Tuesday, March 28, 2006
Health Review: 3/27/06
[To Be Faxed 3/28/06 A.M. to Mom's PCP]
Blood Pressure:
Her pre-dinner BPs look good, including the averages [Average Awakening BP: 137/66; Average Pre-Dinner BP: 120/60]. I’m concerned about her awakening BPs. Although it irritates her to have her BP taken upon awakening (usually anywhere from a 15 minutes to an hour after she awakens), high BP is high BP and I’m wondering if I should increase her before bed dose of lisinopril by 5 or 10 mgs.
Blood Sugar:
Although her Blood Glucose has run, in this period, higher than usual while still remaining in her “good” zone, I’m hoping this will raise her HA1c. You’ll note in the “Extra Meds” portion of the BP chart that lately I’ve given her a second glipizide (10 mg) in the evening, especially when feeding her dessert or a very rich meal.
Urinary Issues:
No change. Macrodantin continues to keep her UTI free.
Hydration:
No change from last month.
Energy Level:
In this period she finally experienced her usual “winter hibernation”, which was late this year: Low energy level, little movement, 14 hours per day of sleep almost every day, occasionally more. A few factors applied: It’s been cold and we’ve had rain and snow; I’ve been having an almost constant cold and although she hasn’t appeared to pick it up, I notice she not only showed some Atypical Lymphocytes on her recent Blood Draw, which she previously never has, but they also ran into the high range. Since everything else in the results looks low normal for her, I’m thinking that her body has been successfully resisting my longstanding cold.
Skin & Circulation:
Two areas, noted below, that I’d like you to check as possibly cancerous, or, at least, of concern. Also, when rubbing down her legs in the evening I’ve noticed an occasional small warm patch on her outer, lower right calf. We just got a new kitten, as well, and she’s been getting a fair number of scratches on her arms and legs which continue to heal well and quickly. Otherwise both continue to be excellent.
Appetite and Diet:
Because she’s been moving so little and sleeping so much, she’s been skipping lunch a lot, lately, or requesting an unusually light lunch. Otherwise, both remain excellent.
Dementia:
Remains unchanged.
Will & Spirit:
Remain strong and high, respectively.
Medications & Supplements:
She’s gotten adult aspirin six times this month (see Extra Meds on BP Report) for various episodes of stiffness or her right knee hurting. I figure both are because she is refusing to move much. I expect this will change within a couple of weeks when the weather rewarms.
CHF:
Furosemide administered 4 times this period due to torso and feet swelling and elevated BP that wouldn’t relent on its own. See BP Report.
COPD:
Her breathing has been very good this period. Other than putting her on concentrated, continuous flow 3/lpm oxygen at night, she hasn’t been mouth breathing much during the day nor has she been moving much so we haven’t used tanked oxygen much.
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. Rare use of Phillip’s Milk of Magnesia as a laxative.
ISSUES FOR APPOINTMENT ON APRIL 4TH, 2006 AT 2:00 P.M.:
Blood Pressure:
Her pre-dinner BPs look good, including the averages [Average Awakening BP: 137/66; Average Pre-Dinner BP: 120/60]. I’m concerned about her awakening BPs. Although it irritates her to have her BP taken upon awakening (usually anywhere from a 15 minutes to an hour after she awakens), high BP is high BP and I’m wondering if I should increase her before bed dose of lisinopril by 5 or 10 mgs.
Blood Sugar:
Although her Blood Glucose has run, in this period, higher than usual while still remaining in her “good” zone, I’m hoping this will raise her HA1c. You’ll note in the “Extra Meds” portion of the BP chart that lately I’ve given her a second glipizide (10 mg) in the evening, especially when feeding her dessert or a very rich meal.
Urinary Issues:
No change. Macrodantin continues to keep her UTI free.
Hydration:
No change from last month.
Energy Level:
In this period she finally experienced her usual “winter hibernation”, which was late this year: Low energy level, little movement, 14 hours per day of sleep almost every day, occasionally more. A few factors applied: It’s been cold and we’ve had rain and snow; I’ve been having an almost constant cold and although she hasn’t appeared to pick it up, I notice she not only showed some Atypical Lymphocytes on her recent Blood Draw, which she previously never has, but they also ran into the high range. Since everything else in the results looks low normal for her, I’m thinking that her body has been successfully resisting my longstanding cold.
Skin & Circulation:
Two areas, noted below, that I’d like you to check as possibly cancerous, or, at least, of concern. Also, when rubbing down her legs in the evening I’ve noticed an occasional small warm patch on her outer, lower right calf. We just got a new kitten, as well, and she’s been getting a fair number of scratches on her arms and legs which continue to heal well and quickly. Otherwise both continue to be excellent.
Appetite and Diet:
Because she’s been moving so little and sleeping so much, she’s been skipping lunch a lot, lately, or requesting an unusually light lunch. Otherwise, both remain excellent.
Dementia:
Remains unchanged.
Will & Spirit:
Remain strong and high, respectively.
Medications & Supplements:
She’s gotten adult aspirin six times this month (see Extra Meds on BP Report) for various episodes of stiffness or her right knee hurting. I figure both are because she is refusing to move much. I expect this will change within a couple of weeks when the weather rewarms.
CHF:
Furosemide administered 4 times this period due to torso and feet swelling and elevated BP that wouldn’t relent on its own. See BP Report.
COPD:
Her breathing has been very good this period. Other than putting her on concentrated, continuous flow 3/lpm oxygen at night, she hasn’t been mouth breathing much during the day nor has she been moving much so we haven’t used tanked oxygen much.
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. Rare use of Phillip’s Milk of Magnesia as a laxative.
ISSUES FOR APPOINTMENT ON APRIL 4TH, 2006 AT 2:00 P.M.:
- Two skin areas to be examined for possible excision: One a mole at the base of her throat which she’s had forever but has, within the last period, become coarser than usual and a very small dry patch on her left upper forearm that she’s also had for awhile but has begun to increase in the last period.
- She hasn’t yet had a flu shot. Prescott never refreshed it’s flu serum supply after it ran out this winter. It may be too late in the season, but I thought I’d mention it in case it’s not. Also, her last pneumonia shot was in 2000. I’m wondering if it’s time for another.
- Should I worry about her high BPs on awakening and raise her before bed dose of lisinopril, or not worry?
- You’ll probably want to take blood for another HA1c, and any other tests you deem significant.
- Any other routine tests, blood or imaging, that you want to prescribe?
