7:15 PM

Just talked to Russ, the NP for Dr. Narayan.  I told him the results of the tests and Dr. Savoka’s recommendations for a test similar to an upper GI except to put in an NG tube to administer the barium.  I also told him that Mikie had been trying to rest but keeps waking up and then acting like he is getting sick.  He hasn’t tossed it yet, but sure looks like he is getting close at times.  We agreed to give it a chance tonight to see if things go past the now reduced balloon and if it doesn’t work out he would order the test in the morning.  I even suggested reducing the size of the balloon to zero and simply tape the tube in place to keep it from coming out.  Russ and I brainstormed the GI tract for a few minutes.  It was interesting watching him bring try to bring things to mind that he had learned and since forgot.  Remember, his work is in neurosurgery, not the gastrointestinal tract.  We wondered how the bile gets back up into the stomach and I noted that I had noticed Mikie hiccupping and gagging a lot after seizures, and sometimes he would do it for no real reason.  Sometimes I would find that he had coughed up some junk and it was hanging in the back of his throat causing him to continue to cough and gag.  I may have mentioned this already, but Mikie has a great gag reflex.  And I found the purpose of a gag is to close off the airway to prevent aspiration.  This explains why when Mikie vomits he hasn’t seemed to be pulling any of this stuff back into his lungs.  All it would take though is one big inhale while he has a mouth full of bile.  Maybe you wondered why God would give us a gag reflex, and now you can thank him for it, as it might save your life someday.

Anyway, I am going to stay late, maybe all night just to make sure I am here if he loses it.  I’m also going to get him back up in his chair in a little while.  We’ll see if keeping him a little more vertical for a while will help.