Dose Inquiry

Discussion in 'Prozinc / PZI' started by Sugarkitty15, May 28, 2020.

  1. Sugarkitty15

    Sugarkitty15 Member

    Joined:
    Apr 14, 2020
    Hi!

    I'm really struggling to understand what's going on with Squeak's numbers. He did have a NADIR of 93 on 5/26 but I didn't decrease the dose since it wasn't below 90. However, his +3 after PM shot was 107, so he may have dropped lower than the 90 for nadir. Same with last night as he was 108 at +3 after PM dose. I tried my hardest to get up at +6 last night and the night before but I slept right through my darn alarm! Today his glucose seems a little higher and I'm wondering if he's bouncing as his +6 is 203 today. Should I continue at .75U? Or do I need to adjust the dose?

    Side note-I gave him .75U this morning. I can't update the spreadsheet until later and realized I forgot to add that in there this morning.
     
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  2. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Try drinking a really large glass of water before you go to bed. So you have to get up in the middle of the night to pee. Then you could test Squeaks in the middle of the night. ;)

    Squeaks looks ok on the 0.75U dose, but I bet he's dropping low overnight, which is why you are seeing the lower numbers at AMPS.

    If +6 doesn't work for you, how about +8 or +10 at night? That would mean you would get yourself up a couple of hours earlier than normal.
     
  3. Sugarkitty15

    Sugarkitty15 Member

    Joined:
    Apr 14, 2020
    Both great ideas! I will try these to hopefully get some overnight readings.
    Do you have any thoughts on why I'm seeing lower pre shot numbers (in the blues) but he's higher during midday? (around the +4 through +7, yellow numbers)
     
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  4. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    When is he eating in relationship to those mid-cycle yellows?
    I know you have notes in the remarks column that say the times. But could you also express those times in our + hour format?
    For instance, I have no idea when your 6:30 am is in relation to the pre-shot test. Or any of the other test times and food given times.
    So if you use the same + hour notations for food, that would help us.
    It's fine to still say 6:30 am, but have the + time too please.

    Yes, it's obvious to you what you mean, but we are a bit in the dark on following along. ;)
     
  5. Sugarkitty15

    Sugarkitty15 Member

    Joined:
    Apr 14, 2020
    Oh gosh, I didn't even think about that! Are you looking for something like this? "fed FF beef at AM shot, +6.5, PM shot & +5. (630a, 1p, 630p, 1130p) was at vet from 8am to 1230pm--no readings or feedings during that time".
    I did update the last few days with layout like this. Let me know if I need to change it at all. I hope this helps!
     
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  6. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Betsy, that was what I was looking for. Now I can see the relationship between the food and the BG tests.

    Thanks!
     
  7. Sugarkitty15

    Sugarkitty15 Member

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    Apr 14, 2020
    Ok great! :cat:
     
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  8. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I see that Squeaks earned himself an automatic 0.25U dose reduction, with that BG level of 62 at +5 last night, 5/30/20.

    Glad to see you took the reduction this morning. Now remember, you want to hold this dose for at least 3-6 cycles, maybe a bit longer, UNLESS Squeaks gives you another BG < 90 mg/dL. Then you would do another dose reduction.
     
  9. Sugarkitty15

    Sugarkitty15 Member

    Joined:
    Apr 14, 2020
    Well, we’re doing another dose reduction based on the +4 after PM shot tonight! (This is good, right?!)
     
    Last edited: May 31, 2020
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  10. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes! Of course it's good! Excellent in fact.

    Ok, after the 0.25U dose, we like to have people try for 0.1U and then 1 drop of insulin, before they stop the insulin.
    You might want to practice measuring those teeny tiny doses.
    Practice with a used syringe, and colored water or fruit juice (not OJ with pulp, that will clog the syringe ;);)), until you think you can consistently draw up those tiny doses.

    I can include some techniques for the drop dosing, if you are interested. Let me know.
     
  11. Sugarkitty15

    Sugarkitty15 Member

    Joined:
    Apr 14, 2020
    Oh ok! That’s good to know. I would love some techniques for drop dosing—I think that would be helpful!
     
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  12. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Here is what I wrote up on drop dosing, for a few other folks.
    Practice, practice, practice is the key.

    Drop Dosing

    How many drops do you get from your insulin syringes if you draw the liquid up to the first line? Not the first line with a number next to it, or the shorter line that shows half unit markings. The very first line on the syringe. What we think of as the zero mark.
    • Practice, practice, practice to see how many drops you can get out of the syringe.
    • Use some sort of colored clear juice like apple juice or colored water.
    • Mark the syringe well. Painter's tape, duct tape, masking tape at the top of your “practice syringe”. So you don't forget and use that syringe to draw up insulin.
    • Draw the "test liquid" up to the first line on the syringe.
    • After you have drawn up a tiny bit of “test liquid”, point the needle up towards the ceiling and give the syringe a "finger flick. To move/push the air bubbles to the top of the syringe. Push out the air bubbles.
    • Slowly “twist” the syringe plunger to push out all the “test liquid.”
    • Then when one small drop of “test liquid” is all that is left on the beveled tip end of the needle, draw the syringe plunger back to "suck" that 1 drop back into the syringe.
    • You are looking for consistency.
    • Try to get evenly sized drops.
    • Practice, practice, practice until you get a consistent number of drops.
    Do you think you have the technique down for the drop dose?
    Then let me know.

    When it’s for real. You’ve practiced and are ready to give a tiny “1 drop” dose.

    Draw up a tiny bit of insulin, needle pointed up to the ceiling and give the syringe a "finger flick”. To move/push the air bubbles to the top of the syringe.
    • Push out the air bubbles that have floated to the top.
    • Slowly “twist” the syringe plunger to push out all the insulin.
    • Then when one small drop is all that is left on the beveled tip end of the needle, draw the syringe plunger back to "suck" that 1 drop back into the syringe.
    "Finger flick” technique - make a circle with thumb and first 2 fingers tucked into first thumb joint. Quickly “snap” those first 2 fingers against the syringe barrel held in your other hand. That will force any air bubbles up to the top of the syringe. Then you can push the air bubble out.

    Syringes have a lubricant inside. Before you draw up insulin, moving the syringe plunger up and down a couple of times helps the plunger move more easily.

    Give the shot. Monitor.

    Later, if you need to, you could increase the number of drops.
    Be aware that some syringes can vary on where the lines are on the barrel.
     
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