6/3 Newman AMPS 427

Suzanne & Darcy said:
How’s Newman doing today?
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I haven't gotten any spot checks today. He has not joined me on my desk as he usually does. Otherwise, his behavior is typical. He eats and naps and eats and naps....... While he may be a little less social, his moves around the house are quite normal.

And then as if on cue, he was there. I poked him and got 249 @ +8.5
 
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So we need to look at whether or not he is bouncing or needs an increase. Count the number of cycles at 1.25. He saw blue on the 1.25 dose. We hold doses with blue nadirs for 10 cycles (not 10 days). The same caveat applies as always: unless he drops low and needs a reduction.
 
Today was the 5th cycle. He got blue on the 3rd cycle, but it was skewed when I fed him some high carb because I had to leave him alone for a few hours. I'm not sure how to count that since we don't know how he would have done without the carb boost.
 
When counting 6-10 cycles, we count from the first cycle on a dose and not from the first time blue (or green) is seen.
 
If Newman doesn’t come back down by this morning (sixth cycle since the blues and we assumed he was bouncing). I would then assume that he’s not bouncing anymore and increase his dose. Bounces can take up to six cycles to clear but Newman doesn’t seem to take that long normally.
 
Suzanne & Darcy said:
Why? Because of the food intervention?
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Yes, my comment was based on the food intervention.

My understanding was that we count cycles on a dose holding for 10 cycles. The first cycle on 1.25 units was on 5/30/22. Held the dose over to 5/31 and continuing on 6/1 we saw blue. That looked good to me, so I would have been thinking that holding the dose was the correct action, but unfortunately because I had to keep an appointment, leaving him alone, I decided to give him some higher carb food as a buffer while I was gone. I saw that as interference in Newman's use of the insulin, resulting in skewed dose trial and results. I asked myself, how would he have done had I not interfered? Perhaps we should stay with the 1.25 dose giving him a chance to get blue again and 'restart' the 10 cycle trial. That would make the first cycle begin with the next cycle which was 6/2/22. There has been nearly all yellow since then. I'm thinking stay with the 1.25 and see if he can get settled back into the blue.
 
The carbs that you gave on that day would not be influencing his numbers now though. But perhaps that’s not what you mean at all.
 
Suzanne & Darcy said:
The carbs that you gave on that day would not be influencing his numbers now though. But perhaps that’s not what you mean at all.
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No, not what I was trying to say. I mean the carbs skewed the 1.25 unit trial.

Suzanne & Darcy said:
So we need to look at whether or not he is bouncing or needs an increase. Count the number of cycles at 1.25. He saw blue on the 1.25 dose. We hold doses with blue nadirs for 10 cycles (not 10 days). The same caveat applies as always: unless he drops low and needs a reduction.
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Let's erase my comment to restart the cycle count.

If we are to hold the doses with blue nadirs for 10 cycles, then wouldn't increasing the dose at this point, be too soon?
 
Okay, so to me this cycle looks like a normal cycle where he started pink, spent a lot of the day in yellow and is back up to pink. I don’t think there’s any bouncing involved, just not enough insulin to get him into lower numbers. What do you think?
 
Excellent job grabbing those tests today, by the way, so we saw what was going on. That’s so helpful to our analysis.
 
Now, I personally don’t like doing increases during nighttime cycles. I’m not saying I never did it, but usually I tried to do them in the morning. Although, a lot of the time my boy had “new dose wonkiness,” which means he went higher after an increase (usually the second day after an increase, which isn’t uncommon.)
 
Suzanne & Darcy said:
:bighug: Hope you’re okay. Talk to you later. :bighug:
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Yes, I am comfortable with the 1.25 for the evening dose.

I agree that there is a pretty clear pattern as you described. If he is in pink or a high yellow number tomorrow morning, I will feel comfortable with an increase to 1.5

If you can, I know you will look in on us in the morning. Have a good night, that's what I am aiming for!
 
Linda and Newman said:
Yes, I am comfortable with the 1.25 for the evening dose.

I agree that there is a pretty clear pattern as you described. If he is in pink or a high yellow number tomorrow morning, I will feel comfortable with an increase to 1.5

If you can, I know you will look in on us in the morning. Have a good night, that's what I am aiming for!
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You too, Linda. I hope you had a good Saturday.
 
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