Indu RN's morning call indicated Perry slept for only a couple of hours in spurts throughout the night otherwise uneventful. This morning he completed 30 minutes of trach collar breathing on 35% oxygen. Bill RT held off on CPAP today to conserve Perry's energy. He had planned to repeat trach collar breathing later in the day but that did not happen as Perry's body needed rest. His heart rate which has been in the 100's for a couple of days was back in the 80's-low 90's today. I am very excited to share today's good news - his stool culture came back negative for C. difficile!!!! A sample was sent late this afternoon for a guaiac fecal occult blood test - results still pending when I left. His feeding was once again stopped early this morning to rest his gut as he has continued to have liquid stools & his abdomen was once again distended to ~10 months pregnant size. The Drs all agree that for now that since he is in need of fuel, he should be started on Total Parenteral Nutrition (TPN) which is nourishment by IV. Prior to his jejunostomy, they did NOT want to start TPN because it is very high in glucose (sugar) & the IV solution would be a great breeding source for yeast & thus another systemic yeast infection which could be fatal. Since today was day #35 of IV anti-fungal (anti-yeast) medication, they feel the TPN is safe to give temporarily. TPN started @ 10p. Another unit of blood was also given this evening for low hemoglobin & hematocrit. He aroused only twice today while I was there but kept his eyes closed each time with ~45 minute episodes of extreme squirming & attempts to remove the most "undesirable" of catheters. It was difficult for 3 of us to keep him contained in the chair & the bed. The culprits: a terrible rash related to acidic liquid stool seepage despite the fecal management system (FMS) & of course the FMS itself. With cleansing, ointment, air exposure, IV Benadryl, & time, he eventually settled down. Although so hard to see him in such discomfort, it was a good thing as he was able to turn himself side to side, strengthen his core muscles, lift his legs, push & pull against us with a great show of strength. Neurology did not consult today which was also perhaps a good thing as the jerks/twitches subside when sleeping.