Mom's Daily Tests & Meds - Current

As of May 1, 2010...

2010-04-29T21:43:00.002-07:00

...Blogger will no longer allow FTP publishing. Updates to this blog, which will probably be few to none, since this section of The Mom & Me Journals dot Net is, essentially, closed by time, can be found at http://dailies2008.blogspot.com. This section of the journal will also remain at in it's domain directory, so accessing links should not present a problem.

Closing out the Practical Aspects of this Journal

2008-12-27T10:35:00.003-07:00

As most, if not all, regular readers of The Mom & Me Journals dot Net know, my mother died at approximately 0709 on December 8, 2008. Although some of the other sub-journals will continue, this journal, if it continues, will not continue in the same form as previously, since it was a reportage of the technical aspects of my mother's life, including daily stats, what she ate, how much she slept, how often she evacuated her bowels and how her medication schedule was upheld or changed on any particular day. As I begin reviewing the more practical journals I may add posts mentioning me noticing peculiar aspects of her life that weren't clear to me while she was alive, but such a review is probably weeks to months in the future.
Thus, this final practical post is a not to meticulous detailing of her last few days, linking to posts in the main journal that mention how her life wound down:

December 7, 2008 @ 00:56: A review of her condition as and her evening before she slept Saturday night.
December 7, 2008 @ 1756: Includes her arising in the morning, what she ate, what she drank, what meds I gave her when she ate, and more review on how much she slept that day.
December 8, 2008 @ 05:18 Includes a review of some of the last meds given to her and what her condition was when I awoke to give her these meds...and stay with her, from then to the end of her life.
December 8, 2008 @ 10:00: Includes a detailed description of her "active dying phase" up to her death.

I think that should do it. There is a "morphine log" and an "acetaminophen log" that I kept from the time she began taking morphine to her death. Hospice asked me to keep the first log as a reference for them so that they could determine if and when she'd more and how much more she might need. The acetaminophen log was for my own reference, in an attempt to avoid overdosing with acetaminophen. Since my mother died a little over three days after this new phase of her life began, Hospice didn't ask for the logs. I can't see any particular reason to publish them, although I retain them and, if it seems, in the future, that it might help elaborate some point connected to caring for Dying Ones, I may publish them.
As well, please be assured, I'm continuing to post over at the main site. If you're curious to know what I could possibly have to say now that my mother is dead and our adventure would seem to have come to a firm end, click over there and see.

Non-Stat Day:

2008-12-06T23:59:00.005-07:00

Medication Changes:

0810: .125 mL morphine sulfate; her breaths per minute were at 24, I needed to run backed up errands and I wanted to make sure that we did not have a repeat of yesterday morning, when she was so breathless that she awakened and began experiencing the middle back pain that goes along with her lungs working too hard. When I returned from errand running at 10:50 she was breathing easily, her breaths per minute were 23, and she was sleeping comfortably.
None of her regular medications were given. Her morhpine and acetaminophen doses are being recorded in hard copy morphine and tylenol logs.

Sleep:

She slept most of the day. She was in bed all day. My guess is that she was awake for maybe five hours in all, between pain episodes, recovering from them and awakening for a regular morphine/tylenol cocktail that she received every 2-5 or so hours throughout the day from noon on

Full Stat Day:

2008-12-05T23:59:00.003-07:00

AM Blood Glucose: Time: 0840 Reading: 200	AM Axillary Dig Temp: Time: 1120 Reading: 96.0
Blood Oxygen: Time: 1115 Level: 93% Pulse: 95	Breaths Per Minute: Time: 1445 Reading: 20
Breaths Per Minute: Time: 0115 Reading: 28	Breaths Per Minute: Time: 0135 Reading: 32

PM Blood Glucose:
Time: 2210
Reading: 184

PM Blood Pressure:
    Time:  2220
    BP:  142/70
    Pulse:  79

Medication Changes:

0850: 500 mg acetaminophen for middle back pain from labored breathing
0945: .125 mL morphine sulfate for air hunger
between 0945 and 1015, all regular medications except iron
1015: per Hospice RN, .125 mL morphine sulfate for continued air hunger and 10 mg furosemide for feet swelling
1145: 300 mg iron
1700: .25 mL morphine for air hunger
1715: 1 Ducosate Sodium pill in order to attempt to head off morphine constipation
2220: Probably about .20 mL morphine sulfate (some drops of it squirted out of her mouth when I gave it to her)
2245: 325 mg acetaminophen, general purposes, she asked for it, saying she thought it would help get rid of her "coldish" feeling
0140: .25 mL morphine sulfate per Hospice RN on call

Food:

Between 0850 and 1100 ate two pieces of multigrain toast with Fleischmann's margarine and cinnamon and a drained can of Mandarin orange slices
At about 1715 ate a piece of ham, a boiled egg and 14 oz of 40% OJ and 60% water (this is mostly her normal breakfast; the toast was served earlier in the day)
At about 2300 ate a piece of Costco Double Chocolate Cream Pie

Sleep:

Up at 0830
Back down at 1145
Up again at 1630
Down for nap at 1930
Up from nap at 2200
Down for night at 0145
Awake 10 hours

BM Full Stat Day:

2008-12-04T23:59:00.004-07:00

AM Blood Glucose:
Time: 1348
Reading: 154

AM 60" Dig Temp:
Time: 1359
Reading: 97.5

PM Blood Glucose:
Time: 2133
Reading: 189

Medication Changes:

325 mg acetaminophen for breakfast
.125 mL morphine sulfate at 2340 for air hunger at 6/lpm
.125 mL morphone sulfate at 0045 as a maintenance dose for air hunger
Skipped prune juice because of high BG number in evening

Bowel Movement: Occurred during bathing. Excellent volume; good consistency; very easy elimination; somewhat challenging clean-up.
Dinner: Grilled cheese and pepperoni sandwich on cracked wheat sourdough bread, 3 garlic stuffed olives, 3 pimiento stuffed olives, 3 sweet peppers
Sleep:

Awake at 1330
Down for nap at 1815
Up from nap at 2100
Down for night at 0115
Awake 9 hours

Full But Switched Stat Day:

2008-12-03T23:59:00.001-07:00

AM Blood Glucose:
Time: 1457
Reading: 211

AM 60" Dig Temp:
Not taken

PM Blood Glucose:
Time: 2136
Reading: 214

Other Temp:
Time: 0100
Reading: 98.4

Medication Changes:

325 mg acetaminophen at breakfast; general purposes and "I don't feel good all over"; I asked her if she wanted it with breakfast and she said "yes"; she, however, refused my offer of acetaminophen or ibuprofen before her nap or with dinner
Skipped the prune juice again tonight to see if this impacts her high BGs

About 2 cups sauerkraut and polish sausage; about 3/4 cup loaded (with sauteed veggies) stuffing
Sleep:

Awake at 1400
Down for nap at 1915
Up from nap at 2100; this was a short nap for her but a bout of dry hacking awoke her
Down for night at 0130
Awake 9.75 hours

Contents of Hospice Comfort Pack

2008-12-03T10:52:00.003-07:00

At my request, the Hospice RN who visited yesterday went through the contents of our refrigerated Comfort Pack and explained the Hospice purposes of all the meds therein contained. Following is what I learned:

Morphine Sulfate: See Morphine Manual
Acetaminophen Suppository 650 mg: For difficulty swallowing and/or end-of-life fever
Haloperidol 2mg/ml: For nausea or severe agitation
Ativan (loracepam) 1 mg: For anxiety, usually, in the case of respiratory patients, due to difficulty breathing; often used with morphine
Prochlorper 10 mg tablets and 20 mg suppositories: For nausea
ABHR: Suppository for nausea
Hyoscyam 0.125 mg/ml: To quiet death rattle at end-of-life; when the RN told me this I immediately asked, "Is this for the patient's comfort or for the family's comfort?"
"You're on the button," she replied. "It's for the family."
"Ah," I said. "Then I probably won't be using it. Over the years I've gotten used to a variety of noises coming from my mother. If she's comfortable and peaceful, I can't see any reason to quiet her death rattle."

Please note, these explanations, above, are not extensive and there is a lot of information they don't include. I wasn't looking for a PDA explanation...merely a thumbnail sketch of why we have them and how we might use them. The RN underlined that before using any of them, at least for the first time, I should always contact Hospice for approval and direction, and, of course, I will.

Partial Stat Day:

2008-12-02T23:59:00.004-07:00

AM Blood Glucose:
Time: 1332
Reading: 198

AM 60" Dig Temp:
Not taken

PM Blood Glucose:
Time: 2059
Reading: 219

Medication Changes:

200 mg ibuprofen with breakfast
200 mg ibuprofen with buttered, cinnamoned toast before nap
200 mg ibprofen at dinner
Extra glipizide with toast before nap because of high "am" BG
Extra glipizide with dessert because of high "pm" BG
4th breathing treatment able to be administered at 0145 just before bed
Skipped Prune Juice; see Miscellaneous BG Notes below

Dinner: Roast chicken thigh, about 1/2 cup Brussels Sprouts with Greek Veta Vinaigrette dressing, about 3/4 cup loaded stuffing with lots of added, sauteed vegetables; 1 slice Costco Double Chocolate Cream pie
Miscellaneous BG Notes: I've decided to try a few strategies to attempt to lower her BGs:

The first, which I did today, is to administer two extra glipizide when both her BGs are very high, as they were today.
The second is to switch from Prune Juice to ducosate sodium (Colace) as a stool softener. I thought I'd start with an every other evening dose, see how that works and increase it, if necessary. I did not administer it this evening since last night was a Prune Juice night. As well, our supply of ducosate sodium is expired so the nurse ordered us more.
I may try cutting out desserts, but this is going to be difficult, since my mother is so used to dessert, now, and so loves it that, generally, if I don't get around to serving it sometime after dinner, she asks for it. I may scale back to desserts like canned Mandarin orange slices, which she loves and considers a legitimate dessert, and/or "do" rich desserts maybe only two to three times a week. As well, I pretty much agree with the Hospice philosophy: "Why not?" when it comes to desserts, and other things. I wasn't able to discuss Hospice's medical philosophy behind the assumption that her glipizide will eventually be discontinued, but I will next week.

