2/23 Michelangelo +12/104, AMBG 100, +7/113, PMPS 146

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KPassa

KPassa

Member Since 2012
Previous Condo.

Not sure if I should have shot today, but I didn't. It's like a repeat of the 21st (my last condo), which I still have yet to see a significant bounce from skipping that shot.

In the past month since both Henry's arrival and Michelangelo's 10-month birthday (2/13), Mikey has seemed to have stabilized both with growth spurts and dose increases as well as eating half as much food as he used to yet getting twice as much exercise with his new playmate. I think these have all contributed to how smooth things have been these last few weeks in regard to consistently lower numbers and a generally better overall disposition. Could these have also contributed to a needed dose decrease? I don't want to lower him if it's just going to bring his numbers back up because he hasn't dropped too low yet on this dose to justify a decrease, but since I've had to skip twice now in the past three days, does this mean I need to lower his dose again?

I think I'm mainly just scared of suffering from déjà vu with December's dose-bouncing all over again. Basically the entire month was a toss-up/toss-out. He started out at a fat 1u, went up to 1.25u, then back down to 1u, then down further to .75u before going back up to 1u and ending at 1.25u the day after New Year's (and then 1.5u a few short days after that). That was the most stressful month of this entire affair so far in terms of the amount of testing I needed to do to make sure each dose increase/decrease wasn't too much/too little. I don't particularly want to relive that. :?
 
Re: 2/23 Michelangelo +12/104, AMBG 100, +7/113

The first two weeks after Mikey's diagnosis back in October, I was shooting blindly because my vet and I were both under the impression that since he was a kitten, his hyperglycemia was temporary and a side-effect of an infection (the UTI). At the time, I only vaguely knew about hypoglycemia from hearing about it from human diabetics, but I noticed that every few days, Michelangelo was seeming to go too low on the shot so I was purposefully skipping a shot every now and again. My vet thought this was bad because Lantus doesn't work that way and needs to be given twice daily. I'm glad he knew that much at least; he just didn't know about basing dose increases on nadir (which is when I kept explaining to him that Mikey seemed to be "going too low" in the middle of the day) and promptly upped Mikey's dose from 1u to 2u. This was one of the biggest reasons I first started looking into home testing because I subconsciously knew 1u was too much and there was NO WAY I was giving him 2u without first proving the increase was necessary.

(Of course, the other biggest reason for me looking into home testing and finding this wonderful place is because it turned out his diabetes wasn't transient and if I was going to be treating him for the rest of his life, I wanted to at least know what I was doing and why I was doing it!)

Either way, that entire long story was because this is how it's feeling again: the dose isn't exactly too high (he isn't dropping into hypo territory or anything), however, I have a feeling it's because I'm skipping a shot every couple of days that's preventing the buildup that would potentially cause a hypo? So, does that mean this dose is still too high? Ugh! I'm so confused as to what to do!
 
Re: 2/23 Michelangelo +12/104, AMBG 100, +7/113

the down side of skipping shots when he is lower at shot time is that you may never see the <50 numbers that make the need for a dose reduction obvious.

I can think of a few ways to handle this:

1. bite the bullet and give the shot when you are home and able to monitor, and see whether he surfs nicely in the 60s-70s all day or drops lower.

2. use the guidelines in the SLGS approach, which would have you go ahead and reduce because his nadirs are getting on the lower side of green.

3. take a guess! Reduce if you think he would have dropped below 50 if you had shot. Be prepared to increase again if the reduction doesn't hold.

4. keep things the way they are, and keep monitoring. It looks like he hit pink last time you skipped a shot, but it didn't last for long.
 
Re: 2/23 Michelangelo +12/104, AMBG 100, +7/113

Thanks for the options, Libby and Lucy! That really helps clear up my uncertainty of what to do next.

I think I'd rather stick with options 1 and 4: Option 4 for right now and Option 1 on a weekend night that I can effectively monitor him. I'm not a morning person and I work during the day, so I'll probably continue skipping his AMS when his AMPS is that low, however, I have no problem pulling an all-nighter! I'm planning on shooting the next low PMPS I get...as long as I don't have to work the next day. If he drops too low, then I'll decrease, but at least this makes me feel more comfortable to hold off decreasing him unnecessarily.

And if I do have to decrease, since 1.88u was too little for him and 2u might be too much...I might end up having to twist drops out of his 2u to get him to 1.94u to see if that works. :roll:
 
Re: 2/23 Michelangelo +12/104, AMBG 100, +7/113, +9/102

1.88 may not have been too little, actually. He hit 43 on it, you don't want it to work much better than that. :lol: He bounced a little, and you increased the dose while he still was in the bounce. He may or may not have come back down to green if you had waited a couple more cycles before increasing. So far 2 units is looking ok, though.

If you were following TR, I would be yelling SHOOOOOOOOT!!! at these blue preshots, so I'm glad you're considering it.
 
Re: 2/23 Michelangelo +12/104, AMBG 100, +7/113, PMPS 126-sh

He hasn't really eaten anything since this morning; neither has Henry so I'm not sure if maybe they're just filled up from the morning all day long or sick with something??

Tonight would be a perfect night to shoot because I don't have to work tomorrow. I just don't know what I'm in for and am kinda freaked out. nailbite_smile

Libby and Lucy said:
1.88 may not have been too little, actually. He hit 43 on it, you don't want it to work much better than that. :lol: He bounced a little, and you increased the dose while he still was in the bounce. He may or may not have come back down to green if you had waited a couple more cycles before increasing.
Click to expand...

Yeah, that was on my Micro and I usually use the Prime. On my Micro, I've seen Mikey hit 26s and 28s while on the Prime, I see high 40s (which I feel is more accurate in comparison to previous numbers and his non-hypo symptoms). At that time, I cross-referenced the 43 on the Micro with my Prime and got a 57, which is why I wasn't too worried and why I increased his dose shortly after. I was using up an open box of Micro strips, so I stuck with the Micro reading to keep consistent with the other Micro readings I'd already taken throughout the day.
 
Re: 2/23 Michelangelo +12/104, AMBG 100, +7/113, PMPS 126-sh

You're going to need to decide which of the options Libby outlined you want to follow. You said you're home, have HC, and strips. At this point, it's probably been 30 min. since your last test. Re-test and see what's doing on.
 
Re: 2/23 Michelangelo +12/104, AMBG 100, +7/113, PMPS 126-sh

Tested and he was at 146. Gave him the full 2u since I've shot that number before. (Still going to keep a close eye on him, of course. :mrgreen: )

I do feel a lot safer shooting tonight than I would have this morning because it looked like he was still trending down this morning whereas now he's heading up.
 
Sienne and Gabby said:
At some point soon, you're going to need to screw up your courage and shoot low!
Click to expand...

Yeah, yeah. I'm getting there. :oops: I actually think tonight's 146 is because I had set out his PM food already when I got that 126 and I let him munch on it a bit while I mustered up my nerve to give him his shot anyway. The +12.5/PMPS test was just a courtesy test and to trick my brain into a stress-free state. :lol:
 
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