Re: 4/20 Gus R1,R2 Both HI (R3 ???)
ps - you won't always have to test every hour when you give R. Right now we're just trying to collect data on how he does with it (which would be easier if there were actual numbers instead of just HI!). Once you know his response you'll be able to use it without so much testing.
Essentially what we are trying to do is find Gus's onset, nadir, and duration for the R. Once you get to doses that do more for him, you have to be very careful to not give R at a time in the cycle when the nadirs for R and Lantus might overlap, or when both insulins are working hard at the same time. If you have R pulling him down at the same time the Lantus joins in and starts pulling down even harder, then you can get into a situation where it is hard to control the drop. Until we have more data, you don't want to give any R between about +2 and +7 in your Lantus cycle. Don't give R within 4 hours of the last time you shot it. That means that you will mostly use it at PS and +7 or +8. You also don't want to give R at a time when a bounce might be clearing. For right now, I would say that we're safe to use R in the first 2 (maybe 3) cycles of a bounce, but after that we'll want to back off and see if the Lantus takes over. We'll be able to refine those guidelines as we go along.
Just for perspective, our goal is not really to give enough R to bring his number down to a better range. Making him drop too fast or too far would just set up another round of even harder bouncing. He is still going to bounce, but we're trying to keep him from bouncing as high. With Jazzy, when I hae used R my purpose is to try to hold her flat at a time when her numbers would otherwise go to the moon.
Have a great day guys!