Sleep:

Awake at 1300
Down for nap at 1715
Up from nap at 2100
Down for night at 0200
Awake 9.25 hours

BM Partial Stat Day:

2008-12-01T23:59:00.003-07:00

AM Blood Glucose:
Time: 1509
Reading: 194

AM 60" Dig Temp:
Not taken

PM Blood Glucose:
Not taken

Medication Changes:

200 mg ibuprofen at breakfast for general purposes and a feeling of "aching all over"
500 mg acetaminophen with dinner for same feeling as above
3rd breathing treatment was accidentally given an hour early; somewhere during the evening I booted myself up into yesterday evening and counted the hours down wrong
10 mg furosemide for continued (a couple of days) and rapid (today) feet and leg swelling

Bowel Movement:Occurred at 1445, during bathing. Excellent volume; fair consistency, turds were large and hard; surprisingly easy elimination; easy clean-up
Dinner: Tuna fish salad sandwich on toasted Multigrain bread
Sleep:

Awake at 1400
Down for nap at 1600
Up from nap at 2100
Down for night at 0100
Awake 8 hours

Partial Stat Day:

2008-11-30T23:59:00.002-07:00

AM Blood Glucose:
Time: 1233
Reading: 123

AM 60" Dig Temp:
Not taken

PM Blood Glucose:
Time: 2028
Reading: 234

Medication Changes:

325 mg acetaminophen instead of 200 mg ibuprofen for breakfast (general purposes)
325 mg acetaminophen before nap (for general stiffness and low level discomfort)
325 mg acetaminophen at dinner (for lower back pain)
325 mg acetaminophen before bed (for lower back pain)
Extra glipizide with dessert
Detox Tea in evening
Got in a 4th breathing treatment today

Dinner: 1 slice home made beef pot pie and 1 slice Chocolate Mousse cake
Sleep:

Awake at noon
Down for nap at 1630
Up from nap at 2000
Down for night at 0130
Awake 10 hours

BM Non-stat Day:

2008-11-29T23:59:00.002-07:00

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:

2008-11-28T23:59:00.002-07:00

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:

2008-11-27T23:59:00.005-07:00

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:

2008-11-26T23:59:00.004-07:00

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:

2008-11-26T12:20:00.002-07:00

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:

2008-11-25T23:59:00.002-07:00

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

2008-11-25T19:05:00.003-07:00

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:

2008-11-24T23:59:00.003-07:00

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:

2008-11-23T11:59:00.003-07:00

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

BM Partial Stat Day:

2008-11-22T23:59:00.004-07:00

AM Blood Glucose:
Time: 1501
Reading: 164

Not taken

PM Blood Glucose:
Time: 2211
Reading: 176

Medication Changes:

200 mg ibuprofen with breakfast for general purposes, although I used her complaint of temporary lower back pain while she sat on the toilet for bathing (a common complaint in these circumstances) to gain her approval for it
Although I probably should have noted this over the last three days it became so routine so suddenly that I didn't. I thought it was predicting a new level of Business as Usual: Today I dialed Mom back to 4/lpm while sitting for most of the time from after her breakfast to her nap and she breathed fine and easily. I've had her on 5/lpm almost constantly for the last three days and fairly frequently over the last week when sitting. But, today, her lungs seem to be more relaxed. I'm not sure whether it's because we're exiting a "Bad Cancer Cycle" set of days or because of the AM ibuprofen, but I'm grateful. Her nose isn't irritated nearly as much (when she's on 5/lpm she sneezes a lot, no matter how much KY Jelly I use on her nose) and her nasal membranes were not irritated enough, today, to bleed.

    Bowel Movement:  Occurred during bathing. Good volume; good but somewhat hard consistency; easy elimination; very easy clean-up.
    Dinner:  Double pepperoni pizza with heavy sauce, light cheese and added Bermuda onion slices, chopped sun dried tomatoes and sliced, pimiento stuff olives
    Sleep:

Awake at 1430
Down for nap at 2000
Up from nap at 2200
Down for night at 0215
Awake 9.75 hours

Partial Stat Day:

2008-11-21T23:59:00.001-07:00

AM Blood Glucose:
Time: 1425
Reading: 167

Not taken

PM Blood Glucose:
Time: 2210
Reading: 135

Medication Changes:

200 mg ibuprofen at breakfast as an experiment to see if this keeps her breathing easier
Peach Detox Tea this evening

Dinner: Home made cheeseburger sandwich on onion bun with thick slice of Bermuda onion, dill pickle relish and slice of Jalapeno Jack cheese, about 3/4's cup home pickled (without sugar) beets (ate only about 1/3 cup) and a little less than an ounce of Doritos flavored chips
Sleep:

Awake at 1400
Down for nap at 1915
Up from nap at 2145
Down for night at 0230
Awake 10 hours

Full Stat Day:

2008-11-20T23:59:00.003-07:00

AM Blood Glucose:
Time: 1402
Reading: 120

AM 60" Dig Temp:
Time: 1412
Reading: 97.2

PM Blood Glucose:
Time: 2205
Reading: 180

Medication Changes:

500 mg acetaminophen for back pain, probably not from air hunger but not sure; not incredible pain but fairly significant; before nap
500 mg acetaminophen with dinner for unusual (but not incredible) upper back discomfort
Skipped 4 oz prune juice, as it didn't quite fit in with the Bedside Evening we had

Miscellaneous Food Note: 1 piece of multi-grain toast with Fleishmann's margarine and cinnamon before nap with her acetaminophen
Dinner: One Hot & Spicy Chicken Cup a Soup, ate about half; 1 slice lemon meringue pie
Sleep:

Down for nap at 1845
Up from nap at 2145
Down for night at 0045
Awake 8.25 hours

Full Stat Day:

2008-11-19T23:59:00.003-07:00

AM Blood Glucose:
Time: 1250
Reading: 172

AM 60" Dig Temp:
Time: 1313
Reading: 97.1

PM Blood Glucose:
Time: 1952
Reading: 201

Medication Changes:

1 brewed cup of Peach Detox Tea in the evening
500 mg acetaminophen after nap for yet another cannula dislodging; this time I caught it before the pain started, although after her body began registering distress; since I knew it would take about 20 minutes for the acetaminophen to kick in, I administered the larger dose, just in case the pain started before the analgesic kicked in. Turns out, luckily, we caught the pain before it started.

Miscellaneous Food Note: 1 piece of multigrain toast with Fleishmann's margarine and cinnamon with acetaminophen mentioned above, just before dinner
Dinner: Taco Bell, Mom's choice; dessert was a slice of lemon meringue pie. She ate about 3/4's of her dinner and about 3/4's of her pie.
Sleep:

Awake at 1230
Down for nap at 1700
Up from nap at 1945
Down for night at 0030
Awake 9.25 hours

BM Additional Stat Day:

2008-11-18T23:59:00.004-07:00

AM Blood Glucose: Time: 1247 Reading: 110	AM Blood Pressure: Time: 1355 BP: 126/60 Pulse: 80
Breathing Resp: 32 BO₂: 91 @ 4/lpm	Right Upper Arm Measure: Today: 11.25" * Last One: 10.75"

PM Blood Glucose:
Time: 2012
Reading: 158

Medication Change:

Separated Mom's 2nd breathing treatment into two sessions because she took a nap early but I felt, along with our Hospice RN, who visited today, that, one way or another, she needs at least three treatments a day. First part of second treatment was the Albuterol, administered at 1530.
325 mg acetaminophen at 2100 for middle back pain
Another 325 mg acetaminophen at 2300 for recurrence of problem
Forgot 4 oz prune juice tonight

Dinner: French onion soup and four cheese & veggie puff pastries; lemon meringue pie for dessert
Bowel Movement: Occurred just before nap. Very good volume; slightly hard consistency; easy elimination; not so easy clean-up.
Miscellaneous Notes on Additional Stats:

Regarding Respiration: The RN said it was "up a bit" at 32/pm. I forgot to ask from what it was up.
* Regarding Right Upper Arm Measurement: The last measurement was taken somewhat over a month ago; I forgot to ask the date. When I mentioned I was surprised because it seemed to me, especially when Mom was sleeping, that she was losing some weight and I found it particularly noticeable in her upper arms, the RN said that, of course, consideration of this type of measurement always "allows for parallax".

Sleep:

Awake at 1230
Down for nap at 1545
Up from nap at 1945
Down for night at 0030
Awake 8 hours

Full Stat Day:

2008-11-17T23:59:00.004-07:00

AM Blood Glucose:
Time: 1356
Reading: 166

AM 60" Dig Temp:
Time: 1404
Reading: 97.9

PM Blood Glucose:
Time: 1936
Reading: 180

Medication Change:

Detox tea tonight

Dinner: Her choice, a TV dinner, one of her favorites, about which I'd forgotten: Swanson's Hungry Man Mexican Dinner. Unfortunately, they don't make them like they used to. She only ate about 2/3's of it before she gave up on it.
Sleep:

Awake at 1330
Down for nap at 1715
Up from nap at 1900
Down for night at 0030
Awake 9 hours

BM Full Stat Day:

2008-11-16T23:59:00.001-07:00

AM Blood Glucose:
Time: 1458
Reading: 146

AM 60" Dig Temp:
Time: 1517
Reading: 97.3

PM Blood Glucose:
Time: 2236
Reading: 141

Bowel Movement:Occurred during bathing. Poor volume; good consistency; very easy elimination; easy clean-up.
Medication Changes:

325 mg acetaminophen when she arose from nap; although she had no pain, she asked for it; it occurred to me it might help her breathe with less stress
No Detox tea tonight

Dinner: Three types of left over chicken from Costco: Chicken Parmesan; Chicken Florentine and Chicken Pot Pie; tart for dessert.
Sleep:

Awake at 1430
Down for nap at 1915
Up from nap at 2215
Down for night at 0230
Awake 9 hours

Full Stat Day:

2008-11-15T23:59:00.002-07:00

AM Blood Glucose:
Time: 1508
Reading: 184

AM 60" Dig Temp:
Time: 1528
Reading: 97.1

PM Blood Glucose:
Time: 2122
Reading: 215

Medication Changes:

325 mg acetaminophen before nap for lower back ache
Extra 10 mg of glipizide with dessert because of high BG readings
500 mg acetaminophen just before bed for another episode of hard pain in the same place as last time
I've been forgetting to note this, but today was a Detox tea day. I haven't been keeping to a strict every-other-day schedule, so I'll start noting when I use it

Dinner: Rest of the KFC from last night; a scoop of German Chocolate Cake ice cream
Miscellaneous Note on Recent BG readings: I am concerned about her high BG readings, but we are also in the middle of negotiating one glucometer malfunction and, thus, having to use expired strips on the other. I am awaiting delivery of fresh strips. I am hoping that this will take care of the problem.
Sleep:

Awake at 1500
Down for nap at 1900
Up from nap at 2115
Down for night at 0200
Awake 8.75 hours

Full Stat Day:

2008-11-14T23:59:00.002-07:00

AM Blood Glucose:
Time: 1410
Reading: 148

AM 60" Dig Temp:
Time: 1430
Reading: 97.1

PM Blood Glucose:
Time: 2127
Reading: 193

PM 60" Dig Temp:
Time: 0145
Reading: 98.4

Medication Changes:

Extra glipizide before going down for a nap, to address a sweet roll she had at breakfast
325 Acetaminophen before bedtime for "coldish" symptoms, including a slight rise in temperature

Dinner: 1 KFC Original Recipe thigh; some of their Mac & Cheese; Some of their cole slaw. No dessert. I didn't mention it, because of her high BG in the evening she didn't ask for it.
Sleep:

Awoke at 1400
Down for nap at 1730
Up from nap at 2100
Down for night at 0200
Awake 8.5 hours

Full Stat Day:

2008-11-13T23:59:00.000-07:00

AM Blood Glucose:
Time: 1434
Reading: 190

AM 60" Dig Temp:
Time: 1454
Reading: 97.4

PM Blood Glucose:
Time: 2102
Reading: 228

Medication Change:

Extra glipizide at dinner to cover high BGs that morning and evening and her choice of dinner.

