Tuesday, March 20, 2007

 

Health Review: 3/20/07

Blood Pressure:
Since 9/06 her BP has become a little harder to control: Her diastolic was wandering more frequently into the 80s and her systolic was regular hitting the 140s and 150s. I increased her dosage of lisinopril 10 mg from 2 per day to 3, adding an extra at bedtime from mid December on. Since then, her diastolic is usually between 65 and 75 and her systolic rarely goes above the 150s, usually coming in between 120 and 145. I think keeping her on this dosage is a good idea.

Blood Sugar:
Blood Glucose control since 9/06 has been excellent. Even through the holidays, I found very few occasions to increase her 10 mg glipizide 2 per day to three.

Urinary Issues:
No change. Macrodantin continues to keep her UTI free.

Hydration:
No change.

Energy Level:
She's beginning to come out of winter hibernation. Although slow this winter, she was no slower than usual for winter and was fairly active during the holidays. I detect no changes from her usual pattern.

Skin & Circulation:
No changes.

Appetite & Diet:
Once again, during winter, reverted to her hibernation pattern of skipping lunch but having hearty breakfasts and dinners. This is beginning to change and light lunches are being added as it gets warmer and she moves more.

Dementia:
Remains unchanged.

Will & Spirit:
Remain strong and high, respectively.

Medication & Supplements:
Remain the same, except for the above noted change in her lisinopril dosage.

CHF:
Furosemide administered very few times since 9/06. I can’t remember the last time she experienced extremity/abdominal edema and I used it.

COPD:
Remains unchanged. Continues to use 3/lpm concentrated oxygen when she sleeps and tanked 2/lpm continuous oxygen when moving around outside.

Bowel Movements:
Continues to eliminate every 24-72 hrs; usually every 48 hrs. Fecal consistency, volume and ease of elimination remain good to excellent. Rare use of Phillip’s Milk of Magnesia as a laxative.

ISSUES FOR APPOINTMENT ON MARCH 22, 2007, AT 1400 P.M.:
  1. We have some Rx’s to renew and one, the lisinopril to change, but, otherwise, everything seems to be going well. No outstanding issues to address.
  2. You’ll notice that between 9/06 and 2/07 I did not take her in for blood work. Her preference was not to go and I didn’t fight her, since she’s been doing fine. In fact, the blood work results for 2/07 and this month show that she remains stable since 9/06.
  3. You’ll also notice that blood glucose numbers are spotty and blood pressure numbers are very spotty. Frankly, Dr. Coury, I was beginning to suspect that I was becoming so statistic happy that the statistics were using me instead of me using the statistics. I decided to see if I could live without statistics, except for somewhat frequent blood glucose numbers and occasional blood pressure measuring, and trust my instincts about how my mother was doing. The result? Mom and I both relaxed more than ever around each other. My mother was thrilled that I wasn’t following her around with a lancet or a cuff and wasn’t insisting that she get stuck every month. I’ll certainly continue the monthly blood draws, now that it’s warming up and she’s begun to move more, and, of course, I’ll keep up blood glucose and blood pressure monitoring a little more assiduously than this winter; especially if she appears to be having health problems. But, now I know, sometimes, monitoring can be an annoyance, rather than a help.
    I will bring blood glucose charts with me and a short review of her BP since 9/06, during the times when I took it. Things have gone so smoothly, though, that I don’t see any need to burden you with every little detail along with this report.
  4. We look forward to seeing you and your excellent staff on March 22nd at 2:00 p.m. Only good things to report, Doctor. I’m sure Mom’s going to make 90 this August, and then, we’ll set our sites on the next “Big One”, just for fun.
  5. Please feel free to schedule any blood tests or other tests as you wish. If you want to order some scans or ultra sounds just for maintenance purposes, there is are imaging labs, up here, that can handle those. If not, well, that’s fine, too. Mom’s cruising.

Comments:
Originally posted by Mona Johnson: Mon Mar 26, 01:37:00 PM 2007

Gail, all the "no change" entries are encouraging, and a tribute to your care. Hope this appointment went well!
 
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