HANK- AMBG 139, +30-143, fed +5:15-172, PMPs 260-

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bettyandhank

bettyandhank

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viewtopic.php?f=9&t=9159 yesterday's condo



Well folks, we are late on top of late. Forgive fortcoming typos...trying to get this ut quickly as possible.
We are new, Hank is not yet regulated. Have had to skip a few shots due to low numbers.

Were in the process of shifting forward in 15 min increments to cover for Daylight saving time, and lost all that PLUS a low number and re-tests causing us to be already 1 1/4 hrs behind normal schdule. Combined we are over 2 hrs. behind. Have hoped to make it up as the PM has become awful past midnite...more if anything goes wrong. Schedule is now all wonky.

A reduced dose was suggestedm but he woke up so high yesterday from being short the night befiore I decided against it then. Last nights shot was somewhere between .75 & skinny 1U...a little lighter than our normal.
He is starving...all this lateness means his breakfast is late, And NOW AM PS or maybe AMPG 139.

WHAT DO WE DO? I hate to keep skippin doses,, but I am too new and not comfortable shooting this. Our 'no shoot' number had been 18o.shot one a little lower a few days ago after a couple retests. I cannot keep pushing this schedule back. it owuld be 1AM before his shot tonight, and worse if the numbers didn't cooperate.

Do we skip again? Have to make a QUICK decision...it's now or never.

we re too new to knwo what to do. I hate for his doses to be so erratic. trying to find some consistency hence the light dose last night.

also we are vet-less at the moment, so oeprating without a net and no one to call.

I will fill the ss, but can someone givbe a quick comment??? what should we do?

a .5 now? skip?

thanks

b&H
 
Re: HANK- AMBG 139 - *** NEED ADVICE

In my schedule.. sorting out a 2 hour late shot would be a disaster (not to mention take most of a week).. I would skip it and straighten out the times tonight..
 
Re: HANK- AMBG 139 - *** NEED ADVICE

I'm not able to give dose insight. But I can ask a couple of questions until someone experienced comes along -- sorry if this is already stuff you've said.

- Are you home to monitor?
- Do you have a hypo kit assembled (some high carb food, some Karo syrup)
- Have you retested after waiting 15 minutes?
 
Re: HANK- AMBG 139 - *** NEED ADVICE

I haven't been keeping up on your condo, I'm sorry. But FYI, I think we have three choices when deciding whether to shoot a low number:

1. Stall 15 minutes without feeding, retest. Stall until the number comes up, then shoot the full dose, and adjust your schedule.
2. Shoot a small (BCS) dose that you feel comfortable with, if you are "data ready" (which you probably are not, being so new).
3. Skip.

Let's see if someone more experienced comes along.
 
Re: HANK- AMBG 139 - *** NEED ADVICE

time, time time...just not enough of it. If not for DST, would have been just over an hour behind. But our normal pre- DST was already on the late side 10PM.
10PM is now 11PM. so with the hour+ we lost playing these games 2 night ago, we have been thrown into a tailspin.

I had hoped to bump him up 10 minutes this morning, 15 mintues tonight.then he threw this monkey wrench at me.

I re-tested and it moved up but only 4pts. Basically the same. i fed him because he was starving. it is not fair that he hasn't had breakfast at Noon.

it may be that as much as i hate it, we skip again and shoot back on schedule tonight. because I am still new and unsure, now that he has eaten

would it be better to give him some small token amount, like a .25? And if I did so, can I still shoot my PM dose at +10? so we can get back to schdule?

Or would it be better to skip.

If i can't do PM dose at +10, ...with doing a token .25 now, then I probably would opt to skip. We cannot keep this craziness up.

But i depserately need to get him some consistency, so just unsure what to do for this moment.

can't we just have one normal day?

Plus not, he had high numbers yesterday from a somewhat similar scenario day before. I've got to get this figured our and him on track. Fell my window is clsoing to do anything or not.

apprecaite any quick feedback
 
Re: HANK- AMBG 139 +30-143 fed *** NEED ADVICE

I don't want to give a +12 tonight regardless.

If i can do a token and a plus 10, then will do that if it is ok.

ALso, later in the week, I will be gone for long hours consecutive days and not here to watch him for the firs time since this all began....

so I had hope to have him in some good holding pattern. We have no vet right now (long story- read last week's condo) so kinda scary figuring this all out.

thanks
 
Re: HANK- AMBG 139 +30-143 fed *** NEED ADVICE

Since you are two hours late already I think it is best if you skip the shot and shoot your pmps at a time that you want to keep as your 12/12 schedule.
Do you have work hours that keep you to a tight schedule. I am trying to get you to find a shooting time that if you need to stall it does not make you late for work or that you will not be doing your pmps at midnight. It is best to find a time so that if you have a lower number you will have time to stall or ask for advice if need be and get some spot checks. Make sense?

