? Marmy’s numbers 6/1/20 amps -109, +1-192, +2-231

tonimarmalade

Member Since 2015
I delayed an increase to 1.75 when Marmy’s amps was 109. My heart rejoiced, but since then she has eaten just an out a tBS of food and her numbers are shooting up like crazy. Makes no sense. This sweet girl has been. On such a roller coaster. Please advise.
 
No reply from anyone\ . Today will be cycle 6 . So tomorrow 1 should increase to 1.75 -Correct? I will post later for today. Thank you .
 
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Sorry that no one got back to you sooner. I would have suggested an increase so your instincts are on target.

I think you may missing why Marmie's numbers jumped up. If you look at Marmie's PMPS from 5/31 (193) compared with her AMPS yesterday morning (109), there's a good chance she dropped into lower numbers over the course of the PM cycle. Given your last test was at PM +2, you didn't see any of the subsequent numbers. The rise in numbers during the AM cycle was a bounce.

If you truly want to follow TR, you have to follow the protocol more closely. You held the 1.25u dose for 19 cycles. The lowest Marmie's numbers dropped was 147. You want to hold the dose for 3 days/6 cycles if the majority of nadirs are over 200 (and you hold the dose for 5 days if nadirs are mostly under 200). I would have suggested increasing the 1.5u dose after 3 days, as well. Part of the issue with holding a dose overly long is that glucose toxicity can develop. In other words, Marmie starts treating the higher numbers as her "new normal" so it makes it both harder to get the numbers into the normal range and it encourages bouncing.

I can understand your reservations about increasing the dose -- Marmie has handed you some big surprises. I think aiming to keep her numbers below 220 (which is around where renal threshold is) would be a good goal. Diabetes is hard on the kidneys so whatever you can do to keep the numbers in a range that is easier on her kidneys would be great.
 
Sorry that no one got back to you sooner. I would have suggested an increase so your instincts are on target.

I think you may missing why Marmie's numbers jumped up. If you look at Marmie's PMPS from 5/31 (193) compared with her AMPS yesterday morning (109), there's a good chance she dropped into lower numbers over the course of the PM cycle. Given your last test was at PM +2, you didn't see any of the subsequent numbers. The rise in numbers during the AM cycle was a bounce.

If you truly want to follow TR, you have to follow the protocol more closely. You held the 1.25u dose for 19 cycles. The lowest Marmie's numbers dropped was 147. You want to hold the dose for 3 days/6 cycles if the majority of nadirs are over 200 (and you hold the dose for 5 days if nadirs are mostly under 200). I would have suggested increasing the 1.5u dose after 3 days, as well. Part of the issue with holding a dose overly long is that glucose toxicity can develop. In other words, Marmie starts treating the higher numbers as her "new normal" so it makes it both harder to get the numbers into the normal range and it encourages bouncing.

I can understand your reservations about increasing the dose -- Marmie has handed you some big surprises. I think aiming to keep her numbers below 220 (which is around where renal threshold is) would be a good goal. Diabetes is hard on the kidneys so whatever you can do to keep the numbers in a range that is easier on her kidneys would be great.
 
Thank you so much. This is very clear. So a cycle is 12 hours NOT a day. I will increase to 1.75 this evening as it is too late for this morning. I plan to print your reply and keep it at my Marmy station. I must reluctantly admit as all of this Comes back to me little by little after being off of the board for quite a long time, that while I am caring for my older sister with dementia and other issues I am beginning with dementia myself it is still very mild but I do forget oodles of stuff thank you again for your help.
 
Please let us know how we can help. Even if you're familiar with the info, I know I find it helpful to review every so often. I don't have Gabby here with me but I have all of your cats so I do go back to the sticky notes. If you have a question, tag one of the moderators or an experienced member. We're more than happy to help. I tend to write out explanations (vs "do this") since I think. understanding what my thinking is helps you to get the rationale.
 
You have already been so very helpful I. Your last post was so clear and I will increase Marmy’s dose this evening. Could you tell me how I might tag you if I can’t get a reply thru the regular thread procedure. BTW, I love that you provide The what and why of your thinking instead of just do this. Thanks again.
 
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