Today's Stats:

Breakfast

Blood Glucose:     Time:  1048     Reading:  110

Blood Pressure:     Time:  1151     BP:  124/60     Pulse:  73

Breakfast:  1205  & Meds What she ate:  1 hard over egg, heavily peppered w/approx 1.5 oz sharp cheddar cheese 2 slices thick cut sugar cured lean bacon 1 slice toasted potato bread with 1 tbl Fleischmann's margarine 1/4 tsp cinnamon on bread 8 oz orange juice diluted w/8 oz water
Med/Dose	Administration	Explanation
Niferex-150 [150 mg elemental iron]	1 hour before breakfast	to pull her out of what I hope is her temporarily severely anemic state
vitamin C mg	with Niferex-150	helps the body metabolize iron
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard pre-breakfast and pre-dinner med
Protonix/40 mg	1 pill at least 1/2 hour pre-meal	standard pre-breakfast med
Albuterol/2.0+IPRAO/.5	nebulized during meal preparation	standard breakfast, sometimes dinner med
metformin/637.5 mg	3/4 of 850 mg tab with meal	standard dose
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
vitamin C/500 mg	with breakfast	standard breakfast supplement
folic acid/400 mcg	with breakfast	standard breakfast supplement
1/4 cup pure cranberry juice w/12 oz water	after breakfast	standard after breakfast supplement

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
aspirin/81 mg	1 tab with breakfast	Has not been receiving this, per doctor's orders, since 6/18/04; he feels that, if she is bleeding internally intermittently, the aspirin, being a blood thinner, will increase the blood flow, and this is a higher risk to take, right now, than protecting her against strokes, including mini-strokes
lisinopril/2.5 mg	1/2 tab with meal	decided to wait until later in the day, just to see how well her blood pressure holds its own on what I hope will be a fairly active, alert day
vitamin E/400 IU	with meal	standard breakfast supplement; temporarily deleted to due physician request regarding concern about it interacting with the iron and some of her other meds
garlic/1250 mg	with meal	can function as an anticoagulant, thus I've nixed this medication, for the time being

    I added cheese to her breakfast, today, to help bind her out of the diarrhrea the Niferex seemed to cause, yesterday. Please notice how long it took from the time I took her blood sugar to the time she ate. This is not unusual. I started awakening her at 1030. She didn't manage to coax one of her hands out for her blood sugar test for 18 minutes. Some mornings are very slow.

Lunch

Blood Glucose:     Time:  1605     Reading:  106

Blood Pressure:     Time:  1613     BP:  119/55     Pulse:  71

Lunch:  1630  & Meds What she ate:  grilled cheese sandwich w/approx 2 oz extra sharp cheddar cheese, 2 slices potato bread fruit plate w/2 strawberries, 2 1" square chunks pineapple, 2 1" square chunks cassava melon, 2 1" square chunks cantaloupe, and six grapes
Med/Dose	Administration	Explanation
metformin/637.5 mg	1/2 a 1000 mg tab with meal	considered bread and slightly sweet pickles

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
lisinopril/2.5 mg	1/2 tab with meal	decided to wait until later in the day, just to see how well her blood pressure holds its own on what I hope will be a fairly active, alert day

    Her blood glucose reading was excellent, considering that she was sampling her way through Costco an hour previous. She was also walkering her way through Costco. Very good readings!

Dinner

Blood Glucose:     Time:  2131     Reading:  78

Blood Pressure:     Time:  2137     BP:  166/76     Pulse:  66

Dinner:  2205  & Meds What she ate:  approx 8 oz macaroni & cheese with ground beef, celery, green pepper and onion 1 strawberry, 1 1" chunk pineapple, 1 1" chunk cassava melon, 1 1" chunk cantaloupe 11.5 oz V-8 juice with 1/4 tsp cinnamon
Med/Dose	Administration	Explanation
Iron Protein Succinylate/36 mg from 720 mg Iron Protein Succinylate	2 18 mg tabs 1 hour before meal with at least 8 oz water	standard lunch med
vitamin C/500 mg	Iron Protein Succinylate	helps the body metabolize iron
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard pre-breakfast and dinner pre-med
metformin/500 mg	1/2 a 1000 mg tab with meal	standard lunch med
lisinopril/2.5 mg	1/2 tab with meal	her BP reading told me this was a good time to administer this

    Although Mom was hungry, she got involved in a movie, My Big Fat Greek Wedding, and became so distracted that, by the time her appestat clicked off (usually 20 minutes into a meal), she had only eaten half of what I gave her. Because her blood sugar was in the 70's, I decided to give her a little fruit to make sure the glucotrol/glucophage/cinnamon was covered and her blood sugar doesn't drop too low, tonight. We usually have this problem at night when our days start late and end late...dinner almost always falls when Mom is riveted to one or another of her shows or movies.
    You'll notice I've also added more iron to her diet, an hour before dinner, once again the Iron Protein Succinylate. Although the Niferex-150 reddens her up nicely for a fair number of hours after taking it, I've noticed, yesterday and today, that during the last third of her day she begins to lose color, again. While her body is rebuilding it's hemoglobin/hematocrit, she needs a mega dose of iron. The first time she was discovered to be anemic the doctor prescribed a daily dose of ferrous sulfate, in three doses, that equaled 195 mg elemental iron. When I remembered this, today, I decided to add a couple of Iron Protein Succinylate pills in the evening. Supposedly, the types of iron she's taking, now, are all much more absorbable and more well tolerated than ferrous sulfate (which is the least absorbable of all iron supplements). So, essentially, I've boosted her to 185 mg elemental iron, absorbable enough to replenish her hemoglobin/hematocrit. We'll see how this works when her blood draw is taken this coming Thursday. Once her hemoglobin and hematocrit return to normal range, of course, I'll be cutting back on her iron supplementation, but, I think I know better, now, than to cut it out completely.