Dinner: Another "Just Dessert" dinner. After I suggested several possibilities for "healthy" dinners, Mom stuck to her guns, "All I want is a big bowl of ice cream." That's what she got; German Chocolate Cake Ice Cream, to be exact.
Sleep:

Awoke at 1400
Down for nap at 1830
Up from nap at 2045
Down for night at 0000
Awake 7.75 hours

Morphine Manual

2008-11-13T10:48:00.014-07:00

Important Caveat: The following instructions are eccentric to my mother and her peculiar pain and health profile. They should not be used by anyone else to any purpose, including self-administration of narcotic pain medication or as a substitute for or adjunct to one's own physician's orders. If you are suffering pain, seek the advice of your physician.

Sliding Scale for Morphine Administration for Pain Experienced on 11/12/08:

Scale Parameters	Amount in mL	Amount in mg
*Low (beginning)	0.125	2.5
Can give up to:
High (end)	0.250	5.0

Further Instructions:

A dose will start to work within 10 - 20 minutes.
This scale and these instructions are for first time use for Mom in her present "narcotic naive" (meaning, someone who has never taken narcotics for pain) state.
* This amount can be taken every 20 minutes until Mom is comfortable. This strategy is known as "loading up" and helps create a dose overlap effect until a comfort level is reached.
Once the dose which achieves comfort is reached, this dose, up to 5 mg, can be administered every hour as needed.
If pain continues to escalate despite above dosage instructions, call Hospice and check to see if any of the following symptoms apply:
1.  Any increment of loss of lower extremity use
2.  Increased urinary incontinence beyond normal
3.  Bowel incontinence
These could be signs of a spinal compression fracture.
Stop administration in the absence of pain and the presence of comfort if these two conditions last beyond 1 hour.

Possible Side Effects:

Nausea: Can administer metaclopramide
"Loopiness"
Sedation
Keep in mind the typical adjustment period for someone who is "narcotic naive" is 3 days. After adjustment period, above symptoms should disappear.

Additional Notes:

The morphine to which the above instructions apply is Morphine Sulfate, an Oral Solution to be taken by mouth or under the tongue.
A syringe is provided in the package which is marked from 0.25 mL - 1.0 mL, in .25 mL increments. This means that I have two dosage increments up to 0.25 mL. Obviously, the above scale is designed for low usage.

Morphine Manual Update: The immediately previous link will take you to a post at my main journal which details a conversation I had with a Hospice RN that elucidated, in detail, the use of morphine for air hunger, including what effect morphine should and, more importantly, shouldn't have on the patient.

BMs Full Stat Day:

2008-11-12T23:59:00.002-07:00

AM Blood Glucose:
Time: 1428
Reading: 126

AM 60" Dig Temp:
Time: 1458
Reading: 97.5

PM Blood Glucose:
Time: 1947
Reading: 186

Medication Changes:

Skipped 2nd breathing treatment; simply forgot it. However, considering her hours, today, if we'd gotten the 2nd treatment in, we probably would not have been able to get a third treatment in or, if so, just an Albuterol treatment.
500 mg acetaminophen at 2015 for sudden, extremely significant sharp, steady middle back pain, below ribs, on the approximate plane of her belly button, across back extending about 5 inches from either side of her spine.

Bowel Movements:

1st after nap at 1930. Excellent volume; slightly loose but good consistency; very easy elimination; slightly challenging clean-up.
2nd occurred when she was preparing for bed at about 2330. Fairly poor volume; slightly loose but good consistency; very easy elimination; slightly challenging clean-up.

Dinner: Carl's Jr. Guacamole Bacon Burger and medium order of onion rings with 12 oz. Ginger Beer. She ate all but half of the hamburger patty.
Sleep:

Awake at 1400
Down for nap at 1715
Up from nap at 1915
Down for night at 0000
Awake 7.75 hours

Miscellaneous Note: Since it appears that her health is beginning to affect her appetite, particularly at night, I will, from now on, be reporting detail about how her eating habits change, as they change. I will most likely also be noting days when there are no changes.

Official Sleep Average Report:

2008-11-12T02:16:00.002-07:00

Although I published a 10 day Sleep Average report on 9/14/08, 10 days does not a trend show. I decided, last night, to see what I could do with all the data I've stored on her sleeping since 9/4/08. Turns out I was able to compare two 34 day periods, through yesterday. The report is here.
Observations from Report Data: Although there is a very slight decrease in awake time (the figures in red) from the first period to the second, I think there are more cogent points to be noted:

Not only has the Longest Awake Day decreased by a half hour, the Shortest Awake Day has decreased significantly. Both of her Sleep Days (10/11/08 & 10/26/08) fell in the second 34 Day Period, as well. Neither of her Sleep Days occurred when she was having serious health issues, although I thought, erroneously, that the second one was prefiguring her third bout of pneumonia (which, thankfully, hasn't yet happened).
Aside from having no days, during the first period, that I would refer to as Sleep Days, she also had two days when she was awake for 11 hours. She had no such days during the second period.
In addition, and surprisingly, the number of days she was up for 9 or more hours increased by two and the number of days she was up for less than 9 hours decreased by two.

So, it'll be interesting to me to see how her sleep quotient develops over the next period. Since I've arbitrarily set the first two periods at 34 days, I'll plan my next report to cover 11/12/08 - 12/15/08.

Full Stat Day:

2008-11-11T23:59:00.003-07:00

AM Blood Glucose: Time: 1218 Reading: 150	AM Blood Pressure: Time: 1330 BP: 130/70 BPM: 84
AM 60" Dig Temp: Time: 1229 Reading: 97.5

PM Blood Glucose:
Time: 2101
Reading: 146

PM 60" Dig Temp:
Time: 2100
Reading: 98.4

Medication Changes:

325 mg acetaminophen at breakfast for a "coldish" feeling
325 mg acetaminophen at dinner for same feeling as above
325 mg acetaminophen before bed for same feeling as above

Dinner: Ham and egg with caffeinated English Breakfast tea; she only ate about 3/4's of her dinner and refused a Costco lemon Danish, so her cold has gotten the best of her appetite, which is unusual. This is the third time, I think, since she was diagnosed with lung cancer and has been on Hospice, that her appetite has failed her when she isn't feeling well. It normally doesn't.
Sleep:

Awake at 1200
Down for nap at 1615
Up from nap at 2030
Down for night at 0145
Awake 9.5 hours

BM Full Stat Day:

2008-11-10T23:59:00.005-07:00

AM Blood Glucose:
Time: 1433
Reading: 166

AM 60" Dig Temp:
Time: 1440
Reading: 97.8

PM Blood Glucose:
Time: 2146
Reading: 155

PM 60" Dig Temp:
Time: 2152
Reading: 98.4

Medication Changes:

325 mg acetaminophen at breakfast for persistent lower back ache with which she awoke
Skipped prune juice; she finally said "no" to all the fluids I was trying to get in before her chosen early bedtime

Bowel Movement: Occurred just before bathing (1500). Good volume; good consistency; easy elimination; easy clean-up.
Dinner: A bowl of Annie Chun's Hot & Sour Soup and a slice of apple tart.
Sleep:

Awake at 1400
Down for nap at 1930
Up from nap at 2130
Down for night at 0030
Awake 8.5 hours

Full Stat Day:

2008-11-09T23:59:00.002-07:00

AM Blood Glucose:
Time: 1327
Reading: 154

AM 60" Dig Temp:
Time: 1345
Reading: 97.5

PM Blood Glucose:
Time: 2051
Reading: 172

Medication Change: Back to scheduling Detox tea; 1 cup this evening before bed.
Dinner: Costco Chicken Pot Pie; 1 slice egg custard tart for dessert
Sleep:

Awake at 1300
Down for nap at 1800
Up from nap at 2030
Down for night at 0130
Awake 10 hours

Partial Stat Day:

2008-11-08T23:59:00.002-07:00

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:

2008-11-07T23:59:00.002-07:00

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:

2008-11-06T23:59:00.002-07:00

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

2008-11-06T23:44:00.004-07:00

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:

2008-11-05T23:59:00.002-07:00

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:

2008-11-04T23:59:00.004-07:00

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:

2008-11-03T23:59:00.002-07:00

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:

2008-11-02T23:59:00.005-07:00

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

Partial Stat Day:

2008-11-01T23:59:00.002-07:00

AM Blood Glucose: Time: 1425 Reading: 120	AM Blood Pressure: Time: 1422 BP: 140/80 Pulse: 79
AM 60" Dig Temp: Time:None taken

PM Blood Glucose:
Time: 2215
Reading: 108

Medication Change:

Skipped 3rd breathing treatment, she wasn't up enough in any period to get third one in.
Skipped 4 oz prune juice; she didn't want it and I didn't see a reason to fight her, since I figured she probably has been getting plenty of fiber over the last few days.

Dinner: 1/4 dark meat roast chicken; steamed broccoli with Greek Feta Vinaigrette; cherry pie for dessert with freshly whipped cream.
Miscellaneous note: She seemed to feel significantly better today than over the past few days, so maybe we were dealing with "just" a cold that passed without complications.
Sleep:

Awake at 1415
Down for nap at 1930
Up from nap at 2200
Down for night at 0130
Awake 8.75 hours

BM Partial Stat Day:

2008-10-31T23:59:00.002-07:00

AM Blood Glucose: Time: 1352 Reading: 175	AM Blood Pressure: Not taken
AM 60" Dig Temp: Time: 14:02 Reading: 98.0

PM Blood Glucose:
Time: 2011
Reading: 117

    Medication Change:  4 oz prune juice before bed.
    Bowel Movement:  Occurred immediately after nap. Good volume; fairly good consistency; very easy elimination; very easy clean-up.
    Dinner:  Home made Mac & Cheese with added meat and veggies. 1 slice lemon Boston Cream Pie for dessert.
Sleep:

Awake at 1330
Down for nap at 1800
Up from nap at 2000
Down for night at 0115
Awake 9.75 hours

BM Full Stat Day:

2008-10-30T23:59:00.004-07:00

AM Blood Glucose: Time: 1256 Reading: 164	AM Blood Pressure: Not taken
AM 60" Dig Temp: Not taken	PM 60" Dig Temp: Time: 2239 Reading: 98.4

PM Blood Glucose:
Time: 2001
Reading: 127

PM Blood Pressure:
    Time:  2026
    BP:  171/84
    Pulse:  87

Medication Changes:

1,250 mg garlic (new daily med)
325 mg acetaminophen at breakfast for unusual stiffness
325 mg acetaminophen after nap, after dessert, for slight fever (relative to Mom's normal temp) and overall achiness
4 oz prune juice

Bowel Movement: Occurred immediately after nap. Fairly good volume; good consistency; easy elimination; easy clean-up.
Dinner: Warmed up, left over Papa Murphy's 5 Meat pizza; Marie Callendar's cherry pie for dessert.
Sleep:

Awake at 1230
Down for nap at 1745
Up from nap at 1945
Down for night at 0030
Awake 10 hours

Miscellaneous Note: You'll notice I took some of the usual morning stats in the evening, instead. She was feeling, in her word "lowgy", even though she ate well, so I checked her for fever and took her BP then, too, since I was still concerned about a possible pneumonia episode.

