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.

Today's Stats:

Breakfast

Blood Glucose:     Time:  1134     Reading:  95

Blood Pressure:     Time:  1247     BP:  122/57     Pulse:  70

BREAKFAST:

Breakfast:  1305  & Meds What she ate:  1 hard over egg, heavily peppered 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/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
Albuterol/2.0+IPRAO/.5	nebulized during meal preparation	standard breakfast, sometimes dinner med
metformin/500 mg	3/4 of 850 mg tab with meal	standard dose; dropped it back from the typical 637.5 dose because I wanted to see how the Niferex-150 affects her blood sugar
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	decide to wait until later in the day, just to see how well her blood pressure holds its own
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

    Not really much to mention about breakfast this morning, except that this is the first day I cut out her garlic. This was not done per doctor's orders; I just happened to run across some research that listed garlic as an anticoagulant, and I know the doctor wants her off anticoagulant substances, right now, as much as possible.

Lunch

Blood Glucose:     Time:  1702     Reading:  132

Blood Pressure:     Time:  1751     BP:  136/55     Pulse:  71

Lunch:  1710  & Meds What she ate:  sandwich w/ 4 oz tuna salad, 2 slices potato bread approx. 3 oz MCS's bread and butter pickles 11.5 oz V-8 juice with 1/4 tsp. cinnamon
Med/Dose	Administration	Explanation
metformin/500 mg	1/2 a 1000 mg tab with meal	decided to continue my observation of her blood sugar by leaving her on the standard dose

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
lisinopril/2.5 mg	1/2 tab with meal	decided to continue to wait, out of curiosity; I'll probably give it to her this evening

    I know, I took her blood pressure well after she finished eating. I forgot to take it. I was distracted by the shitting accident she had, caused, no doubt, by the Niferex-150 she started, today. Diarrhea is one of the possible side effects. It is expected to stop as her system becomes used to the high amount of iron.

Dinner

Blood Glucose:     Time:  2121     Reading:  59

Blood Pressure:     Time:  2158     BP:  126/59     Pulse:  74

Dinner:  2200  & Meds What she ate:  yet another tuna melt, this time with a healthy slice of cheese, on potato bread, as usual, and about a tablespoon of Fleischmann's margarine for grilling about 6 oz of MCS's superior bread and butter pickles, also containing pieces of pickled onion and bell peppers
Med/Dose	Administration	Explanation
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 a 5 mg tab with meal	actually, it was more like 2 mg; that's how much I actually wanted to give her and it is the advantage of having a poorly constructed pill slicer that allows me to do this

    Yes, that was her blood sugar reading, 59. I immediately took it again just to make sure, and got 57. I can think of a few reasons why this is happening, most having to do with the strong iron complex tablet she's taking, some having to do with the fact that she's getting more exercise and her body might be working better. However, she didn't get any exercise today. She was too busy having diarrhea and feeling drained, literally, I guess. She took a 2 hour nap, though, from 1900 - 2100, and is feeling considerably better. The diarrhea is why I gave her the cheese; it's a classic binder. I've decided, for the next few days, at least, until her system gets used to the mega dose of iron she's taking right now (and, she won't be taking it forever, only until her hemoglobin comes up and is stabilized in normal range; then, we should be able to cut back on her iron), that I'll be adding a slice of cheese to her egg in the morning. I considered this out loud in front of her while she ate dinner and she was thrilled.

Today's Stats:

Breakfast

Blood Glucose: Time:  1142 Reading:  106	Blood Pressure: Time:  1257 BP:  108/65 Pulse:  81
Temperature:  97.6

Breakfast:  1315  & Meds What she ate:  1 hard over egg, heavily peppered 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
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
Albuterol/2.0+IPRAO/.5	nebulized during meal preparation	standard breakfast, sometimes dinner med
Protonix/40 mg	1 pill at least 1/2 hour pre-meal	standard breakfast med
metformin/500 mg	1/2 of 1000 mg tab with meal	I decided to give her 500 mg, even though I usually give her 637.5 at breakfast, just to see how she'll do with a lower dose
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	with meal	standard breakfast, lunch and dinner med administered 1 hour pre-meal
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
vitamin C/500 mg	with iron 1 hour pre-meal	standard 1 hour pre-meal 3xday
folic acid/400 mcg	with breakfast	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	didn't seem to need it, this morning, decided to see how the day shapes up BP wise
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
Detrol 2mg	with breakfast and dinner	finished the last of her last Rx; doctor said if it wasn't working, to stop it, so I am

