1/17: Esse AMPS=327 PMPS=412 +1=390 +2=378

Discussion in 'Lantus / Levemir / Biosimilars' started by Michele and Esse, Jan 17, 2010.

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  1. Michele and Esse

    Michele and Esse Well-Known Member

    Joined:
    Dec 28, 2009
    Daily Digest:
    Amps=327 Shot 2.25 30 minutes late, wellness out.
    +1=341. Grumpy w/ testing...
    +3=340. Just hanging out behind the computer...
    +7.5=434. And the bounce continues. Food still available from snack this morning.
    +10.5=413
    PMPS=412. I wonder if this is the beginning of the clear...fed wellness, shot 2.25U
    +1=390. Maybe so...
    +2=378. Will see what the morning brings. I will leave out a whole lot of food tonight.
    ************************************************
    First time I've ever shot before a cuppa. Nice to know I can locate, test and measure before I am awake...and yes, I triple checked...2.25.

    So all the food I left out last night was gone. 1 1/2 cans of 13.5 oz of Wellness...there was some little bits and scraps left, but obviously I went to bed too soon, given the food being gone and her numbers this morning.

    WCR: Sleeping behind the computer monitor, ate a bit, took the shot fine. She seems to be just fine, although she's back in pink.
    WBR: Sore, achy, and still very tired.

    We will see what this day brings...

    Best-
    Michele
     
  2. Roni and Moonie

    Roni and Moonie Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327

    Hey Michele!! Verra nice green last night!! Hope the bounce clears for you quickly--Hope you feel better too--
    I have DH's DS, DFIL & his wife all here--HELP :eek: !
    Cats Flew under furniture, arguing started already, and it's just 2 hrs they are here!!
    Hope you have a great Sunday!--Esse, Do Green!!! :mrgreen:
     
  3. Michele and Esse

    Michele and Esse Well-Known Member

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    Re: 1/17: Esse AMPS=327

    LOL, bless your heart. What a full house!

    I am hoping that she goes green again...she needs time at the lower numbers to get used to them, you know? Malachi the kitten is tormenting Charlotte, who loves it in a growly sort of way, Simon is fast asleep in the bowl next to the computer, Esse is still snuggled in the wires and warmth that is behind the compuer monitor. LOLing at these cats! No matter what they get up to, it's (imho) better than a house full of in-laws hollering at each other!

    Will be going btb in a few minutes...still tired and achy.

    Best-
    Michele
     
  4. Lydia--(Rosie & Basil) GA

    Lydia--(Rosie & Basil) GA Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327

    Holy crow, Esse is a dramatic one!

    I always have to test and feed (and shoot if DH or DS are not around) before coffee. I take synthroid and have to wait after I get up for a while before coffee.

    I hope Esse gets a grip here and gives you a nice, calm day. Oh you cats!
     
  5. Michele and Esse

    Michele and Esse Well-Known Member

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    Re: 1/17: Esse AMPS=327

    Yes, she is indeed the dramatic one...lol. You know, though, I can't really complain - she waited until after I was back from the barn, and is doing her best, you know? She's trying, she really is. Bless her little kitty heart...

    I live on coffee, and don't have the first clue how people do this all the time with just waking up. I just don't know. People at school make fun of me because I get up hours before class...and they show up with hair wet from the shower. But man, I just can't - and never have been able to - tumble out of bed and run out the door. I need "wake up time"...

    We'll see where she is at +1...

    Best-
    Michele
     
  6. Michele and Esse

    Michele and Esse Well-Known Member

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    Re: 1/17: Esse AMPS=327 +1=341 +3=340

    Looks like she's surfing in the mid300s. If this is as bad a rebound as it goes, I'll be pleased. (antijinx, you know? Just big antijinx).

    Best-
    Michele
     
  7. Michele and Esse

    Michele and Esse Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    So...I think that, given how far she's bounced, she went quite low last night. I will wait out this rebound, but I am seriously thinking about reducing the dose. I just think that she went quite low last night. I know the protocols say to wait until I see a 50, but I'm thinking this is a lot like astronomy - the presence of large unseen bodies can be detected by the actions of the bodies around them. LOL, but only kinda. I hate to see her on this roller coaster.

    I've asked before, and I'll ask again (and if no-one knows, that's fine too...): what is the difference between Somogyi and a regular low sugar rebound?

