4/4/18 - Luci - AMPS 152, 2+41, 3+43,3.5+67, 4+ 97, 5+130, 7+259,PMPS 321, 2+ 226,4+203

Yesterday's condo

Why oh why does she wait until late at night to start swimming with the sharks! DH fortunately stayed up with her for the first shift feeding her small amounts of HC FF to try to steer her away from them, took a couple of hours to get her back on top of the lagoon - and she surfed for quite a while...

It seems like every time I even think out loud about a dose change she does something dramatic. I guess I'll stick with the latest dose of 1.75 considering these shenanigans she pulled last night - I'm hoping that perhaps her depot has reached a therapeutic stage and she'll be back in the green for some more visits today. Daytime would be good...but DH handled it like a champ last night and then I set my alarm for the next couple of checks to make sure she was heading in the right direction.

 

Wow! I had been checking in on Luci yesterday, but didn't see any new numbers so I expected to see a condo saying you shot 2u this morning.

Now we know it takes 6 cycles for Luci to break a bounce. I think it's safe to give her 8 cycles to give her time to break any bounces in the future so you don't increase and then have a bounce clearing cycle.

 

So glad her reductions are holding! Hooray for DH, splitting the work is so much easier. She seems to divide her shark taunting times for day and night, so that’s better than always at night.

Keep hanging in the lagoon, Luci, but stay away from the sharks, okay?

 

Back to swimming with the sharks! Still too much insulin? Is that what's causing her to go down there and stay? Mama bean is feeding HC FF 20% gravy w/cheddar...will check again in 30 minutes.

 

Oh Luci!

Their insulin needs change over time, there's no clear answer why and it could be for several reasons or just because: cat.

Funny thing, Asia did almost exactly what Luci is doing, she waffled between 2 and 2.25 in November. Then one day she just decided it was way too much insulin for her and she came flying down the dose ladder landing at .75 units. And then up and down and up and down, but hasn't been over 1.5 since then.

 

p.s. She really wants a reduction, I would shoot 1.5 tonight.

 

She hit 44 last night. She earned a reduction which should have started this AM. I'm not sure why you held the dose of 1.75 For tonight, I would shoot 1.5 and no more.

 

Good catch, Bobbie!

Yes, do 1.5u tonight.

 

Actually, she went down to 41 on 4/1 PM cycle on 1.75 also and the reduction wasn't taken. She needs the reduction.

 

Ok, we will go to 1.5 tonight - however I have to say I'm a bit confused - I was advised earlier not to change dosage 'back to back' - we just moved down from 2 unit to 1.75 on 4/1 - she hit a low of 41 that very night - but then languished at higher numbers - I was not advised to decrease dosage - however yesterday was advised that I could increase to 2 units this morning - well obviously after late last night's numbers I decided I'd better stick to the 1.75...
I'm trying to go with the flow...but sometimes it's frustrating to get different advice from different folks...
Trying to do my best...no one has mentioned before just this moment to drop down to 1.5...

 

I would have stayed on 4/1, it was close to the last reduction and until recently, Luci wasn't holding reductions well. But the one last night was far enough away that she earned it, she just reminded you today she needs less juice.

Typically they always earn a reduction with one under 50, if it is too close to the last reduction and you are not sure which way to go, ask for opinions on taking the reduction or not.

You will sometimes get different advice, it's the nature of a peer reviewed board. We are all just trying to help and using our experiences as a basis for that. People are well intentioned but we all make mistakes, maybe miss an important piece of information or sometimes there isn't a clear "right" answer and people have different interpretations or takes on things. If something ever confuses you, just ask for clarification. You have to figure which advice makes sense and fits in with what you've learned.

 

No worries, it can be all confusing for sure. About the 4/1 drop, that was cycle 3 after the previous reduction and I can see why you might have been told to hold the dose . It usually takes 4 cycles for a depot to drain or fill.

But last night's drop was far enough away ( 7 cycles ) from the reduction that you would want to take it. Maybe where some of the confusion lies is that you were contemplating an increase before she decided to drop on you last night.

No worries, but I would definitely take the reduction tonight.

 

I think it was the 3rd cycle of 1.75u when Luci had that 41. I was the one who suggested to stay at 1.75u because Luci doesn't do well with reductions and I thought the depot was still adjusting from the 2u.

