? [Dosing Advice Sought] What is next for Jai Jai?

[heyhollis]

Hello, all. Jai Jai has just finished his 6 cycles of 0.5 units of Lantus (Please refer to this link for my previous post). His BG looks stablised these two days. I have also increased his food starting from yesterday, the increased intakes seemingly do not have much impact on his BG.

I wonder if I should increase his dose to 0.75 units starting from the next cycle. I hope the current figures already provide you a picture of how Jai Jai reacted to 0.5 dose. If not, the +6 reading will be provided 4 hours later.

Once again, thank you very much for your help. It's been a fruitful experience in learning from you guys.

 

[Robin&BB]

Hello, all. Jai Jai has just finished his 6 cycles of 0.5 units of Lantus (Please refer to this link for my previous post). His BG looks stablised these two days. I have also increased his food starting from yesterday, the increased intakes seemingly do not have much impact on his BG.

I wonder if I should increase his dose to 0.75 units starting from the next cycle. I hope the current figures already provide you a picture of how Jai Jai reacted to 0.5 dose. If not, the +6 reading will be provided 4 hours later.

Once again, thank you very much for your help. It's been a fruitful experience in learning from you guys.

I think you'd likely be ok to increase to the 0.75 - as does not appear from his SS that his #s are dropping much. Will you still be around to test during that cycle if you decide to up the dose?

 

[Critter Mom]

Hi Hollis!

I know the reds aren't the prettiest things to see on Jai Jai's spreadsheet but I see he gave you a pink on today's morning cycle (a smooth Lantus cycle). The positive is that Jai Jai's blood glucose numbers aren't ping-ponging all over the place now. The 0.5 unit dose seems to have calmed things down a good bit. Most importantly he hasn't seen any more of those very scary low numbers.

The TR protocol guidelines would indicate a 0.25 unit dose increase. Therefore his next dose according to TR protocol would be 0.75 IU Lantus starting at the next dose. (As Robin says above, it's important to be able to test because of Jai Jai's history of going low on doses higher than 0.5IU Lantus so a close eye needs to be kept on proceedings.)

@Chris & China or @BJM - I'd be grateful if you could double-check Jai Jai's spreadsheet over and confirm to Hollis that a dose increase to 0.75 IU Lantus is the appropriate next step. (It helps me to help others when I know that you guys are peer-reviewing this.)

.

 

[heyhollis]

Thank you @Robin&BB and @Critter Mom for your reply. And I have to thank once again for your support and advice so far, they put me back on the right direction and Jai Jai has just benefited from the right move.

I have got his +6 reading and I have just inputted into the spreadsheet. The figure confirms that he is steady on 0.5 units.

I will be around whole day tomorrow for testing. After that, I can test the +6 value of the PM shots on weekdays. This is the best I can do right now.

I am now go back to sleep and will get up 4 hours later, sorry that I will not be around for prompt replies

 

[Critter Mom]

Hi Hollis,

Sorry I missed your post. You're doing a fantastic job on testing. You also sound a lot calmer now. I hope you're feeling better about things in general.

If you don't get any further input on this thread tonight and you're not confident of changing dose without someone keeping an eye on your thread during the cycle, I would suggest sticking with the 0.5IU dose for another cycle and we'll see if we can sort out someone to keep you company when you change the dose.

Whatever you decide, it'd be great if you could post a note to let us know. Hope your sleep is a refreshing one.


Mogs
.

 

[heyhollis]

Hi, Mogs. You are right, I am relieved and have much confident in managing Jai Jai's diabetes when you guys educate me with lots of knowledge and experience. I do not understand until you guys taught me even though I read the information a few times. I am sure I have much more things to learn from you.

I am going to test for his AMPS, and I am more comfortable to change his dose to 0.75 units in this cycle because I am here to be with him whole day.

I also bought the 3/10cc syringes yesterday, though they do not have 1/2 unit markings on them (and the needle is longer, ugh). It is still much easier for us to pick 0.75 units from the vial.

