Monday, February 6, 2006
Health Review: 2/3/06
Faxed to Doctor: 2/6/06
Blood Pressure
Taking her blood pressure has been haphazard, although somewhat less than it appears. On 1/09/06 the meter batteries died. When I changed batteries I lost readings from 12/30 - 1/09 that I hadn’t recorded on my own chart.
I’ve been administering 10 mg lisinopril twice a day on 1/10/06: When she arises and at bedtime. Since she tends to sleep 12 hours at “night” I figured the best way to even the dosage would be to give it to her immediately at either end of her night sleep. This seems to have settled her BP. It’s even a bit lower in the A.M., now, when it irritates her for me to take her blood pressure and it’s usually high. No averages this month due to spotty readings. I’m now taking her “stats” every other day...sometimes skipping an extra day here and there. At the moment this seems to work well.
Blood Sugar
Very good control. I notice, though, that her A1c is even lower than it was last time. Believe me, this hasn’t been because I haven’t expanded her diet. In fact, over the holidays I did lots of baking and served desserts and rich side dishes. Sandwiches on her beloved white bread have been frequent, as well as canned fruit packed in syrup, one of her favorites. I also upped the amount of orange juice she receives in the morning. I’m not sure whether to be concerned about her A1c. I’m wondering if this is what the FNP we saw last January meant when she said that Mom’s diabetes would eventually “go on vacation” because of her Chronic Renal Failure, although Her BUN looks better than usual, this time. Her actual blood glucose numbers look good...never running really low, sometimes closer to 150 than 100. I will continue to supplement her diet with refined carbohydrates. SEE “ADDITIONAL NOTES”.
Urinary Issues
No change. Macrodantin continues to keep her UTI free.
Hydration
No change from last month.
Energy Level
No change since last month. She’s up and out more than last winter; continues to sleep 12-14 hours per day (including midday nap).
Skin & Circulation
Both continue to be excellent. No changes.
Appetite and Diet
Both remain excellent. No changes.
Dementia
Remains unchanged.
Will & Spirit
Remain strong and high, respectively.
Medication & Supplements
I’ve boosted her, yet again, to 2 tablespoons Benefiber a day.
A week after her last health review (12/22/05), I added an Omega-3 Fish Oil supplement, one 1200 mg pill, to her diet, since she doesn’t like fish. Although you and I are not concerned about her cholesterol, I figured it couldn’t hurt.
CHF
Furosemide administered 4 times last month due to torso and feet swelling. See BP report.
COPD
She had a little trouble breathing toward the end of last week...allergies and lots of nasal drainage. I put her on tanked oxygen during the day because of mouth breathing, which is unusual. That seems to have cleared up as of yesterday.
Bowel Movements
Continues to eliminate every 24-72 hrs; usually every 48 hrs. Fecal consistency, volume and ease of elimination remain good to excellent overall.
ADDITIONAL NOTES:
Blood Pressure
Taking her blood pressure has been haphazard, although somewhat less than it appears. On 1/09/06 the meter batteries died. When I changed batteries I lost readings from 12/30 - 1/09 that I hadn’t recorded on my own chart.
I’ve been administering 10 mg lisinopril twice a day on 1/10/06: When she arises and at bedtime. Since she tends to sleep 12 hours at “night” I figured the best way to even the dosage would be to give it to her immediately at either end of her night sleep. This seems to have settled her BP. It’s even a bit lower in the A.M., now, when it irritates her for me to take her blood pressure and it’s usually high. No averages this month due to spotty readings. I’m now taking her “stats” every other day...sometimes skipping an extra day here and there. At the moment this seems to work well.
Blood Sugar
Very good control. I notice, though, that her A1c is even lower than it was last time. Believe me, this hasn’t been because I haven’t expanded her diet. In fact, over the holidays I did lots of baking and served desserts and rich side dishes. Sandwiches on her beloved white bread have been frequent, as well as canned fruit packed in syrup, one of her favorites. I also upped the amount of orange juice she receives in the morning. I’m not sure whether to be concerned about her A1c. I’m wondering if this is what the FNP we saw last January meant when she said that Mom’s diabetes would eventually “go on vacation” because of her Chronic Renal Failure, although Her BUN looks better than usual, this time. Her actual blood glucose numbers look good...never running really low, sometimes closer to 150 than 100. I will continue to supplement her diet with refined carbohydrates. SEE “ADDITIONAL NOTES”.
Urinary Issues
No change. Macrodantin continues to keep her UTI free.
Hydration
No change from last month.
Energy Level
No change since last month. She’s up and out more than last winter; continues to sleep 12-14 hours per day (including midday nap).
Skin & Circulation
Both continue to be excellent. No changes.
Appetite and Diet
Both remain excellent. No changes.
Dementia
Remains unchanged.
Will & Spirit
Remain strong and high, respectively.
Medication & Supplements
I’ve boosted her, yet again, to 2 tablespoons Benefiber a day.
A week after her last health review (12/22/05), I added an Omega-3 Fish Oil supplement, one 1200 mg pill, to her diet, since she doesn’t like fish. Although you and I are not concerned about her cholesterol, I figured it couldn’t hurt.
CHF
Furosemide administered 4 times last month due to torso and feet swelling. See BP report.
COPD
She had a little trouble breathing toward the end of last week...allergies and lots of nasal drainage. I put her on tanked oxygen during the day because of mouth breathing, which is unusual. That seems to have cleared up as of yesterday.
Bowel Movements
Continues to eliminate every 24-72 hrs; usually every 48 hrs. Fecal consistency, volume and ease of elimination remain good to excellent overall.
ADDITIONAL NOTES:
- I am concerned about her A1c, which I discuss in “BLOOD SUGAR”, above. Please note that, this time, the reference ranges are different, due, I imagine, to the type of test packet used. She is reading below normal, though, despite “good” Blood Glucose readings. I’m wondering if I should drop her evening glipizide pill for the next couple of months and see if that raises it by April 4th, when her next routine appointment is scheduled. I WILL NOT DO THIS UNLESS I RECEIVE CONFIRMATION FROM YOU! If I don’t hear from you, I’ll assume it’s not a good idea.
- In the recent lab report I notice that her Alkaline Phosphatase is low. I’m wondering if I should be concerned about this. My lab books only refer to a high Alk Phos as “clinically significant”. Her C02 is also slightly high but I note in comparing past reports that it’s comparable to previous “normal” reports.
- If you feel the need to see her before 4/4/06 for any reason, let me know. This will not be a problem.
