No shot for Klinger tonight..advice please

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Marcy & Klinger (GA)

Marcy & Klinger (GA)

Member Since 2010
Hi everyone,
DH tested Klinger at PMPS:
+11.50 82
+11.75 76
+12.25 70
+12.50 71
he fed
+13 94
+13.50 104

I worked late so he still hasn't received his shot and we're at +13.75...
I don't want to have a set back by not shooting, but I don't think I'm going to shoot him tonight. Should I still give 2.5u tomorrow? Or should I reduce to 2.25u?

Marcy & Klinger
 
If it were my Paul, I woudl definately shoot to keep momentum, however, I think I would reduce by half and get a spot check around usual nadir (set the alarm)...I'll see if I can get the others to chime in.

Hey- GREAT numbers, btw!
 
Thanks Melissa. We're now approaching +15... if we shoot now, we wouldn't be able to shoot 12/12 tomorrow morning. It would be more like +10 and then we'd have to walk out the door.
Is it possible with Lev to give a "token" dose and still shoot at my normal +12 (4:30 a.m. MT)?

ETA: +15 157
 
I think when you have a dose as high as 2.5u you can easily reduce by .5u or .75u if you are unsure of giving the full dose. By that, I mean, if you are uncomfortable giving it and feel you need to reduce you have a lot of room to do so and still get a decent amount of insulin in. This is not as possible on very small doses that just don't "divide" well.

Anyway, I would have given something to maintain momentum. By skipping tonight he will probably take a few cycles to get back on track. Hopefully, you will be able to get him on track by late Friday so you can do a curve over the weekend off a low PS.

I really think he would have been ok with his regular dose, or maybe 2.25u. The lowest he was was 70 - which is fine and perfectly safe. You actually WANT him to get to a point where he remains in a shallow curve with the bottom between 60-100 and the top below 200. That's a good curve for a very well regulated lev kitty. But having data to back up that decision is a good idea.

Just don't raise the dose tomorrow am if you see higher numbers.

And, yes, you probably could have given him 1u or 1.5u at +15 and been OK with his regular shot time tomorrow - BUT it is better to test that theory when you are going to be home to test afterward. I think that is how Vicky moves Gandalf back to earlier after having moved him later with split doses for her work schedule - except the lower dose is on the one that is "early" the next morning. I have shot a reduced dose at a +12 when I know the next shot will have to be sooner than +11 - and I think I have made both those shots a bit lower dose.

Hope that helps! I was sort of rambling there.... :roll:
 
following this thread with interest. i thought i was told that a dose redux was not really helpful as the shed would be working anyway.
i get told ALOT of things.
lantus is running my lev show and it's not easy. but i am happy with the numbers i'm getting.
i see you pull the all nighter's marcy. that's just not something i want to do. i see claudia has'nt started that yet but her numbers are so high and that's likely why?
so you wanna look at my ss and be my coach buddy?
i had to shoot a low one and it was at night. i reduced and part went fur.
but so far so good.
 
Sheila & Beau & Jeddie said:
And, yes, you probably could have given him 1u or 1.5u at +15 and been OK with his regular shot time tomorrow - BUT it is better to test that theory when you are going to be home to test afterward. I think that is how Vicky moves Gandalf back to earlier after having moved him later with split doses for her work schedule - except the lower dose is on the one that is "early" the next morning. I have shot a reduced dose at a +12 when I know the next shot will have to be sooner than +11 - and I think I have made both those shots a bit lower dose.
Click to expand...

I actually give 2 reduced shots to move him 2 hours earlier the next morning. So the shot the night before at 10PM is 15% less and so is the shot at 8AM the next morning. From usual 1.3U to 1.1U. Seems to work OK, but there's usually a higher number sometime after all the dose changing/time changing. In my experience it's better than loosing shed by waiting till +14 to shoot. But it's only something you can do as a trial and test to see the results.
 
