1/16 Sami - PMPS 157 NEED ADVICE - +14.5 121

[Tina & Sammy]

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

It's okay. We've all been there before. What would you feel comfortable shooting? 0.5u? 0.75u? Want to get something in the shed if possible. As long as you have HC and can monitor, then you can control numbers, but you do need to feel comfortable with what you decide to do.

You do know that the True Results meter reads lower and is not as accurate. I would put it deep in a closet and never touch it again. ;-)

Yes, I do realize the TrueResults meter reads lower and isn't as accurate, but since my data history is with that meter it gives me a little more information to work with in making a decision.

Would feel more comfortable with .5 or .75 units, but I don't want to screw up her system, or make her go too low.

 

[Tina & Sammy]

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

I'm sorry but enough of that meter. ditch it. We went through all this. It is not valid and you don't change meters at a time like this. Okay?

I only wanted to get a reading with that meter since that is what I have data from. I don't plan on using it in the future, but I felt I needed more information in order to decided with dose to give.

 

[Libby and Lucy]

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

if you're comfortable with 0.5 or 0.75, then I would shoot that. Remember that tomorrow morning's shot will be due 12 hours from now, not at your regular time (if Sami is high enough in the morning, you can shoot 1/2 hour early to start working back toward your schedule.

 

[Cassandra and Sasha]

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

but I felt I needed more information in order to decided with dose to give.

It doesn't really give you more information, as we base dosing on trends and you are now using a new device for that. Stick with one or you will drive yourself crazy and not be able to figure out what to do.

Sami is going to bounce off these numbers at some point. She is not used to them right now, and even though they are still above the normal range, her body views them as abnormal. That is part of the process.

Lower numbers are nothing to be afraid of if you have the right tools (HC canned and test strips). You can control them and you will see that. Please look at Sasha's spreadsheet. She is continuously in the 50 to 80 range and is happy as a clam. She has been as low as 22 before without any problems. We do not aim for that, but low numbers sometimes do happy and you feed them HC and all is fine. I've been at this for 2 years and I wouldn't be advising you of anything that I thought would be harmful to Sami, I promise.

The beginning is scary, and the first low numbers can be scary, but there is nothing to fear right now. Just need to get insulin in her and take it one step at a time.

 

[Tina & Sammy]

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

if you're comfortable with 0.5 or 0.75, then I would shoot that. Remember that tomorrow morning's shot will be due 12 hours from now, not at your regular time (if Sami is high enough in the morning, you can shoot 1/2 hour early to start working back toward your schedule.

Okay, I think I will test her one more time in a few minutes before I shoot. that will be +14.5. And as long as she is still steady or rising I will go ahead and shoot a fat .5 or .75, I guess I will decide when I actually do it.

Now my question is how do I mark my spreadsheet with this information so I have the data for the future?

 

[Cassandra and Sasha]

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Ditto what Libby said - 0.5u or 0.75u is just fine for tonight if it is more comfortable for you. Please do just get a +1 test in after you shoot and we can see what other tests you need from there.

 

[Tina & Sammy]

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Okay, I am really confused now.

Sami is now at 121 at +14.5. Do I still go ahead and shot a .5 and keep testing? And if so how often should I test?

 

[Cassandra and Sasha]

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Now my question is how do I mark my spreadsheet with this information so I have the data for the future?

You can put all of the tests in a line in the blank note line on the right hand side of the SS. Something like this:

+12 157, +12.75 156, +13.5 142, +14 141

Then put the actual PMPS number that you shoot (which will be +14.5) in the PMPS box and add a +14.5 beneath the number.

Does that make sense?

 

[Cassandra and Sasha]

Since you are so far off schedule now and the number is dropping, why don't you go ahead and skip tonight and start over in the AM with the 1.1u dose? Okay plan for you?

 

[Tina & Sammy]

Since you are so far off schedule now and the number is dropping, why don't you go ahead and skip tonight and start over in the AM with the 1.1u dose? Okay plan for you?

That sounds fine, but I really don't want to screw her up again. Even if I wait another 30 minutes I could still adjust to a time that I can shoot for Monday morning. Should I let it go another 30 minutes and test again? Or should I just call it a night and let it go? Either way, I could still test her again in another hour or so to make sure she is surfing or rising.

 

[Tina & Sammy]

Plus, I am going to feed her again (since I don't think she ate enough at dinner) so she might start rising with a snack.

