Mount Kilimanjaro Travelogue: Weekly Update

Hurricane Milton, now a Category 5, bears down on the Florida peninsula. As I write this, I am preparing for the worst. I have often stated that writing is therapeutic for me, so I’ll take a break from my hurricane preparations to share my Mounjaro update and my damn fool opinions with you.

No, I am not on a journey and this is not a travelogue. Yes, I am crazy. So where did the title come from?

An Ernest Hemingway fan, I’m not. I have never been to Tanzania. What’s up with Mount Kilimanjaro, already? Well, I’ll tell ya. Facebook removed my last update because their CommunityStandardBot detected the name of a current vogue drug, Mounjaro. Throughout the history of the commercialized Internet, spammers have used popular keywords to attract attention to unrelated posts. Therefore, Facebook shit a brick thinking I’m spamming my Facebook friends.

I’ve appealed their decisions, but because they’re idiots in charge of social media lunacy and have complete control, I’m not likely to win.

Moon over Mounjaro

Posting a picture of a Mounjaro (there, I said it again) injector pen also triggers Facebook’s schizophrenic paranoia. Therefore, I have replaced that image with something more consistent with the title of this week’s column. The picture at right adds a full moon rising over Mount Kilimanjaro. It is symbolic of the moon I would love to shoot at the entire Facebook executive suite. In any case, I will continue to provide these weekly updates while I am on Mounjaro.

Subscribe and Save

If you want, you can subscribe to this blog by entering your email address. You’ll receive an email notification whenever I post a new column. Then, we won’t need to dick with Facebook. Nevertheless, I shall continue to attempt to post links to my Facebook accounts.

Mounjaro Off Shortage List

During the week, the US FDA removed all doses of Mounjaro and Zepbound from their shortage list. As I reported last week, this means compounding pharmacies and their telehealth partners are in deep shit. They will be unable to sell copycat tirzepatide, the generic name of those two drugs.

Panic is evident among the gratuitous weight loss community. They feel that they have a right to the generic drug at whatever price they feel is “fair”. Sensing the forthcoming shutdown of the compounders, they are now exhorting manufacturer Eli Lilly & Company to provide them “fairly priced” name-branded Zepbound. Their logic is that Lilly giveth and Lilly taketh away, so maybe give back a little. By declaring to the FDA that the shortage is over, Lilly set the process in motion for disallowing most compounded alternatives. By rule, most compounding pharmacies must cease and desist. Thus, addicted customers are denied their fix and are whining up a storm.

Money Talks and Bullshit Walks

We all know that money talks and bullshit walks. Those alarmed customers will make much crowd-sourced noise, thinking they have sufficient market power to impel Lilly to think twice about pricing their now monosourced product. After all, “influencers” used their influence to influence Lilly to “release the vials” at a reduced price. (I explained that move in a prior post). Lilly prices their name-branded product too high for some current buyers of the generic product. But why would Lilly care? They’re not in business for our health, as the saying goes.

Bernie Sanders and the U.S. Senate can conduct showboat investigations of drug prices all they want. Are you taking that pre-election bait? It’s all nudge-nudge, wink-wink shenanigans. They know that money talks and bullshit walks. Politicians are always spewing the latter, because the money will flow to them one way or another.

I do not blame Lilly for wanting to recoup their investment in the product’s development, manufacturing, and marketing. Parasitic compounders can provide cheaper products because they did not make those heavy investments, and now the jig is up. No more gravy train.

When Did Crying Poor Mouth Ever Work?

Lilly should therefore use its big bucks and the legal system to protect its patents. The “but I can’t afford the brand-name prices” argument is specious. It is tantamount to my HOA neighbors loudly protesting a well justified fee increase because they personally cannot afford it. The increase is necessary because irresponsible prior HOA boards had kept fees too low for too long, acceding to the wishes of the poor-mouthers and compounding the problem as time passed. The objectors ignore what the community budget makes plainly evident. It’s all about them, you know, even when they altruistically band together to rectify systemic injustices that imperil their personal coffers.

If they cannot afford the prevailing prices, they can find weight-loss alternatives that are more affordable. Not eating is dirt cheap, for example. I’ve often stated that those who want to lose weight could use the money they are spending on tirzepatide to hire a dietitian, a psychological counselor, and a personal trainer, and still have leftover money for a Glamour Shot of their slimmed-down bod.

That concludes my weekly Mounjaro-related rant. Now onto other subjects.

How Am I Doing on Mounjaro?

