Friday, September 25, 2015 Perry was reported to have slept throughout the night. He underwent dialysis from 730a-1130a. Additional decreases in the dosages of some of his medications were requested as he has continued to be extremely tired. The nephrologist anticipates that perhaps his next dialysis session may be Monday or Tuesday. I informed Dr. Lane (Pulmonary transplant) about Perry's colonoscopy done last October in which found polyp not having been removed for biopsy in the event that the ongoing abdominal distension & other GI signs & symptoms are related. During his OT session, he was transferred by Kim & Rob into the chair. Shortly afterward, he became nauseated & received Zofran. Leg exercises were completed with Rob & arm/hand reaching exercises were completed with Kim. He was then returned to bed & fell asleep almost immediately. The intensivist, Dr. Dar no longer wanted Perry to be trach suctioned by an inline method by the nursing staff, so special catheters were utilized to suction him only by the Respiratory Therapist. Another Metabolic Cart was ordered to be done; however due to few staff being trained to do them & the need for his feedings etc to be stable for at least 12-24 hours, it will not be done today. He remained very tired throughout the entire day with frequent long naps taken. His night shift RN, Dan, was floated from another ICU to the CVICU due to a low census. Perry was sound asleep at my departure ~10p. I am hoping Perry will be able to be alert during the weekend as he has been anxious for a planned visit with his father Sam, Char, Nick & Tonya. I've asked for special permission to be granted if at all possible for more than 2 visitors at a time as it will be very difficult for Perry to communicate without the help of some of my lip reading skills.