Mom's Daily Tests & Meds - Current

As of May 1, 2010...

2010-04-29T21:43:00.001-07:00

...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