The night went much better with a fairly substantial decrease in the frequency of stool leakage around the FMS although extremely watery stools continued to pass through the FMS. He was able to sleep intermittently as the nightly routines do not cease - vitals, medications, blood sugar checks, turning, blood draws from his trialysis catheter. Perry awakened feeling wetness to his back @ 530a. The Lopez port valve of his jejunostomy feeding tube had completely dislodged & formula was saturating his back, bed linens, & the floor. Needless to say, he received an early morning bath.
Jay was his assigned day shift RN & Bill was his RT. Dr. Akindepe, Pulmonologist, rounded at 930a. Perry's hemoglobin had dropped to 6.9 with hematocrit of 20, so today's plan was to give a unit of packed red blood cells. He will recommend that routine labs be drawn less frequently - if possible 3 times a week instead of daily to limit depleting his blood levels even more as several tubes are taken daily. Is to have another bronchoscopy tomorrow. We watched the Macy’s Day Parade.
The Endocrine Fellow & Attending physicians rounded & informed Perry that his TSH (thyroid stimulating hormone) level is still high, so they will increase the Synthroid from 25 mcg to 50 mcg daily & also have a free T4 & thyroid antibodies drawn. At present, there is possibility that Perry has hypothyroidism due to Hashimoto’s Disease which is also known as chronic lymphocytic thyroiditis. Hashimoto’s Disease is an autoimmune disease in which the immune system attacks the thyroid gland often leading to an underactive (hypoactive) thyroid gland. http://www.niddk.nih.gov/health-information/health-topics/endocrine/hashimotos-disease/Pages/fact-sheet.aspx
Dr. Yared, Intensivist, rounded & his dialysis schedule will now become Mondays, Wednesday, & Fridays. He is pleased Perry’s abdominal distention has continued to decrease & if Perry continues to tolerate it, will increase his tube feeding hourly rate if tolerated & continue with the fiber supplement.
A previous heart transplant recipient’s family provided other visiting families in the J5 CVICUs with 2 turkeys, mashed potatoes & gravy, dressing, pop, & chocolate chip cookies which was so very nice. They wanted to do something to make the holiday special this year as their loved one had his transplant 1 year ago, & they wanted to give back. It was thankful for it as well today.
The remainder of the day included CPAP for ~4 hours. Ryan arrived @ 435p which brought a smile to Perry’s face. Ryan was able to join Matt & Ally for a nice Thanksgiving meal as Perry wanted him to attend. Jenn RN took over Perry’s care for the evening as did Marianne RT. Todd RN of course had to come tease Perry about the Bears saying “The Bears are winning, oh wait a minute the game hasn’t started yet.” (Bears vs Green Bay Packers)
Ryan brought back 2 to go containers shared by Matt & Ally filled with delicious turkey & traditional dishes & a caramel apple with pecans. Ryan then relieved me to go to the Transplant House, eat the shared Thanksgiving meal, shower, & then return. Perry & Ryan got to watch part of the Bears game together with Perry napping intermittently & then awakening to see the final few seconds upon my arrival with Da Bears coming out with a victory.
We had lots to be so very thankful for today despite being away from our home & family - the gift of life, love, family, friends, faith, hope, memories of loved ones no longer with us, food, & many, many countless blessings including having fewer issues related to leakage around the FMS as the day progressed which allowed for less pain & discomfort, less skin breakdown, & more restful sleep. Text messages, pictures, phone calls, video messages, & FaceTime. And even getting to anticipate a fall tradition of the Ingram/Barker side, popcorn balls, made at the Witt Family gathering.
Thank you God for everything!!!! Amen