I was on call the past weekend and Miriam had a rough week.
Last Wednesday  evening, I received an urgent phone call from her sharp and  compassionate Internist about Miriam being severely dehydrated.
Two weeks into the skilled nursing facility, she had lost 8 pounds. She was not getting adequate PEG tube hydration. Miriam needed urgent intravenous hydration and blood tests were needed. I drove back that night and started her IV line. 
Thursday  2:30 am, I received a phone call from the nurse at the skilled nursing  facility (SNF). Miriam's BP went up in the 200's because that is how she  responds to pain and discomfort. They were compounded by dehydration and urinary tract infection. Her heart rate was in the 130's and her liver enzymes became mildly elevated. 
Thursday morning, Miriam was admitted to Huntsville Hospital  followed by more IV hydration and IV antibiotics. Her caring Internists  did an excellent job and Miriam recovered the next day.  While  she was there Friday morning and afternoon, her cancelled scheduled  Botox injection to her jaw muscles and her left ankle muscles were  performed by her Neurologist. 
Friday  evening, Miriam was back at the skilled nursing facility (SNF). Her  urine became clear, her vital signs have stabilized and her lab values  have improved. 
 Miriam's trach collar has been capped for nearly 2 weeks. Yesterday, the trach collar was removed by the respiratory therapist.  It is now covered with gauze and will eventually close as it heals. She  has been breathing through her nose without problems and without  aspiration. Although she remains in coma, Miriam seems to open her right  eye more frequently, for more prolonged periods, and appears to slowly  track more and more. God remains in control. 
I  was moved to tears by our neighbor who has visited Miriam frequently  and read to her Miriam's favorite book, the Bible. Miriam's friends from  the Hampton Cove  Publix Grocery also came to visit her. They gave her a bouquet of  flowers and a heart warming get well card. My family and I are deeply  grateful to all of you who have been earnestly praying for her and our  family. 
Every  time I see Miriam opens her right eye, I remind her of Joshua 1:9   "Have I not commanded you? Be strong and courageous. Do not be afraid;  do not be discouraged, for the Lord your God will be with you wherever  you go."  Mark 11:24 "Therefore I tell you, whatever you ask for in  prayer, believe that you have received it, and it will be yours."  
Knowing  Miriam, it is our prayer that God will use this horrific  storm in our family to touch lives  so we can glorify Him. We continue to Commit...Trust....Rest....and Wait  patiently upon the Lord. Psalm 37:5,7 
In His Time,
Alex
 
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