But yes, do reduce to 1.5u tonight. It had been 6 cycles of 1.75u so I think Luci has officially earned the reduction to 1.5u. With 2u being threatened last night, I forgot about the change in dose.

 

I had missed that when I referenced that cycle and in retrospect understand why you told her to hold. Sorry for any confusion about that.

 

I just read your condo from yesterday. Mandy was right, after 6 cycles, you can increase, if it is warranted. The caveat being "if you don't see some action or green numbers". If the cycles continued like they had been, without what happened last night, I would have increased too.

You will see many answers that say "let's see how things go until x time" (when you could change the dose).

 

I will definitely take the reduction tonight - sorry for my confusion...seems like I should be able to figure some of this out...but I just can't seem to wrap my head around her pattern - or lack thereof...

 

Very true.. I should have added that piece of information yesterday.

Just remember ... a flat, yellow cycle means an active cycle to come... it just happened a cycle after I thought it would. Keep an eye open for that and you should be able to see it coming.

 

You were right..Luci just held off until nighttime to pull her antics...

 

It's okay, it just takes some time. I found rereading the stickies helps too. Every time I read again after some time has passed, I am able to absorb new information that didn't make sense to me the last time.

I started understanding Asia's SS better after looking daily at other SSs in concert with advice that was given to that caregiver and trends others noticed on those SSs. Things start to click eventually.

 

Sue, it takes time for things to become clearer. I still learn everyday on this board.

 

Can you help me to discern what a 'flat yellow cycle means' - after reviewing Luci's SS I am hard pressed to find more than 3 yellow's in a row - so does that mean if I test x 2 and it's yellow, is that considered a flat yellow cycle? Or would it be three or more? Seems like everyone I look on her SS there seems to be a pink, red or blue sprinkled in there - if not the nighttime testing with 3 in a row, next morning there's a blue - so that throws me off as far as looking for the trend of flat yellows. It probably varies (God help me, doesn't everything with this disease)...but I'm still looking for a trend so I can be more watchful for these drops - If I'd thought she was headed for that big drop this morning, I would have tested her at 1+. She just always hits me up 'side the head with these drops...I feel like every time I test her it's a big surprise! Sometimes red, sometimes light green...sure isn't easy getting a handle on what to expect.

 

All right. I started with the 230 on 4/2, which jumped up to 403, then came back down to 293, 239, 205, and 227. If there is a outlier number, then I ignore that. So with that, I saw 5 yellows in a row on 4/2 to 4/3 AMPS. Then you had a couple blues after that before the natural increase after the nadir in yesterday's AM cycle. Do you see a similar trend on 3/24 and again on 3/25 and also on 3/28? Does that help? I can go back further so you can study other similar cycles.

 

You can't always see the drops coming, as much as we have tools to try to predict things, cats do what they want to at the end of the day, so don't be too hard on yourself. But given you've have 3 lime greens at a +2 in the past 10 days, it would have my ears up to get more +1's because her onset is super early. Asia's is too, so those +2's everyone tells you to get to predict a cycle may be more like +1's regarding Luci.

Yesterday's cycle could be a flat yellow because those 2 blues are relatively in the ballpark of yellow. Remember the 20% meter variance thing. It's easier to spot on 3/25, ignoring the AMPS, it's a lot of yellow and then the pm cycle weird blue descending numbers and then bam! Lime green the next day. I've found outside of just the flat yellow, any cycle that is atypical of what she would do on an active cycle of that dose is a warning sign that you need to pay close attention. Look for the bounce clearing and look out on the next cycle.

 

Ok, if I think of those two blues as yellow, then it makes more sense.

I understand that the Alpha-Trak meter is expensive to use - strips are expensive. Would it be helpful for me to get an Alpha-Trak for the times when she's under 50? I'd really like to know if the 20% variance happens then? Is she really under 20? Is she over 50? Is it possible to compare the readings from the ReliOn Confirm to the Alpha Track side by side at the time of a really low reading? (or for that matter, a really high reading)

 

No, it wouldn't be helpful. With that meter, the take-action number is 68. You cannot compare a human meter to a pet meter. It's best to use your own meter because you know the numbers and how to interpret them. The 20% variance is only with that one meter. Another meter has 20% variance with its own numbers. The 20% variance isn't applied between different meters.