Jack 9/9/11 Need dosing help please!

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Darlene & Jack

Darlene & Jack

Member Since 2011
So we hit some kind of magic dose with 1.75 units. He has hung in the green a lot. I dropped back a few drops gradually to 1.5 since we were getting a lot of 40's.
Tonight I went out with a friend after work and my daughter was going to give his insulin at 6pm. These things always happen when we are away or I am out! She called me and he was only 51, so I told her to recheck and call me in half an hour. So here's how the evening went:

51 @ PMPS 6pm
49 @ 6:30pm
53 @ 7pm he had also been eating small amounts in between these times
47 @ 7:30
61 @ 8:30 at this time I told her to give him 1 unit...he got that about 8:45
62 @ 10pm

So I don't really know what to do at this point, especially for his morning dose. I had her reduce the dose since he was still low, not coming up fast. But I didn't want to skip the dose entirely and have him get too high overnight since he's been doing so well.
Any help would be appreciated...I don't know whether to give the usual dose at the same time in the morning, or lower it or delay it. I suppose it might depend on his AM reading as well. I'll check him a few times tonight to see how's he doing. He just ate a good amount at 11pm when I got home.
Thank you!!!!
 
Hadn't gotten any feedback so I wasn't quite sure what to do this morning. He hung at 62 for 3 hours last night. 6am this morning he was 71. Since his shot was delayed 3 hours last night I waited another hour and rechecked at 7am (+10) and he was 103. I was going to reduce to 1.25 since it was still really +10, but since he was 103 and the dose last night was reduced, I went ahead with his usual 1.5. Not sure if that was the best thing to do or not.

Dose advice going forward? Stick with 1.5 for a few more days, and then gradually start to decrease by .1 increments?
 
I saw this yesterday. I am sorry, I have no advise for you.
I don't even know what I would do if we got numbers that low. nailbite_smile
Did you try posting on health? Maybe there are more eyes there.
But those numbers Jack has are lovely!
 
Thanks, Peggy, no problem. I know I can't complain about the numbers, they are beautiful! I figure I will see if Vicky comes around today since she knows Jack so well. If not, then maybe I will post over on the Health board. I've been shooting lower and lower numbers at times lately, but I didn't really want my daughter to shoot a 51 that wasn't rising when I wasn't home. I guess Jack doesn't like it when I leave him to have some fun of my own!!

One other question too, if you come on to see this Vicky. Next Saturday we have a wedding to go to in the late afternoon. We will be leaving the house probably about 3pm and won't get home until late. Not sure if I should split the AM dose to give him longer coverage, or just do the usual AM shot and skip the PM shot. With numbers like he had last night I don't think it would be horrible to skip...but we'll see how things are the end of the week. :-)
 
Shoot low to stay low - perfect example is Jack!

Darlene & Jack said:
Hadn't gotten any feedback so I wasn't quite sure what to do this morning. He hung at 62 for 3 hours last night. 6am this morning he was 71. Since his shot was delayed 3 hours last night I waited another hour and rechecked at 7am (+10) and he was 103. I was going to reduce to 1.25 since it was still really +10, but since he was 103 and the dose last night was reduced, I went ahead with his usual 1.5. Not sure if that was the best thing to do or not.

Dose advice going forward? Stick with 1.5 for a few more days, and then gradually start to decrease by .1 increments?
Click to expand...

So you shot 1.5U at +10 this AM? The only thing that gives me pause on that (should it be paws? :lol: ) is that it was a full dose at +10. But it looks like he came up a little bit afterwards and that's what I would expect. You're probably right that the late and reduced shot makes shooting at +10 safe.

You are now in tight control. You are right that skipping his shot last night would have been the wrong thing to do. His pancreas is healing now at these normal numbers.

You might consider continuing to dial back his dose like you did from 1.75 to 1.5U and see how he handles that. Step down to 1.25U and so on, but gradually not all at once.

His numbers are beautiful and you are doing fabulous with shooting these normal numbers. To everyone who worries about shooting low, this is the example for shooting low to stay low. Although I agree last night was worrisome, it is what to expect in tight regulation.

I am so proud of you, Darlene! Look how far you and Jack have come in 4 months!!!!!!!!!

:RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT
 
Darlene & Jack said:
Thanks, Peggy, no problem. I know I can't complain about the numbers, they are beautiful! I figure I will see if Vicky comes around today since she knows Jack so well. If not, then maybe I will post over on the Health board. I've been shooting lower and lower numbers at times lately, but I didn't really want my daughter to shoot a 51 that wasn't rising when I wasn't home. I guess Jack doesn't like it when I leave him to have some fun of my own!!

