3/26 Max amps 96

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Mindy & Max

Mindy & Max

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Yesterday: viewtopic.php?f=9&t=10175&p=100218#p100218

Right, so I went home yesterday and Max was astonishingly at a 70 at +10.5. He was only up to 85 at pmps, so I reduced dose again to 1.25. I really needed to sleep last night if my kids were going to let me, and I didn't want to worry about him. All his evening checks were good. I did check once in the middle of the night after having to feed my son (I'm so glad DH comes home today--maybe we can get back on our "normal" schedule!) and he was down to 94, so all was well with him.

Since he was still under 100 at amps, I kept the 1.25 dose and we'll see what happens when I get home today. I'm not worried about him going too low, just curious to see if he goes high.

So here are today's questions:
1. If he's still hovering around 100 at pmps tonight, do I continue with the 1.25 dose, or do I need to try pushing it back up to 1.5? According to protocol, as long as he's staying between 50 and 200 we can hold the current dose, right? My gut is telling me to hold the 1.25 (unless he starts showing yellow again) because he's going to continue to slide lower on his own.

2. In the unlikely event that his pmps is 85 or lower again, do I do another .25 decrease? I know that doesn't fit protocol, but nothing about his dosing in the last few days has followed protocol in the slightest.
 
Re: 3/26 Max amps 96--more input needed

1. If he's still hovering around 100 at pmps tonight, do I continue with the 1.25 dose, or do I need to try pushing it back up to 1.5? According to protocol, as long as he's staying between 50 and 200 we can hold the current dose, right? My gut is telling me to hold the 1.25 (unless he starts showing yellow again) because he's going to continue to slide lower on his own.
Click to expand...

Now that you made the change, hold the dose and let's see what this accomplishes.

2. In the unlikely event that his pmps is 85 or lower again, do I do another .25 decrease? I know that doesn't fit protocol, but nothing about his dosing in the last few days has followed protocol in the slightest.
Click to expand...

I would say hold the dose. 85 is a good number and is fine to shoot the regular amount. Remember shot is based on nadir not PS number.

Look at Maui's ss and you can see how we shot at these lower numbers and held doses (yes they were less than you are shooting, but the principle is the same).
 
Re: 3/26 Max amps 96--more input needed

Mindy & Max said:
So here are today's questions:
1. If he's still hovering around 100 at pmps tonight, do I continue with the 1.25 dose, or do I need to try pushing it back up to 1.5? According to protocol, as long as he's staying between 50 and 200 we can hold the current dose, right? My gut is telling me to hold the 1.25 (unless he starts showing yellow again) because he's going to continue to slide lower on his own.

2. In the unlikely event that his pmps is 85 or lower again, do I do another .25 decrease? I know that doesn't fit protocol, but nothing about his dosing in the last few days has followed protocol in the slightest.
Click to expand...

1. I agree with your gut, not to mention I strongly believe in gut/instincts.
2. I would not decrease another 0.25u unless the numbers called for it, Lantus needs it settling time, or someone who has been here for awhile, suggests it.
For me, there is no predicting what the next dose move will be until the current shot/cycle is over.
 
Re: 3/26 Max amps 96--more input needed

What Hillary and d said... :razz:
Max is doing so great!!! YOU are doing so great! Nice work in here!!! :thumbup
 
Re: 3/26 Max amps 96--more input needed

I have a different spin. You shot 2.0u with a BG of 86 on 3/21. I'm not sure why you reduced the dose on 3/22 with an AMPS of 103. If you weren't going to be home and weren't comfortable shooting the full dose with that low a number, that's understandable. I would have suggested bringing the dose back up to 2.0 at PMPS since you'd shot the 85 before. There's a very good chance that Max would have earned the dose reduction. At this point though, it's all water under the bridge.

I would not change the dose again. None of these reductions have been earned - they've been for safety/comfort. I'd be concerned that if you tinker with the dose, the reductions you've taken won't hold.
 
Re: 3/26 Max amps 96--more input needed

good points - Sienne..

Love coming here - learn something every day. thanks for that perspective.
 
Re: 3/26 Max amps 96--more input needed

HI Mindy
Your Max and my Max have been talking it seems.
He is enjoying coming down very quickly.
As I said yesterday, coming down the ladder is difficult but the short term
pain is worth the long term game. An OTJ kitty. How amazing will that be.
Getting those lower doses to stick means taking it as slowly as possible.
The longer Max is in the nice normal numbers, being safe, and the right dose of
insulin, the better chance he has of getting off and staying off insulin.
 
Thanks for the input everyone.

Really, I was shocked he was only at 70 yesterday when I got home. I expected him to be higher because of the reduction. And I reduced more because that first time I shot him at 85 he would have crashed if I hadn't caught it (and sleep has been so bad this week I'm going to be in trouble soon if I don't get some). Trust me, I'm not thrilled his dose has dropped so much so fast, but I felt I didn't have a choice. I'd rather have a living kitty with slightly high sugar than a dead or seizing one when I get home/wake up. I fully expect him to be a bit high when I get home today, but he's been surprising me so far, so we'll just have to wait and see. All the "what if" questions are because I can't get on here when I'm at home to get advice at shot time. I need an idea of what to do before it happens.
 
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