11/10 Pumbaa AMPS/153

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Pumbaa

Pumbaa

Member Since 2012
I missed a couple of daily threads so here are the highlights:

11/8 - Pumbaa had a high of 277 during the morning cycle, then went down to 66 in the PM cycle.

11/9 - Big bounce day. Pumbaa hit a high of 410 at AM +4, and was only down to 300 for his PMPS. He did clear the bounce during the PM cycle.

I'm going to try and run a curve this morning, Pumbaa's 7th cycle on the 2.25U dose. Since he's had nadir's below 100, I'm going to hold this dose for a few more cycles and see what happens.

On the home front, the good news is that mom's pathology report came back and there was NO sign of cancer in her lymph nodes, so no further treatment is necessary. :RAHCAT :thumbup flip_cat

The bad news is that I'm feeling cruddy/feverish/fighting off a cold or the flu, and my energy is still zapped. :cry: :-Q grr_red No big surprise, considering what my schedule was like the last couple of weeks.

Have great weekends, everyone!

Suze
 
Hi Suze!!!

I'm sorry I haven't visited your condo in a while. It's been busy here and in LL. Nice AMPS for Pumbaa this morning! I'm glad to see you are still following the TR protocol and I think it is a wise decision to hold this dose for a bit and let him see what he can do.

I'm glad your mom's tests came back neg on the pathology. What a relief for you all!! Sending you big healing vines and hope you feel much better soon.
 
Thank you, Marje!

Kinda/sorta following TR, except for reducing Pumbaa's dose so I could deal with everything the last couple of weeks. Whew!

Hope all is well for you all!

Suze
 
So happy to hear that your mom's path report came back with no signs of cancer cells in the lymph tissue! That is great news! I am such she, and your whole family, are very relieved. Now that the worry is over, of course, your body suddenly "caved" to the stress and you are sick. Feel better soon and take care of yourself. Rest and all that.

Looks like you re near the "fine-tuning" point with Pumbaa's dose - for now (seems that always changes). You might consider dropping to 2u after the curve if he is consistently swinging from 400s to 60s, but a technique to consider when doing that is to reduce on the low PS number, not the high one. The high one needs the larger dose to knock down those high numbers. I got so I could anticipate the pattern with Jeddie. He seemed to have a "normal" PS, followed be a low one, followed by a high one. If the next one were low or mid-range, I would reduce then - and no more than 10-20%.

I know you felt that 2u wasn't holding Pumbaa, so it is possible that he needs 2.15u or something. It could also be that he actually needs LESS than 2u. Maddening, I know.
 
Happy to hear about your mom- I know everyone is breathing a sigh of relief!

Good for the low, bad for the bounce for Pumbaa.

Oh, kitty, kitty, how doth your numbers climb
Be ye orinch or black or tiger stripped
Your purr is so sublime
You play and nap and eat and preen
Grey or white or calico
Tummy rubs means I love you so
So lower, numbers, do not bounce
Be low enough in healthy state
Make your bean happy for more food on the plate!
Sneakers
 
Sheila:

First of all, thank you for your happiness at mom's diagnosis!

Second, holy moly...I was going to raise Pumbaa to 2.50U tonight because of his high numbers today. With that AMPS of 153 and his 200 numbers last night, I feel pretty sure that he cleared his bounce. So I took his escalating numbers (329 at AM +9) to mean that he needed a dose increase. No?

I will hold off increasing tonight, which is no problem since I'm still sofa-bound and napping regularly.

Yes, it is maddening. I never know which way to go, and everyone makes sense. *LOL*

Suze
 
Heather, thank you so much sharing the happiness over my mom's diagnosis!

And give Sneakers a big purr-inducing petting from me for the poem!

Suze
 
Great news about your mom!

As for Pumbaa if you want to take him up tonight it should be fine since he almost certainly needs to go back up.

But I don't like to dose based on a single number or stretch of wonkiness. I think you can hold these doses for a total of 5 days at this point with no problem if you'd like. I've actually been holding for 7 now with longer stretches of green. Take another look at Chip's spreadsheet. Don't want to jinx but with any luck I was correct about how to stop Chip from bouncing. I may hold 2.75 for longer now if he can keep up the back to back greens. And I'll likely take the reductions slower this time to insure they hold.
 
Dale, too late to take Pumbaa up tonight. Sheila posted this morning when Pumbaa's numbers were still decent, but I wanted to see what her reasoning was for reducing Pumbaa instead of increasing him.

