Brady PZ Thread 2

Discussion in 'Prozinc / PZI' started by Irish Pat, May 11, 2020.

  1. Irish Pat

    Irish Pat Member

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    Last edited: May 14, 2020
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  2. Deb & Wink

    Deb & Wink Well-Known Member

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    Guess what Brady is doing this AM Pat?
    The "b" word.

    Come back down Brady, out of the stratosphere. Please.
     
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  3. Irish Pat

    Irish Pat Member

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    Yup he is doing that dang “B” word yet again... I swear he is more like a ball than a cat...but thank you for reaching out...hope you are having a good day
     
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  4. Deb & Wink

    Deb & Wink Well-Known Member

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    Day 2 for me of working on my income taxes.:rolleyes: Not fun, but it needs to be done.
    I'm just grateful that both the federal and state governments delayed the tax filing deadlines.
    Too much else going on in March, when I usually do my taxes.
     
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  5. Irish Pat

    Irish Pat Member

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    I hear ya Deb, taxes are so much fun huh? You sure are a busy woman and still find the time to care for people on this site, you are a very nice woman!!
     
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  6. Deb & Wink

    Deb & Wink Well-Known Member

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    Looks like Brady dropped into some higher 200's (>250) yellow range today.
    I think he may still be bouncing a bit.

    How's the work going that the contractors on doing your home? 3 rooms you said.

    p.s. Busy for sure. I make time for things that are important to me. And treasure every day.
    Can't treasure every MOMENT, since I don't like doing everything a day entails. But do love taking time to have a quiet meal time with watching the birds in my backyard.
     
  7. Irish Pat

    Irish Pat Member

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    Hi Deb....Yes, Brady did drop down in some yellow numbers, made me a little happy...Now tonight he is back up a bit......

    Had the one contractor in that's doing my stairs and banister work, the main floor guy is coming June 1st....Wish I could be excited about it, my wife is very happy its getting done, I am too but somehow it just isn't as enjoyable as I was picturing it to be before all this happened with the virus and Brady....but I know once its done it will be very nice.

    Deb, not gonna lie, I cried tonight and just held him, for some reason tonight I just broke down pretty bad, couldn't stop...This is so hard..im praying he gets better or at least better controlled......I don't want to go on again about all this and what I wish for him and how scared I am....but I know I just needed to cry!!! I fill like its my fault, both my wife and I do, that we didn't feed him correctly or did something wrong along the way, I just wish I could be as good to him as he has been to us...he has healed me many times thru out the almost 11 years he has been on this earth, just being that loving cat when you had a bad day....now I feel like im letting him down...that im not doing enough....but anyway...I better go to bed, early morning tomorrow.....have a great night

    Thanks for listening as usual...You and Marje and JT....and everyone on here are all special people....
     
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  8. Deb & Wink

    Deb & Wink Well-Known Member

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    We all need to get our emotions out there sometimes. Crying can be cathartic, and make you feel better after a good cry.

    Cats don't usually mind a bit of soggy fur.
     
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  9. Irish Pat

    Irish Pat Member

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    Two pretty good days and a bounce....just when I thought it was going good, again!!! Im getting more 500+'s now more than I ever did....
     
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  10. Deb & Wink

    Deb & Wink Well-Known Member

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    Workmen in the house causing Brady to be stressed?

    Just a thought.
     
  11. Irish Pat

    Irish Pat Member

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    No the guys are done with what they needed to do, they don't return until June 1st now....

    Deb, Brady has changed, when they were here yesterday, the old Brady would run and hide, you wouldn't see him until they were gone....Yesterday I had to keep him away from them while they were running their machines...Saws all, drills, hammers.....He wanted to watch, literally...and that is not my cat....so, no, it has nothing to do with anyone being here....

    Could there be something else going on here? Just a thought.....I know other peoples cats bounce, I have checked a lot of SS's, but it just seems like Brady when he gets to that lower number, under 200 and lower...next thing you know he shoots up to the sky

    And it seems the more insulin I give him the higher the numbers are going....Did you take notice to that?