    You'll notice the addition of "temperature" just below BP and BG. I decided to start taking it now and then, at least once a day, just to see what her "normal" is now. It's been bouncing around the last few days. I'll continue to record it for awhile, to see what turns up.
    Today was not intended to be a late rising day. In fact, at 0700 she was on her elbows, and looking alert but didn't want to get up. I intended to let her sleep until 0930, then, called MCS to go over some medical research I did this morning and ended up letting her sleep in until 1140. I don't think this is a problem, today. She seems to be doing much better than she was yesterday and I've already announced to her that I'm going to be keeping her up right into the evening. I expect that she'll probably have a very light "lunch" today, as we'll probably only be able to get in two meals, but that'll be okay...tonight, I've vowed, is finally going to be Chicken Fricassee night; we've got to use the chicken! I'll also be baking blueberry and raspberry muffins, this afternoon, so that will probably be when she has her lunch/snack.
    I've "warned" her that as of tomorrow, we're going to try to develop the habit of her experiencing a "normal" day: Up with breakfast at a "decent" hour, lunch in the middle of the sun's journey across the western hemisphere, dinner as it begins to set.
    I can't remember if I mentioned it yesterday, but I am trying to administer her iron 1 hour before/2 hours after eating. I'm hoping, with the Niferex-150, which has arrived and we'll be picking up this afternoon, this will actually be easy...as, having 150 mg Elemental Iron per dose, I'm expecting that she may only need one dose a day. We'll see, from her blood draw next week.

Lunch

Blood Glucose:     Time:  1734     Reading:  70

Blood Pressure:     Time:  1736     BP:  101/55     Pulse:  85

Lunch:  1745  & Meds What she ate:  8 oz small curd 4% cottage cheese 11.5 oz V-8 juice with 1/4 tsp. cinnamon
Med/Dose	Administration	Explanation
metformin/425 mg	1/2 a 850 mg tab with meal	considered bread and slightly sweet pickles
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	2 hours before meal	standard pre-meal med

    This was, indeed, one of her lighter lunches, eaten after some heavy-duty (for her) walkering, most of it at the second store we visited where she decided to cruise up and down the aisles, reminding herself of her love of shopping. I was surprised at how low her blood pressure was. I took it within 15 minutes of our arrival home, less than a half hour after the last, long leg of her walkering. I was afraid it might be a sign that she is, indeed, bleeding internally, especially provoked by lots of movement and, while this may or may not be the case, I was pleased to note her rather high blood pressure just previous to dinner, on which I report above.

Dinner

Blood Glucose:     Time:  2132     Reading:  85

Blood Pressure:     Time:  2136     BP:  160/76     Pulse:  69

Dinner:  2210  & Meds What she ate:  Chicken Fricassee, including a variety of vegetables and about 6 oz of chicken breast in a light, thin, flour and chicken stock based sauce with a bit of heavy cream for opacity; very peppery, the way she likes much of her food
Med/Dose	Administration	Explanation
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
metformin/500 mg	1/2 a 1000 mg tab with meal
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	administered 1.5 hours before meal	standard breakfast, lunch and dinner fare while she's anemic
lisinopril/2.5 mg	1/2 5 mg tab with meal	once again, her blood pressure readings, today, seemed to indicate that she could handle two half doses of this

    She and I had a discussion, tonight, centering on the proposition that if one awakens at 1140, it is not out of the realm of possibility that one would eat dinner at a little after 2200. I was pleased with her appetite and her capitulation to the idea that one's day begins when it begins, and, thus, if it begins "late" it will end "late", which changes "late" to "on time".

