10/3 Pumbaa AMPS/330 -- WTF?

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Pumbaa

Pumbaa

Member Since 2012
I am certainly not happy this morning seeing a pink on Pumbaa's spreadsheet. *sigh*

At +6 last night, Pumbaa was at 204, and certainly could have dropped down into the 100's after that, but he wasn't dropping quickly (he was only dropping at rate of 7 points per hour), and I saw no indication that he was going to dive. So why would he bounce up to 330 this morning (unless he and the other animals called out for pizza while I was sleeping *LOL*)?

I'm praying big time that this is a fluke, and Pumbaa isn't going to go back to his bouncing/diving ways.

This morning was his 6th cycle at 1.0U, and had he stayed steady/flat with the current dose, I would have raised him a tad tonight, maybe to a fat 1.0U. But I don't want to raise him until he clears this bounce, correct? I really, really, really want to do everything in my power to prevent bouncing and diving.

Pumbaa, you're too much of a macho boy to be wearing pink!

Suze
 
I don't think that is a bounce off a low number. It's just one of those things. Don't get too hung up on the colors. 330 +/- 20% is 264-396. Yes, he is "higher" this am than his average for yesterday, but it is one number. Don't fixate on it, but let a pattern emerge.

If he settles in the 300s than you have a decision to make (raise the dose "early" or not), but he is going to need another increase anyway since his nadir is not going below 200.

Still early on lev....
 
He's been coming down slowly today, so I think tonight I will up him slightly to a fat 1.0U.
 
Sheila, you don't think going up in smaller increments might prevent diving/bouncing? That was the only reason I was going to go up to the fat 1.0U.

Pumbaa is now down to 217 at +9.5.

Suze
 
I might wait to increase until tomorrow night as my mom has a medical procedure tomorrow that will take up most of my day. These things happen.

Update: I did increase Pumbaa to a fat 1.0U tonight. Better than just 1.0U and not as dramatic as a 1.25U dose.

He went up to 312 for his PMPS. for no reason I could see.

I truly prayed that Levemir would prevent this bouncing and diving. *sigh*

Suze
 
He is not bouncing and diving. A variance of less than 100 points can't qualify for either of those.

He may have some insulin resistance that sets in fast with a new insulin. You just have to systematically raise the dose until you can break that. Usually the dose can be decreased after that a bit (or a lot).

The place to raise by "fat" or "skinny" or .1u to .15u is when the base dose is pretty low - like under .5 (or even .75u) or when they are very close to optimal dose AND lower than about 1.5u. I don't think there is much value in trying to do less than .25u when you are still searching for the best dose and are above 1u already - especially because it is a pain to get increments that small.

Again, think in terms of percentages. 25% of 1u added = 1.25u, but 25% of 2u added = 2.5u. I think a general guide would be 20-25% until you are near best dose and 10-20% for fine tuning.
 
Thank you, Sheila, for once again providing great info. (((HUGS)))

I did the fat 1.0U tonight just to move him up a tad, when I know I won't have time to watch him/test him tomorrow due to other commitments. I may take him up the the next level, 1.25U, Thursday night.

Suze
 
I didn't get a chance to respond to this last night, but I have more questions and explanations.

Poor Sheila must think I'm a total idiot at times. *sigh*

Sheila & Beau & Jeddie (GA) said:
He is not bouncing and diving. A variance of less than 100 points can't qualify for either of those..
Click to expand...

I had been asking for a definition of a bounce for months, but never got a clear one. So my interpretation of a bounce was anytime the numbers went up abnormally and it appeared that the liver had dumped sugars. In any case, he went from 204 at his +6 on 10/2 to a 330 for his AMPS on 10/3, which is more than 100 points. So...why wasn't this considered a bounce?

Also, my definition of a "dive" includes those cycles when Pumbaa has no curve what-so-ever, and goes from a PS high to a +12 low. Which he used to do on Lantus all the time, and is now seems to be doing on the Levemir as well at times. I thought he did this on the AM cycle today (10/4) but he actually went up slightly at +9. (I'm not taking into account the =/- 20% meter variance...I'm just looking at his actual numbers, and, no, I haven't figured out the dose overlap yet.)

