SS evaluation and dosing advice needed.

Status
Not open for further replies.
ShadowsMom

ShadowsMom

Member Since 2014
Shadow and I are back. My dad has been hospitalized since Thanksgiving and that's when I dropped off the board. I continued maintaining Shadow on the tight reg protocol and he was doing great, but now he's on Budesonide for IBD and that's playing havoc with his BG. He's transitioned to +3 nadir and he's still at a very small dose, but I think he's bouncing due to the fast drop. How do we handle this?

Shadow's SS
 
I'm sorry that you've been through such a rough time. How is your dad now? I don't know how to advise you, but my sympathies on the bouncing. It's so frustrating. Hopefully, Shadow will be back on track soon.
 
My dad is doing better, thanks! He's in a post acute care facility and is off the ventilator but still has a trache and is being tube fed. They are working on getting him eating and walking again so he can come back home. :) I've just been overloaded... even finding some time to sleep is a challenge. And sorry for all the poop details on the SS... We are working on getting his IBD under control, so we need to keep track of the dirty details.
 
His PMPS was even higher than last night's. I think we are in for a repeat performance of jumping into the dreaded RED. :(
 
He gets multiple feedings. All of the *20cc entries on his SS are feedings since he's syringe fed. He has a tendency to vomit if I give him too much at once, so I space them out a bit. With the IBD, he's on a pretty restricted protein program and we have an appointment with a veterinary nutritionist to further address his issues - possibly with a home cooked diet. I can try looking for a higher carb option. I do have the option of feeding him at +2 if I need to. Would that help?
 
Last edited:
I can do that. His nadir used to be at a more normal +6, but it has shifted. He has a tendency to vomit if he goes too long without food, but I can try to fit more feedings in before his +3 and then give him less later. (Perhaps 10cc at +3 and 4.)
 
Hello again Hellen. Sorry to hear the news about your father. :bighug:

I noticed that Shadow was doing pretty well on 0.2 units in January, getting nadirs down to the 60's, and then you increased up to .4 units. Could you give a bit of background why the increase? His numbers seem to get worse after that. I also noticed that the night of Feb 10th, he got down to the 30's, but you only reduced by .1 unit. I was just wondering what your increase and decrease strategy is with Shadow.
 
To be honest, I think I've been scared of the big jump that he got from that first dose of Budesonide. I jumped the gun on his dose. The same goes for the small decrease - Hating higher numbers and I didn't think that we could manage to draw up 0.15u if we took a full 0.25 reduction. (Sorry... typo!)
 
Last edited:
I see that he did get one jump from the Budesonide, but the next day he was still getting nadirs in the 80's. I think I would let the nadirs be the deciding factor in the dose. Also a test in the 30's calls for a larger decrease than one in the 40's.
 
What would you recommend his next AM dose to be? I will be shifting his feedings forward as well. Should we hold him at 0.30u while I adjust his feeding schedule?
 
Status
Not open for further replies.
Back
Top