Tryin’ to be patient :(

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donnahc

donnahc

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Hi Kids:
I am trying hard to be patient and stick with this dose of 2.4, but I am worried because we have no drop for 3 days, and we are above 270 now all day.

Today: amps 297, shot 2.4
+6 was 288 and he ate nothing before that test (since breakfast)

Do I just shut up and be patient or do I need to do something? Very frustrated I am missing something or doing something wrong here :cry:
 
I wish I had something to offer--but, I don't.

When I started getting flat lines, instead of curves-- I too got frustrated. The new vial of insulin seems to have made a difference for us. Then again, maybe the better numbers we are seeing are due to DKA being futher out or the fluids. Truly, I think it is the insulin. Just a thought--how long have you been using the vial? It probably isn't that since you had drops less than a week ago into blue.
 
Yeah it’s the same vial of insulin and it’s new. I have an older bottle with not much in it and switched to this new one before the dental because folks thought maybe my lousy numbers were the insulin. So...I doubt it’s this insulin but who knows.

Dunno what else to try. I tried feeing small snacks during the day with the feeder. Now I have cut down on leaving food out and on chicken snacks. That doesn’t seem to do anything except make him pest for food mid day and the middle of the night. I gave him a snack last night at 2:30am because he came to me wanting food.

I can’t find the magic button to push :(
 
Aww...I never know what to say when it comes to Asher cause he just doesn't follow the book. Sending you and Asher good vibes for better numbers.
 
Looking at your spreadsheet I see you reduced after those greens at the 2.5u dose. I wouldn't have lowered the dose yet because technically they weren't too low, but would have tried to let that dose settle in more. The numbers you are seeing now are probably a combination of things - initially it was the body's reaction to seeing greens for the first time, and there after it was due to the dose reduction. My suggestion - go up to 2.6u tomorrow for the am shot.
 
Thanks for lookin' things over Kelly.

I think we lowered the dose because there was some thought that the 373 that night (after the 59) was bounce and lowering the dose would be the right thing to do to level out and have the bounce clear. So in other words, don’t shoot the bounce.

Ok so you are thinking 2.6 tomorrow morning and keep an eye on him?

Edit: pmps was 286

**Oh, and Kelly...So when we go to 2.6 tomorrow, if we get a good low nadir and then he bounces high (more than high 200s) again for pmps, what do we do, stick with same dose?
Just want to get some sort of plan in place in case it’s slow again like tonight on here...
 
Right, don't shoot the bounce.

If you up his dose tomorrow I would go with the 2.5 again and see if he drops too much again, and by too much I don't mean he dropped too low I mean that he dropped over 200 points and you don't know how much lower he went before that and the steep drop will cause a bounce too.
 
Sorry, I just want to clarify again, I’m a little thick :shock:

I don’t shoot the bounce, so if he goes low mid day, then bounces to 300 or over for pmps, just shoot the 2.5 or 2.6 again? No reduction in dose like we did last time?
 
That would depend on his bg. If it's lowish lower the dose, but if it is a bounce hold your dose don't shoot the bounce.

My internet service has been hit and miss lately and I havn't been able to keep up with everyone on a daily basis, sorry.

We say shoot the numbers, unless it is a bounce. If you lower your dose because of a lower bg but then it rises but not a bounce go back to your regular dose.

Does that make more sense?
 
Ok, I think I got it. Sorry, just wanted to be clear on what to do.

And I may not need this info right away as sometimes he takes a cycle or 3 to do something on a new dose.

Someone is home here with the kitties the next few days, so I feel ok about raising dose and checking on him.

Thanks guys! You’ll be the first to know :lol:
 
Just to clarify, I think you have to distinguish between a bounce that is true rebound - low #s or steep drop - vs. a liver-training bounce that is from not being used to the good #s. If there are low #s (under 50 on most meters) or steep drops, then you want to reduce the dose b/c those things are signs your dose is actually too high. If you don't see either of those cases but do see bouncy #s, then you hold the dose steady and ride it out. (Robin may have said the same thing, sorry if I'm repeating!)

Back on the 13th I would say the % drop was larger than what you really want, and that would be the reason to lower the dose a hair, rather than the apparent liver-training bounce (which you wouldn't want to reduce the dose for in most cases).

I wish I had some insight into his #s to help you out. I DON'T think the answer is patience though, and I think that fact that you don't feel patient reflects that. I think your choices are to continue with dose increases and see if you can get a more consistent breakthrough (you've tried lower doses, and unless I'm not seeing it there's not much room/point to trying that any further), or consider a different insulin. His response is so varied I find it hard to know what to do. :cry:
 
Thanks guys. I appreciate you all taking the time to look over our confusing spreadsheet.

Joanna, so you said on the 13th the drop was lower than we want, but it sounds like I am going to try that same dose again tomorrow (2.5 or 2.6) since the 2.4 we are on now isn’t cuttin it.
Is that what we should do? I guess we don’t have a choice if 2.4 isn’t enuf.

Hoping I don’t have to change insulins. Dunno if my vet uses other ones and I am scared that folks say the L’s aren’t as forgiving as PZ and that you have to be more rigid and test more, etc.
But if I have to, I guess I have to. Sometimes I hope I can keep up.

I still think PZ is worth a good try yet. How will I know when I should be done trying?
 
Yeah the 2.4 doesn't look like enough anymore. I had a really hard time with that - you get one good cycle on a dose and then you stay with that dose hoping it will come back, and scared to increase the dose b/c it feels like it will be too high then. Never worked that way though with Bix - I only got good results when I kept with the dose increases until I got consistent results, and when I did get a breakthrough I only reduced by 0.1 or 0.2 for the most part, and really kept the pressure on the #s to keep them from creeping up. Once they spend a couple days in yellows or higher their insulin needs can start going up already. Of course Bix's patterns were often different than Asher's.

I think you are done with an insulin when either 1) you feel like you are done with it and want to switch, or 2) you have tried everything within reason and can't get results. If you get to a point for instance where you can see you get good nadirs but not enough duration, or if you have tried lowering the dose and have tried raising it and you can't get anywhere, then it's probably time to switch. If you still want to be on an insulin and you still have a path to follow (like dose increases), then I think you are good to go!
 
Thanks Joanna, I really appreciate you spending so much time on this.
Tomorrow is a new day so we’ll see what the dose increase will bring :)
 
Hi Donna,

I just wanted to add that I don't think you should be leary of the L's. You already get plenty of testing in, you or Thom are usually around to monitor and I've observed before that you tend to think like the L's.

If PZ isn't a good fit one of the L's might be. Do what you feel is in the best interest of Asher.

We are rooting for you and will support your decisions.

Robin
 
Thanks Robin,
That makes me feel a little better if we do have to change insulins. Time will tell. Obviously I will do what’s best for the gray dude.
I so appreciate all the support everyone gives us!
 
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