Semaglutide Kind of Life
I guess "sema-glu-TIDE of life" would work with the meter better but nobody would understand the reference
Well folks, I’m officially a representative of the 21st century. In consultation with my primary care physician, my psychiatrist, and an endocrinologist, I’ve begun taking Rybelsus, the oral version of the semaglutide class of drugs (Ozempic, Wegovy) that have gotten so much press lately. I’m finally on trend.
This was not a decision I or my doctors took lightly. The basic reality is that, going on seven years of uninterrupted use of psych meds, I’ve developed metabolic problems that I no longer feel I can just let go. My cholesterol and its various subcomponents are all over the place, my glucose is consistently above 100, my TSH has been a mess for years, and I now walk around at 270 pound, which is about 60 or so pounds heavier than my healthy weight and almost 100 pounds more than when I started back on meds. (At which time I was too skinny to be healthy, to be clear, thanks to prolonged mania.) This is all compounded by the fact that I can no longer lift weights, the only exercise I’ve ever liked in my life, thanks to a degenerative condition in my left shoulder following rotator repair surgery. (As I shared previously, the orthopedist I talked to just kept saying “there are no good options,” which is not something you would care to hear from a doctor.) To a certain degree this is all just “tough titty” stuff, and lots of people are unable to exercise as they once did, as they would like to. But it’s difficult to stress how important lifting weights has been for my body image, my ability to deal with the desire to avoid taking meds, and my health. I feel trapped without lifting, but I just can’t do it safely anymore. As I’ve said before, people like exercise in part because it helps instill a sense of control, even if it’s partial, mediated control. Now I’ve lost that with nothing to take its place.
It really has felt hopeless: I can’t lose weight thanks to my meds and I can’t get big thanks to my shoulder. “If I can’t get cut, at least I can get big” is a core coping mechanism I no longer can take advantage of. All of this came to a head some months back at the end of a three-month challenge I put myself on, where I got more exercise and ate much better and drank less beer. Wrote my starting weight on the dry erase board in my kitchen and everything; just couldn’t bring myself to ever put my ending weight up there. Because after three months of really trying, I found that I had lost one pound. I’m not obese, but if things continue the way they have for a few more years, I will be. A lot of my clothes don’t fit anymore, and it’s getting uncomfortable to do basic things like bending over to tie my shoes. Obviously, I don’t like this for reasons of vanity/aesthetics, either. Fortunately, my doctor feels it’s time to do something about this with medication. Unfortunately, my insurance company does not agree, so I’m paying for the pills out of pocket - $1200/month retail price, $880.99 after a coupon card that lasts I don’t know how long. That’s still rent, in some places, and I don’t feel great about it! But at this point, I feel like I have to do something. If you want a better sense of what the weight gain feels like, here’s some comments from a psych medication forum that I clipped years ago. Please read that if you’re ever tempted to wonder out loud why people have such a hard time staying on meds.
We are going to be careful and do regular bloodwork, and my therapist and my psychiatrist and Ami will help keep an eye on my moods. I recognize that this is all a bit complicated given how many chemicals already go into my body every day. Still, I’m not really worried about taking new medication or side effects. (I’m used to both.) I am, however, worried about The Discourse.