12/8 9:30pm

We had a very full afternoon and evening getting my Dad settled in at HMC.   Everyone was fabulous and I just felt continually so relieved to be back at my home hospital and so LOVED.

Two of the goals for this evening were:  1) start to wean him off sedation to do a good neurological exam and 2) start working towards getting him off the ventilator.  Today his lungs started to sound a little coarse, so we definitely want to get the breathing tube out as soon as we can in order to avoid any potential developing pneumonia.  

His propofol (sedation drip) was first decreased and then totally turned off for 2 hours tonight, the longest he's gone without sedation since he was intubated Sunday night.  I sat with him the whole time and although he did not become alert, he showed many promising signs.  He turned his head towards my voice and raised his eyebrows, moved all extremities (with very good tone, the left-sided flaccidity seems to have disappeared which is great), grimaced and bit down on his breathing tube, and after I asked him to open his eyes he appeared to be trying very hard to do so.  He fluttered his eyes many times with a look of great consternation.  When he seemed to be getting agitated, he responded very well and calmed down after I soothed him and asked him to relax.  His pupils are still pinpoint, but reactive (albeit a bit sluggishly).  

He did well the first hour or so but then became increasingly agitated.  His fever had gone back up to 102, he was getting moved around in bed a lot, and he was getting a lot of poking and prodding with IV sticks, so he was pretty uncomfortable.  Both of his peripheral IV sites from the hospital in Louisiana needed to be removed due to the fact that they had run their course (one most certainly was getting some phlebitis), and he turned out to be a bit of a difficult stick.  His nurse, myself, and my friend Autumn from the ER all worked to get another IV line in him, ultimately in his foot.  

But because of his less than fabulous IV access, he ultimately needed a central IV line (which most ICU patients have anyway and I'm surprised he hadn't already gotten).  So due to that fact and also that he will get an MRI tonight (which requires him to hold completely still) we re-started his sedation.  I'm glad we did because he looked MUCH more comfortable afterwards.  I could tell that last hour was hard on him and he truly looked like he just needed to rest.  So the plan at this point is to try to remove sedation again tomorrow and see how it goes.

As far as getting him off the ventilator, it goes hand in hand with removing him from sedation.  However, we did adjust his vent settings to more closely mimic his own natural breathing which should help ease the transition.  

When I left tonight, they were putting his central line in and he was then going to MRI.  Hopefully I'll have news of the MRI in the morning.

I came home and Zoey was still awake, which was fantastic.  We hugged and cuddled and my whole soul just felt lighter.  I laid down with her to snuggle while she was falling asleep and she turned to me and said "Mommy, Pop Pop is very sick.  He's in the hops-piddle.  But he loves me very much".  Yeah, that pretty much made me get completely teary-eyed.  Zoey loves her Pop Pop so much and I want him to get better as soon as possible so that he can come home to her.