4/20 Boo Radley dosing thoughts?

[Jessica & Boo Radley]

We introduced ourselves a few days ago (Intro Topic) and got some good feedback on Boo's dosing.

I upped the dose as suggested to 1.75 U bid and within 24hrs had a 49 (and then of course a bounce)! I think that extra push was just what he needed for a "breakthrough". Because of the 49, we dropped down to 1.6 U and again, within a day, we saw a 59 and another bounce. We decreased to 1.5 U yesterday morning and I was somewhat expecting him to follow his pattern, and have a lower day today.....no such luck (430 AMPS, 327 +5).

I guess I'm interested in some thoughts here.
* Do I hold the 1.5 for a few (5 days) to let it settle?
* Do I go back to 1.6 and let that settle?
* Do I take another very small decrease to 1.4 to see if he'd rebounding at the 1.5 and could
potentially respond to an even lower dose?

Looking forward to your insight!

 

[Sheila & Beau GA & Jeddie GA]

I would go to 1.6u and let that settle at least 6 cycles (unless you get a 30 or something - then go back to 1.5u). Here's why:

On lev while there might be a little reaction to the last shot during the cycle after changing the dose, there is usually a settle time before things, well, settle. What you saw on the first dose at 1.6u was still influence by the 1.75u dosing over the two days before that.

One of the guys who use to post on lev likened it to an ocean liner. When you steer an ocean liner, you input a course change and it takes several minutes to make the change - somewhere "down the road" (if the ocean had roads) from the control wheel input.

So, when you see number changes, look at what came before by about 48 hours. Anything in that time will influence the numbers. This is unlike the faster insulins where you can make a dose change decision based solely on the PS number on each cycle.

Caveat to this with Boo Radley: we really don't know how he reacts to lev alone on lower doses. If you see low greens again, I'd say below 50, than it might be a good idea to drop back to 1.25u and see if that yields better numbers and no bouncing.

BTW, upper 40s and 50s are safe numbers, I just don't think they should be goal numbers because they leave so little wiggle room if, say, the cat doesn't eat well for the day. I prefer to aim for 80-90s myself.

 

[Jessica & Boo Radley]

Sheila thanks....I was hoping you'd reply! Makes perfect sense and I'll bump back up to 1.6 on tonight's dose and stay there for at least 6 cycles, more likely 10 unless we get another below 50.

BTW.....I'm not very concerned with hypo's and Boo (I respect hypos, it's just with him, his body does it's own thing when number gets too low). I think the lowest I saw on him at was 29 and at that, acting completely normal. He generally starts producing glucagon at 60....so I try to stay above that if possible to prevent such a major bounce. In my mind, if I can get him to surf at a reasonable level....I can get him used to lower numbers.

Thanks again!!!