Heart rate 101, Fever 99, Off vent all day

It's been another good day for Denise. Her heart rate during the day was around 117, and fevers were in the 100-101 range most of the time, blood pressure normal. When I arrived, the chaplain said he'd already visited and prayed with her that morning. He said that she was paranoid about the doctors & nurses again. About an hour or two into my visit with Denise, I asked her if she had any nightmares or scary thoughts, and she said, "No, why?" I'm glad that she can't remember being frightened. There's some speculation from a couple of friends that perhaps the Ambien that's been used to get her to sleep might be causing the hallucinations (rare but known side effect of Ambien). She didn't have these problems when Ativan was used to keep her knocked out, and it seems to me that they only started when I first heard that Ambien was used. She did say that she had a rough night last night, but because of needing to be cleaned up three different times. She again said that she felt like she was making everyone's job harder because of the messes. I told her that she's making jobs easier, because she's getting better each day. One of the nurses even said that she liked peeking in on Denise because she likes to see that people she's taken care of can and do get better. So Denise is her encouragement. I liked that, so I passed it on to Denise. She asked, "Will I need diapers for life?" I told her that I think Jacob will be in diapers longer than she will.

She's been off the vent since late last night or early this morning, depending on how you look at it. Her nurse told me that Denise told her that she thought her voice sounded closer to normal. Also, it's easier for her to breathe and speak. That little plug in the tracheostomy seems to do nicely for her, even better than the speech valve that she'd had before. All today, and as of tonight, she was still able to get 100 saturation, with an oxygen concentration of 30%. She didn't have that pesky mask today, other than when she was getting her breathing treatment (Levalbuterol & Atrovent... sorry, I can't remember how each is supposed to work). She just had the oxygen flowing through nose prongs (or nasal canulas, depending on who I talk to). During thebreathing treatment, I whipped out a clip-on fan that someone from my school is letting us borrow (THANK YOU!). It looks like yellow duck (the feet are the clamps, and there are eyes & a bill on the blade guard). She loved finally having a breeze on her, because she thinks the rooms are too stuffy. Denise asked why it was easier for her to breathe & talk, and wanted to see the plug in her tracheostomy. So I handed her a little toy unbreakable mirror so she could see everything. I reassured her that everything would come out when she gets better. She talked mostly about the kids. She wanted to make sure that I was recording the antics of the kids on paper (OK, on blog), pictures, and video. She smiled at hearing about splashing in the puddles, and Jacob squishing the worms. She asked, "Did you clean his shoes?" As has been the case for the past couple days, she was more animated in voice than in facial expression. By about 12 noon, she was napping.

That Amphotericin doesn't seem to be so terrible after all. She said that she wasn't feeling any more shakes, aches, or yuckiness than usual. It's not living up to the hype. Almost makes me wonder if it's been discontinued. There are so many changes, it's hard to keep track, or understand them. Not that I understand much of this stuff. It's incredible. Pray for the doctors & nurses. God's using their incredible skills to help get Denise better.

As of tonight, she was sleeping... worn out after a full day of breathing on her own. She had a heart rate of 101 (her Coreg dose was doubled). Blood pressure lowered to 88 systolic. Not quite normal, but acceptable. I bet that getting two units of blood today helped give her enough volume to tolerate the higher Coreg (and accompanying lower BP). Her hemo count has been holding at about 8 for a while. The extra hemoglobin should help her get more bang for the beat out of her heart. Her temps were in the upper 99 range. I'm cautious about getting too excited, because those fevers have come back in the past. Pray a bunch that these infections are gone, and that the fevers will also be gone! Speaking of fevers, I forgot to say that yesterday the nurse told me that they had to give Denise an ice bath the previous night. I think I'd hate that. So I was trying to be empathetic with Denise, and told her how I can only begin to imagine how horrible those must feel. "Oh, no," she said, "I like 'em. They feel good."

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