BM Full Stat Day:

2008-10-29T23:59:00.003-07:00

AM Blood Glucose: Time: 1404 Reading: 159	AM Blood Pressure: Time: 1418 BP: 139/80 Pulse: 87
AM 60" Dig Temp: Time: 1419 Reading: 97.6

PM Blood Glucose:
Time: 2031
Reading: 159

Medication Changes:

325 mg acetaminophen at breakfast for overall stiffness and lower back ache
Skipped 3rd breathing treatment
4 oz prune juice before bed

Bowel Movement: This one was a little worrisome. Occurred when she arose from her nap. Good volume; easy elimination, fair consistency, which means the turds were quite large and solid; somewhat challenging clean-up; She expelled some fresh blood and clots with this movement, thus, even though it appeared to be easy elimination and she reported easy elimination, she's compacting in there. I've decided to give her 1/4 cup prune juice almost every day, now.
Dinner: 1/4 dark meat roast chicken with steamed broccoli with Greek Feta Vinaigrette, about 3/4 cup Uncle Ben's Original Recipe long grain and wild rice; for dessert, 1 slice Marie Callendar's cherry crunch pie with freshly whipped cream.
Sleep:

Awake at 1345
Down for nap at 1800
Up from nap at 2015
Down for night at 0045
Awake 8.75 hours

BM Full Stat Day:

2008-10-28T23:59:00.003-07:00

AM Blood Glucose: Time: 1142 Reading: 159	RN Blood Pressure: Time: 1400 BP: 155/70 Pulse: 80
	Hospice RN Temp: Time: 1356 Reading: 97.4

PM Blood Glucose:
Time: 1904
Reading: 149

    Medication Change:  325 mg acetaminophen at 1500 for sharp pain in middle left back.
    Bowel Movement:  Occurred during bathing. Fair volume; good consistency although, again, a fairly large turd; very easy elimination; very easy clean-up.
    Dinner:  1/4 of a large Papa Murphy's Stuffed 5 Meat Pizza; a scoop of German Chocolate Cake ice cream for dessert
Sleep:

Awake at 1130
Down for nap at 1600
Up from nap at 1845
Down for night at 0015
Awake 10 hours

BM Full Stat Day:

2008-10-27T23:59:00.002-07:00

AM Blood Glucose: Time: 1218 Reading: 112	AM Blood Pressure: Time: 1216 BP: 128/68 Pulse: 82
AM 60" Dig Temp: Time: 1240 Reading: 97.5

PM Blood Glucose:
Time: 1934
Reading: 236

Medication Change:

Gave Mom 325 mg at breakfast for complaints and evidence of stiffness, probably from having spent yesterday sleeping
4 oz prune juice before bed
still upping bedtime lisinopril 5 mg to 20 mg.
Extra glipizide before bed because of high BG before dinner

Dinner: Home made cheeseburgers on onion/cheese buns; about 3/4 cup home pickled (without sugar) beets; for dessert, a scoop of German Chocolate Cake ice cream.
Bowel Movement: Occurred during bathing. Fair volume; good consistency; very easy elimination; very easy clean-up.
Sleep:

Awake at 1200
Down for nap at 1630
Up from nap at 1915
Down for night at 0030
Awake 9.75 hours

More than Full Stat Day:

2008-10-26T23:59:00.003-07:00

AM Blood Glucose: Time: 1408 Reading: 187	AM Blood Pressure: Time: 1406 BP: 135/78 Pulse: 96
AM 60" Dig Temp: Time: 1430 Reading: 97.7

PM Blood Glucose:
Time: 2024
Reading: 161

PM Blood Pressure:
    Time:  2017
    BP:  154/79
    Pulse:  91

    Medication Change:  Skipped 3rd breathing treatment.
    Miscellaneous Note:  Today was an all out sleep day, exactly two weeks since the last. Despite this, she ate well and we got in all her meds. Probably did a little less well on fluids, but I managed to wrangle in more than I expected.
    Dinner:  A bowl of Annie Chun's Hot & Sour Soup with no additions; about 3/4 cup of Mom's favorite deli potato salad.
Sleep:

Awake at 1345
Down for nap at 1615
Up from nap at 2000
Down for night at 2000
Awake 4.5 hours

BM Full Stat Day:

2008-10-25T23:59:00.005-07:00

AM Blood Glucose: Time: 1343 Reading: 168	AM Blood Pressure: Time: 1406 BP: 149/84 Pulse: 90
AM 60" Dig Temp: Time: 1410 Reading: 97.6

PM Blood Glucose:
Time: 2115
Reading: 197

Bowel Movement:Occurred after nap. Fairly good volume; good consistency, although the turd was, again, rather large; very easy elimination; easy clean-up.
Medication Changes:

Upped bedtime lisinopril, again, from 15 mg to 20 mg
Upped sitting O₂ from 4/lpm to 5/lpm through bedtime because her breathing was significantly more labored than usual and she was doing some dry hacking
extra glipizide (10 mg) at dessert because BG was so high after napping
10 mg furosemide about 1 hour before bedtime in order to pull off torso water retention

Miscellaneous Snack Note: Had three squares of Ghiradelli chocolate at 1630 during a watching of the movie Chocolat; about half way through she popped up and said, "Do we have any chocolate in the house?" We did.
Dinner: Costco Chicken Florentine, steamed broccoli with Greek Feta Vinaigrette dressing
Sleep:

Awake at 1330
Down for nap at 1900
Up from nap at 2100
Down for night at 0145
Awake 10.25 hours

Full Stat Day:

2008-10-24T23:59:00.003-07:00

AM Blood Glucose: Time: 1415 Reading: 139	AM Blood Pressure: Time: 1418 BP: 156/80 Pulse: 85
AM 60" Dig Temp: Time: 1431 Reading: 97.6

PM Blood Glucose:
Time: 2128
Reading: 157

Medication Changes:

4 oz prune juice before bed
Increased her before-bed lisinopril from 15 mg to 20 mg

Dinner: Chicken Quesedilla
Sleep:

Awake at 1400
Down for nap at 1845
Up from nap at 2115
Down for night at 0130
Awake 9 hours

Curious Little Review

2008-10-24T20:09:00.002-07:00

I've been noticing, as I've been going through the archived part of these Dailies journals and combining posts to cut down on the number of pages, that exactly three years ago (I'm working through the fall of 2005, right now) Mom used to move her bowels practically every day and her heart rate was about 15-20 beats per minute less. Although I'm not surprised about the change in bowel movements, since she is eating significantly less roughage, now (Cobb salads, for instance, have disappeared from our menu because about a year and a half ago she started eating the meat, croutons and olives and leaving everything else), I was surprised about her heart rate. I ran both of these comparisons by our Hospice Nurse, who visited yesterday. He, of course, confirmed my guess about the bowel movements. When I told him about the heart rate difference, I wondered, aloud, if this could be due to the fact that I read, in a Medscape article, that Ipratroprium increases heart rate. He confirmed this but also said that both her lessening bowel movements and her elevated heart rate could also be because her heart is working harder, now, because her lungs aren't nearly as strong as they used to be; and, as well, her motility is probably less (this is true, even though her "motility" wasn't great three years ago) and her metabolism has slowed, of course. He concluded by saying, "I'm fine with it."
Actually, so am I. I was just curious.

BM Full Stat Day:

2008-10-23T23:59:00.003-07:00

AM Blood Glucose: Time: 1431 Reading: 129	AM Blood Pressure: Time: 1434 BP: 147/81 Pulse: 87
AM 60" Dig Temp: Time: 1453 Reading: 97.6

PM Blood Glucose:
Time: 2145
Reading: 180

    Bowel Movement:  Occurred during bathing. Fair volume; good consistency; very easy elimination; easy clean-up.
    Miscellaneous Breakfast Note:  Instead of buttered, cinnamoned toast, had a Costco lemon sweet roll for breakfast.
    Dinner:  Taco Bell, including 1 Burrito Supreme and 1 Crunchy Taco Supreme; dessert, 1 slice Marie Callendar's lemon meringue pie
Sleep:

Awake at 1415
Down for nap at 1945
Up from nap at 2145
Down for night at 0130
Awake 9.25 hours

Almost Full Stat Day:

2008-10-22T23:59:00.002-07:00

AM Blood Glucose: Time: 1152 Reading: 150	AM Blood Pressure: Time: 1325 BP: 140/70 Pulse: 84
AM 60" Dig Temp: Not taken

PM Blood Glucose:
Time: 2108
Reading: 73

Medication Change:

4 oz prune juice before bed
extra (4th) breathing treatment at 0130 before bed

Dinner: Toasted tuna sandwiches on whole wheat sourdough bread with Doritos Taco flavored and Chipotle Ranch chips; Marie Callendar's lemon meringue pie for dessert.
Sleep:

Awake at 1130
Down for nap at 1630
Up from nap at 2100
Down for night at 0215
Awake for 10.25 hours

Full Stat Day:

2008-10-21T23:59:00.002-07:00

AM Blood Glucose: Time: 1348 Reading: 170	AM Blood Pressure: Time: 1344 BP: 156/79 Pulse: 83
AM 60" Dig Temp: Time: 1405 Reading: 97.2

PM Blood Glucose:
Time: 1952
Reading: 163

Medication Changes:

325 mg acetaminophen before nap because Mom was feeling "achy and coldish"
Skipped 3rd breathing treatment

Dinner:Carl's Jr Bacon Guacamole burgers and onion rings.
Sleep:

Awake at 1330
Down for nap at 1630
Up from nap at 1945
Down for night at 0000
Awake 7.25 hours

BM Half Stat Day:

2008-10-20T11:59:00.002-07:00

AM Blood Glucose: Time: 1448 Reading: 136	AM Blood Pressure: Not taken
AM 60" Dig Temp: Not taken

PM Blood Glucose:
Time: 2227
Reading: 140

    Medication Change:  4 oz prune juice before bed.
    Bowel Movement:  Occurred during bathing. Fair volume; very good consistency; very easy elimination; very easy clean-up.
    Miscellaneous Food Note:  Gave her a Ghiradelli chocolate mint square at 1840; she mentioned that she felt like "a little something sweet; not much."     Dinner:  Croissant, egg, sausage and cheese sandwich.
Sleep:

Awoke at 1430
Down for nap at 2015
Up from nap at 2215
Down for night at 0145
Awake 9.25 hours

BM Half Stat Day

2008-10-19T23:59:00.005-07:00

AM Blood Glucose: Time: 1342 Reading: 134	AM Blood Pressure: Not taken
AM 60" Dig Temp: Not taken

PM Blood Glucose:
Time: 2146
Reading: 141

Medication Changes:

500 mg acetaminophen given at 1700 because of back pain
Skipped 2nd breathing treatment; forgot about it

