1/9 River PMPS 191 +1:196 +2:236 +8:428

Status
Not open for further replies.
Picknickchick

Picknickchick

Member Since 2013
Yesterday

After an interesting day and evening yesterday, River was a very happy cat this morning. His numbers are high, but he was chatty, affectionate, good in both categories in the litterbox, and grooming.
I hope he comes back down soon. I'll be shifting his shot times back to 6:30.

7:30 499 (27.7)
9:30 382 (21.2)
11:30 302 (16.8)
1:30 250 (13.9)
4:00 211 (11.7) yay yay yay!

=^.^= Thank you to the kind people who helped me yesterday =^.^=
 
Re: 1/9 River AMPS:499 +2:382

You are welcome! :-D We've all been there and know how hard it is. I'm glad you found LantusLand so we can help you. It's great to read that River is doing well. :-D :-D :-D Now come down from there, River!
Liz
 
Re: 1/9 River AMPS:499 +2:382

Thanks for the encouragement, Liz!
Each day is a learning experience, so I appreciate the mentoring - with humour! :-D
 
Re: 1/9 River AMPS:499 +2:382

I hope River will give you a nice, slow slide today and surf safely.

Thanks for stopping by Furball's condo. I looked at River's profile and the pictures of all your furbabies are so cute.
 
Re: 1/9 River AMPS:499 +2:382

I went back to take a look at yesterday's numbers. Just as an FYI, if you end up stalling and shooting late, you probably don't want to reduce the dose, too Here's the logic. Fundamentally, there are 3 options with a low pre-shot: skip the shot, stall, shoot a reduced dose.
  • Skipping - This had the biggest impact on the insulin depot. When you skip, you deplete the depot and it can take a couple of cycles to get things back to where you want them.
  • Shooting a reduced dose - the problem with this strategy is that you don't always see the effect of the dose reduction in the current cycle. Because there is a depot, when you shoot a reduced dose, the depot may make up the difference during the current cycle and you see the effect of the reduction in the next cycle.
  • Stalling - stalling allows you to see if numbers are continuing to drop, rise, or remain level. A late shot acts like a dose reduction (and an early shot acts like a dose increase). If you stall AND reduce the dose, it has a double hit on the depot.
Because of the impact of stalling and reducing the dose, you want to try to avoid this strategy. You might find this post on Dealing with Low Pre-shots helpful. Ultimately, you'll get to the point where you can shoot any number that's above 50. The mantra here is, "Shoot low to stay low."
 
Re: 1/9 River AMPS:499 +2:382

Sienne, you were so much help yesterday. I think you patiently told me some things more than once ;-). Now I understand a bit better what to do. I think I needed to experience the low pre-shot to get over it. So since I did a late and reduced PM shot, River is affected by that today.

Since he has a late nadir, I will have to learn to shoot low.

Something I don't understand about yesterday is why his PMPS BG was so much lower than his usual nadir, which seems to consistently be at +7. That really threw me off. Is there any reason for a sudden low reading then?
 
Re: 1/9 River AMPS:499 +2:382

I think when most people start the FD journey, we think about nadir as a fixed point that is at +6. It's neither a fixed point nor is +6 every cat's nadir. If you look at Gabby's SS, you'll see her nadir is typically early -- at around +4 -- except during cycles when it's not. There is an abbreviation we use -- ECID (every cat is different). Nadir is an ECID thing. Some cats have their nadirs in the middle of the cycle. Others are typically early or late. A nadir that's between +5 and +7 is pretty common and is in the middle of the cycle. I think of a "late" nadir as after +9. In fact, there are some cats who will have a nadir at shot time and their high numbers are at mid-cycle. (That's a situation that takes a while to wrap your head around!!)

Nadirs can also move. They are far from a fixed point. Sometimes they move from cycle to cycle, day to day, or week to week. It's good to know where River's nadir may typically fall but don't get wed to the notion that the nadir will always be at that time. Knowing were the nadir usually is can help you to plan when you want to test, etc. But, it helps to always remember that we're dealing with cats. They are inherently unpredictable and they like to keep us on our toes!

Also, you're going to find that several of us will repeat ourselves and each other. Marje and I often tag team without even realizing it. There's no way anyone can absorb all of the information that's available here in the space of a few days. I've been dealing with Gabby's diabetes for years and I'm still learning. The amount of information that will become routine knowledge is completely overwhelming at first. Please ask questions. We're here to help.
 
