NEED advice 2/7 Hershey's 2:30AM dose

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I replied on your other thread but in case you didn't see it - I would either skip or give a tiny, token dose. The last hypo you shot a little lower dose, more than a token, and it took him several cycles to clear. Not sure what will happen if you skip but it might be worth finding out.

I am thinking if he is sky high, a token dose might be .1 or a drop. It just may take a while to get him settled back into a regular schedule.
 
Okay, we'll plan to skip the shot.

I had planned to make a Walmart run tomorrow. Do y'all think he'll be okay to leave? I know I should get a number (or two, if possible) after tonight, but since I'm going to be gone, which numbers do you think are the most important? Do you think we still need to check at 2:30am (which would've been pre-shot time)?

Thanks, again!

Libby
 
I agree, best to be safe and skip if there is a chance he’s going to be more insulin sensitive. Tomorrow is another day.

Again, good job tonight. Nerves of steel ;-)
 
I had planned to make a Walmart run tomorrow. Do y'all think he'll be okay to leave? I know I should get a number (or two, if possible) after tonight, but since I'm going to be gone, which numbers do you think are the most important? Do you think we still need to check at 2:30am (which would've been pre-shot time)?
Click to expand...

I think I would just check him at bedtime for you, and get a good night's sleep. Check him when you get up, but plan on no insulin until his 2:30 PM shot. He'll be fine to leave in the morning. With no insulin at 2:30 am, he won't be going down again, and he's going to go up (hopefully not too high) between now and tomorrow's PMPS.

Carl
 
So, at 2:30pm, just resume the normal dosing? They eat at 2:30am, too, so guess I shouldn't let them go much past then. But, I'll sleep easier knowing he's doing okay now.

Need a kitty emoticon for "whew!"
 
Libby,
2:30 PM is like forever from now! Once you have some numbers, we can look at a dose that makes sense. Could be lower than normal, given "insulin sensitivity after a hypo", but I'll look at how it went after the last episode to see (I seem to recall it wasn't a huge factor, but I've gotten all of the recent incidents in PZI scrambled in my head at the moment).

.....looking for just the right emoticon...



nope....but funny nonetheless! Can't find one, so this will do...



Carl
 
PM +11 (282) No walking, HAWNGRY! so went ahead and fed
AM +6 (438) Walked 24X and fed

Sure hoping that he doesn't rise a lot more, but afraid that's wishful thinking. Would there be a situation where he'd go so high that you should alter the schedule and shoot early (since there was no AM shot, the 12-hrs isn't a prob)? Those black numbers REALLY scare me, too, and I don't want to leave him hanging out there if I should do something different.

Off to Walmart - if my main goal wasn't a new meter I would rather not leave him - going to try not to worry...too much...

Hope y'all have a great day!
 
Your hypo back on 1/28, you shot into the next high number and he still bounced sky high. He does tend to bounce. I think your high numbers are a combo of the carbs and the low number bounce and insulin probably won't phase it. You just have to wait till it clears.

Remember the advice - better high for a day than low for a minute. In terms of being dangerous, last night's numbers are much scarier than today's.
 
Sue, if you skip a shot, can you just start in again on a new schedule once the numbers are ok? Or are you supposed to wait 12 hours to start again? We have done the former, but don’t know if that is technically correct or dangerous. Wanted to clarify that for all here if we could.
 
Yes, Donna, I think you probably could if you can adjust 12 hours later. The idea of waiting (I think) is more about letting the extra carbs clear out and not shooting an artifically inflated number. How long that really takes, nobody knows.

Libby, your 438 is really a +18, right?
 
Yes, Sue, it is a +18. Just tested again and it's (591) - eeks! Now I'm almost as concerned as I was last night! If it's a matter of adjusting to the 12 hour dosing being off, we can work around that somehow. I just don't know how high is of MAJOR concern, you know? My grandma was diabetic - skyrocketed - coma - died.
 
Hi Libby!

Just want to be sure I understand correctly. You are at +18 from your last dose?

This is no ways as scary as last night!
 
If it is really worrying you and you can adjust the schedule, I would give him .5 maybe. The problem is that it may not affect the number if it reflects bounces and is carb induced. A dose didn't on your earlier hypo.

I just wouldn't panic and give him a dose to match that number. Remember, it most likely
isn't "real".
 
Hi Libby.....hey Hershey, knock it off! You stressed mom and dad enough last night, quit being a drama-cat.

The high numbers are a combination of a couple things. One, he hasn't had any insulin for 18+ hours, so nothing is fighting the boost from eating more than normal amounts since he went so low last night. Also, part of it is a bounce from those low numbers. Impossible to tell which is having the biggest effect.

