Ammonia Level is UP!

Tom's ammonia level is higher today than it was yesterday.  Dr. Rutland is not sure the reason.  He is increasing the amount of medicine Tom takes for high ammonia level and will also start him on a mild antibiotic.  There is really no indication that Tom has any infection but, then again, this is something that has been an issue before.

Tom called me at 4:30 this morning and said he was not feeling well so I went to see him before work.  He was doing OK but clearly having more trouble than yesterday.  I feel like he will be better as the day goes on. 

Dr. Rosen actually changed Tom's wound vac yesterday and was very pleased with how the wound looked.  He replaced a few of the stitches as well.  The dressing looks much better.

When Dr. Rutland was in this morning, I mentioned Tom's diet.  When he was in the hospital before, they had him on a low sodium, low protein diet.  It made ordering his meals a challenge but I wonder if that helped with the ammonia level (particularly the low protein part).  He has been on a regular diet for the most part since leaving the hospital on June 1.  The rehab center was supposed to be giving him lower sodium - it wasn't as low as it needed to be and there was no true monitor of it or lower protein.  Tom made a huge effort to choose things that he knew would be lower sodium so that was a big help for the fluid retention but the protein affects his ammonia level.  I told Dr. Rutland that I thought Tom had been off of the ammonia med the last week or so he was in the hospital.  Dr. Rutland told me that was not true.  He did say the dose was lower.  Anyway, as I said yesterday, I need to get diligent again about what and how much medication Tom is taking.

I am not unhappy that Tom will remain in the hospital.  His sister and brother-in-law are coming tomorrow and I am so looking forward to seeing them.  I know Tom is as well.  Of course Tom is not getting the physical therapy he needs most so that is unfortunate but once the ammonia level is back under control, more intense physical therapy can take place.

Please continue to pray.  I am slightly discouraged but I know it will get better - especially with help from family!

There is joyful news to report - I have a new grand-nephew!  His name has not been decided so I am calling him Baby Boy Chapman.  That makes my younger sister a second-time grandmother.  For that, she should be older than me!!  I pray that soon Tom will be better so that we can go and meet him in person!