12/30 Cali AMPS 327 +3=348

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beclt

beclt

Member Since 2011
Today we decided to slightly up her dose to 1.25 units. Hard to imagine that such a tiny bit more insulin would have any impact, but we will give it a go. If we don't see any further results, we will go to 1.5.

I was a bit discouraged that her +3 number this AM was higher and that she was in the 400s yesterday. You can see her spreadsheet below--it is up to date.

Also--any suggestions on not getting air bubbles into the syringe? i feel like I am wasting a lot trying to get the air out. I see some tiny air bubbles in the pen--hoping that isn't going to ruin it quickly.

Second question--where can I get more Lantus? do I buy it online? I got the first pen from a fellow board member, thankfully.
 
Hi There, I haven't stopped by your condo before and wanted to say hi and welcome! BTW Cali is gorgeous!! She's got very pretty eyes.

I think we all have problems with bubbles and you'll probably get a zillion different ways to get rid of them. We all have our ways! What I do is draw insulin, a little more than I need, flick the bubbles to the top then draw air and twist The plunger to get all the air out. What used to take me 10-15 minutes I can do now in about 3 minutes! :-D

I think alot of people order their insulin from online pharmacies from Canada, as it's way cheaper up here. I live in Canada so I just buy from Costco.

Good luck!
 
i saw your post yesterday about the bubbles - did you look at the video in the "taking care of your lantus/levemir" sticky? there are some tips there, depending on if you are using a vial or a pen.

trying to remember why it was that you said you are using u-40 syringes with lantus . . . can you tell again, please? are the doses on cali's ss reflecting what is seen on the u-40 syringe or is it what's the "real" lantus dose, which is 2.5x as much?

that 280 at +10 yesterday and then 437 at pmps might be saying that cali got lower mid-day and began bouncing. hard to know what happened. if cali were mine, though, i think i'd hold the dose and not increase just yet. just my 2cents!

i buy from a local pharmacy that is willing to sell 1 Solostar pen to me.
 
OH, and i just put 2 and 2 together - if you were given a pen when you started in mid-november, and it's now the end of december (6 weeks) and you've got tons of bubbles, add in some high numbers, and it could be the lantus has gone bad. when our lantus has died there have been a ton of tiny tiny bubbles that you simply can't get to coalesce so you can push them out. it's like the tiny bubbles are integrated into the liquid rather than an issue in how you draw the dose out of the pen/vial.

is that what you're experiencing? if so, it may be the new insulin will solve your bubble problem. do make sure you read that sticky, though, because lantus will last longer if you're taking care of it the way it wants.



edited to add - ok i'm a bit confused. looking more at her spreadsheet i see that you've only been on lantus since 12/26 and had new prozinc since 11/16 - was cali on prozinc before that? was the lantus you were given unopened?

if that's all correct, then the lantus takes a while to form a deposit. you had 7 shots at 1u and 1 at 1.25u (again, is that the 'real' lantus dose?) so you want to hold a little bit longer. here's the guidelines for the stage you are at:

Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of this Tight Regulation Protocol for the last few years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting the forum.

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Click to expand...
 
Hi There--a few answers.

1.) we are using u-100 syringes, which I understood was the correct ones to use.
2.) We were on prozinc up until 12/26, which is when we started Lantus
3.) The Lantus pen was new and was placed in the fridge by our friend from the board Tuckers Mom. She left me a pen to try and it was new.

Yesterday I was told that if she has high, flat curves, for 24-48 hours, that we should increase slightly, which I what we did. Only .25 though. I don't think it is bad that we did that, if we should have waited, as she has always been high. Sorry--there were just a lot of answers/suggestions so we did what we thought was best. We can hold on the 1.25 units for a bit though.
 
Per Jill's suggestions, I would continue to increase every 2-4 cycles by .25u until you see some progress. If she stays really high, I might opt for an increase after every 2 cycles. If you see her start to come down, then back off of that. We want to get her into normal numbers as quickly as possible and considering her PZI dose was much higher, it might take a bit of doing to get her into blue.

My apologies....my statement was incorrect. Let me put exactly what Jill stated in your condo:

the TR Protocol has a provision which allows for the dose to be increased after 24 - 48 hours for kitties who are getting high flat curves instead of holding it for 3 days as suggested in the "modified" general guidelines.

if you are able to monitor, you do have the option of increasing the dose by 0.25 unit. considering it took 2u of prozinc to drop cali into the 100s and 2.2u to drop her into green, it's probable the starting dose of lantus was too low to begin with.
Click to expand...
 
Becky --

Don't rush too quickly into dose increases. Lantus doses need some time to settle. From what I can tell on your SS, you're not home that much during the day. If you push the increases, you may have no warning if the dose is too high and you're not there to test. One of the toughest lessons to be learned from using Lantus is patience.
 
re: getting rid of bubbles in the syringe:

this was written several years ago by greg/carmelita. it might be of some help.

"We use the BD Demi+ syringes, and hold them with the needle pointing at the ceiling for most of this process.

For each shot, we do these things:

Throw away the plunger cap and move the plunger a couple of times. (Jojo told us that spreads the plunger lubricant)

Make sure the plunger is all the way to the needle end, uncap the needle, and insert the needle into the insulin cartridge.

Pull the plunger back pretty far, maybe the 4 or 5 IU mark. The vacuum inside the cartridge "fights" this; it goes slowly.

The insulin will start moving into the cylinder very slowly, watch to see how much is in the syringe.

When there is about .5 IU more insulin than needed, withdraw the needle from the cartridge without moving the plunger.

This causes the insulin to move down to the plunger (away from the needle), and the air goes up to the needle end.

Put the cartridge back in the fridge; do the rest of this over the sink.

Press the plunger to expel the excess air at the top. (don't skip this step, even if there are bubbles! The less air is in the syringe when you flick on it, the easier it is to form a single bubble that can be pressed out.)

If there are any bubbles at this point (often there are not), flick the syringe to bring them to the needle end.

Twist the syringe while pressing the plunger slowly to expel any remaining air, and to "dial in" the desired dose. This way, you can see if the bubble is sticking to the side, because you're rotating the syringe and looking at it from all sides.

If there's a bubble stuck to the side of the needle collar, draw a tiny bit more air in to join it, and then rotate the syringe the opposite direction to last time, while pressing the plunger. This spins the bubble together and hopefully centers it on the needle hole so you can squeeze it out.

Because we do micro-dose, when dialing in doses, we try to hold the syringe so the angle on the needle is facing up. This way, the little drop of insulin that forms there can be pulled back into the needle without bringing air, if we accidentally dial the plunger in a drop too far.

That's it, ready to shoot. Now... find the cat....

This method gets easier with practice, and seems to make it snap to get rid of bubbles, without introducing air into the cartridge. The trick is, unless you can make a cartridge that works like Lantus, there's no way to practice this with water or whatever. It won't work drawing liquid from a drinking glass. Maybe this is what old Lantus cartridges are for... "


many of us get tiny bubbles in the pen. eventually they'll collect and make a large bubble. some people use a syringe to draw the air out. i just leave it alone and ignore the bubble if i happen to get one in the pen.


happy to see you've increased the dose to 1.25 units. good timing. with the weekend upon us, you should be able to monitor carefully.
good luck with the new dose!
 
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