    From the beginning in March when he was diagnosed he had a total of 7 black numbers, 2 were back to back so im going to actually say 6 black numbers up to April 25th....From April 26th when I really started going over 2U's he has had 10 total Black numbers up to today..

    Is there something else he should be tested for? Is there other questions I need to ask the vet? Should I ask for complete blood work again, any thoughts? Or is he just a bouncer and I have to live with it?

    Also he has been on cerenia 1/4 tablet everyday since he has been diagnosed, is he ok to be on that everyday for so long?
     
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  12. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Well I was watching for you in the other thread:rolleyes: I wondered where you had gone. Evidently, no where!

    Before I address your questions, etc, it would be really helpful if, when you start a new thread, you can post a link to the previous thread in the very first post of the new one. That way, if we need to look back at something, we don’t have to search. To do that, copy the browser address of the old thread by just opening it. Then open a new thread, put your cursor in the text box, type anything like “Previous Thread” or “Last Thread” or the date of the last thread. Highlight it. Then in the toolbar above the text box, select the hyperlink icon which looks like a sideways paper clip. It’s the 7th icon from your left. When the box opens, paste the browser address you copied into the box. Click “insert”. You can go back and edit your first thread in this post to add it or let me know if you have issues and I can do it. Thanks!

    I’m sorry the other day was tough for you but Deb is right that sometimes you need to get it out. That’s ok. This is an emotional disease and quite a roller coaster at times. It’s also natural to blame yourself and think you did something wrong. Still after all these years, I think if in my 64 years of living, if I could have ONE do over, it would be to never have let Gracie have the steroids. Of course, we don’t know what all is going on in their little bodies to predispose them to FD and what causes that tipping point. In other words, it isn’t your fault.

    IMHO, Brady could be doing better if you could use the modified method. I’m not saying that to make you do something you don’t want to do but I’m just being honest. You are seeing more black because he’s getting closer to better numbers so he’s going to look a little bouncier. When he was mostly in pink and yellow or red numbers, his body was more used to those. Some kitties just bounce higher than others as they get into better numbers. You have to focus on the time he spends in better numbers....not the time he spends in quick bounces to black and then back down.

    If he doesn’t seem to have any symptoms of anything, I don’t see any reason to spend money on additional labs right now. I also wouldn’t continue cerenia unless you know he needs it. If he’s past the pancreatitis and is doing well, and I k ow you’d say ens eating gangbusters, I’d see how he does without it. It doesn’t hurt to give long-term and it does act as an anti-inflammatory but ...why give if it he’s fine without it? But that’s up to you.
     
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  13. Deb & Wink

    Deb & Wink Well-Known Member

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    And Pat, I know you expect to be going back to work at some point, and won't be around as much to test.
    But the MPM (Modified Prozinc Method) is a good choice for Brady right now.
     
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  14. Irish Pat

    Irish Pat Member

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    Added the link from my other post, thanks
     
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  15. Irish Pat

    Irish Pat Member

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    I do have to think about this method, for one I wouldn't really be able to change my method until this coming Monday, so I have a little time. My issues arise with the PMS and monitoring, how do you handle the overnight testing, how often does he need tested during the night? And to respond to Deb, yes going back to work is a big concern with this method and testing, both my wife and I have jobs that require us to be there and it may be hard to stay home or leave for testing purposes if Brady gets in a jam, it is a big concern and one that I have no answer on how to handle....God, I know you guys are trying to help me and trust me im not fighting you on this, I just don't know what my answers are to making sure he is safe and taking care of my obligations with my job once I reach that point and using the modified method...Do either of you have any recommendations on how to handle my dilemma with the modified method and both CG's working?



    As far as the cerenia, the vet is the one that told me he needs to be on this medication, Brady hasn't showed any signs of pancreatitis since the day he came home from the vet after his diagnosis. The vet said he needs to be on the cerenia until the pancreatitis is taken care of, she feels this way because his last test in early April he was a little elevated.... I guess anything over 3 is considered pancreatitis, he has been 5.5, 4.5 and the latest 4.4. Im assuming she wants his levels under 3 and thats why she is saying for him to stay on cerenia, any thoughts there?
     