Thanks for the great information Sheila and Vicky. It looks like we're starting to clear from the bounce. I didn't do a full curve today because his numbers were still funky this morning. I'll probably do a curve on Sunday.
Hope everyone has a wonderful weekend!

ETA: So based on his numbers:
82 @ +11.50;
76 @ +11.75;
70 @ 12.25;
71 @ 12.50;F;
94 @ +13;
104 @ 13.5
When would you have shot?
 
Hi Marcy!
I was thinking about you guys and came looking for you. Looks like you made the leap to lev, and that the overall ss is seeing prettier colors. Hurray!

Your curve today looks to have the highs and lows at similar times to Cody, but i'm disappointed to see that high a number in the picture at +2, and the steep fluctuations still. I'll bet the missed shot drained any shed that may have been filling so you lost the duration, it just pooped out. What is nice is the power of lev- gradually bringing it all the way back down to blue. Working with lev rewards you for your patience (and your patience is impressive girl!) It really looks like you are getting there...

I know I live in another diabetic reality, but to answer your last question " when should I have shot?", personally I don't like to shoot a falling number, and I am slightly wary of rising numbers caused by food (which yours was & especially at your early stage of lev experience). Has anyone mentioned a BCS? big chicken shot. I know that your schedule needs to stay very strict, so when you are forced to wait and test, I would probably try to wait for a rising number up to some point (maybe +1.5hrs) and then if its rising, but late (for your 12/12 schedule), shoot 1/2dose. If you are still falling much later than that, and its a work night- I think skipping or using R is your best choice. this is a tricky part of Lev, and its not ideal, but with the long durations you are seeing, its safer. The holy grail is to find that perfect dose to maintain a perfect 12/12 schedule.
I never learned "the protocol" (acro-rebel) so I truly hope i'm not too far outside the conventional wisdom.

Give Klinger a BIG hug from me! cat_pet_icon
 
Marcy, I would have waited 30 mins, without feeding, and tested again and maybe repeated that again (so I was at +13 now). From there I would have decided to shoot a full dose based on my comfort level and data available, or reduced the shot a bit. I agree about not wanting to shoot a rising number after feeding - as that is a "false" rising number due to the food and not the insulin waning.

My thinking would have been that the full shot took him to 70, a beautiful and safe number, so only backing off maybe a half unit would be safe overnight. However, you do have to stay within your comfort level. I did stall on shooting Beau at low numbers for quite a while and waited until I would be home and could test and stay up if necessary. I think it was a Friday evening. And I shot the low number and he dropped like a rock, but I was there to monitor and feed a little higher carb food. That was when I had to start setting do not shoot numbers, which, supposedly you don't have to do with lev. I did not yet know he was headed OTJ because that was "not in the cards" for a long time diabetic coming off another insulin.

I was by no means criticizing you for skipping the shot, so I hope it didn't come off that way.
 
Lori, I'm sorry, I totally missed your post. You and Tom are doing a great job! Yesterday's numbers look beautiful! I've been trying to keep up with your posts on LL. I'm usually in bed by 8:00 pm :lol: the one night when I caught Klinger dropping quickly, it was extremely hard to keep my eyes open until 11:30 p.m. and then having to get up at 3:45 am. I was useless at work that day for sure!

Nancy, It's great to see you on the board. Thanks for seeking us out. I've missed your posts so much! Klinger is really loving lev. :smile: I agree that the high number at +2 yesterday was still the result of the other night. I hope he gets back on track soon! Lori, Claudia, and I have all switched to Lev. I believe a few others are also looking to switch soon. I hope you and Cody are well and I think of you often. :YMHUG:

Sheila, thank you, as always, for your thoughtful advice and rationale. It really helps me to explain it to DH (who was home the other night and I was working late and he didn't feel comfortable shooting). I didn't feel like you were criticizing me at all. :smile: It will also help me tremendously when this happens again in the future.
Hope everyone has a great weekend!
 
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