10/6 Heart Increased dose but maybe too much?

Yesterday: viewtopic.php?f=9&t=105772

I accidentally gave him 2.5 yesterday, when I meant to increase him to 2.25. Since he's a big boy, I decided to stick with the 2.5 this morning. But based on today's results, I'm not sure if I should keep the 2.5, or bring it down to 2.25 for his PM shot. In 2010, I had him up to 3.5 units at his max

I would encourage you to follow the TR Protocol. You increase the dose by 0.25 if nadirs are largely below 300. That said, the 56 does not warrant a dose reduction.

Increasing the dose:

• Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
• After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
• After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Click to expand...

Given the number of dose changes over the last few days, I might not be surprised if you saw some wonky numbers.

Question is though - do I keep him at 2.5, or drop him down to 2.25.... his PMPS is 94

I kept at the 2.5 and will check his nadir around 1:30am and give him food. Want to keep him in good numbers since his body has quite a bit of recovering to do. The good news of the day was that his weight has increased 0.8 pounds in the past week - mostly from rehydration. Still boney, but not as much

I think I understand your question...
Yes, you'd have been better off increasing to 2.25 instead of 2.5, and tonight you could have gone with 2.25.

No, the 56 doesn't warrant a reduction, but going down to 2.25 isn't really a reduction, it's just setting the dose to what you would have increased to last night per the protocol.

I hope that doesn't confuse things?

All that said.... The 56 this morning isn't necessarily due to the increased dose. Increases don't usually show results that quickly. But because it was a .5u increase (25% increase) that might be a least partly the reason.

Tonight, you might see an active cycle, so some tests in the first 3 hours or so might be a good way to go.

I agree with Carl. I'd suggest a test at +2 or +3.

Hi Sophia

I've been off the board the last two weeks so wanted to welcome you and Heart back. I hope you will be able to get him back to the Falls quickly.

You are using R or was that at the vet? It would be really helpful for us (and we would appreciate it) if you could please annotate his SS in a way that we spot it right away. I figured it out by reading the Remarks.

I think Carl did a good job of explaining. When you start seeing blue/green numbers, it's best to slow down the increases.

I set my alarm to do a +5, which is an hour or so before nadir (just to be safe), and shot a 32. Oops. Good thing he was hungry! I'll start a new condo for today's question...