BM Non-stat Day:

Medication Changes:

• 500 mg acetaminophen at 1230 for moderate pain due to cannula dislodge
• Extra glipizide at breakfast (she's already had one when I gave her toast with the acetaminophen mentioned above)
• 500 mg acetaminophen before nap
• 500 mg acetaminophine with dinner
• skipped prune juice

    Bowel Movement:  Occurred during bathing. Fair volume; slightly hard consistency; easy elimination; very easy clean-up.
    Today's Food:  Even if I tried, I don't think I can remember everything she ate, and she ate a lot during the first half of her day. A partial list: Toast with margarine and cinnamon before her official awakening to accompany acetaminophen; her usual boiled egg and ham for breakfast; a stuffed mushroom with tomato marinara, some salad and some prepared tuna, plus a piece of the $45 chocolate cake just before company left. We'll see if she eats anything during the second part of her day. SECOND HALF OF DAY:  Tuna fish sandwich on toasted multigrain bread; spearmint tea.
Sleep:

• First Awakening at 1230
• Back down at 1315
• Awake "for the day" at 1400
• Down for nap at 1915
• Up from nap at 2200
• Down for night at 0000
• Awake 8 hours

Partial Stat Day:

AM Blood Glucose:     Time:  1418     Reading:  160

AM 60" Dig Temp:     Not taken

PM Blood Glucose:     Time:  2215     Reading:  232

Medication Changes:

• 200 mg ibuprofen with toast before nap for lower back ache
• 200 mg ibuprofen with dinner for lower back ache
• extra glipizide with dessert
• 200 mg ibuprofen before retiring for middle back pain from dislodged cannula
• 1 cup brewed Peach Detox Tea

    Dinner:  Exactly the same as last night
Sleep:  

• Awake at 1400
• Down for nap at 1900
• Up from nap at 2200
• Down for night at 0200
• Awake 9 hours

Partial Stat Day:

AM Blood Glucose:     Time:  1350     Reading:  138

AM 60" Dig Temp:     Not taken

PM Blood Glucose:     Time:  2132     Reading:  231

    Miscellaneous Note:  Another short awakening early this morning at 0620. This time, she was feeling "bad all over" because her cannula was displaced during sleep, although she reported that she wasn't "exactly" in pain. Replacing it assuaged everything. She went to the bathroom, we changed out her underwear, she went back to bed, I rubbed her back, which also seemed to help, and she was down and ready for more sleep by 0705. No ibuprofen necessary, today, at this time.
Medication Changes:

• 200 mg ibuprofen with toast and water before nap
• 200 mg ibuprofen with dinner
• Extra glipizide with dessert because of high pre-dinner BG.
• Skipped prune juice; she'd had enough liquid and adamantly didn't want any more.

    Dinner:  1 slice (1/8 of a 9.5 deep dish size pie) of home made beef pot pie (emphasis on the beef and the vegetables); 1 2" slice Chocolate Mousse cake
Sleep:

• Up 1st at 0620
• Back down at 0705
• Awake at 1330
• Down for nap at 1815
• Up from nap at 2100
• Down for night at 0130
• Awake 10 hours

BM Partial Stat Day:

AM Blood Glucose:     Time:  1512     Reading:  210

AM 60" Dig Temp:     Not taken

PM Blood Glucose:     Time:  2205     Reading:  185

    Miscellaneous Note:  Mom's day began, today, before her day began. It seems that she's either battling a cold or having a "Bad Cancer Cycle Day", it's hard to tell which. At any rate, she arose on her own at 1100, not feeling good at all, we took her into the bathroom to change her, I gave her a piece of toast, some water, her ibuprofen, her Protonix and 1 iron capsule and she went back to bed as she intended when she awoke. I'm not sure, but I expect this to be another sleep day, at least for most of it.
Medication Changes:

• 1st ibuprofen at 1115, before she went back down for night sleep (see above)
• 2nd ibuprofen at dinner
• Picked up Peach Detox Tea

