Today's Stats:

Breakfast

Blood Glucose:     Time:  1208     Reading:  124

Blood Pressure:     Time:  1350     BP:  125/52     Pulse:  74

Breakfast:  1400  & Meds What she ate:  1 hard over egg, heavily peppered 3 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 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	1/2 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	her blood pressure appears to be returning to normal, even a bit on the low side, diastolically, so, considering the amount of lisinopril she received yesterday, I nixed this dose.

    Although my plan, as I stated in my morning journal entry, was to awaken her at 1030, when I attempted this she responded, from out of the depths of sleep, "Go away."
    I'd been checking on her throughout the morning and, usually, when I let her "pick" her wake up time, I determine her druthers by watching her eyes. When her eyelids open by a slit and the bottoms of her irises are visible, this is when I know I'll probably have some success awakening her. This didn't happen until just after noon, today. This was my first indication that she was going to be experiencing the leveling effect of the antibiotic that she didn't experience yesterday. In fact, she wasn't particularly thrilled with the idea of waking at noon, but I could not let her dehydrate any longer. We wrestled her lethargy until about 1315, when I finally semi-whupped her up and she took herself the rest of the way.

Dinner

Blood Glucose:     Time:  1901     Reading:  70

Blood Pressure:     Time:  2006     BP:  135/61     Pulse:  64

Dinner:  2000  & Meds What she ate:  We had nachos, to tempt her appetite. See previous recipe for what they contained; the only difference is that we used a different type of salsa and the tortilla chips were the kind that are formed into little cups.
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 dinner med
Cipro XR/500 mg	1 tab 2 hours after dinner	according to my research, this is the best time to administer this antibiotic

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
36 mg Iron Protein Succinylate	2 18 mg tabs 1 hour before meal	cut this dose since Cipro XR should not be taken 6 hours before or after iron
vitamin C/500 mg	with iron supplement	cut this dose because I cut the iron

    That's right, no lunch today. She slept through it. I wasn't surprised and I didn't worry. I just allowed her body to silently fight the infection and let sleep prepare her for the final onslaught tomorrow. I have no idea what her energy level is going to be like tomorrow. Although I pushed fluids the entire time she was awake, today, since she wasn't awake that much, she went to bed minimally hydrated. So, tomorrow, regardless of her energy level, and I told her this as I tucked her in, I'm not going to let her sleep quite as long as I let her sleep tonight. Optimistically, when I awoke her from a 2.5 hour nap at 1900 and reminded her that the Eukanuba Dog Show was on tonight, she was excited, reared out of bed, and she was seated with dinner in front of her ready to watch it when it started at 2000. She remained attentive through the entire show, we discussed several of the dogs, she chided me when my attention was distracted during a sidebar about a particular breed that she wanted discuss, and we talked imagin-airily about getting a Newfoundland puppy "for The Girls [our cats] to raise. So, I'll be ready for anything, tomorrow.

Today's Stats:

Breakfast

Blood Glucose:     Time:  0942     Reading:  136

Blood Pressure:     Time:  1045     BP:  153/78     Pulse:  58

Breakfast:  1100  & Meds What she ate:  2 oz pork sage sausage scrambled with one egg, heavily peppered 1 slice toasted oat bran 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
lisinopril/5 mg	1 tab with meal	increased her dose because her blood pressure indicated she could handle it, and probably needed it
2 oz aloe vera juice gel	with meal	standard dose to help increase the sensitivity of her cells to insulin
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
metformin	any amount with meal	at this point, I still wasn't quite aware of what the antibiotic was doing to her blood sugar; so, I continued my cut back program

    Although her blood sugar was a little higher than usual, I had no idea what was about to happen as the antibiotic in her body continued to activate in the presence of her other meds. As you can see, above, I was about to find out.

Lunch

Blood Glucose:     Time:  1429     Reading:  177

Blood Pressure:     Time:  1439     BP:  139/58     Pulse:  56

Lunch:  1440  & Meds What she ate:  sandwich w/ 4 oz tuna salad, 2 slices oat bran bread 4 radishes 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	standard lunch dose

    At this point, I figured, time to go back to the old strategy to control her blood sugar until 24-48 hours after her last dose of Cipro XR, depending on how her blood sugar performed. Although her systolic blood pressure was high, for her, I didn't administer any more lisinopril.

