Tuesday, October 25, 2005
Mom's Health Review: 8/30/05 - 10/24/05
Blood Pressure:
Dynamic within the last month. As the chart indicates she has frequently received three 2.5 mg lisinopril tablets a day; occasionally four. I'm thinking it might be time to rewrite her Rx to: Three to four 2.5 mg tablets a day. I don't think she's ready for for a constant 10 mg per day but starting today I'm going to try her for a week on a constant three per day and see if this evens her out. It is primarily her systolic pressure that's been dynamic, so much so now that I can no longer predict on any given day if it's going to be high or low, nor can I attribute highs to anything in particular.
Blood Sugar:
Very good control.
Urinary Issues:
Incontinence continues but not as prodigious as previously. In the last two months she's had a couple of nights of no leakage through her paper underwear and has not leaked through her paper underwear during the day at all. Macrodantin is keeping her UTI free.
Hydration:
Not sure why, but we seem to be doing better with this: Not too little, not too much.
Energy Level:
The perking up I expected in the summer is happening now, to my surprise. Although she continues to sleep 12-14 hours a day, she is more active than she has been for awhile.
Skin & Circulation:
Both appear to be excellent.
Appetite and Diet:
Both remain excellent. No changes.
Dementia:
Remains unchanged.
Will & Spirit:
Remain strong and high, respectively.
Medication & Supplements:
See Blood Pressure for report on lisinopril. She is now taking 1.5 tsps Benefiber® daily. No other changes. Within the last three weeks I've administered 200 mg ibuprofen to her twice in order to alleviate muscle aches from accelerated movement. It seems to work better on her than acetaminophen for muscle aches and since she's on the Protonix I figure, infrequently and at minimum dose, it's better for her than acetaminophen because acetaminophen tends to elevate her blood pressure.
CHF:
I've only had to administer furosemide once in the last two months. I've reinstated nightly foot and leg rubs, which seems to help, although, as noted above, her blood pressure's been shooting all over the map lately, especially her systolic readings.
COPD:
Remains a non-smoker (Yay!). Her oxygen usage has dropped a bit during the day when she's sitting; if she's not mouth breathing I don't hook her up to it. When moving outside she's on 2-3/lpm pulse, mostly; I switch her to continuous if she starts mouth breathing. At night she's on 2/lpm continuous. When doing exercises I continuouson 2/lpm continous.
Bowel Movements:
No constipation or diarrhea this period. Continues to eliminate every 24-72 hrs; usually every 48 hrs. Fecal consistency, volume and ease of elimination remain excellent.
ADDITIONAL NOTES:
Dynamic within the last month. As the chart indicates she has frequently received three 2.5 mg lisinopril tablets a day; occasionally four. I'm thinking it might be time to rewrite her Rx to: Three to four 2.5 mg tablets a day. I don't think she's ready for for a constant 10 mg per day but starting today I'm going to try her for a week on a constant three per day and see if this evens her out. It is primarily her systolic pressure that's been dynamic, so much so now that I can no longer predict on any given day if it's going to be high or low, nor can I attribute highs to anything in particular.
Blood Sugar:
Very good control.
Urinary Issues:
Incontinence continues but not as prodigious as previously. In the last two months she's had a couple of nights of no leakage through her paper underwear and has not leaked through her paper underwear during the day at all. Macrodantin is keeping her UTI free.
Hydration:
Not sure why, but we seem to be doing better with this: Not too little, not too much.
Energy Level:
The perking up I expected in the summer is happening now, to my surprise. Although she continues to sleep 12-14 hours a day, she is more active than she has been for awhile.
Skin & Circulation:
Both appear to be excellent.
Appetite and Diet:
Both remain excellent. No changes.
Dementia:
Remains unchanged.
Will & Spirit:
Remain strong and high, respectively.
Medication & Supplements:
See Blood Pressure for report on lisinopril. She is now taking 1.5 tsps Benefiber® daily. No other changes. Within the last three weeks I've administered 200 mg ibuprofen to her twice in order to alleviate muscle aches from accelerated movement. It seems to work better on her than acetaminophen for muscle aches and since she's on the Protonix I figure, infrequently and at minimum dose, it's better for her than acetaminophen because acetaminophen tends to elevate her blood pressure.
CHF:
I've only had to administer furosemide once in the last two months. I've reinstated nightly foot and leg rubs, which seems to help, although, as noted above, her blood pressure's been shooting all over the map lately, especially her systolic readings.
COPD:
Remains a non-smoker (Yay!). Her oxygen usage has dropped a bit during the day when she's sitting; if she's not mouth breathing I don't hook her up to it. When moving outside she's on 2-3/lpm pulse, mostly; I switch her to continuous if she starts mouth breathing. At night she's on 2/lpm continuous. When doing exercises I continuouson 2/lpm continous.
Bowel Movements:
No constipation or diarrhea this period. Continues to eliminate every 24-72 hrs; usually every 48 hrs. Fecal consistency, volume and ease of elimination remain excellent.
ADDITIONAL NOTES:
- Nice labs this month, especially her hemoglobin!
- I keep forgetting to mention: Her marginally low SGPT from her CMP of 7/26/05 is probably due to the 12 oz. cup of detox tea a day to support her kidney and liver functions. One of the primary ingredients is licorice root which is apparently famous for lowering SGPT.
- The advisability of rewriting her lisinopril Rx for three to four 2.5 mg tabs per day.
- It might be time to prescribe a cane to help her get around the house. Both her walker and her companion wheel chair were gifts from friends who died so Medicare/TriCare isn't yet being used for assistance devices. She does well with the walker outside but our house is small and narrow and has a few steps into and out of the living room. She's getting to the place where she could use some assistance walking around the house, especially on days when she is primarily immobile. She is not, by the way, in favor of the idea but little by little she is less sure of herself on her feet, primarily on her right side, which is the side affected by the years' ago mini-stroke.
- She needs a flu shot. She had a pneumonia shot in 2000. I'm not sure if it's time for another one, yet. Also, either this appointment or next I'd like her to receive a tetnus shot because our yard is pretty wild and the possibility of puncture wounds if she falls is high.
- Any issues of concern to you.
