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Dad made his first real attempt to get out of the hospital today. The hospital is still standing, nobody got seriously injured, and Dad is resting comfortably with medication now, so it all worked out OK. I consider this a good day as it really shows Dad's getting stronger, his voice is getting better and he realizes what is happening. He is also drinking water from a cup now, which means his swallowing is better. Please pray that Dad allows the doctors and nurses to do what is needed to get him better and that he continues to progress as well as he has.

The where supposed to have moved Dad to a rehab facility yesterday, but it got postponed. Because he has a contagious infection, the facilities would not take him. The infectious disease doctor saw him yesterday afternoon and said that he should be good to move on Monday or Tuesday. It appears that he will be going to The Palace in Red Boiling Springs, TN. It is a 3 star facility and was highly recommended by his case worker. We have been unable to find a place for him closer to Nashville or in the Memphis area. By all reports he is doing very well. His speech is improving everyday and his short term memory is improving. His blood pressure is stable now and his swallowing is slowly improving as well.

Dad is doing much better. He is alert and his short term memory seems to be improving. He is frustrated because he wants to talk, but is still very hard to understand. The therapists had him standing today and will have him walk tomorrow. The speech therapist is going to try some yogurt tomorrow and see how he does with it. They are working to get him off of the feeding tube. Roger tells me that he is seeing improvement everyday and that Dad is the best he has seen him since he went in. Dad is asking questions about what the therapists and nurses are doing and understands explanations. He seems to be progressing at a good pace now. Doctors have told me that he may be released as early as Friday to a rehab facility. He has been accepted to two additional facilities. So far none of the facilities is very close to Nashville or Memphis. One of the facilities he has been accepted to is highly recommended by his case manager and is supposed to be pretty good. It may be his choice as to where he goes if he is understanding and remembering what he is told. The doctors will ask him about things instead of me. I suspect if the ask him, he will tell them he wants to go home and not to a rehab facility. He might have to be convinced of the need to go to a facility for a period of time until he can take care of himself without assistance. Please continue to pray for his continued improvement, for his ability to swallow and his speech improve.

Dad's ICU nurse just called me and let me know he has been moved out of ICU and up to the 6th floor. He is in room 611 if you would like to visit with him. She said he was talking a lot and making good sense. He mumbles so it is a bit hard to understand him. She said he didn't remember why he was there and didn't remember much of anything since he got there. She said that was expected. She said his blood pressure was normal, he was tolerating the tube feedings well, and that he was having no trouble breathing as long as he kept the "tent" on. When he doesn't have that, his oxygen level drops to around 80% which is low. With it on, it is between 95 and 100. Please pray that he does well out of ICU and that he continues to improve. The next step is to get him into a rehab facility (aka nursing home).

Dad's nurse said his breathing is good. She stopped short of saying he is doing well because he managed to pull out his feeding tube some. They were able to reset it without going back to surgery, but that is a step backwards for him because they have to reverify that he is tolerating it well. She said his blood pressure has increased some due to them not being able to give him the medication into his stomach because the tube was dislodged. It sounds like he is getting anxious to get out of there. I asked of he was getting therapy while he is in the ICU. The nurse said he is getting physical therapy, but not speech therapy. He needs the speech therapy to help him with swallowing. She is supposed to be checking with the doctor on that. He may still move out of ICU today, but she sounded less positive about it because of the feeding tube issue.

I spoke with Dad's nurse and Roger this afternoon. They both said that Dad is doing very well. He is breathing easily and his blood pressure is good. Roger said that he and Dad were having a good conversation, as best as can when Dad can only answer Yes or No. He is trying to speak, but is hard to understand. I am sure that will get better with time. The nurse said that they will keep upping the amount he gets through the feeding tube and as soon as they determine he is handling it well, they will move him back upstairs.

They removed the breathing tube this morning. Dad is doing well. His blood pressure is up slightly, but not much and he is back on the medicine. So far everything seems to be going well. The doctors said it would take a couple of days to know if he will do well off of the ventilator.

It's hard to believe that it has been thirty days since I first got the call about Dad. Today has been sort of a turning point. Roger, Dad's nurse, and a Doctor all spoke with Dad this morning regarding the tracheostomy procedure. Dad was very alert, and seemed to understand everything. He declined it once with all of them there, and again later when Roger asked after the others had left. His wishes are now known to all the staff and I have confirmation of what I believed his wishes to be. I spoke with his attending a few minutes ago. He also spoke with Dad and believes this to be his desire. He has high hopes that Dad will do fine with the tube removed. They have turned off the ventilator completely and he is doing OK like that, although his blood pressure increased some. The plan is to extubate in the morning. They will not re-intubate or do an emergency tracheostomy if he does not do well or crashes as we all agree he does not want that. By all reports he has a lot of strength now, knows what is going on, hates being where he is, has tried to escape, tried to extubate himself, and is letting everyone who sees him know he is not happy about things as they are. I told the doctor of my concerns about moving him back to the 6th floor since they let him get so dehydrated. He seems to be aware of that, and was very understanding. I think they will be much more aware of things this time. I am sort of in a pickle though. My second daughter is to be born 11 days from today (unless she comes early) and I have a lot to do to get ready for her arrival. I also would like to be in Nashville to be with Dad. I would ask that all who pray, please say extra prayers for Dad during the next few days. It is sink or swim time for him, at his request, and I ask that the Lord helps him swim.

I spoke with Dad's nurse this morning. She said that he is alert and lucid and at least seems to understand what she tells him. She said that he is now fighting them when they are trying to do oral care and such. She said he tried to pull the vent tube last night with his right hand. That seems to be working better for him and he seems to be getting his strength back. If he is as alert as the nurse is telling me he is, then I am hoping that he can tell Roger if he wants the tracheostomy or not. Roger and I both think he will not, but he may surprise us.

I spoke with Dad's nurse as well as the attending physician today. The pulmonologist is wanting to do the tracheostomy again. I am waiting to speak to him about it. The nurse said it might be permanent and the attending said he couldn't say for sure. I do know that Dad would absolutely not want it if it was going to be a permanent, or even long term thing. They have him sedated somewhat on a morphine based sedative and so he is not as lucid as he was before. Roger has said that the seemed to be really out of it. The doctors and nurses said that he is responding to commands and seems to understand them. However, the doctor said that they reduce the sedative in the morning, so he may be more lucid then. Please pray that the Lord guide me in making the decision about the tracheostomy. I am trying to follow Dad's stated wishes balanced with the aspects he never thought of.