Alex 6/28 PMPS 411 - HELP!

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Ginny & Alex

Ginny & Alex

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ok, I reduced the dose to 1.4 and I saw some pretty good numbers yesterday, but today we're back up in the 400s! Hubby is out of town and this shakes me up.

What should I do?
 
Ginny, hopefully someone that can give you some dosing advice will be on shortly. I'm sorry I can't help. How long till you shoot?
 
I am not a dosing person, but I don't want you to be alone with this. You could on post onHealth. Or you could go up by .2. I don't think this is anything to be really scared about.
 
I need to shoot in the next 10 minutes, and you're right, I shouldn't panic.
But it seems every time I make a little progress, I then turn around and lose it.
I guess that's what this whole disease is about!
 
I panic like that all the time, it's not just you! It will be okay though...looks like you're getting some help.
 
If you're just now at +12 I think you will be ok to wait just a little while longer to get some advice.
 
I just reread your previous posts. Joanna and Robin, if I ubpnderstood, were suggesting going back to 1 and starting over, working up slowly. So youcoulddo that now, or you could stay at 1.4 for another day or 2, or you could go to 1.6. No crisis, pick one and then see what ii does.
 
Kim, I hadn't seen any posts from you today. I beginning to get worried.

Barbara, I know I need to learn to calm down, but those numbers really determine my day and evening. I've got to get a grip!
 
I think I'll hold the dose for tonight. I'm supposed to meet a friend for dinner and since I rarely do out, I'd like to go.

Still trying to determine if I should start back at 1.0.
 
You don't know what the 411 is coming from-- maybe it is a bounce from some lower numbers today or a need for more insulin.

But, either way it is okay. If it is a bounce-- we don't know-- theoretically you wouldn't want to increase. But, there is no harm in increasing to 1.6 and shooting the number down. You could just create another bounce--but, no problem. If you can test some mid cycle, you will know more. (this is the 2 options Robin referred to the other night)

Since you are concerned-- I probably would increase to 1.6.

Just my novice thoughts!
 
I think it's fine to hold the dose considering it seem like there was talk about going back to 1 unit.
 
I shot the same 1.4, but will check him again when I get home. Thanks for being here and I'll check back later.
 
I am not disagreeing with Kim. It is just my personality style. I like to have as little uncertainty as possible---ironic,of course, since that is pretty much all there is around here! Anyhow, that would be why my pick was to go back to 1 and work up. Then I would be sure the dose was not too high. But I don't think there is any evidence that that is a better choice than the others. The best thing is to do what you are most comfortable with.
 
You will be okay with whatever you decide-- you can adjust tomorrow if necessary!
 
I'm not great at giving dosing advice either. I think sticking with the 1.4u tonight is good since you are going to be gone and concerned, and you've gotten some pretty good #'s with it. Alex has an interesting spreadsheet...don't know what to make of it. Looks like in May you spent a week at the 1u, so I'm not sure if you need to go back. Let's see what others say. Things can change.
 
I am sorry I was not around, but in my opinion I am glad you stcuk with the 1.4.
I think you should stay there for a couple of days,
The 400 could very well be a bounce and you dont want to shoot into the bounce...

just my thoughts and that is what I would do now..
hang in there and I hope you enjoyed your dinner

Densie and Shakes
 
As long as he is acting ok-ish, no need to panic!!! The keys things are to look out for crisis stuff - hypo, ketones, DKA, not eating, clearly doing really poorly, etc. If they are moderately doing ok, there is room to try things & figure out what to do.

The problem with random high #s like this is you just don't know where it came from or what it means w/o some mid-cycle data to clue you in. The dose might be too high, the dose might be too low, it could be just right but he hit greens and is having some liver training action.

One rule of thumb is that you don't raise on the 1st high #, but you do lower on the 1st low #. So if you ever get a number under 50, PS under 150, or number that is too low for where it is in the cycle (say a 90 at +2), you lower immediately on the next shot. But one high PS, you don't raise, you wait and see if it is a trend, or a wonky.

Since right now things are kind of in "detective" mode, I would try to get a mid-cycle number in the nadir range (maybe +4 to +7, somewhere in there, whatever you can get on any given day) as many cycles as you can. Maybe a bedtime check at night. That will help give you a clue and know what to decide. (I know... crazy number on the 1 day you can't get in a spot test! ohmygod_smile )

Like others have said, if you can sort of prove what dose is either too low or too high, that helps you not have quite as much guesswork. There are some risks to going back to 1u (be sure to test daily for ketones if you do that), but if the #s go higher, then you know that dose is too low, and then you only have one direction to go in rather than general confusion on days like today - great #s yesterday, woohoo, then wth? today :? But... could have been a great day and a green nadir, or could have been totally blah, there's just no way to know for sure.
 
I'm back from dinner and it looks like Alex threw up most of his. +3 is 178, so 55% drop in 3 hours.
What does this mean?
 
Just saw your post, Joanna.
And other than throwing up his dinner, he seems fine. And since he did throw it up, he's ready to eat again and is now washing his "hands and face".
 
Awwww, nothing like the barf & scarf meal plan! Hope he is ok.

It's a substantial drop by +3, but if his eating pattern was different than normal, you can't really make too much of it. If it were normal eating pattern I'd say the dose might be too high, but it really depends on what the nadir is. Some cats drop a lot early, but then not much after that, so it could be fine.
 
Sorry I missed all the excitement, it's been a long day.

I'm going to stick to my too much insulin theory. It might be scarf and barf or it could be too much insulin. I've wanted you to start over at 1unit since almost from the beginning. If he keeps getting 400's than I'm wrong but you then can raise his dose with confidence.
 
I started back at 1.0 unit this morning. I'll try to get a mid-cycle number today and then post tonight to let you see today's numbers. I'm probably going to need lots of hand-holding thru this 'starting over period'. I'm not sure how to determine when/if it's time to change the dose. He was at 317 this morning and seems OK.
 
Holding Hands can be a Good thing!

What time do you do your pretest--EST?

You are doing a Great Job! Hopefully you can "step" into the "right" dose!


We are finally getting some of the rain you have been receiving. Thanks for not keeping it all out there--my yard was getting crunchy!
 
My pre-shot time is 6:15 or so, so that I can shoot at 6:30. I used to try to do them closer together, but I can't rush my boy.
 
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