Chad RN's morning report indicated a restless night partially due to diarrhea every hour & toward later morning 3 times/hour. As a result, a culture for Clostridium difficile (C. diff) was taken. Prolonged use of antibiotics increases the risk of acquiring this disease which causes inflammation of the colon. Antibiotics can destroy healthy bacteria normally found in the gut that are there to protect us against infection. C. difficile spores can then flourish in feces. Surfaces contaminated by feces can then transmit the infection. Healthcare workers can also spread the bacteria to other patients or contaminate surfaces via hand contact. Due to his already decreased auto-immune system related to his Rheumatoid Arthritis & all of the anti-rejection medications that lower his immune system even further, please pray that he dodges this potential risk. A temporary fecal management system (liquid stool containment device) was placed this morning to help lessen the need to be cleaned rather continuously, prevent skin breakdown, lessen the spread of infection, conserve his energy & increase his ability to get rest. His formula feeding which had been held since Friday night was resumed this AM at 20 mL/hr (previously @ 65 mL/hr). He was started on Baclofen 10 mg this AM for the myoclonus (continuous total body jerking & twitches) & Neurology is to see him tomorrow. He slept almost the entire day today. When he's awake the twitches/jerks are present & a significant increase occurs with frustration as well. Since his tongue is also affected with tremors, it makes trying to figure out what he's trying to communicate that much more difficult which then leads to a vicious & exhausting cycle. Rheumatology Dr. was in this morning & she will start him back on medication, Plaquenil if he begins to have inflamed & painful joints. She does not want to resume him on the medication Arava due to the risks outweighing the benefits. Many of the anti-rejection medications will help treat his Rheumatoid Arthritis. No PT by Dean today as he was called out to complete a discharge. Perry was able to tolerate 30 minutes on trach collar @ noon. He was started on dialysis @ 1650 for 3 hrs & continued to sleep through most of the treatment. He was settled in for the night & starting to sleep soundly by 9p. It was a definite Labor Day for him & me during his awakened states. Hoping everyone was able to enjoy the holiday & got a day of rest & relaxation.