Dinner

Blood Glucose:     Time:  1947     Reading:  119

Blood Pressure:     Time:  1956     BP:  174/71     Pulse:  57

Dinner:  2000  & Meds What she ate:  Approx 12 oz macaroni and cheese with hamburger and pork sage sausage, chopped celery, chopped onion and chopped bell pepper
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 dinner med
Cipro XR/500 mg	1 tab 2 hours after dinner	according to my research, this is the best time to administer this antibiotic
lisinopril/5 mg	1 tab with meal	again, because of the volitility of her systolic blood pressure, figured she could use it

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
36 mg Iron Protein Succinylate	2 18 mg tabs 1 hour before meal	no evening iron until she has finished her course of Cipro XR
vitamin C/500 mg	with iron supplement	since this goes with the iron and the iron was deleted, so was this

    I was truly surprised, today, that she remained up the entire day. The zig-zag in her energy level became apparent, today. One minute she give me a bleary stare and tell me she was going in to take a nap. Fifteen minutes later, she'd have forgotten about taking a nap and when I'd query whether she was planning a nap, she'd answer me with a curt, surprised, "No," as though it was the furthest thing from her mind. I imagine that her blood pressure and her blood glucose were probably zig-zagging, too.
    I was truly surprised, considering what I'd read about the antibiotic, that she remained up for so long. She didn't go to bed on this day until between 2300 and 2400, after the Star Trek: Deep Space Nine two parter on Spike TV ended, and we'd discussed it, which surprised the hell out of me that she had the presence of mind and energy to have paid attention. Although it's a series for which she and I both share a fascination, I wasn't expecting her to handle the side effects of the Cipro so well. As it turns out, Saturday was the day it leveled her.

Today's Stats:

Breakfast

Blood Glucose:     Time:  1004     Reading:  119

Blood Pressure:     Time:  1111     BP:  106/57     Pulse:  70

Breakfast:  1130  & Meds What she ate:  2 oz pork sage sausage scrambled with one egg, heavily peppered 1 slice toasted oat bran 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
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; BP too low to justify this
metformin	any dose with meal	not administered because I thought her blood glucose would hold its own
Daily Senior Multivitamin	with breakfast	not administered in order to avoid reactions with any possible medications that might be administered by the urgent care clinic
folic acid/400 mcg	with breakfast	not administered in order to avoid reactions with any possible medications that might be administered by the urgent care clinic
vitamin E/400 IU	with meal	not administered in order to avoid reactions with any possible medications that might be administered by the urgent care clinic
garlic/1250 mg	with meal	not administered in order to avoid reactions with any possible medications that might be administered by the urgent care clinic

    This was the morning I noticed the pinkish tinge of her urine. While she was eating breakfast, I was calling her PCP in Mesa and being instructed to take her to an urgent care clinic. I was aware that we were probably dealing with a urinary tract infection and that she would probably be administered, at the very least, antibiotics. Thus, I held off all her supplements, except the cranberry juice, so there would be no possibility of reactions.

Miscellaneous Midday Stat

Blood Glucose:     Time:  1551     Reading:  134

    I took this at the urgent care center, because I was concerned, since we still hadn't been seen and had no idea when we would be seen, that her blood sugar might be dropping. Obviously, it wasn't, but, since I couldn't guarantee when we'd be seen and out of there, thus, when she would eat, again, I gave her 3 wintergreen Altoids. Good thing I did. We didn't leave the clinic until just after 1700.

No Dinner Stats
    When we were finally released from the clinic, Mom was ravenous and I was hungry. We decided to stop on the way home for Carl's Jr. Six Dollar Guacamole Bacon Burgers, one small order of onion rings and one small order of fries, both of which we split. The only medication she received, that evening, was her glipizide, which had to be administered with her meal, and her first dose of Cipro XR. No stats were taken that evening. I couldn't see any reason to, since that stats weren't going to make any difference in what she ate or what medication I gave her. We ate dinner about 1800. For the three days she'll be on Cipro XR, she won't be receiving her evening dose of iron. That's fine. This is not the power dose that she'll be missing. Cipro XR should not be administered within 6 hours, either way, of iron supplements.
    I did, though, give her 2 oz aloe vera juice, in the hopes that it would perform a little sensitivity training on her cells.

Today's Stats:

Breakfast

Blood Glucose:     Time:  0940     Reading:  108

Blood Pressure:     Time:  1048     BP:  131/66     Pulse:  76

Breakfast:  1100  & 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
lisinopril/2.5 mg	1/2 tab with meal	looks like I might be giving this to her pretty regularly, now; which, I think, is a good sign, since her BP is affected negatively by her anemia and her BP returning to a state where it can handle lisinopril is an indication that she is returning to hemoglobin health
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
metformin	with meal	decided to try her on only glipizide, today, to see how she does, especially since she decided she didn't want a raspberry-um-thing, this morning, but just one piece of toast

    As I headed toward her bedroom at 0900, this morning, I was caught by a business call directly relating to the business we were planning on doing, today, and didn't head back down the hall until 40 minutes later. It's okay, though. We can put the business off for another day.
    Since, for reasons I'll discuss in my main journal, today is going to be a slow day, I'm going to try her on just glipizide, three doses of 10 mg, today, and see how that works. I don't have the aloe vera, yet, and probably won't get that until tomorrow, but this will help me determine how much supplementation she actually needs.

