Archives for 2024

Well, hello laddies, lassies, and tweeners! I am back with another weekly dose of Mounjaro related musings and observations. Here, you won’t get the usual, repetitive, second-hand, derivative crap you find on YouTube, where treatment with Mounjaro and its sister drugs constitute a “weight loss journey” and obesity is defended as a “disease.” I blow off most of those with “thumbs-down” to avoid proliferative pollution on my “home” screen, where I would rather view engineering marvels. You get none of the typical cosmetic weight loss oriented smarmy bullshit here, just straight talk, so let’s start this week’s insouciant stream of consciousness with our new theme song.

First, South Park did it, then Ari. Or she was first. Who knows! But this is great. The gratuitous weight loss crowd sure takes a lot of heat for their “journeys”, as well they should. Enjoy this hip-hop rendition for its ironic parody of what has become a ridiculous obsession!

Old Guy on Mounjaro for Type 2 Diabetes

Being an old guy, I provide a distinct perspective from that of the typical, healthy, middle-aged Mounjaro fanboy/fangirl crowd you see on YouTube. Many of them are playing around with Mounjaro and its sister drugs like they have found a new toy, clinging to another desperation hope that they can miraculously lose weight with little concern over long-term side-effects. They have few comorbidities, so their cheerleading is based on a ridiculously small and flawed sample. I bring a worn-out old type 2 diabetic body to the mix to distort their rosy statistics. From them, you never hear about the negatives, which are certainly important to evaluate whether “Mounjaro is right for you”. From me, you’ll get the unfiltered truth, even if it offends some of you.

Not a Mounjaro Fanboy

We pull no punches here. A spade a spade, and a fanboy is a fanboy. We offer a break from the continual cheerleading and obsessively woke brainwashing mantra that “obesity is a disease and GLP-1s are the cure.” GLP-1 drugs such as Mounjaro, Ozempic, and other, forthcoming brands, are serious type 2 diabetes drugs. Their relabeled use for weight loss constitutes a profiteering abuse of desperate fat people, opportunistic exploitation of the giant weight-loss market. For now, it is the “next big thing”. That is, until it isn’t. How many “next big things” have we seen in the past?

And now, of course, we have the burgeoning secondary market vultures running fat farms, telehealth clinics, and compounding pharmacies all trying to slurp up the crumbs. The weight-loss industry is gigantic and ever-expanding due to the food industry pandering poison to us. The pharma companies, being no slouches at mining profitable diseases, have declared obesity to be a disease, just so they can offer a cure — for a price! And now, they want to shut down the parasitic operations so they can keep all the profits for themselves. That will surely expand the black market and illicit foreign procurement of the needed fixes for those addicted to the drugs. Capitalism in action is causing the fanboys to cry in their low-cal beer. They whine about the cost and demonize big pharma, but they must have their drugs. And the beat goes on.

I’ll shift gears to report my latest weekly results. More rants later.

This Week on the Tirzepatide Train

Tirzepatide Train — get it? Take the T-Train, with apologies to Duke Ellington. Such a journey, already! All facetiousness aside, I’m glad we have a theme song here now. Hell, I might show up in a video twerking to Ari Dayan’s urban beat. I’ll save that for later, so you have something to look forward to in subsequent weeks. For now, here’s how I did this week.

Blood Pressure Improvement

My average blood pressure was down from 124/67 to 119/70, which prompted me to titrate the Losartan dose down from 100 mg to 50 mg. I had previously discussed this with my doctor (a real one, not a telehealth robotic voice with an ever-ready prescription pad), who was OK with it if I continued to monitor it closely. However, he cautioned that due to my CKD, he would not want me to eliminate it completely. I had previously discontinued hydrochlorothiazide, so 50 mg (or even 25 mg) of Losartan might be where I wind up. I suspect my increased exercise activity, along with modest weight loss, are the reason for the improved blood pressure.

