Jay
Yesterday you had a question mark in your subject line which to me indicated you had a question or needed some help. You were not comfortable shooting a bg of of 180 and leaving for the day which is understandable. I gave you some options which are pretty much the standard here for when a ps is too low for somebody to comfortably shoot and leave. One of the options was to not feed and stall 15 minutes to see if Frankie's bg was rising. After I gave you that option I realized that your post was an hour earlier than I had seen it so you had decided to feed wait an hour to get a rising bg which you got. The information I gave you was so if it happened again you would have some options.
Many people here work full time and some work two jobs and don't have the luxury of testing during the day. Many people also work longer than 12 hours some days and have to adjust their shooting schedule accordingly.......but they still follow the protocol of Lantus as best they can with the obstacles that go along with a long work day.
Lantus is a slow acting insulin. which means it will take longer to get into the system so the need to feed right away is not as important as it is with fast acting insulin's. When I suggested you not feed while stalling is so you don't shoot on a food spike number that may drop again.
Your reply to my options from yesterday are below.
I do not want to get into a debate with your or have a war of words but you seem to want a quick fix for Frankie so that his ps falls into one specific range of numbers and his nadir falls into another. That would certainly make life a lot easier for a lot of people here who have the same work schedule as you but unfortunately the pancreas and the liver don't always cooperate with what we would like them to do.
"I dont want to get into a war of words with you either. We went fron 220 PS over the last 4 years to over 300. I'd prefer the former as would every one else. No? I firmly believe that regardless of 'settling time" (shouldnt his shed be full by now?") that I am underdosing him by a large degree. I will not raise his does until I am around during the day to see how he reacts to an increase, as I want to make sure he is safe. If his "shed" has yet to fill doesnt that indicate that I have been underdosing?I think you should read or reread the stickies at the top of the Lantus board on how Lantus works. Take some time and look at other's spreadsheets. I know you have been using the same insulin for 5 years and it is hard to start over and relearn about a new insulin and unlearn everything about the old insulin but in order to do what is best for Frankie on Lantus that is some advice I hope you take.
You cant begin to imagine..waiti yes you can.. you were here when you heard the words "your cat has diabetes" , how frustrating this is for me and how unhealthy this is for Frankie.
Many people here also are the sole caretakers of their cats and they work the protocol with adjustments and many of those people are close to having their cats go OTJ or are already OTJ.
As I expained in earlier post, 4 years ago or so, I held an ineffective dose far to long to allow Glucose Toxicity to destroy his ability to have his Beta cells repair themselves fast enough, for those cells to then procuse his own insulin.
I hope and pray that isnt the case with every shot I give him
Today you are concerned that Frankie's ps is too high. Since you are not home during the day to test you have no idea how low he is going. Dosing with Lantus is not done by ps but by nadir. The best you can do right now with your schedule is to collect data at night when you are home and on the weekends when you are home. That will give a better indication of how Frankie is reacting to Lantus. He may very well need an increase but if you solely base it on his ps the very thing you are worried about may happen....that he will go too low during the day when you are not around.
The above is what I must do, which is why he wont get an increase till Friday this week or Sat.Everyone here is trying to help you do exactly what you want to do which is keep Frankie safe.
There are some very experienced people here to offer some great advise and some new people that can also share what they have learned and are learning with Lantus. You ask for the help but then seem to want to find reasons as to why what is suggested won't work. We are all working toward the same goal here. We want to help our cats as well as each others.
I I really do appreciate the help for sure, and it is very intuitive on your part about my not want to take the advice some have given. That is based soley on Frankies numbers and my frustration at seeing those numbers day after day without any downward movement. Its also in large part based on my attempt to better understand the "why's as well as the why not's" of a certain course of action. Protocols are great in a very controlled environment, however not understanding the reasons why I can or cant do something is troubling to my sense of reason. The last reason, when I post in the morning I am running to catch a bus and I wirte without re-reading and write quickly
Hopefully what I have mentioned here, gives you a better insight into my posting and behavior.
Re: Frankie: +14 AMPS 245.
by Jay » Mon Mar 15, 2010 6:19 am
I fed but i whatever went in came up and out on my carpet 2 minutes later.
FF is gotten progressively un eatable for my 2 guy.
I finally got some food into them both that stayed down. Yippee, made my day.
I wont shoot without food going in. Thats like drinking alcohol on an empty stomach. I wont shoot (now that I wont be home all day) under 220.
We dont have the luxury of following a tight protocol as I have to catch a bus soon to get to NYC to get to my office. As I have said a few times, we need a dose that I can just shoot and forget. At this point its only PS tests that I can do and my only goal is to keep him from 80 to 100 at his Nadir and between 220 and 250 at PS. Not much else I can do, unless I clone myself and can be in two places at the same time and not worry during the course of the day that he is too low. Too high I can deal with, too low when I'm not here is not an option.
Sorry if that doesnt fit the protocol but what else can I do? I'm a sngle dad to a diabetic cat.
Jay
