8/16 Clare AMPS-297;+2.5-202;+6-145

Yesterday's condo: viewtopic.php?f=9&t=123558

Good morning everyone!

Clare's back in her higher numbers this morning. I think we'll try to catch up on some sleep today. ;-) Don's taking her for a walk just now. She's become a hunter of grasshoppers this summer.

I've got a question for the Board. It's likely that the protocol will call for us to go back to the best dose, which is 0.5, but that dose seems to make Clare's BG go pretty low. We're using such low doses that it seems we don't have a lot of wiggle room. So is that what we do, and then just try to manage the low numbers so that she stays within a good range?

Is there a way to do a dose (with some kind of accuracy) higher than 0.25 but lower than 0.5?

Thanks for your advice,

Georgette

Georgette

Re: 8/16 Clare AMPS 297 +2.5 202

Morning!!!

Clare is just bouncing and I see from her +2 (202) that she has come down quite a bit. This is where we say "Patience, Grasshopper" :lol: :lol: :lol: I frequently have to say that to myself as I have an itchy syringe finger. ;-) a bounce can take six cycles (and some times longer) to clear so let's let her clear it and see where she is.

Many, but not all, of us use calipers for micro dosing. Here is some info on Dosing with Calipers.

Try to get some rest but I'd stay on top of her numbers. If the +2 is much less than the preshot, it is likely to be an active Lantus cycle. I'd probably grab at least a +4 and see where she's headed.

Hi Marje,
Oh - I was remembering the post about dosing with calipers when I asked my question; but I wasn't sure if it applied in this case (Of course it does! I'm just slow-thinking today.) when I originally read your post, now realizing that it was you who wrote it, I was so impressed with the care that you took in your testing of the syringes, and the generosity you showed in finding and sharing a project that could benefit so many. Someday I hope to do something that could give back to you and the group, too.

So today at +4 I hadn't yet read your note about doing a +4 ohmygod_smile and at about that time we were on our way out the door for our ritual of Saturday morning breakfast and errands. We gave Clare a snack before we left. She's back on LC today but still getting her pieces of chicken that she loves. And we left her with some extra food.

It was +6 before we read your note (on the way home) and got home to do a test. I realized that we missed an opportunity to see where she was before we left. A lot of this process is training your own brain, isn't it?

Anyway, I plan to order the calipers. Any particular type that's best to use? Maybe one of the video says - I'll watch those again.

By the way. Since we'd tried the higher 0.5 dose for two cycles before we went back to the 0.25, how can you tell the difference between a bounce and the effects of the temporarily larger dose wearing off? When you look at Clare's chart, do you think that we might not need to go higher than where we are now? Just wondering about your views on that.

Thanks!

I'm out doing errands but wanted to reply about the calipers. We bought the digital 4" ones from Harbor Freight. They are really good. When I get back, I'll give you the link and also a good explanation to respond to your question about bouncing. I'd hold the dose for tonight though.

Yes....alot of this is training your brain and learning her patterns. When does she onset? When is her nadir (generally, although it might change). How long is her duration (which might also change).

how can you tell the difference between a bounce and the effects of the temporarily larger dose wearing off?

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Excellent question. If they go up really fast after being low (see how Clare went from 76 to 217 in two hours on 8/15?), then you know the bounce has started. Because bounces can last six cycles, you basically have to wait it out to see when she clears and what she comes down to. When the bounce clears, you want her back in normal numbers. Once you get experienced, you will know if you can take the dose up before a bounce clears. For example, I know if Gracie is taking six cycles to clear a bounce, she needs more insulin. I'll take the dose up before the bounce clears because I have a ton of data and I, generally, know her.

The other thing that throws an interesting slant on it is that the higher dose can affect up to six subsequent cycles due to the depot. At a higher dose, Gracie might continue to see fairly low numbers for six cycles after I reduce. So I have to get past those six cycles to see whether the reduced dose will hold. Not all cats take that long; for some, it's 3-4 cycles after a reduction. That's why we don't like you to take back to back reductions. In other words, if Clare had gone below 50 again today, we would have assumed it was the depot and not had you reduce again yet.

When you look at Clare's chart, do you think that we might not need to go higher than where we are now? Just wondering about your views on that.

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Sometimes my crystal ball works perfectly. ;-) But I wouldn't yet hazard a guess on this. We need to see Clare for a bit longer to see what she is going to do. Remember that FD is a marathon, not a sprint :lol: :lol:

Here's the link to the Harbor Freight 4" digital calipers we use. They are on sale!!!

I hope she had a nice day and you all enjoyed getting out.