The Nittany Turkey

Primarily about Penn State football, this is a tale told by idiots, full of sound and fury, signifying nothing.

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Archives for 2024

Weekly Mounjaro Update: Week 25

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The Turkey is back with you (in time for Turkey Day) to report on my weekly progress with the type two diabetes drug Mounjaro. My therapy started on the first week in June this year. Since then, my HbA1c has improved from 7.6% to 5.5%, which is excellent. However, lest I succumb to the GLP-1 drug for life groundswell that is making this class of drugs the most profitable in history, my approach is cautiously optimistic. Unlike other pop culture sources on social media, I am not a one-dimensional cheerleader for these products. What you get here are honest observations and cynical comments derived from my personal experience with all aspects of the therapy, positive, negative, and “too soon to tell.”

My annual physical exam is nigh. I have blood test results in hand. So, tomorrow, I will discuss my progress on Mounjaro with Dr. DeLorean (not his real name). Also, my final physical therapy session was last Friday. I’ll update you on all that later. First, I want to give you the GLP-1 story of the week.

Silly Rabbit! Trix Are for Kids!

(But What about Mounjaro?)

The story of the week involves parents seeking GLP-1 agonist drugs for their children to slim them down. I’ll give you a little background. The biggest selling drugs in the GLP-1 class are Mounjaro and Zepbound (both terzepatide), and Ozempic and Wegovy (both semaglutide). While originally the target consumer group was type two diabetics, the market exploded when the weight loss associated with GLP-1s became evident. The weight-loss market, comprised of both cosmetic and medically necessary reduction, is huge and ripe for exploitation. Eli Lilly & Company and Novo Nordisk, manufacturers of these drugs, would love for two-thirds of the world’s population to become addicted to their magical weight loss potions. Toward that end recently, the US FDA has approved Ozempic/Wegovy (semaglutide) for use in treating childhood obesity. The abuse potential concerned with injecting harmful drugs into children seriously bothers me.

One Mom and Daughter

I’ll point you to an article in The Wall Street Journal about a twelve-year-old girl whose Mom has been getting her GLP-1 drugs from compounding pharmacies. Her pediatrician did not feel comfortable prescribing the stuff for the kid, so the insistent mom looked for tele-health companies that are all about making money on compounded versions of the vogue drugs. Many of these companies sprang up when the last explosive class of drugs, Viagra et al., went off patent. They are merely drug pushers, with varying degrees of medical intervention.

Typically, they expect the client to do his or her own follow-up and lab testing; they cede that territory to to the client’s local doctor. Of course, people intent on getting their hands on the drug take a “damn the torpedoes” approach. Once they establish a supply channel, they might skimp on follow-up. Hell, some might not even tell their local doctor. Kids certainly have no control over the process. They must rely on parental responsibility or suffer in the absence of it. If parents seek out shady suppliers who provide their patients just enough information to satisfy their lawyers, they are putting their children squarely in harm’s way.

We know too little about the long-term effects of GLP-1 agonists, but parents are insisting on giving them to developing adolescents. Nutritional concerns abound. With their appetite suppression, how will these drugs with their associated appetite suppression affect physical growth and mental development? The answers are not clear.

Treat Your Children Well

I’m not here to tell anyone how to raise their kids, but I object to giving them GLP-1 drugs, injectable or otherwise. People want to irresponsibly give their kids crappy sugar-laden cereal, ice cream, cake, and candy, then throw drugs at them when they fatten up. Sometimes, they just want their kid to look good in her prom dress or her play clothes. A sad example came from a tele-health provider in an interview with The Wall Street Journal. She quoted a client who told her, “My daughter is size six. She’s body confident. She has friends, she’s very active, but I can’t help but think she would be better at a size 0.” Just think about that one for a while.

Where parents can step in to combat childhood obesity is feeding their kids decent food. Since the end of World War II, what kids eat has gone to hell in a hand basket. Even in my youth, we had crap like sugary cereals like Kellogg’s Sugar Frosted Flakes (“They’re g-r-r-r-reat!” —Tony the Tiger), Hostess Twinkies, Oreos, and Pop Tarts. Incessant advertising targeting children makes it hard for parents to avoid buying crap for them. And so, the childhood obesity pandemic took hold. It has degenerated from there — seventy years of crappy child nutrition. Now the CDC considers 19.7% of American children aged 2-19 to be obese.