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  16. Deb & Wink

    Deb & Wink Well-Known Member

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    It depends on what the BG numbers are Pat, as to how often some testing at night would be needed. A +2 is a good test to always get, as it often tells you which direction the BG levels are headed.

    If Brady is running low, a few more tests will be needed. Running a bit higher, less testing is needed.

    Overnight testing? I set an alarm to wake me up when Wink was running low or doing a dose change. I do NOT fall back to sleep easily, so that was really hard for me to do. I was still working at that point, so had to get up to get to work no matter if it was a sleepless night or not. I never ended up taking Wink to work with me, but it came pretty close a couple of times.

    I also adjusted my shot times, to work better with my work schedule. Wink is at least part of the reason I'm now more of a morning person, than a night owl like I used to be. ;)

    You get good enough at testing, that when you wake up in the middle of the night to use the bathroom, you automatically grab a BG test and head back to bed. Both eyes may be a bit bleary eyed, not quite open all the way, for those late night tests, but you can still get a test done.

    There are 2 people in your home that can test Brady, so one person can be the "responsible party" for testing 1 night and trade off with the other person for a different night.


    Brainstorming here a bit Pat. Don't know what would or would not work for you and your wife.
    I've never had a cat with Pancreatitis, so I'm no help with that part of your post.

    Found this vet journal article on Pancreatitis. https://todaysveterinarypractice.com/current-issue-feline-acute-pancreatitis/
    A short excerpt from that article follows.

    "The Spec fPL assay (idexx.com) is a commercially available monoclonal enzyme-linked immunosorbent assay. A study presented in abstract form estimated the sensitivity and specificity of this test for diagnosing feline pancreatitis at 79% and 82%, respectively.15

    Concentration results are considered:

    • Diagnostic (positive) if ≥ 5.4 mcg/L
    • A gray zone if > 3.5 mcg/L and < 5.4 mcg/L
    • Negative if ≤ 3.5 mcg/L.
    The Snap fPL (idexx.com) is a semiquantitative point-of-care test that can help rule out pancreatitis. A value of > 3.5 mcg/L is considered positive; therefore, a positive result must be confirmed by a Spec fPL assay.

    With both tests, positive results must be interpreted in light of other clinical information, rather than considered an endpoint of diagnostic evaluation. After an episode of pancreatitis, the duration of fPL increase has not been reported."

    Since the results you gave us are all in the gray zone, I'm not sure that Brady still needs to be on the cerenia.
     
    Last edited: May 14, 2020
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  17. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I agree completely with Deb’s post. I would not assume he continually has pancreatitis. My Gracie’s specfPL was always high but she never had pancreatitis based on several ultrasounds and never having any symptoms.
     
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  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    @Irish Pat

    I want to give you a couple links.

    The first one here is about tight regulation with Lantus or Levemir and working a full-time job. Even though you are using neither of those insulins and PZ doesn’t have the depot to contend with, it still might give you and Beanie some ideas as you decide what to do before you go back to work away from your home.

    The second one here is just to make you smile....and let you see that where you are is where we all are at some point.

    I also wanted to tell you I’m glad to see you “out and about” the forum and supporting other members. It is a great thing for a member that’s been here a few months to reach out to newer members. Even if you can’t give dosing advice, the support and just bring there is immeasurable. So thank you....it has not gone unnoticed.
     
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  19. Irish Pat

    Irish Pat Member

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    Thank you so much for this information, it is a very good reading.....you always have great information or know where to find it....
     
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  20. Irish Pat

    Irish Pat Member

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    Marje this is amazing, this is FD in a nutshell, the emotions of this writing is spot on and what we all are going thru or have gone thru.....thank you so much, the struggle is real!!
     
