Shoot early in to a bounce after stall?

[Amy & Herman]

Just curious, I’ve seen it discussed before recently but can’t find: Is there ever any merit to shooting early in a bounce after a stall?

This morning I stalled 2.5 hours, my schedule will allow me to slowly bring it back on track, but, those greens at amps have caused a bounce, as expected. If he is still high the rest of day, could I shoot early, say an hour? Might this actually be beneficial? Or is it always a no-no?

I’m just wondering, I know the status quo is to only adjust by half hour total in a 24 hr period and I’m good with that.

 

[Sienne and Gabby (GA)]

When a cat drops into numbers requiring a dose reduction, if there's subsequent bounce, you can shoot the current dose one last time prior to reducing. You can't do that if the low numbers are at pre-shot time. You did exactly the right thing -- you reduced at your AMPS. The challenge is that you may not have been ready to shoot the full 2.25u dose at pre-shot. It takes a while to work up the nerve to not stall. With TR, the basic idea is "shoot low to stay low." Again, you did what you were comfortable with which is fine. You may want to give some thought to how low you are comfortable shooting. When Gabby was with me, I would shoot any number above 50.

What you're suggesting is more feasible with a shorter acting insulin. It's harder with Lantus since an early shot acts like a dose increase. You don't have much data on how Herman manages low numbers or how he is reacting to dose increases. For now, I'd stick with gradually walking back the time.

 

[Amy & Herman]

When a cat drops into numbers requiring a dose reduction, if there's subsequent bounce, you can shoot the current dose one last time prior to reducing. You can't do that if the low numbers are at pre-shot time. You did exactly the right thing -- you reduced at your AMPS. The challenge is that you may not have been ready to shoot the full 2.25u dose at pre-shot. It takes a while to work up the nerve to not stall. With TR, the basic idea is "shoot low to stay low." Again, you did what you were comfortable with which is fine. You may want to give some thought to how low you are comfortable shooting. When Gabby was with me, I would shoot any number above 50.

What you're suggesting is more feasible with a shorter acting insulin. It's harder with Lantus since an early shot acts like a dose increase. You don't have much data on how Herman manages low numbers or how he is reacting to dose increases. For now, I'd stick with gradually walking back the time.

Thanks so much for this input. I feel like I am slowly starting to trust that he can be bumped up with mc fairly reliably. We are currently in a big bounce, but he does that after green...well also after blue...after extended yellow, etc.... We are in bounces what feels like 90% of the time! But we are slowly inching down in numbers. I really want to be on the ball and do my increases as soon as they make sense without shooting past his ideal dose which, from what I understand, can result in even more bouncing. I often wonder, is he better in yellow/blues with shorter/lower bounces or in short periods of green with steeper/longer bounces? He seems to be doing really well overall, weight, attitude, etc - if it wasn't for the progression of neuropathy I would be inclined to keep in the yellow/blues and let him settle there for a couple weeks, but I am fully aware that it is in the greens where the pancreas can heal.