8/27 Boo Radley AMPS 277 +2/230 (we increased)

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Sienne and Gabby said:
So, I'm a little confused. I thought Jill and Libby's point was to hold the dose and not increase yet.
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Then I guess I'm confused because there definitely were various recommendations. I didn't get the point that any one was hard fast, but that rather "there was no right answer".... .

Specifically, I read that you could increase at 4-6 cycles if you were flat about 200...which we clearly are and that there was no "right" answer as to whether 4 or 6 was the correct one....and that two of the posts recommended that I take the increase at 4 cycles and one said they would personally hold for 6....and knowing I am off Saturday and Sunday to watch the increase.....seems like I made the best choice based on the options, feedback given as well as my schedule.
 
My post, which may have added to the confusion last night, was to correct some of the other information that was posted prior to my comment. Jill was pointing out that doses needed to be held a bit longer either because of bounces or inconsistent dosing. She had pointed to her recent informational post about when the cycle count starts (e.g., if you skip a shot or reduce a dose, the cycle count starts over).
 
Jessica:

I contributed to your confusion as well. My apologies. However, I thought once Jill and Libby explained it in detail, that you were on board with holding a little longer. I know it is difficult when you receive multiple, differing opinions and I think Sienne was just giving you info and not suggesting you increase today. For me, any time Jill, Libby, or Sienne post on our condo with suggestions, I give it pretty darn heavy weight when deciding what I want to do considering the breadth of their experience.....smart ladies, those three.

But...it's ok.....just monitor and reread what Jill said. Onward and upward. I wish I had a penny for each thing I have done with Gracie that I should have done differently ;-) ;-)
 
haha, so true, marjorie. i just tell myself i'll have the opportunity again in 12 hours! lots to learn with all of this - and yes, sometimes the advice does differ.

jessica, one good thing to consider - look how many posts a person has and when they joined. libby, jill & sienne are obviously very experienced & willing to give advice & teach others, but there are also a number of people who've been posting on here for a really long time and have a ton of experience and are willing to help out others by giving advice - off the top of my head i'm thinking ronnie, miriam, sandy, dyana, roni - and there are others as well. we are very fortunate to have so many people who really understand how it all works. at 6 months i definitely don't have it all down - so also defer to others with more experience.
 
I appreciate everyone's clarification, but my saying "I'm confused too" was more sarcasm than reality.

I received a lot of really good information last night along with that came a lot of very different information:
Boo Radley might be 'flat' because he is just filling up the shed. Apparently it is a bottomless pit. ;-) That is why I suggested holding for longer than 3days/6cycles. To give Boo that chance to fill up the empty tank.
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hmmm, jessica i see what you mean. solid yellows with just a blue here and there. it doesn't look like bouncing to me. bouncing occurs after a kitty hits a lower BG number than it's used to sending the subsequent BG higher than normal for up to 3 days. i'm not seeing any particular lower than usual numbers, just pretty flat.
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If someone can monitor him closely, I would increase by .25u tomorrow morning as Sienne pointed out the Tilly Protocol indicates you can increase every 2 days (4 cycles) with BG >200. His fourth cycle is tonight so if he stays flat yellow, I'd take hiim up .25u tomorrow morning
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There's not a "right" answer here. I wanted you to be clear with respect to your options given the parameters of the protocol. Boo Radley already has a shed and there was no reason to hold the dose for 10 cycles. Some beans prefer to be more aggressive, others -- not so much. Then, of course, there are those pesky life issues like your schedule, what's easier to measure, etc. I've certainly held a dose for an extra day because the weekend was coming up and I would be able to monitor more closely.
If you want to split the difference, increase tomorrow PM -- that will be after 5 cycles. If it will work better for your schedule to increase on Sunday, that's absolutely fine.
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so, what now? if you're available to monitor, i would go onward and upward until you see a nice break in the numbers. if it were me, i would hold the current dose for 6 full cycles before making another dose adjustment.
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Regardless of WHY the numbers are what they are, usually the best strategy for getting rid of flat yellow/pink is to keep increasing the dose to cause a breakthrough. Using the tight regulation protocol, we're not generally interested in letting a cat "settle" into a dose that is keeping them high. We want to work as quickly as we can (safely) to move them into a dose that will get them into flat blue/green. Usually, the longer a cat sits in higher numbers, the more insulin is eventually needed to bring the numbers back down.
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I learned things I didn't know, which I LOVE. But I had to make a decision knowing my upcoming work schedule, the numbers I've seen for the past few week, and my working knowledge of diabetes. It's been 14 days since I had to split a dose because I was out and it's been almost 3 weeks since Boo's green....those pieces of information were appreciated learning points for the future from times past. The facts still remain that I've had close to 14 days of flat numbers.

I want you all to know I appreciate the feedback because it's exactly what I wanted - I wanted to challenge my mind to see things I wasn't thinking about - your points did that. But please note...the quandary in what happened last night and now today...is the sway - I've been re-reading this thread to see what "changed or what I missed"...and I still see the same thing I saw last night. I received a lot of different advice and a lot of different information. I didn't walk away thinking there was a right or wrong choice, but rather, I could make a choice to hold or go based on those 14 days of flat numbers (and the Tilly reference to shoot at 2-3 days if flat), based on my work schedule for the week, and based on the information that the best strategy to get rid of flat number is to increase the dose until we get a breakthrough.

For the record...so we can let this one go... I took the increase this a.m. I am at home this weekend to monitor. I will be at this same dose until next Saturday because of my work schedule unless we're lucky enough to take a reduction. Again....thanks to you all for your input - you gave me the push I was looking for and I used your info to make the best decision for us.
 
Ultimately, it's your choice. There are always intangibles that no one but you may be aware of. Rest assured though, if you are doing something that is putting Boo Radley at risk, I, for one, will be incredibly blunt!
 
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