Todd RN's AM report was that Perry slept for a good solid 7 hr stretch without budging & his twitching had calmed. He had a hard day today (Saturday) related to continuous total body jerking twitches which lasted all day long without a Neurology consult again today. Nausea with dry heaves @ 115p medicated with Zofran IV without relief & then a dose of Reglan IV which was later effective with return to bed, warm blankets & a nap. Another KUB X-ray was repeated with his stomach appearing of more normal shape & less air than previous KUB. Intermittent bladder spasms most likely related to the continuous abdominal twitching. Frequent back pain due to his rheumatoid arthritis, positioning, & of course aggravated by the body twitching & jerks. Needless to say he was frustrated & annoyed without getting any relief from the twitching. He has been very down & showing no interest or desire to watch the Cubs, the Bears, listen to his favorite music or watching his favorite TV shows or movies for a few days. He answered 1985 for the year several times this evening & at times repeating the same phrases, but I feel such are related to ICU environment & alarm/noise pollution & motor/sensory overstimulation. He is as able to follow commands & his basic neuro assessment is otherwise fine. Ryan arrived @ ~9p which brought a smile. RT assisted him to talk with cuff deflation. He was able to talk for the longest time so far. He said "Nobody else until" repeatedly. He was requesting that nobody else visit until he is able to talk. From ~930p-midnight he had another initial bout of nausea followed by intermittent dry heaves & inability to get comfortable. He was given IV anti-nausea medication, & with continued discomfort the ICU anesthesia Dr. consulted. Eventually Perry was able to describe his discomfort as that of a gag feeling & most likely referred shoulder pain from irritation of the diaphragm. The Dr. ordered for a medication spray to numb the back of his throat to alleviate the gag sensation. With encouragement & exhaustion, Perry relaxed was repositioned, & warm blankets applied & began to drift off to sleep.