Re: 1/9 River AMPS:499 +2:382 +4:302

Good Morning!!
Was reading your condo from yesterday nailbite_smile It can be so scary in the beginning. I have been very lucky with Hoot. He has never gone hypo and he can get real low sometimes. I think his lowest on record is a 29 :o nailbite_smile :shock: So glad River is doing good today. Every day you will get a little braver and gain more knowledge to help for the next time ;-) I learn so much from reading other peoples condo's and all they are experiencing. I learned from your condo ;-) These guys will help you all the way. They are the best :thumbup
Enjoy your day :-D
 
Re: 1/9 River AMPS:499 +2:382 +4:302

I'm glad River is feeling well today despite higher numbers. Once the dose catches up to the stall/reduction you should see some lower ones. Don't worry about being nervous as the numbers go down - you'll get comfortable and they'll become the new normal before you know it.

Sometimes my cat will drop all the way to the next shot if she's clearing a bounce, and sometimes her nadir is what we think of as the typical one at +6. Not just the individual cat but the previous cycle and the overall trends can have a lot to do with when in the cycle you see the lowest number. And cats being cats, sometimes I think they just throw a dart at a little board somewhere and decide that's what their blood sugar will be at the next reading ;-)
 
Re: 1/9 River PMPS:77! Please advise

Sorry to be all dramatic again but the PMPS is 4.3. I haven't fed him, and put a bit of Karo in his mouth, although he's acting fine.
 
Re: 1/9 River PMPS:77! Please advise

River is a challenge! He should be fine at 77. I know you are nervous because of his seizure before. Don't give him any food or karo or anything else to eat, unless he shows symptoms of a hypo. How long until the shot? Another thing is we try to only adjust the shot time by 30 minutes each day. You can do that 15 minutes at each shot or 30 minutes at one shot.
Liz
ETA: I see on the spreadsheet that you are planning on moving up the shot time by 30 mins. Can you stall instead?
 
Re: 1/9 River PMPS:77! Please advise

I don't think you should shoot a 77. You don't have the data or experience of dealing with low numbers yet. My suggestion is to wait 30 minutes and test again. That number may be karo influenced though. The idea is to stall until the BG number starts to rise (without eating anything) then give the shot. It's much safer to give the shot when the BG is rising than when the BG is falling.
Liz
ETA: I've got to run and pick up Anne. I'll be back in 15 mins. If the numbers don't come up and you can't stall any more, you may need to skip the shot tonight.
 
Re: 1/9 River PMPS:77! Please advise

So I will test him at 7:30, and see if he's going up. If he is, should I wait for food/insulin and then test him again, at 8?
How long should I postpone dinner and insulin for, before I do something else?

I feel a bit calmer about this today, (I think). ;-)
Yeah, he's a challenge!

BTW, I have 7 cats here in the kitchen looking at me like WHERE'S DINNER?
 
Re: 1/9 River PMPS:77! Please advise

ETA: I've got to run and pick up Anne. I'll be back in 15 mins. If the numbers don't come up and you can't stall any more, you may need to skip the shot tonight.
Click to expand...
OK, cool. I'm going to test him and post the result, and wait to hear back from you.
If stalling or skipping is best, I'm cool with it - whatever is best for River.

Did I thank you yet?
 
Re: 1/9 River PMPS:77! Please advise

Now it's 7:25 and he's at 10.6, but is that 4 small pieces of ham smeared with karo talking?
I'll sit tight, and I guess test him again at 7:45, is that what to do?
 
Re: 1/9 River PMPS:77! Please advise

I'm back now. So a 10.6 = 191 mg/dl. That should be fine to shoot except it could be karo. Also, ham is usually cured with sugar. Is 7:30 shot time 30 mins earlier than last night?
Liz
 
Re: 1/9 River PMPS:77! Please advise

7:30 is the (scheduled) shot time for last night.
Except last night I actually didn't give the insulin until 8:30, because I stalled.
I gave him insulin this morning at 7:30, though.

I was planning to move it ahead tonight to 7, and tomorrow night to 6:30, to get him back to his 6:30 time.
 