Also, I’m told that old farts with type 2 diabetes and concomitant atherosclerosis might benefit from slightly elevated BP, like 130/80, to increase perfusion through those calcified pipes. Similarly, an optic neurologist once advised me that too much control of BP is not a good thing. Postural hypotension is also a problem for old farts with blood pressure that is too low. I am not a doctor, and I sure as hell won’t succumb to heeding oversimplified advice sophomorically pontificated by opportunistic chiropractors and fat ladies on YouTube. In collaboration with my doctor, I’ll arrive at a reasonable plan.

Glucose Progress A-ight

Moving right along to the big reason I’m taking Mounjaro, my average glucose readings were flat versus last week at 100 mg/dL. However, first thing in the morning, cobweb-eyed readings were down from 93 to 91. Slow, steady improvement is what I am looking for here, and it appears as if I am getting it, ten weeks into Mounjaro therapy. My goal is for morning glucose to be less than 82 and my A1c to be less than 5.2. I don’t want to get there too fast, to avoid treatment induced neuropathy, which I described in a previous opus.

Looseing (sic) Weight

Sorry, I couldn’t resist. How often do you see people writing about “loosing” or “looseing” weight on social media? Lord almighty, we’re a nation of illiterates, dumbed down by imitating our so-called peers on social media! I don’t doubt that the moronic utterances are yet another deleterious side-effect of the ultra-processed crap food that dominates our national diet. But I digress.

I lost three pounds during the past week. However, integrating that over two weeks, it comes to about one-and-one-half pounds per week, which is on target. Again, dropping too much weight too fast can cause profound consequences, especially in an old fart like me. Slow but steady wins the race. Mounjaro helps curb my appetite, but I have also made a conscious effort to avoid eating crappy, ultra-processed food — and believe me, given that we are bombarded with it now from cradle to (early) grave, it is difficult to avoid! (I detect a theme here).

Minimal Side Effects

My side-effects have been minimal through ten weeks. I have been on the 5 mg dose of Mounjaro for the past two weeks after being on 2.5 mg for the previous eight. Constipation goes with the territory, so I keep my fiber up and hope for the best. Fortunately, I have not yet experienced anything more serious than that, but time will tell.

Although serious effects like pancreatitis, gastroparesis, gall bladder disease, intestinal blockages are documented in the literature, you seldom (if ever) see anyone describing such things on YouTube. And did I mention the black-box warning about medullary thyroid cancer and multiple endocrine neoplasia type two (MEN2)? People who are suffering such serious adverse effects understandably lack the energy or inclination to post videos about their catastrophic ailments. They are just too damn sick! So, if you base your understanding of the risks on the flawed sample of YouTube fanboys, fangirls, and fantrans, you might think that constipation is the worst side-effect you would ever encounter.

Happy With Mounjaro Results Thus Far

As for me, ten weeks in, I am mostly happy with the modest results I have experienced on my non-journey. I am not expecting diabetic control miracles, and I am making serious lifestyle adjustments as an adjunct to the treatment. I am mindful of side-effects, but thus far I have not had any bad experiences. Finally, I want to establish a clear exit plan from this drug, one that does not result in giving back all or a portion of its positive effects. All that having been said, I’m going to talk about some beneficial effects I have weakly correlated with my Mounjaro therapy.

Mounjaro vs. Chronic Pain

If you have been following my cynical drivel for a while, you have gleaned that I would question why you think two plus two equals four. So, as you read this, understand that any association between my initiation of Mounjaro therapy and the abatement of a significant amount of chronic pain is anecdotal and weak. My unscientific approach should be enough for you to conclude that, but I want to throw out the disclaimer in advance.

The point I will make is that although I doubt that Mounjaro is solely responsible for the lessening of pain, it certainly is part of it, at least indirectly. From the outset of Mounjaro therapy, my knee pain and back pain, which had been debilitating, rapidly eased. Certainly, I had taken other steps along with the Mounjaro, most notably eliminating lots of the dreaded inflammatory, ultra-processed, crappy food from my diet and amping up the exercise, but this was a dramatic shift that presented itself quite graphically to me.

