Pneumonia (cont)

I went to see Rick this morning. He really looked sick. I prayed with him and then decided to try to get him to eat a little bit. He was lying on his side in the bed and even when I rolled the head up it was still hard to get the food in his mouth and especially his liquids. So I asked for a feeding syringe. This really helped me get some fluids in him. He drank his prune juice and his Mighty Shake, 4 oz each. The nursing supervisor, Tracy, came in saying they decided to stop the Leviquin and put him on Rocephin 1 gram IM daily for 3 days, Augmentin 875 mg bid x 10 days. The Rocephin should kick in and start bringing down the infection. They are going to do a Depakote (seizure med) level today to be sure his seizures are being controlled. They are going to monitor his intake and output. Draw blood for a CBC and BMP tomorrow morning. She decided to put him on ‘honey thick’ liquids to help him swallow easier and get a speech therapy evaluation this afternoon. This will evaluate his swallowing. Rick’s temperature is 100.8 so Tracy gave him a Tylenol suppository. I was able to get some more liquids in him after she brought the thickened juice. I still used the syringe to put it in his mouth. But now he was sleeping more than he was awake and he wasn’t swallowing very well. I didn’t want him to aspirate more into his lungs. So I stopped. It was time for the quarterly care plan meeting that we had already had scheduled. Cheryl decided to come over for that. I was glad she was there. It was a little emotional for her because they spelled out the prognosis of Alzheimer ’s disease to her. It isn’t fun to hear and think about. After about an hour, we went back to see Rick. He was still sleeping. I tried to give him some more juice, but he wasn’t awake enough to swallow much. We finally left. Early afternoon, Tracy called me saying that Rick seemed more alert but his temperature is still 100.8. She was going to give him more Tylenol. The speech therapist, Valerie, had seen him and felt he wasn’t swallowing well at this time. So they suggested they put in an IV to be sure he remains hydrated. Or they could send him to the hospital. States his WBC is high and wants to be sure he is cared for. I decided I would like to give the antibiotics the rest of today and tomorrow morning, to see what they will do. If he isn’t better by then, then maybe he should go to the hospital. So that is the way we left it. I got a call from Valerie, the speech therapist. She said she was going to keep him on pureed foods and only increase the thickness of his liquids to nectar thick, not honey thick. She said she would be doing some ‘thermal stimulation’ in his mouth. This is using frozen lemon glycerin swabs to touch certain areas in his mouth to stimulate swallowing. She said she put down that she would work with him for 12 weeks. She didn’t think she would need to work with him that long, but just wanted to give the insurance companies a heads up. About 4 pm I got a call from Angelica, nurse at Heritage, saying that Rick is starting to come around. He pulled out the IV and bled all over his sheets. Oh, great! Now I have to try to get blood stain out of his sheets. And wouldn’t you know he had the light colored ones on!  She restarted the IV and really taped it up good so that he won’t be so apt to pull it out. She said he was smiling and trying to respond to questions. So Praise the Lord! The antibiotics and IV fluids seem to be helping. I’m planning to go over there tonight after I get off work at 8 pm to check on him. Then I will go back in the morning. Thank you, everyone, for your prayers! Prayer works!