IloveLarry
Member Since 2014
hate seeing these high numbers boo
9/29 larry amps 331 pmps 271 pmps 295
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MommaOfMuse
Member Since 2010
Re: 9/29 larry amps 331
Okay here's a teaching moment for you. He was on 1.5 then on 9/23 you cut the dose in half because of a low pmps. Now if 1.5 gives you a preshot that is too low to safely shoot, then why increase the dose 4 days later?
Now I'm not picking on you, sweetie I'm trying to teach you how to see what I see when I look at a spreadsheet so you can learn to make the best choices possible.
A couple of things could have happened differently on 9/23. Either you could have stalled without feeding and waited for him to go up into a more shootable range. Or shot a full dose on that 94 and set an alarm if needed to get back up with him to test and make sure he's okay on it. Or if you were going to give a Big Chicken shot you don't cut the dose in half, you lower it slightly. That's rolling back to 1.25 or 1 at the most. Also because your working with a depot insulin every time you shoot something other than a full dose because of a low preshot you reset the clock on how long you've held the dose, because his shed has to rebuild back to where it was to give you that 94 as a preshot. So effectively you raised his dose before he had a chance to completely refill his shed and clear any bounce that could have occurred.
Now with that said, again I can only base on what I'm seeing strictly on the spreadsheet, I'm not there living with you and Larry so I may not be seeing things that would tell me other key factors as in how he's feeling, how his general condition is etc. I know just from Autumn's demeanor when she is high from a bounce and when she is just high period. She has "tells" just like any good poker player that can tip her hand for me. But her "tells" are going to be different than another cat's and only you will know what Larry's are. That's why we say this is not all about the numbers, that's a big part of it but it also takes being very observant to their behavior. And you're lucky in that department you have a memory of Larry well to compare to, I never knew Maxwell, Autumn or Cassanova when they were healthy and happy before becoming diabetic, so I didn't know what normal was for them. Like it wasn't until she started getting well that I learned Autumn was a bed cuddler. Up until then she had preferred sleeping at the foot of the bed, which I didn't know if that was because she didn't feel go or that was just where she liked to sleep. So now that I know that about her, I can tell she isn't feeling well if she doesn't come for cuddles at night.
Mel and The Fur Gang
Okay here's a teaching moment for you. He was on 1.5 then on 9/23 you cut the dose in half because of a low pmps. Now if 1.5 gives you a preshot that is too low to safely shoot, then why increase the dose 4 days later?
Now I'm not picking on you, sweetie I'm trying to teach you how to see what I see when I look at a spreadsheet so you can learn to make the best choices possible.
A couple of things could have happened differently on 9/23. Either you could have stalled without feeding and waited for him to go up into a more shootable range. Or shot a full dose on that 94 and set an alarm if needed to get back up with him to test and make sure he's okay on it. Or if you were going to give a Big Chicken shot you don't cut the dose in half, you lower it slightly. That's rolling back to 1.25 or 1 at the most. Also because your working with a depot insulin every time you shoot something other than a full dose because of a low preshot you reset the clock on how long you've held the dose, because his shed has to rebuild back to where it was to give you that 94 as a preshot. So effectively you raised his dose before he had a chance to completely refill his shed and clear any bounce that could have occurred.
Now with that said, again I can only base on what I'm seeing strictly on the spreadsheet, I'm not there living with you and Larry so I may not be seeing things that would tell me other key factors as in how he's feeling, how his general condition is etc. I know just from Autumn's demeanor when she is high from a bounce and when she is just high period. She has "tells" just like any good poker player that can tip her hand for me. But her "tells" are going to be different than another cat's and only you will know what Larry's are. That's why we say this is not all about the numbers, that's a big part of it but it also takes being very observant to their behavior. And you're lucky in that department you have a memory of Larry well to compare to, I never knew Maxwell, Autumn or Cassanova when they were healthy and happy before becoming diabetic, so I didn't know what normal was for them. Like it wasn't until she started getting well that I learned Autumn was a bed cuddler. Up until then she had preferred sleeping at the foot of the bed, which I didn't know if that was because she didn't feel go or that was just where she liked to sleep. So now that I know that about her, I can tell she isn't feeling well if she doesn't come for cuddles at night.