I had been dealing with significant knee and lower back pain for years. Because of my chronic kidney disease (CKD) precluding NSAIDs like aspirin and ibuprofen, I had been taking only Tylenol for arthritic pain, sometimes three or four times per day. However, since starting on Mounjaro ten weeks ago, I have not taken a single dose of Tylenol — even though I had been doing some strenuous hikes in the Central Florida heat until a dehydration episode convinced me of the folly of pushing my old body to extremes. I’ll lay off hiking until the average daytime temperature drops below ninety degrees Fahrenheit. For that, I’ll need to wait until October.

My Knees

One area in which I have dealt with chronic, debilitating pain, is the knees. This might sound facetious, but I fixed that by firing one knee specialist and engaging a new one. Alas, this is a tale that highlights the money-driven aspects of our medical system in the U.S., which I hope will my readers to be cautious in approaching their own, similar medical situations.

My right knee is a classic study in osteoarthritic degeneration, abetted by arthroscopic surgery around 2002. I had torn some cartilage in that knee when I twisted it ascending wet wooden stairs on a rainy day. The pain drove me to my all-purpose sports medicine orthopedic surgeon of the time, who cleaned out the torn, folded over meniscus, gave me rehab instructions, and sent me on my way. Later, I read that it was common to develop worsening arthritis twenty years after this type of surgery. Mine appeared a little ahead of schedule, probably because of the extra weight burden bearing down on the joint.

I didn’t go back to the original surgeon when I started having trouble. I figured “tabula rasa, man!” So, after getting an MRI, I asked my primary care doc for a recommendation for a new surgeon. As you’ll see, he turned out to be a complete dud.

“End-Stage Arthritis of Both Knees”

The first indication of the cursory approach by the recommended surgeon, who I will call Dr. Ferrari (not his real name), occurred at the initial visit, where he eschewed reviewing the detailed MRI. He had his people do a simple X-ray, which in his opinion, called for total knee replacement.

From that time on, for a couple of years, Dr. Ferrari, who is affiliated with one of the large hospital groups locally, relentlessly pushed me toward a knee replacement. A typical appointment would last five minutes, during which the doc, sometimes dragging an intern or a resident along, would cajole me to deal with the reality that total knee replacement was the only possible cure for my “end-stage arthritis of both knees.” (I had never heard the term “end-stage” applied to anything but life-ending terminal conditions). The doc would offer an injection to relieve the pain while he waited for me to make up my mind. Then he’d leave and say, “See you in three months.”

Keep on Pushin’

I was not ready for a knee replacement. While I knew that I could still hike five miles, doing so involved pain both during and after the hike. Nevertheless, I did not want to toss any parts onto the scrap heap if they still worked, even if they weren’t in the greatest shape. I became annoyed with the doc and his relentless technique, no doubt borne of pressure by his employer to perform, and to pay the mortgage on his multi-million-dollar house on the lake (although he told me his Ferrari was paid for).

The final straw was a rushed appointment last August at which Dr. Ferrari ordered x-rays but did not bother to review them with me. He merely popped in with a resident for his usual three-minute drive-by harangue about when we can schedule surgery, and he pooh-poohed my cautiousness over proceeding. I mentioned my age, which he dismissed saying, “You’re a YOUNG 76!” He continued to recommend surgery in connection with BOTH knees, sooner rather than later, even though I did not have significant arthritis in my left knee, just a soft tissue injury that was temporarily painful, but healing.

The Power of Google Reviews

The right knee might have been a candidate due to significant arthritis and soft tissue degeneration, but the left sure as hell was not. Furthermore, the cursory approach exhibited by Dr. Ferrari pissed me off. Knowing what would get his attention, I went home and wrote a bad Google review, stating that this doc was pushing me to get a knee replacement without even bothering to review x-rays with me, rushed through appointments with monomaniacal efficiency, not willing to listen unless it involved scheduling surgery. And, by the way, I could still hike five miles.

The review yielded results, as had previous reviews of medical slouches in other settings. A few years back, I had an oral surgeon (call him Dr. Adonis) who was more interested in his personal fortune and fame than he was interested in my mouth. He responded astonishingly fast to my scathing Google review. In that phone call, I got my chance to tell him what I thought of his egotistical ass.

