? I'm really getting frustrated: Sparkle
- Thread starter Sparkle
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@cwilson --
Pepper -- please do not confuse yourself with the information this caregiver (CG) has provided.
Regarding your SS, you may want to put the information about moving your shot times into the "Comments" section on the far right. If you include comments in the cells where the numbers should go, it will make it hard for you to read the SS. For now, you may want to just leave things as they are and if you need to move a shot time, you can always put the information in the comments section.
Unfortunately, what you described is not how Lantus or Levemir are dosed. You do not base the dose on the pre-shot number and you do no use a sliding scale with either of these two depot-types of insulin. What you are describing is appropriate for ProZinc.
Pepper -- please do not confuse yourself with the information this caregiver (CG) has provided.
Regarding your SS, you may want to put the information about moving your shot times into the "Comments" section on the far right. If you include comments in the cells where the numbers should go, it will make it hard for you to read the SS. For now, you may want to just leave things as they are and if you need to move a shot time, you can always put the information in the comments section.
Amy&TrixieCat
Member Since 2011
Hi Pepper...I'm sorry I haven't had a chance to stop by sooner, but I just wanted to say "welcome" to our little group. There is a ton of great support and knowledge here, and we all want to help make this easier for you and Sparkle.
With regards to your spreadsheet, as Sienne said, the comments section is great for making all sorts of notes. I can appreciate reorganizing to it's easier for you to read; however, for the folks who are trying to help figure out what Sparkle is up to, it's better to leave the area for BG numbers in it's original format.
We've all been at the beginning of this dance, too, so we do know and understand how you feel. Feel free to vent, and to ask as many questions as you need!!
With regards to your spreadsheet, as Sienne said, the comments section is great for making all sorts of notes. I can appreciate reorganizing to it's easier for you to read; however, for the folks who are trying to help figure out what Sparkle is up to, it's better to leave the area for BG numbers in it's original format.
We've all been at the beginning of this dance, too, so we do know and understand how you feel. Feel free to vent, and to ask as many questions as you need!!
Pepper
I can try and fix the SS for you in a little bit if you'd like. I still have editing rights.
Julie gave some great info on the depot and approaches. Let me run through what would have been a good approach to take.
If you get a number in the 40s close to shot time, take a deep breath, don't feed, and retest in 15 minutes. If he's not coming up, feed one teaspoon of low carb food as indicated in Shooting Low Numbers. Then 20-30 minutes after he eats, retest to see if he is rising. The reason we do this is because often the insulin duration is decreasing as you get to the next shot time. You don't want to over feed because the goal is to just feed enough low carb food (one tsp) to get them out of the 40s but which won't give you such a huge food spike.
Normally, once they are coming up above 50 after following the above procedure, if the CG has supplies and is available to test, it would be appropriate to shoot the rise. If you are new and don't have much data, as in this situation, you might continue to stall a little longer without feeding. Last night when he was at 164, you could have easily shot even though you had fed him. As Sienne said, when you are at the end of the cycle and numbers are rising like that...that fast, you don't have to wait two hours without food to shoot. You could have shot the 164 and then given a little more food to keep the numbers rising.
Remember this about Lantus......it's best to not make fast changes. Any dose change can wait unless he goes below 50. If he drops below 50, you want to reduce the dose by 0.25u. However, keep in mind that if he goes below 50 once cycle and by the next shot time, he's high 200s or above, you can shoot the dose he was on that got him into the 50s once to help him through the bounce and then reduce. But if you can't decide whether to increase or not, post and ask for help. And if no one responds, it can wait one more cycle. Don't dose hop.
Also, when starting out, it's best to not fatten or shave doses. Stick with 0.25u increases and decreases (unless otherwise called for in the TR Protocol or SLGS Approach).
One last comment for the masses
...the only protocol used in this ISG is Tight Regulation or the modified TR protocol. SLGS is not a protocol...it is an approach we also use in this ISG but it is not based on scientific research. There are other protocols and methods of managing FD used by other forums.
As Melanie and Ghengis @Brashworks would say...stay calm and test on.
I can try and fix the SS for you in a little bit if you'd like. I still have editing rights.
Julie gave some great info on the depot and approaches. Let me run through what would have been a good approach to take.
If you get a number in the 40s close to shot time, take a deep breath, don't feed, and retest in 15 minutes. If he's not coming up, feed one teaspoon of low carb food as indicated in Shooting Low Numbers. Then 20-30 minutes after he eats, retest to see if he is rising. The reason we do this is because often the insulin duration is decreasing as you get to the next shot time. You don't want to over feed because the goal is to just feed enough low carb food (one tsp) to get them out of the 40s but which won't give you such a huge food spike.
Normally, once they are coming up above 50 after following the above procedure, if the CG has supplies and is available to test, it would be appropriate to shoot the rise. If you are new and don't have much data, as in this situation, you might continue to stall a little longer without feeding. Last night when he was at 164, you could have easily shot even though you had fed him. As Sienne said, when you are at the end of the cycle and numbers are rising like that...that fast, you don't have to wait two hours without food to shoot. You could have shot the 164 and then given a little more food to keep the numbers rising.
Remember this about Lantus......it's best to not make fast changes. Any dose change can wait unless he goes below 50. If he drops below 50, you want to reduce the dose by 0.25u. However, keep in mind that if he goes below 50 once cycle and by the next shot time, he's high 200s or above, you can shoot the dose he was on that got him into the 50s once to help him through the bounce and then reduce. But if you can't decide whether to increase or not, post and ask for help. And if no one responds, it can wait one more cycle. Don't dose hop.
Also, when starting out, it's best to not fatten or shave doses. Stick with 0.25u increases and decreases (unless otherwise called for in the TR Protocol or SLGS Approach).
One last comment for the masses
...the only protocol used in this ISG is Tight Regulation or the modified TR protocol. SLGS is not a protocol...it is an approach we also use in this ISG but it is not based on scientific research. There are other protocols and methods of managing FD used by other forums. As Melanie and Ghengis @Brashworks would say...stay calm and test on.
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Gill & George
Member Since 2015
Just to clarify, Marje, even if the kitty has had quite a lot of HC in the last hour or so before scheduled PS to boost numbers, (I think food was taken up at +11)? (with hindsight Sparkles continued on the up so would have been ok to shoot) Without much data on Sparkles reaction to carbs I was concerned that we were seeing a food spike and was concerned that Sparkles should be safe. Just want to understand for future reference.
sorry to hijack your thread Pepper.
I think it's important to be able to sort out the difference between a food spike and loss of duration at the end of a cycle either because it's the end of the cycle or the HC put the brakes on the insulin...which is what it looks like to me. Stalling a bit (another 20 mins or so) to be sure numbers were still rising wouldn't be a problem but if you can help the CG determine food spike vs loss of duration, then it might not be necessary. If you don't know, better to stall and be safe.
This is one of the things I find is misinterpreted in SSs. Learning to tell a bounce from loss of duration takes time and studying a ton of SSs.
Sparkle
Member Since 2016
I've reread all the posts and appreciate everyone who took the time to explain things. I get some things clearer, some got murkier, but we just go forward. Sparkle slept the entire day yesterday, except for box time. This morning he greeted me in the living room, but as soon as he ate and got his shot, he went right back to bed. Will see what his +2 shows. Thank you to everyone.
Andy & Pimp
Member Since 2015
Please keep asking questions, Pepper. That's why we're all here!
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