Back to the GP today to check on my next Mounjaro prescription. Not the fill-in Fab GP I saw last month, I guess my usual Nice GP is back from holiday. And that’s fine, I think? Anyhow, talked about the prescription, which she has now renewed for 3 months at the initial “starter dose” of 2.5g. Like me she thought a weight loss of 6 kilos in 7 weeks was a reasonable rate and saw no need to change things. So we’ll see. I mean, there’s no guarantee I’ll keep losing weight at that rate, but for now I’m happy with that and would prefer not to up the dosage.
Then I asked her about an issue I had last week with possible blood in my stool (it was hard to tell) but before sending me off for another colonoscopy (last one was three years ago) she wanted to test for blood, so that’s what we are doing. She told me I’d be having a colonoscopy in any case, but if the sample tests show traces of blood then it’s a different protocol to follow. Okey-dokey.
Next up… since my shoulder jab about three weeks ago, well it was starting to feel a bit better, but now the pain has resurfaced but feels more concentrated in the front of my upper arm. I told Nice GP they had told me to come back if the first jab didn’t take and so now I also have a new shoulder traumatology appt request in the system. I don’t know if I’ll get the second jab but I’d like to get another opinion on it.
Meanwhile, probably the BEST news of the summer has been that since about ten days ago I have been getting around on just one crutch for the first time in two years. Yes, it still hurts (a lot), and I still walk at a snail’s pace, but it’s actual walking (as opposed to hobbling). Whatever… I’ll take it! How’s your summer going?
Yesterday was my 7th Mounjaro injection and the “official Monday morning weigh-in” showed that I have lost 5.5 kgs in six weeks. So that’s good. I mean, I was hoping to lose about 3-4 kilos a month so I am more or less “on schedule”, with a couple more weeks to go until the end of August. I know that with most weight-loss it’s normal to lose more quickly at the beginning and then to start to plateau a bit. I mostly want to get down to the required weight for my knee surgery, which is another 6 kilos. Of course, more would be better, but when I hit that target they will at least put me on the surgery waiting list.
I haven’t been dieting or calorie counting (god forbid) but I have been tweaking my daily eating routine a bit. And I’ve basically halved my wine intake, which makes a difference too. BUT… and this is very important, at least for me… there are no “forbidden foods”, I eat whatever I feel like, make sure I’m getting plenty of veg, still enjoy a glass or two or wine and then just eat either very little or nothing in the evenings. And I’ve been doing my cardio chair workouts every day. To be honest, I’m not sure how much of the weight loss is due to the effects of the drug or just me making more effort motivated by having to fork out 210€ every four weeks.
As a result… well, when you are as overweight as I am a six-kilo loss isn’t obvious to the casual observer but I can see some differences here and there. And between being a bit lighter and having built up a bit more muscle strength (those chair workouts are no joke!) today I was actually able to go out for a walk using just one crutch. Not a hobble, a WALK. It felt so fucking liberating. And yes, the knee still hurt quite a bit and I was exhausted when I got home, but it was doable. Which actually hasn’t been possible since August 2024. Plus the shoulder jab has helped relieve some of that pain. So, feeling cautiously optimistic about maybe getting my life back (please please please).
At last! The day after seeing new Fab GP I received the long-awaited phone call from Traumatology saying I had an appointment for my shoulder this coming Monday. After the ultrasound in February I did actually get an appointment in March (for a few days before my knee one) but had to ask for it to be rescheduled. But there was some kind of problem because I never did get another appointment and when I saw Nice GP in May she saw that they had mixed the two March appointments up, assuming I’d gone to the shoulder one, and cancelled the request. So she requested another one. In May. When I saw her last month for the Mounjaro thing she said it was still in the system, nothing she could do. Then I asked Fab GP about it yesterday, who said the same thing but… maybe she tweaked it somehow?
Anyhow, I sure hope they can do something about this because between shoulder pain and knee pain I honestly don’t know which is worse now, and it makes hobbling on the crutches pure hell. These days I mostly drag the right-hand crutch because I can’t lift it enough to use, but I still need to have it with me for things like stairs, very uneven pavement etc. At least they shouldn’t be able to blame this on my being fat and refuse treatment until I lose weight… I hope! 🤞
Today I went to see my GP about getting my Mounjaro prescription refilled and possibly “upgraded”. In case you don’t know, they start you off at the lowest dosage (2.5 mg) which is supposed to get your body used to the medication without too many side effects. Then the usual thing is to up the dosage to 5 mg and see how you get on with that. If you are losing weight at a reasonable rate then you stay where you are, but if you need more (of whatever it is this thing does) then your dose can be steadily increased up to what sounds to me like a whopping 15 mg dose. Each pen holds four doses and the higher the dosage, the higher the price.