Another thing that some people do when they are new is to get a +11 or +11.5 so you will have an idea of how low Hank's ps is and that will give you more time to post and get shooting advice.
With Lantus it is good to have consistency so dose hopping is not recommended. In this case you do not have a lot of data to shoot low.

What would be a good time for you to shoot and still have time to do spot checks?
 
Re: HANK- AMBG 139 +30-143 fed *** NEED ADVICE

Thanks, Miriam! Betty, you've got some good input there. What Miriam says!
 
Re: HANK- AMBG 139 +30-143 fed *** NEED ADVICE

Miriam-

I think you are right. No, right now my schdule is not 'normal' We picked 10/10 and that worked fairly well w/in 15-20 minutes. But these times his counts have been low, and I am new to all this, by the time i sort out what to do, post, wait for advice, & re-test, it has gotten us off.
because we got lows, both blues and greens on Thursday & friday eves, right as we would have been trying to move it up 15 minutes for DST, not only were we not able to shoft early, we instead were late as we had to delay to re-check, etc..
it cost time AND momentum. By Saturday night we added an hour to that with the time change. Then yesterday, when i planned to try and catch up with part of that time, and potentially decrease his dose to .75 to try and circumevent the roller-coaster we keep ending up on, his BG was really high after the
previous eve's dose decicison. We had potponed, re-tested, and ultimately shot a reduced dose even though he was blue and lower than my no-shoot cutoff or data allowed. So it added to our lateness, then he wakes up yesterday in pink. So I went ahead w/ his normal dose yesterday and ever so slighlty less last night.
I do think I would like to try him on closer to .75, maybe tonight i will do that at our 10PM time.

I usually do test about +11.5, then feed, then shoot. This works if all goes well, but if not and we have to post, wait for replies, stall, etc.. then the clock ticks & the +11.5 becomes +12.5, and so on. My last one's just coincided w/ the DST... not a great recipe for our schdule.

I think I will try to test a little earlier tonight. I hope he has a comfortable day and this doesn't set us back too much. it's been a wacky few days.

thanks ya;ll

i just hate that he is all over the place. I hope he can at least stay in yellow today.
 
Re: HANK- AMBG 139 +30-143 fed *** NEED ADVICE

Is it possible to have your shot times be 9 am and 9 pm? That way it will not be so late for your pm shot and if you have to delay you will be more people on to help. It will also give more room to get spot checks.
You really need to pick a dose and stick with it or you are going to have erratic numbers. Lantus really likes consistency.
From skipping and shooting late and reducing you are depleting the shed so it will take some time to build it back up. This is where patience comes in and I know how hard it is to be patient....I am the queen of "impatience."

Was there a dose that was suggested to you by Libby or Jill?
 
Re: HANK- AMBG 139 +30-143 fed *** NEED ADVICE

bettyandhank said:
A reduced dose was suggested but he woke up so high yesterday from being short the night before I decided against it then.
Last nights shot was somewhere between .75 & skinny 1U...a little lighter than our normal.

WHAT DO WE DO? I hate to keep skippin doses,, but I am too new and not comfortable shooting this.
I hate for his doses to be so erratic. trying to find some consistency hence the light dose last night.

also we are vet-less at the moment, so operating without a net and no one to call.
Click to expand...
Aww Betty, I feel your anxiety coming through the page. I hope we can help you feel more comfortable soon.

1. Glad you skipped today, your schedule was too messed up and Hank was lower than you wanted to shoot.

2. A reduced dose was suggested so you would be able to shoot twice a day without having to shoot numbers that were too low for your comfort. I know you saw a higher preshot yesterday, but that was probably a bounce and he came down from there.

3. Even if his numbers are a little pink... give that reduced dose a chance, so you can shoot 12/12 schedule. Skipping doses isn't going to get you on a nice consistent schedule. I know it's upsetting to see pink and you didn't want to go down to the .5 unit, but maybe that smaller dose would have helped you be able to shoot 12 hours later instead of needing to skip. (Maybe. It's easier to be a Monday morning quarterback, so forgive me.)

4. If you can shoot every 12 hours, that is more consistent. Start with a small enough dose so you can do that. If you don't like the numbers, I understand, but it is easier to slowly RAISE the dose after you get on a schedule rather than having to skip because he's too low- which is kind of hard on your plans as you've discovered.

Miriam has given you some good ideas and I agree with everything she says.

You are not alone, we all are here for you!
 
Re: HANK- AMBG 139, +30-143, fed, +5:15- 172- tonight??

Ok folks. Hindsite being 20/20, am glad we did NOT shoot this morning.

