Or wherever insulin goes when it decides not to bother working in your cat anymore....
This has been a horrible week. It started when I realized - a little slow on the uptake here, I guess - that Scruffy's charts didn't match any of those nice, calm, hammock-shaped levemir curves that everyone else seems to have. We had up-and-down-jerking, just like with BCP PZI. Only difference was, the down part of the jerking was significantly lower/nicer than anything PZI had produced. I had been pretty much ignoring the high numbers - and they WERE high - because I thought I had a reason for them. Most of them were occurring directly after I had changed the dose by some minute amount: Levemir isn't very forgiving in Scruffy, for some reason. And a few of them, I'd been out and missed the 12 hour shot. (Although, what happened to all those earlier 16 and 18 hour durations? Gone with the Wind?) It also appears that Levemir has started to operate in some ways like PZI did - when it's done, it's done, and he can go up 200 points in an hour or less.
When I started levemir, there were two things I wanted: 1) better numbers and 2) not to have to use boosters. (Well, okay, that's not totally acurate - I also wanted thick hair, and for Milkshake to not have seizures.) For some reason, I deluded myself into thinking that he was doing okay without boosters for the first month or two. He was spending hours every day well under 200, and most of the time, under 150. Unheard of. His numbers were still better than they'd been for the last year and a half, if not more. I had tried using small amounts of R with the BCP in the past, and it was very unsuccessful. His bg levels would drop, significant but manageable amounts, but then he'd start having high flat numbers that were even worse than what I was trying to correct with R. I had never tried N, and wasn't particularly interested in learning about it at the same time I was trying to make the acquaintance of Levemir. I had used BCP boosters fairly frequently, with no particularly impressive outcome.
So, here we are. I've given Scruffy two .5R boosters in two days. I don't have a good enough grip on when his onset is with Levemir - it seems, like everything else about this stupid disease and my beloved little cat - to vary erratically, unfortunately. I have to decide whether to give the R by itself, which is what I did this morning, and then give the Levemir afterwards, or if it might be okay to give them both at the same time. Yesterday, I gave him Levemir first, and when he headed even closer to 500 in the next hour, I gave him .5R. He was so high at that point that I could have given him a whole unit, instead of a half.
All in all, I'm discouraged about the whole thing again. I was so happy with Levemir. It's still better than either of the other two insulins we've used, so I suppose I should quit complaining and just keep plugging away. Which would be easier to do if there weren't a furry little being whose life depends on my doing better than I have been - plugging away isn't enough....
