- advertisement -

Need some minor handholding...

Discussion in 'Parents of Children with Type 1' started by *Shannon, Feb 14, 2009.

  1. *Shannon

    *Shannon Approved members

    Joined:
    Oct 1, 2008
    Messages:
    573
    Janie started on insulin today in her Cozmo. She's been up and down all day... go high, correct, too low, treat, too high, correct, too low... never terrible in either direction, but not good numbers. Right now she's running high. She had no IOB and was 311. Pump recommended 2.3u to bring her back to target (140). Recommended doses have seemed high to me so I reduced to 1.5u. It's been an hour and she's only down to 270. I know I need to give it another 30 minutes. I checked ketones and they .1, so that's not a problem. I just want that number to come down.

    I know I'll get more confident w/ the pump, but right now, I want Lantus back.
     
  2. Heather(CA)

    Heather(CA) Approved members

    Joined:
    Jun 18, 2007
    Messages:
    10,153
    We don't pump, so I can't really give you any newbie pumping advise BUT, I think you should get some sleep and start fresh in the morning. I also think that it might be better to not do so much correcting,(I forgot to say just at meals) just look for patterns and make adjustments to ratios instead. Getting started on the pump is definately what I would call one of those "Adjustment peroids" Just know that numbers are going to be crazy for a little while, and take some time to watch for patterns and get it right. Your going to do great!:D
     
    Last edited: Feb 14, 2009
  3. *Shannon

    *Shannon Approved members

    Joined:
    Oct 1, 2008
    Messages:
    573
    Thanks for your post, Heather. I'm trying to trust my gut! :) I don't think it knows what it's doing right now, though!

    She hasn't come down anymore. I think I'm going to try one more sm correction and call it a night. I think I goofed by decreasing the last correction.
     
  4. StillMamamia

    StillMamamia Approved members

    Joined:
    Nov 21, 2007
    Messages:
    13,195
    Hang in there. Be kind to yourself, things will get better with the pump.
     
  5. dqmomof3

    dqmomof3 Approved members

    Joined:
    Dec 29, 2007
    Messages:
    2,778
    You are definitely in the "adjustment period" like Heather said. For at least the first week I wanted to drive the five miles I live from the ocean and give that pump a good hard toss into the salt water! After that, though, life got so much better. It is difficult at the beginning to figure out basal rates and correction ratios, and even what kind of infusion sets to use. But you will get there! Don't give up on it :).
     
  6. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    When You went live did they lower basal amount compared to her Lantus dose? If so then that can be contributing to the "swing". Sometimes at pump start they recomend a lower overall basal because for most people the less fastacting is needed for basal. Not everyone.
     
  7. Nancy in VA

    Nancy in VA Approved members

    Joined:
    Jul 16, 2007
    Messages:
    7,308
    Our CDE actually said no corrections between meals the first two weeks. They need to see what the basal program is doing to make adjustments. And. Think all of them run you high to start and then bring you down gradually. I would hold off on the corrections and let the basal run for a while, even if she's high
     
  8. linda

    linda Approved members

    Joined:
    Jul 18, 2007
    Messages:
    1,303
    Hi-Em also Cozmo- I am impressed you are doing adjustments already, We were too afraid, and were told only to call NE...We were told not to correct after 1st correction for 4 hours, I remember how hard that was:(...Fortunatly upon start we did good with the numbers right away...BUT we made other errors one after the other the 1st 2 weeks....not priming once, then over correcting....:eek:Hang in there and like others said, write all numbers, ratios corrections, carbs and look for patterns....give it a chance, GOOD JOB!!!!

    PS I do feel that with the added insulin delivered to the body 24/7 with the pump, as opposed to MDI, you may want to lower the corrections, (You mentioned after you corrected she went low)...and raise the carbs ratio....but again be cautious in the beginning and work with the Rep, or NE if you think they can help...;)
     
  9. *Shannon

    *Shannon Approved members

    Joined:
    Oct 1, 2008
    Messages:
    573
    Thank you so much for your replies, everyone! I will update a bit later today, we're about to leave for Janie's basketball game. THANK YOU!
     
  10. Connie(BC)Type 1

    Connie(BC)Type 1 Approved members

    Joined:
    Nov 11, 2005
    Messages:
    3,388
  11. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
  12. Connie(BC)Type 1

    Connie(BC)Type 1 Approved members

    Joined:
    Nov 11, 2005
    Messages:
    3,388
    Thx :D .
     
