11/26 Clare AMPS 280;PMPS 460. Dosing Question?

[Georgette and Clare]

Good evening, Lantus Land neighbors!

We're sending lots of healing wishes and hugs to the kitties and beans who need them to tonight.

Yesterday's Condo

Today's News:

AMPS 280
+2 279
+4.5 371
+12 416

PMPS 460 (Gave shot two hours late)
+2 288
+4 280

We'll raise Clare's dose back to 0.5 in the morning. We've been here before, and it looks like we need to find a middle ground between the higher and lower dose.

So from earlier discussions I think we have three options: (1) Continue to toggle between 0.5 and 0.25 every 6 cycles or so; (2) Stay with the 0.5 dose and manage with higher carb food and timing mini-meals to match the insulin; and (3) find an intermediate dose between 0.25 and 0.5 and use calipers to ensure accurate measurements.

When we talked about it today, DH, who gives the shots, proposed a fourth alternative: (4) Alternate between the 0.5 and 0.25 doses.

So I want to ask the Board what you think about this idea. What if we tried the 0.5 dose in the AM, and the 0.25 dose in the PM, or vise versa?

Please tell us your thoughts.

Thanks,

Georgette and Clare

 

[Marje and Gracie]

Hi Georgette!!

Creative thinking on DH's part but doing that would wreak havoc with her depot. You want to shoot the same dose as consistently as possible unless she earns a reduction or needs an increase.

The 0.5u dose got her into the 30s. While the protocol says go back to the last good dose in the case of a failed reduction, the last good dose is not one that got her into the 30s

First, I'd see where she's headed tonight. She's already had a significant drop (although....her SS says PMPS was 358 and subject line says 460). If she gets into green, I'd hold the dose.

If you feel you need to increase the dose, I'd probably shoot a fat 0.25u. That's where the calipers come in really handy....that way you both know you are shooting the exact same dose every time. It can be challenging to shoot those in between doses consistently. I know I can't eyeball an in-between dose consistently (but some can).

I'll check back in later for questions but I'm wondering where she's headed tonight!

 

[Georgette and Clare]

Thanks, Marje,

We gave Clare her shot two hours late tonight (by mistake) and will gradually get back on track. I need to correct the SS; the numbers here on the condo are correct. Clare has come down quite a bit so far tonight but has leveled off, so I think we'll go up to the fat 0.25, unless her AMPS looks significantly lower or you feel that we shouldn't.

She's definitely not bouncing like she used to do. Could it be the food? She was on mostly 4-5% before (9 lives) but she likes the 3% (Nature's Variety Instinct) now. Could that small difference in carbs do something to help to level her bounces?

Whatever it is that's helped her clear her bounces more quickly, it's definitely on my list of things to be Thankful for today!

You are, too! Thank you for your knowledgeable support and for your very steadying, comforting presence. We simply couldn't do this without you and our other Lantus Land friends! :YMHUG: :YMHUG: :YMHUG: :YMHUG:

In gratitude,

Georgette and Clare

 

[Marje and Gracie]

I'm definitely one that sometimes rushes taking the dose back up. Ideally, when you reduce the dose and they clear the bounce, they should come right back down to blue. They don't always. I've done both....increased after four cycles when I didn't get any green or even low blue and I've also held the dose to see if she was just slowly responding to the reduction and was still a bit bouncy. Blue numbers can be bounce numbers.

You test Clare enough that I think you can just fatten the dose and see if it will bring the green back if you don't like the nadirs you are getting right now. I also don't think it's wrong if you give her two more cycles to get past the holiday to see if she wants to really clear the bounce out. The 460 tonight could be the high before the break and you might wake to a low blue/high green number. Only Clare's pancreas knows!

I don't think the change in foods changes the bounces. The liver starts to get used to better numbers and does a little less panicking.

Thank you very much for your sweet words. We all were new at one time and needed alot of help; we just pay it forward

Hugs to you and Happy Thanksgiving!