10/23 Oberon PMPS 328/4.6 (1.25 R), +2 328, +4 287

Best with the R:bighug:.

Thanks! Just read your post about TR vs. WR on Butters & Lyla's thread from yesterday. Definitely something I'll keep in mind as we continue on this journey. I'm planning to stick to the (slightly modified) TR protocol while we deal with the IAA issue, since I want to try to get his BG at least down below renal threshold asap. After that, though, we'll see what happens. I know some IAA cats have gone into remission after the antibodies cleared, so I'm not ready to give up on that possibility just yet, but I also would like to actually sleep someday!
 
I'm planning to stick to the (slightly modified) TR protocol while we deal with the IAA issue, since I want to try to get his BG at least down below renal threshold asap
What do you mean by "slightly modified"? TR really is your best option for now. From our experience here, getting to green as much as possible is the one way to keep those antibodies at bay. TR is your best chance of getting there.
but I also would like to actually sleep someday!
That requires learning Oberon's patterns and cycles. One thing to note, since you didn't give R last night, and he was on his way up at +2, I would have taken the opportunity to put away the test kit until the AM. His onset seems to be around +2, if he's not on his way down then, you have the permission slip to sleep. I used to spend ages before I went to bed, trying to figure out if Neko would be safe if I didn't set an alarm to get up. By that I meant - no lower than very upper greens. Look at Oberon's cycles where he's gone green or low blues. At what point in that cycle could you have seen he was going lower? If you looked at that particular cycle plus a couple cycles before then, were there any other commonalities with other cycles where he went lower? Neko had a particular 3 cycle pattern that gave me a heads up she would be going lower.

Does Oberon generally show NDW (new dose wonkiness), seems to have that today. If so, when? If it's always a cycles 1-2 or 2-3, then you can relax the testing on those cycles. How long does he take to clear bounces? All these questions and more can help you figure out Oberon's general direction and whether he'll be safe when you want to go to sleep. You do an awesome job testing, but you really do need to save it for when he's in low blues and greens.:bighug:
 
What do you mean by "slightly modified"? TR really is your best option for now. From our experience here, getting to green as much as possible is the one way to keep those antibodies at bay. TR is your best chance of getting there.

That requires learning Oberon's patterns and cycles. One thing to note, since you didn't give R last night, and he was on his way up at +2, I would have taken the opportunity to put away the test kit until the AM. His onset seems to be around +2, if he's not on his way down then, you have the permission slip to sleep. I used to spend ages before I went to bed, trying to figure out if Neko would be safe if I didn't set an alarm to get up. By that I meant - no lower than very upper greens. Look at Oberon's cycles where he's gone green or low blues. At what point in that cycle could you have seen he was going lower? If you looked at that particular cycle plus a couple cycles before then, were there any other commonalities with other cycles where he went lower? Neko had a particular 3 cycle pattern that gave me a heads up she would be going lower.

Does Oberon generally show NDW (new dose wonkiness), seems to have that today. If so, when? If it's always a cycles 1-2 or 2-3, then you can relax the testing on those cycles. How long does he take to clear bounces? All these questions and more can help you figure out Oberon's general direction and whether he'll be safe when you want to go to sleep. You do an awesome job testing, but you really do need to save it for when he's in low blues and greens.:bighug:

"Slightly modified" meaning that there have been a couple of times that we've actually bumped his Lantus dose up a cycle early because it was clear he was ready. Definitely not planning on relaxing the TR protocol!

Looking at his cycles, when he goes into a dive it takes more than a full cycle to bottom out in the blues/greens. So I usually have plenty of notice. If I count a bounce as time spent over his "normal" of 350 or so, he clears it really quickly, usually within a cycle or maybe two, then goes back to his usual high numbers until the next big dip..

The sleep thing is really just me, and I'm whining... he gets his shot at 7 am/pm, but I'm a night owl so I tend to stay up until midnight or 1, and since I'm up I figure I might as well test him. I'm not staying up just to test (usually). But then I have to get up by 7 to give his insulin, and I end up short on sleep unless I get to go back to bed, which depends on the rest of the family's schedule. Maybe the thing to do would be to shift his shots to 8/8. I'd get a +4 at night (R nadir) and have a good idea of whether I needed to stay up later, but could sleep in a bit more.
 
+4 was my bed time. One thing to keep in mind, if you ever decide to switch to Levemir, the onset and nadirs are later. But it's easy enough to move one hour back if you need to.

BTB (back to bed) was a lovely weekend AM tradition here.

I count bounce time as cycles between blues or better. The pinks are just his sign that the dose is too low and antibodies are fighting hard.
 
If anything above the blues counts, this kid is nothing but bounce! Though now that we're started using R his dives into blue/green are more frequent. Before R it was happening maybe every 10-14 days. Now it's more like every 3-4 days. If he sticks to that pattern, he's about due for another dip tonight or tomorrow.

I've been thinking of his bounces differently. His "normal" state is that he has low available insulin because of the antibodies, therefore high but somewhat stable BG in the 300s; I don't consider that a bounce/response to low numbers. When he temporarily dips much lower (for reasons I still don't fully understand), the antibodies quickly recover and BG comes back up, but the glucagon/panicky liver probably also kicks in, leading to a temporary bounce even above his usual high numbers. That lasts a cycle or so, and then it's back to business as usual in the 300s. I feel like his overall pattern is shifting now, though. I'd love to get to a point where I can think of pink as a bounce and not normal.

For my next trick, I'll teach my husband the early bird how to do the shots so I can really sleep in!
 
Back
Top