Today's Stats:

Breakfast

Blood Glucose:     Time:  1151     Reading:  131

Blood Pressure:     Time:  1219     BP:  153/69     Pulse:  88

Breakfast:  1245  & Meds What she ate:  1 hard over egg, heavily peppered 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
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
Albuterol/2.0+IPRAO/.5	nebulized during meal preparation	standard breakfast, sometimes dinner med
Protonix/40 mg	1 pill at least 1/2 hour pre-meal	standard breakfast med
lisinopril/2.5 mg	1/2 tab with meal	check out blood pressure
Detrol/2 mg	1 tab with meal	standard breakfast and dinner med
metformin/637.5 mg	3/4 of 850 mg tab with meal	check out blood glucose
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	1 tablet 1 hour before breakfast	standard breakfast, lunch and dinner med
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
vitamin C/500 mg	1/2 1000 mg tablet 1 hour before breakfast	standard breakfast supplement
folic acid/400 mcg	with breakfast	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

    There are some changes in how her iron and vitamin C are being administered. This morning I received a call from her PCP's nurse telling me that her hemoglobin had dropped to 8.9. I was asked (again, after having been asked yesterday) how much iron she was taking and when. I told her. Once again, it was strongly suggested that I administer the iron an hour before eating or 2 hours after eating, with "orange juice", upon which I reminded the woman to whom I was talking that she's diabetic and I can't be giving her orange juice all day long, and, as well, I cannot give her anything 2 hours before her glucotrol or Protonix. So, I am now administering her iron and 500 mg of vitamin C to my mother immediately after she awakens. I'm not sure, yet, how we're going to work the rest of the iron. At 1545, two hours after breakfast and at least an hour before her next meal, I administered her second dose of iron and 500 mg vitamin C. She isn't feeling up to par, today, is tired from an extremely active day yesterday, and is coughing a lot, which always happens when she goes down to the Valley. So, soon after taking her iron/C she went down for a nap. I hope to write more about all this in The Mom & Me Journals dot Net, although, frankly, I am very discouraged by the hemoglobin news. I have, however, decided to order a very strong iron poly-saccharide, Niferex-150 which I hope helps. It should be in tomorrow, and I'll probably start giving it to her on Friday.

Dinner

Blood Glucose:     Time:  1952     Reading:  79

Blood Pressure:     Time:  2009     BP:  164/71     Pulse:  60

Dinner:  2030  & Meds What she ate:  4 oz tuna mixture (celery, green onions, dill pickles, enough mayo to substitute for glue) w/1 oz cheese, & 2 slices of toasted potato bread grilled into a tuna melt 12 oz V-8 juice with 1/4 tsp cinnamon
Med/Dose	Administration	Explanation
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
metformin/500 mg	1/2 a 1000 mg tab with meal
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	1 tab 1 hour before meal	standard pre-meal fare while she's anemic
Detrol/2 mg	1 tab with meal	standard breakfast and dinner fare while we're trying, again, to see if this will work on her
lisinopril/2.5 mg	1/2 5 mg tab with meal	her blood pressure indicated she could handle it

    Yes, she had no bananas...oops, I mean no lunch. She slept most of the day; was probably up a total of seven hours, broken by a nap-of-exhaustion. I figure she was sleeping off our day-trip to the Valley, which was a long day for her and included more activity (including walkering activity) than she's seen in months.
    About an hour after dinner, she decided she wanted some hot chocolate, so I gave it to her, with another 500 mg metformin.

Today's Stats:

Breakfast

Blood Glucose:     Time:  0538     Reading:  94

Blood Pressure:     Time:  0624     BP:  141/65     Pulse:  85

Breakfast:  0635  & Meds What she ate:  1 hard over egg, heavily peppered 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
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
Albuterol/2.0+IPRAO/.5	nebulized during meal preparation	standard breakfast, sometimes dinner med
Protonix/40 mg	1 pill at least 1/2 hour pre-meal	standard breakfast med
lisinopril/2.5 mg	1/2 tab with meal	decided she could handle it so gave it to her
Detrol/2 mg	1 tab with meal	standard breakfast and dinner med
metformin/500 mg	1/2 of 1000 mg tab with meal	standard dose, because of orange juice, when her BG is in the 90's
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	with meal	standard breakfast, lunch and dinner med
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
vitamin C/1000 mg	with breakfast	standard breakfast supplement
folic acid/400 mcg	with breakfast	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

Lunch

Blood Glucose:     Time:  1239     Reading:  65

Blood Pressure:     Time:  1130     BP:  150/62     Pulse:  100 Additional BP:     Time:  1515     BP:  128/72     Pulse:  82