Re: 1/9 River PMPS:77! Please advise

So here's the scoop. If you're stalling, you don't want to feed. (There are exceptions here but that's only if numbers are below 50.) The 180+ that you tested at 7:25 is decidedly the Karo talking. The problem now is we don't know where River's numbers really are. Ideally, if you stall and don't feed, when you re-test, we can tell if numbers are going up, down, or staying the same.

Also, can you please put your numbers in US format? I know it's a pain but the majority of us use mg/dL as the convention for posting. What +time is 7:30? At this point I would not re-test in 15 min. It can take a while for the Karo to wear off. How about re-testing in 30 min.

Can your schedule manage a late shot? If you shoot late tonight, your AM shot will be 12 hours later. Also, do you have strips and HC food on hand (in addition to the Karo).

You might want to read over this sticky on Shooting & Handling Low Numbers.
 
Re: 1/9 River PMPS:77! Please advise

When you stall, then that becomes the new shot time. So moving the shot ahead by 30 mins would be 8:00 PM tonight. It's a pain to stall. And shooting early acts a bit like a dose increase. So my thought is to test at 8 and see what he's doing. That will give a little time for the karo to wear off. Can you feed everyone else so you don't lose any limbs? :lol: I know River won't be happy about that. What do you think?
Liz
 
Re: 1/9 River PMPS:77! Please advise

Hi Sienne,

If you're stalling, you don't want to feed.
Click to expand...

No problem, I didn't give anyone dinner. When I saw the low number I thought he might be going hypo so I grabbed something to stick in his mouth with Karo.

Also, can you please put your numbers in US format?
Click to expand...

For sure. I normally do both, and just the US in the subject line. In haste to reply to Liz I included only the world measure.

What +time is 7:30?
Click to expand...

That would be +30 minutes


At this point I would not re-test in 15 min. It can take a while for the Karo to wear off. How about re-testing in 30 min.

OK, I will retest at 8 PM, which would be +1.


Can your schedule manage a late shot? If you shoot late tonight, your AM shot will be 12 hours later. Also, do you have strips and HC food on hand (in addition to the Karo).
Click to expand...

I can do a late shot. Just someone experienced please let me know, as we go along this evening, if and when that should be. I have a hypo kit right in front of me.


You might want to read over this sticky on Shooting & Handling Low Numbers.
Click to expand...

Yep, since yesterday I've read it a few times. However, I am still pretty inexperienced so although I know what I've read, I feel like I need some advice.
I'm not confident enough with these high stakes.
 
Re: 1/9 River PMPS:77! Please advise

I know what you mean about reading and re-reading that sticky on low numbers. I think it's confusing on a good day. I think you have a misunderstanding about how we keep track of time. The + numbers start from the actual shot time, not the time you would ideally like to shoot. What time did River get his shot this morning and how many hours after that is 8:00 PM?
Liz
 
Re: 1/9 River PMPS:77! Please advise

Hi Liz, testing at 8 and seeing what to do from there sounds fine to me.
For now, everybody will chill in the kitchen.

Thanks to you and Sienne, I'm not a ball o' stress like I was yesterday, but my goodness River has a few tricks up his sleeve.
I hope this means he wants to get well :smile:
 
Re: 1/9 River PMPS:77! Please advise

Just to orient you to the lingo....

If you are stalling, what would be your pre-shot number is your +12. So the test that was at 7:30, would be your +12.5. When you shoot, that test would become your PMPS.

Just as an FYI, I would not reach for HC with a 77 this late in the cycle. Even with a number in the 40s, I'd probably give a teaspoon or two of LC and re-test in 20 - 30 min. Because it's late in the cycle, there's very little insulin left to influence numbers. LC may bump a low number up all on it's own.

It takes a while to get the hang of when to reach for the HC. A lot depends on where in the cycle you are, how fast numbers are dropping, etc.
 
Re: 1/9 River PMPS:77! Please advise

Hi Liz,

I think I'm clear on the shot times, (I hope!) but what's been messing me up is changing River's shot times twice: first when I joined LL to bring it 1.5 hours earlier so I can always do a +2 after each shot, and then yesterday when I stalled, it probably appears like I'm on crack cocaine.

So River got his shot this morning at 7:30; this becomes the new hour zero, yes? That time is +11.5 hours after I gave him his insulin last night.
 