 

[heyhollis]

Hi, all. Jai Jai's AMPS falls into the black zone. hmm hmm. Is it too fierce if I raise his dose to 0.75 units?

 

[Shiloh & Rhonda (GA)]

This is just me, but I am normally more comfortable doing the dose changes during the day, when I am sure I can monitor. What time is it there?

 

[heyhollis]

This is just me, but I am normally more comfortable doing the dose changes during the day, when I am sure I can monitor. What time is it there?

It is 7:30am right now. We have just given him 0.75 units. Whether I should check him at +3, +6, and +9, or at +4, +8, then PS?

Which one do you prefer?

 

[Chris & China (GA)]

I agree that it looks like you should go ahead and go up to .75 on your next shot....let's see if we can get some prettier numbers!!

You might want to start posting over on the Lantus forum too....Everyone there uses Lantus or Levemir so you'll get the most experienced eyes helping out!

 

[Shiloh & Rhonda (GA)]

Hollis, your SS shows you gave .5 for the AM shot. That is why I was asking.

ETA: Never mind....I see the .75 now.

 

[heyhollis]

Thanks to @Chris & China and @Shiloh & Rhonda to second the dose increase, I will start posting on that forum too. Have a nice day and stay healthy

 

[Critter Mom]

I do not understand until you guys taught me even though I read the information a few times.

Tell me about it, Hollis! I went through exactly the same thing last year. I have post-traumatic stress disorder and it makes it extremely difficult to read and understand written material, especially when it's stuff that's new and unfamiliar. After Saoirse was diagnosed, I started trying to find out more about how to help her on the internet. I read things over and over till I was blue in the face and still the information would not sink in. Were it not for the members here and all the 'condensed' FDMB help guides I don't know what I would have done.

I'm really glad to hear you're feeling better about things now. Anxiety and comprehension do not make good bedfellows.

It's great that you're going to be able to monitor Jai Jai throughout the whole day.

I just want to double-check your new syringes with you. Can you confirm that they are 0.3ml U100 insulin syringes, please?

.

 

[Critter Mom]

Hi again, Hollis.

I'm glad to see that @Chris & China and @Shiloh & Rhonda have checked in on your thread. It's good that you're moving to the Lantus support group: there are more members there that are very experienced in using Lantus and they will be able to help you from here on in.

(Ladies - are you both OK to keep an eye on Hollis and Jai Jai now? I'm fading here.)

.

 

[Shiloh & Rhonda (GA)]

Aine, I will be good for a couple of more hours at least. Feel free to fade. You have done extra duty the last few days.

 

[heyhollis]

Hi, Rhonda. It will be nice to have you around for a few hours. Jai Jai and I will be fine, don't worry.

Tell me about it, Hollis! I went through exactly the same thing last year. I have post-traumatic stress disorder and it makes it extremely difficult to read and understand written material, especially when it's stuff that's new and unfamiliar. After Saoirse was diagnosed, I started trying to find out more about how to help her on the internet. I read things over and over till I was blue in the face and still the information would not sink in. Were it not for the members here and all the 'condensed' FDMB help guides I don't know what I would have done..

Ah, you mentioned that you have got PTSD and I hope that you are getting better and better now. I also got some kind of PTSD after the fur shot....I shot only once after that incident. My hubby is taking up my role because he is more steady in handling the syringe. But, he does not test BG so far he is so afraid to make Jai Jai bleed.

One more point I would like to add, we still inject saline solution to Jai Jai (per the vet's advice) which keeps him hydrated and flushes out the toxic in the kidneys.

I just want to double-check your new syringes with you. Can you confirm that they are 0.3ml U100 insulin syringes, please?

Yes, the syringes are 0.3 cc (BD Ultra-fine Insulin Syringe 3/10cc 29g X 1/2"). This is the only stock item at the pharmacy. If not, I have to make the order and wait for some more days for the delivery.