Medication nightmare

It did, which is why we did the next check.

I can't wait to see how she looks at lunch!

 

WOW! I have been watching this and leaving you in WILF's capable hands - and I just want to say - WOW! Your family is amazing...

 

So very true! That's what I've been trying to think, too.

Soooooooooo excited about those numbers! Good instinct on doing that recheck at 4:48. It all worked out great!

Ok, I'm a little bit confused here..... thought you were going to split the Levemir dose? So 12 units last night..... and 13 this morning??? Or am I confused? That's entirely possible....

 

I love it when a plan comes together! Amazing progress, for such a short time.

D is hard, but I find the math part easy. It gets easy, even boring, after a while. What I find hard is the uncertainty.

I hope you're starting to see our general philosophy here, the insulin has to match your life, not the other way around!

 

You're not confused at all. A true split would be around 15/15, since she was taking 30. However, she's been on 25 for the last couple of days and has done very well. Wilf suggested the 12 Levemir in the evening: this replaces the 15 NPH we were giving her. So yes, the total basal for right now is a little more than what she was getting, but it is much more effective. I think we'll be able to bring the morning basal down in the next few days.

Slow and steady wins the race.

 

Nah. We're just like everybody else here: we'll do what it takes, no matter what, to make sure our children grow up happy, healthy, and in control.

Wilf, OTOH...

 

My thought (if one can have thoughts at 3am) was something like "She's not on a steep incline, just a gentle slide. I'll check back later." It was a bit nervous, indeed.

 

Managing D isn't easy, it takes gumption to let a lowish number ride or to make a big correction. But you made an excellent call and the result was a good night, and now you're off to a great start for today. Very nice to see..

Note that if you were on NPH you would have had to treat that as a developing low, but with the Levemir she's "steady as she goes"..

The morning rise is possibly the so-called "dawn effect", which is seen in many people.

Just a heads up that you may see insulin needs starting to come down a bit more in the next few days if BG starts staying below 160 for any length of time.

Hope you all have a great day!

 

The beauty of Levemir is you can split it any way you choose. It doesn't have to be 50/50.

The 12 units was a best estimate of what was needed to keep her steady overnight - we got lucky there..

The daytime 25 units will likely start coming down a bit once she starts spending more time with BG in range, but by giving a bit more than needed to keep BG steady it can be used to help cover small snacks without needing to inject each time.

When DD was on Levemir she always got about twice as much at night as during the day, and this allowed her to "graze" quite a bit..

 

Heard about the "dawn effect" but have never seen it in action. Thanks for the explanation!

And good news from the lunch front: her BG is 157. She had the uncovered chocolate Jell-o at around 9:30am (snack time!). From the figures last night for her lunch today, I figured on a bolus of 8 for lunch (55.24/7 = 7.89) plus I added one for correction (I remember, will count as a half unit later) since she was 157. So her lunch bolus was 9 units. Way better than the 14-16 she was getting.

 

Sounds like everything's on track - now just a matter of staying the course, gathering data, and tweaking if patterns of things needing attention start to emerge.

Congrats on the successful switch to Levemir last night!

 

I am so happy for your daughter! Those numbers look so much better! I'm sure she'll even feel better once things are "stabilized" (ha!). It is so heartening to see success in progress.

 

Thanks, Coni, for all your support as well through this. We really appreciate it!

 

2:58pm: 88 BG. 1 serving of microwave popcorn, 13.4g: glass water. No bolus.

So far, so good. She's done really well today. She never went so low as to have to use her juice and crackers.

Next challenge (and it's a doozy!): dinner. We're having pizza. Wal-mart take and bake pepperoni. 34g/slice, and we expect her to eat 2. 68/7 = 9.71, or 10 bolus. 102g for three slices: 102/7 = 14.57, or 15 bolus.

 

Pizza is VERY tricky. YDMV, but at this end it is slow to digest (esp. if there's lots of cheese) and we have found that it's best to not give the bolus until AFTER the pizza and any dessert have been eaten. If you do it that way, it would let her eat what she wants and get the appropriate bolus after.

Good luck with tonight - will be out until late at this end, but it looks like things are right on track. If it were my DD I'd try a first little tweak, giving 11.5 Levemir instead of 12.. :cwds:

 

Beautiful!

 

I called James, and he's good with that. We'll test her BG before dinner, so we can get a good starting point and have a correction factor (if any): then we'll bolus her after for the meal plus a correction.

We'll tweak the Levemir. It's a valid suggestion, considering what her levels have been all day.

Hope you have fun tonight!

 

This is just SO amazing...

 

For future reference, and as we always remind ourselves - YDMV - I do not get the "pizza effect" with thin crust pizza. For what's it's worth.

 

I had to take a break from the computer last night. Everything looked good yesterday. Here's the rundown.

I found out this morning that she had a 79 BG at 1:38pm yesterday. She felt shaky. She had her juice then. I've told her that 79 is a good number: she needs to check it again in about 15 minutes so we can see if it is going down. We're all still learning here.

5:28pm: 277 BG (after two pieces of chocolate she told no one about)
Dinner: two pizza slices (34g each) and glass of water.
5:45pm: 14 NovoLog (10 for the pizza and 4 for correction of earlier number)
7:00pm: 11 Levemir (Was going to do 11.5, but we were out and the pen doesn't do half units. Next time I'll grab a syringe.)
7:20pm: 93 BG.
8:14pm: 63 BG. Was shaky. Drank 8oz glass of milk.
9:19pm: 162 BG. Had carrots (uncovered, 8g) and glass of water.

We only checked her once in the middle of the night, because we were both so darn tired.

2:58am: 156 BG

This morning...

6:45am: 188 BG
7:00am: 25 Levemir
7:05am: 8 NovoLog
Same breakfast as yesterday: Cocoa Puffs, SunnyD, and milk. Same proportions. 57.1g = 8 NovoLog.

This is so cool. Figuring out yesterday's insulin dosages, here's how they stacked up.

25+8+8+10+11 = 62 (All the Levemir and NovoLog doses)
Two corrections were given: 1 unit at lunch and four at dinner. THose count as half: so 2.5 total there.

62+2.5 = 64.5. That's 24.5 units insulin less than we were giving just 4 days ago. And she's feeling better, she's more active, and a personal celebration: no wet bed for three days.

We'll tweak the Levemir back up to 11.5 tonight, since we'll be home and I can grab a syringe for that. I'm also thinking I should tweak the dosage down for the 7am dose, since her numbers during the day seem to be lower than those at night. I'll work this weekend on an Excel spreadsheet and her new recording notebook. We're going to record everything so we can show her new endo.

Any suggestions at this point? Wilf, I hope last night was fun and you had a great time.

Now... on to work!