4/17 Charlie AMPS 123, +4 92, +5 87, +9 100, PMPS 134

Yesterday's post

Hi friends. I haven't slept. These bounce breaking cycles are brutal. Is it possible to skip Charlie's shot in the morning to catch up on sleep? Shot is in ~4 hours (10AM EST) I need to call out of work because of this.

I'm thinking of giving a reduction as well Any advice is appreciated. I need a solution for overnight. I can't keep staying up late like this or not sleeping.

 

He's been pretty flat for the last 3 hours. You needn't stay up.

He hasn't earned a reduction even per SLGS. After so many weeks of high numbers, he is finally seeing good numbers and isn't even bouncing to pinks any more. In fact, he's staying largely below 250. I know it's hard, but he will feel good in this range and it's also easy on his kidneys for him to be below the renal threshold.

Soon you will get comfortable with these numbers and not need to stay up like you do now.

 

Okay I won’t give the reduction but I want to be comfortable knowing I can go to sleep and he’s not suddenly going to drop way lower than he normally does.
If I give his shot in the morning will I be able to go back to sleep? I can’t monitor tomorrow I really need sleep I feel deleruois and now at this point I’m overtired and can’t get to sleep

 

He doesn't seem to be dropping below 90 on this dose. You could just leave food out for him and test around AM+4.
I think you said he is a grazer, right?

 

Okay that makes sense. Yeah he seems to stay around 90 in his nadirs and that’s great but whenever he gets below 100 I always worry he’s gonna suddenly plummet. Like you said it’s probably just a matter of me getting comfortable with it. Plus these bounce breaking cycles are so different from his regular cycles and unpredictable they scare me. Maybe I need to figure out the rhythm of them and a testing strategy

yes he’s a grazer. I’ll give him his shot and leave out extra food and then set an alarm for +4. That’s a good plan. Thank you so much Bhooma

 

That was a beautiful cycle from Charlie!

Agree that you can't keep staying up all night.

Jess, I remember so clearly this period of adjustment you're currently in - after so long in the pinks those blues and greens feel *so* alarming at first. But as Bhooma says you will get comfortable with them. Remember that Lantus produces long gentle cycles in the lower numbers, which is what you are starting to see with Charlie. There really is nothing to be scared of with numbers like you are currently seeing

I understand the fear of him going low, but if you stand back and have a look at the numbers he hasn't really got close to a lime. I think you will start to relax when you have a few more cycles with him in the blues and greens and nothing bad happens. It's a mental adjustment that needs to happen, and a trust that the insulin is working as it should. You also need to start working on your carb manipulation skills. Your anxiety will lessen if you know that adding a teaspoon of higher LC food will keep him surfing, adding a teaspoon of MC food will bring him up out of a little dip, adding a tablespoon of MC with a quarter teaspoon of honey will bring him out of a big dip etc. You have been reading about the rest of us doing this, but it is not the same as doing it yourself. Maybe its time to start practicing so you can see how reactive to carbs Charlie is at different times in the cycle. Once you learn this it will build your confidence to let him surf, and know you have the skills to intervene if you need to. Knowing you can leave food out and go to bed is key.

And you know one day he will may have a lime and you will cope!

 

Hi Jess, I’m so sorry you had one of those bounce breaking overnight brutal cycles. I can relate so well.

Charlie is doing very well on this dose and his Bhooma mentioned he’s not bouncing up to pinks! That that’s so great!

I agree with Helen, it’s great to know what foods will get Charlie to surf and figure out how carb sensitive he is. That will help you learn what will help him if he does give you a dip too low.

You could also consider an Automatic feeder, if you don’t already have one. They’re great in dispensing food when you learn their patterns and or want to give them some carbs to keep them from dipping too low.

I give Ivy a small snack at +1+2+3 in both cycles and have her automatic feeder open up at that time. I use that all the time, even if I’m home because I want her to be used to eating from the feeder.

I just use a small amount, like 2 teaspoons each time, (That food has been portioned out from her main meal in both cycles).
I also give her about 2 teaspoons overnight at +8, as she tends to have a late cycle dip.
For me it was around 2 am and since she wears the Libre, the alarm was going off at 2 AM so I knew what was going on
Once I started giving her those carbs, that stopped happening. (I just use her regular low-carb food as it is nearing the end of the cycle and I don’t want to overcarb her)

I hope you can get some rest today to recover from that overnight cycle. Sending you lots of good wishes. You’re doing great with Charlie and his numbers are really looking good.

 

What helped me was trying to remember what the typical Lantus curve looks like and meter variance. I think it took some time to trust this though.

Since you’ve started, nothing after +6 has given you any actionable information. This is unpopular here but neither have the +1 tests (or +2 for that matter)… so if it were me I’d be looking in the +3 to +5 range, occasionally spot checking the rest, and sleeping.

You’ve got 2 months of data which is a lot, the only caveat I’ll say is he’s relatively new to greens so I might be a little more cautious if you’re in a borderline situation.

