BM Almost Full Stat Day

A.M. Blood Glucose:     Time:  1234     Reading:  105

A.M. Blood Pressure:     Time:  1301     BP:  132/58     Pulse:  56

P.M. Blood Glucose:     Forgot to take

P.M. Blood Pressure:     Time:  21:38     BP:  153/74     Pulse:  54

    Dinner: Rolled flank steak with Portobello mushrooms and corn on the cob with chocolate cake afterwards.
    Her Bowel Movement occurred with Mom being aware of it at 1536: Wore than poor volume, yet another tag end; excellent consistency; very easy elimination; very easy clean-up.

BG Stat Day:

A.M. Blood Glucose:     Time:  1231     Reading:  115

P.M. Blood Glucose:     Time:  2040     Reading:  92

    Well, things are looking good, even without the evening glipizide dose. I think, for awhile, anyway, I'll be recording what she eats for lunch, again, just in case anything disturbing develops.
    Lunch occurred around 1800 when she arose from her nap. She had about 2/3 cup of cottage cheese, six mini dill pickles and a 1 oz. bag of peanuts.
    I served a super-spectacular dinner: Braised country style beef ribs in an amazing home concocted hoisin sauce and a healthy dinner salad with mixed greens, sliced radishes, chopped Bermuda onions and green pepper, chopped pickled asparagus, chopped green pimiento stuffed olives, fresh shredded Parmesan, topped with crushed Salt & Pepper Kettle Chips instead of croutons and my mixture of Greek feta/Italian dressing. She didn't quite finish her salad but finished all her meat. I only braised two ribs because each rib was probably about 8 oz and pretty lean.
    I should note that I got her out on the driveway for a walkering session, three laps, well before her nap.
    She retired at 2325. Her light went out just minutes ago.

BM BM Full Stat Day:

A.M. Blood Glucose:     Time:  1326     Reading:  121

A.M. Blood Pressure:     Time:  1325     BP:  140/65     Pulse:  54

P.M.Blood Glucose:     Time:  2017     Reading:  88

P.M. Blood Pressure:     Time:  2007     BP:  127/72     Pulse:  53

    Although she was awake and pulling herself to a sitting position when I entered her room at 1300, she was slow on the uptake (¿I wonder why?) and it took awhile and much petting of and talking to The Little Girl to get Mom into the bathroom.
    Notice the double BM up there? She had two minor releases, today, getting rid, I guess of the tail ends of her head 'em up move 'em out bowel movement yesterday: The first was in the morning at 1325: She didn't even know she'd produced this one. The last was at 2120. Both were smeary and required challenging clean-up and patience on her part to endure my thoroughness. I'm not sure whether the consistency is due to upping her Benefiber dose or the fact that she's had green pimiento stuffed olives a lot, lately, for lunch.
    Dinner was an old favorite that we haven't had for a couple of weeks, mac & cheese with added extra sharp Vermont White Cheddar, added ground round and pork sausage and added chopped onions, green peppers, celery and garlic.
    We had a low going through here today, which more or less accounted for a longer than usual nap, from 1700 to 1930. She'd complained about her knee bothering her all day long. Just after dinner I gave her a 325 mg aspirin for it. She stayed up until almost midnight and her demeanor was so lively that she tried to pull one of her cruelty stunts on The Little Girl, who, interestingly, recognized her approach, yelled at her, backed away from her and refused to let Mom pet her again until just before bed when she was in the bathroom getting ready to retire. The Little Girl's reaction surprised Mom. I was pleased. It's a good idea to keep on one's toes when around Mom when she's feeling good.
    This evening, by the way, was the first evening of deleting one of her glipizide doses from the schedule. I'll probably be knocking out evening sweets, as well, although I can't see any reason not to push them into the morning hours, if she's interested. Usually, though, she's not. I think we'll give the experiment a few days, though, before I insert any sweets into her meals. I will, by the way, reinstate twice daily blood glucose readings, although I'll still skip days with her blood pressure readings.

Current Medication & Supplement Schedule

2/9/06: Change in Med Schedule: Amount of Benefiber at breakfast now is 2 Tbl, measured as 6 tsp; although I haven't been changing this schedule as the upping has taken place, it has occurred in two increments of 1 tsp upping apiece.