Big Government Abetting Big Pharma and Big Fooda

I’ve written before, ad nauseam, about the food industry and Big Pharma holding each others’ hands while together they make the population sicker. Ultra processed food, high on sugars, sicken people. Big Pharma steps in with expensive magic potions to fix what the food industry damaged. And it goes on and on and on. Instead of government fixing the problems with the lobbyist influenced food pyramid and the adulteration of food, they turn a blind eye to the abuses, while green-lighting all the great new expensive drugs Big Pharma can offer. Direct-to-consumer advertising, legal only in the U.S. and New Zealand, closes the loop between the fat man on the street and Big Pharma. It is only a matter of time before the ballsy marketeers from Big Pharma implore you to ask your pediatrician whether Mounjaro is right for your six-year-old.

Harrumph!

Enough of That… Where’s My Update?

Let me start with the weekly numbers, and then I’ll fill you in on the labs and the PT. This past week included my birthday. I didn’t do anything wild, but I did deviate from my typical diet, going way over my self-imposed carb limit. So, it is no surprise that my average glucose increased to 110 mg/dL (6.11 mmol/L). However, morning fasting glucose averaged 91.7 mg/dL (5.07 mmol/L), an improvement from last week’s 100 (5.56).

My weight was flat for the week, at 195.2 lbs (88.5 kg). I am happy to take a break from losing weight, as I have dropped 50 lbs (22.7 kg) way the hell too fast.

I have noticed that my resistance to Mounjaro is increasing. Appetite suppression has waned, but I have cleaned up my diet. I might need one more dosage bump to finish the job I started. As you’ll see below, my insulin resistance is way the hell too high. I need to get that under control. Nevertheless, I hope to conclude the Mounjaro therapy during 2025. None of this “on it for life” BS. We’ll see…

Blood Test Results

If you ignore my fasting insulin level, which I’ll get to shortly, my metabolic results were pretty damn good for an old fart in his eighth decade. HbA1c was 5.5%, which is in the “normal” range, down from 5.7% in September. My eGFR, a calculated measure of kidney function, has improved to 60, which elevates me from the morass of chronic kidney disease Stage 3A to Stage 2. Because of diabetes, high blood pressure, and metabolic syndrome, my kidneys have taken a serious beating for many years. Positive results in this area never fail to elevate my spirits!

But then…

Alas, my fasting insulin rose to 18.7 uIU/mL, which suggests that I am extremely insulin resistant. What is the connection between Mounjaro therapy and this number? I will discuss it with Dr. DeLorean tomorrow, but my bet is that he won’t offer any brilliant revelations. He will tell me that a single test and one number is meaningless. After all, I, not he, ordered the test. But there is a method to my madness. I believe that insulin resistance underlies a cascade of metabolic issues. But who am I?

HOMA-IR

I had tested fasting insulin back in July. At that point, it measured 14. Holy Crap! This is a significant increase, no matter who orders the damn test. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) is a calculated measure of insulin resistance recognized by metabolically savvy doctors, so I’ll use that score to illustrate the extent of my insulin resistance. HOMA-IR is a function of concurrent fasting insulin level and fasting glucose level. Any score above a 2 signifies insulin resistance. In my case, July’s number was 3.3 and November’s was 4.4.

However, the model is controversial. “The HOMA-IR score should not be used in patients on insulin, and studies have questioned its accuracy in those with impaired glucose tolerance, normal BMI, the elderly, and others.” Well, I am elderly and I certainly have impaired glucose tolerance.

I’m not going to panic. What can I do about it? I have already adjusted my diet and I will be increasing my exercise, now that physical therapy for my back has concluded. But if Mounjaro is causing the decrease in insulin sensitivity, my desire to get off the drug will accelerate. The alternative would be chasing dosages upward while insulin resistance also increases, in an endless upward spiral. That’s all speculation at this point. I need some hard facts, and I’m skeptical about getting them.

Physical Therapy Concludes

I think the physical therapy did me some good, especially, the core strengthening exercises, which enabled me to comfortably hike 8.6 miles (13.8 km) on Thursday. After hearing about this from me, my PT task master gave me a going-away gift by doubling the number of daily exercises I do at home. Facetiousness aside, I will do them diligently.

