I wanted to give you some more info and also check in with you about dosing.
First, the dosing. You all made the move to all wet so you could give TR a try but, with the last reduction, you reduced under SLGS. You left SLGS in your signature line so is that still the way you wish to go?
The reason I’m asking is we need to be very careful about taking back to back reductions. He’s still at a dose that’s high enough to have a large depot. The depot can affect up to six subsequent cycles after a reduction. That means that the 54 from today could still be from the 4.25u. With TR, we would not take a reduction because he didn’t drop below 54. I know you will ask if he would have dropped below 54 without the HC? I don’t know. It’s possible or, if you had fed LC or MC, it might have just stopped him at 54 and kept him flat there. I’m not saying you shouldn’t have fed HC; a drop that much that early does require a little more than LC. Point is, we dose based on what we see and and what “might” or “might not” have happened.
I’d like you to look at
Lucy’s SS and scroll down to about 10/4/2008. Lucy was on TR and headed quickly down the dosing ladder dropping from 3.25u to.1u in a few weeks. And then she hit a wall. Libby had to go all the way back up to 4.25u before Lucy started back down and eventually went OTJ but Libby always said she learned a lesson about taking so many reductions so quickly in such a short time.
To answer your question about the reduction....it depends on whether you are sticking with SLGS or TR. If it’s SLGS, any time he drops below 90, he gets a reduction. IMHO, that “could” result in too many back-to-back reductions too quickly until one reduction is too many and he hits that wall and progress stops or stalls.. I don’t have a crystal ball so I can’t tell you exactly how SLGS will affect Henry.
OTOH, switching to TR means you hold doses until he drops below 50 so he would then
not have earned a reduction today. Holding onto good doses longer, especially when they are doing this well, gives the pancreas more time to heal. I know you won’t believe me but there will be a time that numbers in the 50s won’t scare you. But....will you be more tired? It’s likely depending on whether Henry drops and when he drops.
But, it’s really important for you to make a decision. Summary:
SLGS.....reduce the dose tonight to 3.75u
TR....hold the dose
We are here to support you all.
I’ll check back at +6.