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September 10, 2015 - We Need to "Tackle" The Problem Maybe With Some Hail Marys

According to Chad RN’s morning call , Perry slept fairly decent during the night with fidgeting on occasion for which he received medication to calm him. His WBC count was @ 8 & a 6 yesterday. Hydralazine IV was given to lower his BP. Soft restraints remained on throughout the night. His day shift RN, Hannah, informed me that Perry had squeezed her hand & briefly opened his eyes during her early AM assessment. The last Blake chest tube was removed with a scant to a moderate amount of serous drainage seeping from the site. She removed his leg soft restraints as he had remained quiet. Upon my arrival, he was starting to have a scant amount of clear bloody drainage from his NG tube & a ~250 mL combination of green bile & coffee ground gastric secretions were in the suction cannister. He remains on TPN IV @ 65 mL/hr & formula via jejunostomy @ 20 mL/hr for nutrition. Since I was with him & he had remained still, his arm soft restraints were able to come off. He did not open his eyes or squeeze my hands per command today. I did however feel slight increased tone kick in for a few seconds as I provided passive range of motion during shoulder exercises. His urine output has been of a decent amount & pale light yellow with IV Lasix being administered. He was taken for a brain, abdominal & pelvic CT scan @ 2p. It was his first time out of the CVICU since 8/5. Hannah RN informed me that when the plate was placed beneath him for the CT he suddenly opened both of his eyes wide & was a little jittery for a short bit. RT informed me that another Metabolic Cart has been ordered, & he will be completing that tomorrow to determine his nutritional needs based on his energy requirements. He has not had any breathing challenges while he has remained in this state. At 4p, Perry did briefly squeeze Hannah’s hands & very subtly moved his feet per command while keeping his eyes closed. He briefly raised his L arm upward & back down otherwise he had remained asleep without movement until ~620p. From 620p until ~7p, Perry began attempts to move purposefully & frequently from side to side & arching backward when on his back with facial redness & facial strain as if he were crying with writhing pain. He drew his arm/hand to his forehead several times as he does when he tries to self-comfort long before transplant. He received Vicodin & Dr. Adi (Intensivist) was at his bedside witnessing part of his discomfort after Hannah had paged him to come. I provided Dr. Adi with an update of the significant changes in Perry's condition since last Friday & his complete lack of interest in music, favorite TV programs & movies, the Cubbies, etc. He ordered a dose of IV Fentanyl without much relief & then Propofol to relieve the discomfort & sedate him @ which immediately took effect. No gallstones or kidney stones were seen on the previous CT scan. Dr. Adi is also going to order a psych consult relative to the signs of depression which Perry had been exhibiting prior to this change in mental status as it is not unusual for ICU depression/psychosis to occur after such a long stay & as we've come too far for Perry to give up. I am thankful that Dr. Adi listens & is pro-active for a more favorable outcome. Please continue prayers that the causes of these changes & discomforts can be identified & overcome. And that God, Jesus, & the Holy Spirit heal, protect, guard, guide, comfort & uplift this man named Perry Joseph Paul DiGiovanni!!!!!! And that they continue to show the doctors & nurses the Way as they try to figure out how to best care for this man we all dearly love!!!! Are you ready for some Football🏈???!!!???!!!! Come on TEAM PERRY!!!!!!

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Comments (2)

  • Joni DeBusk
    Joni DeBusk

    Perry sure married the "right" woman, a nurse. I doubt a secretary wife would not be able to understand nor explain Perry's problems to a doctor and get them to LISTEN. Thankful that Dr. Adi is going to be pro-active and hopefully bring some comfort to Perry and he can settle down and get on with recovery. E-Hugs coming your way. Lots of prayers being lifted. Love, Joni & Ken

    3 years ago · Reply
  • PEPE DIGIOVANNI
    PEPE DIGIOVANNI

    Let's go PERRY we need you to keep it going. We love you we will keep praying PEPE

    3 years ago · Reply

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