Combined Dinner Stats: 5/11 - 5/13/05

5/13/05

Blood Glucose:     Time:  2107     Reading:  112

Blood Pressure:     Time:  2107     BP:  133/69     Pulse:  59

BM 5/12/05

Blood Glucose:     Time:  1903     Reading:  138

Blood Pressure:     Time:  1902     BP:  150/66     Pulse:  52

    Both stats are a little higher than usual. I'm not sure why. Could be that she was up for only two meals, breakfast and dinner, and the scone didn't get a chance to work it's way out of her system. We've been having scones regularly and, since I haven't been taking her Lunch Stats during this stat collection, I don't have any idea how long it's taking for her body to metabolize the sugar they contain.
    I was not at home for her Bowel Movement. It happened about 1645. Her report tells me that it was easily eliminated and of fair volume. Cleaning her after I arrived home a little after 1700 told me that it was fairly soft, as she had attempted to clean herself [apparently she had wandered through the house literally butt (versus buck) naked and found some toilet paper to use] and had managed to smear her lower parts with feces stem to stern. As well, using paper in her toilet clogged it a little.
    I noticed, last night, when she awoke for what is becoming her regular middle-of-the-night peeing, that her urine appeared to be a bit cloudy. I don't know whether this was because it came out cloudy or it was mixing with the half flushed water in the toilet. Tomorrow morning should "tell the tale", since I managed to clear the pipe last night when she returned to bed and deliver a cleansing flush to the toilet.

5/11/05

Blood Glucose:     Time:  1854     Reading:  129

Blood Pressure:     Time:  1854     BP:  133/59     Pulse:  52

    Not sure why her glucose is this far above normal at dinner. I'll repeat the same lunch, yoghurt, two slices of olive loaf and 12 oz. diet root beer, for the next couple of days, if I can get away with it, and we'll see if it might be the olive loaf, although I doubt it. It's a fairly regular substitute for olives.
    This isn't something I'm freaking over. Just a minor mystery. If it turns out to be the olive loaf, I won't delete it from her diet or even serve it less often. I'll just be aware of what it does to her blood glucose.

BM - 1030

    She was up on her own, this morning. I was so involved in reading backed-up email newsletters and discarding junk mail that I didn't hear her. The Little Girl, who usually signals me that she's up if I'm not paying attention, was transfixed by the goings on around our property, since I opened all the windows this morning. I was alerted by Mom calling me, from her seat on the stool. She'd had a bowel movement and was asking for toilet paper. Despite all the things she remembers, the fact that I clean her, now, after every bowel movement and that I disallow toilet paper (or any paper, for that matter) to be used in her bathroom so it won't end up in her toilet, are aspects of her care I believe she judiciously chooses to forget because both practices are repugnant to her. So, every time she has a bowel movement I am either forced to remind her, in detail, why I clean her (because she always reacts with shocked surprise) and why no paper of any kind is allowed in her bathroom, or, if it's "one of those days" when I simply can't find it in myself to repeat any information, let alone this, I tell her, frankly, that I'm not in repeat mode on that day and she'll just have to trust that I've told her all this before, what we're doing is a very regular part of our routine and that's that. Of course, saying this is also a repetition, but it's a short one, not liable to throw me into repetitive insanity.
    So, yes, she was up early (for her). Probably about 1015. Her Bowel Movement was easily expelled. It was good volume and consistency, a finisher from yesterday's (5/10/05) short, quick, small movement that happened early in the afternoon (about 1415). Lately she's been having what I call "clean" movements, after which clean-up is a breeze. Today, though, although certainly not loose, her movement was soft and extremely magnetic. Clean-up was involved and messy. She was not pleased. I've learned to coax her to "relax" when I'm cleaning around her urethra and clitoris (yes, her shit travels all the way up into her clitoral hood if her movement is at all soft) or she complains that it "hurts". Well, of course it hurts, I tell her. She's clenched tighter than a crocodile's jaws on a human limb! I also remind her, when she complains, that the alternative is for her to lie on her back and spread her legs while I "have at" her. I consider that this would be much easier on me but she is not interested in the indignity involved.
    A little over a month ago I began habituating her to traipsing to the bathroom every two hours so "we can check [her] underwear, see if it needs to be changed". Invariably, she argues that she "doesn't have to go" then discovers, after seating herself on the toilet, that she has to pee. I've noticed, too, that this habit has caused her to become more aware of her urges to urinate. As well, it appears as though doing this is also informally training her to hold her urine (about 50% of the time, which is significantly better than previously) until the two hour check, thus, her paper underwear is often dry as a bone when we visit the bathroom. As well, a couple of times in the 'middle' of her night, usually just before I retire, she's awakened and taken herself to the bathroom to pee. When she does this I immediately change her underwear. As a result, we have mornings sprinkled throughout her week when her bed is almost completely dry. Today, for instance, I could have gotten away with not changing and washing her top sheet and spread, but I did it anyway, since we are working our way through her new sheets and spreads and she delights in the surprise of what her bed is going to look like each day.
    I wish I had read about and/or thought of the two hour underwear check before this. I did, in fact, run across an article. a week or so after I began the routine, which suggested it, although it didn't mention that the routine could have an effect on urinary behavior. The reason I initiated the routine is because I was getting tired of washing cushions three times a week. I noticed, about the same time that when she sits crooked on the cushions on her chairs she is more likely to leak. I've been reminding her to modify this behavior and I believe I'm noticing that she is having less trouble rising out of her chairs because her 'seat' is better aligned.
    One other bit of urinary behavior I've been working on modifying: She developed the habit that I call "The Lazy Man's Pull Down". When preparing to sit on the toilet she hasn't been pulling her pants and underwear down far enough so that she doesn't sit and pee on them. Thus, she was wetting the upper back of her pants in the bathroom on the toilet and we were going through two to three pairs of pants a day. I began reminding her to pull her lower clothing "all the way down so you don't pee on it" a couple of weeks ago. Since then, my laundry loads have lightened, a bit.
    Breakfast was normal, served at about 1130. We're still working our way through the batches of scones I baked. No medication additions or subtractions.

