Today's Stats:
Breakfast
Notice that within an hour of awakening my mother (I take her blood glucose immediately after awakening her, while she's still in bed), she was bathed, dressed and eating? No hassles, either.
I'm experimenting with her lisinopril, in order to try to find the correct dosage for her. I'm pretty sure it's 3.5 mg, but that was hard to do with the tiny pink pills and a less than precise pill cutter. We'll see how her blood pressure washes out at lunch.
Lunch
Her blood pressure looks pretty good on 3.75 mg lisinopril. I'd prefer 3.5, but I think we can live with 3.75, for awhile. This may be the best dose, anyway, as it has to last until dinner.
I dropped back the iron because her lips are taking on a slight maroon rim.
I have to mention; I set up a few pages of data on my mother for the Home Health Care PT. He asked for about half the data I gave him. The last page, though, was a list of things I felt he should know about my mother before working with her. One of the items, close to the top, I believe, was that "her diet is superb". Every time I make her a meal, now, and I spend intense thought and a fair amount of time planning and preparing what she eats, I think of this. She does enjoy a "superb diet", always tailored to her changing likes and dislikes and her nutritional requirements. It's been a long struggle. She used to refuse vegetables, except canned spinach with lots of vinegar. She used to eat lots of sandwiches, usually made with loads of sandwich spread, baloney, peanut butter, pickles, sliced ham, maybe some margarine, thick slices of cheese, ketchup...except for eggs, breakfast meat, white toast and orange juice for breakfast, this was just about all she ate. It was common for her to refuse what I'd prepare for dinner and head for the bread and sandwich makings. Sometimes all she'd eat during a particular day was popcorn, supplemented with Hershey's Almond Kisses and a variety of packaged chips. It was almost impossible to control her blood glucose on this kind of diet and, needless to say, there were, eventually, other physical implications. Despite all this, though, she felt good, performed well, had a good energy level. Until mid-2002. That's when everything changed and age and her diet caught up with her. In some ways, declining health was the best thing that happened to her. It forced changes in her diet and life-style, most of which have taken the entire four years to accomplish.
I expect her nutritional profile to continue to require fairly dynamic manipulation throughout her life, depending on how her body responds to advanced age. Her diet, however, is one of two aspects of her life that I work on of which I am most proud. The other is managing her medications and, so far, cutting back instead of adding medicine. Supplements tend to get added and subtracted as necessary, but, generally, so far, medications started high and have dropped, steadily, as I've discovered what works for her, what doesn't, and for what I can substitute nutritional management. I think most people caring for an Ancient One would be surprised at how few of the medications their Ancient One is on that they need, and how many of the goals the medications are supposed to address can be accomplished either with strikingly lower dosages or through nutrition and movement management. The problem, I think, is that doing this takes full time attention. Most people caring for an Ancient One aren't lucky enough to be able to devote themselves to full-time caretaking. Almost everyone doing what I do also has to hold down a job, usually full-time and often also has a family to manage. Sometimes some of the jobs I do can be done by various members of an entire family but, often, this isn't possible, either for cultural or family-specific reasons. Even nursing homes are able to care for Ancient Ones with the intensity and thoroughness of which I am capable.
Bottom line? We need to seriously and quickly rethink how we incorporate Ancient Ones into all levels of society, starting with the family.
Dinner
Her BP was high, for her, this evening, both systolically and diastolically. Although I was surprised initially, we'd had a spirited confrontation over her eating mustard straight out of the jar with a fork just before dinner, she was angry when I took her BP, and she is the type who, when she does get angry, which is rare, she holds much of it in, although it is obvious in her tight expressions and clipped responses. So, I figured 3.75 mg of lisinopril wouldn't hurt her.
I finished my research on calcium/vitamin D supplements and am satisfied that giving her extra supplementation at dinner, besides what she gets at breakfast in her multi-vitamin and the calcium/vitamin D she gets in dairy products, etc., isn't going to hurt her. If her calcium shows a significant rise on her next blood tests I'll cut it out, but that's only a week away, so I think we're safe.
