Partial Stat Day:

AM Blood Glucose:     Time:  1425     Reading:  168

AM 60" Dig Temp:     Not taken

PM Blood Glucose:     Time:  2106     Reading:  212

Medication Changes:

• Because of unusually high BG and her request, in the afternoon about an hour before napping, for "some chocolate", which I gave her (two chocolate covered mint Ghiradelli squares), she received two extra glipizides: One when I gave her the chocolate and one in the evening before bed because of her unusually high evening BG and the very starchy dinner and high sugar dessert
• She didn't drink her usual amount of liquid, today, although she got close, but her refusal included her usual cup of Detox tea every other night; I didn't fight her on this.

    Dinner:  Costco Chicken Pot Pie and a slice of lemon tart.
    Miscellaneous Note:  I'm not sure why her BGs are running so high. The obvious explanation would be the presence of infection, but other indicators don't seem to be pointing to this. It could just be a lack of movement, although she's moving a bit more over the last few days. We'll see how this plays out.
Sleep:

• Awake at 1400
• Down for nap at 1830
• Up from nap at 2100
• Down for night at 0030
• Awake 8 hours

Full Stat Day:

AM Blood Glucose:     Time:  1217     Reading:  169

AM 60" Dig Temp:     Time:  1239     Reading:  97.4

PM Blood Glucose:     Time:  2046     Reading:  129

Medication Change:

• 325 mg acetaminophen for aching lower back at breakfast

    Dinner:  Baked ham, steamed Brussels sprouts with Greek Feta dressing, stuffing with lots of added veggies; a slice of raspberry tart for dessert.
Sleep:

• Awake at 1200
• Down for nap at 1630
• Up at 2030
• Down for night at 0130
• Awake for 9.5 hours

BM Almost Full Stat Day:

AM Blood Glucose:     Time:  1303     Reading:  116

AM 60" Dig Temp:     Not taken

PM Blood Glucose:     Time:  2117     Reading:  161

    Bowel Movement:  Occurred while preparing for bed. Excellent volume; good, soft consistency; very easy elimination; somewhat challenging clean-up.
Medication Changes:

• As of last night, decided to include two 1,250 mg garlic tabs in her supplements, one at breakfast, one at dinner, to help ward off opportunistic infection
• Added Yogi Detox tea, tonight as her last glass of fluid before bed. Will be giving her either Detox or Peach Detox tea every other night
• Check out new Current Medication & Supplement Schedule

    Dinner:  Costco Chicken Pot Pie; dessert was a scoop of German Chocolate Cake ice cream.
Sleep:

• Awake at 1300
• Down for nap at 1730
• Up from nap at 2100
• Down for night at 0130
• Awake 9 hours

Current Medication & Supplement Schedule

UPON AWAKENING BEFORE BREAKFAST:

Med/Dose	Administration	Explanation
Albuterol/Ipratropium	inhaled upon awakening before breakfast	to address lung congestion
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
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; OTHERWISE, given at meal

BREAKFAST

Med/Dose	Administration	Explanation
Niferex-150 Forte [150 mg elemental iron] Rx with extra B12 and folic acid	1 tab with breakfast	to keep her iron deficiency anemia under control
100 mg Macrodantin	with meal	to prevent UTIs
Daily Senior Multivitamin	with breakfast	standard breakfast supplement
6 tsp Benefiber	with meal, in orange juice	promotes timely, easy bowel evacuation; may occasionally be given in lower or higher doses
1/4 tsp cinnamon	with meal, sprinkled on toast	said to increase cell sensitivity to insulin
1,250 mg garlic tablet	with meal	added as a natural antibiotic to try to head off lung infections

BEFORE NAP:

Med/Dose	Administration	Explanation
2 Niferex-150 Forte tablets [150 mg elemental iron] Rx with extra B12 and folic acid	before nap	to keep her iron deficiency anemia under control

FOUR HOURS AFTER FIRST BREATHING TREATMENT:

Med/Dose	Administration	Explanation
Albuterol/Ipratropium	inhaled upon awakening from nap	to address lung congestion

DINNER:

