8/31 Karamelle AMPS 438 +4 432 +9 424 PMPS 423 +6 364

JoM

JoM

Member Since 2023
8/30 Karamelle AMPS 357 +4 334 +9 342 PMPS 376 +5 300 +9 323

Question about when to raise the dose. I know at times Ive been told 6 cycles with no green, others Ive been told 10 cycles. As I said in my last post, Im having a terrible time with bubbles since switching back to these prior syringes and lowering the dose to 0.25. I dont know if its the syringes or the low dose but Ive had to scrap the caliper for now as it just isnt working. Plus Ive had to add a drop (or what I think is a drop) extra in each dose to make up for the bubble I just cant get rid of. One of the syringes was clearly just wrong. The plunger barely hit the fat line at the top. No idea if that dose was right. But today is the 5th cycle that shes running over 300 (with the exception of a 296) and the 6th since any green.
 
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Can you switch to a different syringe so you can avoid these bubble issues if they are prevalent in what you are using?
It may sound crazy, but I use Walmart's Relion syringes and find them to be fine ( I do use calipers).
 
I held doses with green nadirs (note the plural) for 10 cycles. You also have to pay attention to how low in green those nadirs are and whether you have room to increase. Karamelle did get to a 75, but that was on cycle 4 at the reduced dose, could have had a bit of larger depot influence in there. Since then, the nadirs have been higher. Another consideration, I'd give it the full six cycles to clear the bounce. On August 21st when she saw a 29, she took a full six cycles of wobbly bouncing before hitting green again in cycle 7.

I wonder if you could try an experiment with the syringes. Load it to 0.5 units with some coloured liquid (tea, juice, pop), then practice twisting the syringe to get even sized drops. Reload to 0.5 units and twist out drops until there is no more liquid, and count the drops. Do the same with what you are using for 0.25 units. Is it half the number of drops of 0.5 units? If not, you could draw 0.5 units of insulin and twist out half the drops that are in that dose to get 0.25 units. I found it easier to get rid of bubbles with a slightly larger dose.
 
Staci & Ivy said:
Can you switch to a different syringe so you can avoid these bubble issues if they are prevalent in what you are using?
It may sound crazy, but I use Walmart's Relion syringes and find them to be fine ( I do use calipers).
Click to expand...
Do you have a link to the ones you use? I cant seem to find any on their site that are the right kind.
 
Wendy&Neko said:
I held doses with green nadirs (note the plural) for 10 cycles. You also have to pay attention to how low in green those nadirs are and whether you have room to increase. Karamelle did get to a 75, but that was on cycle 4 at the reduced dose, could have had a bit of larger depot influence in there. Since then, the nadirs have been higher. Another consideration, I'd give it the full six cycles to clear the bounce. On August 21st when she saw a 29, she took a full six cycles of wobbly bouncing before hitting green again in cycle 7.

I wonder if you could try an experiment with the syringes. Load it to 0.5 units with some coloured liquid (tea, juice, pop), then practice twisting the syringe to get even sized drops. Reload to 0.5 units and twist out drops until there is no more liquid, and count the drops. Do the same with what you are using for 0.25 units. Is it half the number of drops of 0.5 units? If not, you could draw 0.5 units of insulin and twist out half the drops that are in that dose to get 0.25 units. I found it easier to get rid of bubbles with a slightly larger dose.
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Well Im in the 6th cycle now. I could wait till tomorrow morning I guess. Shes even higher now than shes been.
Re: syringes. I dont really get the twisting thing. When I twist the end of the plunger, it just turns the white part attached to the rubber, not the rubber itself.
I agree that the larger doses seem to be easier to get rid of the bubbles but I am drawing up to about 1.5U and then pulling and pushing the insulin up and down, flicking when its at the top. If I flick when its any lower I just get splattered insulin all inside of the syringe and massive bubbles to try and push out again. Ive even tried pulling out some insulin, pushing it all back out and then pulling it out again, I seem to get the bubbles out until it reaches the top and then poof! theres a bubble. No amount of flicking and moving the syringe up and down will get rid of it. It must be the syringes. I was having this problem off and on before. I may just open a new package and see if they are better in that one. Its so frustrating!!!
 
Other things, if not already doing it - move the plunger up and down a few times before drawing insulin, to distribute the silicone. Draw the larger dose, then pull down the plunger a bit more to create a gap (large bubble) on top with the needle pointing up. Flick/tap the syringe to try to get those smaller bubbles up to the top or larger bubble. Bubbles seem to like to join other bubbles. In my time, there was only one brand of syringes available in Canada. Bubbles were part of life.
 
Wendy&Neko said:
Other things, if not already doing it - move the plunger up and down a few times before drawing insulin, to distribute the silicone. Draw the larger dose, then pull down the plunger a bit more to create a gap (large bubble) on top with the needle pointing up. Flick/tap the syringe to try to get those smaller bubbles up to the top or larger bubble. Bubbles seem to like to join other bubbles. In my time, there was only one brand of syringes available in Canada. Bubbles were part of life.
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Yep, Im doing all that. If I flick when the insulin is pulled down, it just makes a big splatter of insulin. I try to flick lightly. I found flicking when its almost to the top works best but its like the bubble is up inside the chamber of the part before the needle. I can see it, but when I pull the insulin back down to make a space it disappears and reappears when I push it back up. I will try the "other" liquid methods see if I can perfect this.
 
Wendy&Neko said:
Other things, if not already doing it - move the plunger up and down a few times before drawing insulin, to distribute the silicone. Draw the larger dose, then pull down the plunger a bit more to create a gap (large bubble) on top with the needle pointing up. Flick/tap the syringe to try to get those smaller bubbles up to the top or larger bubble. Bubbles seem to like to join other bubbles. In my time, there was only one brand of syringes available in Canada. Bubbles were part of life.
Click to expand...
I just tried it with the colored liquid. Some cherry juice. It had some tiny bubbles at first, I flicked, they disappear, I pushed it up and it was fine, NO BUBBLE!!!! So what did I learn? hmm. Only that I pulled it to over 4 units. Tried again pilling to 1.5U and still worked perfectly and again with 1U and it still worked. Tried it with plain water and it was a bit more difficult getting out the bubbles but there was no bubble at the top like Ive been getting. I did find in the past that if I pull up insulin and squirt it out that it works better the next draw. I guess thats what I'll try. Thanks for your help.
 
Ive decided to hold the dose a bit longer, whatever dose it is, hard to tell with the bubbles. I have an appt tomorrow, have to leave at 11:30amish and will be gone a lot of the afternoon, so I dont want her plummeting then.
 
Remember that holding the dose six cycles applies to increases and bounces.

If you have increased the dose, hold six cycles. If there is no blue or green, increase by 0.25u.

If, in six cycles, you see blue or green nadirs, hold the dose ten cycles.

If you have reduced, you don’t hold the dose a certain number of cycles unless you’ve seen blue/green which has caused a bounce. If shes bouncing, you can hold for six cycles when she to see if she comes back to green when she clears. If she doesn’t, increase the dose.
 
Marje and Gracie said:
Remember that holding the dose six cycles applies to increases and bounces.

If you have increased the dose, hold six cycles. If there is no blue or green, increase by 0.25u.

If, in six cycles, you see blue or green nadirs, hold the dose ten cycles.

If you have reduced, you don’t hold the dose a certain number of cycles unless you’ve seen blue/green which has caused a bounce. If shes bouncing, you can hold for six cycles when she to see if she comes back to green when she clears. If she doesn’t, increase the dose.
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I'll need to read this a few times to get it. But in the mean time, I'm holding the dose because I will be gone most the day tomorrow.
 
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