Archives for October 2025

Welcome to another week of geriatric polypharmacy, antiquarian aerobics, superannuated institutional bashing, and of course, our wonderful new feature, Bullshit Corner!

Although I originally conceived this weekly literary effort to chronicle my progress with the GLP-1 receptor agonist drug Mounjaro, I have expanded its mission to offer a record of my general health travails as I daringly descend the dark, dank, decrepit depths of the aging pit. Verily, exploring this dubious topic by itself would be boring as hell, so I often spice up my weekly reportage with relevant editorial opinions — which make it even more so.

Who Am I and Why Are We Here?

For you first-timers here, please allow me to introduce myself: I am a 78-year-old geezer with a health rap sheet longer than Al Capone’s, a veritable metabolic disaster area. I’ve been writing this series since June, 2024, when I started on Mounjaro to control my blood glucose. Since then, as a reforming Type 2 diabetic, I’ve initiated a serious personal clean-up campaign stressing diet and exercise in a futile effort to fix the effects of a half-century of neglect.

Along the way, I upgraded my primary care physician (PCP) experience by dumping my high-priced concierge “primary don’t-care physician” (PDCP) in favor of the youthful and caring Dr. Macallan (not his real name). Then, in August this year, I became a lab rat in a three-year study of muscles and mindfulness in aging, called SOMMA. I’ve lost weight, reduced some drugs, but recently gained some new ones, been imaged in every conceivable way, and seen a broad variety of healthcare providers. You can read about it all here, week by week.

If you’re old and can relate to all this, or you’re young and want to see what you might be in for, you’re in the right place. Catch up and join the party! Stay tuned for the latest installment of Peptide Purgatory and stick around for Bullshit Corner, which takes aim at the “plants are poison” influencers.

This Week in Mounjaro Madness

SOMMA finally delivered the long-awaited results packet, and it turns out I’m the statistical freak of the cohort — stronger, faster, and better oxygenated than men half my age. The study is about aging, but apparently, my quads didn’t get the memo. Unfortunately, neither did my big toe, which promptly reminded me of my mortality with a gout flare straight out of the blue. And somehow, during a busy week of volunteer activities, I found the time to change gyms due to a massage parlor betrayal. So, this week’s theme is performance, pain, punishment, and pharmacology — with a side of scientific bureaucracy.

The September Check-In

As I wrote a few weeks ago, the SOMMA research assistant called in late September to make sure my leg hadn’t fallen off after the muscle biopsy and to ask the usual follow-ups: how I felt about the study, whether I still wanted to continue, and, knowing what I know now, would I do it again? I said yes to all of the above — I’m in this for the full three-year run.

My aims in joining the SOMMA study are not because of my altruistic wish to serve science and my fellow old farts. My intellectual curiosity and wish to track my progress maintaining strength and functionality as I age were driving forces. So, at every opportunity, I’ve asked when and how I’ll receive the informational dividend from my investment in blood, sweat, tears, and tissue.

What Can We Do Better?

When the assistant asked what they could do better, I nagged her about not having seen many results yet, apart from the CBC and A1c. She said they were preparing a results package and that I would indeed get the data relevant to me. I took her at her word — and, miracle of miracles, the emailed PDF packet finally arrived on Friday.

I also joked that I was looking ahead to my next muscle biopsy with bated anticipation because the experience had been “fun.” She said I was the only participant who’d ever uttered those words, and that there probably wouldn’t be another biopsy. Pity — I was just starting to enjoy the vacuuming. Then, she scheduled my cognitive testing session, which would be completed by phone with a researcher at Wake Forest Baptist Health. Read about that gem later. We also scheduled a six-month follow-up call locally with my favorite SOMMA research assistant.

What follows is a summary of the results package. They’ll be repeating the associated testing at one-year intervals for the three-year duration of the study.

The SOMMA Scorecard

The results were, to put it mildly, gratifying:

• VO₂ peak: 26.4 ml/kg/min — 20% higher than the study’s male average. My mitochondria are clearly working overtime.
• Leg press 1-RM: 285 lb (one leg at a time per protocol) — roughly 30% stronger than my peers. In the real gym, I routinely press 360 lb bilaterally; SOMMA measures function, I measure stubbornness.
• Grip strength: 42 kg — still crushing walnuts, despite the hand arthritis you read about here.
• SPPB: 12 out of 12 — balance, gait, and chair-stand perfection.
• FEV₁: 130% of predicted — lungs of a man who doesn’t know he’s supposed to be old.
• Blood pressure: 125/63 — textbook.

If SOMMA is trying to figure out why some people resist the usual slide into frailty, they may have accidentally recruited one of the control variables. I’m quite pleased with the reported results.

