01/23/20 Apple AMPS 187 - Low number scare last night, back to normal for now

The very big lesson you will learn from using Lantus is patience. (Ask Marje!!!) Give this dose more than one cycle to see if it's working the way you want it to. A failed reduction is always a possibility but I would not jump to that conclusion within 5 hours of having reduced the dose. You are more likely seeing a bounce from the numbers last night. Apple hasn't spent all that much time in green numbers so a bounce is a good possibility.
 
Sienne and Gabby (GA) said:
The very big lesson you will learn from using Lantus is patience. (Ask Marje!!!) Give this dose more than one cycle to see if it's working the way you want it to. A failed reduction is always a possibility but I would not jump to that conclusion within 5 hours of having reduced the dose. You are more likely seeing a bounce from the numbers last night. Apple hasn't spent all that much time in green numbers so a bounce is a good possibility.
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What we were concerned with was the wisdom of the reduction on our part, was it too hasty or the correct call. We had the greens, albeit a dangerous low at 49. So you agree with the reduction and holding a couple of cycles to see what happens? Then raise it again if the numbers go into the reds or pinks?
 
With TR, any drop below 50 should signal you to reduce the dose. There are certain situations and certain cats where this instruction is modified (e.g., a cat that's been diabetic for over a year) but for now, that's the guideline I'd suggest with Apple.

You'll have to see if higher numbers turn around. It's likely that Apple may bounce due to the 49. You want to avoid increasing the dose if there's a bounce that's clearing since the end of the bounce may cause numbers to drop back down and a dose increase may do likewise. It can be a very exciting cycle if you increase the dose simultaneously with a bounce breaking.
 
Sienne and Gabby (GA) said:
With TR, any drop below 50 should signal you to reduce the dose. There are certain situations and certain cats where this instruction is modified (e.g., a cat that's been diabetic for over a year) but for now, that's the guideline I'd suggest with Apple.

You'll have to see if higher numbers turn around. It's likely that Apple may bounce due to the 49. You want to avoid increasing the dose if there's a bounce that's clearing since the end of the bounce may cause numbers to drop back down and a dose increase may do likewise. It can be a very exciting cycle if you increase the dose simultaneously with a bounce breaking.
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We are in no hurry to increase the dose again and will let this new reduction run a course..we're just trying to get a handle on how long or what numbers would dictate the increase again. A couple of cycles, like 2 days worth and red or pink numbers? Not exactly sure how to phrase this, I hope you can decipher.
 
Sorry, Caren, to just get to you now. One thing I will add is that Apple looks to me like she is, in fact, bouncing today. Bounces can last up to six cycles and I’ve actually seen a few last a bit longer. What you are looking for to determine if it is a failed reduction is, if within the next six cycles, she clears the bounce and does not come back to green.

If that happens, then you will want to increase back to 2.25u as the last good dose. It might take her two cycles to clear the bounce....or all six. So be patient. And yes, Sienne is right.....I was probably the most impatient of new FD moms at first. I learned to not chase the numbers but let them come to you.
 
Marje and Gracie said:
Sorry, Caren, to just get to you now. One thing I will add is that Apple looks to me like she is, in fact, bouncing today. Bounces can last up to six cycles and I’ve actually seen a few last a bit longer. What you are looking for to determine if it is a failed reduction is, if within the next six cycles, she clears the bounce and does not come back to green.

If that happens, then you will want to increase back to 2.25u as the last good dose. It might take her two cycles to clear the bounce....or all six. So be patient. And yes, Sienne is right.....I was probably the most impatient of new FD moms at first. I learned to not chase the numbers but let them come to you.
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Marje, no apologies necessary. As you can see from the spreadsheet we had greens last night. We didn't even think about it this morning and shot at 108. I'm around to monitor, but I hope we didn't make a mistake....
 
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