1/22 Mikey AMPS 135 +11/359 PMPS 364 +4/267 +11/228

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Re: 1/22 AMPS 135 OK TO SHOOT 2.75u?

I've only looked at your spreadsheet, so far. First question is are you going to be home today, to test and monitor, and do you have all the tools you need (test strips and HC or syrup if needed)?

Here is a good link to read: Dealing with Low Preshots

You can stall if you don't feel comfortable shooting at this instant. You would test again in 20 minutes (without feeding) to see if he is rising or dropping.
 
Re: 1/22 AMPS 135 OK TO SHOOT 2.75u?

i would - looks like mikey was bouncing yesterday from the blue 104 the night before. the usual caveat - will you be around to monitor him, just like you did yesterday, and do you have the supplies (strips, high carb food or karo) in case you need it?

at some point this bouncing will lessen, and shooting low will help that to happen. i'd get a +2 to see where he's going.
 
Re: 1/22 AMPS 135 OK TO SHOOT 2.75u?

Your spreadsheet says you shot. Good job! I'm proud of you. :smile:
 
Re: 1/22 AMPS 135 OK TO SHOOT 2.75u?

I'm home so I was fine with shooting the 2.75u. I just wanted to make sure it was ok to do so.
 
Re: 1/22 AMPS 135 +2/119 +4/121

Hi Jenn:

First, could you please fix the subject line to include Mikey's name? I couldn't find him :-D :-D THank you!!

Jenn PM'd me this question:

I was just looking over Mikey's SS and condo's. Can you explain to me why it takes 6 cycles before we increase, but twice when he went into the green's we did the decrease the next cycle? Why wouldn't you wait 6 cycles for him to be in the green before decreasing also?
Click to expand...

Remember, we're following the protocol:

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit.
If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.
Click to expand...

So...we wait 6 consecutive cycles to determine if we increase so the shed has time to fill on the dose you are on. Because Mikey's nadirs have been generally below 300, then you are following the guideline I bolded above.

However, if he drops below 50 (since he has been diabetic less than a year, he is newly diagnosed), then he earns a reduction. He dropped to the 30s on 12/1 and the 40s on 12/30. He earned a reduction both times. If you were to leave him at that dose for six more cycles, you put him at risk for being overdosed. By having those numbers on 12/1 and 12/30, he's letting you know he's ready for a reduction.

Sometimes reductions fail and we have to go back up. It's just a fact of FD. I also bolded this above.

The other thing I'd love to see is you getting your confidence in this. One thing that will help you immensely is if you can routinely get a +10 or +11 on Mikey so you can expect what he might be doing at PS. I was THRILLED that you shot today!!! Good job!! When you shoot a number like this, just get a +1 and +2 so you can see what MIkey is going to do.

I hope my explanations helped answer your questions. If not, please let me know :-D
 
Re: 1/22 Mikey AMPS 135 +2/119 +4/121 +6/188

Sorry about the subject line, I put his name in now. "My eyes" saw it, my fingers just forgot to type it! :lol: :lol: :lol:

I think I understand it now. I think I was confused because when increasing the dose it gives you how many days or cycles for decreasing it just says the number. It probably would have helped me if it said "if just ONE time" or "anytime" ..."kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit." I understand now but I will still verify to make sure I should shoot or not. You all see things on the SS that I still don't or remember things in the condo's that we've talked about that I forget. I was looking today for something I remembered and had to go through every condo back to Dec. 10 before I found it! You all are really amazing!

I will start getting the +1,+2 and +10,+11's more often. There was a little difficulty with the holidays but now things have settled down.
 
Re: 1/22 Mikey AMPS 135 +2/119 +4/121 +6/188

Jenn:

I think you only need to get a +1 AND +2 if you shoot a lower number than you have shot. You also just need to get either a +10 or +11. The only time you would need both is if he is dropping rapidly towards the end
of his cycle.

Maybe you could print out the stuff that is most important? Very nice cycle today!
 
Re: 1/22 Mikey AMPS 135 +2/119 +4/121 +6/188

Ok, thanks for clearing that up.

I have been printing out the "important stuff" and I have it in a binder with dividers for the main topics. There is still so much to remember and look through! I will get the hang of this!!!
 
Re: 1/22 Mikey AMPS 135 +2/119 +4/121 +6/188

there's a ton to remember - it just takes a while. and none of us mind repeating, so don't worry about it.

what a great cycle for mikey today - that nice string of blues is beautiful!
 
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