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  21. Irish Pat

    Irish Pat Member

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    Both these articles are fantastic and very helpful, each in their own way....Thank you so much
     
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  22. Irish Pat

    Irish Pat Member

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    I must say we are struggling with the bounces BIG TIME, I know this site doesn't acknowledge the somogyi effect, but the article I have read is Brady to a "T"....Everything that is described in this article is what is happening to Brady down to the water drinking and urination part when his BG. shoots up to those BLACK numbers. After those BLACK numbers he seems to stay flat for a cycle with the numbers being in the 300 and 400's...I did post on the regular feline health portion of the site asking opinions about the somogyi effect just to get opinions.....Something is just not right with what is going on with Brady, I wish I could convince the vet to try a different insulin, maybe prozinc isn't the right choice for Brady....

    UPDATE AFTER INITIAL POST

    Spoke to the vets office...they don't us any other insulin for cats other than prozinc, they do have other insulins but according the vet tech its ones for canines. SO, I guess im stuck...
     
    Last edited: May 16, 2020
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  23. Irish Pat

    Irish Pat Member

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    Thank you Marje, this means a lot as well.....Trust me I hope the responses I give are of encouragement, at this stage it is WAY TO EARLY for me to even think about giving someone help with dosage advice, especially when im still so confused, no smart comments here please, lol. I just know how this feels and I know people need to think they have someone who cares out there, I try to be that guy as best I can.
     
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  24. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Just so I don’t have to reinvent the wheel, Sienne, who has access to the medical library at OSU because she teaches at the university and in the hospital, researched Somogyi at length and wrote this:

    The other thing I want to emphasize about Somogyi that even most vets don’t understand is that the premise behind it is that it results from a chronic overdose. Even if you, as a CG, decided you believe that Somogyi occurs (and I hope you don’t), Brady is not overdosed because you’ve increased his dose slowly and systematically. If you’d been following a vet’s advice, they would have been increasing by a unit at a time and potentially bypassing a good dose.

    I wish I had a dime for every time a vet has told one of our members their cat was experiencing Somogyi. I even had a vet tell me that about Gracie early on and that she didn’t think Gracie was diabetic. This was a board certified feline internal medicine specialist and she wanted me to stop insulin. Thankfully, I listened to the members here. I did reduce Gracie’s dose a bit and, as the members here said would happen, she went up into pink and yellow and stayed until I gave her more insulin.

    I’m not sure how to reassure you that there is nothing different about Brady’s curves. In ten years, I have studied literally thousands of SSs. I could post a ton of them here for you to look at and see that he’s not any different. Even simply, you can go to Do Daa’s thread in the PZ group and open his SS and look. They are so similar that it could be the same cat.

    Anytime a cat goes into those higher numbers, they are going to drink more which means they are going to pee more.

    Patience, Grasshopper :) And I say this to you as one who had the reputation of being a most impatient newbie.
     
  25. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    This is really disheartening that a vet in this day and age is so far behind the curve on treating diabetic cats. I have to say that when I went to my vet and told her I wanted to switch to Levemir, she did not say, “I only use Lantus”. She took the time to investigate it and then wrote me a prescription. She also then said that she had learned more about FD from working with Gracie and me than she ever learned in vet school.

    Although there are never any guarantees that Brady will do better on Lantus or Levemir, they are the gold standard insulins for treating FD in cats. Perhaps you need to provide some research about this directly to your vet and have a heart-to-heart. Remember your vet works for you and you are Brady’s advocate.

    I don’t say this lightly but if you have a vet that is not willing to work with you and learn, I’d find another vet. I used five different vets here before I found our current one and she is a Godsend. Yes, most of the others were nice and efficient but they ere not willing to go further than what they had learned in vet school. That doesn’t mean my current vet caves in on anything I ask her for; she doesn’t. But she sees us as a partnership in my cats’ care and she doesn’t dismiss my questions or concerns. If she doesn’t know, she finds out and then we discuss. I have learned a lot from her.
     
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  26. Irish Pat

    Irish Pat Member

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    I promise I will get to you shortly on all of this....I just got home and feeding Brady and giving him his insulin...Also have to run for some food, so I will be back a little later....I read over briefly but will be back to go over it all...thank you
     
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  27. Irish Pat

    Irish Pat Member

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    I need to ask you guys a question before I head to bed, tomorrow is dose change, when my vet tech called back after I explained to them what was going on with Brady they said not to change anything until I talk to my normal vet, who was not in today, before making any kind of changes, dosage and the cerenia….that wont be until Tuesday....