Current Med Doses And Typical Breakfast & Lunch

Breakfast:  Anywhere from 0930-1300  & Meds What she typically:  1 hard over egg, heavily peppered 3 slices thick cut sugar cured lean bacon 1 slice toasted oat bran bread, or a scone or muffin during spring and summer, with 1.5 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]	1/2 hour before breakfast	to pull her out of what I hope is her temporarily severely anemic state
vitamin C/500 mg	1/2 1000 mg tab with Niferex-150	helps the body metabolize iron
100% Aloe Vera gel/1 oz	just before meal	helps increase the cells' sensitivity to insulin when used with glipizide
Protonix/40 mg	1 pill at least 1/2 hour pre-meal	standard pre-breakfast med
glipizide ER/10 mg	1 pill with meal	standard breakfast and dinner med to increase cells' sensitivity to insulin
aspirin/81 mg	1 tab with breakfast	standard breakfast med - given for anti-coagulant properties
lisinopril/2.5 mg	1 tab with meal	given for kidney protection when her blood pressure can handle it and blood pressure control
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; a natural antibiotic and anti-coagulant

Lunch:  Anywhere from 1400-1700  & Meds What she typically eats:  8 oz non-fat, artificially sweetened yoghurt 4-6 unpitted variety olives in a vinegar, olive oil, dill brine 11.5 oz V-8 juice or cranberry juice (as described below)
Med/Dose	Administration	Explanation
none at the moment

Dinner:  Anywhere from 1800-2100  & Meds What she ate:
Med/Dose	Administration	Explanation
100% Aloe Vera gel/1 oz	just before meal	helps increase the cells' sensitivity to insulin when used with glipizide
Niferex-150 [150 mg elemental iron]	just before meal	to pull her out of what I hope is her temporarily severely anemic state
vitamin C/500 mg	1/2 1000 mg tab with iron supplement	helps the body metabolize iron
glipizide ER/10 mg	1 pill with meal	standard breakfast and dinner med to increase cells' sensitivity to insulin
lisinopril/2.5 mg	1 2.5 mg tab with meal	given for kidney protection when her blood pressure can handle it and blood pressure control
vitamin E/400 IU	with meal	given for anti-coagulant properties
garlic/1250 mg	with meal	given for anti-coagulant properties
calcium-vitamin D/500-200 mg	with meal	believed to be an osteoporosis preventative