Med/Dose	Administration	Explanation
1 tab glipizide ER/10 mg	since she usually eats soon after arising from nap, if her BG is normal or only slightly above, she gets this just before dinner; if her BG is high (130 or above) she gets this after she awakens from her nap	to control Type 2 diabetes
1 tab 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
1,250 mg garlic tablet	with meal	added as a natural antibiotic to try to head off lung infections

BEFORE BED AT NIGHT:

Med/Dose	Administration	Explanation
glipizide ER/10 mg	1 pill with dessert or after a high refined carb meal	Rarely given; only in cases of lots of carbohydrates throughout the day; otherwise, see DINNER MEDS
Ipratroprium/Albuterol	inhaled four hours after last breathing treatment	to address lung congestion
2 Niferex-150 [150 mg elemental iron]	an hour or so before bed	to keep her iron deficiency anemia under control
4 oz prune juice	nuked to room temperature	to ease evacuation problems
1 12 oz cup Yogi Detox Tea [Regular or Peach]	every other night, this is her last major cup of liquid for the day	general purpose health measure
lisinopril/15 mg	1 10mg tab + 1/2 tab more after she is sitting on her bed, before she lays down	Given to lower her blood pressure and protect her kidneys; works by relaxing the blood vessels.

OTHER TIMES:

Med/Dose	Administration	Explanation
Tanked continuous oxygen, 4/lpm continuous	when awake and sitting	to make sure she doesn't become breathless
Tanked continuous oxygen, 5/lpm	24/7 when she's sitting if her breathing is labored on 4/lpm; always when she is moving or exercising	to make sure she doesn't become breathless
Concetrated oxygen, 5/lpm continuous	24/7 when she's sleeping	to make sure she doesn't become breathless

    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):

• Albuterol Sulfate: 0.083% solution/3 mL; every three to four hours, mostly combined with Ipratropruim
• Ipratroprium Bromide: 0.02% solution/2.5 mL; every four hours with Albuterol (can fudge time by 1/2 hour to 3.5 hours, depending on need)
• Niferex-150 Forte: 900 mg; 300 mg 3x/day (Rx)
• Protonix: 40mg 1x/day (Rx)
• Glipizide: 10 mg; 2-3x/day (Rx)
• Lisinopril: 15 mg 1x/day; if necessary, I can increase this dose by scattering other low mg doses throughout the day (Rx)
• Macrodantin: 100 mg 1x/day (Rx)
• Oxygen, 4-5/lpm pulse and continuous/concentrated and tanked-may titrate (Rx)
• Oscal: Calcium/Vitamin D combo 1x/day (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
• Garlic: two 1,250 mg tablet per day (supplement)
• Yogi Detox or Peach Detox Tea: One 12 oz freshly brewed cup every other day
• Senior mult-vitamin
• Prune Juice: 4 oz in evening to stimulate easy, regular evacuation

    The following are administered occasionally and/or daily, as needed:

• Opcon-A for itchy, weepy eyes
• Phillip's Milk of Magnesia to break through constipation; Tbl dose at a time
• Ducosate Sodium if a little more help is needed to break through constipation
• Extra Strength Tums for very occasional upset stomach
• Desitin and/or Level 3 Barrier Cream (used every day on thigh creases) for urine skin irritations and rashes.
• 2% diphenhydramine cream used for skin rashes due to urine irritation and/or sweat-heat rashes. I use this when the oil based zinc creams don't do the trick (which is fairly often). This cream isn't oil based and allows the skin to breathe better; it also stops itching and heals more quickly.
• Extra Strength Acetaminophen or Regular Acetaminophen for occasionally unusual aches and stiffness
• {Rx} Furosemide 10 mg once to twice a day for very occasional 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.

