January 2024 Round Up

SW ⟫ CW ⟫ GW

207.7 ⟫ 195.7 ⟫ 186.93

Drug Plan:⟫ Ozempic 0.5 mg

Another month over and time for a bit of a round-up. The constipation issue is still causing problems – I did manage to ‘go’ but was disappointed as I still feel rough as balls and over-full. I am also still struggling with cravings for sweet things, generally eating stuff that I haven’t eaten for quite some time and way too much of it.

I guess it could be stress – stuff always going on in my head whether it’s about what’s happened in the recent past, something I’m dreading for the future, or simply my brain doing weird and wonderful things. I just wish I could have remained in that Trulicity head-space. I wonder if maybe I’m psyching myself out? I took my second Ozempic injection today – definitely did it correctly as there was the teeniest, tiniest spot of blood at the injection site, so I guess that’s reassuring inasmuch as I appear to be doing that correctly.

I’ve asked Stripes to empty the fridge in my room of all the little treats I’d stashed in there – hopefully that will stop any late night snacking or at least make me think about it properly first rather than giving in to impulse.

I’m also considering taking some photographs. The thought actually makes me feel more than a little sick, but one of the best ways to see results is to take photos that you can compare things to. Maybe I’m feeling nauseous at the thought in case these turn into yet another set of photos of when I started something that I failed to finish? On the other hand, it would be really cool if I could see myself develop Ozempic face? I have seen some really cool progress photos that other people have posted that demonstrate this so clearly and would love to see if that happens for me.

I’m trying to be more positive – both in my head and out loud – but I’m not sure how well I’m doing at that. There is a lot of negative self-talk in my head that I struggle to block out, and now that I’ve done a week of Ozempic and seen no weight loss, the little voice is having a field day telling me that I might as well give up, that it’s obvious Ozempic isn’t going to work for me, that I’m just being lazy and should eat less, do more (those words should be tattooed onto the forehead of every Doctor in my life who’s told me it’s that simple and I should be able to do it so that they can SEE them every single day, the same way they live rent-free in my head).

Positives:

⟫ I made it through week one of Ozempic with minimal side effects;

⟫ Although the scales haven’t moved downwards, they haven’t moved upwards either;

⟫ I’m grateful that my GP was willing to prescribe Ozempic and give me the opportunity to continue on this journey with its’ assistance;

⟫ I recognise the temptation of the things I chose to put into my fridge and am taking action to remove that temptation;

⟫ my nails are growing strong!

Moving in to February, I need to show more gratitude, be more aware of the things I say in my head, and make better food/snack choices – I have my birthday to celebrate but apart from that, I can’t think of any big ‘social’ events that require food-thought/preparation. Overall, January has gone well and I am grateful for that.

Nearly a week on Ozempic...

SW ⟫ CW ⟫ GW

207.7 ⟫ 195.2 ⟫ 186.93

Drug Plan:⟫ Ozempic 0.5 mg

How the heck do I tell if this is working? I followed the injection instructions and was pretty sure I was feeling something but after a few more days I’m really not sure. There’s been some mild irritation of the injection site, but the ‘feelings’ I am used to after injecting Trulicity are absent.

I’ve been struggling with feeling so hungry all the time! Actually, I shouldn’t say all the time as that’s not accurate. I’m sleeping better (thank you Big Narstie Moroccan Peaches!) and when I wake up, I do feel like I’ve had some sleep, but I’m generally not hungry first thing in the morning so I drink iced water.

That hasn’t changed much, but as soon as I’ve had breakfast – whether it be toast or a flapjack – I am rampaging hungry! I’ve been having my main meal so early – like anytime from 4 pm – and then for the rest of the day, I want to snack on things constantly. I am going to bed early (for me) like anything from 10.30 pm to just after midnight, so the out of control eating thing is probably around 12 hours max. But I wasn’t struggling like this when I was on Trulicity.

The scales aren’t moving – not up or down, but I am up from my lowest low which I think was 191 kg. I guess this could be the transition and also that I’m on a relatively low dose of Ozempic. I believe the therapeutic dose is from 1mg upwards and I’m on half of that.

