? 11/2 Eddie AMPS 124 +3 181 +8 223 PMPS 220 +2 223 (reduction after yet another 24-hour wild ride)

Discussion in 'Lantus / Levemir / Biosimilars' started by Jodey&Eddie&Blue, Nov 2, 2021.

  1. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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  2. tiffmaxee

    tiffmaxee Well-Known Member

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    Congrats on the reduction
     
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  3. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Post SRT can be an incredible ride. Sometimes I felt like we were on the down slope of a roller coaster and hanging on for dear life. :woot:

    There are some things you can consider now that you know you are seeing some downward pressure on the dose. One of the things Melissa mentioned is a "depot drainer". What some people with larger dose cats do is a smaller dose, affectionately called a BCS (big chicken shot), or 1/2 dose, the cycle after a reduction is earned, to try to drain the larger depot. This is the complete opposite in idea to the "shooting through the bounce", but similar in that you return to the new lower dose the cycle afterwards. Some people use a 1/2 dose BCS, I found a 2/3 dose more effective for Neko - though truth be told, I only did it a very small number of times. After first SRT, Neko was guaranteed to bounce to the moon after a reduction, so it wasn't needed. :rolleyes: Second SRT she was more regulated and I had to be cautious. Whenever I got a reduction number that was quite low (20's on the human meter!!:eek:) that was grounds for a BCS for her. Eddie is looking much more regulated and less bouncy so a BCS might be something you want to experiment with to see if it helps. Especially if he earns a reduction during the day, that 1/2 dose might give you more sleep at night.

    Other tricks I used, were sometimes back to back reductions. Meaning reductions two days in a row. I also did larger reductions than protocol called for a couple of times. That could be handy if you need a bit of a breather. It's OK if he runs in slightly higher numbers a couple of days if you can't monitor closely due to work or other reasons.
     
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  4. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    Thank you for this! Daily I'm appreciating more and more the complexity of the SRT/Insulin choreography especially when you throw in a roller-coaster!! I will check in with you about this once I've had a chance to read it a few times. Occasionally I feel so out of my depth (another metaphor, but who's counting?).
     
  5. FrostD

    FrostD Well-Known Member

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    Have you tested him in the past few hours?
     
  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    If it helps, Neko's 2012 SS, starting early August and Neko's 2015 SS starting mid November. The latter shows a couple of times I BCS'ed. I also BCS'ed once right after SRT in 2012, but that was for the ride home. I also moved the reduction point to 70 (3.9) on my human BG meter, to give me a margin of safety from the 50 that is stated in TR. The other thing I did was stick with 0.5 unit reductions for a while below 5 units dose. My mantra was, take the reduction (early or larger) than normal, I can always go back up in dose if needed. The few times I tried going back up, she usually rewarded me with low numbers. I learn to trust my gut when it was telling me she needed less insulin. That really just means learning her patterns on insulin and when it looked like she was leading up to low numbers.
     
  7. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    Yes, just tested +3 181
     
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  8. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    Ok, just tested @ +8=223. Are we level to keep to 11u tonight if we are going in this direction?
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Stay the course, he's starting to bounce from that 59 last night. Let's see where his nadirs land after this bounce is over.
     
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  10. FrostD

    FrostD Well-Known Member

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    He may break it again overnight, so just be sure to get that before bed test. If flat or lower he's probably heading down, set an alarm to get up again.
     
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  11. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    Yes, I will do that (although I'm starting to appreciate what sleep deprivation means to cognition! Even the spreadsheet seems labyrinthine at night). So, while I will do the bed test and the setting alarm test, and I will hold the course and shoot at 11u again.

    This might seem self-evident and I'm sorry if I appear a bit dense but I'm just, as I've said, getting introduced to the complexities of the TR/SRT dance. Working with insulin is kind of like knowing how to use fire.

    I will post again at PMPS. Thank you @FrostD and @Wendy&Neko
     
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  12. FrostD

    FrostD Well-Known Member

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    No worries! In some ways I'm fortunate to have had a diabetic cat after kids...they broke me into sleep deprivation and now long, uninterrupted sleep is just a bonus lol

    When Mr Kitty started coming down after starting cab it was like pin the tail on a running donkey. Just take a best educated guess and maybe it's right, maybe it's wrong. But always better to be safe/cautious
     
  13. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    @Wendy&Neko and @FrostD

    Here we are at PMPS and we've got 220. I am going to follow the advice & go with 11u unless I hear differently in the next few minutes. The SS kind of looks like yesterday and so I guess I'll have to be up around 3:30 am again (at +7).

    Phew.
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    The only reason to change our suggestions would be possibly if he had gone low again. He didn't. Get a +2, that will tell if you have to set an alarm for later, or not.
     
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  15. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    Ok. I'll get a +2 in about 30 minutes (10:30 pm PDT).
    Thank you!
     
  16. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    At +2, we've got 223. I'll try this out to see if I'm learning (correct me if I'm wrong): but 223 would seem to indicate we're not going to go too low tonight but that things will go lower at AMPS (like back to blue)??? Although it was 223 @+8 today, too.

    Thank you.
     
  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    With the PS and the +2 about the same, it looks like a "normal" Lantus cycle with possibly some downward movement. But it doesn't look like he'll dive tonight, so you can forgo the middle of the night test. I make no predictions as to where he'll be at AMPS.
     
  18. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    One more thing, sometimes flat yellow indicates a cycle with action to follow.
     
  19. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    Jun 2, 2021
    at times like this a crystal ball would be helpful but I hear you. It’s a bit like a black box: either a “normal” cycle or an action cycle. Roll the dice.

    Thank you for keeping company.
     
  20. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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