Lunch

Blood Glucose:     Time:  1551     Reading:  100

Blood Pressure:     Time:  1612     BP:  135/68     Pulse:  58

Lunch:  1615  & Meds What she ate:  sandwich w/ 4 oz tuna salad, 2 slices oat bran bread approx. 2/4 cup small curd 4% cottage cheese 11.5 oz V-8 juice with 1/4 tsp. cinnamon
Med/Dose	Administration	Explanation
acetaminophen/250 mg	1/2 a 500 mg tab with meal	we walkered a very little this afternoon before she ate; her knees continue to be very iffy and she didn't do as well as she did yesterday; so I gave her this to help
2 oz aloe vera juice	with meal	considering how well her blood sugar is performing, decided to try this; 2 oz is the dosage recommended on the bottle

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
metformin/250 mg	with meal	decided to see how her blood sugar performs with just the cinnamon and the aloe vera juice

    Considering how well her blood glucose tested without the metformin at breakfast, and considering that I was able to obtain aloe vera juice before lunch, I decided to try depending on only the cinnamon and the aloe vera juice and see how her blood glucose tests at dinner.
    I'll discuss this further at The Mom & Me Journals dot Net. Give me maybe an hour or so from the time of this posting to get over there, write and publish.

Dinner

Blood Glucose:     Time:  2100     Reading:  158

Blood Pressure:     Time:  2119     BP:  167/78     Pulse:  56

Dinner:  2140  & Meds What she ate:  I made what I normally call "Quick Beef Stroganoff" but what my mother, who is sitting beside me at the dinner table as I write and reading The Joy of Cooking for pleasure has informed me is actually a cross between Beef Stroganoff and Sauerbrauten, so, I guess it's actually Quick Beef Strogansauer. Essentially, what she had was: approx 6 oz beef rib eye steak approx 1/4 cup chopped celery approx 1/4 cup chopped green and gold bell pepper approx 1/4 cup chopped yellow onion a little less than 1/8 cup tarragon vinegar a dash of sweet basil a dash of Old Bay Seasoning approx 1 Tbl sour cream approx 1/2 cup brown gravy (from a powdered mix) approx 3 oz fusilli
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
lisinopril/5 mg	1 tab with meal	her BP was pretty high, for her; could be because of the cold, but I thought it might be wise to give her a 5 mg dose of lisinopril, even though she had 2.5 mg earlier today; she used to be on 10 mg twice a day, which was probably unnecessary, so I don't feel at all as though I'm overdosing her, now
vitamin E/400 IU	with meal	gave this to her in the interest of a little more anticoagulation, in case her BP is a result of needing this property
garlic/1250 mg	with meal	gave her this for its antibiotic properties, since I don't have any standard antibiotics in the house, at the moment
acetaminophen/500 mg	1 tab with meal	I think she was sweating out the end of a low grade fever when she awoke from her nap, she has some congestion, as well, and her knees are still "iffy", so, I administered a full extra strength dose

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
metformin/250 mg	1/4 a 1000 mg tab with meal	decided not to reintroduce this tonight, even though her blood glucose is high, because I'm planning on starting a new regimen tomorrow that should take care of this type of spike

    Once again, I'm going to discuss these stats over at The Mom & Me Journals dot Net, so meet me over there in a little while.

Today's Stats:

Breakfast

Blood Glucose:     Time:  1101     Reading:  126

Blood Pressure:     Time:  1203     BP:  149/68     Pulse:  67

Breakfast:  1215  & Meds What she ate:  1 hard over egg, heavily peppered 2 slices thick cut sugar cured lean bacon 2"x 2"x 1" raspberry-um-thing w/1/2 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
lisinopril/2.5 mg	1/2 tab with meal	her blood pressure indicated she could handle this, today
metformin/225 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

    Pretty normal breakfast, this morning. Although her blood glucose was a little high, I attributed this to the pizza and decided not to increase her metformin, although I didn't decrease it, either. More on new ideas to treat her diabetes at the immediately previous link at The Mom & Me Journals dot Net.

