More of the same

Tom still "doesn't feel well".  He says his stomach hurts - I don't know whether it is from the reflux or it's upset or both.  He says both.  He ate some breakfast and lunch but is still very lethargic.  His ammonia level is just over 100 today.  Dr. Rutland is not too concerned about that - Tom is making sense and opened his eyes, listened and asked Dr. Rutland questions this morning.

Dr. Rutland will talk to Dr. Miller and they may decide to do the Endoscopy tomorrow.  Tom wanted to know if he would have to go without food :-).  Dr. Rutland said only until after the procedure.  Physical Therapy came in while I was there at lunch so I stayed to "help".  Tom kept telling me to "go to work" because he didn't want to do anything and I basically forced him to participate.  He sat up in bed and did some leg lifts and arm lifts.  He moaned and complained the entire time but I was very glad he did it and told him so.

I wish I knew what was going on with him.  I don't think it is just the ammonia - I know he is exhausted from the reflux because he has an episode every time he eats or drinks anything - he ended up with the hiccups about 4 times last night!  The swelling in his feet has gone down but he still has a lot of fluid.  All of his blood tests are stable and his WBC is down to 14.  I will feel better if the Endoscopy is done.  Hopefully they won't find anything, but if they do, at least we can address it and then maybe Tom will feel better. 

Tom called at 11:30 last night and again at 1:30 looking for me.  I felt so bad.  I was encouraged that he was able to dial the phone (one call was from the room phone and one call was from his cell phone).  I know it seems like something so little but when he's lethargic, dialing a phone can be complicated.  I translate that to lower ammonia levels even though that is not always the case.

Dr. Rutland told me today that he shares his notes with UAB but that doesn't include the hospital information so tonight I will assemble the dates Tom has been hospitalized and send it to them tomorrow.  I have most of it along with what he was primarily admitted for.  Dr. Rutland wants to be sure they know how many times he has been hospitalized - I normally call them each time but it might not hurt to have a summary.  It's actually very scary to see how much time Tom has spent in the hospital.  I doubt it will really matter as far as the list position but maybe it can be used for even more exception points.  At this point, I will try just about anything!!!