My back pain still bothers me, but the therapist told me in advance that there were limits to what she can do. Only surgery can assuage some of my back issues and others are not correctable by any means. Still, I think the hard work and the ongoing exercises will pay off.

The numbness and burning in my right thigh persists. I will be seeing a physiatrist (physical medicine and rehab doctor) in early December, hoping to get some relief through non-surgical means. The condition, tentatively diagnosed as meralgia paraesthetica, is annoying but not debilitating. It involves a sensory nerve, which as the name suggests affects only sensation, not control of muscles. Like lots of other annoyances that accumulate with advanced age, I can learn to live with it if the correction would be more of a pain in the ass than the pain in the ass itself!

Get Some Exercise, Fat Boy!

The physical therapist had asked me not to do my usual resistance exercise program while she was punishing me physically, so I obeyed. Now that she is out of the picture, I will get back into it, and then some. In December, I will join the exercise program at the same rehab and will resume the dumbbells and stationary bike at home.

Have a Happy Thanksgiving!

That’s all for this week. I hope to bring you some more egocentric information about my ongoing Mounjaro therapy next week after I see the doctor for my annual physical. On Thursday, I anticipate another dietary deviation at Thanksgiving dinner, but I will try to minimize its glucose impact. No sense killing myself on Thanksgiving!

I wish all of my U.S. readers a very Happy Thanksgiving, and I apologize to my Canadian readers for missing Thanksgiving last month. (Even if I’m not Canadian, I can still say I’m sorry!). See y’all next week!

MI

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Penn State 26, Minnesota 25

The title of this post suggests that it is about Michigan, right? MI is the USPS abbreviation for that state. What else could it be? So, I’m stupid and I think “MI” is an abbreviation for Minnesota? Nope. That ain’t it. “MI” stands for myocardial infarction. I stole its use as a chapter title from the late American author and Pennsylvania native from Shillington, John Updike. He employed it as a cannily ambiguous chapter title in “Rabbit at Rest”, which he wrote in 1990. This Pulitzer Prize winner was the final element in his “Rabbit” series, the first of which was published in 1960. But I digress.

Suffice to say that the Heart Attack Kids were at it again this week, letting an underestimated, determined opponent jump out to an early lead. The Minnesota lead persisted into the second half. But as scary as this game was to those whose lives hinge on Penn State reaching the CFP playoffs, it was one of the most entertaining Penn State games this Turkey has watched in sixty years of Nittany Lions fanhood.

Something for Everyone

It truly offered something for everyone, with more byzantine plot twists and turns than a British murder mystery. The Penn State punting and kicking game provided unexpected thrills in the first half. First, a Riley Thompson punt from the end zone was partially blocked, giving Minnesota a short field and enabling them to score on a crazy-ass double-reverse flea-flicker from Max Brosmer to Jameson Geers. Then, Penn State came back with a six-play touchdown drive that should have tied the game at 17-17. But Ryan Barker’s extra-point try was blocked and recovered by Ethan Robinson. He ran it 97 yards untouched for a two-point defensive conversion. That made the score 19-16 in favor of Minnesota going into the locker room at halftime.

By the way, that Nittany Lion touchdown drive had another entertaining aspect. A phantom pass interference call that turned an incompletion into a decent gain and a first down. Many looks at replays revealed that Allar’s pass was well out of bounds and therefore, uncatchable. Also, the interaction between the defender and the intended target, Harrison Wallace III, was negligible. We Penn State fans, knowing that we needed all the help we could get in this close encounter of the shitty kind, accepted the gift from the officiating crew.

Second Half Thrills

The second half would provide more thrills, chills, and spills, but in the end, Penn State snatched victories from the hungry jaws of defeat, showing the strength of character they have displayed in coming from behind in several games this season. That is the attitude and commitment level of champions, and it is what is necessary to progress in the playoffs. Against a very tough and determined Golden Gopher defense, they pulled it out, even effectively managing the clock on the stifling final drive.

Highs and Lows

Good Work, Tyler (as usual)

Minnesota head coach P.J. Fleck told the media, “We did everything we could do to shut down Tyler Warren, but he still got 102 yards.” The Minnesota game plan involved nullifying Warren on offense and Abdul Carter on defense. Drew Allar had a quietly competent day and was instrumental in the victory by converting three fourth downs on the game sealing drive. The Nittany Lions as a team committed no turnovers while forcing Minnesota QB Max Brosmer to turn the ball over twice, once on an interception and once on a fumble.