One other question too, if you come on to see this Vicky. Next Saturday we have a wedding to go to in the late afternoon. We will be leaving the house probably about 3pm and won't get home until late. Not sure if I should split the AM dose to give him longer coverage, or just do the usual AM shot and skip the PM shot. With numbers like he had last night I don't think it would be horrible to skip...but we'll see how things are the end of the week. :-)
Click to expand...

I must have been typing when this was posted. What is your normal shot times? 7AM/7PM? Since you know this is coming up, you could split dose him a few days ahead of time to get to 9AM/9PM, then split dose again Saturday 9AM/11AM to get him to 11PM, but if the wedding reception is anything like receptions I've been to, 11PM is probably early. At least you would have him back to that late.

The other consideration is how soon do the shots need to be back to 7AM? That would be why you might consider skipping the shot Saturday night/Sunday early AM. So you use split doses to get his +12 to 11PM, then just skip it that night till 7AM Sunday morning. That way he's not going a whole 24 hours between shots. Does that make sense?

Hope that helps you develop a plan. Let me know if that helps.

It will be a good use of split dosing.
 
Thanks for your help and encouragement, Vicky! It is good to be in tight control now, and now that I am doing it without horrible consequences I can clearly see how it works to shoot low to stay low, and to be consistent with doses. And I'm glad it happened gradually...going from shooting 100 slowly down to shooting 60's or 70's. I don't get so panicked about it now, until last night with those really low numbers. (And though Jack and my wallet may not agree, all our frequent testing has paid off as I am better able to predict what he will do when I shoot a low number, which is especially helpful when no one will be home to test him).

Do you think I should have shot earlier last night? When would have been a "safe" time to shoot, do you think?

And yes, Rachel deserves a big hug and lots of praise for her good job with him last night. I am lucky to have both my kids willing to help with Jack so much. I had been forgetting to show her how to let off a few drops and reduce the amount in the syringe, but she did a great job figuring it out when I told her.

Our usual shot times are 6am/6pm, but this morning his shot was done at 7am. I could keep him at 7am/7pm this week, then maybe on Thursday split dose to get him to 9am/9pm. Then do as you suggested with the split dose Sat. AM with 9am/11am. Then depending on how late we run if we skip 11pm it wouldn't be 24 hours without a shot as you said. Then Sunday AM I can get him back to 6am. Am I understanding that correctly?
 
Darlene & Jack said:
Thanks for your help and encouragement, Vicky! It is good to be in tight control now, and now that I am doing it without horrible consequences I can clearly see how it works to shoot low to stay low, and to be consistent with doses. And I'm glad it happened gradually...going from shooting 100 slowly down to shooting 60's or 70's. I don't get so panicked about it now, until last night with those really low numbers. (And though Jack and my wallet may not agree, all our frequent testing has paid off as I am better able to predict what he will do when I shoot a low number, which is especially helpful when no one will be home to test him).

Do you think I should have shot earlier last night? When would have been a "safe" time to shoot, do you think?
Click to expand...

You waited till you saw a decent rise, the 61, and that's standard for determining when to shoot a low. When they hang like this it can be hours before you see a rise and the 61 was probably the point when the system had started to pull from shed. You don't want them to pull from the shed too long. Remember the insulin's goal is to maintain these kind of blood glucose levels! By making sure you keep the shed full, you keep it from exhausting its resources. So I think you hit it right on and the proof is in the resulting numbers!

Darlene & Jack said:
And yes, Rachel deserves a big hug and lots of praise for her good job with him last night. I am lucky to have both my kids willing to help with Jack so much. I had been forgetting to show her how to let off a few drops and reduce the amount in the syringe, but she did a great job figuring it out when I told her.

Our usual shot times are 6am/6pm, but this morning his shot was done at 7am. I could keep him at 7am/7pm this week, then maybe on Thursday split dose to get him to 9am/9pm. Then do as you suggested with the split dose Sat. AM with 9am/11am. Then depending on how late we run if we skip 11pm it wouldn't be 24 hours without a shot as you said. Then Sunday AM I can get him back to 6am. Am I understanding that correctly?
Click to expand...

Yes, you understand perfectly :-D Sounds like a plan.
 
Great, that will be our plan for this week then. :smile:

So back to last night...say that he didn't start rising until even later than he did (+15). At what point do you just skip the shot vs. shooting a full or reduced dose at say +16 or +17? I thought I remembered seeing in a sticky or maybe a post that after waiting 3 hours for a rising number it might just be better to skip? I read the stickies on shooting low numbers last week, need to read them again.
 
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