Brief update... Since last weekend, Perry has been experiencing R sided flank pain & an increase in oral & trach secretions which is how he typically presents with the start of a developing pneumonia. He has regressed at times to using hand signals instead of mouthing words & was not able to do trach collar trials on Tuesday, Wednesday & completed one 40 minute trial on Thursday & a 33 minute trial today. Trach secretion cultures were taken on Tuesday & Wednesday both of which were rejected & another specimen sent to lab again on Thursday early AM which the preliminary results back today indicated gram positive organisms which are frequently the sources of pneumonia & septicemia. He of course has been sleeping quite a bit for the last several days & very restless & not able to get comfortable on several nights. A bronchoscopy was done at 1230p today with thick & thin cloudy & opaque white mucous returns with a sample sent for cultures as well. IV "heavy gun"antibiotics, Vancomycin & Zosyn were started today. He is to have a repeat bronchoscopy on Monday & insertion of a different trach tube that has a sub-epiglottic suction port to allow for suctioning of his secretions that sit above his trach cuff. I have repeatedly stated over & over & over again to nurses, RTs & physicians how much mucous he collects at the back of his throat (pre-transplant) & as a result a huge abundance sits on top of his trach cuff so with his trach continuing to leak air & gurgles there has been mucous seepage into his lungs increasing his risk for infection. Pre-transplant it would literally take hours for him to just break up the mucous collection in the morning & then all day long as well. FINALLY.... the trach tube was specially ordered & arrived yesterday & I was informed that the trach would be changed yesterday. Today, I was informed that the physician who needs to place it, is out of town until Monday. According to their policy, the physician who places the original trach has to be the one who changes out the trach. Although a different physician, Dr. Dale Marsh, did his first trach change on 10/07 & another physician changed out his trach on 11/13 during a bronchoscopy.
He did walk this morning with assist & the EVA walker for a distance of ~80 feet today into the J5-6 CVICU.
Sam is doing well after having a TAVER aortic valve repair procedure (groin access instead of having to crack his chest) on Wednesday & so very thankful. My sister is on a train coming from DC, so I will be picking her up ~240a.