Bowel Movement: Occurred during bathing. Fairly Good volume; very good consistency; very easy elimination; very easy clean-up.
Dinner: 1/4 dark meat roast chicken; about 1 cup steamed Brussels Sprouts; 1 slice Coco's Caramel Turtle pie.
Sleep:

Awoke at 1330
Down for nap at 1900
Up from nap at 2130
Down for night at 0130
Awake 9.5 hours

BM Full Stat Day:

2008-10-18T23:59:00.004-07:00

AM Blood Glucose: Time: 1329 Reading: 150	AM Blood Pressure: Time: 1328 BP: 153/79 Pulse: 84
AM 60" Dig Temp: Time: 1355 Reading: 97.7

PM Blood Glucose:
Time: 2102
Reading: 131

    Medication Change:  4 oz prune juice before bed.
    Bowel Movement:  Occurred during bathing. Good volume, although the main turd was rather fat; good consistency; easy elimination; easy clean-up.
    Breakfast Note:  Had Costco croissant split and sprinkled with Chinese Cassia cinnamon instead of usual Multi-grain toast with margarine and cinnamon.
    Dinner:  Blueberry buckwheat pancakes with real maple syrup and Fleishmann's margarine; sausage patties.
Sleep

Awake at 1315
Down for nap at 1845
Up from nap at 2045
Down for night at 0115
Awake 10 hours

Full Stat Day:

2008-10-17T23:59:00.003-07:00

AM Blood Glucose: Time: 1233 Reading: 147	AM Blood Pressure: Time: 1238 BP: 148/77 Pulse: 82
AM 60" Dig Temp: Time: 1247 Reading: 97.4

PM Blood Glucose:
Time: 2045
Reading: 111

Medication Change: Seasonal flu shot at about 1210.
Dinner: 1/4 dark meat roast chicken, about 1 cup steamed broccoli with Asian Marinade, about 3/4 cup deli potato salad; dessert was 1 slice of Coco's Caramel Turtle pie.
Sleep:

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

BM Partial Stat Day:

2008-10-16T23:59:00.003-07:00

AM Blood Glucose: Time: 1517 Reading: 115	AM Blood Pressure: Not taken
AM 60" Dig Temp: Not taken

PM Blood Glucose:
Time: 2117
Reading: 142

Medication Change:

4 oz prune juice before bed
Skipped 3rd breathing treatment

Bowel Movement: Occurred during bathing. Fairly poor volume; good consistency; very easy elimination; slightly challenging clean-up.
Dinner: Sausage marinara over egg noodles with Parmesan cheese; three Ghiradelli chocolate squares for dessert
Sleep:

Awoke at 1500
Down for nap at 1900
Up from nap at 2100
Down for night at 0115
Awake 8.25 hours

Full Stat Day:

2008-10-15T23:59:00.002-07:00

AM Blood Glucose: Time: 1413 Reading: 128	AM Blood Pressure: Time: 1419 BP: 120/93 Pulse: 81
AM 60" Dig Temp: Time: 1430 Reading: 97.2

PM Blood Glucose:
Time: 2115
Reading: 132

Medication Change: 325 mg acetaminophen with breakfast after Mom complained of "aching all over" once she had walked into the bathroom.
Dinner: KFC thigh, macaroni & cheese and cole slaw; for dessert, three Ghiradelli chocolate squares
Sleep:

Awoke at 1400
Down for nap at 1830
Up from nap at 2100
Down for night at 0215
Awake 9.75 hours

BM Full Stat Day:

2008-10-14T23:59:00.001-07:00

AM Blood Glucose: Time: 1213 Reading: 173	AM Blood Pressure: Time: 1211 BP: 147/86 Pulse: 84
AM 60" Dig Temp: Time: 1222 Reading: 98.1	Weight: Time: 1400 Reading: 144.8

PM Blood Glucose:
Time: 2041
Reading: 106

    Medication Change:  4 oz prune juice before bed
    Bowel Movement:  Occurred just before nap. Fair volume; good consistency; easy elimination; fair ease of clean-up
    Dinner:  1 slice Costco chicken pot pie; 1 slice Marie Callendar's lemon meringue pie
Sleep:

Up at 1200
Down for nap at 1630
Up from nap at 2030
Down for night at 0100
Awake 9 hours

Partial Stat Day:

2008-10-13T23:59:00.003-07:00

AM Blood Glucose: Time: 1515 Reading: 132	AM Blood Pressure: Not taken
AM 60" Dig Temp: Not taken

PM Blood Glucose:
Time: 2133
Reading: 184

Medication Changes:

3rd glipizide with dessert because of high BG when she awoke from nap
Skipped 3rd breathing treatment; wasn't up long enough for it

Dinner: Costco Dim Sum; 1 slice Marie Callendar's lemon meringue pie for dessert.
Sleep:

Awake at 1500
Down for nap at 1900
Up from nap at 2130
Down for night at 0030
Awake 7 hours

BM Full Stat Day:

2008-10-12T23:59:00.002-07:00

AM Blood Glucose: Time: 1301 Reading: 169	AM Blood Pressure: Time: 1258 BP: 123/70 Pulse: 89
AM 60" Dig Temp: Time: 1313 Reading: 97.9

PM Blood Glucose:
Time: 2014
Reading: 207

Medication Changes:

325 mg acetaminophen at nap time for middle left back pain
3rd glipizide when I served her pie, because of her elevated BG before dinner
4 oz prune juice before bed

    Bowel Movement:  Occurred during bathing. Fairly good volume; good consistency; very easy elimination; easy clean-up.
    Breakfast Notes:  Cherry Danish with breakfast instead of usual toast with margarine and cinnamon.
    Dinner:  Baked Salmon with basil butter; about 1 cup Brussels sprouts with Greek feta dressing; 1 slice Marie Callendar's lemon meringue pie
Sleep:

Awake at 1230
Down for nap at 1700
Up from nap at 2000
Down for night at 1245
Awake 9.25 hours

Partial Stat Day:

2008-10-11T23:59:00.002-07:00

AM Blood Glucose: Time: 1441 Reading: 134	AM Blood Pressure: Not taken
PM 60" Dig Temp: Time: 2207 Reading: 98.7

PM Blood Glucose:
Not taken

    Miscellaneous Note:  Today was an official sleep day for Mom. When I roused her from her nap she wasn't interested in getting up. I had already known, from the way the up part of her day had already gone, that she was verrrry tired. She also reported that she wasn't hungry and wanted to go back to sleep "for the night".
    I suggested that we get her up on the edge of the bed, feed her a very light dinner, get some fluid in her, have her take those pills which are necessary (see Medication Notes) and, if she still wanted to go back to sleep, that would be fine.
    I also took her temp. It was slightly elevated, for her. We had a lively hour-long visit while she was awake, eating and drinking. She decided afterward, though, that she definitely wanted to go back to sleep, so I let her.
    I'm not sure whether she was recovering from the visit, whether she wasn't feeling good for some other reason, or what, but I decided to trust her instincts about sleep.
Medication Changes:

325 mg acetaminophen at 2030 for slightly elevated temp
Skipped 2nd glipizide because of extremely light "dinner"
Skipped 3rd breathing treatment

Dinner: 2 slices pannetone; 1 cup ginger tea
Sleep:

Up at 1430
Down for nap at 1900
Up from nap at 2130
Down for night at 2230
Awake 5.5 hours

BM Partial Stat Day:

2008-10-10T23:59:00.003-07:00

AM Blood Glucose: Time: 1404 Reading: 132	AM Blood Pressure: Not taken
AM 60" Dig Temp: Not taken

PM Blood Glucose:
Time: 2040
Reading: 126

Bowel Movement: Occurred during bathing. Fair volume; good consistency; very easy elimination; very easy clean-up.
Medication Changes:

325 mg acetaminophen before nap for "sharp" pain middle left back
4 oz prune juice before bed

Dinner: 1 slice Costco Chicken Pot Pie with dollop of sour cream; 1 slice Costco American Chocolate Cake for dessert.
Sleep:

Up at 1330
Down for nap at 1800
Up from nap at 2030
Down for night at 0100
Awake 9 hours

Partial Stat Day:

2008-10-09T23:59:00.005-07:00

AM Blood Glucose: Time: 1359 Reading: 115	AM Blood Pressure: Not taken
AM 60" Dig Temp: Not taken

PM Blood Glucose:
Time: 2013
Reading: 153

Medication Change:

500 mg acetaminophen with breakfast because she slept diagonally on her bed and complained, upon rising, that she "ached all over".
Forgot her 4 oz prune juice this evening.
Panting when breathing in evening. Dialed her up to 5/lpm O₂ while sitting.
10 mg furosemide before bed for torso water retention and because she was having panting when sitting, even at 5/lpm and after last breathing treatment.

Dinner: 2 slices Streets of New York Pizza with pepperoni, sauce, cheese, sun dried tomatoes, green olives and onions; Costco chocolate cake for dessert.
Sleep:

Up at 1345
Down for nap at 1800
Up from nap at 2000
Down for night at 0100
Awake 9.25 hours

BM Partial Stat Day:

2008-10-08T23:59:00.005-07:00

AM Blood Glucose: Time: 1319 Reading: 2151	AM Blood Pressure: Not taken
AM 60" Dig Temp: Not taken

PM Blood Glucose:
Not taken

    Miscellaneous Note:  We had family company all day, today through early Friday morning, so our routine changed a lot, including many fewer stats taken.
    Bowel Movement:  Occurred during bathing. Fairly good volume; good consistency; very easy elimination; very easy clean-up.
    Dinner:  Slice of Costco Chicken Pot Pie with a dollop of sour cream; Slice of Costco American Chocolate Cake for dessert.
Sleep:

Up at 1300
Down for nap at 1800
Up from nap at 2030
Down for night at 0200
Awake 10.5 hours

Partial Stat Day:

2008-10-07T23:59:00.002-07:00

A.M. Blood Glucose: Time: 1230 Reading: 112	A.M. Blood Pressure: Not taken
A.M. Arterial Temp: Not taken

P.M. Blood Glucose:
Time: 2004
Reading: 138

Medication Change: 4 oz prune juice before bed.
Dinner: 1/4 roast chicken; potato salad; steamed broccoli with Greek feta dressing; Marie Callendars' Chocolate Cream Pie for dessert.
Sleep:

Awake at 1200
Down for nap at 1715
Up from nap at 2130
Down for night at 0130
Awake 9.25 hours

BM Full Stat Day:

2008-10-06T23:59:00.002-07:00

A.M. Blood Glucose: Time: 1429 Reading: 133	A.M. Blood Pressure: Time: 1426 BP: 164/87 Pulse: 85
A.M. Arterial Temp: Not taken

P.M. Blood Glucose:
Time: 2151
Reading: 138

    Medication Change:  Gave her 325 mg acetaminophen at 1700 when she complained that her mid-left back hurt "sharp".
    Bowel Movement:  Occurred during bathing. Good volume; very good consistency; very easy elimination; very easy clean-up.
    Dinner:  Sauerkraut simmered with fennel seeds and some sort of sliced, medium-hot Spanish sausage; lemon sorbet for dessert.
Sleep:

Up from 0400 - 0500
Up for day at 1400
Down for nap at 1900
Up from nap at 2130
Down for night at 0115
Awake 9.75 hours

Full Stat Day:

2008-10-05T23:59:00.002-07:00

A.M. Blood Glucose: Time: 1352 Reading: 128	A.M. Blood Pressure: Time: 1349 BP: 164/80 Pulse: 70
A.M. 60" Dig Temp: Time: 1430 Reading: 97.0

P.M. Blood Glucose:
Time: 2045
Reading: 161

Medication Changes:

I'm not sure whether I skipped a day or we got 11 pills instead of 10...actually, considering that I loaded up the pill box meticulously, I think we may have gotten an extra pill. I even went back to check my entries to see if I'd made a mistake, here. I hadn't. At any rate, there was a Levaquin 500 mg in her slot for last night's pills, so I gave it to her. Either it's the 11th pill in a 10 day course or the 10th pill. Not sure.
4 oz prune juice before bed
skipped 3rd breathing treatment; she wasn't up a lot, today, at the right times.