 

Thank you Helen. I apologize if I'm coming off as whiny and spoiled. I am SO SO grateful that he's finally down into the good numbers, and that he's so good about shots and testing. I'm especially grateful for all of you here and your constant support at all hours of the day and night. Thank you.

I do try to remind myself often that lantus gives you gentle cycles, but as you said, I need to make that mental adjustment and really trust that to be true. I'm feeling a lot more comfortable with his numbers during regular cycles than I was last week, I just need to get comfortable with the overnight bounce-breaking ones. They're a pain in the @$$ !! I think I may feel better after a few more of those (but please let's do them during the DAY, Charlie).

Maybe today I'll try to give him a tsp of MC food during his nadir just to see what happens? I don't have any higher LC food--just MC (15%), HC (~23%), and Karo.

 

Thanks so much Staci Yeah I hate these cycles. I had a feeling going into last night that it was going to be a cycle like that--I should've posted earlier to prepare, but at least I got a lot of good data. I'm grateful he cleared the bounce much quicker than last time, maybe he'll learn to stop bouncing soon (I think that can happen, right?).

I also feed through the beginning of cycles--I put out his full portion of food at AMPS and +2 (and +4 during the day) and he usually eats half of it each time and grazes on the rest up until the next serving. I have an auto feeder but never use it because he can't have dry food--he gets almost immediately addicted lol. I think if I could hone in on where Charlie's nadir is during nighttime cycles I'd feel a lot better. It looks like it's around +5 for regular cycles and maybe +7/+8 for bounce breaking cycles? Does that look right to you? Maybe when I know he's clearing a bounce I can set an alarm and wake up at +7 to test and feed.

 

Thanks so much for helping me with this Tim I appreciate it. Unfortunately, usually I'm doing all those tests because I'm already awake worrying and can't get to sleep anyway Though I think (hope) that as I get more comfortable with these numbers I'll be able to adjust it to the testing schedule you're suggesting. I think +3 and +5 sounds spot on for regular cycles. What would you suggest for bounce breaking ones? Is that what you mean by borderline situation?

 

I just meant more like if you weren’t sure to get another test or not, err on the side of caution until you have more confidence in his patterns. I guess I’m confused a bit about bounce breaking cycles… not sure I’m seeing that?

 

You don't sound at all whiny or spoiled Jess, just a bit overwhelmed and anxious and *very tired*. Completely understandable, most of us have been there

Giving MC later in the cycle may well shorten it and bring his BG up faster than you like. Giving it early in the cycle at +2 or +3 will flatten the curve and stop a steep drop. Honey or karo will result in a quick and steep spike in the BG (best reserved for actual limes). For me, I needed to see all of these in action to start to understand how they really work (and am still learning and fine-tuning!). When you can see they are heading into an active cycle (from +1, +2 or +3 tests) and you cannot be there or stay up late there is nothing wrong with giving some carbs to keep them steady. You built the confidence to do this through knowledge and experience.

Suggest you (re)read this sticky: https://www.felinediabetes.com/FDMB/threads/what-is-feline-diabetes.194441/ - particularly the bit about the "insulin gestapo". Took me a while to get my head around why you feed carbs (sugar) during an active cycle in the first place. This explains it nicely.

Maybe consider a wet food automatic feeder for the late night snacks. You don't have to go fancy. I got a very basic inexpensive one with just two slots, runs on a AA battery. I can safely go to bed knowing he will get a snack in 1 hour and in 3 hours. I used to leave food down but would never know if he would scoff the lot in one go and then have nothing for later in the cycle when he may need it. The feeder has made such a difference!

Hope you are getting on okay today on so little sleep, and are spared more tough nighttime cycles this weekend!

 

Aww, Jess, I'm so sorry you're losing so much sleep with the bounce-breaking cycles! They really can be brutal and overnight is a whole different thing. It is really hard to be so far behind on sleep and I hope you're able to catch up.

I just wanted to throw out there that there are feeders that accommodate wet food. The PETLIBRO isn't cheap, but it's refrigerated (whereas most simialar ones are ice packs of questionable efficacy, based on reviews). I really wanted to do this with Xander for the same reason, but unfortunately he hated it and refused to eat out of it, so we returned it. But maybe you'd have better luck with Charlie!

 

Ah gotcha. I really really hope I'll start feeling confident soon.

His bounce breaking cycles just keep going down and don't really have any clear nadirs, or sometimes they have late/end-of-cycle nadirs. You can see examples on the 4/9 AM and PM cycles, the 4/13 PM cycle, and then last night. It's rough because I just keep testing waiting for him to start going back up so I can feel safe go to sleep, but it doesn't really happen. Plus the anxiety of them having possible additional dip at the end

 

Thanks Helen. I screenshot that first paragraph to save for reference I didn't try the MC today because it was already +4 and I wanted to see how low he'd go, but I'm going to do it tonight (unless he starts bouncing). I'll give him a tsp (?) with his +2 meal. I'm thinking when I know he's having a bounce breaking cycle I could even give him some late on on purpose to shorten it?

