3/30 Max AMPS 397 +1 399 +3 303 +4 233 +5 143 +6 126 PMPS 354

[Max & Lori]

We dose increased back to 5.5 units this morning and I know we are in for some wild roller coaster rides knowing Max, but I’m going to try and ignore the bouncing. I am trying to get us back on track following @Wendy&Neko recommendations.

Thinking this is glucose toxicity we need to break through. My fault. Life is full with a big family, a high maintenance cat and everything else. I have a grandchild that I also help care for who has a rare genetic disorder called congenital central hypoventilation syndrome (CCHS). Her brain doesn’t tell her lungs to breathe when she’s asleep. She is 2 years old now. She was born shortly before Max was diagnosed. They didn’t think she would survive. She’s had a tracheostomy since she was born and is on a ventilator when she sleeps. She has to have her trach suctioned pretty often. Her mom is great but I help her as much as I can. I don’t want pity but I’m just pulled in so many directions. I’m not complaining about any of it. I love my family and Max and all that goes with it. I just wish I could do a better job of managing it. I’m certain there are others who have diabetic cats and other responsibilities too so I need to get it together BETTER. I also somehow became desperate for a quick fix to get Max’s numbers in a better place and thought a slight decrease would help. It didn’t.

Max had higher LC to try and prevent a dive and another snack @+1. It’s confusing to me knowing what percentage to give because I never know with his unpredictable patterns of bouncing and diving.

Vet visit tomorrow. Girls night out tonight. Daughter, grand daughters and me on a shopping spree at a local event here tonight at 6 pm. Max’s shot at 5:30.

 

[Max & Lori]

Wendy, could you give me suggestions on when the times are I should test Max? He’s all over the place some days.

I’ve been testing and feeding hourly up to +4 at least trying to control the drop, obviously I’m not doing a good job of it. Sometimes the big drop is between +2 and +3, other times it’s between +3 and +4, then he also does it between +4 and +5 sometimes. The food is higher carb up to 9%. If I go higher than that, it stays with him too long and it slows him down too much. Makes him stay high and flat if he’s already starting at a higher number. Does that make sense?

What would help me with Max is to know:

1. What times should I test? It’s ALOT of pokes and strips going hourly through the morning trying to slow him down.

2. What times should he get food? I’ve been feeding him at amps, then every time he gets checked hourly until nadir. That was suggested to me a while back when the diving first started. If I see he’s bouncing I don’t do that. It’s still a lot of feeding. Doesn’t that affect his numbers in a way that I am not getting an accurate idea of what his nadir truly is? I don’t understand that. I’d like to get into some manageable routine that won’t drive me crazy. I’m crazy already.
As always thank you @Wendy&Neko

 

[carfurby (GA)]

Good luck with the new dose. You're doing the best you can for Max. Don't be hard on yourself. I hope you can have fun tonight. Sending prayers.

 

[Max & Lori]

Good luck with the new dose. You're doing the best you can for Max. Don't be hard on yourself. I hope you can have fun tonight. Sending prayers.

Thanks Carla. You’re so kind. I will try! The girls are making me go.

 

[Wendy&Neko]

If life is keeping you too busy, there is no harm in backing off how much work Max is for you, or his dose a bit. There is only so much you can do with him, it really is up to his body.

1. What times should I test? It’s ALOT of pokes and strips going hourly through the morning trying to slow him down.

I'd skip the +1 test, unless he's been sliding down the previous cycle into preshot. I might try doing a test at +2.5 with him next. Sometimes he let's you know he going to dive by +2, but sometimes not. It might be an interesting experiment to see if +2.5 gives you a better heads up on how the cycle is shaping up. After that, maybe a +4 and use that number to tell you when test next. If he's dropping fast, then in an hour, if a slow drop around +6 to catch nadir times.

