Monday, May 23, 2005
You might want to check into...
...the posts I made today over at Tests and Meds this evening, the lastest post and the one immediately preceding. We're dealing with a sudden, stubborn bout of water retention which is signaling an episode of congestive heart failure. I explain, in the aforementioned posts, how I'm dealing with it. This is the first semi-serious problem we've had since our appointment on January 24th with The Wondrous FNP and I'm pleased to report that I'm not freaking. With each passing day since that appointment I find myself calmer and more sure of myself in reacting to my mother's habits and dealing with her health. Truly, not a day goes by but what I don't bless that woman and wish her very, very well.
I've got a couple of essays coming up shortly, I hope: Two issues that have been teased in the last couple of days. I'd planned to write about them tonight. I even drank coffee late in order to stay up but it's been a long, busy, thought provoking day and I'm tired, despite the infusion of caffeine. My plan is to set the alarm, in case the coffee causes a restless sleep tonight, so that I can hot foot it to the lab and pick up Mom's results from her latest blood draw and urinalysis.
I didn't come up with any fancy-schmancy reporting form for the FNP. I kept it to a simple table so I can't see any reason to publish a separate form for copying. Surely any of you who would be interested in such a form know how to construct a simple two column table in your word processing software. I've already faxed the information to the FNP, including a readout of her blood glucose and blood pressure measurements since January 24th.
Here's Mom's Health Review: 5/23/05, in case you're interested:
Blood Pressure:
Seems to be no change but I’m concerned about her systolic and would like to discuss, during her next appointment, the possibility of increasing her lisinopril to 5 mg in the evening, since morning seems to be when her systolic is highest. Her blood pressure, as well, tends to rise when she has a urinary tract infection and when she’s on antibiotics so I’m happy to wait a month to see what happens.
When I’m taking her morning blood glucose I try to avoid taking her blood pressure as it’s easy to irritate her in the morning (and taking her blood pressure really irritates her), she’s moving a lot then and I usually get high blood pressure readings.
Blood Sugar:
Doing well. When it goes really high (say 150 to low 200’s) there's always a reason: Pancakes in the morning when we have company; dessert or fruit at lunch rather than dinner, i.e., the 170 on 5/20 was a left over piece of chocolate cake eaten at breakfast from the previous day’s birthday celebration for one of her daughters. I try to keep sugar consumption to the evening meal since her body manages to digest it readily overnight and her blood glucose is usually normal (or close to normal) when she awakens.
Urinary Issues:
Medicated for a urinary tract infection from 5/13/05 - 5/19/05: “Cashed in” the PRN prescription for Levaquin and administered it as follows: 1 dose daily with lunch (to avoid mixing with her iron) of two 250 mg pills for a 500 mg dose once a day. Infection caught, this time, before she began bleeding. It appears that the antibiotic course worked. Because of this I delayed her monthly blood draw/urinalysis until the day after the antibiotic course ended. I figured it would be more valuable then.
One refill on Levaquin remains. I don’t expect to have to use it before seeing you again.
Hydration:
Doing well on this though it remains tricky. I don’t think her urinary tract infection was a result of dehydration but rather bacterial infection from scattered fecal matter, which is typical.
Energy Level:
Improving slowly, typical of warmer weather. She is moving a little bit more than during the winter and sleeping somewhat less.
Skin Condition & Circulation:
Excellent, including extremities. I continue to monitor this throughly during her daily bath.
Appetite & Diet:
Both excellent. I’ve eased up and am adding fruit, especially seasonal berries, this spring, simple desserts (ice cream, etc.) occasionally and pancakes with berries and maple syrup in the morning, usually when we have company but sometimes just because I know she likes them.
She is also eating more sandwiches since her blood glucose seems to be handling these better.
Dementia:
Remains stable, confined to short and long term memory confusion and forgetting how to perform common tasks like using the microwave, turning on machines, etc.; no improvement and no decline.
Will & Spirit:
Both high and strong.
Medication:
Remains the same as last report, other than the antibiotic course for the UTI.
Took two extra strength acetaminophen tablets twice last week before napping, once for upper back “twinges” and once because her right knee was “bothering” her.
No other temporary changes.
Bowel Movements:
Remain regular, easily eliminated, loaded with iron, about 24 - 48 hours apart. No constipation, no diarrhea, no loose or hard stools, no leakage.
Blood Draw & Urinalysis:
I should be able to pick up my copy of the results on 5/23/05. I’m expecting good results, as we haven’t had any obvious, difficult health problems since the last round.
If there is anything that causes you concern that I don’t pick up on, please contact me at the phone number and/or address on the second page of this fax entitled “Patient Information”. Otherwise, I plan on having her next draw done on June 17th, 2005. Next week I’ll be calling to schedule an appointment with you for the week following that blood draw or whatever later time is convenient for you. My expectation is that this will be a routine appointment for prescription review and renewal, general health review, etc.