Commendatore Enzo, the knee surgeon, was just as quick to respond to my poor Google review. That phone call was comical, as Dr. Ferrari tried to convince me that my characterization of his approach was unfair. He was adamant that he had spent more than five minutes with me, and that he is a partner with his patients in determining their care, so he certainly wasn’t ignoring my comments and questions. When I asked him why he didn’t even bring the x-rays up on the screen, let alone review them in detail, he went silent for a moment and then weakly added, “Most patients don’t want that.”

Goodbye, Doc! Go wax the Portofino!

Enter Dr. Kahuna

A few months later, I found a new knee doc, who is affiliated with a large orthopedic group out of Philadelphia. When the appointment date finally arrived, he reviewed x-rays and described my options. He manipulated the bad right knee, telling me that I had surprisingly good range of motion. I scheduled an MRI and follow-up appointment to have a look at the left knee to figure out the source of the pain on that side.

The left knee turned out to be just what I thought, a soft tissue injury that would heal, although being an old fart, things heal more slowly. At this point, after about a year and a half, the pain in the left knee is gone. The new knee doc, who I’ll call Dr. Kahuna, because his hobby is surfing, told me that it would not require surgery and was in good shape overall, with minimal arthritis.

I told the new doc that I would like to keep hiking if that wouldn’t be too hard on the knees. He encouraged me to do that, plus he told me that I should lose weight to make it easier on the joints, and if anything, INCREASE my activity level. I am deeply grateful to this doctor, who, by the way, trained under the legendary orthopedic surgeon who did my left total hip replacement twenty-three years ago. Dr. Kahuna provided the impetus to motivate me to play through the pain and get active again.

And then…

I got back out on the trails even before I started Mounjaro therapy on June 3. My knees and my back initially paid the price, along with the price of the large bottles of Tylenol. I imagined that I was trading modest pain relief for hepatotoxicity, because as I’ve said so many times here, there ain’t no such thing as a free lunch. However, as time went on, a few weeks into Mounjaro, the pain lessened. I gave up the Tylenol, which I no longer needed. Along with hiking, I increased my resistance training and cardio schedule to five days per week. Paradoxically, aside from some sore muscles, the joint pain eased even more.

Surely, the advice by rheumatologists to osteoarthritis patients to stay active is validated by my experience. Furthermore, the change in my diet away from inflammation-causing foods (about all our ultra-processed crap food these days), was a key factor in reducing my chronic pain. Several other variables, such as strengthening weak muscles, are also complicit in assuaging the creakiness.

You want to talk about “non-scale victories” (NSVs), as the weight-loss weenies refer to collateral progress that distracts them from their central obsession with the almighty scale? I’ll tell you. Before my Mounjaro awakening, I negotiated the stairway in my house painfully, one step at a time both ascending and descending, due to my chronic, debilitating knee pain. I am now bounding up and down the stairs normally and free of pain. I got yer NSV right here, fanboy!

Ultra-processed crap foods are big causes of inflammation and the pseudo-disease of obesity. This leads us into my next topic — a gigantic, world-class crap food business combination. Read on and take a “journey” into the future Pringle-ization of America!

Big Fooda’s Latest Consolidating Move

Oh, yes, what we need is more high-carb, high-sugar, high-crap snacks! Oy vey! To the unmuted joy of all U.S. crapophiles, Mars, Incorporated, of Snickers fame, is making a move to increase its share of the humongous U.S. foodcrap market by acquiring Kellanova, the Kellogg spinoff which makes junk food like Cheez-It!, Pringles, Pop-Tarts, and Eggo. The unabated American appetite for ultra-processed crap inspired Mars to shoot for the moon, valuing Kellanova at $35.9 billion. That’s a lot of crappy Pop-Tarts!

The combined entity wil now serve up even more doses of ultra-processed, addictive, sugary treats to us and our pets. Oh, yes, our pooch is fattening up, too, and soon, doggy Mounjaro (call it Bonejaro) will be available at your local telehealth vet and their affiliated compounding pharmacy. Mars’ “pet care” brands, with over $1 billion in annual sales include the familiar IAMS, Banfield, and Whiskas products, among others. For developing human addiction, in addition to Snickers, Mars offers M&Ms, Twix, Dove, and Nature’s Bakery (which is about as close to natural butylated hydroxytoluene and guar gum as one cares to get). Mars’ 2023 top line was greater than $50 billion.

