When a dose brings no rise at all

The thing that matters most here is telling it apart from a rise that merely arrives late. In the moment the two feel almost identical: you took a dose and nothing has changed for a long while.

The difference shows up afterwards. With a late rise, it eventually comes up. Here the curve stays near the floor until that dose is done. Above, the solid line carries on almost flat past the dose marker instead of climbing the way the dotted one does.

So telling the two apart depends on how long you watched being in the record. A note saying only that it did not work leaves no way to know whether the call was made after thirty minutes or after three hours, and no way to separate the two when you look back. Noting how things were up to the next dose makes that distinction fall out naturally.

Where you look on the graph differs

What follows is not a medical definition of the three terms. It is a way of not confusing them when reading a graph. Your eye goes to a different place for each.

• Delayed ON — it does come up. The start is simply late. On the graph, look at the horizontal distance from the dose marker to where the curve begins to rise.
• Incomplete ON — a day where the timing of the rise is about usual but the height stays low. On the graph, look at the vertical height of the peak.
• ON Failure — from that dose, no meaningful rise appears at all. On the graph, look at the whole stretch from that dose to the next.

Horizontal distance, vertical height, whole stretch: this split is for reading the graph, not a standard that separates the three terms medically. No numeric cut-offs are set here either. How many minutes counts as late, and what height counts as low, differs between people and differs for the same person at different times. This is not a diagnostic standard; it is a way of deciding what to write down.

In practice many days overlap. Some come up late and low at once. When that happens, do not force a choice — just record the three values as they were: the dose time, the time things began to change, and how well you were moving at the best moment. Looking at the curve later will show which it was.

These are factors that come up in conversation about this pattern. This is not a list of confirmed causes, and more than one of them is often in play at once.

• Longer time spent in the stomach may have kept that dose from being absorbed in time.
• A meal may have fallen close to the dose.
• The state of the gut that day, or constipation, may have been at work alongside it.
• The dose itself may not have gone as remembered.