karenkarma
Member Since 2013
I haven't posted his numbers in a few days, but here is access to his spreadsheet via my signature.
Tommy The Cat Update
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Chris & China (GA)
Member Since 2013
Hello again Karen and extra sweet Tommy The Cat!!
Karen, anytime you get a number under 50, it's an immediate reduction in dose. On the PM cycle 12/11 you have Tommy at 49...that should have reduced him back to 1.75...and then yesterday's AM cycle you got a 39..That's a very low number and if you had reduced on the 11th, would have meant a reduction back to 1.5!!
Please reduce Tommy back to 1.75 today if it's not too late already, and then hold that dose for at least 6 cycles...but if he goes below 50 again on 1.75, he should be reduced to 1.5u ...That's how this protocol works...Cats EARN their reductions by either going too low, or by staying in normal numbers for at least a week and then they are reduced to see if they can continue down to (hopefully) no insulin
Please feel free to ask any questions you may have about the protocol and how it works...that's what we're here for!
Edited to add..sorry to hear about your car crash and hope you're feeling better! I know the first days after something like that are the worst!
Also, the higher numbers you're seeing after those lows are bounces, so it's important that you learn to see bounces and don't assume you need to increase the dose because of what looks like high numbers. Bouncing happens when Blood Glucose numbers go lower than the liver is used to, so it thinks there's something wrong and releases hormones and sugars to bring it back up to where it thinks is "normal". Of course Mr. Liver is wrong, but he's gotten used to living at high numbers and doesn't understand that REAL normal numbers are good things! The more time Tommy spends in those lower, normal numbers, the more his liver will re-learn what "normal" is. Bounces can take up to 72 hours to clear, but as Mr. Liver relearns what normal is, he won't bounce as high, and will clear them faster. When we first started, China would bounce into the 300-400's and take the full 72 hours to clear..Now she bounces into the 200's and usually clears them in one cycle.
Think of it as "Liver Training School"....LOL
Karen, anytime you get a number under 50, it's an immediate reduction in dose. On the PM cycle 12/11 you have Tommy at 49...that should have reduced him back to 1.75...and then yesterday's AM cycle you got a 39..That's a very low number and if you had reduced on the 11th, would have meant a reduction back to 1.5!!
Please reduce Tommy back to 1.75 today if it's not too late already, and then hold that dose for at least 6 cycles...but if he goes below 50 again on 1.75, he should be reduced to 1.5u ...That's how this protocol works...Cats EARN their reductions by either going too low, or by staying in normal numbers for at least a week and then they are reduced to see if they can continue down to (hopefully) no insulin
Please feel free to ask any questions you may have about the protocol and how it works...that's what we're here for!
Edited to add..sorry to hear about your car crash and hope you're feeling better! I know the first days after something like that are the worst!
Also, the higher numbers you're seeing after those lows are bounces, so it's important that you learn to see bounces and don't assume you need to increase the dose because of what looks like high numbers. Bouncing happens when Blood Glucose numbers go lower than the liver is used to, so it thinks there's something wrong and releases hormones and sugars to bring it back up to where it thinks is "normal". Of course Mr. Liver is wrong, but he's gotten used to living at high numbers and doesn't understand that REAL normal numbers are good things! The more time Tommy spends in those lower, normal numbers, the more his liver will re-learn what "normal" is. Bounces can take up to 72 hours to clear, but as Mr. Liver relearns what normal is, he won't bounce as high, and will clear them faster. When we first started, China would bounce into the 300-400's and take the full 72 hours to clear..Now she bounces into the 200's and usually clears them in one cycle.
Think of it as "Liver Training School"....LOL
Here's the link to your condo from 12/7.
Chris has a point about reductions. However, there are times when you an "shoot through the bounce." When you get a high preshot number after Tommy's number indicate that a reduction is needed, like last night at PMPS, you can shoot your current dose to help resolve the bounce. You would shoot that dose one time and then reduce.
You might want to revisit the Tight Regulation guidelines:
Chris has a point about reductions. However, there are times when you an "shoot through the bounce." When you get a high preshot number after Tommy's number indicate that a reduction is needed, like last night at PMPS, you can shoot your current dose to help resolve the bounce. You would shoot that dose one time and then reduce.
You might want to revisit the Tight Regulation guidelines:
karenkarma
Member Since 2013
He is 128 this morning.
I am going to give him 1.75.
I am going to give him 1.75.
karenkarma
Member Since 2013
I have fed him already and I have to leave. I don't know what else to do.
karenkarma
Member Since 2013
Well, I was gonna shoot him but now he is 103.
Chris & China (GA)
Member Since 2013
If you get a number you're not comfortable shooting, you should not feed, and stall...ask for help...Retest in 20 minutes and see if the number is coming up.
