The Dosing Ultramarathon

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Kris & Teasel

Kris & Teasel

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AMPS was 9.2! I increased his dose to 2.8 u last night after several days of red, pink and yellow and this is where I am this morning. I'll retest in 20 minutes or so and try to keep 3 hungry cats at bay. I don't want to skip a dose so I'll have to think very hard about what to give later.

There seems to be a pattern: I up the dose a bit after days of bouncing and it puts him into low PS territory at the next dosing time. If I don't give a shot, we move backward. If I stick with a similar dose that gave a low PS, I approach a hypo nadir number. I think I need to give him a dose unless his PS is far too low but lower that dose substantially.

Retest BG was 10.7. I'll give him 2.0 u and monitor.
 
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I agree you are between a rock and a hard place (where do these sayings come from? ). As you know, human meter users often shoot at 160-180 once they have data, can monitor and know how to steer low numbers. We are not sure what that lower number should be for AT users, but we assume it is higher. Saying that, you know this sugar dance, you can monitor and steer. I think going for it was wise and will give you data for the next lower pre shot number.
 
Nice Kris, I don't know what happend with this cycle, seeing his +2 is really high comparing his AMPS... What do you think? I think it may be too much insulin for that #? or maybe too less... it's so hard...
 
BG at +2 was 20.7. I know he's prone to food spikes or this could be a bounce after a low value last night. I've read a lot of discussions on FDMB about the differences in readings between the AT and a human meter. It appears that the difference widens or narrows depending on the magnitude of the BG so that makes a comparison very complicated. I don't plan to switch to a human meter (yet) so I'll just get more data for Teasel and make my decisions based on that.
 
yes but a BG spike from 10 points up is really a lot... can't imagine that is it?.... don't you think?
 
Ruby&Baco said:
Nice Kris, I don't know what happend with this cycle, seeing his +2 is really high comparing his AMPS... What do you think? I think it may be too much insulin for that #? or maybe too less... it's so hard...
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Hi Ruby,
He does have food spikes sometimes even though he eats the same stuff all the time or it could be a bounce after a low last night. Or maybe he's already bouncing from the 2.0 u I gave him this AM. It's impossible to know. Teasel is very, very, very difficult to predict! That's why I seem to keep going around in circles. :banghead:
 
BG at +3 is 20.1. I'm betting on a high, flat day today. That seems to happen when I choose to shoot on low yellow or high blue preshots. That's a pattern, isn't it??!! :mad:
 
Does look like a flat higher cycle and yes, looks like he has done that before. But usually, he drops in the next few cycles. Guess the silver lining (?) is that he doesn't drop into scary territory when you shoot a lower number, and I do think shooting was a lot better than not shooting.
 
Sue and Oliver (GA) said:
Does look like a flat higher cycle and yes, looks like he has done that before. But usually, he drops in the next few cycles. Guess the silver lining (?) is that he doesn't drop into scary territory when you shoot a lower number, and I do think shooting was a lot better than not shooting.
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I agree, Sue. He's very unpredictable but some trends are emerging over time as data accumulates. I'll take what I can get! Also, I have to remind myself that I've only been at the FDMB protocol for 3 weeks. He's been doing this all along but I had only occasional glimpses on a BG curve day. Ignoring numbers and looking at Teasel the cat, he's doing fine.
 
We've said before that in this sugar dance, only the cats hear the music! Teasel just hears very different music from most....
 
AMPS was 19.6 and I gave him 2.0 u again. This might be too low a dose - who knows? If it is, then I'm approaching a better dose from below rather than above. His low PS when I've raised the dose slightly (just 0.2 u) tells me that he hasn't lost insulin sensitivity. However, he seems to start doing the bouncing jitterbug as soon as we get near what might be a good dose for that point in time. And maybe the good dose for him now is less than it was a month ago - ?? That bout of low BGs when I first signed up here on 08/17 might have been telling me that I'd gotten him out of his previous insulin resistance but now we're on shifting ground trying to find a new equilibrium. Or I could be totally wrong about all of this ... :(
 
I think that's great Kris to approach it this way.
I think the way you explain it makes total sense! Great catch Kris! You are really doing that homework! Haha
 
BG at +6 was 18.9. High flat day but too early to say it's because of a too low dose or bouncing. I'll persevere a while.
 
PMPS was 23.6. He'll get 2.0 u again tonight. I'm thinking of trying a slight increase to 2.2 u in the AM and leaving him at 2.0 u in the PM. This is roughly like an average dose of 2.1 u and might have a similar effect as doing 13/11 dosing. Not sure exactly when I'll start this.
 