Dinner: 1/4 dark meat roast chicken; deli potato salad, about 3/4 cup; Brussels sprouts, about 3/4 cup. A medium scoop of lemon sorbet and a medium scoop of wild berry gelato for dessert.
Sleep:

Awake at 1330
Down for nap at 1700
Up from nap at 2030
Down for the night at 0000
Awake for 7 hours

Full Stat Day:

2008-10-04T23:59:00.004-07:00

A.M. Blood Glucose: Time: 1407 Reading: 120	A.M. Blood Pressure: Time: 1408 BP: 147/81 Pulse: 76
A.M. 60 " Dig Temp: Time: 1414 Reading: 97.5

P.M. Blood Glucose:
Time: 2031
Reading: 124

Medication Changes:

10th day of 10 day Levaquin 500 mg course

Dinner: Home made sausage marinara on shells with parmesan; 9 grain garlic toast; apple pie with freshly whipped cream.
Sleep:

Awake at 1330
Down for nap at 1715
Up from nap at 2015
Down for night at 0200
Awake 8.5 hours

Full Stat Day:

2008-10-03T23:59:00.003-07:00

A.M. Blood Glucose: Time: 1338 Reading: 180	A.M. Blood Pressure: Time: 1319 BP: 153/75 Pulse: 69
A.M. 60" Dig Temp: Time: 1356 Reading: 97.6

P.M. Blood Glucose:
Time: 2041
Reading: 148

Medication Changes:

9th day of 10 course Levaquin 500 mg regimen
4 oz prune juice before bed

Dinner: 1 Taco Bell Burrito Supreme and 2 Crunchy Taco Supremes.
Sleep:

Awake at 1245
Down for nap at 1700
Up from nap at 2030
Down for bed at 0115
Awake 10 hours

BM Full Stat Day:

2008-10-02T23:59:00.001-07:00

A.M. Blood Glucose: Time: 1423 Reading: 224	A.M. Blood Pressure: Time: 1427 BP: 102/72 Pulse: 117
A.M. 60" Dig Temp: Time: 1447 Reading: 97.7

P.M. Blood Glucose:
Time: 2043
Reading: 209

Bowel Movement: Occurred during bathing. Excellent volume; good but fairly soft consistency; very easy elimination; slightly challenging clean-up.
Medication Changes:

Administered 325 mg acetaminophen at breakfast, just in case, after her collapse in the hall
An extra 10 mg glipizide at 2245 when she had dessert, because of her high blood sugar readings today
8th day of 10 day course of Levaquin 500 mg

Dinner: Home made cheeseburgers on onion buns with dill pickle relish and jalapeno Jack cheese with Mrs. Fanning's Bread & Butter Pickles; dessert was a scoop of German Chocolate Cake ice cream.
Sleep:

Awoke at 1330
Down for nap at 1800
Up from nap at 2030
Down for night at 0045
Awake 8.75 hours

Full Stat Day:

2008-10-01T23:59:00.000-07:00

A.M. Blood Glucose: Time: 1321 Reading: 97	A.M. Blood Pressure: Time: 1318 BP: 145/76 Pulse: 79
A.M. 60" Dig Temp: Time: 1347 Reading: 97.4

P.M. Blood Glucose:
Time: 2115
Reading: 115

Medication Changes:

Administered 500 mg acetaminophen at breakfast because of side back pain
7th day of 500 mg Levaquin
4 oz prune juice before bed

Dinner: Just Dessert at her request: A heaping bowl of German Chocolate Cake ice cream with Dark Chocolate Sauce.
Sleep:

Down for nap at 1730
Up from nap at 2100
Down for night at 0145
Awake 9.25 hours

BM Full Stat Day:

2008-09-30T23:59:00.001-07:00

A.M. Blood Glucose: Time: 1327 Reading: 178	A.M. Blood Pressure: Time: 1325 BP: 125/66 Pulse: 76
A.M. 60" Dig Temp: Time: 1341 Reading: 97.3

P.M. Blood Glucose:
Time: 2019
Reading: 102

Bowel Movement: Occurred during bathing. Good volume; good consistency although expelled as small balls; very easy elimination; easy clean-up.
Medication Changes:

6th day of 10 day course of 500 mg Levaquin

Dinner: Costco Chicken Parmesan; Brussels sprouts with Greek Feta dressing; no dessert.
Sleep:

Awake at 1300
Down for nap at 1730
Up from nap at 2015
Down for night at 0015
Awake 8.5 hours

Full Stat Day:

2008-09-29T23:59:00.001-07:00

A.M. Blood Glucose: Time: 1127 Reading: 134	AM Blood Pressure: Time: 1124 BP: 145/74 Pulse: 79
A.M. 60" Dig Temp: Time: 1136 Reading: 97.6	PM Blood Pressure: Time: 1330 BP: 104/58 Pulse:

P.M. Blood Glucose:
Time: 1912
Reading: 133

Medication Change:

5th day of 500 mg Levaquin course.
4 oz prune juice before bed
Skipped 3rd breathing treatment

Dinner: Chili Cheese Dogs made with Mom's favorite canned chili (generic Kroger); Hebrew National polish sausage; whole wheat Bolillo roll; chopped yellow onion; grated jalapeno Jack & sharp Cheddar cheese; Marie Calendar's lemon meringue pie for dessert.
Sleep:

Awake at 1100
Down for nap at 1500
Up from nap at 1900
Down for night at 2330
Awake 8.5 hours

Very Partial Stat Day:

2008-09-28T23:59:00.003-07:00

A.M. Blood Glucose: Time: 1457 Reading: 138	A.M. Blood Pressure: Time: Not taken

P.M. Blood Glucose:
Time: 2116
Reading: 144

Medication Changes:

10 mg furosemide at 1730 to see if we can't pull the rest of that fluid off her feet.
4th day Levaquin course

Dinner: 1/4 dark meat roast chicken; about 3/4 cup steamed broccoli with Greek Feta dressing; about 3/4 cup Uncle Ben's Original Recipe Long Grain & Wild Rice; a healthy scoop German Chocolate Cake ice cream with dark chocolate sauce.
Miscellaneous Dinner Note: She didn't eat a lot of dinner, which is unusual; she usually finishes it. I don't think this was a failure of appetite, though. She was highly distracted by this evening's Cosby Show Marathon on the TVLand channel that I taped at her request. As well, she really dug into her ice cream. Wanted to make a note of this, though, just in case her appetite is getting ready to change, a bit.
Sleep:

Awake at 1430
Down for nap at 1700
Up from nap at 2100
Down for night at 0115
Awake 8.75 hours

BM Full Stat Day:

2008-09-27T23:59:00.009-07:00

A.M. Blood Glucose: Time: 1307 Reading: 132	A.M. Blood Pressure: Time: 1308 BP: 149/75 Pulse: 81
AM 60" Dig Temp: Time: 1322 Reading: 98.1

P.M. Blood Glucose:
Time: 2046
Reading: 116

Bowel Movement: Occurred at 1715. Very good volume; very good consistency; easy elimination; very easy clean-up.
Medication Changes:

1st breathing treatment between 0850 and 0905, since she was up and I figured she could probably use it, considering that we skipped her 3rd treatment yesterday
4 oz prune juice before bed
3rd Day of 500 mg Levaquin course

Dinner: 1/4 of a Streets of New York Pizza with double pepperoni (her favorite), onions, sun dried tomatoes and green olives, light on the cheese, heavy on the sauce; refused offer of dessert. Sleep:

Up briefly at 0845 to go to the bathroom and rearrange self
Back down at 0930
Awake at 1300
Down for nap at 1730
Up from nap at 2030
Down for night at 0100
Awake 9.75 hours

Partial Stat Day:

2008-09-26T23:59:00.004-07:00

A.M. Blood Glucose: Time: 1419 Reading: 171	A.M. Blood Pressure: Time: Not taken
A.M. 60" Dig Temp: Time: 1440 Reading: 97.9

P.M. Blood Glucose:
Time: 2052
Reading: 104

Medication Changes:

2nd day of 10-day course of Levaquin 500 mg 1/day
Skipped 3rd breathing treatment (with some reservation) because she wasn't up long enough to take the third. Because she was so tired she was nodding off in her rocker, I decided not to try to keep her up any longer to get the breathing treatment in.

Dinner:Croissant, sausage, egg & cheese sandwiches with 1 scoop each of lemon sorbet and wild berry gelato for dessert.
Miscellaneous Notes: It seems that the diagnosis of pneumonia was probably correct. Her thick tongue had reversed itself by "morning". Her strength is back, probably as it was before but I didn't want to take any chances so we used the wheel chair all day. Transfers were easy. More is reported at the current movement journal. She is definitely feeling better. The feet edema remains but is slowly reversing itself.
Sleep:

Up at 1400
Down for nap at 1745
Up from nap at 2045
Down for night at 0030
Awake 7.5 hours

BM Partial Stat Day:

2008-09-25T23:59:00.003-07:00

A.M. Blood Glucose: Time: 1321 Reading: 156	A.M. Blood Pressure: Time: Not taken
PM 60" Dig Temp: Time: 1515 Reading: 98.9

P.M. Blood Glucose:
Time: 2008
Reading: 162

Medication Changes:

500 mg Levaquin added tonight for a 10 day course as a preemptive prescription for what is probably pneumonia. Taken at 2000.
4 oz prune juice before bed

Bowel Movement: Occurred during bathing. Fairly good volume; fairly good consistency although still packed into one large turd; easy elimination; easy clean-up.
Dinner: Carl's Jr Guacamole Bacon Burger and 1 order onion rings; dessert was a scoop, each, of lemon sorbet and wild berry gelato.
Sleep:

Miscellaneous Notes:

Today was not a good day for my mother. Throughout the day her feet and leg edema continued, although much less than before the furosemide. Her weakness and inability to use her legs as usual continued. She was unusually tired. Around 1430, as my mother was completing her breakfast, I called Hospice to report all these symptoms, as they were developing at an alarming rate and not subsiding as I felt they should. I reported them as a reference point, more than anything else. As the conversation ended, the Hospice RN to whom I spoke asked that I take her temperature and call her again if it was over 99.0. It wasn't, although just barely under, so I didn't call.
An hour or so later, though, Mom began to develop "tongue thickening", thus having a little trouble pronouncing her words. About this time I decided to call Hospice again to add this to the list of symptoms, just in case. The RN to whom I'd spoken has left to go on an "eval", but the receptionist promised to pass this information along.
After an extended conversation in two parts which I will detail over at the main journals, it was decided between me and the Hospice RN on call to put Mom on a preemptive course of antibiotics for what was probably developing pneumonia.
By the time Mom went to bed the antibiotics seemed to be kicking in; whe was feeling better and looking better, a little less weak in the legs, was able to transfer with a bit less difficulty.

