1/5 Pumbaa - SSDD - I want to know what time you shoot

Last Pumbaa thread was on 1/3 and can be viewed here.

Pumbaa is back into his yo-yo routine of bouncing/dropping, bouncing/dropping. I thought about increasing him to a skinny 3.0U tonight, until I realized that his recent low numbers have been artificially inflated due to steering with higher carbed foods.

An excellent area of discussion is the following quote, and my question about shot time refers to this:

Marje and Gracie said:

If you want to keep it simple, then follow Libby's advice: dose for the nadir you want whether it be 60 or 90 or whatever and then hold the dose until he earns a reduction and ignore the bounces. Maybe you want to start trying the three times between 40 and 50 before giving a reduction to give him more time at a dose.

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I agree with the above, including the three times for Pumbaa to drop below 50 before giving him a dose decrease since he has failed decreases in the past.

But...Pumbaa has his lowest numbers regularly during the PM cycle. Anywhere from +5 to +11 PM, which is between midnight and 6 am, which is when I should be/need to be sleeping and resting my body and gearing up for another day of hard work. I can't and won't continue to operate like a zombie during the day due to a lack of sleep at night for testing, and have been relying on higher carbed food at night to keep Pumbaa's numbers up so I can get some sleep. The problem is, by doing this, I don't know Pumbaa's true nadir numbers, since I am artificially inflating them in order to get necessary sleep. :YMSIGH:

So, I want to know what time you shoot, based on later nadirs with Levemir. Please let me know why you chose that time, and how it works for you. I am so looking forward to the input!

I have thought and thought about this, and what it boils down to is that my best time to sleep would be the first 5 hours after his PM injection. So that would mean 10 pm/am, instead of his current 7 pm/am. Since I work at home, I have no problem with the 10 am shot time, other than the nadir interfering during early evening hours when I need to stop working and go and do chores at my mom's house, or when I have dinner plans during the nadir hours and Pumbaa goes low.

I don't know how Pumbaa and Larry would react to having their main feeding times changed to 10 am/pm either. They are free-feeders and always have food available (other than 2 hours before Pumbaa's PMPS), but they are also such creatures of habit and expect me to feed them when I feed Beck (the drooler). And they ALL expect me to feed them as soon as I get up in the morning. I wouldn't change Beck's feeding schedule much, since I need to make sure she poops after eating, before I can leave the house. (Ya know what I mean, dog owners? ) So this would be a big adjustment for all.

The above goes along with my 2013 resolution to make dealing with a diabetic cat less insane. Especially a bouncer/diver like Pumbaa (and so many others), when there is only one person dealing with the care of this FD kitty. I need to care for Pumbaa, but I also need to care for me, and I need to find the right balance. Adjusting injection times is one variable I can control.

Thanking everyone in advance for their input on shot times!

Suze

We shoot at 5:45am and 5:45pm. I have to admit, I do not love the 5:45AM shot, but the PM shot is what dictates our schedule. Both DH and I get home from work just after 5:00, and of course the entire herd (5 kitties) wants to eat as soon as we get home. Logistically, it just makes sense for us to test/feed/shoot at this time...so, unfortunately for me, this is what rules the morning routine. Overall, though, it does work well for us, since I don't have to be at work until +4 in the mornings...it gives me lots of time for testing and carbing/steering if necessary.

I actually don't see any dives since 12/1. Last night, he dropped from 214 to 83 over the hours but that's still less than 50 mg/dL an hour. It is a truism that many cats are lower at night. I know of no way to control that.

The problem with getting other people's shot times is ECID. Gracie also can run low at night but she usually comes down to about +5 or +6 and then goes up a bit and then down again towards the end of the cycle. We shoot at 7/7 so we can be in bed by +5 or +6 and then can usually sleep until +9 or +10. If he's most active from +5 to +11, you could shoot at 12/12 and then go to bed, right? Would that work any better?

Hi Suze,
I don't shoot, so can't help you there. But after reading this, I had a question. You said you work at home, so morning shot time doesn't really matter. And you said that it might interfere with dinner plans and with going to your Mom's to do chores since that would be Pumbaa's AM cycle nadir timing. You said that ideally, you would like to be sleeping between midnight and 6am. I got all that.
My question is this - as far as work, is it always done at home? If so, then if I were in your shoes, I'd forget about the clock. Who says you have to sleep at "normal" times? Who says you have to work 9-5 or whatever? For just a minute, pretend you don't have Pumbaa, or better yet, that he doesn't have diabetes and you don't have to worry about shot times.
Make a list of the things you do every day that MUST be done at such-and-such time. Like chores at Mom's for instance? I'd take that list, and schedule my life around only those specific events that need to be done at a set time every day. Then I'd "remember" Pumbaa's shot schedule. And I'd fit his nadirs into my schedule. Shots only take 5 minutes, so you can do those any time of day or night. If it's the nadirs that you are most concerned about, then pick a range of hours 12 hours apart and don't plan your sleep during that time.