Since his went down and you did feed him, it throws things off...Your choices are to skip the shot completely and let the shed drain a little, and then you can do your PMPS at your normal time, or you can give a BCS (big chicken shot) that's any dose less than you'd normally give just to have SOME insulin on board, or go ahead and shoot the scheduled dose if you're able to test throughout the cycle if necessary
If you have the supplies to test today and can be home to do it, I'd probably go ahead with the 1.75, but you have to be comfortable with your decision, so if your gut tells you to shoot less (or not shoot at all) that's fine too
I see you decided to skip....that's fine...Shoot the 1.75 tonight ...and if you happen to want to change your shooting schedule, tonight would be the time to do it..since you didn't shoot, if you wanted to change from (for example) 8am/8pm to 7am/7pm, you could safely do that tonight.
In the future, if you need advice quickly, please add the ? icon to your first post (that way it shows up for people scanning the boards) and Edit that first post's subject line to add something like "Stalling...Advice needed" so people will notice that you're needing some help
Since his went down and you did feed him, it throws things off...Your choices are to skip the shot completely and let the shed drain a little, and then you can do your PMPS at your normal time, or you can give a BCS (big chicken shot) that's any dose less than you'd normally give just to have SOME insulin on board, or go ahead and shoot the scheduled dose if you're able to test throughout the cycle if necessary
If you have the supplies to test today and can be home to do it, I'd probably go ahead with the 1.75, but you have to be comfortable with your decision, so if your gut tells you to shoot less (or not shoot at all) that's fine too
I see you decided to skip....that's fine...Shoot the 1.75 tonight ...and if you happen to want to change your shooting schedule, tonight would be the time to do it..since you didn't shoot, if you wanted to change from (for example) 8am/8pm to 7am/7pm, you could safely do that tonight.
In the future, if you need advice quickly, please add the ? icon to your first post (that way it shows up for people scanning the boards) and Edit that first post's subject line to add something like "Stalling...Advice needed" so people will notice that you're needing some help
karenkarma
Member Since 2013
Gotcha! Thank you
He held out the whole day, no insulin with his highest number 268. Goooo Tommy!
He held out the whole day, no insulin with his highest number 268. Goooo Tommy!
Chris & China (GA)
Member Since 2013
One thing I forgot to add...when you skip the shot, put N.S. in the U column (for No Shot)
When you post your condo tomorrow, remember to put the date, Cat's name, and the AMPS number in the subject line. If you have a question included in the condo, add the ? icon so people will know you're condo includes a question.
Put the link to the prior day's condo into the new one too. Just copy the link, and put it between the YOUR LINK HERE
Hopefully he won't lose too much momentum by the skip today, but we'll just have to see how he does...but don't be discouraged if you get higher numbers than you'd like and think you should go back to 2 units...Since you skipped, you drained the depot some and it'll take a little time to refill
All in all, good day for him considering the skip!
When you post your condo tomorrow, remember to put the date, Cat's name, and the AMPS number in the subject line. If you have a question included in the condo, add the ? icon so people will know you're condo includes a question.
Put the link to the prior day's condo into the new one too. Just copy the link, and put it between the YOUR LINK HERE
Hopefully he won't lose too much momentum by the skip today, but we'll just have to see how he does...but don't be discouraged if you get higher numbers than you'd like and think you should go back to 2 units...Since you skipped, you drained the depot some and it'll take a little time to refill
All in all, good day for him considering the skip!
I'd like to add just a little more to Chris's info.
We talk about being data ready and that means having spot checks at +1, +2, +10, and +11 as well as the other more common test times like +3 and +6. The importance of the early tests is they tell you if he gets a food spike which is important to know when you are shooting lower than you've shot before. The late cycle tests let you know whether your PS is a dropping number or a second dip. You don't need to get all those tests every cycle....you can just alternate them as spot checks.
The importance of knowing whether you have a dropping number or a second dip is huge when you are starting out. A dropping number is where the BG slides down from one PS to the next with the lowest number being at the subsequent PS. Once you have data, shooting a dropping number allows you to take advantage of overlap and carryover.
Lantus is known for its second dip which is when the BG comes down, nadirs, and then rises again. At the very end of the cycle, it drops again but not as low as the nadir. Once you have data, If you get a second dip at a PS, it's generally safe to shoot without stalling or shooting a BCS because numbers will tend to go up from there until onset.
I just thought it would be good for you to be aware of these for the next time he gives you a lower PS...it might help
We talk about being data ready and that means having spot checks at +1, +2, +10, and +11 as well as the other more common test times like +3 and +6. The importance of the early tests is they tell you if he gets a food spike which is important to know when you are shooting lower than you've shot before. The late cycle tests let you know whether your PS is a dropping number or a second dip. You don't need to get all those tests every cycle....you can just alternate them as spot checks.
The importance of knowing whether you have a dropping number or a second dip is huge when you are starting out. A dropping number is where the BG slides down from one PS to the next with the lowest number being at the subsequent PS. Once you have data, shooting a dropping number allows you to take advantage of overlap and carryover.
Lantus is known for its second dip which is when the BG comes down, nadirs, and then rises again. At the very end of the cycle, it drops again but not as low as the nadir. Once you have data, If you get a second dip at a PS, it's generally safe to shoot without stalling or shooting a BCS because numbers will tend to go up from there until onset.
I just thought it would be good for you to be aware of these for the next time he gives you a lower PS...it might help
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