Re: 6/20 Heart AMPS 479, Time to increase?
When I see the high numbers, my very first thought is test for ketones often, whenever you can. You don't want that kind of problem to compound the situation.
The next thing is to mention that the 12/12 timing is pretty important. If you dicker with the doses, up and then down, and then changing the times, late and then early, there is no way that Heart's body can establish a decent and settled shed.
LANTUS & LEVEMIR – INSULIN DEPOT –AKA- STORAGE SHED
That shed has to be in place at all times, and any change, any change at all, will affect that shed and in turn, distract from treating the FD in the numbers.
You have to have a shed equal to your current dose at all times; it's your spare gas tank. It carries you on the times when you are a wee bit late, but you will have to top it up later.
And while you are topping up the shed, that spare tank, not all of the current dose is going to Heart - only a bit of it is going to Heart because priority is to have that shed filled.
And once it's filled, the whole dose goes to helping Heart.
So, you give 2units and don't see much progress for possibly up to 6cycles, then all of a sudden BOOM, you see movement! What happened there? That shed is filled and Heart got every drop of the dose.
When you go up in dose, you go through the same thing, but not as long. You may see some improvement after just a couple cycles, but there are some kitties who seem to take their sweet time and don't budge till that 6th cycle.
When you decrease, that shed's gotta be drained. If you drop from 2u down to 1.5u, then the shed's gotta dump .5u and so you won't see how the decrease is working right away until the sheds been drained of the excess.
When you give a late shot, it's just like a decrease. Lucky think you have that shed because Heart can use some of that reserve, but keep in mind that the next shot won't all go to Heart. A wee bit of it has to go back into the shed to top it up.
When you give an early shot, the shed and Heart treat it like an increase and so some of the shot goes the shed because your regular tank is not emptied.
And so the balancing act continues. Always watch the shed. Any and all changes are going to cause that NDW and it's never what you expect ... why?
Cuz Heart's a cat and who ever knows about a cat!
Heart's numbers are so high and you likely do need to increase the dose. Be sure to use only one meter so that your numbers are consistent. Since one meter may test higher and another lower, switching between them will present Heart's numbers unfairly.
When you do increase the dose, be sure to stick to the 12/12 and for at least 4-6 cycles, just to give Heart a chance to settle on the dose, fill the shed and see if he likes it or needs more.
