today, so that's a plus.
The staff are doing better talking "to" him & not "over" him as they are accustomed to patients who are not awake or able to respond as well as Perry. The physical therapists (PT) came and got him up into the chair & struck his best Godfather pose (see photo). The male therapist asked if he should send people in to ask him for favors & Perry gestured "send them to me" kind of gesture which brought smiles to all. It took a lot of Perry's energy to move up and down from the bed to the chair and back, and on his first stance from bed to chair he drained a lot of blood out of one of the chest tubes (thank goodness it was older darker blood) so there was a "huge" shift in pressure within his chest cavity... things did stabilize & his organs adapted with the shift in time.
Later in the day, a Nurse Practitioner stopped by and added a PICC line (special IV access that is for long term use placed in the arm for blood draws, IV meds) so they plan to pull out the Swan Ganz, arm arterial line and other lines in his neck sometime tomorrow after the bronchoscopy if all goes well and they are no longer needed. He is anxious to get all of those out and continues asking when that will take place so that he may be a bit more comfortable.
We are doing a little better with his mouthing words/sentences & using a white board or pointing at letters when he needs to tell us something. Perry says he needs Michael as he is able to read his lips best, so Michael has been by his side a bit more helping to communicate for Perry and lessen his frustrations of not being understood. Ryan was also doing well with deciphering Perry's non-verbal communication before he departed, and he is now on his way back to Cleveland so his boys will be able to team up and help with this tremendously. As he gains strength, stamina & more dexterity, he'll be able to use his computer to communicate easier.
It was another long day filled with a lot of work and new milestones, so Perry was ready to go to sleep right after watching the Cubs pull out another win (6-0 now post transplant!) on the iPad with Michael and Kim. He is a bit nervous for the results of tomorrow's bronchoscopy so please continue whatever it is you all have been doing to help us get to this point!
Thank you all!