Evie's numbers

So what do we think we learned from last night’s skip? I’m thinking that we learned that she needs at least a little insulin instead of a complete skip when she has that low of a preshot. I don’t like seeing her in the yellows again, and we can guess she was in yellow some time last night and we know this morning. She would also be having a better cycle today most likely due to having a lower AMPS. Now, I am actually glad that you skipped the shot last night so we could see some of what happened (also, I hope you got some good sleep!). It’s all helpful information on her spreadsheet. The question is: how much would be appropriate. If confronted with a preshot number that low again, I would be cautious at this point and shoot quite a small dose the first time and see how things went. By small, I mean less than half of her already small dose. I’m interested to hear what you both think about this. We will actually be in a better position to decide this question after we see how she does on .6 units. Who knows if she will keep on needing reductions.
 
Suzanne & Darcy said:
So what do we think we learned from last night’s skip? I’m thinking that we learned that she needs at least a little insulin instead of a complete skip when she has that low of a preshot. I don’t like seeing her in the yellows again, and we can guess she was in yellow some time last night and we know this morning. She would also be having a better cycle today most likely due to having a lower AMPS. Now, I am actually glad that you skipped the shot last night so we could see some of what happened (also, I hope you got some good sleep!). It’s all helpful information on her spreadsheet. The question is: how much would be appropriate. If confronted with a preshot number that low again, I would be cautious at this point and shoot quite a small dose the first time and see how things went. By small, I mean less than half of her already small dose. I’m interested to hear what you both think about this. We will actually be in a better position to decide this question after we see how she does on .6 units. Who knows if she will keep on needing reductions.
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I like the sound of the token dose because she is low again now at AMPS, but not as low as yesterday. Also her nadir did not reach green today.
All that being said I would still feel a lot better starting with a token dose, and a very small one at that if you agree - what do you think about 0.2?
I think I am mostly worried about how low insulin could push her overnight especially starting off with a low AMPS.

By the way, I will test again in another few minutes to see if she is going up or down or flat.
 
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A lot of the time stalling without feeding will cause numbers to drop. Remember that you are not shooting the number where she is now, but you are shooting the number she will be in a couple of hours. Look at last night by +2. See what I mean.
 
But I would still like to know where she is now and if you fed her (which is fine). We know where she was pre-food. ETA: I see you fed her.
 
I'm sorry if I was supposed to stall again or not feed or not shoot.

I literally feel so dumb about understanding all this. There is no pattern to this madness.
Just when I think I know what exactly to do her numbers surprise me yet again.

I anticipated a stall today, so I gave it enough time....but then her glucose drops after stall and again I have no idea how to proceed.
 
AliceL said:
I'm sorry if I was supposed to stall again or not feed or not shoot.

I literally feel so dumb about understanding all this. There is no pattern to this madness.
Just when I think I know what exactly to do her numbers surprise me yet again.

I anticipated a stall today, so I gave it enough time....but then her glucose drops after stall and again I have no idea how to proceed.
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It’s okay. You did fine. I would have done a very small dose too with her being this low. Just make note of what you did and that you fed and when you shot. Like how much later. I think it’s good that she has food on board since we are really in uncharted waters. .2 was what I had in mind
 
So we see that 15 minutes after eating she went to 164. So that's good. Also, the 148 was really very borderline with what we had talked about shooting if she was at 150. We say this over on the Lantus/Levimir forum all the time, but a lot of the time stalling makes decision making more difficult because without food they frequently will drop in numbers (makes it scarier.) So since she was so borderline, I would have just done the same thing... fed her and then gone ahead and shot the reduced dose (since you saw the 120.) If I had decided not to stall (so just looking at the 148), I probably would have fed, retested in 15-20 minutes and then shot the .6 dose. Would I have been nervous? You bet! But I do know that her numbers would go up with feeding, giving her some time to rise before the insulin really kicked in. And I would know that the onset for ProZinc was going to be maybe at about +2 (giving her more time to rise possibly, or at least to stay flat.) I would be nervous, but I would know that I could test and feed her during the cycle. Just some thoughts. I really do think you did fine. After all, the sticky notes say that one option is to stall without feeding (which you did and then retested). So no harm done. We are all learning what Evie's patterns are together. She has made some fantastic progress and you are helping her to make even more.
 
Oh Goodness!!

AliceL said:
I literally feel so dumb about understanding all this. There is no pattern to this madness.
Just when I think I know what exactly to do her numbers surprise me yet again.
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Suzanne really nailed it in the above post - see how there's no way you could have been 'prepared' for all the different scenarios in such short period of time - Evie has thrown so much at you over the last few days. It takes time to even start to understand all this and Evie has been in a real hurry this week.
 
Thanks so much for all your help Suzanne and Shelley!

Tomorrow morning would we go back to 0.6 dose or hold 0.2 token dose?
(Obviously depending on what happens tonight and also what tomorrow's AMPS is)

PS. I must start a new thread already but I just want to keep this one open for tonight in case something goes awry.
 
Shelley & Jess said:
Oh Goodness!!


Suzanne really nailed it in the above post - see how there's no way you could have been 'prepared' for all the different scenarios in such short period of time - Evie has thrown so much at you over the last few days. It takes time to even start to understand all this and Evie has been in a real hurry this week.
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Exactly! We've ALL been running to catch up with (and understand) Evie this week for sure!
 
AliceL said:
Thanks so much for all your help Suzanne and Shelley!

Tomorrow morning would we go back to 0.6 dose or hold 0.2 token dose?
(Obviously depending on what happens tonight and also what tomorrow's AMPS is)

PS. I must start a new thread already but I just want to keep this one open for tonight in case something goes awry.
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Right, don't start a new thread yet. Maybe tomorrow morning would be a good time and you can report on her morning number and what you decide. I would use the same parameters that we discussed last night for dosing. I don't think you are going to have a really low preshot, but we will see. @Shelley & Jess ?
 
She is 157 this morning so I am going to shoot 0.6U as discussed.
I don't mind admitting I am terrified though, I have to keep reminding myself to think of her nadir instead of her starting point.
Will update on a new thread.

Lowest ever AMPS by the way ...and on only 0.2U of insulin the night before!
That seems amazing!
 
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AliceL said:
She is 157 this morning so I am going to shoot 0.6U as discussed.
I don't mind admitting I am terrified though, I have to keep reminding myself to think of her nadir instead of her starting point.
Will update on a new thread.

Lowest ever AMPS by the way ...and on only 0.2U of insulin the night before!
That seems amazing!
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:nailbiting::nailbiting::nailbiting: Me too.
 
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