leslie? you know that what we always suspected for so so very long is now confirmed right? it is okay, nothing has changed in bayley's eyes and really we knew so long ago that this is no surprise, her SS told us this long ago, but i'm sure it still must of been a little upsetting to get black and white confirmation.
okay bayley IS an acro. you get 2 ISG's of peeps to support you, this and HD ISG. if you have not already read up on acro now is the time. any questions you have we are here to answer.
you have that R, we know that it is something to explore using now. i'm gonna be toast after today, omg turn out for oldtimers day is huge, i have 9 million condos to get to, but i will be back tomorrow to check on linda/bearman and i'll stop by your condo too. let's make tomorrow test flight for R day? all you are gonna do is give 0.1 units of R after you give AMPS (separate syringe) and then test to see the response. i am so not expecting crappus from that dose of R based on what your current lantus dose it, maybe maybe you'll get 25 or so points off BG than what was gonna happen w/o the R, but we always start at 0.1 units when firing up R for first time since it is a new insulin and a powerful one. after shooting you do what is called an R curve. the +1, +2, +3, +4. if +4 is higher than +3 the curve is over (there is always the odd cat that has a weird R curve..like my cat doesn't have R onset until +3~+4 when most cats are already over and done with their whole R curve!). we are gonna do that a few times to find out what her R onset, nadir and duration are because w/o knowing those you cannot use R successfully. ocne you know those and you know your cat's onset/nadir on the basal insulin already then it is not hard to work them together.
we also shoudl talk about switching to lev in case you get to the very active GH output doses one day. it is far easier to switch insulins while dose is still in this range than later on. and that does say 'in case' not all acros have the mega insulin doses ever. in fact they can go off insulin if GH output wanes enough. and wax and wane it does (i like to call it 'rev ups' and 'less active phases', think that is more descriptive of what is actually going on). it is the nature of acromegaly to have phases of different insulin needs (it is actually different insulin resistance not needs per se, they have working pancreases, but the GH counteracts the natural insulin hence the need for extraneous insulin). you understand right?
~jojo