There's no rule that says you have to wait until +24 to shoot. We normally tell people to do that so that they can maintain the same shot schedule as before. But once you get past the 18 hours since the last shot point, you only have two choices. Either shoot then, and adjust to a new 12 hour schedule, or wait it out. In theory, you could shoot a tiny dose, then pick up at +24 to keep on schedule. But then you have to shoot a tiny dose then as well. You also have two different doses of insulin in his system at the same time if you do that, and while the first is peaking, the 2nd is just starting to kick in. That, IMO, can be dicey, because you could have "too much" in his system, and you repeat what happened last night, but the timing of things is a nightmare. Plus in your dose decisions, you have to consider the "post hypo sensitivity" factor.

I would wait it out, At +24, I would shoot a normal .8 dose, or maybe a tad less. But by then, all the extra carbs from last night, and all the insulin, would have cleared. You don't shoot a higher dose just because the BG is really high. You would expect it to be really high for the reasons mentioned above.

If this ever happens again, where you have to skip due to a low number at the normal time, you could shoot at +2 or +3, with a reduced dose, if you are planning to shoot the next shot at the "normal" time in the evening. But once you get into the +6 time frame, you run into the whole insulin onset, nadir, duration time nightmare I described above.

Hoping that isn't too confusing...

Carl
 
Holey Moley! Didn't even see this earlier. Not enough coffee, I guess.

Glad to hear Hershey is ok, even if showing off with higher numbers. And great job Libby, keeping your cool and all!
 
Sue,
I was clear on that, think Libby was too. And that's one option that will work. She could even work her way back to the normal schedule if she were to shoot early today. It would just take a few days to do so. Ideally, in the next couple of days, Hershey would throw a non-shootable number at +12, and she could hold off on shooting until the old "normal" time. Then it's just proceed as normal....

Carl
 
Just in the door from Wally World with the new Relion meter. Went with the Confirm because the only difference I remembered was that it holds more numbers than the micro, which is a cute little meter. Went with blue, all masculine and whatnot. We are 1:10 early from regular schedule, but I hate to keep waiting. Going to read about the meter real quick and I think we'll use both meters, just to get an idea of the new one. Sound like a plan?

Hershey didn't even try to come meet us at the door. When I approached him, he lifted his head but barely opened his eyes, didn't speak to me, just made a noise in his throat. *sadness* So, if we test - feed - shoot at ~1:30 can we stretch each dose by...say :10 - :15 until we get back to the 2:30 schedule?

Thank y'all, so much, for helping us reason through all of this!
 
1:45pm - finished setting up the meter. He got out of the rocker and jumped in my lap. So, that was good.

Relion (395)
ipet (489)

hmmm...now what does that tell us? I'm guessin' we still shoot the .8u But, GLAD to see he came down from (591) to (489)...how come??

Skipping the walking, we've been through a lot in the last 18 or so hours...
 
My guess why his #'s are coming down is because the carbs/bounce are wearing off.

Can you test the two meters side by side for a few days so we can see what the new numbers look like compared to the old numbers. That way we can fit the new ones into the scale.

Also as I look back I'm noticing that he has been backing down in dose, when you started the 1 unit looked a tiny bit too high, then .9u looked a tiny bit too high and now it looks like .8u might be a bit too high.

If you get a lower PS I would back off the dose again. Maybe your top dose should now be .7u, what do you think?
 
I agree with Robin, I would back off of the .8 dose-- it looks too high. I would think that you needed to consider, that he could also be a little insulin sensitive after last night's low numbers.
 
Thanks, y'all, for keeping up with us and for the assurances that last night wasn't my fault. Still feel that guilt, you know, that's he's so dependent on me and trusts that I'll take care of him and then something happens to remind me I have little control over things...

I looked at his SS last night and gave it another glance this morning, only to find I was totally confused. After reading your thoughts and looking at it, again, I see what you mean about the .8 maybe being too high now. I'll get most, if not all, readings with both meters to see how to compare the two - esp try to get a few highs and a few lows. Boy - that new meter is FAST at sucking the blood up!!

Robin - You suggested if I get a lower PS, backing off the .8. Lower like how much lower? I was just starting to feel comfortable with the .8, guess Hershey wants to keep us on our toes?! So, the .7 will be like the .9, pretty close eyeball, right?

He's been sleeping a lot today, but I guess he's trying to get over last night, too. Earlier (at PM +2.5) he jumped on the back of the recliner and from there to the futon (just over 3'); that was encouraging! We're at PM +5.5, so almost time for the +6 test. I'll post when I get it.
 
Nice, I guess they do get closer at lower numbers.

Remember that these are still carb/bounce induced numbers so for your AMPS I wouldn't shoot more than .7u depending on the bg #.

At this point I would scratch .1u off of every step of the scale.
 
So, scratch .9 completely - AND .8?

So,
200 - 249 .4
250 - 299 .5
300 - 349 .6
350+ .7

Is that what you mean?

I was pretty tickled the meters were so close. Had to do a double-take. Wish they were always that close! How many more numbers do you think we need tonight? Should I test at +9 or give him a break until AMPS?
 
Yep that's what I mean. No more .9u or .8u.

Get whatever tests in that you are awake for and can get. Every test is good data.

Otherwise have a good night.
 
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