I’m also suffering from constipation so feel bloated and sluggish. I’ve taken Dulcolax twice with little results. I’m almost tempted to have one of the VLCD shakes I have on hand as they often lead to stomach upset. Sounds awful to admit that I’d rather have the world falling out of my butt at the moment than struggle for much longer like this. I just feel like I have a bowling ball in my stomach constantly, and I can’t relax because I’m constantly waiting for the diarrhoea to start.

I know this isn’t a short term thing and I need to manage my expectations. My body is probably confused and I know I’m stressed with stuff that’s going on. Trust the process but keep an eye on things I guess. Now I need to try to find a relatively comfortable way to sit/lie with this poop bowling ball causing me so much grief!

And on to Ozempic

Start Weight in November 2023:⟫ 207.7 kg 457.9 lbs

Current Weight in January 2024:⟫ 195.2 kg 430.3 lbs

Eating Plan:⟫ Ozempic 0.5 mg

Shocker of shockers, my doctor’s appointment was not to discuss the Trulicity but to talk to me about the Oviva programme. It’s a funded VLCD whereby they take you through a 12-week meal replacement then help you come off of that safely. I did actually look into this last year and self-referred. It took ages for them to come back to me, and when they did they said they needed more information from my surgery. I got in touch with the surgery to find out what the hold-up was, and was asked to forward the email to them and they would handle it.

(Narrator:) They did not, in fact, handle it.

Oviva discharged me from their programme due to non-response, so I chased the surgery again. Same person I spoke to who remembered me but ultimately, what I got back was that it was too late and they would have to start the referral process again.

Hence the phone call!

Anyhow, I explained about that snafu and also about the Trulicity being out of stock and we had a really good conversation. She was extremely impressed with how I’d done whilst taking the Trulicity and could completely understand my desire to continue on some kind of semaglutide, but ultimately it was down to supply issues. We spoke about Rybelsus and Ozempic and what was easiest to get hold of, and we decided Ozempic at 0.5mg was the easiest to get hold of at the moment so we would go with that and review the situation in six weeks.

She also moved me to a higher dose of Metformin in slow release form as she thought it made sense to get the best out of all of the medications I was taking, and also changed my Atorvastatin. It was quite possibly one of the most positive medical interactions I’ve had apart from the nurse who takes care of my Endocrinology appointments who I would marry if I could because she’s just so incredibly supportive and kind, even when our conversations stray from diabetes etc.

I didn’t want to make the swap to Oviva when the semaglutide is working for me – I’ve done VLCDs so often in the past and although I can lose weight, it’s so difficult to stick to. It made no sense to me to go back to that when I was finding that Trulicity was working for me.

Stripes picked up the prescription and I admit, I was a little squeamish. The thing about Trulicity injections is that it’s like a pen where the actual needle is pretty much completely hidden – spring release, ouch and done. This felt way more deliberate – opening and screwing on the needle, the test where you get a droplet of Ozempic on the tip of the needle (should have taken a picture as it would have looked so cool), then injection site and press, count to six. I hate needles – always have, which is kinda hysterical if you could see just how many tattoos I have – but I have to be completely honest and say not only did I not feel this needle, I was pretty much convinced that I had messed up and nothing had gone in!

The effects feel different – or maybe it’s the change to different type and amount – but the overly-full, nauseous feeling I was used to from Trulicity wasn’t there. In fact, the best way to describe it is a kind of big nothing – I don’t feel hungry, don’t feel sick, don’t feel much of anything when it comes to the whole food thing. But I think it is working. I saw an advert for the new McDonald’s Steakhouse and I thought that looked absolutely gorgeous and yes, I wanted some. I could picture it in my mind, as well as the hot, crispy, salty fries and how they would taste on my tongue – heck yeah.

Dinner time and the thought of the burger made me feel ‘meh’. Like, was it worth any potential gastrointestinal distress for a burger? And somehow my brain said nah, let’s not bother. And that was it – no back and forth about whether I really wanted it or not, would it taste as good as the adverts made it look, no bartering with myself about what I wouldn’t have if I decided to have the burger. It was just – nah not today.

I don’t know if anyone other than a ‘food addict’ or however you would describe some people who suffer with food noise, but this was pretty wild for me – even after ten weeks on Trulicity. With Trulicity, it was often the fear of the consequences that stopped me over-eating or choosing the ‘wrong’ things – that and the ever-present lump in my throat and feeling like everything I’d eaten was just sitting there, making my stomach and chest feel heavy. This wasn’t so much fear of the consequences as lack of real inclination to bother with that food.

