Festive Friday

ei34

We made it!!  How is everyone?

ei34

How are you feeling @levioosa and @charlotte989875?  I hope that everyone (knotties + their loved ones) stays healthy.

Last day of school here and everyone is off the wall (some adults in addition to kids lol).  We usually go up until the 23rd so this is a nice change.  I'm in hosting mode tomorrow (annual cousin Christmas Cookie decorating party) and of course, Christmas Eve.  With the 22nd and 23rd off it's so nice to be able to get home from work later and just focus on tomorrow.

MyNameIsNot

Today is also my last day before break. I ended up taking all of the next 2 weeks, so I'm off until the 6th. I am beside myself excited for a break. 

My mom is having hip replacement surgery today. It's a fairly routine outpatient surgery and she's in good health so I'm not worried, but I'll be happy when we hear she's out of surgery. 

The holiday should be pretty low key for us. I'm hosting a family cookie day Sunday. Mom is convinced that she's going to be mobile enough to decorate from a chair. (She is as stubborn as I am, so I'll be surprised if she isn't.) Then we'll do our family thing on the 24th at my sister's. H and I will probably just hang out in our pajamas and make a nice meal on the 25th. I'm just really looking forward to not having to set an alarm for a while. It should be sunny but chilly here most of the week, so we'll probably get in some hiking.

banana468

I'm overwhelmed and making lists in an attempt to make what I have to do feel more manageable.  I'm off until the 27th and just need to chip away at this bit by bit.

Chiquito is off to school with no temp and no plans for the weekend.   Chiquita has fencing tomorrow and I need to have her to school for 7 AM.  Currently waiting in line to get my Mom of the Year award for planning to get up at 6 AM.   I'm excited to see her battle and then she has singing in the afternoon.  Depending on timing, we may hit up a place or two on the way home for gifts.

I'm crossing fingers that we all stay on the up and up or on the road to improvement. 

VarunaTT

Yesterday was my primary and my allergist appointments.  My arms are sore today, as I got a flu shot, and my 3 allergy shots.  I love my primary so much and I'm lucky to have her.  We had some long discussions about Ozempic and the like, a "get these vaccines updated" list for me b/c I'll be damned if I'm taken out by measles or something else that modern medicine already took care of, and a referral to a dermatologist b/c she thinks something is up with my skin.  She thinks eczema or cirrhosis, but wants an expert opinion.  If a dermatologist can take care of all of my danged itching, I'd be really happy.  It's much better since treatment for allergies, so maybe a new problem has revealed itself since those aren't masking whatever is wrong.

I have some fun plans this weekend.  One friend is coming Saturday afternoon so we can visit one last time the local vegan ice cream store that is soooo delicious, but is having to close.  Then I have a Winter Solstice party Saturday evening.  Sunday I'm going to see "The Fall" 4K restoration at one of our local indie theatres and I'm really excited about that.  I might go tonight too, depending on how I'm feeling.  

Today is a slow day at the office, b/c everyone else is driving to the holiday party they're having in another city.  It would've been close to a full day of driving for me to go there and back, so I declined going in person, though it would've been fun to meet everyone IRL.  I'm hoping I can convince them to come to my city next year; it's an easier, faster, shorter drive from the major cities most of them are in, and I think we probably have much better places to eat than the city they went to.

Otherwise SSDD.  I figure some of you will be offline all next week, so happy celebrations to everyone!  WW always helps keep me sane and I love and appreciate you all!!

banana468

Yes!  I'll likely be more unavailable here with the insanity creeping in. Best wishes to all of you for these next two weeks!  Holidays can bring a lot of extra baggage and throw up bat signals if you need Knottie Therapy! 

CharmedPam

Happy Holiday’s everyone! I work till 2 on Monday but it’ll probably be slow here. Everyone seems to have some fun things planned! What did your doc say about ozempic, @VarunaTT? Are they suggesting it for you?

Today is pretty chill.  I did a new meetup this morning for people who work from home. They had a starbucks meet up this morning from 8-9:30 and I thought it would be a nice intro to the new group.  I met some nice people from it.  Although my work does start at 8 lol! This kinda defeated the purpose.  I actually had to leave at 9 to ummmm work from home? 