    Lately, she's only been drinking one "dose" of cranberry juice a day, usually at lunch or dinner. She "takes" it for kidney protection, enhancement of waste elimination and for its anti-oxidant properties. I serve her pure cranberry juice, about 6 oz., mixed with about 10 oz. water and two teaspoons of Splenda®, to make it more palatable to her. Occasionally she'll get two glasses a day, if she asks for it.
    Throughout the last "stat ketchup" period she has not taken any other medications, including Phillip's Milk of Magnesia (which I very occasionally administer for minor constipation) and acetaminophen (which I sometimes administer if she is exceedingly stiff or complaining of joint pain).
    Because her blood sugar remains under such good control, especially at lunch, I don't worry about a second "dose" of cinnamon, anymore. There are also days when she skips the V-8 juice, especially if we're having lots of vegetables in other ways.
    As the weather warms up (the warming is happening late this year) and she moves more, I expect that we'll be getting out more. This means that her lunches may become heartier, especially if we "take lunch/dinner out", which often happens when we are out and about. She loves to eat in restaurants. When we eat out, I let her have anything she wants. This isn't as food-hardy as it might seem, as her food choices have improved steadily and extraordinarily over the last more than a few years. If eating out frequently becomes the case, it will be interesting to see how her blood glucose levels respond, especially since she'll also be getting significantly more exercise.

Further Stat Review

    You'll notice that on May 8th I took her stats in the morning. This is because she had a two scoop brownie Sundae on Saturday night. Thus, the next morning I was curious as to how well her body had assimilated the sugar overload from the night before. As you can see, it did well.
    I forgot to take stats tonight. I've become so relaxed about the taking of stats that, as I'm sure you've noticed, I forget an occasional day here and there.
    You'll also notice that when I take breakfast stats I avoid taking her blood pressure. Essentially, her most active time is her "morning". It is hard to find a time to take her blood pressure when she is not talking, or moving, or fussing with me. As well, this is when she wears her bulky bathrobe over her clothes and this piece of clothing gets in the way of taking her blood pressure without fussing.
    Although her diastolic looks very good, I am still concerned that her systolic is all over the map and usually above 120. I don't want to add too much more blood pressure medication to her schedule, but I'm considering asking the FNP at our next appointment if perhaps I should be giving her one and a half 2.5 mg tablets of lisinopril, or at least try this. Or, some other variation on three tablets a day...say, maybe, 2 tabs at night, or maybe one tab three times a day. I'm not going to vary her medication, though, until her next appointment, which will probably be sometime during the latter half of June.
    She has another blood draw coming up on Friday. Although I'm sure she's not looking forward to it, I am. If everything remains as it is now, her urinalysis should come out fine and clear, she may be a little anemic but only a little, and everything else except her BUN and probably her eosinophils should look pretty good.
    Oh, yes. I forgot to take stats today.

Yes, I'm catching up on stats...

...finally. I'm dating them day by day (the days they were taken, anyway). These stats are a continuation of one set of stats per day. I have no information on what meals were served, nor Bowel Movement stats. I'm thinking I'll probably start recording these again, at least in an abbreviated manner. I certainly won't record day after day of the same breakfasts, anymore.
    My intention is also to update her medication schedule and keep up with changes in that, although I believe it has endured only one change since the last time I recorded it. When recording meals, the presentation will be somewhat less formal and will include "recipes", such as they are. I will probably include BM information here, too, from now on.
    As a review, her eliminations continue to be normal, regular and easily moved, normally every 36 to 48 hours. Occasionally she'll clean out her colon over a two day period. Volume and consistency remain good and normal (for someone who is ingesting as much iron as she). No constipation, no straining.
    Meals have remained, mostly, as always. Breakfast is almost always bacon, eggs, toast and orange juice. Lately, of course, the toast has been replaced by scones and throughout the summer muffins will probably be frequent. Cinnamon is still served on her bread. Lunch, now, is usually 8 oz. of non-fat, artificially sweetened yoghurt, olives, anywhere from 4 to 6, or a couple pieces of olive loaf and either V-8 juice or cranberry juice (about 6 oz. pure cranberry juice with a couple of teaspoons of Splenda to make it palatable to her and 12 oz. of water). I don't put cinnamon in her V-8 juice, anymore. It doesn't seem necessary. Dinners remain varied, depending on her mood, my mood and what we have in the pantry. Desserts remain rare.
    Well, without further ado, let me put Mom to bed and begin recording past stats.

Combined Stats: 5/8 - 5/9/05

Dinner 5/9/05

Blood Glucose:     Time:  1945     Reading:  94

Blood Pressure:     Time:  1944     BP:  142/65     Pulse:  56

Breakfast 5/8/05

Blood Glucose:     Time:  1150     Reading:  102

Blood Pressure:     Time:  1159     BP:  132/59     Pulse:  50