8/17 Biscuits'amps 300 +9.5 272 pmps 333 +3 329

I’m headed out soon but two observations:

—-looks like he needs more insulin but
—-some nighttime tests are needed to see if he’s dropping down before you increase.

Next increase should be to 40u bid.

Good luck and I’ll pop in when we are back :)
 
Marje and Gracie said:
I’m headed out soon but two observations:

—-looks like he needs more insulin but
—-some nighttime tests are needed to see if he’s dropping down before you increase.

Next increase should be to 40u bid.

Good luck and I’ll pop in when we are back :)
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I'm waiting for the vet to get back to me on cabergoline dosing; I sent her lots of information and she's reading up on it now. I'm hoping that will lower his insulin need. I've been testing but I've been bad at posting super busy lately. It seems to me that he goes up after I give the R several times, is that a just a bounce? He didn't receive any R when I was away for those 3 days and he was nice and low when I came home. Is it possible that it adjusts on its own or is that just a crazy thought , or did I just catch him on a good day? I need to refill Lantus and I will increase. My mind's going in six different directions with this acro. I know you're busy getting ready for your beautiful vacation, thanks for taking time to read this !
 
I had the same thoughts as Marje -- more PM tests and more insulin.

I think that you're seeing a delay in the bounce due to the action of R. Looking back just a bit, there's a lower number (e.g., the 120) followed by a bounce where you give R and that takes the edge off of the bounce. When you stop the R, you see where the numbers are at baseline. A couple of things to remember... You're dealing with a BIG depot. With that size of a depot, it's likely that changes will occur slowly. (Think of it as trying to turn an ocean liner vs a sail boat. That size of a depot isn't agile.) R is a "bolus" insulin and is helpful due to it's quick action and very short duration. Take away the bolus and you're dealing with the "basal" insulin (i.e., Lantus). That's your baseline without the influence of R.

Does that make sense?

 
Sienne and Gabby (GA) said:
I had the same thoughts as Marje -- more PM tests and more insulin.

I think that you're seeing a delay in the bounce due to the action of R. Looking back just a bit, there's a lower number (e.g., the 120) followed by a bounce where you give R and that takes the edge off of the bounce. When you stop the R, you see where the numbers are at baseline. A couple of things to remember... You're dealing with a BIG depot. With that size of a depot, it's likely that changes will occur slowly. (Think of it as trying to turn an ocean liner vs a sail boat. That size of a depot isn't agile.) R is a "bolus" insulin and is helpful due to it's quick action and very short duration. Take away the bolus and you're dealing with the "basal" insulin (i.e., Lantus). That's your baseline without the influence of R.

Does that make sense?
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So the Lantus just sits there and doesn't work too well unless I give the R to get it moving?
 
Not quite! It will just take longer because it moves more slowly. One of the quirks with Lantus is that it tends to bring numbers down better when you're starting at a lower point. Unlike R which hammers the numbers down, Lantus tugs at numbers gently. With R, it's like a batter slamming into a baseball and everyone has to go running to catch up -- you don't know where or how far the ball will go. The batter gets to first base. With Lantus, it's more like the batter hits a bunt -- the batter gets to first base but without all of the potential drama. The days when you start with lower numbers, you're seeing a flatter Lantus cycle without benefit of R.

Remember, with a depot insulin, a bit of the insulin goes to form the depot so it can be released over the duration of the cycle.
 
Mollycat said:
So the Lantus just sits there and doesn't work too well unless I give the R to get it moving?
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It's been suggested several times for me to use more R but I I'm not clear on how often I can use R, more than twice a day? I give 0.1 amps yellow , 0.25 pink, 0.5 red. + 6 , pink 0.5, red 0.75. should I give it more often should I give it more?
 
I've not used R. I would not be the best person to coach you on its use. I usually refer people to Wendy or Marje or others who have experience with it's use if you need more help with R. I also would wait for them to be available since I don't want to give you misinformation.

You can use R more than once in a cycle. HOWEVER, you do not want to overlap the nadir from the R and the nadir from Lantus. If Lantus is pulling numbers down, you do not want the R active part of both cycles to be on top of one another since it could make for a way too "exciting" cycle.
 
Sienne and Gabby (GA) said:
I've not used R. I would not be the best person to coach you on its use. I usually refer people to Wendy or Marje or others who have experience with it's use if you need more help with R. I also would wait for them to be available since I don't want to give you misinformation.

You can use R more than once in a cycle. HOWEVER, you do not want to overlap the nadir from the R and the nadir from Lantus. If Lantus is pulling numbers down, you do not want the R active part of both cycles to be on top of one another since it could make for a way too "exciting" cycle.
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I believe that @Bronx's dad might have a clear answer for this, I don’t know off hand who else is using or has used R.
Maybe @Olive & Paula?
 
Mollycat said:
It's been suggested several times for me to use more R but I I'm not clear on how often I can use R, more than twice a day? I give 0.1 amps yellow , 0.25 pink, 0.5 red. + 6 , pink 0.5, red 0.75. should I give it more often should I give it more?
Click to expand...
I believe that @Bronx's dad might have a clear answer for this, maybe @Olive & Paula? I don’t know off hand who else is using or has used R.
 
Mollycat said:
It's been suggested several times for me to use more R but I I'm not clear on how often I can use R, more than twice a day? I give 0.1 amps yellow , 0.25 pink, 0.5 red. + 6 , pink 0.5, red 0.75. should I give it more often should I give it more?
Click to expand...
I have used R twice in a cycle but that has backfired on me. 1st dose did nothing, but the 2nd dose dropped him too low on the next cycle. However, I was using much larger doses of R than what you are using. ECID for sure when it comes to R. If you can monitor closely, I would raise your R scale a bit.
 
Krystina & Nelli said:
I’m hoping @Wendy&Neko might be around to give you... understanding
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I can't even believe how much insulin I'm giving. I know that 'he needs what he needs'. Will it ever end. Refills every 2 weeks is getting hard. I'm venting my frustrations. Sometimes I think I should just do what the vet tells me and just let it ride, give him insulin and keep him happy and do what's best for all of us .when and if he starts declining then I'll have to make a decision. He's not going to recover from the Acromegaly. I love Biscuits, I just want to do what's best for him, there's going to be a point where the cost will be a factor.
 
Mollycat said:
I can't even believe how much insulin I'm giving. I know that 'he needs what he needs'. Will it ever end. Refills every 2 weeks is getting hard. I'm venting my frustrations. Sometimes I think I should just do what the vet tells me and just let it ride, give him insulin and keep him happy and do what's best for all of us .when and if he starts declining then I'll have to make a decision. He's not going to recover from the Acromegaly. I love Biscuits, I just want to do what's best for him, there's going to be a point where the cost will be a factor.
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OMG. I UNDERSTAND. Life ?!?? Why God, why?
Please hang tough, if just for a little bit longer.
I guess Wendy (@Wendy&Neko) is not around... :-|
I feel your pain. I feel your pain, darlin’.
 
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