Sleep:

Awake at 1300
Down for nap at 1600
Up from nap at 2000
Down for night at 0100
Awake 8 hours

Almost Full Stat Day:

2008-09-24T23:59:00.002-07:00

A.M. Blood Glucose: Time: 1156 Reading: 127	A.M. Blood Pressure: Time: 1153 BP: 171/82 Pulse: 91
Hospice RN BP: Time: 1315 Reading: 146/60

P.M. Blood Glucose:
Time: 1943
Reading: 168

Medication Changes:

Administered 500 mg acetaminophen with breakfast to ward off any possible knee or back inflammation from her "cleaning out the drawers" episode this morning
2.5 mg metaclopramide before dinner because she's showing many of the signs of experiencing some acute something-'er-other: Feet and leg edema (very pronounced, for her, this evening); severe leaning to the right; mental haziness which translates, as well, to difficulty finding words; more difficulty than usual supporting herself on her legs; significant right eye edema and some left eye edema. I'm not sure what she's experiencing, yet, and, if it passes without any more emergent episodes, I may not know, but, just in case, I figured, when she's in this state, although her appetite is rarely affected, it's not uncommon for her to vomit later in the evening. I wanted to nip that possibility in the bud.
Gave her slightly less than 20 mg furosemide before she went to bed, because her leg and feet edema is unusual, for her, and I figured, it would be a good idea to get her to shed that water NOW. I usually give her 10 mg, but that is for episodes less severe and that have come on less quickly than this. The reason I say, "slightly less than 20 mg" is because I gave her two halves that weren't quite half, on purpose.

Miscellaneous BP Note: Obviously, it's still tricky, taking her BP on her left arm, although I wasn't sure of this until the Hospice RN took it with the standard bicep cuff on her right arm and got a significantly lower and much more normal BP for her. So, even though her arm is improving, unless I feel as though there is some emergent reason for me to take it, I'm going to drop this stat for a few more days.
Dinner: 1/4 dark meat roast chicken; about 1/2 cup Brussels sprouts with Greek Feta dressing; about 3/4 cup Uncle Ben's Original Recipe Long Grain & Wild Rice; for dessert, a scoop of lemon sorbet and wild berry gelato.
Sleep:

Awoke at 1130
Down for nap at 1530
Up from nap at 1930
In bed for night at 2345
Awake 8.25 hours

No Stat Day:

2008-09-23T23:59:00.001-07:00

Medication Changes:

No acetaminophen today; her choice.
4 oz prune juice before retiring.

Dinner: Sausage and scrambled eggs with added chopped green onions, poblano and Anaheim chilis; 1 slice lemon meringue pie.
Sleep:

Awake at 1500
Down for nap at 2030
Up from nap at 2130
Down for the night at 0015
Awake for 8.25 hours

BM Full Stat Day:

2008-09-22T23:59:00.003-07:00

A.M. Blood Glucose: Time: 1428 Reading: 140	A.M. Blood Pressure: Time: 1426 BP: 153/75 Pulse: 76
AM 60" Dig Temp: Time: 1441 Reading: 98.0

P.M. Blood Glucose:
Time: 2134
Reading: 132

Bowel Movement: Occurred just before retiring: Fairly good volume; good consistency although still rather large turds; easy elimination; easy clean-up.
Medication Changes:

I took Mom off the acetaminophen today, almost completely. I think it's screwing around with other of her functions, she doesn't really want it anymore, doesn't think she needs it, and I think she's probably right. That having been said, we decided to give her 1 500 mg dose at dinner.

Dinner: Grilled cheese and pepperoni sandwich on sourdough bread with left over pickles from "Champagne Kick-Off" night; 1 slice lemon meringue pie for dessert
Sleep:

Awakened at 1400
Down for nap at 1945
Up from nap at 2115
Down for the night at 0100
Awake 9.5 hours

Full Stat Day:

2008-09-21T23:59:00.003-07:00

A.M. Blood Glucose: Time: 1258 Reading: 155	A.M. Blood Pressure: Time: 1256 BP: 148/78 Pulse: 83
AM 60" Dig Temp: Time: 1313 Reading: 98.1

P.M. Blood Glucose:
Time: 2124
Reading: 163

Medication Changes:

500 mg acetaminophen at breakfast
500 mg acetaminophen before nap with toast with butter and cinnamon
500 mg acetaminophen with dinner

Dinner: Chicken Quesedilla, made as usual, with 1 slice lemon meringue pie for dessert.
Miscellaneous Note: I decided to try taking her BP again this "morning". It didn't bother her quite so much; she only winced once. This shows in her BP. I guess we're back on track with that.
Sleep:

Awoke of own accord at 1245
Down for nap at 1745
Up from nap at 2115
Down for night at 0200
Awake 9.75 hours

BM Full Stat Day:

2008-09-20T23:59:00.003-07:00

A.M. Blood Glucose: Time: 1353 Reading: 141	A.M. Blood Pressure: Time: 1356 BP: 150/98 Pulse: 83
AM 60" Dig Temp: Time: 1409 Reading: 97.9

P.M. Blood Glucose:
Time: 2154
Reading: 242

Bowel Movement: Occurred just before going to bed for the night. Fairly good volume; good consistency; easy elimination; easy clean-up. Still fairly large turds.
Medication Changes:

Forgot 3rd breathing treatment
500 mg acetaminophen with breakfast
500 mg acetaminophen before nap with croissant
500 mg acetaminophen at dinner
500 mg acetaminophen before bed with toast with butter and cinnamon
4 oz prune juice

Dinner: Chile Rellenos; about 3/4 cup total of Lemon Sorbet and Wild Berry Gelato.
Miscellaneous Note: I know, that's pretty high BP, up there. I thought it might "time" to be able to get a good BP, but, obviously, it was not. My mother winced a couple of times while I held her arm and tried to get her to relax it. Not a comfortable position for her. Not sure whether we'll try again tomorrow. We'll see.
Sleep:

Awoke at 1330
Down for nap at 1830
Up from nap at 2130
Down for night at 0130
Awake 9 hours

BM Partial Stat Day:

2008-09-19T23:59:00.003-07:00

A.M. Blood Glucose: Time: 1451 Reading: 143	A.M. Blood Pressure: Time: Not taken

P.M. Blood Glucose:
Time: 2137
Reading: 219

Bowel Movement: Occurred during bathing. Good volume; packed consistency; fairly easy elimination; very easy clean-up.
Medication Changes:

500 mg acetaminophen at breakfast
500 mg acetaminophen before nap with croissant
500 mg acetaminophen at dinner

Dinner: 1 3 oz bag microwave popcorn, sic garlic stuffed green olives; 1/2 slice pineapple upside down cake.
Miscellaneous Notes:

She decided that she didn't want or need acetaminophen before going to bed. I honored her decision.
She had a cherry Danish for breakfast. That, with the croissant with her acetaminophen before napping, explains her high blood sugar.

Sleep:

Awake at 1430
Down for nap at 1900
Up from nap at 2100
Down for bed at 0100
Awake 8.5 hours

Partial Stat Day:

2008-09-18T23:59:00.003-07:00

A.M. Blood Glucose: Time: 1452 Reading: 135	A.M. Blood Pressure: Time: Not taken
AM 60" Dig Temp: Time: 1510 Reading: 98.1

P.M. Blood Glucose:
Time: 2127
Reading: 190

Medication Changes:

500 mgs acetaminophen at breakfast
500 mg acetaminophen before nap with 1 piece toast with butter and cinnamon
500 mg acetaminophen at Dinner
500 mg acetaminophen before bed with toast, butter and cinnamon
4 oz prune juice before bed; it looks like this is going to become a regular every-other-day regimen

Dinner: Chicken Quesedilla with cheese, chopped green onions, chopped pepperoncinis, chopped dark meat chicken, salsa (no sugar); dessert: 1 slice pineapple upside down cake.
Sleep:

Awoke at 1430
Down for nap at 1900
Up from nap at 2100
Down for bed at 0130
Awake for 9 hours

BM Full Stat Day:

2008-09-17T23:59:00.004-07:00

A.M. Blood Glucose: Time: 1326 Reading: 146	A.M. Blood Pressure: Time: 1323 BP: 157/84 Pulse: 82
A.M. 60" Dig Temp: Time: 1332 Reading: 98.4

P.M. Blood Glucose:
Time: 2122
Reading: 135

Medication Changes:

500 mg acetaminophen at breakfast for lingering shoulder pain and stiffness
500 mg acetaminophen at 1800 just before nap for same reason as above
500 mg acetaminophen at dinner for same reason as above
500 mg acetaminophen 1/2 hour before bed for same reason as above

Bowel Movement: Occurred during bathing. Good volume; pretty hard, large consistency; very easy elimination; easy clean-up.
Dinner: Home made cheeseburger on onion buns with thick slice of Bermuda onion and jalapeno Jack cheese; also, several pickled vegetables, left over from the "Champagne Kick-off Dinner"; no dessert, surprisingly, she didn't want any.
Miscellaneous Notes:

Wasn't sure about taking her BP because the arm that works best for the wrist cuff is the same that was injured, but decided to try it. It was obvious that Mom was uncomfortable having it taken and I think this partly what showed up in the reading, so I'm abandoning BP readings until I'm sure it isn't uncomfortable for her.
The other possibility that might be "lending a hand" to her elevated BP is that she is, again, experiencing more foot and lower leg swelling than usual (although on most people it would be considered minor); not as bad as some days ago when I gave her furosemide, but still a concern. I'll keep my eye on this.
Around 1800 Mom asked if "there is any chocolate in the house"...funny how her memory works! I gave her one of the Ghiradelli Mint Chocolate squares. I was going to give her one of all three flavors, but she only wanted the Mint and only wanted one.
Got a "battery low" signal from Mom's glucometer when I first attempted to take her BG upon awakening. This battery is less than half a year old. I'm noting this here because we're due to put in a supply order, soon, and I want to report this to our diabetic supplier.

Sleep:

Awoke at 1300
Down for nap at 1830
Awoke from nap at 2100
Down for night at 0130
Awake for 10 hours

Maximum Amount of Acetaminophen in 24 Hours:

2008-09-17T00:08:00.002-07:00

This is per our Hospice RN: 4,000 mg. I wanted to remember this. I also find this interesting, as the bottle of Extra Strength Tylenol that we have also quotes this amount.
Not only that, but I just discovered, reading the bottle, that I've been citing our Extra Strength Tylenol as being 650 mg per tab. Seems it is actually 500 mg per tab. I'll change that in the last post, but won't bother, otherwise.

