11/2/10 Squamee AMPS 287 .9

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judy and squamee(GA)

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AMPS 287. Lot of eating this morning for several hours before shot. My Glucometer battery went dead and I had to run out and buy another. Also bought a second Glucometer so I will have a backup on hand.
Her mouth symptoms are definitely less, and the Fortiflora is still working! :-D
 
If one throws enough stuff against the wall, at some point something's gotta stick. And Judy, you been a mad stuff thrower. I hope some stuff sticks here for you - you guys could take a good break. :smile:
 
Well, I would say up. But if you think up was what was causing the numbers to get wacky last time then you might go down? I don't know about down since that is not my baby. You could PM Joanna to look at this topic.
 
If it were me, I would probably stay at 0.9 until the data is clearer. You had a nice U-curve yesterday, so no reason IMO to try anything under 0.8, and the #s are good enough (barring ketones) I don't see a need to rush to higher doses. You may find if her eating patterns are changing a lot that her insulin needs will change too, so it may just be confusing for a while, but you are doing great, so no worries! :) That's great she is eating well, yay!!! Today's curve is a little funky, but it doesn't look to me like the dose is too high, so I'd probably just stick with it and see what happens. Could be her eating patterns affecting things, who knows.
 
Err yea I realized I did not make clear that I would up if the numbers tonight were a lot higher like you were potentially expecting.

"Flat" curves [if you end up with one] are usually interpreted here as not enough insulin. But for your sitch and for today a flat curve is just fine. If the PSs are about even I would stick with the same dose for now. Under 300 is OK territory for your current situation. Hopefully you could improve a little on that over time but for now under 300 is way cool.
 
Thanks,all. THe 226 at +10.5 made me think I should stay with .9. But this stuff is really crazy making. How can you possibly figure in the nadir when you never know when it is? Why should she be hitting her low point at +10.5?
 
First up, they say ProZinc nadir moves around for the first 45 days, so nadir data isn't that reliable supposedly during that period.

Second, there are "factors" :lol:

- if their eating patterns are different day-to-day that can change the pattern - for instance one day maybe she didn't eat from +4 to +6 and got a nice clean +6 nadir, another day chowed down at +4 and muddied the numbers (nothing wrong with that, it just can make the data more confusing to interpret)

- they seem to me to have some weirdness on PZI where they will throw unexpected #s at you if the dose isn't "perfect" (they are SOOOOOO fussy!!!!!!!!!!). If I overshoot with Bix, he will often stay flattish til late in the cycle, then drop down to a good #. I think of it as his body protecting him from the extra insulin, so maybe instead of a 40 nadir at +6 I get a 200, but then at +10 I'll see a 120 and realize I overshot. I'm not really sure that's how it works, just how I think of it. (and in those cases he'll usually have a pretty low +12 whereas Squamee is headed back up, so I'm not sure it's the same pattern in today's case, doesn't seem like a late drama-drop that would suggest overshooting to me)

So I tend to think if you have a day with a perfect U-curve and you can see the nadir in that, that's kind of your measure. If that nadir is at say +6, and then you have a day with a nadir at +4, and another with a nadir at +10, I'd say something was off on those cycles - dose was too high, or maybe too low, or maybe other factors were at work. Or could just be the ProZInc adjustment factor.

I know that doesn't really answer any questions for you :) I do think there is quite a bit of mystery to a lot of it. Lori can quote the funny song if she is around, what is it? "Will she be high? Will she be low? Nobody knows." or something. I would try not to worry about any one number, or any one cycle, and go with overall impressions more. If it's mostly U-curves, good. If it's mostly numbers under a certain level, good. If you can get perfect results, great, I'm just thinking you 2 probably need some rest!!!!!!!!!!!!!!! :mrgreen:
 
p.s. not to mention a sputtering pancreas, which she likely has - I have very little idea how to decipher that aspect of it, but with Bix's sputtering Panc I do see a fair amount of variation in #s and in response to doses, which makes it uber-confusing
 
I know I am probably being too obsessive about this, but if the nadir moves around, how do you know when to test? And if you can only test once in the middle of the day, how do you know if that is an accurate reflection of the low for the day? I think maybe I am having a tantrum because everything feels so out of my control. TOday my grandson told me, "We are going to play a game, and you have to take what you get, and no fussing" I think I have to remind myself of that here. Test what you can, take what you get, make your choices, and NO fussing!
 
Smart grandson, wow!!! (I'm sure he got it from your side of the family ;-) )

Even if you did pinpoint a nadir, there's no guarantee it will always be there, and no matter how much we test, we really don't get everything. I mean who knows, maybe the BGs spike up and down all day and we just don't see it. With high flat rebound, I've seen speculation that there's an unseen dip to low #s and then back up to high and it just never gets tested. Unless you have a continuous monitor (talk about opportunities for obsessing there!!!!), you really don't know what's going on all the time.

I see our testing as a guidepost - you'll never know 100% the low or high for the day, but you can often see trends, and you can try to stay within some "safety" boundaries. I think that may be why many vets don't want you to get #s as low as 50 or so - even if it's safe, there's not a huge margin for error, and especially if you are not hometesting that can be risky. I think that's part of why for years people have been happy with sort of the 300 PS, 100 or 150 nadir as a target - it's not super-risky in either direction, even if it's unlikely to lead to remission.

You may get some insight from those who have used Lantus or Lev - I don't think the nadirs on those are as clearcut as on PZI (?). I'm not really sure how they cope with that.
 
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