Snacking is Such a Business, Already!

In its positive evaluation of the business combination, the press release stated: “Snacking is a large, attractive and durable category that continues to grow in importance with consumers. Upon completion of the transaction, Kellanova will become part of Mars Snacking, led by Global President Andrew Clarke, and headquartered in Chicago, allowing Mars to bring even more beloved brands to more consumers globally. Mars intends to apply its proven brand-building approach to further nurture and grow Kellanova’s brands, including accelerating innovation to meet evolving consumer tastes and preferences, investing locally to expand reach and introducing more better-for-you nutrition options to meet evolving consumer needs.”

Better for you? Yep, I’ll have a tube of Pringles with my Pop Tarts and wash it down with a Snickers Blizzard! I hear that Eli Lilly is planning to produce 20 and 25 mg doses of Zepbound. We’re going to need it!

Ready-to-Wear R&D Department

What Mars REALLY gets in the deal is Kellanova’s R&D department, a well-established, professionally run operation with its roots in creating sugar addiction dating back to the Kellogg’s cereal days. I am told that some of the “food scientists” hopped over from the tobacco industry when the going got hot there. The release went on to say, “The addition of Kellanova’s R&D capabilities will enable the combined business to share best practices in brand building, deliver enhanced digital capabilities, unlock complementary channel strengths and advance brand ecosystems and immersions.” Oh, yeahhhh! What we need is some advance brand ecosystems and immersions! These inherited scientists will hone the promotion of and addiction to high fructose corn syrup to a razor’s edge (which figuratively cuts all our throats)!

More Information about the Merger

If you can stomach any more of this (pun intended), I have a website for you, dedicated to the dissemination of information about the merger. You’ll need to sign a disclaimer to get into it swearing sixteen ways to Sunday that you understand that the deal might not go through and that anything you read might well be bullshit. After you sign off on that, you are greeted with a splash screen that declares “Snacking is Better Together.” The menu provides four options: Overview, Portfolio, Resources, and FAQs.

On the “Portfolio” page, logos for the various brands are depicted and those that generate billion-dollar sales are starred. (An asterisk means greater risk that your ass will be addicted). The billion club includes Pringles and CheezIt on the Kellanova side, and the very healthful M&Ms, Snickers, Twix, Dove, and Extra (choong gum) on the Mars side.

On the FAQ page, a big question is whether the combined enterprise would continue to operate in Battle Creek, Michigan, given the rich heritage of the storied Kellogg brothers associated with that headquarters location. Mars gave some weak assurance that Battle Creek would “remain a core location”. “Mars understands and appreciates the special role Battle Creek plays in the Kellanova culture, as well as the highly complementary category expertise that Kellanova talent brings.” We’ll see how this shakes out.

I imagine those Kellogg scientists are already working on how to make Pringles and M&Ms a mandatory component in every school lunch program! As the late Senator Everett Dirksen once said, “A billion here, a billion there. Pretty soon, you’re talking about REAL money!” This deal is about real money and our continued descent into the crap food pit of despair.

Mounjaro to the Rescue

With all that new, scientifically marketed crap food coming to market, just think of the increased potential for big pharma profits! Hook more people on Cheez-Its, Pop Tarts, and M&Ms and you’ll have a self-sustaining vicious circle of obesity created and treated by corporate America. What could be better, from a standpoint of childishly externalized responsibility?!!? It is all out of our hands. Cure the dread disease we all enjoyed contracting!

So, yes, I have a few opinions all right, but in its place, Mounjaro has been a net positive for me. If I can keep my diabetes under control, weight loss is a secondary issue. I am certainly happy about the secondary benefits of reduced pain and debilitation I described above, but I remain wary about both short- and long-term adverse effects.

Next week, I will tell you about my yo-yo dieting career, and how I had my diabetes under control, but spun out of control. In the meanwhile, stay healthy, mind your carbs, and get that A1c below 5.0!