The Gout Reality Check

Just as I was basking in the glow of scientific validation, my left foot reminded me that no mere mortal escapes uric acid. Another flare — the familiar dull ache, a feeling of walking on a broken marble, then followed by the morning “who glued my toe to the sheet?” moment. Then, several nights of sleeplessness due to excruciating foot pain. Chronic gouty arthritis had struck yet again!

So yes, I can leg-press nearly 360 pounds, but a crystal the size of a gnat’s eyelash can still take me down faster than an NFL blitz. Evolution clearly has a sense of humor.

Gout, Steroids, and the Glucose Roller Coaster

When the gout flare hit that Friday, I initially misdiagnosed it as an injury from a spirited gym session two days prior. I had logged twenty minutes of treadmill time with a steep incline, followed by seated machine individual calf raises with heavy weight. My rational mind demanded a scientifically based cure, and I thought I found one. Resolutely, if not impulsively, on Saturday I did what every smart woman does: indulge in retail therapy. I bought two pairs of decent running shoes, Vietnam’s finest, along with appropriate foot beds and dancer pads to relieve pressure on the balky MTP joint. The financial diarrhea inducing wallet catharsis took my mind off my fiery toe for a while. Yet, when that distraction subsided by Monday morning, the pain was still awful.

My diagnosis was off-base. My recollection of prior bouts with gout came late to the party. On Monday, that tardy dawn of realization finally inspired me to phone my podiatrist, whom I shall call Dr. Toebender here. Her first available appointment was Wednesday, five days after the gout presented. Being a dumbass, I didn’t press for an earlier squeeze-in, and I didn’t even consider the ER. I guess I’m a masochist!

Dr. Toebender Comes Through

On Wednesday, Dr. Toebender’s x-rays confirmed the current flare, along with joint erosion from many prior chronic gout flares. With her help, I took the standard modern route: corticosteroid injections, prayer, profanity, ditching red meat and shellfish (I dumped booze already several years ago), and embarking on a course of colchicine. Toebender ordered labs to gauge my urate level.

The steroids worked, of course, but they turned my metabolism into a temporary carnival. Within a day, my glucose traces shot up 20–40 points, and my Dexcom Stelo’s glucose tracking graph looked like the Richter scale during an aftershock. Sleep? Forget it. Two hours down, four hours staring at the ceiling fan, contemplating the futility of circadian rhythm.

The post-flare lab panel, though, told a strangely upbeat story. Hemoglobin jumped to 13.4 g/dL and hematocrit to 41.8%, up from 12.9/40.4, just two weeks after my third and final iron infusion — proof that the new batch of red cells is rolling off the line. Even more curious, uric acid dropped to 4.1 mg/dL, the lowest I’ve ever seen. That lovely anti-inflammatory and renal trifecta — prednisone, losartan, and Farxiga — created a perfect storm of urate excretion. For the moment, my blood chemistry reads like I’ve been cured of gout and blessed by St. Rheumatology himself. Reality, of course, is less divine.

A History of Chronic Gouty Arthritis

Per standard procedure, Dr. Toebender had started me on the classic colchicine protocol — a loading dose followed by a week of maintenance. However my PCP, known here as Dr. Macallan, wants me to stay on colchicine for three months, then transition to allopurinol for long-term urate control. I am complying, dutifully swallowing the tiny blue tablets that promise to keep the crystals at bay. Gout flares be gone! (I hope).

As a side note, I looked back over my prior blood urate history. Back in 2020, a nephrologist found it was 10.2 and since then, it had never been below 6. My earlier doctor chose to ignore the 10.2, despite the nephrologist passing that result to him. Common medical wisdom suggests that I could have been on allopurinol at least since that time, possibly averting several flare-ups. While I could write off this apparent negligence to the confusion of the pandemic years, ample opportunities to revisit the problem existed in succeeding years. Thus, in retrospect, I have yet another screw-up validating my decision to move on from a doctor who once declared, “I can’t keep track of all your chronic conditions.”

For now, the flare has subsided and the numbers look virtuous, I’m eating chicken, and the drugs have brokered a temporary peace. My iron is rising, my glucose has stopped jitterbugging, and my uric acid is somewhere down in the Mariana Trench. Moreover, as a side-benefit, I now have an Imeldific shoe collection. The body, it seems, can be bullied into balance — at least until the next microcrystal stages a coup. (And retail therapy is a temporary fix at best).

Cognitive Testing: The Great Brain Fade

As if that weren’t enough, I got the scheduled phone call from Wake Forest Baptist Health (one of the co-principals in the SOMMA study) for the SOMMA cognitive-testing segment. I wish I could say I aced it, but I was juggling a to-do list that morning and fielding too many interruptions. The call consisted of memory drills, word recall, and mental math — the kind of thing that makes you long for a root canal. (Examples: Count backward by 7 starting at 93. That one was easy, but I think I screwed up the one that involved spewing as many words starting with “L” as I could recall — lovely).