I did remember the vitamin E, tonight. I gave her cranberry juice with dinner and, although she didn't get V-8 juice today, which tends to help keep her regular and she seems to be a bit constipated, again, she had plenty of fiber, today, contained in lots of vegetables and 2 slices of whole grain bread. Of course, today, she's also had a fair amount of cheese, which is a binder, and her liquid intake seemed low to me, although I didn't question her thirst, and won't unless she begins to look ragged, tomorrow.
|
Blood Glucose: Time: 0830 Reading: 119 |
Blood Pressure: Time: 0846 BP: 147/63 Pulse: 71 |
|
Breakfast: 0930 & Meds What she ate: 1 hard over egg, heavily peppered 2 slices thick cut sugar cured lean bacon 1 slice toasted oat bran bread with 1 tbl Fleischmann's margarine 1/4 tsp cinnamon on bread 6 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 |
| Protonix/40 mg | 1 pill at least 1/2 hour pre-meal | standard pre-breakfast med |
| lisinopril/3.75 mg | 1/2 tab with meal | blood pressure appeared to be able to handle it |
| Daily Senior Multivitamin | with breakfast | standard breakfast supplement |
| folic acid/400 mcg | with breakfast | standard breakfast supplement |
| garlic/1250 mg | with meal | standard breakfast supplement |
Notice that within an hour of awakening my mother (I take her blood glucose immediately after awakening her, while she's still in bed), she was bathed, dressed and eating? No hassles, either.
I'm experimenting with her lisinopril, in order to try to find the correct dosage for her. I'm pretty sure it's 3.5 mg, but that was hard to do with the tiny pink pills and a less than precise pill cutter. We'll see how her blood pressure washes out at lunch.
Lunch
|
Blood Glucose: Time: 1337 Reading: 145 |
Blood Pressure: Time: 1346 BP: 107/56 Pulse: 66 |
|
Lunch: 1415 & Meds What she ate: small salad with mixed greens and herbs, 1 small sliced radish, a little shredded cabbage, 1 sliced green onion, a little shredded carrot and 2 Tbl home made Ranch dressing 1 deviled egg flavored with mustard, mayonnaise, minced Bermuda onion, dill pickle relish, celery salt, McCormick Salad Seasoning and onion powder 1 slice cracked whole wheat sourdough garlic/Parmesan cheese toast 1 cut licorice detox tea w/ 1/4 tsp. cinnamon |
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| Med/Dose | Administration | Explanation |
| Iron Protein Succinylate/18 mg | 1 18 mg tab with meal | dropped the dose by half; explanation below |
| vitamin C/500 mg | 1/2 a 1000 mg tab with meal | helps metabolize iron |
Her blood pressure looks pretty good on 3.75 mg lisinopril. I'd prefer 3.5, but I think we can live with 3.75, for awhile. This may be the best dose, anyway, as it has to last until dinner.
I dropped back the iron because her lips are taking on a slight maroon rim.
I have to mention; I set up a few pages of data on my mother for the Home Health Care PT. He asked for about half the data I gave him. The last page, though, was a list of things I felt he should know about my mother before working with her. One of the items, close to the top, I believe, was that "her diet is superb". Every time I make her a meal, now, and I spend intense thought and a fair amount of time planning and preparing what she eats, I think of this. She does enjoy a "superb diet", always tailored to her changing likes and dislikes and her nutritional requirements. It's been a long struggle. She used to refuse vegetables, except canned spinach with lots of vinegar. She used to eat lots of sandwiches, usually made with loads of sandwich spread, baloney, peanut butter, pickles, sliced ham, maybe some margarine, thick slices of cheese, ketchup...except for eggs, breakfast meat, white toast and orange juice for breakfast, this was just about all she ate. It was common for her to refuse what I'd prepare for dinner and head for the bread and sandwich makings. Sometimes all she'd eat during a particular day was popcorn, supplemented with Hershey's Almond Kisses and a variety of packaged chips. It was almost impossible to control her blood glucose on this kind of diet and, needless to say, there were, eventually, other physical implications. Despite all this, though, she felt good, performed well, had a good energy level. Until mid-2002. That's when everything changed and age and her diet caught up with her. In some ways, declining health was the best thing that happened to her. It forced changes in her diet and life-style, most of which have taken the entire four years to accomplish.