    WCR: Apparently has low energy (who wouldn't, with all the sugar needed for cellular activity sitting around in her blood...); slept behind the computer all afternoon. Just now got up for a snack, but isn't really eating, just kinda checking things out. She did groom this morning, has used the box, and will eventually make it to the window to watch the storms, but she's feeling this for sure.

    WBR: Sore, achy, just back from the barn and packing sandbags. It's started raining, although not badly (yet). Tomorrow, when the rains really start, since I'm not in class, I'll be out laying them with a team. So...storm alert, sandbags get heavy, and life does indeed continue. BTW, Barbara, rice bags are simply wonderful.

    Best-
    Michele
     
  8. Amy and Six

    Amy and Six Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    Paws crossed this bounce passes quickly.

    Take care yourself and Esse!
     
  9. Helene & Tizon

    Helene & Tizon Well-Known Member

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    Dec 29, 2009
    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    Looks like you are experiencing 'save-a-strip' day again.

    Without starting 3rd WW (because it's been done exactly on that subject - look in think tank - he's the story as I understand it. In order to have somogyi per se you need a "hypo" event (and 50 doesn't count as hypo as normal cats walks around at 50 and are not hypo!). Rebound (sugar dance) is because the liver has forgotten what normal numbers are like and thinks the cat is 'distressed' and reacts and dumps a bunch of sugar into the system. The hormones which trigger the liver to act in such a way can last up to 72 hours.

    I hope this helps a bit.
     
  10. Michele and Esse

    Michele and Esse Well-Known Member

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    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

     
  11. Michele and Esse

    Michele and Esse Well-Known Member

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    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    There will be no WW3 on My thread. LOL.

    O.K., I see the difference. There has to be a symptomatic hypo event to set up Somogyi, whereas with a normal rebound, it's just a number that the liver is unused to, or overreacts to, that sets it up. But otherwise, the mechanism (e.g. the way things work) is fairly similar, yes? From my learning, Somogyi and rebound are the same thing, uses the same counterregulatory hormones and can last similar lengths of time. I've been looking for that one difference, and it seems that there has to be a symptomatic hypo for Somogyi, whereas regular rebound does not need the actual hypo.

    If so, then I've got it. Thanks, Helene, and if anyone dares start WW3, I will be quite unhappy. Learning and discussion is fine...WW3 is definitely not.

    Best-
    Michele
     
  12. Barbara and tuffy

    Barbara and tuffy Well-Known Member

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    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    Looks like a jumping jack or jane. I read somewhere here that they don't think Somogyi exists in cats or very rarely. Maybe someone will answer that question for sure. Ms. Esse come down where you belong. You need not bounce that high. Good luck with your storms.
     
  13. Helene & Tizon

    Helene & Tizon Well-Known Member

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    Dec 29, 2009
  14. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    I will be more than happy to bestow the drama queen/Queen of Rebound title to Esse. I would very much like for Gabby to be retired from the title. You are welcome to pass it along to someone else. Apparently, Libby & Lucy designated Gabby as the next recipient.

    I hope your girl is down to better numbers for PMPS.
     
  15. Michele and Esse

    Michele and Esse Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    No thank you, Sienne. LOL...'cause we just don't need that. She'd feel like she had to live up to the title - she's compliant like that - and I just don't need the drama llama ding dong ss...especially when school starts Tuesday. LOL.

    Thanks for the link, Helene. I'll read through it once I manage to get the courage up.

    Barbara, if Somogyi has to be triggered by a true symptomatic hypo event, I can imagine it's fairly rare. We see cats in hypo range without any symptoms on a regular basis. What I learned about somogyi in school wasn't that, but in humans, perhaps it's different?

    Either way you look at it, it's a rebound from a low sugar number...how low, and how symptomatic is what the line of demarcation is. What I am interested in seeing is if the lows are caused by too much insulin, what would a reduction in insulin do? That's what I'm wondering, I suppose...

    Dinner in about 30. I over slept this morning, so breakfast and shot were late, but am getting back to the schedule tonight. Will see how things go. Hopefully, we don't tank again, and get a gradual decrease and holding pattern down there in the blues or upper greens...

    Best-
    Michele
     
  16. Lydia--(Rosie & Basil) GA

    Lydia--(Rosie & Basil) GA Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    Michele, you are one devoted bean. BTW, I was an astronomer in a past life (the past life known as the 70s) and I love your analogy about using the seen to predict the presence of the unseen. So rebound is kind of a gravitational sling-shot effect with the "gravity" coming from the low.

