Today's Stats:

Breakfast

Blood Glucose:     Time:  1011     Reading:  104

Blood Pressure:     Time:  1113     BP:  132/65     Pulse:  68

Breakfast:  1130  & Meds What she ate:  1 hard over egg, heavily peppered 3 slices thick cut sugar cured lean bacon a 2"x 2"x 1" raspberry, hmmm, well, thing, I devised last night, a sort of quick bread thing, with 1/2 Tbl Fleischmann's magarine 1/4 tsp cinnamon on raspberry thing 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/500 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
Prilosec/20 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/250 mg	1/4 of 1000 mg tab with meal	standard dose
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
folic acid/400 mcg	with breakfast	standard breakfast supplement
vitamin E/400 IU	with meal	standard breakfast supplement
garlic/1250 mg	with meal	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	although her blood pressure could probably take it, I decided to wait because she had some last night and we have some walkering to do, later, at the mall; I've noticed that her BP tends to drop after exercise, immediately, probably during, so I wanted to keep her at her morning level for endurance purposes

    That's right, she set her teeth into her breakfast just an hour and 15 minutes after I'd taken her blood glucose. Today, I intend to explain why this is going to be happening on a regular basis, now.
    You'll note that instead of Protonix, I gave her Prilosec this morning. I forgot to notice that we were getting low on Protonix and turn in the new Rx, so I switched the two out. I'll be turning that in for filling today.
    Also, I cut her metformin down to 250 mg, today. We'll see how that works, especially since she got a little more sugar and a little more food today than normal at breakfast.

Lunch

Blood Glucose:     Time:  1608     Reading:  115

Blood Pressure:     Time:  1615     BP:  127/57     Pulse:  65

Lunch:  1630  & Meds What she ate:  sandwich w/ 4 oz tuna salad, 2 slices potato bread 6 oz cottage cheese, heavily peppered 11.5 oz V-8 juice with 1/4 tsp. cinnamon
Med/Dose	Administration	Explanation
metformin/250 mg	1/4 a 1000 mg tab with meal	judiciously continuing to drop her standard dose of this med

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
lisinopril/2.5 mg	1/2 tab with meal	still waiting

    I am very, very pleased with her blood glucose readings, considering the hearty breakfast she had, including the added sugar in the raspberry-um-thing. We did some walkering after breakfast, a fair bit more than she's done in a couple of days, and she was okay (I continue to take the wheelchair, just in case). At both places she stopped to sit on her walker and rest, but after a few minutes, she was up and inching her way toward me. Her knees weren't shaky, although she tired before we were done, so I boosted her oxygen, before we got to the second destination, to 4L, then took her back down to 3L on our way home.
    She wanted to eat out, but I explained to her that I'm trying very hard to manipulate her food and medications to maximum effect so that I can reduce her medicine intake, and, that I'll have enough on my hands trying to negotiate the unseen factors in eating out tomorrow, when we have a planned luncheon to attend. That was fine with her. As long as I am straightforward with her about what I'm doing, she is more than willing to cooperate.

Dinner

Blood Glucose:     Time:  2114     Reading:  143

Blood Pressure:     Time:  2340     BP:  155/72     Pulse:  66

Dinner:  2147  & Meds What she ate:  Cobb Salad including: approx 1 cup (if smashed) assorted herbs [mizuna; arugula; frisee; parsley; dill; cilantro] and greens [red & green romaine; red & green oak leaf; lollo rosa; tango; baby spinach; red & green chard; radicchio] 1/2 boiled egg 1/8 cup shredded carrot 1/8 cup diced green pepper 1/4 cup diced celery 1 1/2 sliced radishes 1/4 cup sliced yellow onion .5 oz white cheddar/pepper jack cheese .5 oz peppered turkey breast .5 oz lean pastrami .2 oz crumbled Doritos Nacho Cheese chips 3 Tbl homemade ranch dressing (1/4 cup mayonnaise, 1/2 cup sour cream, 2/3 cup 1% buttermilk, an old packet of Hidden Valley Original Ranch Salad Dressing Mix from 1996 without any sweeteners [That's right, they used to make it without sweeteners of any kind; in fact, just for fun, here's a list of ingredients from the back: salt; monosodium glutamate; maltodextrin; garlic; onion; parsley; spice; carrageenan; calcium stearate; and, capitalized, bolded and italicized by the manufacturers, NO PRESERVATIVES. I found this in my cupboard, today, when I wanted to make ranch dressing for the salad, tonight, but didn't want to go to the store for a packet of Hidden Valley Ranch Dressing mix. Yes, I've read the labels of "the original" ranch dressings, lately, and, yes, as I recall, they all contain sweeteners. As well, I consider myself lucky that I haven't hired one of those elder-care helpers to check our cupboards for expired food. It occurred to me this evening, I think I might write the company, include a Xerox of the back of the packet, which includes the date of manufacture, and request that they make a variety of their mix without sweeteners, like they used to. Oh! Cool! I just looked up Hidden Valley on the internet. The company has a web address. I think I'll pick up a packet of what they are manufacturing, now, and email them about it. Should be interesting.])
Med/Dose	Administration	Explanation
36 mg Iron Protein Succinylate	2 18 mg tabs 1 hour before meal	to pull her out of what I hope is her temporarily severely anemic state
vitamin C/500 mg	with iron supplement	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/250 mg	1/4 a 1000 mg tab with meal	standard dinner med
lisinopril/2.5 mg	1/2 a 5 mg tab with meal	actually administered a while after she ate, when I finally remembered to take her blood pressure; tonight, it was high enough, both systolic and diastolic, for me to administer it without reservations
garlic/1250 mg	with meal	gave her an extra dose today, and will continue for a couple of days, because I think she may have a slight bladder infection
1/4 cup pure cranberry juice w/12 oz water	after breakfast	gave her an extra dose for the same reasons as with the garlic

    Although the posting time on this will show sometime after 2300, it is actually 0035, July 12, 2004. Mom is still up, due to her nap, I'm sure. That's fine. So am I. She's watching old comedies on TVL. I'm doing this.
    I find her blood glucose reading especially interesting. Exactly what it was last night. If you'll recall, she didn't get any metformin at lunch because her glucose reading was so low. Today, I gave her 250 mg metformin because her glucose was 5 points over normal. From a mathematical point of view, the administration of the metformin appears to have kept her glucose from going any higher than 143, today. However, after having done some reading about glipizide (not the timed release formula), I'm thinking that maybe it it is the glipizide that works so well on her, and not the metformin. When I was researching, last night, I looked up glipizide. I learned that although 40 mg/day is the maximum recommended dose, it is believed that anything over 20 mg/day doesn't appear to have much effect. I think I might experiment with this, perhaps giving her 10 mg glucotrol before lunch and skipping the metformin, regardless of what her blood glucose is (unless it's down in the 50's, in which case, depending on what she eats, I might not give her anything). I want to do a little more research, but I expect I'll be doing this within the next few days. If you're tuned, stay so.