If at first you don’t succeed, try, try again.
Happy Monday. Having watched my Nittany Lions and Steelers go down in flames, and having observed my Pens exhibiting mediocrity, I can concentrate on my lifestyle adjustments for Type 2 diabetes.
Welcome to my weekly update. If you have been reading this column from time to time, you’ll know that I have been injecting GLP-1 RA drug Mounjaro weekly since last June as an adjunct to cleaning up my diet and diligently pursuing an exercise program. You also know that at age seventy-eight I suffer from a variety of chronic conditions and I am about thirty pounds overweight, as the weight charts go.
Today, I’ll give you the latest on my current mishegoss, a urinary tract infection (UTI). I’ll conclude with my weekly update, telling you how effectively Mounjaro is currently working to treat my Type 2 diabetes.
Who wants a UTI?
Recently, I’ve been dealing with a UTI. I’m now on my second round of antibiotics. The first, failed drug was a seven-day course of nitrofurantoin (Macrobid). With test strips still showing significant infection after the week was up, Dr. DeLorean (not his real name) ordered a culture, while also prescribing ciprofloxacin (Cipro). It turns out that Cipro was a good choice. On Friday, the lab reported results of the culture, revealing the culprit pathogen as Serratia marcescens, which is resistant to Macrobid, but susceptible to Cipro.
S. marcescens is a cool bacterium. It is a ubiquitous strain you will find in your bathroom and other damp places in your environment, including the soil. If you have ever seen a pink film or plaque on fixtures or tile grout in the bathroom, it is likely S. marcescens. This little critter has some fascinating history, as you’ll find by reading the Wikipedia article about it. Colorful history notwithstanding, you do not want this bug multiplying in your bladder, let me tellya!
Shotgun! Shoot ‘im fo’ he run, now!
Dr. DeLorean’s logic — eradicate the most likely pathogen quickly, then execute Plan B if that fails — is a “shotgun” blast approach. E. coli accounts for 90% of UTIs, and although resistance is increasing, E. coli is susceptible to Macrobid. I suppose the numbers say it was worth a shot, especially because a culture requires four or five days to watch the little pink monsters grow. Macrobid proved to be ineffective, so the next antibiotic was Cipro. I dropped off a sample at the doc’s office just before my first dose so they could do the culture I mentioned in the opening paragraph of this section.
My symptoms and my test strips are much better seven days into the course of Cipro, which is to run for a total of ten days. I’ll keep an eye on the test strips because S. marcescens is resistant to many antibiotics and it could have figured out how to evade the effect of Cipro. I have no fever, so my hope is that this is an uncomplicated infection that will go away soon, and I have largely resumed my exercise program and streamlined diet.
My Week on Mounjaro
I wanted to write more this week, but events conspired to limit my writing time. Therefore, this will be another short update before I go see the dentist for a cleaning. If it’s not one thing, it’s another, already!
My overall average glucose measurement is unreliable, because my Stelo monitor is flaky this week, typically reading 20 mg/dL higher than the finger stick method. For what it’s worth, it tells me that my seven-day average glucose was 115 mg/dL (6.39 mmol/L), which probably means I’m right around 100 mg/dL (5.56 mmol/L). A more accurate measure is average morning fasting blood glucose at 96 mg/dL (6.00 mmol/L) per my finger stick glucometer, which tracks closely with professional lab tests.
I would hope to get my morning fasting glucose down to about 85 on the average. I don’t know whether that is doable, but my efforts to maintain a low-carb diet with adequate fiber while exercising six days per week in conjunction with Mounjaro remain directed at that goal.
My body weight, unlike my belly, was flat for the week, settling in on 187.6 lbs (85.3 kg) at my Monday morning weigh-in. It was up and down during the week due to the UTI, no doubt.
I’ll try to find some more interesting content next week, as my TMI UTI is bound to be boring many of you. I am following the court case involving a compounding pharmacy association’s battle with the FDA to keep tirzepatide on the shortage list, among other topics related to GLP-1 RAs. See you next week!
