New Adventure with GLP-1

My heart Doctor recently suggested that I might be a candidate for one of new drugs being used for weight loss. I have always thought that I could do anything that I set my mind to. After 30 years of being overweight, I have never been able to override myself and make the necessary changes needed for weight loss. No excuses. After the recommendation by my Doctor, I began to look into these new drugs. I had been prescribed Fen/Fen (sic) back in about 1996. It actually was working for me when researchers began to see problems with the heart when using this drug and my Primary Doctor immediately discontinued the prescription.

After learning all that I could about GLP-1, I began to wrap my head around the fact that I probably could not get to a healthy weight by myself. I met with my heart Doctor again in January and he prescribed Wygovy for me. When I went to the pharmacy to pick up the drug, I was told that my insurance company did not cover the drug and my cost would be $1,650 per month. Susan and I had just changed Part D Medicare providers and Cigna denied the claim for the drug. The Doctors office staff appealed the denial and the claim was denied again. I was told that the drug company has some programs for patients without insurance. It looked like I could apply for a grant and maybe get the drug for about $650.00/mo. I looked into other alternatives to get the drug and the all involved "compounded drugs". I had been warned against these options by my heart doctor. I took the position that maybe I was going to have to do this without help.

My son, Blair works for an insurance company in California that provides medical mal-practice insurance in several Western states. He has a large number of contacts in the medical profession. I was discussing the Wygovy issue with him and he said he had been contacted by one of his friends and colleagues who had recently retired from a 40 year Internal Medicine practice in the Bay Area. She had told him she was doing some innovative things with GLP-1 drugs, using a Canadian pharmacy and a different dosing strategy for weight loss. Blair thought of me and proposed that I meet with the Doctor.

I had a phone conversation her and set up a tele-health appointment. In the meeting, she outlined the program for me. The program would consist of a concierge type relationship with her, for which I would pay a flat fee. She would arrange for me to purchase the drug from a Canadian pharmacy and provide medical guidance for the weight loss process.

I was given the pharmacy information and I contacted them in Canada. I purchased the re-usable drug pen for the 2.4mg dosing for about $550.00 including shipping. Just a side note here. The dosing schedule for Wygovy starts with a very small dose of 0.25 mg./week, and increases to a maximum dosage of 2.4mg/week. If you buy a months supply of the drug at the 0.25 mg. dosage, it costs the same as if you buy a months supply of the drug for a 2.4 mg. dose. The Wygovy re-usable pen delivers 4 weekly doses of the prescribed amount of the drug. So, starting out, you would pay for the pen and it would do four injections of 0.25mg. The total amount of the drug in the pen is 1.0 mg. The pen has four markings on it showing the dose of 0.25 mg. on the cylinder. Each week you dial up a dose of .025 mg. and when the pen has been used four times, you throw it away and get a new one calibrated for the same or new dose for the next month. What my Doctor is doing different is starting with the maximum dosage pen and using it more than four times. In the starting month, I am instructed to count the clicks on the calibration dial and set the pen for eight clicks. This delivers a 0.25 mg. dose. I do that for four weeks and I will have used 1.0 mg. of the pen's 9.6 mg. capacity. I have 8.6 mg. left in the pen. In the second month the protocol is to increase the dosage to 1.0 mg. per week. When that happens, she will instruct me to dial up 32 clicks on the pen to deliver 1.0 mg. At the end of month 2, I will have used 5.0 mg of the pens capacity of 9.6. I am assuming she may adjust the dosage a little to make the remaining 4.6 mg. last through the third month. Doing the math, the original pen that cost $550.00 has been used to deliver doses for three months. The per month cost of the drug is now $183.00. Compare that to the original retail price of $1650.00 or even the Canadian pharmacy price of $550.00/mo. This works out to be much more affordable than even the "compounded" drugs.

To start the treatment, I contacted the Dr. using Face Time . The task was to work me through the injection process. I had had a lengthy discussion with the pharmacist regarding the mechanics of the injection and had watched numerous YouTube videos about the subject. After some discussion, I set the pen to 8 clicks, attached the needle and did the injection in my belly fat to the right of my belly button. I was surprised that there was literally no pain. I pushed the button on the back of the pen and counted to 6. I then removed the pen and looked at the counter window. The window had reset itself to "0". The Doctor told me that re-setting to 0 means the dose was delivered. First mission accomplished. The Dr. then instructed me on how we would communicate in the future. I am to send a text message to her, each week when I do the injection giving her my start weight, and my current weight on the morning of the injection.

Today is the beginning of week 2. I weighed my self and administered the injection. I had lost 6 lbs in the first week. Everything that I read says that the initial 0.25 mg. dose is meant to see if the patient can tolerate the drug and what side effects may occur. I did not notice any effect at all in the first week. I don't feel that my appetite is any less, nor do I have any indication of side effects. I was very mindful of my eating during week one. I really attribute the week one weight loss to my efforts. I wanted to commit to eating better, even before I see effects from the medicine. My Doctor says that the drug can start working in the first month. It does not matter how I did it. I will take a 6 lb./week loss anytime.

One day after my second injection, I finally felt some effect. I went to breakfast with Susan at about noon. I ordered a relatively light breakfast. Ham, eggs, toast and fruit. I was not able to finish the fruit. Later in the day we ended up at our favorite pizza place and we ordered a small pizza to go and a pint of IPA. We sat in the restaurant drinking the beer while we waited for the pizza. The beer didn't taste as good as it should have. I struggled to finish it.... We were on the road in the motorhome, so we enjoyed our pizza there. I was only able to eat 2 pieces of pizza and 2 hours later when we got home, I still felt full. It is now noon on the next day, and I am hungry but not craving anything. Funny feeling...

2/28/2025: Last day of being 70 years old. Yesterday was a bit different from Wednesday. I did not eat until about 1:30 PM. I had half of a sandwich from AJ's. After Susan's medical appointment, we went to Casa Lupe. I had about half a basket of chips with Guac and salsa. I ordered flautas with whole beans and rice. My wight jumped up 2.5 lbs! Gotta not do that.

Susan has organized a family dinner at Chinese Garden for my birthday tomorrow. I am going to have to be very mindful of what I eat. I love their food and I love having dinner with my kids.