Partial Stat Day:

2008-09-16T23:59:00.005-07:00

A.M. Blood Glucose: Time: 1214 Reading: 121	AM BP [taken by Hospice RN]: Time: 1400 BP: 132/56 Pulse: Didn't ask

P.M. Blood Glucose:
Not taken

Medication Changes:

500 mg acetaminophen with breakfast to alleviate soreness and stiffness in left shoulder from last night's fall.
500 mg acetaminophen at 1700 for same reason.
500 mg acetaminophen at 2030 for same reason.
500 mg acetaminophen at 2230 for same reason.

    Dinner:  1/4 dark roast chicken; about 1 cup steamed broccoli with Greek Feta dressing; about 3/4 cup Uncle Ben's Long and Wild Rice (Original Recipe); 1 slice pineapple upside down cake for dessert.
    Miscellaneous Food Data:  2 pieces of buttered toast sprinkled with cinnamon for breakfast instead of one; 1 piece of toast with acetaminophen at 1700; 1/4 cup prune juice before bed.
    Miscellaneous Notes:  I didn't take her blood sugar at dinner because I just didn't like the idea of poking her while she was feeling so uncomfortable.
Sleep:

Awoke at 1200
Down for nap at 1500
Up from nap at 1700
Down for bed at 2345
Awake for 9.75 hours

Full Stat Day:

2008-09-15T23:59:00.002-07:00

A.M. Blood Glucose: Time: 1443 Reading: 143	A.M. Blood Pressure: Time: 1440 BP: 138/78 Pulse: 76
A.M. 60" Dig Temp: Time: 1501 Reading: 98.2

P.M. Blood Glucose:
Time: 2115
Reading: 141

    Medication Change:  Gave Mom 650 mg acetaminophen after a fall on her way to bed. She hit her left bicep as she fell. Also complained of lower back hurting, but it usually does; and her upper left thigh.
    Miscellaneous Food:  Gave her a croissant and a cup of decaf coffee with the acetaminophen just before bed.
    Dinner:  Home made chicken soup; croissant; 1 chocolate mint Ghiradelli's square.
Sleep:

Awoke at 1430
Down for nap at 1800
Up from nap at 2100
Down for the night at 0145
Awake 8.25 hours

BM Full Stat Day:

2008-09-14T23:59:00.002-07:00

A.M. Blood Glucose: Time: 1341 Reading: 153	A.M. Blood Pressure: Time: 1338 BP: 161/79 Pulse: 70
A.M. 60" Dig Temp: Time: 1405 Reading: 98.5

P.M. Blood Glucose:
Time: 2037
Reading: 153

Medication Changes:

Gave Mom 325 mg acetaminophen with breakfast because of her temperature measurement, which is higher than normal for her.
Kept her on 5/lpm O₂ until 1620 this afternoon because she was a bit breathless even when sitting. Put her back on 5/lpm when sitting at 1715 when I noticed that she was showing signs of breathlessness, again ("kecking" frequently, breathing fast), I asked her if she felt breathless and she confirmed, "A little". She got her normal 2nd breathing treatment at 1730.
I've been noticing light edema in her feet for a couple of days. It continues today. Her BP has been unusually high, both systolic & diastolic, for two days, now, too. When her breathlessness didn't seem to be completely relieved with the breathing treatment and the 5/lpm O₂, I examined her for other signs of fluid retention: Fuller than usual face, fuller than usual belly, etc. None seemed extraordinary but, on a hunch, I decided to give her 10 mg furosemide at 1805, just before she went down for a nap.

Bowel Movement: Occurred during bathing. Very good volume; very good consistency; easy elimination; very easy clean-up.
Dinner:Appetizer dinner, again, with souped up potato salad and three Ghiradelli chocolate squares for dessert.
Sleep:

Awoke of own accord at 1330
Went down for nap at 1815
Awoke from nap of own accord at 2000
Down for night at 0000
Awake 8.75 hours

Sleep Average for last 10 days

2008-09-14T13:19:00.001-07:00

I figured I've got enough data, 10 days worth since 9/4/08, to calculate a fairly reliable sleep average, which appears as follows:

Average hours awake: 9.5
Average hours asleep: 14.5

This average includes:

Longest Awake Day: 11 hours (two of those days this period)
Shortest Awake Day: 7.5 hours (one of these)

    From now on, I'll calculate these on a weekly basis each Sunday before she awakens.
    Although all my previous "data" is anecdotal, I was figuring, pre-5/14/08, that she got about 12-14 hours of sleep every day, which would bring in an inexact average of 13 hours. Using this, it is apparent that her sleep quotient is rising a little.
    I've also amended each post from 9/4/08 to include, in the Sleep list, the number of hours she is awake each day. Thus, the way I calculate her "sleep time" is to add all these awake hours, divide by the number of days, then subtract from 24 (hours in a day).

Full Stat Day:

2008-09-13T23:59:00.001-07:00

A.M. Blood Glucose: Time: 1412 Reading: 137	A.M. Blood Pressure: Time: 1410 BP: 154/78 Pulse: 75
A.M. 60" Dig Temp: Time: 1432 Reading: 98.4

P.M. Blood Glucose:
Time: 2131
Reading: 131

Medication Change: Gave her 325 mg acetaminophen at breakfast for low grade fever (for her).
Dinner: Home mixed sauerkraut and chopped Polish sausage with fennel seeds; a slice of pineapple upside down cake for dessert.
Sleep:

Awoke at 1400
Began nap at 1800
Awoke from nap at 2100
In bed at 0200
Awake 9 hours

Miscellaneous Note: I'm keeping my eye on her BP, which was unusually high again this morning. Could be the alcohol. Could also be that her hemoglobin is bouncing back up...and could be a combination of both. I'm curious to see what happens the next time she has a glass of wine. I meant to offer her a glass of Mateus at dinner, tonight, but forgot. Wouldn't it be interesting if wine raises her hemoglobin, and, as well, her blood pressure?!?

BM Full Stat Day +1:

2008-09-12T23:59:00.002-07:00

A.M. Blood Glucose: Time: 1347 Reading: 134	A.M. Blood Pressure: Time: 1345 BP: 151/80 Pulse: 75
A.M. 60" Dig Temp: Time: 1405 Reading: 97.7

P.M. Blood Glucose:
Time: 2111
Reading: 121

P.M. Blood Pressure:
    Time:  0107
    BP:  176/83
    Pulse:  79

    Bowel Movement:  Occurred during bathing. Good volume; excellent consistency; easy elimination; easy clean-up.
    Medication Change:  Gave her 650 mg of acetaminophen with her breakfast. She complained of a lower back ache the previous night but didn't want anything before bed, believing, as usually happens, that the back ache would resolve itself while she slept, since it's usually from the way she stands when she brushes her teeth before bed. However, she slept very weird, that night, flung off the wedge with her back arched and her head cocked back, and awoke with the same back-ache about which she complained. I offered her the acetaminophen, clarifying that I thought the "extra strength" dose would be appropriate, and she agreed. As far as I know, it eradicated her back ache.
    Dinner:    Tonight was "Celebrate Champagne" night. We had an appetizer dinner consisting of a variety of meats and cheeses on multi-grain saltine crackers, a variety of pickles, including Bread & Butter pickles, and some beefed up potato salad to which I'd added chopped onion and capers. As well, she had a glass of Champagne equally probably 6 oz., and three Ghiradelli chocolate squares for dessert.
    Miscellaneous Note:    I attempted to take her blood pressure before bed, as Hospice had suggested after having alcoholic beverages. She was so irritated with me, though, for taking it, that she would not relax, insisted on talking and moving throughout, her arm was as tight as a drum. I've recorded the first BP above, which is unbelievably high. The second time the cuff registered "E[rror]". So, I gave up and gave her the usual dose of lisinopril.
Sleep:

Awoke at 1330
Went down for a nap at 1800
Awoke at 2100
To bed at 0130
Awake 9 hours

Full Stat Day:

2008-09-11T23:59:00.001-07:00

A.M. Blood Glucose: Time: 1424 Reading: 131	A.M. Blood Pressure: Time: 1421 BP: 128/72 Pulse: 68
A.M. 60" Dig Temp: Time: 1434 Reading: 96.9

P.M. Blood Glucose:
Time: 2050
Reading: 149

Medication Change:

Gave her exactly 4 oz prune juice before bed. Although she had a "good" bowel movement yesterday, it was large, hard, not particularly easy to eliminate and it was obvious from the volume and from the fact that she reported that she didn't feel as though she was "done" (I stopped her, anyway, because she was straining to eliminate; when I wiped her it didn't feel like there was anything pressing at her anus). I figured she could use a little boost to help move the rest of what she's storing in there along.
10 drops of Debrox in each ear just before bed.

Dinner: Home made stewy chicken soup; 1/6 Marie Callendar's Cherry Crunch Pie with freshly whipped cream a la mode.
Sleep:

After attempting unsuccessfully to awake Mom at 1300, which would have been 1 hour shy of her 12 hour sleep mark, she awoke easily at 1400.
Down for nap at 1915
Up from nap at 2030
Down for bed at 0100
Awake 9.75 hours

BM Almost Full Stat Day:

2008-09-10T23:59:00.001-07:00

A.M. Blood Glucose: Time: 1427 Reading: 131	A.M. Blood Pressure: Time: 1424 BP: 148/75 Pulse: 68

P.M. Blood Glucose:
Time: 2146
Reading: 128

    Bowel Movement:  Occurred before nap. Very good consistency; not easy elimination; consistency on the hard side; easy clean-up.
    Dinner:  Grilled cheese and pepperoni sandwich; Marie Callendars' cherry crunch pie with freshly whipped cream a la mode.
    Sleep:

Arose at 1400
Down for nap at 1930
Arose of own accord at 2100
To bed at 0200
Awake 10.5 hours

BM Full Stat Day:

2008-09-09T23:59:00.001-07:00

A.M. Blood Glucose: Time: 1127 Reading: 118	A.M. Blood Pressure: Time: 1125 BP: 121/64 Pulse: 76
A.M. 60" Dig Temp: Time: 1140 Reading: 97.4

P.M. Blood Glucose:
Time: 1925
Reading: 126

    Bowel Movement:  Occurred during bathing. Fair volume; good consistency; very easy elimination; very easy clean-up.
    Medication Change:  325 mg acetaminophen for "stiffness".
    Breakfast Change:  Croissant sprinkled with Vietnamese Cinnamon (the kind that tastes like Red Hots; she always gets this, no matter what her bread is).     Dinner:  Home made chicken soup with loads of vegetables, loads of chicken; home made peach cobbler with freshly whipped cream for dessert.
    Sleep:

Awoke at 1100
Went down for nap at 1500
Awoke from nap at 1900
Went to bed at 0200
Awake 11 hours