  13. Pumperdoodle

    Pumperdoodle Approved members

    Joined:
    Jan 28, 2008
    Messages:
    10
    Hang in there Shannon!! Our first couple of weeks were tough. You just have to call the doctor everyday and let them adjust the basal rate and bolus ratios until you get your BS under tight control. You will get there and when you do you will realize why you went on the pump. Keep her in a safe range and start again tomorrow. The other great thing about the pump is that you do not have to wait 3 days to change your regiment like you did on shots... tomorrow the doctor should be able to advise you if a change is necessary. You will learn how the pump works and how the insulin is absorbed as time goes by. Try not to correct too much because the first few days you are still trying to adjust your basal rate.
    Hope this helps
     
  14. show2tj

    show2tj Approved members

    Joined:
    Apr 2, 2011
    Messages:
    40
    Aarrgh!

    [SIZE="5We had this same thing happen to Sebastian in the beginning. Something to do with adjusting to the insulin change (at least that's what we were told). When he was high we were told to give him one unit of insulin by shot and watch him (mind you, he's 4). They wanted to get him down. If you have a CGM, watch for rapid falling and correct with one glucose pill before you hit a real low. Wait 10-15 minutes and if the rate of fall has slowed down, watch for another 10 minutes. If she is still falling, give her another glucose pill and repeat. If you don't have a CGM, then you might want to make sure you check her 1 hour out and then again at 1.5 hours out. I am sure you know all this!!! Then, if it were me (and remember, I am intense) I wouldn't change the doctor's settings right away, so I would go into the temporary basal setting and raise the basal for a temporary period of time (I would start with 4hours at 5% and see how it goes). Of course right now your are playing the guessing game. Ultimately, for us, it was essential to get the basal right and for us, it was easiest to get the pm basal right since he wasn't eating. So, what I did was set a basal rate for every hour (I started with the one the Doc gave us). Since the results of a basal increase will usually show up 1 hour to 1.5 hours later, when I woke, I would go back to the previous hour's basal rate and would increase it or decrease it accordingly. Sometimes you just have a sense -- for example, if she's in the 300's, a .025 raise in basal probably isn't going to do much, so you might want to try .05. Anyway, by the end of about 3 nights, we had a pretty good basal going and at least we knew that one half of our day was somwhat managed. Then, we set another basal pattern and plugged in the general guidelines for basal rates. For me, it is too annoying to go through each 1 hour basal rate, so if you see a pattern: ie. from 9-12 she needs .75 basal, then you can plug in .75 for her basal in a new pattern (our pump has 3 different basal patterns we can set, hopefully your pump does, too). Then, we just leave the first pattern behind. Should you need to go back to hourly monitoring, you still have the 1 hour increments plugged into the first pattern. We use pattern "A" as our adjustment pattern. For daytime, we set basal rates meal by meal. For three days we will do a no carb breakfast and set the basal rate hour by hour for breakfast. Then, next we will do lunch and then dinner. Her blood sugar shouldn't vary much if you have the basal set correctly and she hasn't eaten any carbs. Once you get the basal set correctly, the rest is easier and if you feel uncomfortable adjusting boluses and corrections on your own, your team can help you set some good parameters and you can tweak them from there. The team will be much better at helping you once you establish some good basal rates! Good luck. Sorry for the length. I just don't know how to say this with less words. Tracy [/SIZE][/
     
    Last edited: Feb 28, 2012
  15. selketine

    selketine Approved members

    Joined:
    Jan 4, 2006
    Messages:
    6,055
    Tracy - the original post and other posts are over 3 years old.
     
  16. show2tj

    show2tj Approved members

    Joined:
    Apr 2, 2011
    Messages:
    40
    duh!

    responding to old posts. just goes to show you how tired I am. Too funny! Thanks!
     
  17. DsMom

    DsMom Approved members

    Joined:
    Nov 9, 2010
    Messages:
    1,700
    Have done this more than once myself!:eek::D
     
  18. BittysMom

    BittysMom Approved members

    Joined:
    Aug 21, 2011
    Messages:
    870
    I was wondering how she was starting on a Cozmo:confused: lol
     
  19. cm4kelly

    cm4kelly Approved members

    Joined:
    Apr 28, 2011
    Messages:
    547
    I wanted MDI back too for a while

    When my son first started his pump two years ago (he was three then) I remember wanting MDI BACK! His blood sugar ran regularly 300 - 500! I remember thinking that we had better numbers on injections!

    But slowly as we made adjustments things got better - it just doesn't happen overnight. I compare it to new diagnosis. You need AT LEAST 2 WEEKS to get this down. I would really say even 6 weeks.

    Be patient - and give it a chance. THere is so much tweaking that has to be done over several weeks to get this better. You will soon learn to love the freedom your pump gives!
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice