09/14 Milo dosing +10.5 304

Nice start today. I hope Milo surfs safely. I'm back to work today after having last week off. I hate not being able to know what they do when we're at work.
 
Thanks everyone. I am encouraged by Milo’s numbers. It’s been a long time since his +2 wasn’t quite a bit lower than AMPS, I believe. I won’t be able to test again until +9 or later. I loaded up the autofeeder and he ate twice before I left. Giving his shot at 5:30am gives me a couple of hours to make sure he’s doing ok before I leave. It wil be interesting to see if he can stay into decent numbers with the .5 reduction. Not ideal, I know, but hopefully he doesn’t bounce up really high. I need him just high enough not to require daytime monitoring and steering with food. Have a great day everyone!!
 
I missed out on the reduction reason and the skipped shot yesterday. Looks like he's in a bounce today.

Are you changing the dose based on the pre-shot numbers?
 
I had to return to work and his numbers were so low lately I had to keep steering him with food. It was recommended I think outside the protocol and do “at least” a .25 reduction. I aired on the side of caution and reduced from 2.5 to 2 as it was my first full day away from him for work in 6 months. Now I think maybe 2.25u would be better to try...
Thoughts? I need to shoot something shortly
 
I couldn’t stall yesterday because the schedule would be too late to monitor him sufficiently before work. I chose a fur shot instead.
I missed out on the reduction reason and the skipped shot yesterday. Looks like he's in a bounce today.

Are you changing the dose based on the pre-shot numbers?
 
I agree with @Sue and Luci it's possible it could be a bounce. I also see on Milo's SS there was also a "no shot" in there yesterday morning, so I'd suggest you take that into account too when deciding what to do at this point. If he is simply trending higher, the "no shot" could be playing into that...impacting the depot.
Hard to know what is happening for sure based on one pink number.
 
I guess I'm confused then...you were going to do a .25 reduction...and I see that the last few were 2 units...

Bounces are going to happen...so perhaps it's best to stay with 2 units for now. It's better to stay steady/consistent with Lantus...rather than reacting to a now higher number. Let's see if 2 units will bring him into some nice easy blues so that you can work and he won't go too low...does that sound like a plan?
 
Thanks. I will stick with 2u and see how he does.
I guess I'm confused then...you were going to do a .25 reduction...and I see that the last few were 2 units...

Bounces are going to happen...so perhaps it's best to stay with 2 units for now. It's better to stay steady/consistent with Lantus...rather than reacting to a now higher number. Let's see if 2 units will bring him into some nice easy blues so that you can work and he won't go too low...does that sound like a plan?
 
Thanks for the opinions. I’ve stuck to 2u and see if it’s just a bounce that clears or not. Trying to figure out this return to work hasn’t been easy... I guess we’ll all figure it out...me, Milo, his pancreas and Singha.
 
Since Milo didn't actually earn a reduction from 2.5 units, I would not have reduced to 2.0 units. The high you are seeing today is also the after effect of yesterday's skip.
 
Since Milo didn't actually earn a reduction from 2.5 units, I would not have reduced to 2.0 units. The high you are seeing today is also the after effect of yesterday's skip.

So with that in mind, do you think she should go back to 2.5? She was concerned because she's had to go back to work and can't monitor all day. I agree the skipping and reductions aren't helping these numbers...but what to do once you've gone down that road?
 
If a reduction was needed to give the caregiver a break, a temporary reduction to 2.25 would have been OK for a while.
 
If a reduction was needed to give the caregiver a break, a temporary reduction to 2.25 would have been OK for a while.

So with that said, do you think she should go back to 2.25 tomorrow morning?

I really didn't get a clear understanding of why the dose was lowered to 2.0 units...perhaps Sam will come back to explain that decision...?
 
If you read through the convo from yesterday there was a suggestion of a .25 reduction or possibly more. I aired on the “possibly more” because I was scared of leaving him. I guess it wasn’t maybe the best route. I was extra concerned because he often won’t eat throughout the day unless I am home coaxing him, no matter what I leave out. I just didn’t want to take a chance.

I really waffled on what to do. I hope he’ll come down still. He’s only gone down to 326 at +4 tonight.
 
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