Re: 1/9 River PMPS:77! Please advise

Lara

I know it's scary and you worry about a hypo. But remember that you are in control because you (1) test and (2) you have food/gravy/syrup to bring up the numbers.

Symptomatic hypos on lantus and levemir when following a TR protocol are rare. The only ones I can remember since I've been here were people not following the TR protocol or were not testing regularly or both.

So, yes, we need to be vigilant and we need to be respectful of numbers but you are in control.
 
Re: 1/9 River PMPS:77! Please advise

Excuse me, I got something wrong here. I shot River at 7:30 last night, which was one hour later than his normal time of 6:30. Not 8:30 as I said earlier.
I was going to move his shot time today to 7. I tested him at 7 for his PMPS and he was 77, tested him 20 minutes later, and now at 8 he is 191 (10.6).
 
Re: 1/9 River PMPS:77! Please advise

Thank you Marje! This is why I'm so glad you, Liz and Sienne are here. Because I have not much of a clue.

So now it is one hour later than he should have had his shot. Should I wait and test, shoot, shoot reduced, or not shoot? I don't know what is the best course of action, because at PMPS time when I saw the 77 I gave him some ham with Karo.
 
Re: 1/9 River PMPS:77! Please advise

Sure, I just did. He is now at 191. I updated his SS the moment after I tested him.
 
Re: 1/9 River PMPS:77! Please advise

I'd be tempted to go ahead and shoot your regular dose and feed. You'll have food on board and at least one hour, if not two before the dose kicks in. In addition, the late shot acts like a dose reduction.

Are you OK with this plan?
 
Re: 1/9 River PMPS:77! Please advise

Sienne, I've tried to put on my big girl panties ;-) but I find that River is so tricky that I am standing here wondering what in the world to do.
I don't know what to do, frankly, I'm just so very inexperienced!
 
Re: 1/9 River PMPS:77! Please advise

I think you are good to shoot. He will probably bounce from that 77, kind of like he bounced from the 185 last night. Get a +1 and +2 and see what he's doing. We will be here to help out. You can do it! :-D
Liz
 
Re: 1/9 River PMPS:77! Please advise

By the seat of my pants! Thanks Liz, Marje and Sienne.

So now that I've boasted that I understand the SS, I just gave River his insulin at +13.5. Now this becomes the PMPS time, is that right?
However, in the meantime, I have this +1 time, for the reading I did at 8. I'll do another test in one hour, at the new +1 time.
So which one is the +1?
Egads.
 
Re: 1/9 River PMPS:77! Please advise

If you just shot at +13.5, that's your PMPS test number. If you look at Gabby's SS, you'll see how I stack numbers if I'm testing more than once in an hour. If you put the numbers in the +11 cell with the +times noted, you'll need to manually color the cell.
 
Re: 1/9 River PMPS:77! Please advise

Thanks again, I'll change the SS.
Life is far too interesting these last few days :?
 
Re: 1/9 River PMPS:77! Please advise

Yes, kind of like that Chinese curse. :lol: :lol: You can also update the subject line with his PMPS of 191. Not that we're anal retentive around here or anything. :lol: :lol:
Liz
 
Re: 1/9 River PMPS:77! Please advise

Not in the very least! ;-)

ocd%2Bcat%2Bmis%2Bcell%5B1%5D.jpg
 
Re: 1/9 River: It's complicated ;-)

:lol: :lol: :lol: :lol: I understand completely! Uh, but your subject line should have in there somewhere "PMPS 191".
Liz
 
Re: 1/9 River PMPS 191 +1:196

Good shooting, Lara!!!
I've been checking on River's condo silently, and now I think it's time for some cheering!
:RAHCAT :RAHCAT :RAHCAT

Well done, Lara!
And I'm glad River's feeling good today.
Surf safely, RIver. Blue looks very good on you.
 
Re: 1/9 River PMPS 191 +1:196 +2:236

Thank you, Mariko. I'd be most happy with a little vacation in the blues!
I saw Lucy's update, and this is great!
 
Re: 1/9 River PMPS 191 +1:196 +2:236

Hmm. I sense a pattern here. :lol: :lol: River is bound and determined to get you shooting low. Great job tonight Lara!
 
Status
Not open for further replies.
Back
Top