Mel and The Fur Gang
IloveLarry
Member Since 2014
Re: 9/29 larry amps 331 pmps 271
im so confused? i thot kp or someone said i should increase a few days ago, and i said i wanted to wait, so i did. it seemed he wasnt improving, but i dont understand all this about waiting after the dose decrease, so what do i do now? i dont understand. thx.
im so confused? i thot kp or someone said i should increase a few days ago, and i said i wanted to wait, so i did. it seemed he wasnt improving, but i dont understand all this about waiting after the dose decrease, so what do i do now? i dont understand. thx.
MommaOfMuse
Member Since 2010
Re: 9/29 larry amps 331 pmps 271
Really not trying to confuse you, just trying to get you to think things through and understand the whys behind things.
First off raising him is probably the correct thing to do, but I want you to know WHY its the correct thing to do, and not just because someone told you to. Understand?
So if we look at his spreadsheet logically if a dose of 1.5 takes him low enough that you aren't comfortable giving him is evening shot then logically wouldn't raising that dose cause more preshots being too low to comfortably shoot? Which is why I had you lower it in the first place as because you were about every week or so getting a preshot at night that you were having to reduce dose on then he was jumping up into the super high numbers again.
You also have to take into account your own limitations, Kay and I can and will shoot a 94 because we know if we have to, we can stay up with our kids and monitor. We can hold them a little tighter in those low double digits because we can stay with them if we have too. But you have sleep issues so we have to make sure that not only is Larry safe but that you can take care of Pam as well.
Mel and The Fur Gang
Really not trying to confuse you, just trying to get you to think things through and understand the whys behind things.
First off raising him is probably the correct thing to do, but I want you to know WHY its the correct thing to do, and not just because someone told you to. Understand?
So if we look at his spreadsheet logically if a dose of 1.5 takes him low enough that you aren't comfortable giving him is evening shot then logically wouldn't raising that dose cause more preshots being too low to comfortably shoot? Which is why I had you lower it in the first place as because you were about every week or so getting a preshot at night that you were having to reduce dose on then he was jumping up into the super high numbers again.
You also have to take into account your own limitations, Kay and I can and will shoot a 94 because we know if we have to, we can stay up with our kids and monitor. We can hold them a little tighter in those low double digits because we can stay with them if we have too. But you have sleep issues so we have to make sure that not only is Larry safe but that you can take care of Pam as well.
Mel and The Fur Gang
KPassa
Member Since 2012
Re: 9/29 larry amps 331 pmps 271
I think what Mel is trying to say is that you reduced the dose too much when you shot that 94?
Either way, you've been on this 1.75u for a few days now without any super low numbers, so this dose doesn't seem too low to me if you want to keep holding it for longer. I would not suggest another dose decrease just yet; he hasn't "earned" one by either having pre-shots consistently too low to give the regular dose or from dropping too low at nadir (below 50). You might have to deal with a bit of bouncing, but Larry is a bouncy cat on Lantus (which is why I keep suggesting switching to Levemir when you get the chance ;-) ).
ETA: cross-post with Mel
I think what Mel is trying to say is that you reduced the dose too much when you shot that 94?
Either way, you've been on this 1.75u for a few days now without any super low numbers, so this dose doesn't seem too low to me if you want to keep holding it for longer. I would not suggest another dose decrease just yet; he hasn't "earned" one by either having pre-shots consistently too low to give the regular dose or from dropping too low at nadir (below 50). You might have to deal with a bit of bouncing, but Larry is a bouncy cat on Lantus (which is why I keep suggesting switching to Levemir when you get the chance ;-) ).
ETA: cross-post with Mel
KPassa
Member Since 2012
Re: 9/29 larry amps 331 pmps 271
In follow-up to Mel's comment, you don't want to raise the dose if you're getting pre-shots too low for what you consider safe enough to shoot the full dose with your monitoring capabilities. Not that you shouldn't have increased the dose, just that you might have to monitor a bit more closely for a little while and start shooting lower pre-shots if you're up for it.
In follow-up to Mel's comment, you don't want to raise the dose if you're getting pre-shots too low for what you consider safe enough to shoot the full dose with your monitoring capabilities. Not that you shouldn't have increased the dose, just that you might have to monitor a bit more closely for a little while and start shooting lower pre-shots if you're up for it.