ADDITIONAL NOTE: The major change here is that her second dose of glipizide at her last meal of the day has been dropped, due to her unusually low HA1c results from her blood draw of 2/03/06.     As well, her extra folic acid (the 400 mg pill), has been transferred to her evening meal, since she receives 400 mg folic acid in her Daily Senior Multivitamin in the evening.
    A few other schedule changes have taken place: I now administer her evening lisinopril, iron and Vitamin-C at bedtime in order to separate these dosages, as much as possible, by 12 hours, so the levels in her body remain fairly constant.
    I have also cosmetically changed the schedule to better represent the timing of her medications: There is now an UPON AWAKENING BEFORE BREAKFAST schedule and a BEFORE BED schedule.

UPON AWAKENING BEFORE BREAKFAST:

Med/Dose	Administration	Explanation
lisinopril/10 mg	1 10 mg tab upon awakening before breakfast	given to lower her blood pressure and protect her kidneys; works by relaxing the blood vessels
Niferex-150 [150 mg elemental iron]	1 tab upon awakening before breakfast	to keep her iron deficiency anemia under control; switched from breakfast to immediately upon awakening in order to separate doses by about 12 hours.
vitamin C/500 mg	1/2 1000 mg tab with iron supplement	helps the body metabolize iron
Protonix/40 mg	upon awakening before breakfast	standard pre-breakfast med; protects her intestinal lining to prevent ulceration and bleeding

BREAKFAST

Med/Dose	Administration	Explanation
100% Aloe Vera gel/1 oz	just before meal	helps increase the cells' sensitivity to insulin when used with glipizide
glipizide ER/10 mg	1 pill with meal	standard breakfast and dinner med to increase cells' sensitivity to insulin
coated aspirin/81 mg	1 tab with breakfast	standard breakfast med - given for anti-coagulant properties
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
garlic/1250 mg	with meal	standard breakfast supplement; a natural antibiotic and anti-coagulant
1 1200 mg Omega-3 Fish Oil capsule	with meal	Although her PCP is not concerned about her cholesterol and triglycerides, I've added this to see if it helps keep these levels optimum. As well, it seems that there are other benefits ascribed to this supplement which may or may not apply to my mother, including sharper mental functioning and increased skin elasticity.
1 12 oz cup Yogi Tea Detox or Peach Detox tea	with meal	This tea is specifically designed to promote liver and kidney functions.
2 tbl Benefiber	with meal, in orange juice	promotes timely, easy bowel evacuation; may occasionally be given in lower or higher doses
1/2 tsp cinnamon	with meal, sprinkled on toast	said to increase cell sensitivity to insulin

No regular LUNCH medications or supplements.

DINNER:

Med/Dose	Administration	Explanation
100% Aloe Vera gel/1 oz	just before meal	helps increase the cells' sensitivity to insulin when used with glipizide
folic acid/400 mcg	with breakfast	standard breakfast supplement
vitamin E/400 IU	with meal	given for anti-coagulant properties
garlic/1250 mg	with meal	given for anti-coagulant and antibiotic properties
calcium-vitamin D/500-200 mg	with meal	believed to be an osteoporosis preventative; although current research suggests that it does not perform well in women; I give it to her anyway because I doubt that it will hurt her and the extra Vitamin C is probably good for her
100 mg Macrodantin	with meal	to prevent UTIs

ADDITIONAL NOTE: If Mom decides to have dessert, which is very occasionally, I have lately decided to supplement her dessert with a second 10 mg of glipizide, just to make sure she her blood sugar doesn't soar at night while she's sleeping. When this happens, I note it in the daily reports.