A Thorough Grilling

Other drills like repeating a list of words, which I was asked to recall after doing several other memory tests were predictably boring. The research assistant asked me what day of the week it was and what was the date. I said “Tuesday, October 14.” [long pause]. He asked, “What year?” LOL. I won’t keep you in suspense. I responded, “2025.” Yay!

Another brilliant question was, “Do you know where your local study is being conducted?”

“Advent Health Translational Research” was my answer, which must not have been specific enough, because the assistant asked, “Where is that located?” Wishing to thwart further back-and-forth, I gave him my complete thought picture: “It is on a side street off Princeton Avenue whose name I do not recall because my Tesla’s GPS navigates me there, but I believe the building’s address is 301 West Princeton.” After another long pause, the researcher said, “‘Orlando’ is all I needed.” Comic relief!

I fear my performance didn’t exactly scream “cognitive resilience.” The local cognitive-testing results aren’t in the packet either, so for all I know, I might have scored just high enough to keep them from mailing me a helmet. We’ll see whether they ever release that data.

SOMMA’s Informational Dividend

All sarcasm aside, I’m glad I signed up. SOMMA’s baseline data alone justified the trouble — hard numbers that quantify where I stand in the aging continuum. The CBC confirmed I need iron, the A1c reassured me that Mounjaro’s still doing its job, and the performance metrics were worth their weight in sore quads.

The missing cognitive results? Maybe they’re sparing my ego — or maybe the lawyers haven’t cleared that packet yet. I’m content to go where my brain takes me until I find myself in some strange place and don’t know how I got there.

My Week on Mounjaro, Farxiga, colchicine, etc.

I didn’t let the gout attack slow me down too much, but I obviously needed to suspend my workout program. In a busy week of volunteer activities running on fumes due to steroid sleeplessness, I somehow found the mental clarity to evaluate a new gym. The local Adventist Health-run sports medicine gym, shared with an active physical therapy operation, was too small with too few machines and no barbells. I have barbells, dumbbells and a bench at home, but it was their overcrowding and restricted hours that annoyed me. The final straw was management’s decision to plunk a massage table and a seated massage chair, along with a masseuse hawking her services, right in the middle of the gym, where there was no free space. What were once merely cramped quarters became human gridlock.

(Can you imagine stripping down and getting a massage amidst the treadmills and stationary bikes? I didn’t want to stick around to watch that embarrassing comedy show.)

A visit to the local “Y” made my decision clear. For $6 less per month I would be getting spacious exercise rooms, more and better machines, a dedicated weight room, much more convenient hours of operation, and far less noise and congestion. Remarkably, the YMCA has the latest Technogym equipment from Italy, so I can scan a QR code on the machine with their smartphone app and track my performance automagically. Very cool! I’m not a young man and I’m not Christian, but for me, the YMCA has it all. They actually deliver what Advent Health pretends to provide while.

I wish Advent well in their desire to monetize every possible square foot of potentially revenue producing space under the guise of better serving its members! (BTW, Advent: we’re not fools!)

The Mounjaro Numbers, Already!

The steroid injection made this a topsy-turvy week, so I’ll skip the glucose numbers. I will only say that my weight was stable from last week to this week at 170.6 lbs (77.5 kilos).

And now, let’s look at some seed oil bullshit!

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Executive Dysfunction (But Make It Aerobic)

This week I proved you can be a statistical freak of nature and a medical train wreck at the same time. SOMMA crowned me the outlier king—VO₂ sparkling, grip crushing, leg press stout (their timid single-leg 1RM number understates my real-world 360)—while my left big toe staged an uprising. Enter the steroid carnival: glucose bouncing like a five-year-old on a trampoline, sleep evaporated, and a lab panel that somehow looked virtuous anyway (hemoglobin rising nicely post–iron infusion, uric acid hiding at 4.1 thanks to prednisone + losartan + Farxiga playing bouncers at Club Purine). Podiatrist fired colchicine across the bow; Macallan wants three months of that, then allopurinol forever. Your Turkey complies, begrudgingly.

Meanwhile, I dazzled Wake Forest with cognitive “brilliance” while juggling sixteen distractions and forgetting everything except my own ZIP code. The study didn’t include those scores—probably out of kindness. I also dumped the Adventist hamster-cage gym for the YMCA, where the Technogym machines don’t share floor space with a pop-up massage parlor.

And in Bullshit Corner, we baffled you with the seed-oil panic. Spoiler: your canola isn’t plotting your demise; your diet pattern is. Save the tallow cosplay for TikTok.

Net: Strong lungs, stubborn quads, seditious toe, caffeinated glucose, rising hemoglobin, and one more week of aging disgracefully. Carry on.