6/19: Sammy - AMPS 93; +3 82; +10 132; PMPS 133; +3 58 - Taking a trial reduction

Status
Not open for further replies.
Tina & Sammy

Tina & Sammy

Member Since 2010
Yesterday's Condo

Sammy seems to be back to normal on the eating, and so far his numbers are staying down. As I mentioned last night I am very tempted to reduce again and see how he does. Before the accidental increases his numbers were doing so well and there is a possibility that he will be able to sustain himself without insulin. I am just really nervous about removing the support too quickly.

He is a bit higher today, than he has been the last couple of days, which does concern me a little, because that larger depot is gone now, and we might be seeing that he does still need insulin, but it might also mean that his body is still having a reaction to too much insulin. Plus, he is finally eating much better than he was in the last day or so. I guess I will see how today's cycle goes and decide if I want to reduce to .1unit (.15mm) tonight.

Now that I am using the calipers I am really seeing exactly how much the syringes really do vary. Most of the recent doses of .25 units have appeared to be more like .1 unit on the syringe based on where the lines are. If you are not using calipers to measure your doses I highly recommend it. It is amazing the difference one dose to the next can vary depending on how accurate the lines are on the syringe, and if you are talking about quarter units, or smaller, you could be giving as much as twice as much insulin if the lines are not right. I really think that is the #1 reason why Sammy's numbers might have gone wonky at times in the past. We all know how important it is to stay consistent and how can you really do that when the syringes are not consistent.

If you don't know about Dosing with Calipers you must check out @Marje and Gracie tutorial on how to do it. I only wish I had started using them sooner.
 
Last edited:
I found the same thing with Gracie's numbers, Tina. At the time, We were using Monojects and so the dosing inaccuracy was compounded by the hub which contained varying amounts of insulin that couldn't be measured.

I'm glad it's working for you and Sammy.
 
Marje and Gracie said:
I found the same thing with Gracie's numbers, Tina. At the time, We were using Monojects and so the dosing inaccuracy was compounded by the hub which contained varying amounts of insulin that couldn't be measured.

I'm glad it's working for you and Sammy.
Click to expand...

I am also using Monoject syringes and I do notice a bit of difference with the hub from syringe to syringe. I do worry that if the lines are so far off how can the hub be the same in every syringe, and I am sure it isn't. But I think that just the fact that I am measuring with calipers I feel like the dosing is so much more accurate than what I was doing before.

Thank you so much for the video on how to use the calipers. It is very helpful and honestly, now that I am using them, I really think it should be the only way to go.
 
I don't use calipers, but I do use a control syringe to measure ALL doses from - even doses on the lines - and I've noticed the variation as well. I'll probably start using calipers eventually, I just haven't gotten around to buying them yet!

I'm glad Sammy is doing so much better now that you've found more consistency in his dose. It must be a huge relief!
 
Patricia & Noodle said:
I don't use calipers, but I do use a control syringe to measure ALL doses from - even doses on the lines - and I've noticed the variation as well. I'll probably start using calipers eventually, I just haven't gotten around to buying them yet!

I'm glad Sammy is doing so much better now that you've found more consistency in his dose. It must be a huge relief!
Click to expand...

Yes, it is a huge relief!

How do you use a control syringe?
 
Well, I am not sure if the higher number at +10 is due to the fact that he is not back to normal eating and not getting enough insulin or if he is still getting too much. This morning he had a pretty flat cycle, and the last few days have been amazing.

Based on the fact that he was able to come down from the 200's on just .25 units the last couple of days, I am inclined to try a reduction to .10 unit tonight. I know at least 24 hours of that time on .25 unit he wasn't eating a full diet, so I could be making the wrong decision, but I would rather decrease and have to go back up then increase without really know for sure if it is too much insulin.

I am sort of interested to see what his PMPS will be. He just had a +10 snack so I am wondering if he will take a double dip.
 
I notice a big difference in the occasional BD syringe - calipers definitely make things easier. And it's nice if DH is doing the shooting cause I'm away. I just tell him to measure what the calipers are showing.

The depot of a larger dose can influence 4-6 cycles. Today is cycle 5 of .25U. Just another thing to consider in the mix.
 
Tina & Sammy said:
I am also using Monoject syringes and I do notice a bit of difference with the hub from syringe to syringe. I do worry that if the lines are so far off how can the hub be the same in every syringe, and I am sure it isn't. But I think that just the fact that I am measuring with calipers I feel like the dosing is so much more accurate than what I was doing before.

Thank you so much for the video on how to use the calipers. It is very helpful and honestly, now that I am using them, I really think it should be the only way to go.
Click to expand...

You're welcome, Tina.

On the Monojects, I switched to Terumos because in the testing I did on MJs, I found the hub could contain as much as 0.46u more insulin than the dose and that amount was getting into Gracie because the hub design was poor. When we first started using MJs, the needle came down through the hub into the syringe. But then Gracie's numbers started getting really wonky and, on close inspection, I realized that the needle stopped in the hub and that after I gave the shot, there was no insulin in the hub. I had so many conversations with the company that makes and distributes the syringes that it would make your head spin. They finally quit responding to my calls and emails. It wasn't their problem as far as they were concerned. So i switched syringes.

Just be aware there can be large and/or varying degrees of insulin in the hub that you are giving to Sammy.
 
Marje and Gracie said:
You're welcome, Tina.

On the Monojects, I switched to Terumos because in the testing I did on MJs, I found the hub could contain as much as 0.46u more insulin than the dose and that amount was getting into Gracie because the hub design was poor. When we first started using MJs, the needle came down through the hub into the syringe. But then Gracie's numbers started getting really wonky and, on close inspection, I realized that the needle stopped in the hub and that after I gave the shot, there was no insulin in the hub. I had so many conversations with the company that makes and distributes the syringes that it would make your head spin. They finally quit responding to my calls and emails. It wasn't their problem as far as they were concerned. So i switched syringes.

Just be aware there can be large and/or varying degrees of insulin in the hub that you are giving to Sammy.
Click to expand...

Thanks for that information. Aren't the Terumos discontinued now or can you still get them? I am really hoping that Sammy is on his way to another OTJ trial, but if not I might consider changing syringes. If I can't get the Terumos what is the next best syringe to get?
 
You are correct that the Terumos are discontinued and i think ADW finally ran out of them. I've stockpiled them so I haven't ventured into the new syringe arena yet. I do know the EasyTouch syringes are horrible. ADW recommends Ulticare; I will probably try those and also the BDs that Wendy uses with Neko.
 
Marje and Gracie said:
You are correct that the Terumos are discontinued and i think ADW finally ran out of them. I've stockpiled them so I haven't ventured into the new syringe arena yet. I do know the EasyTouch syringes are horrible. ADW recommends Ulticare; I will probably try those and also the BDs that Wendy uses with Neko.
Click to expand...

Good to know! I will stick with the Monoject for now, only because I have an entire box. If I find that Sammy's numbers are still a bit wonky even with the caliper dosing then I will see about switching. I do have a few Relion syringes as well.
 
So far so good, Sammy has come down from PMPS. We did take a trial reduction tonight to .1 unit and we will wait to see how it goes. I plan on holding this dose at least for 3-4 cycles. If I we start to see a similar pattern of good numbers for a few cycles and then starting to rise again then I will probably start another OTJ Trial, but for now I will try to hold this new dose. If the numbers start to rise and continue to rise then we might have to go back up, but I am very hopeful that we can go for the Trial very soon.
 
Status
Not open for further replies.
Back
Top