Re: 9/30 Reuben PMPS 369 +2/198 +3/110 +3.75/66 +4.25/58 +4/
Okay, here we go
I've looked at numbers and condos of the past few days (starting on the
24th September). So: On the 24th, a couple of days after starting a new vial (on the 22nd), Reuben was on his 8th day of 1.75u - which overall hadn't seemed to be doing that much for him up to that day, at least once the shed had drained from the 2.0u before.
That makes me think that there may well have been a slight pooping-out effect happening with the previous vial of Lantus.
Either way, from the 23rd/24th, Reuben stared seeing lovely runs of greens. It looks to me that his shed may have taken a bit longer to refill up to that point (or, again, the shed may have been okay but the insulin may not have been up to par anymore). When things were balanced out (shed re-filled and functioning, insulin perfect, Reuben ready and raring to go),
you got your first green PS, also on the 24th, in the evening! A wonderful progress milestone! and you shot it - another major rite of passage :mrgreen: - and reaped the rich reward the very next day (the
25th September), when Reuben dipped into the 30s, his shed being full enough to overflow and psh the numbers down. So he earned his reduction to 1.5u that evening cycle.
The 25th was when I personally learned
the difference between a true dropping number and a second dip late in the cycle :smile: Marje explained that what you shot the morning of the 25th (he dipped from the previous +11 of 186 to an AMPS of 147) was just a second dip, not a true dropping number. This is where the factor of meter variance can come in, too.
(
Recap from the 24th: I posted how "meter variance" covers about 20% in either direction of whatever number one has had from a test. This can be confusing, of course: For a BG of 60, 20% variance would be 12 points, so it could be between 72 and 48. For a tested 48, you'd react differently than for a tested 72. It's good to remember that the number you're getting off the meter may not be *exactly* accurate. But it's a little distracting to get too caught up in meter variance, I always find. Still, for defining a surf, the issue of variance comes up. If you tested every hour one day, and got a 60, then a 69, then a 56, then a 64... That would be a surf. If the range was higher up, the meter variance would allow for greater fluctuation, meaning if you had a 240, then a 261, then 232, then a 256, that would still essentially be a surf. The higher the surf, the wider the fluctuation window based on 20% meter variance.)
True dropping numbers warrant *very* close monitoring - even getting a (+0.5) already can be a good idea. For a second dip, one doesn't have to quite as wary - though if that dip is a big one, again, attention should be paid. It's something one needs to develop a gut feel for, I find.
On the evening of the 25th, Reuben bounced a bit off those low low greens. Normal, and not a problem at all :smile:
Textbook TR-protocol progress so far! And Textbook Lantus-Behaviour, too: Though you had reduced to 1.5u that evening, Reuben's shed was still busy spilling the overflow into his system, which is why you did have to work a bit at getting him and then keeping him above 50. Makes sense, yes?
One the
26th September, you started out a bit put off by Reuben's pink AMPS - I think that was still just the bounce from spending all that time in the lox greens the day before. Normal, again. He came down nicely, but fairly quickly (from the higher 300s to the 60s in 4 hours), which is why you got what I would call another little bounce. These few days look to me like Reuben's liver still just being a tad on edge about the repeated (beautiful) strings of green BGs.
Happily, by the
27th September, after a bit of hanging out in the yellows/blues for the AM cycle, he was ready to flex his drama muscles again: In the PM cycle, he dipped again into the 30s, earning his next reduction (to 1.25u) within 3 days of the last one. This is also something we see fairly frequently:
when a cat hits that one "key dose", s/he can often "unlock" (accelerated) progress. That doesn't mean s/he will race down the rest of the dosing ladder (though it can), but I think it *does* mean that things are looking promising.
One good mental note to take away from the 27th is that an HC bump in BG can wear off really, really quickly: it did, for Reuben (he went from +3.5 of 38 to +4 of 61, and you were already hoping for sleepus, but luckily reconsidered and got a +4.5, which was 44 :lol
, and it demonstrates why we recommend
not becoming complacent after on HC-boosted number. Another useful LL-option that came up on the 27th: Opening the next condo at (+11) already, giving people the option of chiming on on any dosing queries *on the run-up to AMPS* rather than *at* AMPS (which can delay the shot). You chose to shoot through the bounce Reuben did off those low greens.
So, the morning of the
28th September, you shot through the bounce. That worked out nicely, and brought him back into the blues at pace.
With the shed still draining from the previous dose, you saw beautiful greens again that PM cycle. Poor Meeeeezer was having some tummy trouble again and threw up a couple of times. And again, all those pretty healing greens made Reuben's liver a tad edgy, so he spent some time bouncing - the entirety of the
29th September, in fact :smile: He started to come down out of the bounce in today's AM cycle, though, which again is great progress: NOT a prolonged bounce, very nice! You accidentally shot an hour early on the 29th in the morning - but he was bouncing, undeterred, and it didn't have any adverse effects.
Another good thing to note: This morning, you *did* shoot a dropping number - Reuben was steadily dropping due to his bounce clearing, from the tailend of yesterday's AM-cycle right up until this morning's AMPS. But, as you've seen, this time there were no dramatic side-effects from shooting a steady drop: he dipped into the blues and then decided to try the pinks one more time, before going back to the pretty greens in tonight's PM cycle. Tonight's greens arose, I believe, out of
the shed having re-filled, in combination with the bounce clearing. (Today's AM cycle also looks like a demonstration something we sometimes see in bounces - the bounce starts to clear, and then the kitty seems to decide it wasn't quite done, so the bounce goes up a bit again, before clearing properly. Sort of a "second dip in reverse".)
Overall, I think you're seeing phenomenal progress with Reuben. If my crystal ball is working, I suspect the now-refilled shed will provide you with some more lovely greens over the next few days. If Reuben's liver doesn't overreact and send him into a bounce, I'd say you may be heading for your next reduction fairly soon. If he does bounce of just-above-50 greens - it's no big deal, it's normal. Even though he's had that persistent tummy trouble and some food issues, he's doing beautifully and earning reductions in perfect TR-protocol manner,
You can be VERY proud of your Meeeeezer boy, and of yourself :mrgreen:
So that's what I'm seeing over the past week.
Wattaya think? :lol:
Hugs,
Jane