The constipation is still real but I’m pretty sure that’s a leftover from Trulicity and I won’t see if Ozempic is going to affect me the same way for a little while. And I know it’s only been a couple of days so things might change in terms of this but I think that so far this is the smoothest transition I could have hoped for. And of course, I need to keep my eye on the supply issues so that I know what’s going on. I have three weeks’ worth left and a whole lot can happen in three weeks.

SKM vs the Scales - the beginning.....

Start Weight in November 2023: 207.7 kg 457.9 lbs 32 st 7 lbs

Current Weight in January 2024: 194.4 kg 428.5 lbs 30 st 6 lbs

There’s possibly some rounding up or down, but to be honest I can’t seem to make my brain ‘math’ at the moment as I haven’t really slept, so those will do as the starting figures for the blog.

Why start now? Well, today marks ten weeks of being on Trulicity for my T2D and weight loss. I would be more than happy to keep going into week 11, but unfortunately Trulicity is out of stock for the foreseeable future. So here I am on injection day, with no injection.

I have a telephone appointmnent with the doctor’s surgery tomorrow morning and I have no idea what to expect. I have seen talk of Rybelsus which is in tablet form, Mounjaro, Zepbound – but literally until I have this phone call I have no idea what the doctor is going to suggest.

And I am bricking myself. I have lost weight in the past – I lost over seven stone doing the Cambridge Diet, as well as other VLCDs over the years. I’ve also done Slimming World and Weight Watchers. Each and every time I’ve failed. Some of it was willpower, some life circumstances, some just crummy luck. But without fail, the weight has come back plus some until I was super morbidly obese.

I followed the Weight Management programme for my area to quality for weight loss surgery on the NHS. I’ve done all of that successfully, but between qualifying and having the phone call with my prospective surgeon, life once again got away from me. I put on 10 kg over the course of 18 months and the surgeon warned me that if I hadn’t got back down to 193kg by the time of my surgery (or at least maintained) then it might not happen.

I had tried Trulicity with limited success, mainly caused by difficulties obtaining it. I would manage two weeks worth of injections only to find that the pharmacy were out of stock so I had to begin again at the lowest dose. At one stage, I made it up to 3mg but again, supply issues meant that I was injecting two of the 1.5mg each week and this wasn’t sustainable because there simply weren’t the pens available on the NHS.

This time, I had am amazing Endochrinology nurse (I’ll call her Violet) who convinced me that getting my diabetes numbers down would only be a good thing for the surgery and that I should give Trulicity another try. So, November 2023, I started. I already had enough pens for six weeks – two weeks on 1.5mg, 2 weeks on 3mg and then up to 4.5mg.

The difference was pretty much immediate. I suffered from a number of side effects: nausea, chronic fatigue, vomiting and constipation. But I wasn’t hungry – the noise in my head that was always on about food, what I’d just eaten, what I wanted to eat, what food I saw on the TV – it was just gone. And with it gone, as well as false hunger pangs, I was absolutely fine eating a small breakfast and a dinner. I was full (often overfull) from the smallest meals and felt amazing. And the scales! The scales were dropping at an amazing rate – I put new batteries in to be sure that I was getting an accurate reading! It was working.

I read a few things that gave me food for thought (pun intended). Like how for years, many fat people had been made to feel like failures and pariahs because they couldn’t control their eating (or wouldn’t control their eating), how weight loss was simply calories in, calories out and how it showed a lack of commitment to being healthy and fit to remain fat. Like it was something that people aim for rather than fight against. Like so many fat people haven’t tried every single diet out there (including all of the frankly ridiculous/dangerous ones) and failed each time.

Semaglutide and its’ ability to help people lose weight is revolutionary. And of course, that means it can (and is) being monetized. There are people paying hundreds per month to buy what they hope is the real thing on the black market. People taking ‘compounds’ and hoping that they’re safe but willing to take the risk in order to lose the weight. Which is kinda horrifying actually.

So here I am, Monday 22nd January 2024, hoping that the doctor is going to pull a rabbit out of their hat tomorrow and make it possible for me to continue this journey with this help. And it’s not an exaggeration to say that I am terrified about trying to continue to do this without this help. Because if I manage to lose another chunk of weight but put it all back on, I can’t imagine how impossible life could be weighing more than I did at the start of November.