Lunch:  1250  & Meds What she ate:  Lunch at Black Angus - her choice 8 oz prime rib approx. 15 steak-cut fries the equivalent of 5 onion rings 1.5 loaves of Black Angus' individual dark bread loaves 3 tbl whipped butter
Med/Dose	Administration	Explanation
metformin/637 mg	3/4 a 850 mg tab with meal	decided on this while she was consuming the bread
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	with meal	standard breakfast, lunch and dinner med

Dinner

Blood Glucose:     Time:  1957     Reading:  138

Blood Pressure:     Time:  2016     BP:  153/70     Pulse:  100

Meal:  2025  & Meds What she ate:  1/2 a Costco chocolate muffin with 8 fresh raspberries, smothered in whipped cream
Med/Dose	Administration	Explanation
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
metformin/850 mg	1 tab with meal	check out blood sugar and what she decided she wanted for dinner (and what I allowed her to have)
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	1 tab with meal	standard breakfast, lunch and dinner fare while she's anemic
lisinopril/2.5 mg	1/2 5 mg tab with meal	blood pressure interestingly high
Detrol/2 mg	1 tab with meal	standard breakfast and dinner fare while we're trying, again, to see if this will work on her

    Today was the day we traveled to the Valley for doctors' appointments. Our first was at 1130, our second at 1515. This is why her stats are a bit uppity, especially considering the meals she consumed. I don't worry about blips like this. They happen in everyone's life, so, they certainly deserve to happen in my mother's.

Today's Stats:

Breakfast

Blood Glucose:     Time:  0947     Reading:  93

Blood Pressure:     Time:  1049     BP:  142/65     Pulse:  67

Breakfast:  1058  & Meds What she ate:  1 hard over egg, heavily peppered 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
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
Albuterol/2.0+IPRAO/.5	nebulized during meal preparation	standard breakfast, sometimes dinner med
Protonix/40 mg	1 pill at least 1/2 hour pre-meal	standard breakfast med
lisinopril/2.5 mg	1/2 5 mg tab with meal	reappearance on her morning menu
Detrol/2 mg	1 tab with meal	standard breakfast and dinner med
metformin/500 mg	31/2 of 1000 mg tab with meal	standard dose when blood sugar is in 90's
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	with meal	standard breakfast, lunch and dinner med
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
vitamin C/1000 mg	with breakfast	standard breakfast supplement
folic acid/400 mcg	with breakfast	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
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

    The news, today, is, first, that I was able to get her up and fed before noon, and not just before. She didn't want to get up, just because she's used to sleeping in. But, I told her this morning, unless she has imperative health reasons for staying in bed, which she no longer has, we're going to begin practicing decent sized days that include a morning during morning hours.
    Further news: Her blood pressure is back up, this morning, to where I can begin administering lisinopril in the morning. The chances are excellent, now, that she'll soon be receiving her full, daily 5 mg dose of lisinopril, divided between morning and night half doses. This is good news because it means her body is beginning to operate, again, like it used to and allowing the ingestion of lisinopril, which protects her kidneys from the more devastating renal effects of diabetes.
    Tomorrow, stats will be taken but not entered until evening. We'll be traveling the the Valley, early, for two appointments and waiting until after rush hour to return. I imagine at least 2 of our meals will be eated "out". Should be an interesting stats experience.

"On the Road Again" Lunch

Blood Glucose:     Time:  1512     Reading:  73

Blood Pressure:     Time:  1621     BP:  127/56     Pulse:  74

Lunch:  1515  & Meds What she ate:  4 oz polish sausage in a sesame seed hot dog bun w/ an oz each mustard and ketchup 4 oz sauerkraut 16 oz diet soda
Med/Dose	Administration	Explanation
metformin/425 mg	1/2 a 850 mg tab with meal	figured, with all the exercise and her spectacular BG number, this is all she'd need
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	with meal	standard breakfast, lunch and dinner med

    Today was our first "lunch out" day since I've been keeping my nose on the tail of her anemia. Little by little, her walkering is expanding. Today, before lunch, including our visits to the post office and the natural foods store where I buy her iron she probably did .3 of a mile. At Costco she probably added another .5 of a mile, walkering the perimeter of the store, at her insistence. "I haven't been here in awhile, I want to see what they've got," and off she headed. She spotted some ham steaks that she decided she'd like for dinner, so I guess I'll find out what happens to chicken when it's refrozen. I'm very optimistic about the stats I'll be taking before dinner.