What times should he get food? I’ve been feeding him at amps, then every time he gets checked hourly until nadir. That was suggested to me a while back when the diving first started. If I see he’s bouncing I don’t do that. It’s still a lot of feeding. Doesn’t that affect his numbers in a way that I am not getting an accurate idea of what his nadir truly is? I don’t understand that. I’d like to get into some manageable routine that won’t drive me crazy. I’m crazy already.

The idea with feeding is to have fresh carbs (food) on board about 1/2 hour or so before he starts his dive. His big drops seem to happen between +2 and +3 and between +3 and +4. So maybe give him a good sized high LC or low MC feed at +2.5 after his test, MC or high LC depending on what it tells you. You might have to move that feed back to +2 if you see he's really dropping by +2.5. Then another feed at +3.5. A feed is more like a mini meal. If you test him, and he's low blues or green after that, you can give him a tsp of LC to help him surf.

Have fun with the girls night out.

 

[Max & Lori]

Thanks so much for that Wendy. I will try this out. It will help a lot! One other question, his preshot numbers are going to be high most of the time so should that preshot meal be a good sized higher carb also, if it looks like he’s sliding down? It sounds crazy to do that when he’s over 300, but I don’t know how much that meal plays into the big dives. What do you think?

 

[Wendy&Neko]

No, I would just do a regular LC preshot meal. Isn't that what you are doing now? He won't be onsetting until 2-3 hours after that, and higher carbs at PS would just drive his numbers up more before then. When he does have a lower blue PS, his cycles seem to be pretty flat.

 

[Max & Lori]

Yes that’s what I’m doing. I was just wondering if that meal had anything to do with the diving if he was already going down from a big bounce. If that makes sense. Like he’s going down before the insulin onsets then when the insulin kicks in does that make him dive? I might be thinking too much.

 

[Suzanne & Darcy]

Hi Lori. I'm thinking about you today as Max goes to the vet, right? I'm off to the vet myself. Got to take another cat in :-( but it will be okay.

Oh, and by the way, I think you are amazing with everything you have going on. Be kinder to yourself. You are pulled in many different directions and a lot of people just wouldn't be willing to keep trying everything you do, with family or with Max. You are strong and you are smart. You will manage Max just fine; and you have loads of us here who care and are on your side, too! I think it's really beautiful of you to try to help out your grandaughter's mom (your daughter? or daughter-in-law?) a lot of the time. It must be very stressful and time consuming for them to deal with everything, and I know the breaks help to keep them going -- and what a relief for them to know that you are trained and that they can trust you to take the very best care of her. You really are amazing. That is an over-used word these days, but in this case, it really applies to you.

 

[Max & Lori]

Hey @Suzanne & Darcy ! Yes I’m taking Max this afternoon to see the vet. He’s a lot better but just thought I’d make sure.
It’s my son and daughter in law who have Ava (my grand daughter). They also have another daughter who’s 3 years old so they are only a year apart. All six of my grandchildren (I have 3 sons) are age 4 and under so it’s something else when they are all over here on holidays. Otherwise I only have a couple of them at the time. Another grandchild is due in August. So they keep me busy too. Ava was born, my mom passed away, and Max was diagnosed all within a year after I retired so I feel like my life got flipped upside down, but I am so blessed and thankful for my family as well as Max and my dog Tank. My dog also needs close attention. He has a tumor on his arm that came back after it was removed. It is benign though.
Ava is a joy to be around though, despite all the things she’s been through she’s the happiest child. She’s learned to talk with the trach she has. She does everything else a normal child does, except she needs that ventilator when she goes to sleep or she will stop breathing. My son and daughter in law are excellent with her. I just help out sometimes so they can have a break. I didn’t mean to go on and on but it does me good to talk about it all sometimes because I usually just keep my stress all bottled up until I’m really upset. Not a healthy way to be. I have some hobbies I enjoy too though but I put myself last.
Thank you for such kind words Suzanne, you made me cry! You and Wendy and some of the others are so wonderful and I appreciate you ladies so much. I don’t think would still have Max without you. I hope you know how much you’re appreciated! Good luck with your kitties. I will update after the vet visit.