Sheila & Beau & Jeddie (GA) said:
He may have some insulin resistance that sets in fast with a new insulin. You just have to systematically raise the dose until you can break that. Usually the dose can be decreased after that a bit (or a lot).
Click to expand...
Insulin resistance is another thing I've been trying to research and understand. Since I don't yet, I appreciate having this pointed out so I can learn from it.

But what I don't understand is why Pumbaa only starts showing signs of this the higher his dose goes. He did the same thing on Lantus. More erratic numbers the higher the dose.


Sheila & Beau & Jeddie (GA) said:
The place to raise by "fat" or "skinny" or .1u to .15u is when the base dose is pretty low - like under .5 (or even .75u) or when they are very close to optimal dose AND lower than about 1.5u. I don't think there is much value in trying to do less than .25u when you are still searching for the best dose and are above 1u already - especially because it is a pain to get increments that small

Again, think in terms of percentages. 25% of 1u added = 1.25u, but 25% of 2u added = 2.5u. I think a general guide would be 20-25% until you are near best dose and 10-20% for fine tuning.
Click to expand...
Thinking in percentages makes sense, until my stubborn brain tries to be logical about all this (when I still haven't discovered the logic behind insulin in a cat), and says that Pumbaa has much flatter numbers at lower doses, and that taking him up to higher doses in smaller increments may prevent these wider swings in his numbers, which is the reason I switched him to Levemir in the first place. *LOL*

Poor Sheila. There really is a reason behind what I say and what I do. After six months, I swear I don't understand this insulin in cats any better than I did on the first day! And I so thank you for your help and patience. If you hit me on the head enough times with a 2 x 4, I might just finally get it! (Ya think?) ;)

Suze
 
Suze, I will read this again tomorrow and try to answer - have had a headache most of the day (weather changes? We dropped 25 degrees this afternoon with a cold front and rain...), so I can' tthink straight right now.

Have you perused the petdiabeteswiki site? Tons of great info there.

http://petdiabetes.wikia.com/wiki/Main_Page (try and ignore the annoying advertising that is taking over...
 
Sheila, no emergency. Hope your head feels better soon! When I lived in Chicago, I, too, would get massive sinus headaches with the weather changes.

I will go back to that link and do some more reading today.

Suze
 
Ok - now my excuse is that I am really tired. Got only 5 hrs of sleep last night and spent all day at my aunt's going through old family photos to find ones she wants scanned. I opened my big mouth about making a family photo book..... :roll:

Glad to read on the other thread that you are more accepting of imperfect process - or letting down expectations and accepting reality - and also seeing that he is doing better overall (big picture).
 
Sheila: Yes, I became a realist once again, due to your great explanations. Thank you for that dose of reality.

You are so sweet for helping us here and helping your family with their digital photos needs. I've been doing the same thing for my family...scanning and fixing all of those old photos to share with everyone. Not an easy task, that is for sure. But someone in the family needs to share the history of our ancestors, right? And keep them alive in our memories?

Suze
 
Actually, its really important to go though the records with older relatives now rather than later so you can ask questions and get IDs on the really old photos. I found out today that my mom and aunt's father had a law degree. I never knew that before. He died fairly young and when I was young so I never knew him when I was an adult and could be taking in those kinds of facts. Wish I could have talked to him about it.

I love old photos and actually the scanning and cleaning up of them. It's like magic when you can get details out digitally that your eye can't see on the print.
 
Sheila & Beau & Jeddie (GA) said:
Actually, its really important to go though the records with older relatives now rather than later so you can ask questions and get IDs on the really old photos. I found out today that my mom and aunt's father had a law degree. I never knew that before. He died fairly young and when I was young so I never knew him when I was an adult and could be taking in those kinds of facts. Wish I could have talked to him about it.

I love old photos and actually the scanning and cleaning up of them. It's like magic when you can get details out digitally that your eye can't see on the print.
Click to expand...

Preserving the family history and sharing it with current younger generations, and hopefully with generations to come, is important, but so few people take the time to do this. I've been asking my mom for years to sit down for a few minutes each day, and just write down some of her childhood-and-beyond memories to share with us all. So far, she hasn't done this. How sad, that is, especially since she just lost a very beloved aunt as well as her brother this year. I want to read her wild stories when she's gone, and see her as a whole person, and not just as my mom.