Dinner

Blood Glucose:     Time:  2017     Reading:  97

Blood Pressure:     Time:  2033     BP:  120/53     Pulse:  86

Dinner:  2045  & Meds What she ate:  8 oz ham steak pan fried in 1 Tbl canola oil and 1 Tbl maple syrup 12 oz V-8 juice with 1/4 tsp cinnamon 1 medium banana
Med/Dose	Administration	Explanation
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
metformin/500 mg	1/2 a 1000 mg tab with meal
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	1 tab with meal	standard breakfast, lunch and dinner fare while she's anemic
Detrol/2 mg	1 tab with meal	standard breakfast and dinner fare while we're trying, again, to see if this will work on her
acetaminophen/500 mg	1 tab with meal	gave it to her to prevent stiffness in her legs from her extraordinary walkering, today

    Well, apparently I needed the nap I took. I "went down" (Mom's words for napping) at a little after 1800 and woke up just before 2000. Mom was already in the kitchen, a banana peel in front of her. She said she'd been up, "Oh, about a half hour or so," which means she could have been up anywhere from a couple of minutes (long enough to eat a banana, anyway) to a couple of hours. She was hungry. So, I considered the banana part of her dinner and took her stats. I was surprised at her blood glucose reading. For the past several months, since injuring her back, if she'd eaten a banana 10 minutes or more previous to me administering her regular meds, her blood sugar would already have boosted itself above normal and would have been on it's way higher. A "97" reading under Banana-before-a-meal circumstances is excellent! She often asks what her readings are and "how" they are. She did tonight. When I told her about the Post-Banana reading I explained that this meant that the exercise she was getting was doing its job and helping her body to regain some of its former health and robustness.
    "I suppose that means you're going to make me walk, more," she said, deadpan. Well, woman, of course! So far, this sardonic comment is the only negative reaction I've gotten to her increased movement out into the world beyond our home. I continue to have high hopes.
    I was pleased with her blood pressure, too. We may swing back and forth, on a daily basis, regarding timing of her lisinopril, but it looks as though 2.5 mg a day, at the appropriate time, based on her blood pressure readings, is going to do the trick. Maybe, with the increased movement, she won't need to take 5 mg a day. The less the better, when it comes to medication.

Today's Stats:

Breakfast

Blood Glucose:     Time:  1021     Reading:  95

Blood Pressure:     Time:  1109     BP:  126/52     Pulse:  65

Breakfast:  1120  & Meds What she ate:  1 hard over egg, heavily peppered 2 slices thick cut sugar cured lean bacon 1 Costco croissant with 1/4 tsp cinnamon sprinkled inside 8 oz orange juice diluted w/8 oz water
Med/Dose	Administration	Explanation
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
Albuterol/2.0+IPRAO/.5	nebulized during meal preparation	standard breakfast, sometimes dinner med
Protonix/40 mg	1 pill at least 1/2 hour pre-meal	standard breakfast med
Detrol/2 mg	1 tab with meal	standard breakfast and dinner med
metformin/500 mg	1/2 of 100 mg tab with meal	standard dose, because of orange juice, when her BG is in the 90's; and, frankly, didn't think to drop it to 425 mg, which I could easily have done, I think. I was just moving too fast, this morning, to think of it
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	with meal	standard breakfast, lunch and dinner med while she's anemic
acetaminophen/500 mg	1 pill with food	administered today specifically to counteract possible stiffness in the backs of Mom's legs from her recent walkering
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
vitamin C/1000 mg	with breakfast	standard breakfast supplement
folic acid/400 mcg	with breakfast	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	decide 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; vitamin E, by the way, has a thinning effect on the blood and enhances the use of blood thinners; this is why it's off the list, temporarily, I assume

    As I aroused Mom, I predicted internally that we wouldn't be done with breakfast until 1230 or so. As it turns out, at 1154 I was firing up my computer to input breakfast stats while Mom is savoring her cranberry juice and a few cigarettes before I put her back on oxygen for awhile. I'm not sure why the morning went so fast, but I'm pleased. I have yet to style Mom's hair, which takes about a quarter hour, and I think we should play a game of Sorry, just to give her body some time to think about having a bowel movement, then, we'll head for the grocery. Mom and I talked about Chicken Fricassee, last night, something neither of us has had; we actually didn't know the description. So, I looked it up and, lo and behold, we have everything we need for it except heavy cream. We could also use a few more pieces of chicken, since I've got enough stock for a full recipe. So, that's what we're going to have, tonight. In the process of making up the almost non-existent shopping list for this cooking venture, both Mom and I added a few other things we need besides the sugar that prompted the trip. I mock warned her that as she suggested items she was lengthening her walker time and distance in the store. This didn't seem to bother her. Just in case, you'll notice, I added a 500 mg acetaminophen to her morning med regimen. I'm really looking forward to an active day for her.

