Nathan RN reported that Perry awakened about 2a & was up for a couple of hours otherwise an uneventful night. Matt & Ally came for a visit (friends of Ryan who both work at the Cleveland Clinic). Matt called to tell me that Perry (Mr. D) missed me & wanted me there. Upon my arrival, I was greeted with a lasagna & Italian cookies by these 2 sweethearts. Perry was up in the chair upon my arrival & tolerated being up for ~3 1/2 hours with the eventual arrival of the lift team. With it being the weekend, there was no scheduled OT or PT so I provided his exercises throughout the day. The RT who had him during day shift was not an RT that I was familiar with caring for Perry. He wanted to have Perry trial the Passy Muir. Upon the trach cuff deflation, Perry almost immediately struggled with ridding secretions and may have aspirated as he began to mouth "I can't breath," suddenly became hot & diaphoretic (sweaty) & purplish redness to his face with facial vein protrusion, & decreasing oxygen saturations to the lowest of 70% - so I immediately requested back up. With additional trach suction, oral suction & the resumption of oxygen via vent, his saturations improved to the 90s & back up to 100%. Throughout the next several hours, Perry had frequent coughing with intermittent difficulty as he coughed & required more frequent trach & oral suction. Not wanting to have to wait any longer to be sat up at the edge of his bed, Perry began edging his way to dangle his feet over the side of the bed @ 415p & pushing the call button for the nurse. He is not at all happy when I reinforce that he must be assisted by staff for safety reasons & when I have to confine him & halt his movement as he waits for staff to arrive. He was assisted to sit at the edge of his bed by Rachael RN & myself for ~25 minutes at 430p which he tolerated remarkably well with occasional body tremors & twitches. He was able to take a nap before Michael & Kim arrived. After napping, he asked Sebastian RT to allow him to try trach collar breathing which he was only able to tolerate for about 7-10 minutes before he began to struggle with his breathing, becoming pale & again diaphoretic with facial forehead vein protrusion. Matt RT responded with quick assistance to convert him back to CPAP with a return to baseline. Michael & Kim arrived @ ~6p. They were happy to see changes in his outward appearance & color. They visited until ~9p before he was settled in for evening & ready to get some much needed rest.