6/23 Henry's home from the hospital. AMPS +11 67

One last thought - not sure if you got any of the a/d food from the vet? I keep a stash on hand now, it's MC and they really like it so it's a good option when she's being picky and I need to get some higher carb in her.

Also as an aside there's this great video about how to give meds, using a/d. I tried a version with civvie Sam before his dental and it worked wonderfully -
 
Liz & Minnie said:
Also we don't give R the same cycle as a dose increase because you don't know the impact of the R vs the increase - though clearly Henry is not in a typical situation and I'm not sure if 0.2 qualifies as an increase. It is very frustrating taking over from ER doctors when they've been dosing with R and compensating with IV dextrose. They use a big hammer vs our delicate management.

Hopefully Wendy will check in sometime soon, she's our R guru.

Also adding @Lisa & Oberon who uses R
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True. I got an email back from the vet a couple of hours ago. She said she gave him .5U of R at 3pm so that would have been AMPS +6 and his BG was 328 at the time. They may have dextrose, but this Karo syrup does the trick and is easy to dose and works quick, I'm more afraid of staying in the 300s for long than I am giving a little syrup and monitoring. The 300s are deadly for Henry.

edit: I get this is almost opposite the prevailing wisdom of keeping out of hypo at all costs, but not minding the 300 & 400s too much
 
I should revise my previous comment about when dosing R - it's given at shot time or mid-cycle. You don't want the L and R nadirs to overlap. I still haven't quite figured out when 'mid-cycle' is myself, though I'm sure it fluctuates along with nadir. I'll consider anywhere been +4-7... but again, Wendy is the expert. I still call it 'R roulette' because Minnie can have different responses under seemingly identical conditions of L + R + BG + ketone! :banghead:
 
Liz & Minnie said:
One last thought - not sure if you got any of the a/d food from the vet? I keep a stash on hand now, it's MC and they really like it so it's a good option when she's being picky and I need to get some higher carb in her.

Also as an aside there's this great video about how to give meds, using a/d. I tried a version with civvie Sam before his dental and it worked wonderfully -
Click to expand...

I didn't get the a/d yet, but he is pounding food. He ate a whole can of FF when I got up
 
I only have a short time, then have to head out for a work obligation. As Liz said, R should be given at preshot, at least to start. Mid cycle means after nadir. It's closer to middle of cycle with Lantus than Levemir when it tends to be later. Basically you are trying to avoid both L and R driving numbers down at the same time, to avoid that big drop (and bounce).

I'm concerned about the 37, which you got well past the time R should have been in the system. That could have been from the 2.0 unit dose of Lantus. A better approach might be to shoot 1.75 units of Lantus and supplement with R. However, I cannot be around today to help with this. I can't even peak in online once I'm gone. We have a number of R users and I'm hoping one of them can at least walk you through the first few times you use it. @Sandy and Black Kitty @Lisa & Oberon @Liz & Minnie have all dealt with ketones and using R to fight it. Starting an R scale, how about 0.1 units if over 300, 0.25 units if over 350. Thoughts from others?

When you get a chance, and you've sorted a dose, please start a new thread for today. I know, technically this is still yesterday's cycle. But for help later on today, people will prefer to help shorter posts.
 
Wendy&Neko said:
I only have a short time, then have to head out for a work obligation. As Liz said, R should be given at preshot, at least to start. Mid cycle means after nadir. It's closer to middle of cycle with Lantus than Levemir when it tends to be later. Basically you are trying to avoid both L and R driving numbers down at the same time, to avoid that big drop (and bounce).

I'm concerned about the 37, which you got well past the time R should have been in the system. That could have been from the 2.0 unit dose of Lantus. A better approach might be to shoot 1.75 units of Lantus and supplement with R. However, I cannot be around today to help with this. I can't even peak in online once I'm gone. We have a number of R users and I'm hoping one of them can at least walk you through the first few times you use it. @Sandy and Black Kitty @Lisa & Oberon @Liz & Minnie have all dealt with ketones and using R to fight it. Starting an R scale, how about 0.1 units if over 300, 0.25 units if over 350. Thoughts from others?

When you get a chance, and you've sorted a dose, please start a new thread for today. I know, technically this is still yesterday's cycle. But for help later on today, people will prefer to help shorter posts.
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Thank you for the reply. I'm starting to question the accuracy of this nova meter, because 15 minutes ago it gave me a 350 and now at 11.25 it's reading 297. Libre is at 309
 
Wendy&Neko said:
I'm concerned about the 37, which you got well past the time R should have been in the system. That could have been from the 2.0 unit dose of Lantus. A better approach might be to shoot 1.75 units of Lantus and supplement with R. However, I cannot be around today to help with this. I can't even peak in online once I'm gone. We have a number of R users and I'm hoping one of them can at least walk you through the first few times you use it. @Sandy and Black Kitty @Lisa & Oberon @Liz & Minnie have all dealt with ketones and using R to fight it. Starting an R scale, how about 0.1 units if over 300, 0.25 units if over 350. Thoughts from others?
Click to expand...

I'm around but definitely would appreciate others advice as well! Also tagging @Suzanne & Darcy.

John, how about starting a new thread at shot time. You might also want to start a separate tab to create Henry's own R scales - you can see mine, which I based on Black Kitty's! Agree with Wendy's suggestion on your starter scale. I'll add some other info about monitoring after R dosing in your new post, tag me when you've done it so I know where to reply :)

PS I think the different readings on the nova are within the 20% margin of error? Don't get too hung up on it. I personally think different meters have different levels of accuracy at different ranges of BG
 
Liz & Minnie said:
I'm around but definitely would appreciate others advice as well! Also tagging @Suzanne & Darcy.

John, how about starting a new thread at shot time. You might also want to start a separate tab to create Henry's own R scales - you can see mine, which I based on Black Kitty's! Agree with Wendy's suggestion on your starter scale. I'll add some other info about monitoring after R dosing in your new post, tag me when you've done it so I know where to reply :)

PS I think the different readings on the nova are within the 20% margin of error? Don't get too hung up on it. I personally think different meters have different levels of accuracy at different ranges of BG
Click to expand...

Will do. Thank you.
 
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