JUST BEFORE BED:

Med/Dose	Administration	Explanation
Niferex-150 [150 mg elemental iron]	just before sx	to keep her iron deficiency anemia under control
vitamin C/500 mg	1/2 1000 mg tab with iron supplement	helps the body metabolize iron
lisinopril/10 mg	1 of 10 mg tab	given to lower her blood pressure and protect her kidneys; works by relaxing the blood vessels
100 mg Macrodantin	with meal	to prevent UTIs

OTHER TIMES:

Med/Dose	Administration	Explanation
Concentrated oxygen, 2-3/lpm continuous	when she's sleeping	to make sure she doesn't become breathless
Tanked pulse oxygen, 2-3/lpm	when she's sitting around or indulging in light moving	if she becomes breathless; she does not always use this when she's up
Tanked oxygen, 2/lpm continuous	when she's moving or exercising	almost always uses this

    The following are prescribed meds, treatments or supplements (all the rest are OTC supplementals which, although approved by her PCP, were not suggested by him):

• Protonix (Rx)
• Glipizide (Rx)
• Lisinopril (Rx)
• Macrodantin (Rx)
• Oxygen, 2-3/lpm pulse and continuous (Rx)
• 81 mg Aspirin
• Oscal: Calcium/Vitamin D combo (recommended by the nursing home; although research has since shown that this supplement does not alleviate the possibility of breakage or weakening bone structure, I continue it anyway, since it seems likely that it couldn't hurt
• Iron Supplementation; the specific supplement I use was not suggested by her doctors; in fact, their suggestions were, through our experience, shown to be far less effective than this one and prone to increase the possibility of needed transfusions; I found this supplement through research

    The following are administered occasionally, as needed:

• Opcon-A for itchy, weepy eyes
• Phillip's Milk of Magnesia to break through constipation
• Ducosate Sodium if a little more help is needed to break through constipation
• Extra Strength Tums for very occasional upset stomach
• Extra Strength Acetaminophen for occasionally unusual aches and stiffness
• Adult Buffered Aspirin for occasionally unusual aches and stiffness
• 200 mg Ibuprofen for occasionally unusual aches and stiffness
• {Rx} Furosemide 10-20 mg once to twice a day for very occasional abdominal water retention; when I give this to her I note it in these daily reports.
• {Rx} Metoclopramide 5 mg administered 1/2 hour before meal in the case of very occasional nausea. When I give this to her I note it in these daily reports.

ADDITIONAL NOTE: You'll notice that I have on hand three different types of OTC analgesic. Although she rarely asks for or needs an analgesic and will sometimes refuse one when I suggest it, I make a judgment call regarding which to use: Ibuprofen if the pain is sharp and appears to have been provoked by some kind of movement "mistake"; Adult Buffered Aspirin if the stiffness and/or aches occur in the morning before breakfast, in which case I switch out her normal 81 mg aspirin with the Adult dose, also at other times during the day if she appears to be especially ruddy and can handle aspirin; Extra Strength Tylenol (sometimes halved) if she seems pale and/or more frail than usual and she's had either an Adult Buffered Aspirin or an Ibuprofen much earlier in the day. I automatically see to it that I do not "mix" analgesics within an 8 hour period.

BM (Non-stat Day) When she shits I feel better.

...funny how that works.
    The clean-'em-out Bowel Movement I predicted yesterday happened today at 1635: Better than excellent volume; slightly smeary consistency at the end but otherwise excellent; very easy elimination; slightly challenging clean-up.
    She only slept until 1500, although she'd asked me to allow her to sleep until 1600. Had a good breakfast with ham rather than bacon. She looks good, feels good, is drinking good, shat good, is refusing movement, which is okay...so, she just needed the sleep. Really needed it. I'll report on dinner later, whatever and whenever we have it, this evening.
ADDENDUM: Well, I obviously wasn't able to keep her up for a full 12 hours (minus nap, which she didn't take) yesterday (yes, I'm adding this the day after), but we did good. Although refusing to walker, she was feeling good, relatively lively, and remaining awake until close to 0200 this morning, finally retiring at 0130. Dinner was light, I made ham and cheese sandwiches again, with a different type of cheese and bread, added slices green pimiento stuffed olives and gave her 11.5 oz V-8 juice. I offered potato chips but she refused them, which was fine. We mostly watched TV and talked. I suggested reading out loud but she wasn't interested. I'm going to check on her at 1230 today and see if she appears to be close to awakening, but I'll probably let her go until about 1300. That's not uncommonly late for her. Over the next few days I'll ease her back into her normal hours.
    We're being brushed by the tail of a low, again. I should have figured this from her sleep day yesterday but it was so bright and sunny and windless that it never occurred to me she might be reacting to the weather.

