Hi Sue!
I was just checking in. Looks like things are going well. You are sitting on your hands and giving the 1u 2x/day, and got a spot check in before bed the other night. Way to go! :thumbup
I know at one point you said you would hold it for 3 days and then adjust. So, Im not sure if you increased this a.m. or not by looking at your spreadsheet. I am going to offer you a few thoughts, based on experience with my diabetic cat, reviewing your ss and the protocol. Obviously YOU make the choice as you see fit for you and Sam.
One thing I notice on your ss is a lot of moving around on dose (you know this). Sometimes these jumps are greater, in either direction, than they need to be. Example: Going from F1u to .7, or .6u to 1u. It is quite possible, aside from the jumping around, that these larger increments in dose will cause you to miss the one that will work. My suggestion...when/if you increase Sam's dose is to give him a Fat 1unit rather than a full .25 increase. Because you are unable to test a lot, it is also a slower/safer way to go.
So when do you increase? Well, you have a few options. Here is the protocol which can act as a guide:
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Now that the dose is settling in, we can start to see what kind of nadirs Sam is getting (usually around +5 to +7). Sam dropped into the 200's by +2 the other night (good catch!). This means he *could* have dropped below 200 by the time he hit his nadir. If that is a possibility, it may be best to hold the dose a few more days before increasing to a F1u. Then you could try for another curve this weekend.
The other option, would be to assume he did NOT go below 200 the other night and increase now to a F1u. I would continue to get before bed, and possibly 'out the door/before work' checks everyday. I would do a curve first thing this weekend.
I was always hesitant to raise a dose if I could not do spot checks, so I aimed for increases on days that I would be home. I just felt it was the safest thing for us. So, if you wanted to be cautious and not bothered with a ton of extra testing, maybe holding the 1u until Thursday night or Friday a.m., increase to a F1u, curve on Saturday or Sunday. Make sense? ;-)
Hopefully if anyone else reading this agrees or disagrees, they will offer their thoughts as well.
I keep meaning to ask you. What type of syringes are you using?
How is Sam feeling? It is nice to see him out of the reds, if even for a day or so! I bet both of you are very pleased.
Carolyn