Actually, we should all be doing that. We never know what tomorrow is going to bring, and I want to be remembered by my family. I want my nieces and their kids to point to a photo of me and say, "Did you read the stuff she wrote about her life? What an interesting woman she was! I'm surprised she lived as long as she did!" *LOL* (Trust me, I'm lucky to be alive at 55 due to my wild younger days!)

Sheila, you're lucky that you love scanning and cleaning up old photos. Since cleaning up photos is part of my normal job, cleaning up old photos with scratches and dust (I need a couple of pairs of good white cotton gloves) and stains and color distortion isn't my favorite thing to do in my spare time. But I do it whenever I can, and then load the photos on my mom's digital picture frame, and share the photos with appropriate relatives.

Some day I hope to take all of my dad's home movies and video tapes and convert those to digital as well.

Suze
 
Suze, I think I would love your job. Heck, at this point I would love almost ANY job. Freelance is not supporting me now. I used to do some old photo clean up as part of my former job, but there was another guy in our company that mostly did that.

I think doing my own family stuff is more interesting because the subject is interesting: who do they look like, etc. There's an aunt on my paternal grandmother's side that looks like my younger sister in costume in a photo from c. 1915 - at least to me.

Unfortunately, there are no younger generations that these family records will go to. My sisters and I did not have kids, my aunt's daughter died very young, and my uncle never had kids. My mom and aunt's two uncles never had kids either. I think they had an aunt that did have kids, but I don't know those cousins. All four of my grandparents were either only children or had 1 or 2 siblings, which is odd for the generation born at the turn of the (last) century. Very small families.

Yeah, I'd like to be remembered too, but that's not going to happen - no one to remember me. But you are right, people should be leaving written or spoken family histories. You could audio record your mom. Maybe sit down with her over tea or coffee and ask her questions about her youth and relatives she remembers. Then you can transcribe it later.
 
That's so sad that there are no younger generations for your immediate family. I thank God my sister had kids, because neither I nor my brother did.

Sheila, you WILL be remembered! Maybe not by future generations of family, but by all of those, here, who you help daily, and by all of the other non-FD friends in your life. You still need to write down those memories, and make sure that they will be found upon your demise so that they can be shared with all of your friends.

As for my mom, my asking her questions won't cause her to admit to the dirt. *LOL* She needs to type out that stuff, privately, when she thinks of it, and realize that no one will read it until she is gone. Otherwise, she is very emotionally constipated and doesn't share a whole lot with her family/friends. Unlike me! *LOL* I display my thoughts and emotions like a neon sign on my forehead. Not always good, but that's just how I'm wired.

Suze
 
Suze,
I just want to say do not feel alone! I have no more of a clue about FD, insulin and cats after almost 2 years at it. My Miss is an enigma. OTJ within a month of dx, off insulin for 4 months, back on for no discernible reason and unregulated since. Tons of money and tests later, I am only thinking I might be making a breakthrough.....but that is wishful thinking on the basis of less than a weeks worth of numbers :roll:
I hope things smooth out for you soon. I know Missy's bounces seem to have finally leveled out on the Lev.
 
Mares:

It looks like Missy has calmed down a lot with her BG levels just since 10/2/12! :thumbup I hope that remains the case for you and Missy, and it's smooth sailing for you from now on! <--insert anti-jinx

The Humilin R is a fast acting insulin, isn't it...to kick start the process and add some oomph before the Levemir kicks in?

Compared to what you have been going through with Missy, I have nothing to complain about with Pumbaa. So far I am very, very pleased with Pumbaa on Levemir, and how he has smoothed out. And he's acting so much better now that his numbers are more even. Now I just have to get his numbers down, and pray he doesn't develop any complications (infections, etc.).

I think the worst thing for me is that I am a "fixer" of things that need fixing, and my logic and common sense don't work in relation to FD and Pumbaa. *LOL* Once I finally get that through my thick skull (if I ever do), and learn to go with Pumbaa's flow, instead of trying to be the one in control, I'll be fine.

