? 8/2 Max PMPS (8/1) 169, +5 116, +8.5 113; AMPS 222, +4 211, +8.25 97, +10.25 83. Pancreas waking up?

Last post 7/31
Max's numbers have been pretty good for the last few cycles. On 7/30, I shot a half dose (0.75U) because I didn't want Max to drop too low during the night when I knew I couldn't monitor him (rather than totally skip as he'd kept me up the night before threatening a hypo). To my surprise, Max surfed and then climbed into the lemon tree.

I decided to shoot a skinny 1.5U on 7/31 for his AM shot just to see how he'd react, and he surfed the WHOLE day! Shot another skinny 1.5U at PM shot, and he dropped to 65 (+4) then 64 (+5) even after eating in between +4 and +5, and before his normal nadir. He then bounced up to 282 by +8 and was 401 by AMPS read. Figured the skinny doses bit me in the butt.

Gave him his regular 1.5U dose 8/1, and he surfed all day again! Another lower PMPS read had me cautious still. Me staying up all night a few nights ago is still affecting me, and I'm shutting off alarms and going back to sleep rather than getting up and testing Max! I decided to shoot a 1U (so a bit over 3/4 dose) last night, and Max surfed in the two tests I got, then settled into the lemon tree again. I decided to see how he'd do at 1.25U at his AM shot since I stopped him from dropping below 50 twice (which would mean a dose reduction). He went from the lemon tree to the green bean patch (is that what some have called the greens?).

I am not really sure if the numbers mean Max's pancreas is starting to work a little bit, or am I manipulating his levels by the dose decreases and increases? I don't want to really keep decreasing his PM shot, but I also know I'm just too exhausted right now still, come bedtime, to wake up every 1-2 hours. Shot time is still 12:30 AM-ish, so bedtime is around 1:30 AM as the other cat and the dogs think they need to get fed and get ear stick treats as well when Max does. I try to go to bed ASAP after giving Max his shot, but something always gets in the way of that. I don't expect Max to be very high at his PMPS test, as it appears as if he's bouncing again (no clear nadir), so unsure of what tonight's plan will be after his PMPS read...

 

He's never earned a reduction, so his dose is 1.5 units. However, bouncing around in dose makes it really hard to figure out what to do. To give yourself a break, why don't you take a temporary reduction down to 1.25 units. Hold that dose until you've recovered. Then if he needs the increase go back up. Think of it as a vacation/break dose for yourself. You need to take care of you to take care of Max.

Two things to remember. First, we decide what the dose should be based on nadirs, not the preshots. When you shoot low, often the cycles stay low and flat. Oh, and a third thing to remember. If you lower the dose for one cycle, the depot will still control a lot of what the following cycle looks like. So those cycles where you did a night time reduction, he did well the first part, then drifted up - that's the higher depot influencing that first part of the cycle.

 

That all make sense, thank you, The ‘never earned a reduction! is what makes me wonder if I need to stop stopping him from dropping and do nothing until he drops below 50? The last few times he started heading down to the 50s around +3 or +4 I have stepped in. I’m pretty sure had I not intervened on 7/29, he would have dropped below 50. But pretty sure isn’t the same thing as sure.

I just tested him at 12:30 am and his PMPS was 96- but there was no clear nadir today or last night- I’m sure due to my reductions, so I’m not sure what I’m shooting for. I am totally scared that 1.25U will drop him too low. But then it could also do nothing but keep him on an even keel. I’ve already stalled 30 min, so will retest and see where he’s at. If I shoot 1.25, I will plan to be up until sunrise, but maybe he’ll surprise me. Sadly, I have to take my 91 yr old dad to a doctors appointment later this morning. Argh, I feel like I have my twins as babies all over again. Up every few hours to test rather than feed!

 

He was a bit higher (102) after the 30 min stall. I decided to shoot the 1.25U again. Looks like I still need to understand the depot and learn better when to step in when he’s dropping.

 

He earned his reduction today!