Tuesday, March 31st. Still at Jackson Memorial Hospital in Miami

Well, March did come in like a lion and lasted all month!  Rich was suppose to have tracheostomy today, but as the ICU Medical Director was telling me that at 11:30, I looked at his tube feeding and mentioned that he was not NPO ( nothing by mouth).  He abruptly left the room and I could tell he was mad that no one wrote the order for NPO.  Okay, so now the critical care anesthesiologist fellow tells me he and the attending anesthesiologist will be doing the trach at bedside tomorrow afternoon.  When I saw the Medical Director of ICU coming off of the elevator, I asked him about a PEG tube. (Percutaneous endoscopic gastrostomy) which is a tube placed into his abdomen for the purpose of tube feedings, liquids, and medications.  He said they would get in touch with Interventional Radiology to do this.  I asked if anesthesia and radiology could coordinate their efforts to try to do it under the same anesthetic, but we will see on that.  Meanwhile, case manager working on transportation for Rich to Pensacola.  I have told you how I am going back and forth thru the stages of grieving (denial, anger, bargaining, depression, and acceptance).  Thought I was getting into the acceptance phase, only to get angry today that Rich could leave me like this.  I miss him so much it is almost unbearable.  His blood pressure on the low side today, heart rate still being controlled by amiodorone and  Metropolol .  Eyes still wandering today.  Since he doesn't have a blink response, nurse felt his eyes open today, even with ointment were drying out.   She lightly taped his eyes. I took off the tape to talk to him.   Appeared to focus at times, but eyes really wandering today.    Oh dear Lord, help us, I am so sad.