IloveLarry
Member Since 2014
Re: 9/29 larry amps 331 pmps 271
yes i see what u both mean. i am slow learning partly due to cognitive dysfuncton. reading comprehension is tough also. at any rate, i had not increased jst yet bc of the low ps we were having like mel said, and bc thats why we had decreased. then K had said to increase, and the last post i saw mel said she agreed since he flattened out? then i said i wanted to wait a bit longer and i did but then i was worried with all those numbers in the 300s. then i did inrease bc i thot u both agreed, and i was supposed to decide? maybe i messed up tho, i didnt realize with that BCS i should hold it longer. this is all hard to me. i hope hes ok and will be ok. thanks.
yes i see what u both mean. i am slow learning partly due to cognitive dysfuncton. reading comprehension is tough also. at any rate, i had not increased jst yet bc of the low ps we were having like mel said, and bc thats why we had decreased. then K had said to increase, and the last post i saw mel said she agreed since he flattened out? then i said i wanted to wait a bit longer and i did but then i was worried with all those numbers in the 300s. then i did inrease bc i thot u both agreed, and i was supposed to decide? maybe i messed up tho, i didnt realize with that BCS i should hold it longer. this is all hard to me. i hope hes ok and will be ok. thanks.
IloveLarry
Member Since 2014
what do u think i should do now mel? wait and see how it goes? on this dose? i dont wanna hurt larry or cause him any problems.
MommaOfMuse
Member Since 2010
Your fine to leave him at this dose. I wasn't worried about you raising it to get him better numbers. He's been fine on it before.
I was simply trying to teach you how to reason these kind of decisions out without having to wait for one of us old timers telling you what to do next. So if for some reason there is either no one around or the board goes down etc.
Mel and The Fur Gang
I was simply trying to teach you how to reason these kind of decisions out without having to wait for one of us old timers telling you what to do next. So if for some reason there is either no one around or the board goes down etc.
Mel and The Fur Gang
IloveLarry
Member Since 2014
ok, ty mel! i appreciate ur help. 
hi nadine.
hi nadine.
MommaOfMuse
Member Since 2010
I really hope you realize I'm not picking on you. nailbite_smile
I do realize that you have difficulty in learning through just reading, just like I can't learn from listening to lectures so that's why I'm trying to go over things now in tiny bites for you.
But instead of giving you the answer right away I'm trying to get you to think about it and tell me back why. Understand? If you don't know that's fine and that tells me that is an area we need to work on, so you do know why.
In other words I want more than just a Good Morning from you. :lol: I want us to discuss that cute little guy of yours and how things are going, I want you to question things for yourself and then bring those questions to the board.
I'd much rather see a post late at night with HELP! PMPS-94 Can't stay with tonight..BCS advice needed. Than you saying nothing and then I'm scrambling in the morning to figure out with just what is posted in the title of his condo why he's way up again.
I would much rather discuss problems before or as they are occurring than to have to unweave the knot after it happens. And it also teaches you to be part of the next generation of mes.
I didn't learn to dance the way I do with my cats and to also teach you all to dance by blindly following anyone's advice. I took their advice and suggestions and then probably made them hate me with all the questions. I was constantly coming back with..BUT WHY? Show me what you're seeing that is making you say this or that. Where is that in the protocol? Have I missed something and if so what?
Its actually one of the very reasons I left TR and moved to Lev ISG before we had Relaxed Lantus even though in the beginning I still had a Lantus cat. It was a smaller group, they had more time to teach me. TR was just too busy and I felt lost in the crowd and often didn't feel like anyone was taking the time (and they really can't) to actually teach me to do this on my own.
Even now Hon if you have been watching Autumn's condo I still run back to others with more experience..Jill and Libby are some of the best I know around here. And there are a lot more that are fantastic when you hit a snag. Some I have personality clashes with so tend not to seek them out but even with those clashes in style and personality you can bet your bottom dollar if I need them, not only will I seek them out, they will respond. We just know on a day to day basis we don't like each other much, but if the kitty needs then the kitty needs and we all pitch in to help.
That is one of the best things about this board is that there is a mother load of experience, knowledge and wisdom but you have to get out of your own little condo space and go meet folks..Yes, even leave Relaxed Lantus and go forum hopping, stop in at TR say Hi to folks, cheer kitties on and watch and read other condos. I even pop in to things I've never dealt with when I have the time like the Acro board, the PZI board, I don't often post there but I do read and read a lot. I go to other Diabetic cat care forums and read their protocols and look to see what they are doing and how its working. Why? because ECID and there is no one size fits all formula to this disease.