I check out Chip's spreadsheet almost every day. He's doing great again! I hope your slower dose decreases work for him this time around!
antijinx-emoticon.png


Suze
 
Thanks...I typed in the 2.50U beforehand to remind myself to raise him. *LOL* I just fixed the SS. (I had it correct on the dry erase board in my kitchen, though.)
 
He had a similar stretch of wonkiness the first time you hit 2.25 on Levimir, I wouldn't worry about it too much as long as he doesn't keep creeping up for days.

At this point it's probably best to stick with by-the-book Tilly and up after 5 days total.
 
Any time I see 60s followed by 400s it looks to me like too much insulin. But it could just be a "one time response" to low numbers and once the bounce clears he can hold more even on the same dose. I would actually have held 2u a few more days, but you had/have already gone to 2.25u so just stay there for a while. I am not sure I would raise him after tomorrow. I think he is still swinging a bit and the 300s later today were part of that. Even though tonight's PS is higher than last night's PS, the am cycle looks a whole lot better than yesterday's am cycle - so things are still changing and settling.
 
Dale and Sheila:

I think these days I am just petrified of Pumbaa going back into IR/GT that I just want to do something/anything before this occurs again. Hence why, before tonight's injection, I was all set to raise him to 2.50U...I saw his numbers this morning not as still being a part of his bounce during Friday's AM cycle (even though my brain knows a bounce can take 72 hours to clear), but as a sign that this wasn't enough insulin for him. *sigh*

Thank God I have you two, and others, providing input. (((HUGS)))

Suze
 
And he was a lovely 153 again - even one hour late. That tells me he is still sorting out this dose and an increase might (probably would) mess that up.

When the swings start, the best way to stop it (IMO) is too back off the dose until they stop then, if necessary raise more slowly (smaller increases and/or longer settle time).
 
And how about that 88 at PMPS tonight? He's still dropping, so I'm stalling.

I didn't try moving his injection time back tonight because of this drop. So 8 am and 8 pm will be his new time until we get him settled down.
 
Might be the "magic" dose (knock wood/antijinx)... will have to see if he bounces again, but as long as he can recover like this in 3 days again, I would NOT raise him. He may even need to drop back to 2u and hold that dose through a few swings to settle things down..

You will be getting some spot checks tonight, right? I would expect to see some greens in the 60s, or even lower.
 
Knock on wood and insert
antijinx-emoticon.png
, and from your keyboard to God's ear about this being Pumbaa's magic dose. (((HUGS)))

Yes, I will be spot checking Pumbaa tonight to see what he does. I'm still fighting off/recovering from the flu, and hope that I can get a nap in and wake up to my alarm to check my little guy, since I have been up now for 8 hours and really need some sleep. :(

It's times like these that I wish I had a designated other to take over for me. I know that many of us deal with our FD cats all alone, and that isn't easy, is it?
 
That's starting to look more like a nadir to me. :cool:

Go Pumbaa go!

I'd hold this for a total of 7 days minimum. And keep the new shot time for a few more days if you can swing it.
 
Dale: But last night he really did have a +8 nadir, so that's good.

I marked on my SS to hold the dose for 7 days. Unless, of course, he earns a dose reduction. And unless he bounces, in which case I'll wait for the bounce to clear before making any decisions.

Due to having to stall, his new injection time is 1-1/2 hours later than normal. Now I can see how, with Chip, that it's easier for you to not keep trying to get him back to a normal shot time. I hope I don't have to go that route. As it is, I have to put a post-it note on my forehead to remind me what the new testing times are. *LOL*

Suze
 
You're doing a great job, and that is a much more predictable nadir.

Leave the shot times for a few more days then you can move them back. I don't like to shoot early or move the times back when things are in a critical stage. You can probably stall (no more than 2 hours every 24) with no ill effect and often great benefit. I suspect it's moving them back (shooting early) which is more disruptive to the Levemir depot matrix. Perhaps kind of like you can step off a curb and land on your feet. But if you blindly walk into a curb you may trip over it. Disruptions in the depot matrix may cause instability, both uncharacteristic lows and/or bouncing. So shoot the full dose on time or no more than 2 hours late. No skipped shots or chicken shots or fur shots if you can help it.

When Pumbaa *snaps* into regulation things will hopefully get more predictable and easier without all the bouncing and diving.
 
Chippendale's:

Thank you for the good advice, and for the great curb analogy!

No skipped shots, chicken shots or fur shots on my agenda. (That reminds me, I need to buzz Pumbaa's fur again around his flanks. That makes it so much easier for me to avoid fur shots!) And hopefully I'll never have to delay a shot by more than one hour. *crossing my fingers*

Suze
 
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