Wednesday, September 23, 2015 I remained on vigil during the night beside Perry taking a few brief winks. He did well throughout the remainder of the night & early morning arousable from a deep sleep with much effort but responsive, oriented to self, person, place, month & @ times the correct year (it’s either 1985 or 2015 - the year varies but that's not unusual for him for all that he has been through. He was able to follow commands & his neuro exam essentially normal except for myoclonus. Alistair Begg had contacted Dr. Lars Svensson who came to meet & greet Perry @ ~645a. How wonderful is that? God is good!!! My dear neighbor sent me a picture & text @ 0724 that brought smiles & much laughter. Refer to the picture of my furry baby boy. I’m so glad that Karen is nothing like Miss Gulch from the Wizard of Oz. “Wrigley found his way into my garden this am and came out with a piece of the fence around his neck! He just stood still on the patio waiting to be rescued with the "busted" look on his face! Too cute! Hope today is a good day!💛💛” A Neurology physician consulted this AM relative to last night’s mental status change. I provided her with additional information that she had not been made aware of pertaining to his previous EEG’s & those related mental status changes. She was pleased with his neuro exam. Dr. Koval from Infectious Disease came to see Perry & informed me that there was a variation on Perry’s brain CT scan in area behind his eye but that it may be artifact, or a variation that may be a part of his make-up, or something that may be of concern. She felt much more confident after having seen him & completed a neuro exam but is going to ask the dayshift radiologist to review the CT scan as well. She suggested an MRI but Perry has metal in his foot so not sure yet if they will need to proceed with another diagnostic or not. No other Drs came to tell me anything since the morning. While I was gone to get something to eat, I listened to a pianist & flutist perform a few songs from the Sound of Music, & special requests “Twinkle, Twinkle Little Star” & “Can You Feel the Love Tonight” for a little child in a wagon who was a patient which melted my heart. Upon my return, Perry told me “4 doctors came by & told me they were worried about my brain.” He did not recall last night's episode. His nurse Rachel was busy with another patient. He's supposed to have another video surveillance EEG but it was not entered as a STAT so she didn't know when it was going to be done. We had 2 afternoon visits. Ally who is a newly employed Physician’s Assistant for ENT here & girlfriend of Matt who is Ryan’s friend from early childhood & a dentist at the Cleveland Clinic. She is a sweetheart & brought me a pasta salad. I received a call this morning from Lois who is the nurse from Alistair Begg’s congregation, & we planned an afternoon visit depending on how the day progressed, so we were able to have a meet. She was delightful, & she & I have much in common. Once again a welcomed blessing. Perry was extremely tired, napped intermittently but was responsive to stimuli & commands. He's not producing much urine today only about 10-20 cc/hr (30+ cc/hr is what kidneys are supposed to be putting out) but since he had only 300 cc formula (Tuesday) & 720 cc formula (Monday) instead of the 1440 cc, he's dehydrated & after dialysis that his kidney output drops, so not too concerning. Perry had asked me to stay tonight so here is where I will stay for tonight. I will bring a change of clothes to have on hand in the future. Unfortunately I had fallen asleep for probably 20 minutes & awakened just as Perry was being given Oxycodone 10 mg for pain ~710p. I told the nurse that he hadn't complained to me earlier about having any pain, so when I asked him if he was having pain he looked at me with that oh so dumbfounded look 😳 (not the right emoji as the eyes should be crossed & appear as a ridiculously stupid Jerry Lewis or Jim Carey facial expression) & he mouthed "I need the bedpan." Almost immediately Perry was out for the count. I learned that he had been getting Oxycodone & Fentanyl for pain on recent nights, & since he's not had any sort of pain indication all throughout the day except when he's had to wait for the lift team I'm wondering if he's been saying "bedpan" & it's been interpreted incorrectly as "pain" - that I cannot say for certain but it is suspicious since he’s not reported any pain issues to me. Nurses are also supposed to ask how you rate your pain on a 1-10 scale & where are you having pain, so I would think that if he had been asked he would have given them that same dumbfounded look. He was able to only slightly move his head, raise his eyebrows, or very slightly wiggle his toes during his neuro assessments. Needless to say, I didn’t get much sleep.