    I hope you have a calm evening tonight and especially tomorrow night.
     
  17. Michele and Esse

    Michele and Esse Well-Known Member

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    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    Was it your fault Pluto is no longer a planet? I mean, talk about cognitive dissonance. Generations of folks are still trying to reorder their universe because of that. ROFL.

    See, I do think rebound is a grav slingshot thing...sometimes, all we have is the seen, and have to make conclusions based on what the seen shows us. Applying that to Essemama, if she is continuously high after going green, then one can relatively safely assume that the green is causing the red. IF the green is causing the red in a regular fashion, then the green must be the problem. If the green is the problem, and the green is caused by the insulin, then the solution to the red is less green, which is created by less insulin. If we are working from nadir rather than from apex, the number we need to find is the nadir...but if one can't get the nadir (because one is incredibly lazy and can't wake in the middle of the night), would it then be safe to say that a low green has caused the red, and thus insulin should be reduced?

    I'm now quite confused. This is why I never went into quantum physics...I get myself all bolluxed up and confused. But Schrodinger's cat did exist. Of that, I'm sure...

    Best-
    Michele
     
  18. Lydia--(Rosie & Basil) GA

    Lydia--(Rosie & Basil) GA Well-Known Member

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    Re: 1/17: Esse AMPS=327 PMPS=412

    I don't know the answer to that. Well, the answer is No, not good enough if you are doing an experiment. But the answer is different when you are trying to suss out what works for treating your kitty. You might want to try playing with the data by exporting it to Excel and graphing parts of it to see what the slope of the drop would have to be to get to green in those untested zones. Then you could ask if, looking at the slope of other days, it makes sense that she could have gotten into the greens. I say that, but working in Excel with graphs is torture. It might be easier to graph by hand!
     
  19. Libby and Lucy

    Libby and Lucy Senior Member Moderator

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    What we see over and over again here is actually that the solution to the red is MORE green. Her body has to get used to green, there is no shortcut. Some cats get it right away, others have to bounce for quite a while before the red/pink goes away.

    You need to stop thinking of green as the enemy! The more time Esse spends in green numbers, the more opportunity her pancreas has to heal.
     
  20. Lydia--(Rosie & Basil) GA

    Lydia--(Rosie & Basil) GA Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 PMPS=412

    So, Libby, if the slope is torturously steep into (unseen) greens, that means not very much time at all spent cruising in the greens. Therefore, not worth looking at unless there are big long untested stretches, and then, you'd have to make too much of a guess to be meaningful, so the whole thing isn't worth worrying about. You have to see the greens, and they have to be there a long time.

    Hey, Michele, Esse will get there. I know it.
     
  21. Michele and Esse

    Michele and Esse Well-Known Member

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    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    Lib, I don't see green as the enemy. I really don't. I see red as the enemy, for sure and certain. I know that the more time she spends in green, the better...but how to go to the green without the huge reds? That's what I'm trying to figure out...how to get the green without the giant red spike afterwards. And if insulin decrease is not the answer, why do we decrease after a seen/known green?

    What I am having difficulty with is being able to stay up and do a 24 hour curve on the days she goes green. I think Esse has gone below 50 several times recently that I haven't caught...and that worries me. OTOH, as I said earlier, I'm willing to wait this out and see what happens...I'm just trying to get the science behind all of this so I can not be so worried about things. I'm **really** not challenging you guys at all - I'm just trying to understand what's happening, KWIM?

    And Lydia, thanks for that. No, I won't use Excel to graph - that is a bother and a chore at the very least...LOL. I"d rather handgraph, but I just don't have the time. LOL.

    Hang in here with me, Libby...I'm not being obstinate...I'm just worried for Esse, and sometimes get frustrated. Tonight is one of those times.

    Best-
    Michele
     
  22. Michele and Esse

    Michele and Esse Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 PMPS=412

    BTW, the whole projected slope thing doesn't work with Esse...she dropped from 431 to 48 in just over 4 hours a few weeks ago...knowing that, it's going to be nearly impossible to algorhythm this so that it can be a reasonable projection. I mean, that slope had to be close to 180*...which isn't a slope, it's freefall. She has also seen times where she flattens out - with no real rhyme or reason. To account for that would have to be an overlay, and it would also be suspect, because of the high drop slope potential.

    In other words, nope, can't do it; too many unknowns, and too many variances. Which sucks, of course, but also means I don't have to spend a day graphing things. LOL!