I expect her nutritional profile to continue to require fairly dynamic manipulation throughout her life, depending on how her body responds to advanced age. Her diet, however, is one of two aspects of her life that I work on of which I am most proud. The other is managing her medications and, so far, cutting back instead of adding medicine. Supplements tend to get added and subtracted as necessary, but, generally, so far, medications started high and have dropped, steadily, as I've discovered what works for her, what doesn't, and for what I can substitute nutritional management. I think most people caring for an Ancient One would be surprised at how few of the medications their Ancient One is on that they need, and how many of the goals the medications are supposed to address can be accomplished either with strikingly lower dosages or through nutrition and movement management. The problem, I think, is that doing this takes full time attention. Most people caring for an Ancient One aren't lucky enough to be able to devote themselves to full-time caretaking. Almost everyone doing what I do also has to hold down a job, usually full-time and often also has a family to manage. Sometimes some of the jobs I do can be done by various members of an entire family but, often, this isn't possible, either for cultural or family-specific reasons. Even nursing homes are able to care for Ancient Ones with the intensity and thoroughness of which I am capable.
Bottom line? We need to seriously and quickly rethink how we incorporate Ancient Ones into all levels of society, starting with the family.
Dinner
|
Blood Glucose: Time: 1816 Reading: 106 |
Blood Pressure: Time: 1904 BP: 160/72 Pulse: 65 |
|
Dinner: 1905 & Meds What she ate: Almost 16 oz (included second helping) of Kraft Macaroni and Cheese with added sauteed Bermuda onion, green pepper, celery, added grated Vermont White Cheddar, added Old Bay Seasoning, added sage pork sausage, mixed with half the recommended margarine and a couple splashes of 1% buttermilk instead of 1/4 cup milk. 1/4 cup pure cranberry juice mixed with 10 oz water. |
||
| 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 |
| garlic/1250 mg | 1 1250 mg tab with meal | given as an anti-coagulant instead of an extra 81 mg aspirin |
| vitamin E/400 IU | 1 400 IU tab with meal | given as an anti-coagulant instead of an extra 81 mg aspirin |
| lisinopril/3.75 mg | 3/4 of a 5 mg tab with meal | blood pressure could use it |
| calcium-vitamin D combo/600-200 mg | 1 600-200 mg tab with meal | to help stem osteoporosis |
Her BP was high, for her, this evening, both systolically and diastolically. Although I was surprised initially, we'd had a spirited confrontation over her eating mustard straight out of the jar with a fork just before dinner, she was angry when I took her BP, and she is the type who, when she does get angry, which is rare, she holds much of it in, although it is obvious in her tight expressions and clipped responses. So, I figured 3.75 mg of lisinopril wouldn't hurt her.
I finished my research on calcium/vitamin D supplements and am satisfied that giving her extra supplementation at dinner, besides what she gets at breakfast in her multi-vitamin and the calcium/vitamin D she gets in dairy products, etc., isn't going to hurt her. If her calcium shows a significant rise on her next blood tests I'll cut it out, but that's only a week away, so I think we're safe.
I did remember the vitamin E, tonight. I gave her cranberry juice with dinner and, although she didn't get V-8 juice today, which tends to help keep her regular and she seems to be a bit constipated, again, she had plenty of fiber, today, contained in lots of vegetables and 2 slices of whole grain bread. Of course, today, she's also had a fair amount of cheese, which is a binder, and her liquid intake seemed low to me, although I didn't question her thirst, and won't unless she begins to look ragged, tomorrow.
posted by Gail Rae @ 23:59
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