Mel and The Fur Gang
I do realize that you have difficulty in learning through just reading, just like I can't learn from listening to lectures so that's why I'm trying to go over things now in tiny bites for you.
But instead of giving you the answer right away I'm trying to get you to think about it and tell me back why. Understand? If you don't know that's fine and that tells me that is an area we need to work on, so you do know why.
In other words I want more than just a Good Morning from you. :lol: I want us to discuss that cute little guy of yours and how things are going, I want you to question things for yourself and then bring those questions to the board.
I'd much rather see a post late at night with HELP! PMPS-94 Can't stay with tonight..BCS advice needed. Than you saying nothing and then I'm scrambling in the morning to figure out with just what is posted in the title of his condo why he's way up again.
I would much rather discuss problems before or as they are occurring than to have to unweave the knot after it happens. And it also teaches you to be part of the next generation of mes.
I didn't learn to dance the way I do with my cats and to also teach you all to dance by blindly following anyone's advice. I took their advice and suggestions and then probably made them hate me with all the questions. I was constantly coming back with..BUT WHY? Show me what you're seeing that is making you say this or that. Where is that in the protocol? Have I missed something and if so what?Its actually one of the very reasons I left TR and moved to Lev ISG before we had Relaxed Lantus even though in the beginning I still had a Lantus cat. It was a smaller group, they had more time to teach me. TR was just too busy and I felt lost in the crowd and often didn't feel like anyone was taking the time (and they really can't) to actually teach me to do this on my own.
Even now Hon if you have been watching Autumn's condo I still run back to others with more experience..Jill and Libby are some of the best I know around here. And there are a lot more that are fantastic when you hit a snag. Some I have personality clashes with so tend not to seek them out but even with those clashes in style and personality you can bet your bottom dollar if I need them, not only will I seek them out, they will respond. We just know on a day to day basis we don't like each other much, but if the kitty needs then the kitty needs and we all pitch in to help.
That is one of the best things about this board is that there is a mother load of experience, knowledge and wisdom but you have to get out of your own little condo space and go meet folks..Yes, even leave Relaxed Lantus and go forum hopping, stop in at TR say Hi to folks, cheer kitties on and watch and read other condos. I even pop in to things I've never dealt with when I have the time like the Acro board, the PZI board, I don't often post there but I do read and read a lot. I go to other Diabetic cat care forums and read their protocols and look to see what they are doing and how its working. Why? because ECID and there is no one size fits all formula to this disease.
Mel and The Fur Gang
IloveLarry
Member Since 2014
oh ok. ill read this again until i absorb it but i thot u did want us/me to start deciding and doing on our own? so i did instead of asking u about the 94, and the dose increase. ill figure it out. i would rather we hae decided together on his dosing also but understood u to say to start doing it on my own? or try, so i did. my brain isnt awake yet, so ill process this info later today im sure.
MommaOfMuse
Member Since 2010
I DO want you to start deciding on your own but when you're ready. I'm here to give you the pros and cons of those decisions, so that you know ahead of time the risks and advantages each step gives you so you can feel confident in your decisions.
Okay lets back up and take that 94 for example because its a recent event and is a nice talking point.
Lets say it went this way.
YOU: Hey Mel,
Larry just handed me a 94 pmps, I'm exhausted and I know I'm not going to wake up to retest him if I shoot a full dose so I'm thinking maybe I'll give .75, sound good?
ME: Well you can but I think you'd do better if you only rolled him back to 1.25 since he's going to be eating with that preshot so he'll more than likely rise for another 2-3 hours before the dose kicks in. If your really worried, can you stall for 30 minutes without feeding him and post back that number? Let's make sure he's headed up before we decide.
YOU: Okay that works, thanks will be back in 30 with the new number.
(30 minutes later)
YOU: Okay we're at 135 now...still not comfortable shooting a full dose even though he's rising I'm still whipped. So what about me going with that BCS of 1u instead of 1.25? Still look good to you?