    Bowel Movement:  Occurred during bathing. Fairly good volume; fairly easy elimination; somewhat dry consistency; easy clean-up.
    Dinner:  Sauerkraut with Hebrew National Polish sausage and a little over a cup of doctored (with much veggies and some spices) deli potato salad.
Sleep:

• Up at 1100
• back down at 1145
• Up again at 1445
• Down for nap at 2000
• Up from nap at 2200
• Down for night at 0130
• Awake 9.5 hours

Miscellaneous Notes:

    I've published a new Med & Supplement Schedule and linked it to the links at the right and, I think, over at the the main journal, at least that was my intention. If it's not hooked up there I'll do that shortly. The chances are good that I'll be amending the Schedule fairly frequently as her medications and supplements change, which it appears that they are bound to do during this period of her life. This time I added the ibuprofen at breakfast as a regular OTC med and the morphine as a PRN med, although we haven't used it, yet.
    In case you hadn't noticed, I haven't been taking her temperature, lately, in the morning. It hardly seems necessary unless something prompts it. I feel her forehead and if she feels temperate I tell her, "You're alive," at which she smirks and sometimes chuckles, and that's that.

BM Partial Stat Day:

AM Blood Glucose:     Time:  1250     Reading:  151

AM 60" Dig Temp:     Not taken

PM Blood Glucose:     Time:  1954     Reading:  160

Medication Changes:

• Skipped one 300 mg iron capsule; she wasn't up enough to get it in without crowding the capsules
• Skipped Peach Detox Tea
• 2nd 200 mg ibuprofen with dinner

    Bowel Movement:  Occurred at 1310 during bathing. Good volume; slightly dry consistency; easy elimination; easy clean-up.
    Dinner:  One container Annie Chun's Hot & Sour Soup.
Sleep:

• Awake at 1230
• Down for nap at 1530
• Up from nap (reluctantly) at 1930
• Down for night at 2245
• Awake 6.25 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
200 mg ibuprofen	with meal	as general purpose non-inflammatory agent and to allay niggling little aches and pains throughout the day As of 12/2/08:  I now alternate this with 325 mg acetaminophen, depending on whether we are addressing general discomfort (acetaminophen) or possible inflammation (ibuprofen). As well, it is not necessarily an every day med as of 12/3/08.

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
• Ibuprofen: once 200 mg tablet once per day at breakfast; can add 1-2 tablets every 6 hous as needed up to 2400 mg
• 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: 6 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.
• Morphine Sulfate: for instructions on use see Morphine Manual

Partial Stat Day:

AM Blood Glucose:     Time:  1257     Reading:  185

AM 60" Dig Temp:     Not taken

PM Blood Glucose:     Time:  2122     Reading:  137

Medication Changes:

• 200 mg ibuprofen at breakfast for general purposes

    Dinner:  1/4 of the pizza we had a couple of nights ago; a scoop and a half of Maple Nut ice cream with dark chocolate syrup
Sleep:

• Awake at 1230
• Down for nap at 1715
• Up from nap at 2100
• Down for night at 0045
• Awake for 8.5 hours

Partial Stat Day:

AM Blood Glucose:     Time:  1449     Reading:  159

AM 60" Dig Temp:     Not taken

PM Blood Glucose:     Time:  2146     Reading:  185

Medication Changes:

• 200 mg ibuprofen at breakfast for lower back ache (mild) and general purposes
• 200 mg ibuprofen just before nap for returning lower back ache
• 3rd glipizide with dessert because of high BGs in "AM" and PM.

    Miscellaneous Food Note:  Had a piece of toast with Fleishmann's margarine and cinnamon with the ibuprofen just before nap.
    Dinner:  1/4 dark meat roast chicken; about 3/4 cup of Brussels sprouts; about 3/4 cup doctored (with lots of veggies) deli potato salad; about 3/4 cup home made peach cobbler with a scoop of Maple Nut ice cream for dessert; left about 1/3 of the meat; ate only about half of her dessert
Sleep:

• Awake at 1430
• Down for nap at 1915
• Up from nap at 2130
• Down for night at 0130
• Awake 8.75 hours