While not Mounjaro related, I’m going to get an MRI later today—that is, if the imaging center doesn’t decide to close for the coming storm. Last week, I mentioned that I had tweaked my back while on vacation in September. I have been dealing with back pain and sciatica symptoms since then. We’ll see where the imaging leads. I’ll keep you in the loop. Back to my ongoing Mounjaro therapy and related subjects.

Glucose Tracking

I had previously mentioned that I started using a Dexcom Stelo glucose biosensor, an over-the-counter continuous glucose monitor. The first 15-day sensor worked well. However, the second one started giving me erratic readings, typically 20-30 mg/dL higher than my blood glucometers. I contacted Dexcom customer service, who investigated my claim and agreed to provide a replacement. It arrived three days after they opened my case. Now THAT’S excellent customer service!

I’ll wait until after my MRI to attach the new biosensor. Dexcom warns customers not to wear them while undergoing magnetic resonance imaging, lest they incur damage to the product. I’d also be worried about causing the little lithium battery in it to explode on my arm, but no need—the radiological techs would make me remove it, anyway. In this connection, my lovely, comedic wife Jenny retorted that someday, the Israelis will figure out how to incorporate Semtex and a detonator in Hezbollah continuous glucose monitors, much as they had done with pagers and handheld transceivers. But I digress.

The Numbers, Already!

My average glucose for the week, as measured by my glucometer (Ascensia Contour Next One), was 109 mg/dL, up one from last week. Call it flat. I am pleased with my glucose progress, the result of dietary adjustments and Mounjaro.

Blood pressure continues to be higher than it was before my vacation and my bout with Covid, which raises concerns about undetected Covid-related issues causing secondary hypertension. Also, my back problem cannot be helping. The average for the week was 134/76; last week, it was 135/80.

Finally, my weight decreased by five pounds during the week, perhaps related to some “distress in the lower tract,” as the old Pepto-Bismol commercials called it. Over two weeks, my weight loss was 3.6 pounds, which is in the acceptable range. I do not want to be losing more than one to one-and-a-half pounds per week. The main objective is to control blood glucose; my doctor and I agree that we’ll take the weight loss if it comes. Accordingly, I remain on a low dose of Mounjaro, still 5 mg.

Hurricane Milton

As I write this, Hurricane Milton is a Category 5 storm. It has taken direct aim on Central Florida, where we live.

We were preparing to breathe a sigh of relief, thinking we got off easy when Hurricane Helene dealt only a glancing blow less than two weeks ago. Alas, now we’re more directly threatened by Milton. To compound our problem, debris associated with Helene still hasn’t been completely removed.

Furthermore, another rainmaking storm has been hanging around our area dumping several inches of rain since Sunday morning. Forecasters expect Milton to produce an additional eight to twelve inches, hence flooding will be a severe problem. Some Central Florida communities have not yet recovered from the flooding associated with Hurricane Ian, two years ago.

We have not had a hurricane as powerful as Milton in Central Florida in my forty-eight years here. In 2017, we had Hurricane Irma, which precipitated my re-roofing and interior drywall repair. Twenty years ago, Hurricane Charley, who made landfall on the Southwest Coast and whose sustained winds were down to 100 mph when he arrived was a more compact and faster moving storm. Nevertheless, it dealt a catastrophic blow to the Orlando area. A good friend of mine lost his house to Charley. It was damaged beyond repair.

Mounjaro Shipment Delayed

I just got a call from Express Scripts, the dreaded PBM that fulfills my prescriptions when I get pissed off at Publix. I had ordered a three-month supply of Mounjaro from them, which they say will be delayed due to Hurricane Milton. They will wait for carriers to resume operation, then they will expedite my shipment via an express delivery agent. I was grateful for the call, because I had been concerned that my Mounjaro would be blown away or ruined if delivered around Milton’s impact period. So, one fewer thing to worry about.

My current stock of Mounjaro is sufficient to get me through a few weeks. However, I still have some concerns about how I will refrigerate it if we have a protracted power outage. I do not have a generator, but I have a couple of battery powered refrigeration devices that will work until the batteries lose their charge. I have enough fully charged LiFePO4 batteries to keep things going for a couple of days. After that, unless I can find a local friend with power and refrigerator space, I would need to accept Eli Lilly’s word that the drug is good stored at room temperature for up to twenty-one days.

That’s All for Now

I’ve prattled on long enough, letting you know about the end of the shortage, my progress on Mounjaro, and the one thing on everyone’s mind here in Central Florida, Hurricane Milton.

While I am uneasy (to put it mildly), I’ll “hunker down” and hope for the best. I plan to be back here writing another weekly update for you next week, come hell or high water—and we’ll have plenty of both! I’ll let you know how Milton treated us.