ME: Yep that's what I would do. He's making really good progress and we don't want to drop him too far back but we want him high enough you feel safe getting a good night's sleep. Are you still going to be up for a little bit after you shoot? If so how much longer and can you swing another test before Light's out? Just to check in, if so I'll wait and watch for you.
YOU: Yeah for about another hour or so. I'll grab that extra test and report back before hitting the hay...
ME: Cool beans, I'll be watching for you. Here's hoping for an uneventful night you two.
(couple hours later)
YOU: Hey Mel, we're good his at 215 now I'm turning in before I turn into a pumpkin..Nitey Night.
ME: Looks good, Sweet Dreams see you both in the morning.
See how that works? You're still deciding but we are working together to decide. I throw out what I would be comfortable doing and you counter with what you feel you can do, and together we figure out a plan on what is going to work best for you and Larry.
Mel and The Fur Gang
Okay lets back up and take that 94 for example because its a recent event and is a nice talking point.
Lets say it went this way.
YOU: Hey Mel,
Larry just handed me a 94 pmps, I'm exhausted and I know I'm not going to wake up to retest him if I shoot a full dose so I'm thinking maybe I'll give .75, sound good?
ME: Well you can but I think you'd do better if you only rolled him back to 1.25 since he's going to be eating with that preshot so he'll more than likely rise for another 2-3 hours before the dose kicks in. If your really worried, can you stall for 30 minutes without feeding him and post back that number? Let's make sure he's headed up before we decide.
YOU: Okay that works, thanks will be back in 30 with the new number.
(30 minutes later)
YOU: Okay we're at 135 now...still not comfortable shooting a full dose even though he's rising I'm still whipped. So what about me going with that BCS of 1u instead of 1.25? Still look good to you?
ME: Yep that's what I would do. He's making really good progress and we don't want to drop him too far back but we want him high enough you feel safe getting a good night's sleep. Are you still going to be up for a little bit after you shoot? If so how much longer and can you swing another test before Light's out? Just to check in, if so I'll wait and watch for you.
YOU: Yeah for about another hour or so. I'll grab that extra test and report back before hitting the hay...
ME: Cool beans, I'll be watching for you. Here's hoping for an uneventful night you two.
(couple hours later)
YOU: Hey Mel, we're good his at 215 now I'm turning in before I turn into a pumpkin..Nitey Night.
ME: Looks good, Sweet Dreams see you both in the morning.
See how that works? You're still deciding but we are working together to decide. I throw out what I would be comfortable doing and you counter with what you feel you can do, and together we figure out a plan on what is going to work best for you and Larry.
Mel and The Fur Gang
IloveLarry
Member Since 2014
ok i am glad ur not picking on me. sounds like a good idea. i will try and remember next time. doent larry look cute on the new avi?
sounds like a good idea. i will try and remember next time. doent larry look cute on the new avi?
MommaOfMuse
Member Since 2010
He is adorable as always.
Nope not picking on you anymore than I'm going to start picking on others...lol
Honestly hon, I want the best for you all which is exactly why I don't like letting anyone use to just being told what to do and when. Sure we all need the hand holding for a few months until we get the steps down. But every momma bird kicks her babies out of the nest when they are ready to fly. That doesn't mean she just leaves them to plummet to the ground, she hovers chirping FLAP FLAP FLAP!
Well I'm your momma bird and you are actually ready to fly on your own (at least from the nest to a low branch), but I'm still here flying right beside you chirping FLAP FLAP FLAP! You will never strengthen your wings enough to fly away if you don't learn to use them at all.
Mel and The Fur Gang
Nope not picking on you anymore than I'm going to start picking on others...lol
Honestly hon, I want the best for you all which is exactly why I don't like letting anyone use to just being told what to do and when. Sure we all need the hand holding for a few months until we get the steps down. But every momma bird kicks her babies out of the nest when they are ready to fly. That doesn't mean she just leaves them to plummet to the ground, she hovers chirping FLAP FLAP FLAP!
Well I'm your momma bird and you are actually ready to fly on your own (at least from the nest to a low branch), but I'm still here flying right beside you chirping FLAP FLAP FLAP! You will never strengthen your wings enough to fly away if you don't learn to use them at all.