I don't know, Kris. I like the 2.8 for the higher pinks and 2.6 for the lower pinks. The nicest number you got in the past few days was the amps after the 2.8 the night before. It looks like it takes a couple cycles for a dose to impact his numbers. You do get some discouraging numbers after a good one, which might suggest taking time to settle in or some bouncing after a nice number.

But I am just musing. He is very difficult to predict!
 
Sue and Oliver (GA) said:
I don't know, Kris. I like the 2.8 for the higher pinks and 2.6 for the lower pinks. The nicest number you got in the past few days was the amps after the 2.8 the night before. It looks like it takes a couple cycles for a dose to impact his numbers. You do get some discouraging numbers after a good one, which might suggest taking time to settle in or some bouncing after a nice number.

But I am just musing. He is very difficult to predict!
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I appreciate your input, Sue. He's one tough nut to crack! I can't decide if that nice AMPS on 09/05 was because of the dose of 2.8 u the night before or because it was a dose increase from the AM dose on 09/04 (2.6 u). There are other examples of a 0.2 u dose increase being followed by nicer numbers - eg., on 08/23 (increase from 2.4 u to 2.6 u) and 08/28 (increase from 2.8 u to 3.0 u). The general idea of giving 2.8 u on a high pink and 2.6 on a lower pink makes sense based on overall trends. If I squint at his SS as a whole, I see the blues and greens scattered in the region of 2.6 - 2.8 u doses (approximately). It's the nonsense numbers that follow that are very confusing.

I'm fairly sure that 2.0 u is too low. My plan was to slowly work his dose upward as I described in my previous comment. I figure it might end up around 2.6 - 2.8 u. Have to think about this more ...
 
It definitely looks like 2 is not enough insulin. I do think the doses Sue suggested are good. I understand the idea of working up slowly, but since it does seem to take some time for Teasel to settle in...I just hate to see him in high numbers for a bit.
But as you say...he's hard to predict!
 
AMPS is 22.8. I'm giving 2.2 u soon. I'm reluctant to jump back up to 2.6 u in one step, given his propensity for bouncing. I also don't like him in high numbers but we're not in the early days of FD where focused intervention might get a cat to remission. He's had a lot of exposure to high numbers the past 7+ months so a few days more won't alter much. I really appreciate the other eyes on his SS and the feedback - please keep it up! :)
 
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From what I see, 2U was definetely too low (but I do understand why you did it ) try 2.2 indeed and stick with it again for a few cycles to see what it does and then go up again and so on... OMG Teasel is loving those jumpy numbers isn't he?o_Oo_Oo_O
 
Ruby&Baco said:
From what I see, 2U was definetely too low (but I do understand why you did it ) try 2.2 indeed and stick with it again for a few cycles to see what it does and then go up again and so on... OMG Teasel is loving those jumpy numbers isn't he?o_Oo_Oo_O
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His numbers could make me crazy if I let them! That's my plan, Ruby - 2.2 u for a few cycles, then increase.
 
19.4 at +5.5. One more 2.2 u dose tonight then I'll try 2.4 u tomorrow morning. I have a late afternoon/early evening wedding to go to tomorrow so he'll have to miss a dose. I'll be gone from about +9.5 until late-ish. I hate to do this but it has to be - no one else to give him a shot.
 
I think this is fantastic! Just catching up now due to not being here much the last few days.. You know what they say.. Softly softly catchee monkey! :)
 
AMPS was 26.9 after no shot last night. Lovely wedding though - outdoors in a beautiful setting on a beautiful late summer evening. Sticking to my plan to give 2.4 u today (day 2). Tonight's shot will be the 3rd cycle at this dose. I'll raise it to 2.6 u tomorrow AM.
 
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AMPS was better at 17.2. I accidentally under filled the syringe a tiny bit so it looked more like 2.5 u than 2.6 u. Thought I'd go with that just to see what happens.
 
OMG! A blue PMPS of 11.1. Haven't seen any blue for days! I'm going with 2.3 u this evening. I didn't want to drop his dose too much and I might as well learn to eyeball between marks on my U100 syringes. I'll do a before bed test.
 
H-U-G-E bounce! AMPS was 25.6. I'll give 2.5 u this morning - sneaking up on 2.6 u but I have to be careful with Mr. Goodyear Rubber ... no point in getting frustrated!
 
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