Frank's Saga

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Those little babies are adorable!!! OH my gosh I wish I could take a little orinch one!! But my kitties would not take to that well...

Remember that if the dose was a set and forget thing, that would mean remission wasn't likely to happen since the BG would be the same throughout. So...changing requirements are a good thing!
 
I think we had a slight bounce after this morning. I wish I knew I could safely stick to 3.5; we may have actually gotten in the single digits if I had upped the dose. (We were so close to the shoot/don't shoot number.) But I'm hopeful that 3.5 is a good number. (Did I say the same thing at 3? Lol.)
 
I think you're seeing a bounce as well. I think 3.5 is good...I wouldn't up the dose on a bounce because it's not a "real" number.
 
I hope I didn't over shoot this morning. My gut tells me we'll be fine but I might make a trip home this afternoon.
 
I think tonight and last I caught a bounce for Frank. Hoping for 2 non-bouncy days to see some decent numbers...suspect another increase is needed but I'm not sure it needs to be very much, so I really want some non-bounce days.
 
I think I'm ready to increase Frank's dose again, but before I do that...what are the "ideal" preshot numbers that I want? Frank has had some decent 200s preshot, but it's hard during the week to get midcycle numbers. At what point are his cycles good enough that I don't consider increases anymore?
 
Generally you're looking for yellows pretty consistently at preshot and then high double digits nadir...that's what we consider well regulated numbers.

I agree that you can probably increase. Frank is still more in pinks preshot and yellows mid cycle so increasing might help that.
 
Frank's Mom said:
Happy I didn't do that increase last night!
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My goodness! I don't think the stall with no food is going to get him up to a full dose number. Have you set a "no shoot" number in your mind? That's the one where you'd start with stall/retest, move on to deciding on a very low dose or opt for no shot, depending on your comfort level and/or ability to monitor.

If these PS lows pop up more you might consider lowering the dose so that you get two shootable PSs a day. Another thing to try is taking a break from sliding scale dosing for a couple of days to see if that calms things down. It can work really well but sometimes it's an extra variable that gets things more jumbled up.
 
Kris & Teasel said:
Have you set a "no shoot" number in your mind? That's the one where you'd start with stall/retest, move on to deciding on a very low dose or opt for no shot, depending on your comfort level and/or ability to monitor.

If these PS lows pop up more you might consider lowering the dose so that you get two shootable PSs a day. Another thing to try is taking a break from sliding scale dosing for a couple of days to see if that calms things down. It can work really well but sometimes it's an extra variable that gets things more jumbled up.
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My "adjusted shot" number is around 150-250, taking into account what he ate and how much he ate. Unfortunately this morning I had to leave for work and couldn't do the stall and re-test, so opted for NS. We'll probably get off work early, but I can't be for sure, and so I can't even guarantee that I could run home for a mid-day test. (I hate leaving for lunch only to come back to find out I can leave for good for the day.)

Frank got no dry food yesterday, not a single piece. I wonder if that didn't help contribute to this low number. Also, I didn't freeze his food last night, so maybe he ate everything before midnight even rolled around, and then had no food the rest of the night, leading to a low BS.

All I can say for certain is THANK GOD I'm doing PS testing! I can't imagine if I had just given him the full dose of 3.5, or even the 2.5 that the vet thinks I'm giving. I guess I could have done a token dose of like .5, but not being home to check him just made it seem risky. So, he ate breakfast and has his frozen food out for the day, and whatever time I get off work I'll go home to check.

Is it completely unadvisable to give a small dose mid-cycle if numbers are high? I know it would mess up the 12 hour cycle. Maybe this is where I'd like lantus better? Ugh. I feel like I'm just getting the hang of things with prozinc, and I know lantus is a different protocol that I'd have to learn all over again. Things to think about, for sure!
 
Frank's Mom said:
so opted for NS.
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Safety is number one, always!

Frank's Mom said:
I wonder if that didn't help contribute to this low number.
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It's possible. Do you have a sense of how carb sensitive Frank is?

Frank's Mom said:
All I can say for certain is THANK GOD I'm doing PS testing!
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I think we all say this over and over to ourselves.

Frank's Mom said:
Is it completely unadvisable to give a small dose mid-cycle if numbers are high?
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I'd say yes. It creates the problem of two overlapping insulin curves, two nadirs, etc.

Frank's Mom said:
Ugh. I feel like I'm just getting the hang of things with prozinc, and I know lantus is a different protocol that I'd have to learn all over again. Things to think about, for sure!
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It's still early days for ProZinc. I'd give it more time.
 
Wow! Go Frank! See it's the moment where I say "well clearly you need an increase" that he likes to throw these low numbers...just to let me know that I don't really know what's going on! :joyful:
 
Ha! The day that Frank's BG dropped some after I set stricter limits on how much food he got, I swear I think he read his feeding schedule note on the fridge and saw that he would only get 2 cans a day and so did it on purpose. I never said out loud that I was limiting his food, so the only thing that could have happened is that he read the note.
 
Well, now I don't know if we're seeing a bounce or an extreme high from no insulin this morning. I wish I would have given a small dose. Any input on if I should back off a bit now or go ahead with the increase?
 
Frank's Mom said:
Well, now I don't know if we're seeing a bounce or an extreme high from no insulin this morning. I wish I would have given a small dose. Any input on if I should back off a bit now or go ahead with the increase?
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Could be both. I wouldn't give 3.5 u tonight after the 120 this AM. Maybe 3.25 u or even 3.0 u?
 
For what it's worth, I think the NS was the right decision. It's hard to see those high numbers, but without being home to monitor, it's just not safe to shoot on a low number like that. He'll get back to regular numbers in no time.
 
I think your reasoning for that is sound. It's hard not to react to bounce numbers, but you're right that trying to chase the numbers rarely works. I think you might have been okay at 3.25, or even 3.5 (his normal PM dose) since my suspicion is that the low AMPS was an anomaly, and not a new trend. But there's no way to know until a few more days have passed. Plus, I think mama-sense is a real thing and as I'm sure you've read a hundred times here: better high for a day than low for a moment.

I am curious that the PM cycles are so stable, but the AM cycles are not. Are they 12/12? Or 11/13? Any differences in food between AM and PM cycles?
 
His morning shot don't vary by anymore than 15 minutes, but usually they are between 720-740 am. The evening shots are usually around 730, but could be as late as 8, although that's the exception, not the rule. He gets a morning meal (.25 can) and .75 left out frozen for the day. Then usually a BG a 530pm and .25 can if he's loud. Then pretest and shot at 730, another .25 of a can, and .5-.75 left out frozen over night. Yesterday the AM food and PM food equaled a can each 12 hours, and the shots were at 736a and 747pm. It's not exactly 12 hours, but usually pretty darn close.
 
Yup, I would call that close enough. Maybe he's just going to have a wonky morning cycle. Not easy when you have to leave for work though, huh?
 
Djamila said:
Yup, I would call that close enough. Maybe he's just going to have a wonky morning cycle. Not easy when you have to leave for work though, huh?
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It makes me wonder what he does all day when I'm not here. And all night when I'm sleeping. Lol. Last night he ate something crunchy off the floor. It looked like a piece of chicken skin,but I don't eat fried chicken. Lol. Maybe it was a girl scout cookie crumb. Idk.
 
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