BM Changed Stat Day:

AM Blood Glucose:     Time:  1139     Reading:  144
AM 60" Dig Temp:     Not taken

PM Blood Glucose:     Time:  1836     Reading:  196

    Bowel Movement:  Occurred while preparing for bed. Fair volume; good consistency but still pretty hard packed; very easy elimination; very easy clean-up. Medication Changes:

• extra garlic tab with dinner; wondering if she's fighting an infection and giving her some extra help
• 325 mg acetaminophen after dinner for very uncomfortable lower back ache

    Dinner:  Mac & Cheese with all the added stuff; refused dessert; ate only 3/4s of her Mac & Cheese; wasn't very hungry, tonight
Sleep:

• Awake at 1130
• Down for nap at 1430
• Up from nap at 1830
• Down for night at 0000
• Awake 8.5 hours

    Miscellaneous Note:  I mention my discussion with the Hospice RN who visited to day over at my most recent post at the main journal. Although it seems like the consideration of the prune juice every night addressed it, I'm not sure that it does, because of tonight's BG reading. She gets the prune juice, 4 oz of it, just before bed, so it can't explain an unusually BG reading almost 20 hours later. I'm thinking, then, that maybe this is evidence of Mom fighting an infection, especially considering the mention of right lung "crackles" by the RN, today; and, of course, the recently increased tiredness and the difficulty breathing on lower levels of O₂, although, today, she breathed fine at 4/lpm, when I remembered to dial her back. So, we're still hunkering down and waiting to see what happens. Mom mentioned to me, tonight, without being bidden, that she felt sure she'd feel better tomorrow. I hope she's right. She doesn't like feeling like this. I don't like it on her behalf.

BM Partial Stat Day:

AM Blood Glucose:     Time:  1332     Reading:  154	AM Blood Pressure:     Not taken
AM 60" Dig Temp:     Time:Not taken

PM Blood Glucose:     Time:  1958     Reading:  171

    Bowel Movement:  Occurred during bathing (1350). Good volume; good consistency although still rather large turd; easy elimination; fairly easy clean-up.
Medication Changes:

• Skipped 600 mg of iron supplement; partially had a problem getting them in because of her sleeping schedule, today and partially because I forgot
• Skippped 3rd breathing treatment because of sleeping schedule.
• Extra glipizide with dessert

    Dinner:  1/4 dark meat roast chicken; lightly steamed broccoli with Greek Feta Vinaigrette; about 3/4 cup of instant stuffing with added chopped, sauteed onion, celery, garlic and sun dried tomatoes; A slice of Tiramisu for dessert
Sleep:

• Awake at 1300
• Down for nap at 1615
• Up from nap at 1930
• Down for night at 2330
• Awake 7.25 hours

Partial Stat Day:

AM Blood Glucose:     Time:  1436     Reading:  161	AM Blood Pressure:     Not taken
AM 60" Dig Temp:     Not taken	PM Digital Temp     Time:  2146     Reading:  97.6

PM Blood Glucose:     Time:  2119     Reading:  183

Medication Change:

• 325 mg acetaminophen with dinner; complaining of "not feeling right" but couldn't delineate further; thought "a Tylenol" would help
• Ran out of prune juice so she didn't get that tonight
• third glipizide with dessert
• Skipped 3rd breathing treatment; not up long enough at anyone time to get it in
• Mostly on 5/lpm O₂ when sitting

    Dinner:  Kung Pao chicken over mixed brown rice; Tiramisu for dessert.
Sleep:

• Awoke at 1415; tried earlier, this was the first time I had success
• Down for nap at 1815
• Up from nap at 2100
• Down for night at 0130
• Awake 8.5 hours

Full Stat Day:

AM Blood Glucose:     Time:  1527     Reading:  164	AM Blood Pressure:     Time:  1529     BP:  150/87     Pulse:  84
AM 60" Dig Temp:     Time:  1550     Reading:  97.7

PM Blood Glucose:     Time:  2200     Reading:  175

Medication Changes:

• 3rd glipizide with dessert
• 4 oz prune juice before bed
• Skipped 3rd breathing treatment
• Mostly on 5/lpm O₂ when sitting

    Miscellaneous Review:  I've gotten in the habit of giving Mom a caffeinated tea after breakfast. I'm not sure that it makes a lot of difference, but I'm assuming that it's part of what is keeping her "up" hours steady. I've been doing this for about two weeks. I'm saving the herb and fruit decaffeinated teas for in the evening after dinner.
    Dinner:  Sausage, egg and cheese croissants; 3 Ghiradelli chocolate filled squares
Sleep:

• Awake at 1500
• Down for nap at 1945
• Up from nap at 2145
• Down for night at 0145
• Awake 8.75 hours