Surprising Lunch
    The first surprise was that, after we arrived home from a rousing walkering of the grocery store, Mom's was "ravenous", just 3 hours after she'd sat down to breakfast. Good sign, I figured, and set about getting her lunch and taking her stats, below:

Blood Glucose:     Time:  1508     Reading:  189 - 2nd surprise

Blood Pressure:     Time:  1506     BP:  101/52 - 3rd surprise     Pulse:  74

Lunch:  1520  & Meds What she ate:  sandwich w/ 4 oz tuna salad, 2 slices potato bread approx. 2 oz MCS's bread and butter pickles 12 oz V-8 juice with 1/4 tsp. cinnamon 3 sugar free, diabetic candies
Med/Dose	Administration	Explanation
metformin/750 mg	3/4 a 1000 mg tab with meal	as an attack on her surprisingly high blood sugar reading
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	with meal	standard breakfast, lunch and dinner med when she's anemic
acetaminophen/7400 mg	1 pill with meal	an attack on her surprisingly high blood sugar reading

    I can't say why her blood glucose was so high. It might have been the croissant, but I doubt it. It might be that, over the last few days, I've been lowering her level of metformin retained in her body to the place where it's a bit too low to take care of normal meals, so, I might have to up her metformin a bit, for awhile. I would be happy, with her much improved diet, more exercise, more awake time and improved alertness, if I could lower her metformin dosage judiciously and then, every so often, find that I have to mega-dose her for a day or two. I don't consider this a problem.
    Surprise number 3, her blood pressure, how low it was immediately after her jaunt around the grocery and, I might add, right after a cigarette, is a bit of a concern. But, typically, the more active people are, the lower becomes their blood pressure, so maybe I'm about to find out what my mother's true blood pressure is. In any case, I did not administer lisinopril and decided that I'll not post my decision to not administering it at lunch; only at breakfast and/or dinner.

Dinner

Blood Glucose:     Time:  1957     Reading:  80

Blood Pressure:     Time:  2040     BP:  137/61     Pulse:  61

Dinner:  2045  & Meds What she ate:  6 oz tuna mixture (celery, green onions, dill pickles, enough mayo to substitute for glue), 3 oz sharp yellow cheddar, one slice Bermuda onion, 1 oz dill pickle relish, grilled between 2 slices of toasted potato bread (a tuna melt) 1 slice lemon mousse cream cheese cake; 1" x 3" x 3".
Med/Dose	Administration	Explanation
glipizide/10 mg	1 pill at least 1/2 hour pre-meal	standard breakfast and dinner med
metformin/750 mg	3/4 a 1000 mg tab with meal
Iron Protein Succinylate/18 mg from 360 mg Iron Protein Succinylate	1 tab with meal	standard breakfast, lunch and dinner fare while she's anemic
Detrol/2 mg	1 tab with meal	standard breakfast and dinner fare while we're trying, again, to see if this will work on her
lisinopril/2.5 mg	1/2 5 mg tab with meal	seems that the lisinopril will now be most helpful being administered at dinner

    The dinner, even though it seems like somewhat of a repeat of lunch, was Mom's idea. She loves tuna. She remembered that she had it at lunch, today, and couldn't get it "off her taster". So, at her suggestion, we had tuna melts, tonight. The lemon mousse cake was something she eyed in the store that I allowed her to get. We'll be eating it mini-slice by mini-slice, chopped off the cake which will remain in the freezer over the next few weeks.
    I'm pleased with today. Although I was surprised at the high blood glucose, but it reminds me of her more active days, a few years ago, when her blood glucose at lunch was regularly high. So was her energy, her level of activity and her alertness. So, although I'll keep my eye on her sugar numbers, but I'll consider this, for the time being, lacking evidence for the opposite, optimistic.