Yes!
You can make this work. It just takes some planning.
Here is an example of my schedule when Lucy was on Lantus.
Shot time was normally between 6:15-6:45. Lucy had a fairly typical Lantus curve, onset between +2 and +3, nadir around +6. This was my general schedule – of course there were times when I needed to test more, like if she was dropping sharply or when she was careening down the dosing ladder toward OTJ. Note that this is just 4 tests a day on a typical work day.
6:15 am – wake up, test/feed/shoot
7:30 am – leave for work. This allowed me an hour in case I needed to get a +1.
6:00 pm – come home. Test/feed/shoot whenever I got home, preferably before 6:30 but later was ok if necessary.
8:30 pm – every night - +2 to see how the night is going to go. If already heading down, test more as needed.
10:30 or 11:00 pm – every night - before bed test. Sometimes the numbers would demand that I stay up later, but if this test was comfortable, then off to bed.
The hard part of managing tight regulation while working is the point at which the cat starts RUNNING down the dosing scale. This is not an easy time for anyone – be conservative if you need to. I was very lucky that Lucy made her big run during the holidays, when I could take extra time off work. If you are not able to do that, be prepared to skip shots or take reductions when you may not want to. It’s ok, if your cat is intent on getting those dose reductions he or she will do so anyway! The payoff during this time can be huge, so some short-term sacrifice can be worthwhile. Post on the board for suggestions.
Tips for working within a tight schedule:
This all sounds great, but is it safe?
Diabetes is never 100% predictable, but by getting a few spot checks every evening, you will have a good idea of how low each dose is taking your cat and whether an increase or decrease is appropriate. By contrast, basing your dosing on the results of a single curve can leave you guessing – kitty was high all day on the curve, but is he really high all the time, or did you just happen to choose a day when he was bouncing to do your curve? To me, getting some midcycle tests in 8 or 9 cycles out of every 14 seems safer than relying on curves in only 1 or 2 cycles.
Others who have managed Tight Regulation while working, please add your suggestions to this thread!
Sources:
Libby and Lucy. “Is Tight Regulation Possible with a Full-Time Job? Yes!” Feline Diabetes Message Board, 2 Dec. 2014, https://www.felinediabetes.com/FDMB/threads/is-tight-regulation-possible-with-a-full-time-job-yes.129378/
You can make this work. It just takes some planning.
Here is an example of my schedule when Lucy was on Lantus.
Shot time was normally between 6:15-6:45. Lucy had a fairly typical Lantus curve, onset between +2 and +3, nadir around +6. This was my general schedule – of course there were times when I needed to test more, like if she was dropping sharply or when she was careening down the dosing ladder toward OTJ. Note that this is just 4 tests a day on a typical work day.
6:15 am – wake up, test/feed/shoot
7:30 am – leave for work. This allowed me an hour in case I needed to get a +1.
6:00 pm – come home. Test/feed/shoot whenever I got home, preferably before 6:30 but later was ok if necessary.
8:30 pm – every night - +2 to see how the night is going to go. If already heading down, test more as needed.
10:30 or 11:00 pm – every night - before bed test. Sometimes the numbers would demand that I stay up later, but if this test was comfortable, then off to bed.
- In addition, I would squeeze in extra tests whenever I could – if I got home at 5:00 one day I would grab a +11, etc. Lucy’s nadir was around +6, so by shooting at 6:15, even if I had to monitor a low cycle I was usually done shortly after midnight.
- Saturday was curve day, and Sunday too if I was home. If I was gone for a few hours on curve day, it was not a huge deal because I already had a good bit of data collected throughout the week. With the curve, I was basically looking to confirm what I already knew from those weeknight tests.
- Sometimes I came home at lunch if I had reason to believe she would be going too low that day, for example shooting very low or if a bounce was due to clear and I wanted to catch the low number. 20 minute drive home, 15 minutes at home, 20 minute drive back.
The hard part of managing tight regulation while working is the point at which the cat starts RUNNING down the dosing scale. This is not an easy time for anyone – be conservative if you need to. I was very lucky that Lucy made her big run during the holidays, when I could take extra time off work. If you are not able to do that, be prepared to skip shots or take reductions when you may not want to. It’s ok, if your cat is intent on getting those dose reductions he or she will do so anyway! The payoff during this time can be huge, so some short-term sacrifice can be worthwhile. Post on the board for suggestions.
Tips for working within a tight schedule:
- No dose increases without enough data to know where this dose is taking your cat. If I was able to get the right tests during the week, I could often increase the dose after 3-4 days. If I wasn’t confident, I would wait until after curve day. It is VERY important that you are able to trust your dose if you will be gone every day. Fortunately that is not hard to do if you manage your dose changes methodically.
- Know your cat – plan your dose increases around your cat’s typical response. For example, if your cat usually responds on cycle 3 of a dose increase, plan so cycle 3 will be a cycle when you’re home. I often did increases on Thursday nights – that would leave me home and able to monitor on cycles 3-7. Depending on the results of those cycles, I could do another increase if needed on Sunday night.
- To avoid getting into situations with too much overlap and having to leave for work, especially because Lucy was prone to dramatic responses, I tried to avoid shooting any earlier than +11 during the week. If there was a day I arrived home after 7:30 pm, I would either skip that evening’s shot or skip the next morning’s. Use your head about which one to skip – if at 7:30 she was high, I would go ahead and shoot and skip the AM. If the evening number wasn’t too bad, I might skip the evening shot and plan to shoot in the morning (which would be +24). This might cause higher numbers for a few days, but is sometimes necessary.
- High carb food can be your friend. Of course you don’t want your cat to be over dose, but if you do run into a low number at a time when you have to leave, carb her up! We call that aborting the cycle. High carb gravy, syrup, whatever works for your cat. If you have been following the Tight Regulation protocol and being careful with your dose increases, your cat should not ever be so far over dose that you can’t fix it with food. Safety first.
This all sounds great, but is it safe?
Diabetes is never 100% predictable, but by getting a few spot checks every evening, you will have a good idea of how low each dose is taking your cat and whether an increase or decrease is appropriate. By contrast, basing your dosing on the results of a single curve can leave you guessing – kitty was high all day on the curve, but is he really high all the time, or did you just happen to choose a day when he was bouncing to do your curve? To me, getting some midcycle tests in 8 or 9 cycles out of every 14 seems safer than relying on curves in only 1 or 2 cycles.
Others who have managed Tight Regulation while working, please add your suggestions to this thread!
Sources:
Libby and Lucy. “Is Tight Regulation Possible with a Full-Time Job? Yes!” Feline Diabetes Message Board, 2 Dec. 2014, https://www.felinediabetes.com/FDMB/threads/is-tight-regulation-possible-with-a-full-time-job-yes.129378/