BM Full Stat Day:

A.M. Blood Glucose:     Time:  1404     Reading:  95

A.M. Blood Pressure:     Time:  1417     BP:  107/58     Pulse:  67

P.M. Blood Glucose:     Time:  2138     Reading:  220

P.M. Blood Pressure:     Time:  2134     BP:  131/63     Pulse:  60

    Today is the second of our official Mother's Day Celebration Days. Although I'd promised her last night that I would allow her to "sleep in" (as though she doesn't usually do this), I considered awakening her earlier. I ended up talking to MCS on the phone, though, which kept me out of Mom's bedroom until 1400. When I entered, she was sitting on the edge of the bed, ready to go. She even mentioned that she thought she'd "gotten [her] sleep out."
    Breakfast involved a substitution of HoneyBaked Ham slices instead of bacon and The Wildflower Bread Company's cranberry scones instead of toast.
    Although she didn't have an official lunch, when she laid down for a nap at 1730, so did I; I was exhausted from a short night and a very busy shopping morning. I was so tired that I didn't awaken when she did. She was up by 1830; she remembered checking the clock when she noticed I was still sleeping. She was hungry so she found a jar of Bread & Butter pickles in the frig (not MCS's, unfortunately). By the time I awoke she'd eaten about a third of the pickles. That's what her evening blood sugar reflects.
    For dinner I served broiled steak and a mixture of peas, sauteed onions, celery, garlic and green olives with bits of bacon seasoned with Greek Feta dressing. Later in the evening I served a light dessert, the slices of fruit tart I bought at The Wildflower Bread Company.
    Her Bowel Movement occurred at 1715, just before she napped: Fair volume; excellent consistency; very easy elimination; very easy clean-up.
    She retired at 0015, 5/15/06. Her light went out at 0045.

BM x 2 Full Stat Day:

A.M. Blood Glucose:     Time:  1410     Reading:  136

A.M. Blood Pressure:     Time:  1432     BP:  108/59     Pulse:  59

P.M. Blood Glucose:     Time:  2002     Reading:  148

P.M. Blood Pressure:     Time:  1957     BP:  110/55     Pulse:  66

    Mom was actually up at 1315 but I forgot to take her stats until after her bath when she had relocated to the breakfast table. The gap between her blood sugar and her BP during the "morning" measurements occurred because I wanted to make sure she was settled, breathing evenly and was most likely to be at a resting pressure. I guess I got it right. Polish sausage was substituted for her usual bacon.
    She didn't take a nap today. I'm not sure why but that was fine with me. No lunch, either, which wasn't a big deal...I didn't manage to get breakfast on the table until almost 1500; it seemed as though the day was filled with interruptions and do-overs; so, she received only two iron capsules today, although I gave her a second glipizide.
    Since she refused lunch, dinner was earlier than is normal for late breakfasting days. The house was warm, I didn't want to "slave over a hot stove" (one of my mother's favorite phrases in regards to cooking, which she's never really enjoyed), so I served a cold food dinner: A variety of pickled things, the last of the fresh vegetables, sliced into bite sized pieces and, at Mom's request, chips and dip. I had suggested popcorn but she overruled me.
    Her first Bowel Movement happened during her bathing at 1345: Fairly good volume; excellent consistency; very easy elimination; easy clean-up. Her second occurred at 2200: Poor volume (probably the rest of her morning movement, which means, overall, it was a "very good volume" day; excellent consistency; very easy elimination; fairly easy clean-up.
    She retired at 0030, 5/13/06. Her light just went out at 0055.

BM Full Stat Day:

A.M. Blood Glucose:     Time:  1352     Reading:  127

A.M. Blood Pressure:     Time:  1350     BP:  124/61     Pulse:  53

P.M. Blood Glucose:     Time:  2047     Reading:  101

P.M. Blood Pressure:     Time:  2045     BP:  141/66     Pulse:  56

    She awoke on her own at 1330. Because of the last two days have been early and busy for her, I decided to let her define her own awakening time, especially since, when I went in at noon to awaken her after 12 hours of sleep she was sprawled in a position that indicated she was completely relaxed and she was snoring. I checked on her again at 1245 and she was still hard at the log sawing. I actually thought she'd sleep longer than she did.
    I heard her head into the bathroom but didn't bother her for a few minutes because I was a little behind schedule with setting up the rest of the house for bathing and breakfast. When I entered the bathroom 15 minutes later she had already had her Bowel Movement: Fairly good volume; excellent consistency; very easy elimination; fairly easy clean-up.
    Breakfast was normal. She wanted to go back to bed two hours after she awoke but I kept her up until 1700. When she arose at 1900 I'd been down for a hard nap for about an hour. I didn't hear her awaken and go to the bathroom. What I did hear was the knocking about of glass in the kitchen. When I struggled awake (I'm not sure why I felt so beaten, today) she was snacking on pickled asparagus spears, which is fine, using a fork to get them out of the jar, which was extraordinary and appreciated. I thanked her for this. She decided asparagus spears was enough for her lunch (along with the second iron capsule I slipped her.)
    We ate dinner at about 2115: The left over chili (her request; earlier she'd requested Mac & Cheese but changed her mind) and cornbread.
    Although she was complaining of stiffness, which meant her level of stiffness was unusual for her, she refused the adult buffered aspirin I offered her before bed, also typicaly for her, and I didn't push. "All I need is to lay down and relax," she said. I trust her self-evaluations on this issue.
    She retired at 2300. Light out at 2315.
    As I make this last entry, it is 0133. Unable to sleep, my mother emerged from her bedroom at midnight straight up. We talked and she watched TV until 0125. Her light is on as I write. I'll report, later, when it goes out.
    Her light went off just now at 0145, 5/12/06.
    In case you wonder why I try to record as regularly as possible what time she arises, what time she retires and how much sleep she gets, my mother's medical profile is not unusual for oldsters her age, although my success at treating her infirmities is. Despite my ability to keep her chronic conditions light, there are still aspects of her conditions I am helpless against, one of those being her need and desire for sleep (which reminds me to post a reminder here to myself to write about what I discovered about the intractability of her sleep habits over the last few days). My hope is that within my meticulous recording of the seemingly inconsequential details of my mother's old age, including her sleep habits, other caregivers to Ancient Ones will find confirmation of their own experiences and use this confirmation to relax about their abilities to care for someone who's health profile in old age is much like my mother's.

Full Stat Day:

A.M. Blood Glucose:     Time:  0841     Reading:  143

A.M. Blood Pressure:     Time:  0857     BP:  154/74     Pulse:  55

P.M. Blood Glucose:     Time:  1937     Reading:  114

P.M. Blood Pressure:     Time:  1933     BP:  145/66     Pulse:  57

    I awoke her much earlier than she usually arises because we had an appointment for a tour at yet another Adult Day Center, one I discovered very close to our home and with which I was impressed when I dropped by last week.
    Breakfast was sausage and egg, no toast, since I knew we'd be having a complementary lunch at the Center and I had no idea how much starch would be included. Lunch was much better than I expected: A grilled, marinated chicken breast which was quite tasty; a splendid helping, almost a cup, of peas, frozen, not canned; seasoned, roasted red potatoes, which Mom didn't eat (she's not that much for potatoes); a pre-lunch "appetizer" of orange Jello with mandarin oranges in it; a small, light, yeasty roll; about 3/4 of a cup of water packed peaches.
    Mom did quite a bit of walkering around the center and participated in their "Sittercize" session, which lasted about a half hour and was a lot more fun and somewhat more strenuous than what Mom and I do. She did well, kept up and had no complaints of back or knee stiffness for some time afterward, although when we got home her right knee was a little weak and she asked for an adult buffered aspirin, which I gave her, before her nap. She napped until just before 1700.
    For dinner I served grilled sharp yellow cheddar sandwiches with pepperoni and a display of fresh cut vegetables including green peppers, radishes, carrots, grape tomatoes and green pimiento stuffed olives with some home made Ranch dressing for dipping. She used a little of it but decided she preferred the vegetables without the dressing.
    Before bed I gave her a second glipizide. I decided that now that her hemoglobin is up, as long as it stays up perhaps it would be a good idea to reinstitute two glipizides a day, since her HA1c will probably be coming up, also. We'll see how it goes.
    She went to bed at 2345. Her light went out at 0014, 5/11/06.

Current Medication & Supplement Schedule

5/10/06: Change in Med Schedule: From here on out, including today, Mom will be receiving two 10 glipizide ER tablets: One upon arising and one either at dinner (depending on how far dinner lags behind her arising) or, most likely, when she retires. Extra folic acid has been removed because she is receiving a mega dose/day with her Niferex-150 Forte.

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 Forte [150 mg elemental iron] Rx with extra B12 and folic acid	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 a couple of hours apiece.
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
glipizide ER/10 mg	1 pill before breakfast	If her blood sugar is high enough so that it doesn't drop too low in the 45 minutes or so before she actually eats breakfast.