I truly get the desire the consistency, but still up against what this darling boy is presenting me. We are still so new to this and don't have enough inherent knowledge yet to make these crucial spot decisions.
Upon advisement, rather than shooting low on Sturday, i delayed, retested and ultimately shot a reduced dose a little late and he was all pink and yukky yesterday.
Last nights attempt to try out a slightly lower dose for us than prescribed (by our now non-existent vet) hoping for that consistency and some sleep (we did somehwere between .75 and a skinny1) and he WAKES UP BLUE again where he's been most of the day. Our schedule was so wacked out, we were so late.
All these decisions to make come w/ this intense sense of urgency, trying to keep on schedule. If we start tmuch earlier, the number may still change and not be reflective. I try testing about 30 minutes before shot time, then feed, then get his shot together while he eats, which when it all works out, works out!
The glitch is when the numbers are askew and quick decisons must be made & I run to the board for help. Typing, posting, waiting for reply & advice, re-testing etc. Now we are up against the clock, late and so on.

I want to keep the inuslin in him, and truly understand the benefits of consistency. But he keeps throwing me off. I was TRYING to start a new dose last night, just slighlty less than where we'd been. But then look where we landed.
If I knew this morning that 5 hours later he would still be in the blues, there wouldn't have even been a question. At some point I may get a bigger picture understanding, and may have an arsenal of other options for times as this..ie: a token dose, then back to regular dose that night?? But still too unsure to go it alone. He looks good, had a blue day.for all I know he is still blue now. THEN WHAT?
They would have had me on 1U bid, NO MATTER WHAT. I would have hypo'ed him 3-4 times already.

So, let's see what tonight brings. By looks alone, i think he is still low. How could this be ya'll? Could this indicate any sort of internal heling on his part- could his little pancreas be working again on it's own? is that too much to read into or wishful thinking.


Side note: I set a vet appt. to try a new vet a week from tomorrow. Let's hope this turns out better. I feel like i bring vet baggage with me. I am just a confused mother with a diabetic cat and lots of questions who needs to better understand, that all.

Until then, we are punting on our own. Keep fingers crossed for no drama and good health between now and then.
Thanks so much for all the support. we sure need ya'll and are so grateful.
Just wished sometime it could be called rather than typed in. Wouldn't it be great to have a 'feline diabetes' nurse, kind of like a milk nurse for a newborn, to move in with you for that first month to acclamate. Novel idea!

I have my online 'nurses' ...and thank goodness for that!

PS: We will try to come back a little earlier tonight for any questions so we can FINALLy get back to schedule. My plan will be if numbers are high 100's, to shoot the same slightly lower dose as last night. Otherwise, be thinkin' what for us to do if lower blue.
I now have more spot checks and am building data.
Won't be home much to spot check later this week. So have to get settled in here pretty quick.

Back soon!

B&H
 
Re: HANK- AMBG 139, +30-143, fed, +5:15- 172- tonight??

I know you're frustrated and confused, and I know it's a leap of faith to trust people on the internet, but can you please try our suggestion to reduce Hank's dose? I don't mean to reduce it just for tonight, I mean to change his dose. Skipping every other shot is not good for him and just leads to higher numbers. That is what is making those pink numbers show up, not the need for more insulin.

You need to have a dose that will keep him in a range where you can shoot the same amount comfortably, every 12 hours. 1 unit is not doing that for you. If I were you, I would shoot 0.5 units tonight, and shoot that every single cycle for at least 3 days unless he is still going low on that dose (we'll help you decide whether to increase after that). It will help your schedule because you won't have to wait for advice so much, it will help your stress level immensely, and it will probably help Hank's numbers. If we don't like his numbers after 3-5 days, we can increase the dose slightly if needed.

Please try it? What you can't do with Lantus is get distracted by preshot numbers that are high. You have to look at the big picture, pick a dose and commit to it, and let the dose do it's thing. Lantus builds on itself cycle after cycle so it needs time and consistency.
 
Re: HANK- AMBG 139, +30-143, fed, +5:15- 172- tonight??

Betty,

Feel free to look at our spreadsheet from early last fall, when we were just getting Kitty on the right path, if you want to study up on Libby's excellent advice.

Sometimes the numbers will go high, sometimes low. If low, we're prepared for that with our high carb food and support.

I think the way I understood it is that we don't control numbers; we control the dose, and the dose controls the numbers. So choosing one dose, and sticking with it, through whatever numbers you get, is the key to good health for Hank.

There is so much to learn. You'll be amazed by how much you know four weeks from now! :-D
 
Re: HANK- AMBG 139, +30-143, fed, +5:15- 172- tonight??

Hi Libby- & all.

it's not just the pink, it's the blue/green too, they all confuse.