    Best-
    Michele
     
  23. Lydia--(Rosie & Basil) GA

    Lydia--(Rosie & Basil) GA Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 PMPS=412

    Yes, that's a bright side. But I really wonder, what is the physiology of this--those sudden steep slopes coexisting with the flat plateau-like levels. It's so interesting, and would be more interesting in the abstract, if it weren't about our own little kitties.
     
  24. Barbara and tuffy

    Barbara and tuffy Well-Known Member

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    Re: 1/17: Esse AMPS=327 PMPS=412

    Michele: It is a learning curve for Esse. She is reacting to protect herself from numbers she is not used to. Tuffy can drop and has probably spent more time in the 20s and 30s then most cats but she is fine there. No hypo. Reducing her dose too quickly only resulted in going back up. ECID, who knows when it will kick in or what makes it kick in. It happens and I guess we are just along for the sugar ride/glide/drop whatever. Hang in there.
     
  25. Michele and Esse

    Michele and Esse Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 PMPS=412

    One of the reasons I can handle regular ER blood and guts, but just can't survive pediatrics ER...because peds is not abstract enough for me.

    The physiology is fascinating...why does the liver react sometimes, but not others? Why flat blues, but the moment greens show up, rebounds into reds? Is there a little sensor in the liver saying 'well, o.k, 100 is fine, but not 90.' What's the difference, aside from the obvious? What's the trigger? Does the liver ever sleep?? And who stole the pancreas' alarm clock?

    Gah. I don't know. It's the steep slopes that get me every time...I can handle the flats; freefall is not fun (without a parachute, that is...then it's a lot of fun!). I find myself on edge and worried every time she starts to drop - will she go easy, or will this be a giant downhill ski event? I'm trying to see if there isn't a predictor, but I don't see anything conclusive on my ss which would even begin to give me the alert.

    Sigh.

    Best-
    Michele
     
  26. Michele and Esse

    Michele and Esse Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 PMPS=412

    Barbara, I'm not the best passenger in the world...I know Esse is leading this dance, but it's sooooooooo hard to just go along for the ride. Blergh.

    We'll be fine in the end...I'm just being all scientific and frustrated tonight is all. LOL. It'll pass - it always has before! ROFL.

    Best-
    Michdele
     
  27. carolynandlatte

    carolynandlatte Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 PMPS=412

    Holy Buckets, thats a lot of food!!!!!!!!!!!! :eek: A thanksgiving feast! ;-)

    I hope esse is feeling a little better and has a nice mellow drop along with a steady surf (wherever you may want that to be).
     
  28. Michele and Esse

    Michele and Esse Well-Known Member

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    Re: 1/17: Esse AMPS=327 PMPS=412

    LOL, Carolyn, don't forget there are 9 cats in this household, including a kitten who is constantly hungry (he's just over 6 months, and has the appetite of a teenager...) and a three year old who plays as hard as the kitten (they play together...). So 40 oz of food for 9 cats isn't too bad, I don't think. Do you? They're all healthy and at good weights (except for Esse).

    Esse is 390 at +1, so at least we're heading in the right direction. I'll be checking her at +2, and unless it's a fast drop (like last night), we should be good to go.

    Best-
    Michele
     
  29. Cassandra and Sasha

    Cassandra and Sasha Well-Known Member

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    Dec 28, 2009
    Re: 1/17: Esse AMPS=327 +1=341 +3=340 +7.5=434

    I see what Libby is saying, because you do get very worried, it seems, every time Esse hits any green. I know she had past clinical hypo events and I'm sure that does produce lingering fear, but you do have to try and push those fears aside to an extent. Lantus just doesn't produce the same results. We see it here constantly and it's been published in current studies over and over again.

    In some cats, there is just no way to see green without red. In other cats only pink may be seen, and others may produce black - ECID applies to how far they are capable of bouncing too.

    Why the numbers 40 and 50 were chosen as a point for reducing by Kirsten and Rand.....who knows why they chose those exact numbers. Possibly because they are high enough that the majority of cats are complete asymptomatic at that point. I'm sure it has something to do with the fact that many non-diabetic cats test in this range, so to try and go below that would be futile. There had to be some number for earning decreases....so there it is.

    As far as reducing after a known/seen low green - I said that was what I personally did. When I first came to LL, I was told that if the low green came around once it would come around again, and that is true. If we all just guessed what the numbers had been and reduced or increased based on that, LL would probably be full of a bunch of incorrectly dosed cats.
     
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