Suze
 
Suze,
Oh I SO know the feeling!! In my 'other' life, I troubleshot aircraft electrical systems. Things were right or they were wrong. So, it has been so frustrating for me with Miss. Esp since she was OTJ within a month of dx and off insulin for 4 months. One would think you could figure out what changed! We have had every test I can think of run and cannot find anything, as yet. She did test positive for
Lyme disease, but has been treated and retested and is clear. Her tli was slightly low and we are waiting on the retest results right now.
I have noticed she seems to feel better on Lev than she did on Lantus, even when he numbers were higher.
She has settled down lately. (whew!) Yes, R is exactly what you descibed. I was scared to even try it, but saw how it was working in Lu-Ann's Grayson, so thought I would try it. It is seeming to help for a longer period of time than I expected. I don't really understand why, but I am enjoying it! She has made me crazy the last year or so. grr_red But she is so sweet, I just can't quit trying.
I was just saying to a friend how I have to quit trying to understand what is going on and just go with the flow, but it certainly goes against my grain. You would think someone with MS would get that!
It is just amazing how they wiggle their way into your heart, isn't it? And I think we are even closer since the FD. All I want is for her to feel flip_cat good!
 
Mares:

I can't even begin to to understand how you felt when Miss went OTJ so quickly, only to go back to needing insulin again after 4 months. (((HUGS)))

I agree...I think people like you and me need to stop trying to think logically about our cats and FD and just follow their lead in the dance. It goes against my grain, too! *LOL* And trust me, I'm not saying that others who have a better grasp on all of this don't think logically. I think that people like you and I are more black/white, right/wrong, broken/not broken thinkers and the people who do a better job of understanding and dealing with FD are more capable of dealing with the gray areas in between the black & white. It's just how we're wired, I think.

You're dealing with MS and with Miss and her problems? My heart goes out to you! :YMHUG: Dealing with wonky syringes and frequent BG testing is hard enough without MS, especially with a wiggly cat.

I know what you mean, though, about feeling closer to Miss now. After all I've put him through since April when he was diagnosed (and bit me hard enough at the vet to require an Urgent Care visit for me, for antibiotics and a tetanus booster, as well as filling out an animal bite report and having him quarantined in my house for 10 days--not a problem since he's always been an indoor-only cat), he's now a combination juvenile delinquent and Mr. Lovey Dovey. He frequently sits on my lap purring (and trying to knock the test supply case on the floor simultaneously) while I test him. And now, two weeks after starting him on Levemir, he no longer hides at feeding time, as he no longer dreads the injections since Levemir doesn't sting him like the Lantus did.

May what you are now doing with Miss continue to work for you! And may she go OTJ once again! <-- insert anti-jinx

Suze
 
Sheila- you will be remembered. Those shawls and capes you make are lovely and unforgettable. As for the family history- check into genealogy clubs or a library that has genealogy department and see if they would be interested as a depository for the information.

I have long ago relatives from Europe, missionary great-grandparents to Africa, grandparents and a parent who lived in Africa, others in New Zealand- all with a history our generation doesn't know. We keep telling my grandmother she needs to write stuff down. I think I will get a voice recorder and give it to her this Christmas as she has her 90th birthday in January. My aunt can get the recorder from her and download it on-line when it gets full. Though we have a very prolific family tree- 6 kids from the original great grandparents, around 15 grand kids, and looking at probably 60-70 great grand kids and at least 6 great-great grand kids- we aren't going ANYWHERE :lol: I just found out that my grand dad was allergic/food intolerant to salad- which happens to be a problem that has cropped up for me recently :sad: . Apparently he had some trouble on his wedding day as the rehearsal dinner had salad...
 
The nature of live is to move forward and to leave some kind of legacy for your kids (stories, photos, etc.). I feel like I am rapidly approaching a brick wall......

Anyway, I think that whatever way you can encourage older relatives to tell their stories is good. Some will write, others will just want to talk/tell you in person and you have to record or write down things. I think it is easier to record so you don't miss anything.

Heather have you done any food allergy/intolerance tests - like elimination diets, etc? Both of my sisters have a gluten intolerance (celiac) and I have had problems which I kept thinking were celiac, but turned out to be lactose intolerance. My point being that it is very hard to pinpoint the problem food because we eat so many different foods, with even more ingredients in them, every day. To me "salad" could be lettuce, tomatoes, any veggie in it, dressing ingredients, croutons on top, etc. It's a painstaking job of detective work to figure it out.
 
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