I was heeding the board's advice, lowering his dose to .75 last night with the intention of trying it on for a few days exactly for the reasons you mentioned. I looked back and both you & couple others had recommended trying that dose. (check this weekend, i think) I understand the skipped doses are not good. But I remain uncomfortable shooting him too low...which he has been a number of times including this morning.
I wasn't certain what to do & did seek advice making the best decision i could in the circumstance. I couldn't beleive he was so low still on a reduced dose.

The only other single reduction .50 shot was done per advisement on the board on Saturday. Otherwise our dose hasn't changed. Just began to see a pattern in the last days which is when ya'll began to suggest the reduced dose I started last night.
I AM following the advice and grateful. My understanding was also that until i have more data, to not shoot below 180. I shot lower at 165 Saturday, but that's the lowest so far. I have been getting in more spot checks now.

I do plan to try the .75 dose as last night, but as of today, he had a full day of blues. Would you have had me shoot that low number this morning? That confuses me. He remained blue in my subsequent checks so i felt great that was the decision in hindsite.

But if he show up in the blues here in a few minutes, I would again be reluctant. I get the shed build up and momentum part, but do not understand shooting amounts, especially full doses, if he has low BG numbers, and chancing hypo-ing, to stay up re-testing, feeding, re-testing, etc..if he is in good range. That part still confuses.

As it were, if shot this AM likely may have hypoed him. He remained in blues without it. I may be missing some logic,...but that part doesn't make sense yet. Believe me it's far from all making sense still...It's not black & white ..I have questions at most turns.

At least we get to get back on schedule. That parts good. And he really has looked good today. We have been literally exhausted. My big worry now is will he be low again & i'll be conflicted. We are overdue for a drama-free night.

So .75 is the plan, unless a Blue/green number with my newbie no-data status. I'll check back shortly either way with a report and/or for guidance.
BTW, my .75 & bubble is probably a skinny .75. Can you bless that? (check your message Saturday, i think...I believe that was you recommendation then)

OK, off to test.


back soon
 
Re: HANK- AMBG 139, +30-143, fed, +5:15-172, 260- EYES

Ok, ....we are about to shoot. i got reduced dose conflciting amounts. I just read back through a few days posts. Libby & Sienne suggest .75 several times earlier, now today I am seeing .50. this will need to ride for possibly a week due to my being gone alot.
Can i get concensus? My lean is toward .75, but I can be am open ....need to hurry for our time.

skinny 75?
 
Re: HANK- AMBG 139, +30-143, fed, +5:15- 172- tonight??

Hi Betty.

Just to be clear: If this was my kitty.... I would consider this:

Both the 1.00u and now the .75u have proven to be too much to shoot 12/12 schedule.
You've had to skip because these doses brought Hank too low to shoot. We are too learning how Hank responds as you go along.

The one time you shot .5u - you increased the dose the very next cycle because you saw a preshot of pink. You didn't give this dose a chance to settle.

Please try to stick to the 0.5u dose - even if you see a preshot of pink. Doses can be increased gradually, but if you keep skipping you'll have trouble with consistency.

I understand things are confusing right now, but why don't you start over right now? Get a lower dose and stick with it. I believe you can see that even the .75u is a little too much for Hank right now. OK?

Don't be overly concerned with a pink number YET. You need to be able to shoot twice a day and if that means pink preshots for a little bit, then so be it. Hank responds very well to Lantus and will come down easily. You just don't want him to come down too much too fast, OK?
 
Re: HANK- AMBG 139, +30-143, fed, +5:15- 172- tonight??

I think Libby wants you to shoot .5u tonight and stay with that dose for at least 3 to 5 days.
I
 
Re: HANK- AMBG 139, +30-143, fed,+5:15-172 PM260- EYES @ bottom

Oh, and if you need to be gone often... definitely go for a lower dose of 0.5u! Safety first, you don't want Hank to go low when you are not home.
 
Dear Betty, Please LISTEN to your dosing advisers! They are experienced. They know what they are doing. Don't panic! Just go with the 0.5 dose and give it every 12 hours until you are advised to change it. Don't skip shots! Don't equivocate! We all want the best for Hank and for you. You can do it!
Ella & Stu
 
Hi Betty, I hope you didn't think I was being too blunt. I was trying to answer quickly before you needed to shoot. This whole diabetes adventure is very confusing at first and please know that we've all been scared and worried. My vet is great but if I had shot what she recommended, my kitty would have been in a coma on day one. (5 units was recommended!!) This board saved us.

You are trying to learn and understand everything very fast and it is so much to digest, especially when you have a kitty that responds so well to the insulin. Right now just concentrate on a few things to start and the rest will come easier as you go along. I suppose you've been bombarded with lots of stuff and I apologize if I've added to it.

My heart just ached when you explained what happened with your vet and I just want the best for you and Hank.

I am happy to see you did shoot the 0.5u tonight. Great job and best of luck that Hank will give you a shootable number tomorrow too! :thumbup
 
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