Mel and The Fur Gang
IloveLarry
Member Since 2014
ok, i understand the bird analogy! very good. flap flap flap. flapping away here. keep flapping!
i still dont ge the part tho where u said why would i increase ater the 94, etc. but then u said u thot inreasing was good? i dont knowhow to type it out, an cant type anymore for awhile. hands r KILLIG me. typing is no friend to bad hand pain, and its frustrating whn u cant communiate in the style u have available. im not good at written/reading communiation unless its silly,playful, light. oh well. im still stumped on that but whn i feel btr maybe i can figure i out. no more energy or strength to do it right now. hagd.
i still dont ge the part tho where u said why would i increase ater the 94, etc. but then u said u thot inreasing was good? i dont knowhow to type it out, an cant type anymore for awhile. hands r KILLIG me. typing is no friend to bad hand pain, and its frustrating whn u cant communiate in the style u have available. im not good at written/reading communiation unless its silly,playful, light. oh well. im still stumped on that but whn i feel btr maybe i can figure i out. no more energy or strength to do it right now. hagd.
MommaOfMuse
Member Since 2010
Okay see that's the kind of things I need to know.
The reason I asked was not because what I thought you did was wrong but because I wanted you to tell me why. I knew why, or at least why I think its a good idea, but I was checking in to see if you knew.
Now had the roles been reversed and you asked me the exact same question because you saw me do it with Autumn here is my response.
Well I did the BCS because I had been up all night the night before walking someone through a hypo and my fibro is full flare up and I was just too tired to stay with her and monitor. Ya I knew she'd be higher the next day but it was safer than shooting and not being able to monitor..Momma needed sleep.
I raised after that because going back over her spreadsheet 1.75 looked like a better dose than the 1.5, it wasn't that I'm worried about shooting that low, just shooting that low when I'm already nodding off before dinner and I knowing if I took my nighttime meds for the Fibro I wouldn't awake up even for the second coming of Christ. lol.
That was the kind of answer I was looking for. Something that said...the raise was to get to better numbers, and that the BCS was because of whatever factor that made it impossible to monitor at that lower range overnight.
Not an you did wrong by any means...but a How Come, explain it to me so I know you know why. ;-) Because if you don't know why then we need to work together so you do know. Because the only way you are going to get blue and green preshots is if you can shoot blue and green preshots, even if they happen on the pm cycle. That is where depot insulins are different than N or the PZI family. We have to make sure you know how to tell if he's going to be okay if you keep that shed full even if you're not there to check on him.
You've learned the hard parts, the testing and the shooting now comes learning how to read that spreadsheet and use it to tell you the next step to the dance.
Mel and The Fur Gang
The reason I asked was not because what I thought you did was wrong but because I wanted you to tell me why. I knew why, or at least why I think its a good idea, but I was checking in to see if you knew.
Now had the roles been reversed and you asked me the exact same question because you saw me do it with Autumn here is my response.
Well I did the BCS because I had been up all night the night before walking someone through a hypo and my fibro is full flare up and I was just too tired to stay with her and monitor. Ya I knew she'd be higher the next day but it was safer than shooting and not being able to monitor..Momma needed sleep.
I raised after that because going back over her spreadsheet 1.75 looked like a better dose than the 1.5, it wasn't that I'm worried about shooting that low, just shooting that low when I'm already nodding off before dinner and I knowing if I took my nighttime meds for the Fibro I wouldn't awake up even for the second coming of Christ. lol.
That was the kind of answer I was looking for. Something that said...the raise was to get to better numbers, and that the BCS was because of whatever factor that made it impossible to monitor at that lower range overnight.
Not an you did wrong by any means...but a How Come, explain it to me so I know you know why. ;-) Because if you don't know why then we need to work together so you do know. Because the only way you are going to get blue and green preshots is if you can shoot blue and green preshots, even if they happen on the pm cycle. That is where depot insulins are different than N or the PZI family. We have to make sure you know how to tell if he's going to be okay if you keep that shed full even if you're not there to check on him.
You've learned the hard parts, the testing and the shooting now comes learning how to read that spreadsheet and use it to tell you the next step to the dance.
Mel and The Fur Gang
IloveLarry
Member Since 2014
ty, thats vry helpful. i am at a handicap relying on my hands and eyes to comunicate, kinda like if u can hear and speak but not good with sign language and ur in a roomful of ppl and its ur only coice, tho ur ears and mouth work fine. im jst winging it and me and larry pay big the more i type. glad u understand
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