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; also protects digestive tract lining
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; adult buffered aspirin can be substituted if she's complaining of aches, pains or unusual stiffness
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
garlic/1000 mg	2 500 mg tabs 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

LUNCH:

Med/Dose	Administration	Explanation
Niferex-150 [150 mg elemental iron] OTC	1 tab with meal	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

DINNER:

Med/Dose	Administration	Explanation
glipizide ER/10 mg	1 pill with meal	Given with meal if sufficient hours have passed between arising and dinner or if her BG is exceedingly high before dinner. Otherwise, given at bedtime.
100% Aloe Vera gel/1 oz	just before meal	helps increase the cells' sensitivity to insulin when used with glipizide; also protects digestive tract lining
vitamin E/400 IU	with meal	given for anti-coagulant properties
garlic/1000 mg	2 500 mg tabs 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

JUST BEFORE BED:

Med/Dose	Administration	Explanation
glipizide ER/10 mg	1 pill before bed	Normally given at bedtime in order to separate the two doses by several hours; otherwise, see DINNER MEDS
Niferex-150 [150 mg elemental iron] Forte Rx with B12 and folic acid	just before sleep	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

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):

• Niferex-150 Forte
• 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: a third OTC Niferex-150 capsule per day

    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 Full Stat Day:

A.M. Blood Glucose:     Time:  1008     Reading:  105

A.M. Blood Pressure:     Time:  1032     BP:  140/68     Pulse:  54

P.M. Blood Glucose:     Time:  1930     Reading:  129

P.M. Blood Pressure:     Time:  1928     BP:  110/51     Pulse:  54

    It was blood draw day today so I awoke her at 1000. She was eating breakfast at noon, straight up.
    Lunch happened after her nap around 1730: peanuts and V-8 juice.
    Dinner, which happened earlier than usual since my intention was to have her in bed between 2200 and 2300, was sauerkraut & sausage with fennel seeds and garlic/Parmesan sourdough bread.
    She received an adult buffered aspirin before her nap because her knee and back were bothering her a little.
    Her Bowel Movement occurred at 1700 straight up, upon awakening from her nap: Fairly good volume; excellent consistency; very easy elimination; very easy clean-up.
    She went to bed at 2245. Her light went out at 2300.

Full Stat Day:

A.M. Blood Glucose:     Time:  1311     Reading:  157

A.M. Blood Pressure:     Time:  1310     BP:  141/76     Pulse:  60

P.M. Blood Glucose:     Time:  2029     Reading:  101

P.M. Blood Pressure:     Time:  2028     BP:  134/62     Pulse:  59

    Once again, Mom was up on her own probably at about 1245. I was busy doing something, I can't remember what, but it involved a trip to her bathroom to replenish washclothes at 1300 and there she was, on the toilet, Mr. Man at her feet, petting and gently playing with him; so I had to scramble to get things ready for Stats & Bathtime.
    I decided to take her P.M. BP because her A.M. BP was higher than I was expecting. She's looked good all day, though, no apparent fluid retention except a tiny bit in her feet this evening before bed, but I'll keep an eye on her blood pressure and my ear trained for the dry hacking that means I need to pull water off her.
    Breakfast was normal. Lunch, after her nap, was a bag of peanuts, and coffee: "No V-8 juice please," which was fine since I planned Cobb salad for dinner, which is what I served, this time including very sweet grape tomatoes, some avocado, fresh shredded Parmesan and bits of very lean pastrami along with the other usual suspects.
    I encouraged her to bed down a bit earlier than usual since tomorrow is Blood Draw Day and I'll be awakening her between 0930 and 1000 (probably closer to 1000). She retired at 2330. Her light has yet to go out as I finish this post, at 2354. I expect it to be extinguished soon.

BM Almost Full Stat Day:

A.M. Blood Glucose:     Time:  1331     Reading:  141

A.M. Blood Pressure:     Time:  1329     BP:  114/54     Pulse:  57

P.M. Blood Glucose:     Time:  2041     Reading:  88

P.M. Blood Pressure:     Not Taken

    She awoke on her own at 1315. Breakfast substituted sausage for bacon.
    She was pretty lively, today, probably because she was complaining of feeling "awfully stiff" this morning so, with her permission, I substituted an adult buffered aspirin for her usual 81 mg aspirin. Her nap was short, about a half hour. She mentioned that she didn't actually sleep. It was warm without wind so I ushered her out to "look at the yard". Surprisingly, she didn't resist, as she usually does. We were out for about 45 minutes. She spent about half that time sitting but moved quite a bit, including off the driveway in the dirt, also a surprise, although encouraged by me, as I wanted to show her some of the serendipitous flowers sprouting in our yard.
    She only wanted peanuts for lunch, no V-8 juice. Dinner was a hearty home made dhili & cornbread. She received a second glipizide at night.
    Her Bowel Movement occurred just before her bath at 1320: Fair volume; excellent consistency; very easy elimination; very easy clean-up.
    Regarding the lack of BP for the second time in the evening: Once again, I'm trying not to irritate her. She was watching an episode of Matlock. When I approached her with the cuff during a commercial she looked at me with disgust and said, "Is that really necessary?" I decided it wasn't. I'll probably be dropping the evening BP more often as I did, since she's holding her own; although if I'm concerned by conditions such as feet or belly swelling, I'll, of course, take it.
    She retired at 0100, 5/8/06. Her light went of at 0115.