 

[Cassandra and Sasha]

It's not a problem to skip tonight. Her shed is a bit overfilled from the increase today, and skipping will let it drain out. I don't normally advise to skip if it can be helped, but this is a special situation.

If your schedule is flexible, then you can certainly dose later tonight if you want, but we do try and stick as close to 12/12 as possible. As Libby said, that would put your next shot time at 12 hours past when you shoot tonight.

 

[Tina & Sammy]

It's not a problem to skip tonight. Her shed is a bit overfilled from the increase today, and skipping will let it drain out. I don't normally advise to skip if it can be helped, but this is a special situation.

If your schedule is flexible, then you can certainly dose later tonight if you want, but we do try and stick as close to 12/12 as possible. As Libby said, that would put your next shot time at 12 hours past when you shoot tonight.

Okay, at this point I will test again in another 10-15 minutes and see where she is. If she is on the rise I will go ahead and shoot .5 and then feed her again. If she is surfing or lower I will skip, and go ahead and feed her.

If I skip should I just check and dose at the normal time of 6:00 am tomorrow?

 

[Cassandra and Sasha]

Okay, at this point I will test again in another 10-15 minutes and see where she is. If she is on the rise I will go ahead and shoot .5 and then feed her again. If she is surfing or lower I will skip, and go ahead and feed her.

If I skip should I just check and dose at the normal time of 6:00 am tomorrow?

Sounds like a good plan. If you do skip tonight you can shoot at whatever time is best for you in the AM, as long as you can stick to it 12/12 and can get some before bed tests in the future with whatever time you choose.

 

[Michele and Esse]

You're in for a rebound, no matter what you do. How bad it is depends on what action you take right now.

I think Cassandra had a great suggestion: skip the shot, and keep an eye on Sami until you see a consistent, 3x rise. She seems to still be dropping, at a point where the insulin should've been depleted. That tells me that 1.5 is too much for her, and it would be best to let her find the bottom by herself and not add any more insulin into her system at the moment. If you do add insulin, you're setting up for a hypo event.

Of course it's your choice, but if it were me, and my cat, and Cassandra suggested it, I'd be skipping the shot, be prepared for low numbers, and pick everything up tomorrow morning at the regular shot time with 1 unit.

Best-
Michele

 

[Cassandra and Sasha]

I think Cassandra had a great suggestion: skip the shot, and keep an eye on Sami until you see a consistent, 3x rise. She seems to still be dropping, at a point where the insulin should've been depleted. That tells me that 1.5 is too much for her, and it would be best to let her find the bottom by herself and not add any more insulin into her system at the moment. If you do add insulin, you're setting up for a hypo event.

Just to clarify, this isn't necessarily always what happens with a dropping PS. Oftentimes there is a double dip with Lantus/Lev - meaning the insulin will give a true nadir and then drops again around PS time. It is fine to shoot that with experience and no low numbers may ever come from it. However, given the unwarranted increase and the immediate drop following the increase, it does appear that the shed is too full right now. Shooting would still be fine as long as monitoring was done, and it is possible that the cycle would have to be controlled by food, but it is very difficult to predict that as we do not know when the bounce from these numbers will begin.

Because of carryover and overlap, there will always still be insulin still working past shot time with Lantus and Levemir.

 

[Tina & Sammy]

You're in for a rebound, no matter what you do. How bad it is depends on what action you take right now.

I think Cassandra had a great suggestion: skip the shot, and keep an eye on Sami until you see a consistent, 3x rise. She seems to still be dropping, at a point where the insulin should've been depleted. That tells me that 1.5 is too much for her, and it would be best to let her find the bottom by herself and not add any more insulin into her system at the moment. If you do add insulin, you're setting up for a hypo event.

Of course it's your choice, but if it were me, and my cat, and Cassandra suggested it, I'd be skipping the shot, be prepared for low numbers, and pick everything up tomorrow morning at the regular shot time with 1 unit.

Best-
Michele

Okay, I skipped the dose. At +15 she was 120, somewhat steady from +14.5, but still dropping notheless. I did just feed her again, so more than likely she will start to rise again. I will prepare myself for a higher number in the morning.

My next question is, should I continue to test her for the next few hours to make sure she does start to rise or do you think it is okay to give her a break on the testing since I didn't give her a shot. If I should continue to test how often, every 30 minute or every hour?

 

[Michele and Esse]

Clarification noted, Cassandra, and I *knew* that already. I just forgot to put that in my post. LOL.