2.5 mg
208€
5 mg
272€
7.5 mg
359€
10 mg
359€
12.5 mg
446€
15 mg
446€
At 208€ per 4-dose pen, the 2.5 mg dose is already too expensive for me, especially as this is meant to be a long-term treatment. So I was going to ask my GP if she thought I could stay with the initial dosage and see how I go, but it turned out my GP wasn’t there (on holiday?) and I ended up seeing someone new. Oh well. You may recall that when my old GP (and friend) Agustín retired just after Covid lockdown his replacement was (I’m sorry but she was) a really horrible woman who seemed miserable at her job. She didn’t listen to me at all, sent me for treatment I never asked for or wanted, like fucking bariatric surgery, without informing me. I was thinking about changing clinics when one day I went to an appointment and Heartless GP was gone and there was a new doctor there. Another woman, but this time a nice one. Well, I mean she was a bit cold and clinical but she did get things done, things I asked for. So I have been more or less happy with Nice GP though I can’t actually talk to her (I’ve tried). Anyhow, then today…
Another woman. I still don’t know if she is now my new GP or if Nice GP is on holiday, but the first thing she did was apologise for taking another patient ahead of me saying she had seen me in the waiting room but it looked like I was waiting for someone else (well I was, so I wasn’t sitting outside her door) but no harm done. Then I sat down and told her that I was there for a new prescription but wasn’t sure if I should continue with the original 2.5 mg dose because it seemed everyone switched to 5 mg after the first month. But I’d already lost 2.5 kilos in three weeks and I thought that was a good rate of weight loss (slow but sure), and she agreed. I told her that price was a factor and, indeed, forking out 208€ a month was probably better motivation and more effective than whatever the medication was doing. And she laughed. SHE LAUGHED. Omg. Then she showed me the price chart above and said… you know “hay una trampa” (there’s a trick) and I was all ears.
Then she leaned in and said that when they were first showing them this new medication and how it worked they also showed them this “trampa” which was this. Say, like me, you are paying 208€ for four 25 mg doses a month. That is what that pen is going to always cost. BUT… if you bought the 5 mg one at 272€ and only took a half dose each time then it would last twice as long and cost 136€ per month. And I was like… whaaat? Even better if you go for the 10 mg one, which would last for four months at 90€ a month. I was a bit overwhelmed. First of all, that Mounjaro pen took a while to master (I have it down now, can administer it without needing the video 😅) but cutting the dose? Tricky. New Fab GP said she didn’t know how all the different pens actually worked, saying they could explain it to me at the farmacia, but I was unsure. So we agreed that I would continue on the 2.5 mg dose for another month while I did more research on this. So far everything on google is saying I SHOULD NOT do this, but they would say that, wouldn’t they?
Meanwhile, we talked about how my weight gain happened after all that chemo (2008-2009), followed directly by menopause and, well, just getting older, and she’s the first doctor has agreed that chemo can seriously affect metabolism. She said another benefit of Mounjaro is that it helps not only with blood sugar levels and lowering appetite, but it also metabolically “rebalances” your body. Hmmm. I dunno about that but I do know I’ll stick with it for now because I really really want a new knee.
… my journey into Weight Loss Injection Land. In the end Peter popped back to the farmacia yesterday evening to pick up the first hideously expensive batch of Mounjaro – 4 injections for 210 euros. I decided to wait until this morning to get started but upon opening the box and seeing THESE INSTRUCTIONS (gee just 17 easy steps) I was a bit overwhelmed to say the least. And then I read the fateful words NEEDLES NOT INCLUDED and was like… what the FUCK. Also, why the fuck didn’t anyone ask Peter if he had needles or needed to buy some?
So it was back to the farmacia today and hey, they only had boxes of 100 NEEDLES that are compatible with Mounjaro, but whatever. Bought them. Then it was back home to do the deed. Luckily my friend Jane had sent me this very helpful video, which made more sense to me than a metre long fold out page of printed instructions. And then I did it! It’s a bit faffy because you have to work out the dosage each time and “prime” the thing (unlike the easy one-shot belly injections I had to do after all my cancer operations) but I am now INJECTED. And so now what?
Well apparently “Mounjaro (tirzepatide) starts working within hours of your first injection, though the timeline for visible results varies. Immediate Effects: Appetite suppression and reduced food cravings can begin within 24 to 72 hours.” (googled info)
Which got me thinking yet again… I don’t actually have a big appetite that needs suppressing. I don’t get food CRAVINGS (at least not the all caps variety – probably the only thing I ever actually crave is a nice glass of wine). And once I start eating (thanks to the adhesions) I am not able to overeat in any meaningful way. So do I really need an appetite suppressant drug that works by making people feel nauseous? I guess we shall see.
Meanwhile meanwhile… today I was going over the properties for Wegovy (my first choice before the GP talked me out of it) and dammit, I wish I’d stood my ground. Because Wegovy is a lot more than just a weight loss medicine…
Wegovy (semaglutide) reduces excess body weight (by an average of 15-19%), and lowers the risk of major cardiovascular events like heart attack, stroke, and cardiovascular death. Beyond appetite suppression and weight loss, Wegovy improves several interconnected health factors.
Cardiovascular Risk: It is the first weight-loss drug officially approved to specifically reduce the risk of serious heart and circulatory issues in overweight/obese adults.
Blood Sugar & Insulin: It helps the body release insulin when eating and stops the liver from producing excess sugar, lowering overall blood sugar levels.
Inflammation: Clinical studies show it reduces systemic inflammation markers and lowers blood pressure.
Liver Fat: For individuals with metabolic dysfunction, it reduces fat build up and scarring in the liver.
All of that sounds like it would benefit me more ALONG WITH losing weight. Also… cheaper! Well, just by 30 euros a month but still. And it comes with its own needles, plus is way simpler to use. So I am feeling like I made a mistake going with Mounjaro but I’m in now for at least this first month. Wish me luck!
casa azahar 