Re: 1/25 Atlas AMPS 116, +3 96
I have some long thoughts about Atlas. I hope you don't mind me putting them here. Maybe they will help.
Here’s my observation, based on my experience with Lucy and on what I’ve seen with a lot of other cats here. At this stage in the game, the lack of bounces means that Atlas’s pancreas is on the job. Our job is to give the newly functioning Mr. P as much support as possible so it has lots of time to heal and get strong as we gradually remove the exogenous insulin from the picture. We want to provide support, but we don’t want to put Atlas in any danger AND we don’t want to exhaust the bean (well, maybe a little!).
A lot of your decisions will have to be based on what your gut tells you at shot time. It is perfectly fine to take 0.25 reductions at this point when reductions are earned, and that is what I would do (and it is what I did with Lucy during most of her trip). He is holding the reductions just fine so shaving isn’t necessary. If he gets to a point where he is having more trouble with reductions, then you can switch back to shaving. Don’t get thrown by an occasional blue number – keep your consistent dosing just like you always have and don’t adjust the dose based on seeing a higher number or two. They happen. As long as they go away, we’re fine.
Also, there were times when I had to skip or BCS a dose just to try to let Lucy’s shed drain a little. There is no harm in that and Atlas will hardly notice. You can see times on Lucy’s spreadsheet when I skipped, and she might have been blue or yellow at the next shot time but she came back down immediately. It let me get some sleep and it let her clear out some of the shed so we could get a better picture of what the dose was doing for her. Many people have to do this on the way down the dosing scale. Obviously if you find yourself skipping often, then you need to reduce the dose. It's just a tool to help you maintain control of the numbers.
There is always a possibility that a cat who goes down the dosing ladder too quickly can “lose it” and their dosing needs will increase. Lucy did this on her first trip down. It was a learning experience for me, and I did a much better job of managing her on her second trip down. A big part of that was learning to follow my gut and learning when it was better to just not shoot. The Lantus shed is a wonderful thing, but sometimes it does get in the way. :smile:
Sooooo….. next time Atlas is running 50s for several cycles in a row, or earns a couple of reductions in quick succession, if he gives you a 50s preshot maybe try giving half of his dose, or even no dose, just for one cycle. Get a few spot checks and see where he is at the next preshot. Then restart at whatever his dose is supposed to be (currently 2.5, unless he earns a reduction before then). Don’t hesitate to increase the dose again if it looks like a reduction isn’t sticking, but I don’t mean just one or two blue numbers, I mean an overall trend.
I have to get back to work, but I’ll try to check back in later.
What do you mean?
I've got nothing to add on the dosing instruction... thanks to you and libby for discussing in your condo as opposed to PM... it's nice info to store in the back of my mind for when the wee-dub and I are hopefully someday in a similar situation!