Shoot at a time just before you go to bed. Plan on waking up by nadir. Then do your "work/job" and take a lunch break at shot time. After the shot, plan on your chores at Mom's or whatever else it is that you have to do on "the real world" time schedule. Then catch the 2nd cycle's nadir. Then relax, get ready for bed, and start all over again. It's a 24 hour routine, but it doesn't really matter what the clock on the wall says, does it?

Carl

Thank you for the input, everyone!

I'm very, very tired, and the MB was down for quite some time tonight when I was going to reply, so, now, I am just going to reply to Carl's post, if you don't mind.

Carl, pre-Pumbaa FD, I was much more able to deal with what life threw at me, when it threw things/merde in my direction, including excruciatingly tight deadlines, because I could normally get my required 7 hours of restorative sleep, and then wake up and face a new day and all of the challenges, full of energy. That hasn't been the case since Pumbaa was diagnosed and went on insulin, and I don't see that changing, no matter what time I shoot him or how flexible I am with my schedule.

The problem now is that I am ruled by that 12 hour shooting schedule, and Pumbaa's fluctuating nadirs. I don't do well with this broken up sleep/napping a few hours here and there. I can't forget about the clock, like I could pre-FD, because Pumbaa is the one controlling the clock. Even if I go to bed finally at 4-5 am, I still have to be up at 7 am for the next cycle of testing/feeding/shooting. This is what is killing me.

Last night, for example...Pumbaa seldom does anything but go up until after +4, but he dropped to 47 last night at his PM +4. I really did NOT see that coming, and was glad that I caught it. After the +5 52 reading, I set my cell phone alarm for +6, and stayed awake until nearly +6, but fell asleep minutes away from the +6 and a nuclear bomb could not have waken me up at that point. I was just dead-to-the-world exhausted.

I just don't know the answer. My life was much more flexible before Pumbaa FD. Now I just try to fit in work/sleep/life when I can. And I really don't like how rigid this 12 hour schedule is. But I've been trying to deal with it as best I can.

Suze

Last night, for example...Pumbaa seldom does anything but go up until after +4, but he dropped to 47 last night at his PM +4. I really did NOT see that coming, and was glad that I caught it. After the +5 52 reading, I set my cell phone alarm for +6, and stayed awake until nearly +6, but fell asleep minutes away from the +6 and a nuclear bomb could not have waken me up at that point. I was just dead-to-the-world exhausted.

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This advice might not be popular, but..... if that happens again, just abort the cycle. Give him a bowl of Cap'n Crunch (not really), carb him up at +4. He's already made his point, whether it's one, two or three times under 50 before he gets his reduction. No sense nursing up a low at +4 and denying yourself sleep. If a nuclear bomb isn't going to wake you up, him dropping down to 40 at +6 isn't going to either. So don't let him have that chance. Carb him up with something that will keep him safe, but will also wear off by +10 or +11 so you aren't shooting carbs the next morning. I don't know what that magic food is, but as much as you've been trying different foods and carb levels, there's gotta be something someplace in your footnotes that will do the trick.

Carl

Carl: That is pretty much what I have been doing for a few weeks now...giving Pumbaa higher carbed food at night when he's going low and I need to sleep.

On 1/5 at PM +5, I left 19% carbs food out for him to graze on, as he instinctively knows to eat when his numbers are low. But this still doesn't give me peace of mind, and I still try and get up and test him simply because sometimes even 19% food given every hour is barely enough to keep his numbers up (see 12/17).

I've always been a deep sleeper once I do go to sleep, and the Queen of hitting the snooze button without ever waking up. Maybe one day I'll win the lottery and be able to afford to hire the percussionist from a marching band to crash cymbals in my ear at night until I get up and test Pumbaa. haha_smiley

And 19% is the highest carbed food I've tried so far...maybe I need to get some really big guns/kitty Cap'n Crunch like Friskies Selects Indoor Chunky Chicken & Turkey Casserole/Brown Rice/Greens which is 32% carbs. (Yikes!) But I'm also worried that they (Pumbaa and Larry) are going to start liking getting this higher carbed food, and will stop eating their normal low carbed food. That would not be good.

Suze