Chad RN's night shift report was that Perry had remained unresponsive to commands & that he slept fairly decent with a few fidgety/feisty episodes for which soft restraints were applied for his safety & further sedated. He had dialysis this morning as his BUN (blood urea nitrogen) had significantly increased. His WBC count remained @ 8. His formula rate was increased to 40 mL/hr & IV TPN remained @ 65 mL/hr. Propofol 12.2 mL/hr (30 mcg/kg/min). Nothing of concern on the CT of his brain, abdomen & pelvis was relayed to me. He remained unresponsive to verbal commands throughout the day. It was decided that perhaps the Baclofen given for the myoclonus (spasticity twitching/jerking movements) may be contributing to his change in mental status, so this evening it was ordered to discontinue the Baclofen & discontinue the Propofol, increase Klonopin from 0.5 mg to 1 mg twice a day, continue Keppra 750 mg twice a day, start IV Valproate sodium 1000 mg (Depacon) & then give Depakote 500 mg twice a day. Around 5p, Perry began to have another fidgety/feisty episode during which he attempted to pull out his trach becoming disconnected from the vent so soft restraints had to be applied. He continued to be in nearly constant side to back to side motion with discomfort & agitation, drawing his legs up frequently as well as placing them over the side of the bed, pushing me away several times all the while remaining non-responsive to verbal commands & keeping his eyes closed. Despite soft restraints, his continuous movements & exhibited strength to pull away & push back led to several attempts to remove his trach, NG, & other catheters. As a result, the Propofol was continued with the need for a couple of boluses until Perry eventually settled down around 1030p. He ended up with Propofol getting bumped up to 16.2 mL/hr = 40 mcg/kg/min until he was finally out for the count with the loss of the NG tube in what seemed a good 15 round fight. After all, he is my Italian Stallion!!! Lots of things were on my mind & heart throughout 09/11/2015 - our need for God to be at the center of each of our lives, Perry of course, myself, our sons & future daughter-in-law(s) & hopefully someday grandchildren that will need Perry in their lives, Perry's parents & brothers & their families, my parents who celebrated their 58th wedding anniversary, the victims & their families & friends of 09/11/2001, the service men & women of the USA of past, present & future as well as their families & friends, Perry's donor & his family & friends, our families & friends, Perry's physicians & nursing & ancillary staff, my patient & her family & friends, the many patients & families & friends who have come & gone over the last 47 days in the CVICU, the patient & family & friends for whom the Purple Heart was displayed in the ICU, the many friends & acquaintances that I have made on J-82 & in J5-5 CVICU, & the dear lady I'd been trying to get to come stay with me during the last 2 weeks whose husband returned back to the ICU this evening after having coded & helping to console her as she contacted their sons to tell them that the "Good Lord didn't take him today!!!"