Lunch

Blood Glucose:     Time:  1614     Reading:  113     Time:  1810     Reading:  140

Blood Pressure:     Time:  1812     BP:  130/57     Pulse:  64

Lunch:  1645  & Meds What she ate:  sandwich w/ 4 oz tuna salad, 2 slices potato bread 3/4 cup 4% small curd cottage cheese heavily peppered 11.5 oz V-8 juice with 1/4 tsp. cinnamon
Med/Dose	Administration	Explanation
glucotrol/10 mg	1 tab 1/2 hour before meal	thought I'd give this a try today

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
metformin/250 mg	1/4 1000 mg tab with meal	decided to see how taking glipizide instead of metformin at lunch worked

    First, you'll notice that I forgot to take her blood pressure at lunch. So, I took it halfway between lunch and dinner, when I decided to do a between meal check on her blood glucose. As you can see, it appears as though the research I've read is reliable, any dosage of glipizide over 20 mg doesn't appear to make a difference. So, tomorrow, we'll (or I'll) make a quick trip to Costco and pick up some aloe vera juice. The recommended dose is 1 Tbl (15 grams) twice a day with her glipizide.

Dinner

Blood Glucose:     Time:  2014     Reading:  90

Blood Pressure:     Time:  2109     BP:  156/66     Pulse:  59

Dinner:  2110  & Meds What she ate:  Cobb Salad exactly like the one she had for dinner on July 11, 2004, with the addition of: 3 diced green olives fresh sweet basil leaves added to the greens 1 diced green onion
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
lisinopril/2.5 mg	1/2 tab with meal	normally, she only gets one dose a day, but, because her blood pressure remained high, for her, today (I think I allowed her to smoke more than usual, which may have been the cause), I administered this twice, her dinner dose being the second dose

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
metformin 250 mg	1/4 a 1000 mg tab with meal	I am, as you can see, cutting down on her metformin; because her blood glucose balanced itself out by dinner, I decided I could dispense with this medication, tonight, in the interest of seeing how 3 doses of glipizide worked on her by morning

    Tonight's discoveries and personal recollections, I think, deserve to be discussed at The Mom & Me Journals dot Net. The previous link will take you directly to that discussion, once it's posted, which will probably be within a half hour of the time this is published.

Today's Stats:

Breakfast

Blood Glucose:     Time:  1233     Reading:  110

Blood Pressure:     Time:  1337     BP:  140/62     Pulse:  72

Breakfast:  1350  & Meds What she ate:  1 hard over egg, heavily peppered 4 oz sugar cured ham steak a 2"x 2"x 1" slice of that raspberry-um-thing w/3/4 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/250 mg	1/4 of 1000 mg tab with meal	new 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	decided to wait until later in the day, especially since she too her lisinopril in the evening, yesterday.

    Although, from the looks of it, Mom slept in again, she actually didn't. Since we retired around 0230 this morning and she roused (on her own, I might add) at 1215, she actually got only 9h45m of sleep. This is a record low, taking into consideration her typical sleep times. I attribute some of it to the nap she had yesterday and some of it to the increased activity in her life. Today, though, for reasons on which I can't quite put my finger, I have a feeling that she'll be going to bed at her usual time, somewhere between 2200 and 0000. I expect we'll only get in two meals. She's decided that I've overruled pizza long enough, so that's what we're having tonight. Her plan is that we'll order pizza around 1830 so it will be here in time for her pizza-TV plan (really good pizza-TV doesn't usually start until 1900).
    Yes, I picked up the Protonix, yesterday, so no substitutions there. I am very pleased with her blood glucose. Tomorrow, I think, will be a good time to start midday glipizide. I haven't decided whether to administer it with metformin or not.
    Although we have no out-of-the-home plans, I've "warned" her that we'll be walkering on the driveway, later, just to keep her in practice. She seems amenable to this.

Dinner

Blood Glucose:     Time:  1826     Reading:  116

Blood Pressure:     Time:  1912     BP:  135/53     Pulse:  64

Dinner:  1915  & Meds What she ate:  1/4 of a 14" Streets of New York Pizza with extra sauce, pepperoni, Canadian bacon, onion, green olives and sun dried tomatoes
Med/Dose	Administration	Explanation
36 mg Iron Protein Succinylate	2 18 mg tabs 2 hours after 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

Conspicuously Absent Meds & Supplements
Med/Dose	Administration	Explanation
lisinopril/2.5 mg	1/2 tab with meal	decided to wait until tomorrow morning; her systolic is okay for it, but I don't like her diastolic

    As I suspected this morning, we did, indeed, have only two meals, today. She picked the pizza toppings; except for the extra sauce, which I picked. We froze half the pizza for a future lunch or dinner.
    Her energy has been pretty low, today, but I think most of that has to do with the weather. When the pressure drops, her joints bother her and she finds it even harder to move than normal. I dressed her up and we started out to do some walkering on the driveway, but when we got about halfway down the driveway she looked at me under the brim of her hat and said, "I don't want to do this, today." I asked her if she felt bad and she said, "No, I just feel like I'm having to push through the air in front of me." As she said this, she raised her arms and mimed trying to push a brick wall forward. I respect that.

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.