Tina, I think you should be testing a bit this evening, and posting numbers. She may get kinda low, and it will be a bit scary for you, but remember to look at the patient, and do what is suggested here on the boards. You'll get through, and yes, she may go quite high tomorrow (take a look at my ss for good examples of rebounds that go skyhigh...).

BTW, what did you feed her?

Best-
Michele

 

[Cassandra and Sasha]

You can stop testing for now. Maybe grab one in a few hours if you want just for data.

Just post again in the AM if you need help with the shot - one of us should be around. I would go back to the fat 1u/1.1u dose that you were on prior to this last increase today.

 

[Michele and Esse]

You can stop testing for now. Maybe grab one in a few hours if you want just for data.

Just post again in the AM if you need help with the shot - one of us should be around. I would go back to the fat 1u/1.1u dose that you were on prior to this last increase today.

Really? On a dropping number? Cool, I just learned something. Tina, this is why newbies shouldn't give advice. LOLOLing at me...

Best-
Michele

 

[Tina & Sammy]

BTW, what did you feed her?

It was LC canned food. I put out a few differnt things because what I put out earlier didn't go over well with anyone. Here is what I put out:

Turkey & Giblets Feast
Tender Beef & Liver Feast
Flaked Tuna with Egg Bits

Sami ate a little out of all these bowls, and remember I have 5 cats. Two of which got some of the dry HC prescription food in the other room, where Sami had no access.

 

[Cassandra and Sasha]

Really? On a dropping number? Cool, I just learned something.

This is really just surfing, not a true drop. It was not a massive OD and there is little chance of any danger as the insulin continues to wear off. Not a problem taking a break from testing for now. :smile:

 

[Michele and Esse]

Really? On a dropping number? Cool, I just learned something.

This is really just surfing, not a true drop. It was not a massive OD and there is little chance of any danger as the insulin continues to wear off. Not a problem taking a break from testing for now. :smile:

Aha! Thanks for the concept...now, to remember that when Esse goes low.

And Tina, I have 9 cats. It is very, very hard to know who ate what, especially since some won't eat when the others are around (my two shy girls).

Best-
Michele

 

[Jill & Alex (GA)]

looks like quite a lot going on here... on many levels! ;-)
nice job testing, tina. you've collected a lot of useful information today. happy to hear you'll be taking the dose down a little...

 

[Tina & Sammy]

Really? On a dropping number? Cool, I just learned something.

This is really just surfing, not a true drop. It was not a massive OD and there is little chance of any danger as the insulin continues to wear off. Not a problem taking a break from testing for now. :smile:

Okay, will do. I will try to test her one more time before I go to bed, just to get the data, but only if she is up and about too. I don't want to have to wake her up or disturb her if she is already in bed, which is highly likely because it is already past our normal bedtime.

My guess is that she will be back in the 200's, or higher, tomorrow morning and I will feel very comfortable shooting the 1.1 unit in this range, but if some sort of miracle happes and she says in the low 100's I will be back her tomorrow morning for more advice.

Thanks for all the help. It is very reasuring that someone is always here to lend a helping hand.

 

[Tina & Sammy]

looks like quite a lot going on here... on many levels! ;-)
nice job testing, tina. you've collected a lot of useful information today. happy to hear you'll be taking the dose down a little...

Absolutely, at this moment the plan is to go back to 1.1 unit tomorrow morning. I think I have learned my lesson, although I can be very hard headed at times, so don't be surprized if I screw up again.

 

[Tina & Sammy]

And Tina, I have 9 cats. It is very, very hard to know who ate what, especially since some won't eat when the others are around (my two shy girls).

Yeah, what is up with that. Crystal the smallest of all my cats likes to eat when no one else is around. And for that matter Sami use to sneak back into the kitchen after everyone was in bed to sneak more food. I think she still does this, but not as much because there is no dry food left out for the midnight snack, just wet food and after awhile they don't have any interest in it.

I am thinking about getting a timed feeder though because I have two little piglets who will wake me up at 3:00 am if they are hungry and there isn't fresh food. It was okay when enough dry food was left out overnight, but now they finish up the wet or are not interested in what is left by 3:00 am. Bummer for me because they won't let up until I get up and feed them. Hubby usually gets to sleep right through their antics.

 

[Jill & Alex (GA)]

we ALL screw up... multiple times!

whenever you're prepared to see sami in green, there's room to take the dose up to 1.25 unit.
eventually the goal should be to keep sami in normal numbers overall. with the long acting insulins, we use overlap and carryover to our advantage to achieve that goal...