    Tomorrow will be a week and obviously his numbers aren't so good, do I bump up his dosage to 3U tomorrow or do you all feel I should wait to talk to the vet...Also, he is obviously still bouncing cant get the numbers down today......also should I wait because he is still bouncing?

    Sorry got into doing something and couldn't get back on, wife and I are watching a movie but I wanted to get a quick dosing question in for tomorrow morning...Hopefully you guys are still around??
     
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  28. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    He has has a few nadirs below 150 but not many and he doesn’t hold onto the blue for long. Personally, I would not wait. I’d increase his dose to 3u in the morning unless you see a long string of blue or green tonight or wake up to a blue AMPS.

    As all members here do, at some point, you will need to decide if you want to take your vet’s dosing advice or ours. It’s hard for you to always be torn by differing advice. However, the vet sees those blue numbers and thinks he’s doing fine but he isn’t.

    I asked my vet once why so many vets tell their clients that it’s fine if the cat is in the 200s on insulin. She said it’s because the vets can’t be there 24/7 to help with low numbers so it’s a safety thing. There have been some vets on here with their cats and they learned a lot which they took back to their practices. Take a look at Charlotte’s SS. Her CG is a very experienced vet who came here for help and, as you can see, Charlotte went into remission. Here is the post from her last day on insulin.

    And, just because this was so special but also will let you know that others share your journey, I hope you can take time to watch this.

    Enjoy your movie. Good luck with the increase.
     
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  29. Irish Pat

    Irish Pat Member

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    He is on 3U starting today....I also watched the video and read that SS, great information, one again thank you
     
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  30. Irish Pat

    Irish Pat Member

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    I totally understand what you are saying here, Brady has an apt on Wed afternoon and I will be discussing a few things with my regular vet..actually will be calling her Tuesday to discuss some things...….I have been happy with my vet, she has been good to us through the years with both Brady and Emma....
     
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  31. Irish Pat

    Irish Pat Member

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    You were an impatient newbie at one time...really...lol...now I find this hard to believe, but then again im sure everyone is very impatient when they get the news your pet has diabetes.....I hate that im this way, I really do....I cant stand myself sometimes because my mind goes 900 miles an hour because of what happened with Brady...I do try to step back and take a deep breath, I know we will get through this in time.....glad you guys are hanging with me....
     
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  32. Irish Pat

    Irish Pat Member

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    Well nadir, which isn't very low at 277 comes in at the PS time...Have a feeling it may be a long night....We shall see, hope this 3U works for us!!
     
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  33. Deb & Wink

    Deb & Wink Well-Known Member

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    I also hope this 3U works for Brady.

    Marje is in a much later time zone than I am. By the time I go to bed, she probably hasn't even started to cook dinner!
     
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  34. Irish Pat

    Irish Pat Member

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    I hear ya Deb...My bed time is real soon here.....he is at 188, giving him his 1/4 can hitting the hay soon...will check before bed......Hope you have a great evening
     
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  35. Irish Pat

    Irish Pat Member

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    Well today was an interesting day!! Started off with a low PS number of 127, dropped to 120 after he had some food and then climbed to 158 after Brady snuck the rest of his food and snuck a small bowl of crumbled up Purebites (chicken) that was on our counter, up high, and didn't think Brady could get to It...I was wrong, he could and did....It would have been a few (several ) Purebites, you know them shavings at the bottom of the bag, so I hope that doesn't screw up his numbers...I did shoot 3U at 6:45 AM so I hope between his food and the Purebite food thief that this doesn't throw his numbers into some crazy mess.....Was nervous about shooting the 127, so I will be checking his BG regularly today.
     
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  36. Irish Pat

    Irish Pat Member

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    So since I didn't shoot until basically about 45 minutes or so past his normal shot time, how do I get back on track? Normal shot time is 6, shot at about 645 AM today....I assume I have to shoot as close to 645 PM tonight, but how do I get back on my 6-6 schedule?
     