Oops, that's right, that left over piece of chocolate cake was eaten at breakfast, not lunch. I need to change that over at Tests & Meds.
The review is wordier than I'd planned but I'm getting better.
Later.
I've got a couple of essays coming up shortly, I hope: Two issues that have been teased in the last couple of days. I'd planned to write about them tonight. I even drank coffee late in order to stay up but it's been a long, busy, thought provoking day and I'm tired, despite the infusion of caffeine. My plan is to set the alarm, in case the coffee causes a restless sleep tonight, so that I can hot foot it to the lab and pick up Mom's results from her latest blood draw and urinalysis.
I didn't come up with any fancy-schmancy reporting form for the FNP. I kept it to a simple table so I can't see any reason to publish a separate form for copying. Surely any of you who would be interested in such a form know how to construct a simple two column table in your word processing software. I've already faxed the information to the FNP, including a readout of her blood glucose and blood pressure measurements since January 24th.
Here's Mom's Health Review: 5/23/05, in case you're interested:
Blood Pressure:
Seems to be no change but I’m concerned about her systolic and would like to discuss, during her next appointment, the possibility of increasing her lisinopril to 5 mg in the evening, since morning seems to be when her systolic is highest. Her blood pressure, as well, tends to rise when she has a urinary tract infection and when she’s on antibiotics so I’m happy to wait a month to see what happens.
When I’m taking her morning blood glucose I try to avoid taking her blood pressure as it’s easy to irritate her in the morning (and taking her blood pressure really irritates her), she’s moving a lot then and I usually get high blood pressure readings.
Blood Sugar:
Doing well. When it goes really high (say 150 to low 200’s) there's always a reason: Pancakes in the morning when we have company; dessert or fruit at lunch rather than dinner, i.e., the 170 on 5/20 was a left over piece of chocolate cake eaten at breakfast from the previous day’s birthday celebration for one of her daughters. I try to keep sugar consumption to the evening meal since her body manages to digest it readily overnight and her blood glucose is usually normal (or close to normal) when she awakens.
Urinary Issues:
Medicated for a urinary tract infection from 5/13/05 - 5/19/05: “Cashed in” the PRN prescription for Levaquin and administered it as follows: 1 dose daily with lunch (to avoid mixing with her iron) of two 250 mg pills for a 500 mg dose once a day. Infection caught, this time, before she began bleeding. It appears that the antibiotic course worked. Because of this I delayed her monthly blood draw/urinalysis until the day after the antibiotic course ended. I figured it would be more valuable then.
One refill on Levaquin remains. I don’t expect to have to use it before seeing you again.
Hydration:
Doing well on this though it remains tricky. I don’t think her urinary tract infection was a result of dehydration but rather bacterial infection from scattered fecal matter, which is typical.
Energy Level:
Improving slowly, typical of warmer weather. She is moving a little bit more than during the winter and sleeping somewhat less.
Skin Condition & Circulation:
Excellent, including extremities. I continue to monitor this throughly during her daily bath.
Appetite & Diet:
Both excellent. I’ve eased up and am adding fruit, especially seasonal berries, this spring, simple desserts (ice cream, etc.) occasionally and pancakes with berries and maple syrup in the morning, usually when we have company but sometimes just because I know she likes them.
She is also eating more sandwiches since her blood glucose seems to be handling these better.
Dementia:
Remains stable, confined to short and long term memory confusion and forgetting how to perform common tasks like using the microwave, turning on machines, etc.; no improvement and no decline.
Will & Spirit:
Both high and strong.
Medication:
Remains the same as last report, other than the antibiotic course for the UTI.
Took two extra strength acetaminophen tablets twice last week before napping, once for upper back “twinges” and once because her right knee was “bothering” her.
No other temporary changes.
Bowel Movements:
Remain regular, easily eliminated, loaded with iron, about 24 - 48 hours apart. No constipation, no diarrhea, no loose or hard stools, no leakage.
Blood Draw & Urinalysis:
I should be able to pick up my copy of the results on 5/23/05. I’m expecting good results, as we haven’t had any obvious, difficult health problems since the last round.
If there is anything that causes you concern that I don’t pick up on, please contact me at the phone number and/or address on the second page of this fax entitled “Patient Information”. Otherwise, I plan on having her next draw done on June 17th, 2005. Next week I’ll be calling to schedule an appointment with you for the week following that blood draw or whatever later time is convenient for you. My expectation is that this will be a routine appointment for prescription review and renewal, general health review, etc.
Oops, that's right, that left over piece of chocolate cake was eaten at breakfast, not lunch. I need to change that over at Tests & Meds.
The review is wordier than I'd planned but I'm getting better.
Later.
