1/30 Spicey Update

Hi everyone, Just wanted to touch base. On the 28th the Amps +14 is a 48. Not a typo. I did not give a pm shot because I was worried that the insulin may have been shot into the fatty layer and had a delayed effect becuase of the U100 5/16 inch needles. And i did not feel the .4 unit gave good results. So on the day that I shot .5 i used the u40 syringes so the .5 is approximate because I wanted to see if the needle length made a difference and I felt it didbecause that is how I got the Amps +14 at 48 number. The new syringes came in on the 28th and I used the new U100 1/2 inch needle syringes on the .4 dosing from then on. And I did not feel that I had good results with those numbers. So I am trying the .6 dosage with new U100 syringes and I already feel that there is a difference and I want to stay with that dosage for a few days to see what happens. And we have been on a 12/12 schedule but that 48 scared me and decided not to give a pm shot and knew that the numbers in the 1/29/10 amps would be high. And the food consistency has been the same since 1/21/10. But I feel now that I have the syringes that I feel comfortable with and spicey in a routine that there will be a lot more consitsency.

David

 

Uh oh, the Great Battle of the Syringes!!! Your house must be overflowing with them by now! I'm glad you have some that you feel comfortable with - that is very important, otherwise it's just tearing your hair out all the time on whether or not it's working right.

One thing to keep in mind is that when PZI works well, it is often when overlap builds up between doses. It often takes 3 or 4 cycles on a dose before you get that nice timing where one dose is kicking in (generally somewhere around 2 hrs after a shot, plus or minus), and the previous one is wearing off. I'm not 100% sure I've got Spicey's data clear in my head, but I *think* one reason the 0.4u might not have seemed great was because of that one shot at +13 (when +12 was 144 I think). No problem at all giving a shot late like that for safety, but it's good to be aware that the effect of the insulin will generally be reduced because of the loss of overlap, so you can't always judge the dose from that set of data.

Sometimes also with PZI when you see a late drop where the next PS is lower than a mid-cycle #, that can be a sign that the dose is too high. It's kind-of counter-intuitive, but it's a PZI pattern that's not unusual.

So if you stay with 0.6u, keep an eye out for the 3rd or 4th shot especially on that dose, and get a mid-cycle # if you can. That will often give you a better sense than the first couple shots will of how the dose is working. If it were me, I would probably try 0.4u for a couple more days. It's not clear to me that a higher dose is needed, but again I'm not 100% clear that I'm getting all the #s right in my head with the SS. I'll go look at it again now.

[ETA: Took another SS look - what I see is that on 1/27 in the 3rd cycle on 0.4u you got a perfect +12 - 144, so that dose in my mind is a good one to stay with. (May even end up being a bit too high, but I'd probably try it another cycle or two after a 144 PS rather than lowering it right away.) So then with the late shot that night, the higher #s after that don't count for true 0.4u data IMHO.

Then when you went up to a higher dose you got a shockingly low PMPS, suggesting that dose was too high.

Now on 0.6u you are seeing an approximate 50% drop from the PS to a mid-cycle test (+3) that is probably quite a bit earlier than the nadir. So that also suggests to me the dose might be a bit high. (Ideally you want a 50 - 65% or so drop from PS to nadir - anything more than that is probably a little too steep.)

Does that all make sense? Just trying to explain my reasoning why it might make sense to go back to 0.4u for a couple days. Not necessarily a bad thing to have shot 0.6u to get through those higher #s and back to some better PSs, but if it were me, I'd return to 0.4u for safety until you can test more nadirs and see how that dose is working. If the nadirs and PSs are too high after a couple days, then I'd consider a dose increase at that point, but not before. To my eyes, 0.6u looks potentially too high. Just my 2c!!! ]

 

Hey, David... good to hear the update. You've got a good head on your shoulders and I think you have a good understanding of FD, the treatment and Spicey... So I know she is safe with you... Keep plugging at it and you'll get there... that preshot was really nice tonight, eh?

 

Yes the preshot was a relief tonite after the few days of highs.