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  37. JOJI and Kit

    JOJI and Kit Well-Known Member

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    we typically split the difference to walk it back.
     
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  38. Irish Pat

    Irish Pat Member

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    Can you explain a little bit by what you mean? Please, this guy was born yesterday, lol
     
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  39. Irish Pat

    Irish Pat Member

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    Starting to panic a little bit, Brady just ate some LC food, started giving him some at +4.25 when his BG was at 98, he ate some of his normal 1/4 not all...He just finished it up at the +5 mark and his BG is at 75
     
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  40. JOJI and Kit

    JOJI and Kit Well-Known Member

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    normal shot time = 6:00
    most recent shot time = 6:45
    6:45-6:00 = 45min i.e. the difference to split
    45/2 = 22.5 min is the split difference. of course you can round this to something like 20-25min min or whatever your error tolerance is.
    so for example:
    6:45 - 20min = 6:25 for the next cycle
    and then back to 6:00 for the cycle after that.

    hth, jw
     
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  41. Irish Pat

    Irish Pat Member

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    My only problem now is his BG he is at 75, starting to panic a little
     
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  42. Irish Pat

    Irish Pat Member

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    Will test again in about 15-20 minutes
     
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  43. JOJI and Kit

    JOJI and Kit Well-Known Member

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    please understand that i’m no expert or senior member, but if brady were my cat and i felt panic at that number i might feed something really small like a teaspoon or two and test again in 20-30min
    jw
     
  44. Irish Pat

    Irish Pat Member

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    That's what im doing....gave him a little high carb....im going to see what happens here...
     
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  45. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Don’t panic. He’s almost at mid-cycle and I saw he’s flat after 15 mins.

    Personally, I’d rather see you give him two tsp LC and see how he reacts. If you’ve already fed HC, don’t give more food....just retest 30 mins after any food you give. I’ll be around and watching.

    Deep breath....you are in control with food and your meter.
     
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  46. Irish Pat

    Irish Pat Member

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    So here is what happened....he got his normal 1/4 can when he was at +4.25 (98 BG) Im going to give it to you in time even though different time zone so you can see what took place

    9:49 AM 128
    10:55 AM 98 fed his normal 1/4 can of LC
    11:31 AM 75
    11:47 AM 69 took a lot of deep breaths but decided to give him a teaspoon of the HC as im in the middle of working and taking calls had to do something
    12:10 PM 83 feeling a lot of relief at the moment

    I think I handled it pretty good, not A+ by any means, but I think I could give myself a C+ or C-....It was concerning me that he was still dropping after the LC food and with my job I handle some delicate calls and cant let the individuals hang so I made that HC food choice.

    I think the next thing we need to discuss is what my next dose should be, if I follow the rules of SLGS, im to go back to 2.75 for a week again......
     
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  47. Irish Pat

    Irish Pat Member

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    Thank you thank you thank you for being here @JOJI and Kit
     
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  48. Irish Pat

    Irish Pat Member

    Joined:
    Mar 14, 2020

    And as always thank you for being here
     
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  49. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Pat

    I know it’s hard but you have to do the times in terms of + numbers because it allows us to see where he is in relation to the insulin working. I can’t tell a thing from the actual time because I have no idea where that is in the cycle.

    You can provide it in these terms: if it’s on the hour of when you shot then it’s just +3, +4 +5, etc. If it’s 15 mins past then it’s, for example, +4.25. 30 mins past is +4.5, and 45 mins past is +4.75. If you tested at 20 mins past, just round to 15 mins past. Also....we need to know how much you fed and what carbs e,g, LC, MC, HC.

    I’m glad you got him flat but HC wears off so your day might not be done. I’d not feed and test in an hour
     
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  50. Irish Pat

    Irish Pat Member

    Joined:
    Mar 14, 2020

    Ok thank you.....this is my first episode with something like this and I don't really know what box in the SS to put it in, so yes if you can help with it all I appreciate it.....
     
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