I'll look into automatic wet food feeder--I didn't know those existed! I don't worry about him scoffing it all in one go, he always leaves some left over. I do worry that he won't get up to eat though. Is that a crazy thing to worry about? I guess I won't know until I try it.

 

Thanks so much! I'll look into this. What did you end up doing with Xander for those overnight bounce breaking cycles?

 

Why do I keep having to make these decisions on low sleep?

So he dipped below 90 today, and SLGS says I should reduce. Bhooma had suggested lowering his reduction point to 80 when I first switched, so that's an option too. I don't want to mess up all the progress we've made on this current dose, but I also don't want him going any lower than he did today--he was drinking more water and "hiding" under a table for a lot of the day, which he did last time he dipped below 90. That could've just been because he was sick of me testing him and wanted to be left alone though, lol. I'm wondering whether to:

• follow the guideline and reduce by .25 with his shot tonight
• give a skinny dose of his current dose and see what happens the next couple of cycles
• lower the reduction point to like 85 and continue giving his regular dose and just carb manipulate at night

If I give a full reduction and it fails, will that screw up his current rhythm?

 

Honestly? Just waited for them to ride out. I'm sorry that that's such a cop out answer!

For what it's worth, it does get better. Much closer to the beginning of our journey (like the first month or two) I was posting about this constantly, except you're further ahead of me because it took me so freaking long to realize that a bounce-breaking cycle is what was happening. As far as I could tell he just had his nadir all the way at the end of the cycle (or even hours into the next). I don't think anyone had really explained to me that no, this wasn't a problem of nadir timing; it was bounce breaking and he was just bouncing literally all the time. But at some point it did change. It took a long time for us (we're just now finally starting to see some real progress 4 months in) and it was hard. Lots of miserable cycles and so much stress about decision-making. But it kinda just stopped and at the same time (convenient) I realized what had actually been happening the whole time.

Did you switch to SLGS because TR was too aggressive for you? I'm sure you've mentioned that and I've just forgotten, I apologize.

 

Haha it’s not a cop out, I had a feeling that was going to be the answer. I’m so glad that stopped for you. These cycles really are a nightmare. I had read somewhere on this forum that “bounces happen until they don’t,” so I’m hoping that implies that they get used to the greens and stop bouncing? And I’m hoping that’s what this shorter bounce indicates with Charlie.

Yes, I switched to SLGS because TR is too aggressive for me and I’m constantly on edge. It takes me sooo long to get comfortable with a new dose and pattern, and TR doesn’t really give me enough time for that

edit: also, it’s a big help to know that you were posting about it constantly too. I feel like I’m so annoying all the time hahaha I’m glad I’m not alone

 

Well, I'm not at the "don't happen" part yet, but that is the impression I'm under, yeah. Since the whole mechanism that's occurring with a bounce is the body panicking and dumping a bunch of sugar to protect itself, eventually the body realizes that a blue isn't dangerous enough to freak out about. And then maybe a lower blue, and then some green. At some point it starts to recognize those numbers and calms down a little. But from what I understand, anytime they become unused to those numbers, they're gonna bounce again.

I feel like I was just in a constant state of bounce with very little in-between for a long time. Now I'm seeing bounces clear in a day, or even a cycle (one time even less!). It absolutely DOES get better. Just way more slowly than would be really nice for us. Hang in there. I totally understand how you're feeling and I wish I could help.

 

I see normal action with meter variance in those cycles… either way, you’ll dial it in I’m sure

 

Oh, my! Charlie is having beautiful numbers--look how far he's come from all those pinks! I would definitely lower his reduction number to 80, as Bhooma suggested.

Lantus is designed to create flat curves--and Charlie is following that beautifully! His numbers are looking so good!

 

It’s crazy to think how far he’s come in just a few weeks. How far we’ve come. I’ve learned so much already.

I decided not to reduce his dose yet. I’m going to have to force myself out of my comfort zone for his sake and get used to these numbers. Maybe one day they won’t stress me out at all and I won’t even blink an eye at them. Thanks for your input and encouragement

 

Thanks Tim

 

I promise, you are absolutely going to get to that point LOL I never thought I would and look at us now, Kai's reduction point is 45 .
Like everyone else has said, we all understand the frustration and stress of hitting those low numbers for the first few times.
Please know that you are doing a magnificent job! ❤️

 

Lovely last couple cycles.

I agree with Tim, last night was a "normal Lantus cycle", not a bounce breaking cycle. The 9th was more like bounce breaking, start high and slide down.

Once you learn how Charlie responds to food, how much of what carbs he needs and how that varies during the cycle, you'll have a lot more confidence. Typically you need bigger guns earlier in the cycle when the insulin effect is building, and less when it's fading. Don't be afraid to play with amounts and timing and learn what Charlie needs. Auto feeder rock! They gave me my life back.

 

Beautiful cycle today
I hope Charlie surfs safely tonight