Innovative Play Calling (when they work, you look like a genius)

The fake punt was great. Boy, was it ever great!

How Low Can You Go?

On the other hand, the Nittany Lions were absolute shit cakes and molasses candy on third down attempts, converting one of eleven. That is 9% for those of you who are mathematically challenged. Absolutely putrid, with all due respect to a staunch and well-prepared Gopher defense. We got to see another talent of Tyler Warren’s when he rescued Penn State from a ridiculously busted fourth down play with an equally ridiculous 16-yard punt. And then, there was the blocked PAT for a defensive two-pointer. According to James Franklin, the blocking at the line of scrimmage deviated from their standard schema to allow the block for unexplained reasons.

Put The Gopher Clamps on Carter

Minnesota was effective at nullifying Abdul Carter, who wound up with only three tackles (one solo) the entire day. However, he was instrumental in preventing a late touchdown that could have won the game for the Boat Rowers. He popped outside to cover a behemoth would-be receiver on a tackle eligible play he sniffed out. The ball sailed harmlessly incomplete, and Minnesota settled for three. This left them a point behind with almost six minutes to go. Fortunately, they never got the ball back.

Always Take PSU’s Opponent and the Points?

Here again, we have an example of Penn State not covering the spread, which was seen at levels as high as 12.5 but settled down to 11 at game time.

Report Card

You know I don’t do stupid “report card” cliche crap. So, I’ll just use this space to bitch about others who use that tired old convention. Produce some new material, schmuckos! LEARN TO WRITE readable prose, so you do not need to use gimmicks, I implore you! Relax, I’m just playing with ya.

Governor’s Victory Bell Trophy

The pretty Governor’s Victory Bell Trophy, awarded to the winner of the Penn State-Minnesota game, which is not played every year, is now in Penn State hands. Unfortunately, so is the abominable Land Grant Trophy, which goes to whoever is unlucky enough to win the Penn State-Michigan State game. We’re stuck with that gigantic piece of George Perles-designed moose shit until the next time Moo U. beats us. Looking at the Spartans this year, that could be the Twelfth of Never. Another digression? Typical. Par for the course here, as you know. So, let’s move along.

So, Now What?

Well, one last game, the Senior Day home game against Maryland (4-7, 1-7 Big Ten), who suck. In that game, Penn State will try to avoid injuries but still come out with a win to secure a spot in the College Football Playoffs. I hereby request that there be no widow makers present and no “dullard looks” in evidence. The scheduled 3:30 PM kickoff should help with that, but only God knows what the weather will be like.

And, oh yeah, with Indiana having been clobbered by tOSU, if the latter should happen to lose to MI next weekend, it will create another MI scenario. Penn State will then play Oregon in the Big Ten Championship in Indianapolis, unless Washington pulls off a huge upset against the Ducks in the Border War. Wouldn’t THAT be cool? Not only one more game for PSU in the playoffs, but also an extra watching opportunity for us fans at the Big Ten Championship. Fun times!

But hold your horses. Gotta beat the Twerps first. Yep, go 1-0 this week. Uh huh.

While laying low as we turkeys must do around this perilous time of year that sees the mindless slaughter and birdicide of many of our hokie brethren, I’ll be back mid-week to deliver my assessment of the mighty Maryland Terrapins.

Row Your Damn Boat, Already!

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#4 Penn State (9-1, 6-1 Big Ten) at Minnesota (6-4, 4-3)

Minnesota Golden Gophers

This game is for all the marbles. That is, if there are any marbles in the Governors’ Victory Bell Trophy, presently in the trophy case at the All-Sports Museum at Beaver Stadium. If the Nittany Lions play well, Minnesota will be rowing its P.J. Fleck rowboat, while Penn State roars past with trophy in hand in its twin-diesel yacht. But this is a crazy dangerous game for PSU, especially if they slack off. The Gophers are deceptive, with a decent quarterback and one more serviceable wide receiver than what Penn State has, which is zero.