VarunaTT

She gave me the guidelines under which she would prescribe it.  She is in favor of it, but stressed that you have to up the protein you're eating and you have to weight train, and she wants you in counseling as well.  She supports using them, stated that "we don't really know the why behind this working", but said that basically it's causing anorexia like side effects in bodies.  If you're not keeping up with weight lifting/protein, your body will eat your lean muscle mass, and that without counseling to help, when you stop and the "food noise" comes back, you'll go right back to your original issues. 

I continue to test in "pre-diabetic" range and I have issues with binging behaviors, so the "food noise" reduction (as well as binging in general according to 2 other friends who have very similar mental health dx as I do), is very appealing, as a crutch, so I can I work out other things. I have been hesitating on finding a new therapist, one b/c my old one retired and two, b/c I want them to understand it's not an eating disorder I'm struggling with, it's an all around "I binge whatever in unhealthy amounts".  I need to redirect that behavior entirely.  I have been working on it with the same tools I used to stop alcohol, but food and $$ have proven much more difficult.  Insurance will not pay unless I have an actual diabetic diagnosis.

I have not made any decisions yet.  I'm going to wait until after I move in May to make any.  Right now, I'm doing well w/my sobriety, but another "binge" behavior I have is "I'm doing so well on this one thing, I can now do well on ALL OF THESE THINGS!!!" and it never ends well.  So, I'm trying to hold myself back right now and really firm/cement my work on sobriety and just that, while slowly untangling the other things.

short+sassy

@VarunaTT, I don't agree with some of what your doctor is saying.  I've been taking a similar GLP-1 medication (tirzepatide, active ingredient in Mounjaro) for 18 months and actively participate in forums about it.  I've read countless peoples' stories.

If you're pre-diabetic, I'd think you should be taking some type of T2 medication to stave that off.  That are a lot of choices out there and the retail price of Metformin is cheap even if your insurance doesn't cover it.  But I'm not in the medical field and this isn't an area I have that much knowledge about.  

I have a lot of thoughts and they feel jumbled, so I'm just going to bullet point them and they aren't necessarily in any particular order:

---Overall, it is very well understood how these medications work so I'm not sure why she said that. They lower insulin resistance, while also increasing how much insulin* the body produces.  But now all the insulin produced is being used more effectively.  That's why they were approved for treatment of T2 diabetes first. 

*I personally do not get the benefit of more insulin production, since my body stopped making it long ago.  But this is a great benefit for T2 and pre-diabetic folks.

These medications also slow gastric emptying, which also helps with blood sugar management but has the added side effect of appetite suppression.

---I'm making "food noise" it's own bullet point, but it also fits under the first one.  I personally don't suffer from "food noise", but the reduction of it is a huge benefit that most other people talk about.  I didn't really understand what it was until I read other people describing it.  They talk about it like they think about food all/most of the time.  That they usually feel hungry and rarely have a feeling of satiety.  It doesn't sound psychological to me at all.   It sounds like a misfiring in the brain/body for these processes.

Some people have their food noise instantly disappear as soon as they start taking a GLP-1.  For others, it takes a little while to build up in their system but then the food noise disappears.  A lot of people who get to their goal weight, want to keep taking a small dose just to keep the food noise from coming back.

Here's a quick summary of how GLPs-1 reduce food noise in the brain:  Glucagon-like peptide-1 (GLP-1) signalling in the brain: From neural circuits and metabolism to therapeutics - PubMed.  I've also read they can affect the dopamine reward center of the brain.  In fact, GLP-1s are now being studied for treating alcoholism but there are no major clinical trials on this yet.

Anecdotally, many people lose their desire to drink alcohol and/or eat sugary or fatty foods while on a GLP-1.  I've also read people talk about having a reduction in other addictions like impulse shopping and even illicit drugs.

