Samwise AMPS & PMPS 4/10 +2.5 +4 +6

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sueandsamwise

sueandsamwise

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AMPS 132 No shot. Here we go again. :-D

+2.5 272 Shot 2U Since Sam is getting close to 300 I shot 2 units. I'll do another test at +4.

Okay, this is +4 from the shot at 2.5. 64 BG. :mrgreen:

+6 63 :mrgreen: from shot.

+10 120

PMPS 418 1.6U What a jump in 2 hours.
 
Re: Samwise AMPS & PMPS 4/10

OK, just looked at your SS. Curious why you went with 2u? Here is the logic I would have used:

- PS is 272
- I shot 2u into a 366 recently and got a low nadir, so I know that dose is too high for that PS.
- I shot 2u into a 377 last night and got a PS too low to shoot this morning, again confirming that dose is too high for that kind of PS.
- SO, since this PS is 100 points lower and 2u was too high for a 375-ish PS, I am probably looking at something like 1.6 for this PS.
- Going back to check that against recent data, I see that I shot 1u on a 233 a couple days ago and the next morning's PS was too low to shoot, so that makes 1.6 sound way too high, probably should try something like 0.8.
- I have been overshooting lately, so let's knock another 0.2 off of that, shoot 0.6, and see what happens. If the #s are all higher then I'll know I over-reduced.

Another way to look at it is in %s. You want something around a 70% drop. The last time you shot 0.8 you got better than a 75% drop (you don't know how low the actual nadir was), so that makes that dose look too high, on ANY PS. Granted that one was on a low PS, but the % rule applies to any PS, more or less you can expect a dose will give around the same % drop anytime you shoot it. So on a 272 PS like you have today, you could expect a dose of 0.8 might give you a nadir around 68, which is a little low for comfort IMO when his insulin needs appear to be changing and doses are a lot of guesswork right now. So again that would lead me to try 0.6.

Now all that said, my gut feeling is 0.6 would likely be too little insulin, but my point is you won't know that until you try, and with repeated low nadirs you are putting him at risk. With the changes in patterns and low #s lately, my guess is my gut reaction is based on PAST results when he did need more insulin, so I wouldn't really trust my gut right now anyway.

I KNOW he is actually doing really well right now, I KNOW some of that is due to your being aggressive with doses and getting him in good #s, and I KNOW I am probably driving you nuts right now with the lecture :lol: . But I really do think you have to lower the doses further, and don't shoot a dose that was too high a day or two ago. IMO 2u should be off the table at this point - you got a 34 nadir on it, so it is scratched off the list of useable doses.

So anyhoo, I'd get some early to mid cycle checks in today. I am really worried the 2u will be too much insulin. In addition to the 200 no-shoot rule I think you should add the following:

Cap all doses at 1.6 for now, even on the highest of PSs, until you have more data on how that is working.
Lower the dose from there on lower PSs. I'd go with something like:

200 - 250 0.6
250 - 300 0.8
300 - 350 1u
350 - 400 1.2
400+ 1.4
500+ 1.6

Or if it's easier to stick with more of a steady dose and less sliding scale, I would say try 0.8 as your basic dose, and maybe raise to 1u for PSs in the higher zones.

And then gather data on those doses and revise as needed. They may turn out to be too low, but you won't know until you try, and they may save some nailbite_smile with the scary-low nadirs.

Oh yeah, just saw your latest post, I think his panc could be sputtering. When you have an unshootable # at something like +14, there a reasonable chance that's not the PZI keeping it there. Hard to say for sure though, if the dose was too high, it could just be from that.
 
Re: Samwise AMPS & PMPS 4/10

Well, I'll tell ya, I thought the 2U would be to high too. I was expecting a lower # at +6 but we haven't hit the +6 yet. That would be around 4 my time. I think I will lower a bit more and not shot so much when he's in the 200 range. I wish I knew what was keeping the numbers down, the insulin or the pancreas. Unjinx................
 
Yeah, that's awfully low for a +4 - 77% drop, which is more than you want even at the nadir, and you're not there yet. Hope he is doing ok? Taking a nice bath again? I'd keep an eye on things. You just never know when a low will be too low, and hypo can appear in a a second where it wasn't there the second before. Yes, I'm trying to scare you :mrgreen: ...my nerves can't take it!!! All joking aside I don't want to see you guys in a crisis one day. I think you have plenty of room to reduce your dose and still get decent #s.

As far as what is insulin, what is pancreas I would assume it is all insulin. It could well be some pancreas in there, but it really doesn't change your decisions. You can't do any guessing that the dose was correct and the pancreas is what gave you a lower #. I think you have to assume it's the insulin, and if a number is lower than where it should be in the cycle, like this +4, then the dose is too high.
 
Re: Samwise AMPS & PMPS 4/10

sueandsamwise said:
Well, I'll tell ya, I thought the 2U would be to high too.
Click to expand...

Last lecture for today :mrgreen: if you are thinking that, you should NOT be shooting it. If you think a dose is too LOW and you don't have ketones it is ok to shoot it and collect data to prove to yourself you were right, the dose really is too low. If you think you have the right dose, then yes, shoot that. If you think your dose may be too high, you SHOULD NOT shoot it. Ever. Period. Unless you have a ketone crisis and are sitting at hand with your hypo kit and monitoring every hour minimum. That's the only exception I can think of. I mean, we all have goofed and shot something and then seconds later thought "darn, I think I overshot" and then it's all nailbite_smile nailbite_smile nailbite_smile and kicking yourself. But if you ever realise that before shooting, you should revise your dose down, even if someone else, your vet or whatever, told you to shoot that.

Whew, I'm exhausted from all this lecturing!!! :lol: :lol: :lol: It's just not my style!
 
I thank you for your lectures anyway. It is nice to have someone with experience help out. I am going to revise his doses down since it seems that he wants to go way low again. At least I'm not getting the 30's like I was yesterday. He's staying up in the 60's. His + 6 was 63, he went down a point. I am keeping an eye on him since it's to crappy to be outside anyway. Thanks, Joanna! :YMHUG:
 
Wow, he really mixes up those PSs doesn't he? One possibility is that he rebounded off of today's lows (could have been an unseen lower low), the dose was high enough to basically be shooting through the rebound (by accident), until the PZI wore off at the end. So that's one explanation why you got major zoom at the end of this cycle, vs. other cycles where maybe he didn't rebound, and that's where the PSs stay low. Hard to say really. It doesn't look like he rebounded off that 38 the other day, so who knows. But the fact that a couple days ago you shot 1u on a 233 that was about the same timing as this shot (+14), and got a low PS the next morning makes me think this # is a product of rebound from dose too high rather than just normal PZI poop-out. I think he's seen enough good #s at this point that I doubt liver training is much of an issue anymore (which is why I think you are often seeing better PSs now).

Anyhow, YAY on the 1.6. flip_cat We'll see how he does. If he's rebounding he could run in red #s all night from that, so I'd stick with the same dose in the morning (barring any new low #s that indicate a further dose decrease is needed), and of course lower as appropriate on a lower PS.
 
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