I would like to add 2 more cents... Gayle, I think you and I are in a similar boat right now. I'm not here every day (I'm not even here every week), so most of the caregivers here do not have a clue who I am or what experience I have. Like you, I lurk, and if I see something that I need to add or if I see something starting to go very wrong, I will step in. I'm guessing that is why all of us are posting in certain condos right now.
The thing is, if someone a person doesn't even know pops into a condo and starts saying things that contradict what they have been hearing every day from people they DO trust, you have to get them to trust you and understand WHY you are giving that contradictory advice. Even if what you are suggesting is indicated by the spreadsheet, it can take a lot of work and a lot of tact to teach the caregiver to see it, especially if others have told them something different. People in LL aren't used to Jojo-speak anymore and most don't respond to that approach. It's why we had to re-write the stickies. Take it slow, be patient, understand what limitations and concerns they have already expressed. The cat will only benefit if you get the caregiver to understand what you are saying so they will act.
If you take it slow and explain yourself, then another benefit might be that the people who are helping in the forum daily might start to learn too. No promises there, but it's worth a try. I know I like to learn new things. I really do study and try to understand when somebody says something that goes against what I believe.
I have to admit, I'm scratching my head about the advice to give R at PS and half that dose at +6. Giving R at+5 or +6 with Lantus only makes sense if that cat's nadir has already passed (it could make sense for a high dose cat whose numbers aren't even moving at all yet, as long as you make clear to the caregiver that once numbers start to move, their strategy will probably have to change). It also doesn't make sense to me to give more R at a time in the cycle when the Lantus is working, then give less R after the Lantus wears off.
Jojo taught me to start trying R *after* the nadir, when you could get more clear data because the Lantus or Levemir is exerting less influence on the system. Once I had that data, I could decide when in the cycle it made sense to use R. For my cats, it made sense to use it after nadir/before preshot, to help cover that end of cycle rise and to help cover the food spike. And Jojo did help me with Jazzy and encouraged my R use after +8 and +9 (Levemir cat). I see your mention in the other condo that giving R at +10.5 would skew the PS. My thought is "yes, that's the point! I don't want to see the high PS, keep the PS down so the Lantus can work better." I think +8 or +9 is probably more ideal, but if I came home from work at +10 and saw a high number, why wouldn't I go ahead and shoot some R to at least try to hold the number flat until PS? I'd rather have a PS of 300 than 600.
I try to teach people the same way she taught me - learn your cat's Lantus/Lev cycles, learn your cat's R cycles, then lay the two cycles on top of each other to figure out when you can use R. In some cases you are using it to gently pull down a high number, in other cases you are using it to *prevent* a high number that you know is inevitable.