For me personally, I didn't lose my desire to drink alcohol and it also didn't affect how I enjoy any particular food.  But I haven't regularly eaten or drank high sugar stuff since I was diagnosed with T1 years ago.  I did cut way back on alcohol, but that's only because it's counterintuitive to weight loss and not because I suddenly had an aversion to it.

---Some misunderstandings about insulin resistance (IR).  People without diabetes can also suffer from it.  It can be a HUGE deterrent for maintaining or losing weight.  People who are a normal weight can have insulin resistance, though it is much more common in overweight/obese people.  And the heavier a person becomes, the worse insulin resistance can get.  It's like a vicious cycle.

Since I'm a T1 diabetic and take all my insulin externally, I'm in a unique position to talk about exactly how effective this medication can be for IR.  On only my SECOND day taking tirzepatide, I had to cut my short-acting insulin by 70% and my long-acting by 30%.  Once it built up in my system and I titrated up to higher doses, I'm now at a 95% reduction of short and an over 50% reduction of long.

---I would not recommend a GLP-1 medication for someone with an eating disorder.  It's too easy to not eat much food when appetite suppression is high.  I've had times where I have had to force myself to eat, in order to get in enough calories for the day.

Perhaps some people are better off with therapy in conjunction with a GLP-1.  Especially if they had ED problems are those tendencies in the past, but most people don't need counseling just because of this medication.

I took tirz for a year before I started therapy.  However, my therapy has nothing to do with it.

It's also ridiculous to describe GLP-1s as causing anorexia-like side effects on the body (eyeroll).  No matter how someone loses weight, it can unfortunately cause a loss of muscle mass.  GLP-1s don't have a greater effect on that than any other way, except perhaps their effectiveness at weight loss so it potentially happens faster.  A higher protein diet and weight training can minimize the loss of muscle.

I've been great about my protein because it plays into my eating preferences anyway.  I have not been good about weight training or even exercising, in general.  This is an area I struggle with because it takes motivation, which has always been in short supply for me and not just for exercise.  But that's a much more complicated problem and I can't handle more than one major change at a time.  So I focused on weight loss and improved diabetes management first.   But now I'm starting to move my focus more to this.  I didn't have much muscle to speak of to begin with, lol.  And with time I can rebuild whatever I may have lost.

While different issues, I can understand you wanting to focus on your sobriety first.  Sometimes for mental health, it's too overwhelming to try and fix everything, so it's best to focus on one first.  Though KIM what I wrote above that GLP-1s decrease alcohol cravings for many people.

---Welcome to my insurance world of "we know how much this medication helps you, but it's expensive so we aren't covering it".  I wish you didn't have to become a member.

But there are ways around that.  Because Ozempic/Wegovy are currently in a shortage, you can also buy the active ingredient (semaglutide) from a compound pharmacy.  Red Rock and Hallandale are some of the big ones that sell to consumers.  Your doctor would have to write a prescription and have it sent to them.

There are also telehealth services that have doctors or nurse practitioners on staff who will write a prescription for you (if they feel it's appropriate).  Then procure your medication from a compounding pharmacy and arrange for it to be mailed to you.

Here are a couple of the telehealth services I've heard good things about and are on the cheaper side.  I don't use either of them because I found tirzepatide from a compound pharmacy cheaper elsewhere.  But the service I used for that doesn't sell semaglutide.

--Orderly Meds ($99/month for three months or $199/month for all doses of semaglutide).  I spoke to one of the owners earlier this year, it was a good vibe.  I think there was also a monthly membership fee at the time, but I didn't see anything about that on their website currently.  I'm on their mailing list and can get you a $50 discount code if you opt for them.  It's a referral code, but I don't care about that.

--Pomegranate Health ($90/month for 0.25mg-1.0mg or $110/month for 1.5mg-2.5mg).  Both of those plans unfortunately also require a $69/month membership fee, but I think there are other benefits with that.


It's even cheaper than this if you ever want to explore buying the active ingredient from a US lab.  And dirt cheap if you go with a Chinese lab.  But especially for a new medication, baby steps!  And compound pharmacies will be more comfortable and familiar.  But I've tried all the routes and recently switched to a Chinese supplier.