BM Full Stat Day:

A.M. Blood Glucose:     Time:  1212     Reading:  123

A.M. Blood Pressure:     Time:  1239     BP:  143/65     Pulse:  58

P.M. Blood Glucose:     Time:  2052     Reading:  161

P.M. Blood Pressure:     Time:  2050     BP:  112/60     Pulse:  60

    Mom has been talking "sugar" for the last few days. I suggested pineapple slices after dinner, since we still had lots and they needed to be used. She suggested pineapple upside down cake.
    "If I make that, that's all we'll have for dinner, Mom, since it'll be loaded with sugar."
    "That's fine with me!"
    She had a light lunch, including cottage cheese, the last of MCS's bread and butter pickles and a requested serving of Salt & Pepper Kettle Chips, which accounts for her "high" blood glucose before dinner. I poured her some V-8 juice but she refused to drink it, even though I argued that she should, since she'll be missing vegetables today, otherwise.
    "I won't miss them," she said, so I drank it.
    Her Bowel Movement occurred at 1235: Good volume; excellent consistency; very easy elimination; very easy clean-up. I think, though, that she's working herself up to a master BM, considering her recent profiles, so I'll give her a day and if she doesn't eliminate anything tomorrow, or eliminates only a little, I'll probably hit her with a mild dose of laxative tomorrow evening, just to clean her out.
    It was warm, yesterday (for winter), sunny and not at all windy. I worked at getting her out and walkering. At one point I simply put her shoes on, got everything ready and ordered her up.
    She gave me that "fuck you" look and said, "Not today. I just don't feel like it today." So, I turned in the movies we had and kept her happy with more movies while I searched the web.
    Maybe tomorrow she'll be a bit more tractable.
    Oops! Forgot to fill in the stat forms above! Also, I should mention that on 2/6/06 I forgot to administer her evening lisinopril, which explains, in part, her high BP this morning. I'm pleased to see, though, that it's not as high as I was expecting.

Non-stat Day:

    Dinner was an exact repeat of yesterday's. I was so involved in research of her low hemoglobin that I didn't get around to doing anything "fancy", as my mother called it, or labor intensive.     Sleep was normal.

BM Full Stat Day:

A.M. Blood Glucose:     Time:  1202     Reading:  138

A.M. Blood Pressure:     Time:  1202     BP:  139/65     Pulse:  56

P.M. Blood Glucose:     Time:  1954     Reading:  104

P.M. Blood Pressure:     Time:  1952     BP:  103/75     Pulse:  61

    You can see the pumpkin pie still swimming in Mom's bloodstream this morning. Otherwise, though, everything looks good. I have to say, it's nice to see that when she's irritated with me taking her blood pressure in the morning her systolic remains in the 130's.
    Yet another outing today: I didn't ask her, I just designed the day so that she'd accompany me to Costco. I don't think she wanted to go, but she didn't protest. It just took a looooonger than usual time to get her ready. Although she managed to make the sample kiosks at the front of the warehouse, halfway down the aisle portion of the store she decided to sit down on her walker and stay where she was, next to the chili paste kiosk. It was very, very hot chili paste, and although she loves hot-hot, I didn't think she'd make a meal of the samples and I was right. She didn't. Once I finished and herded her toward the checkouts, even though we didn't have to wait in line long, she decided to sit out checkout at the luncheon area.
    She went down for a nap when we returned but it was later than she usually naps, 1730, so she wasn't down long. All she wanted for "lunch" was V-8 juice.
    For dinner we had grilled Canadian ham and Jarlsburg Swiss on sourdough with spicy mustard (no sugar or honey), some Kettle Chips she tried at one of the kiosks and insisted we buy (which is okay; they'll last a long time) and pickled asparagus spears (mmmm, mmmm). She also had some fresh cut pineapple slices at about 2130.
    Her Bowel Movement occurred at 2055: Fair volume; excellent consistency; easy elimination; very easy clean-up.
    [Added at 0018 2/6/06] Retired at 0010 2/6/06. Light still on as I close this out. Her light will probably be on until after I retire. I'm tired tonight.
    Later.