The Golden Rodents are coming off a tragic loss to Rutgers (5-4, 2-4), 26-19, in Piscataway. Before that, they handled Illinois, Maryland, UCLA, and USC, but lost to Michigan and Iowa. Rutgers held Minnesota to 35 yards rushing. Although the Scarlet Knights allowed 262 yards passing, they concentrated on covering senior wide receiver Daniel Jackson, one of the best out there (he ranks 6th in the conference).

The historical (and sometimes hysterical) record between the two combatants is tilted in Penn State’s favor 10-6. On Gopher turf, which is torn up with perilous holes and burrows, the teams have split 4-4. Minnesota has won some memorable games in the series, including the 2000 upset that heralded the onset of The Dark Years [cue minor-key cello].

What Dem Gophers Got

Senior Quarterback Max Brosmer is among the better quarterbacks Penn State has faced this year, ranked 8th best passer in the conference, a notch below Drew Allar. Although Jackson is his best receiver, he spreads the ball around to his secondary targets, who rate “not too bad”.

The Gopher ground game? Well, it sucks. You would think that ground-dwelling rodents would know how to handle stuff on the turf, but nooooooooooo. Minnesota is next-to-last in the Big Ten, averaging only 104.7 yards per game. They rely on two running backs, sophomore Darius Taylor and senior Marcus Major, who average 74.7 and 27.2 yards per game, respectively. Rutgers held Taylor to 28 and Major to 9.

How about the Boat-Rowers’ offensive line, you ask? Not so good, I say. We already covered their run support, but their pass protection is putrid, having given up 23 sacks this year. Brosmer’s ass must be pretty sore by this time.

Defensively, Minnesota shines brighter than many Nittany Lions opponents thus far, ranking fifth in the conference after tOSU, Indiana, and Oregon. The Rodents are in company there, and overall in the FBS, Gopher total defense ranks #11. They’re 34th in rushing defense and 17th in passing yards allowed, squarely between Penn State and Indiana. They also are tied for 7th in the FBS in turnover margin, averaging +1.2 per game (compared to Penn State’s +0.3).

In that connection there lies one great big caveat for the Penn State offense. Minnesota ranks 4th in the FBS and best in the Big Ten in passes intercepted. They have snagged 16 so far this year with 207 return yards. Their best secondary vacuum cleaner is freshman DB Koi Perich (named after two fishes), with five interceptions this year.

The kicking and punting situation is about the same for both teams. The Gophers use a familiar (albeit fishy) name, Koi Perich, for punt returns, and his numbers are as good as Nick Singleton’s in that role.

The Nittany Turkey’s Lame Keys to the Game for PSU

  1. Start strong and lead the race wire-to-wire
  2. Pressure Brosmer continually. He should be seeing #11 and #33 in his nightmares.
  3. Nullify Jackson either through double coverage or by cheating.
  4. Hear this, Drew Allar: No picks!
  5. Don’t look past this game thinking you’re already in the playoffs.

Da Wedda

Looks like a warming trend is in store for Minneapolis with a forecast high of 37 and a low of 32. A shitty-looking fall day is in store, with 98% cloud cover. Winds will be from the northeast at 4 with gusts to 10. Only a 12% chance of precipitation, which at those temperatures would be white. Kickoff is at 3:30 PM EST/2:30 CST. Sunset in the Twin Cities is at 4:37 CST. Accordingly, some of the second half will be played under the lights. The moon will be a waning crescent. Thus, there is no danger of a super-moon mooning the Gophers, as it did with Purdue. Both teams know how to play in cold weather — advantage no one.

Da Bottomus Linus

I thought I would sound smart if I wrote that heading in made-up Latin. Most of us clowns who write about football try to sound smart by endlessly reciting second-hand statistics, but I already did that above. I’m stalling, I know.

As I write this, the spread is Penn State – 12.5, with an over/under of 45.5, which suggests a final score of 29-17, PSU on top. The Nittany Lions do not need to play a perfect game, just a competent one, avoiding risky passes against the boat-rowing interceptors. Minnesota is capable of scoring points, too, so a good start is essential to avert one of those too close for comfort heart attack specials. I’m picking Penn State to go 1-0 this week but I also think they will make one stupid mistake that will cause it to be closer than it should have been. Penn State 31, Minnesota 24. They’re not covering the spread, and I’ll take the over.

I’m thinking that I covered it all, so don’t sue me if I left something out. It’s my birthday and I can do whatever I want. I will be back with you to pay penance for my egregious errors and omissions after the game.