Susie Continues Her Ozempic Journey: Month 3 Artwork

Dr. Pepper....Really?

Welcome to "Dr. Pepper...Really," where Dr. Gary Pepper—a board-certified endocrinologist and Associate Professor at a major U.S. medical school—delves into the world of metabolic health. Join him as he interviews individuals sharing their personal journeys with metabolic issues and chats with experts in metabolism, nutrition, thyroid disease, diabetes, hormone imbalances, weight management, and more. The show aims to provide you with valuable insights and perspectives from top professionals on common yet critical issues affecting your health and well-being.

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Dr. Pepper....Really?

Susie Continues Her Ozempic Journey: Month 3

January 24, 2024 • Gary Pepper, M.D. • Season 3 • Episode 3

In this engaging follow-up episode, Susie enters the 14th-week of her journey with Ozempic, highlighting its impact on her health and lifestyle. Initially hesitant about injections, she finds them surprisingly easy and experiences significant health improvements without major side effects, except for an isolated heartburn incident. Remarkably, Susie notes a shift in her eating habits, feeling full sooner and savoring food without overindulging. She's thrilled with a 14-pound weight loss and improved energy levels. Medical check-ups show encouraging results, particularly a notable decrease in her A1C levels, pushing her out of the diabetic range. Susie's commitment to a healthier lifestyle, including smarter food choices and ongoing medication, is evident. The podcast touches on broader issues of medication accessibility and the psychological aspects of weight loss, providing food for thought on this modern approach to an age-old challenge.

Gary Pepper, M.D., an associate professor at a prominent medical school and endocrinologist with 40 years of experience, brings clarity to numerous topics within the field of metabolic health. His view points are unhindered by corporate interests, unlike many other current "thought leaders" in medicine. Dr. Pepper, a dedicated educator, established his homebase website www.metabolism.com in 1996 and has blogged on important topics since then. Not one to be left behind by technology he began podcasting in 2020 with the onset of the pandemic and continues publishing vlogs on YouTube at his channel metabolism123. So whatever your choice in media, you will be gaining fresh insights by tuning in to his opinionated shows or reading his blogs on critical health topics.

1:00:00

[Music]Welcome back. Here we are at Dr.Pepper, really. We have Susie with usagain who is on herosempic journey and she has told methat she's doing well. So Susie, whydon't you fill us in?How are things going? I'd be glad tofill you in Dr. Pepper.Nice to see you again.Things are going very well. When Ilast spoke with you, I had been onweek three of taking theosempic, still at a subtherapeuticdose. In other words, taking it butnot enough to really haveeffects. At the suggestion of mydoctor, I increased it to 0.5milligrams after week four.And that's when things really startedto happen. I am now 14 weeks intothis, so time goes byquickly. And I'm still taking theplain five milligrams. Right from thebeginning, I reallydid not have a problem doing theinjection. I mentioned last time theneedle is super tiny.Even though I'm a nurse practitioner,I don't love injections.Never like giving them,never like getting them. This isreally nothing and takes about asecond to do. Very clear,very easy. It's an actual, it lookslike a pen and you dial up your doseand inject it. It takesliterally a couple of seconds. Sothat part's been great. What's reallybeen good is I've beenfeeling very, very well. I know thereare concerns aboutside effects with osempic,including GI things like nausea,diarrhea, constipation. And really,I've not experiencedthat. I did have one day when out ofthe blue, I had really, reallyintense heartburn and veryuncomfortable to the point where Ifelt like almost like I had to laydown, which is not theright thing to do for heartburnanyway. But I felt reallyuncomfortable. Thatlasted through theevening, through the night, throughpart of the next day. I took a littlepepcid to help calm itdown. It went away and it has notcome back since. So has that kind ofsymptom happened to youbefore where you've had such badheartburn? I mean, are you sensitiveto coffee or something?Actually, yes. In the past it has. Itake medicine on aregular basis for heartburn.So it had happened in the past, butthis was unusual in terms of theexpense of it and theduration of it. Okay. But you saidthat hasn't come back again. You'repretty good with that.How about things like craving? Do youhave that? That's been so interestingbecause as I talkedabout in the first one, the firsttime we met, I love food. I love toeat. I look forward togoing out. I look forward to havingdinner with friends. I've still hadthe feeling of, oh boy,I can't wait to eat something, butnot in so much in the craving way.That's been a reallybig noticeable change. So I'll stilllook forward. I think last time Italked about having a muffinwhen having coffee with a friend,I'll still think this is great. I'mgoing to have coffee in amuffin. I'll look forward to it. I'llorder the muffin. But what I find isI eat like a third ofthe muffin and I'm full and I takethe rest home and I have it for thenext day. That's a bigdifference as opposed to sitting downand saying, here it is. I'm justgoing to eat the whole thing.I'm kind of glad about that because Idid not want to lose sort of thepleasure I get from eatingand food and all the socializationwith that. Right. Haveyou noticed any change inlike change in your body shape?People talk about theirface getting thinner orthey're losing tone intheir arms or things like that.Yes, actually. Probably because I seemyself every day. I don't notice itas much. A few people havecommented to me that I do seem alittle thinner. I can tell you Iweigh myself every week and sincestarting this journey 14 weeks ago,I've lost 14 pounds.Terrific. And do you overall,do you notice how you feel like yourenergy or anything?I do. I feel a little more energetic.And as you know, it's veryreinforcing. So if you get on thescale Friday morning before doing theozepic, which is my routine, and Isee, oh, I lost half a pound,three quarters of a pound, a pound.It's very motivating to want to keepdoing and doing thethings that may be working. I'm alsotrying to eat a little bit healthier.Sure. Shopping theperimeter, like you said, I'm gettingto know the parameters, we're gettingto know each other more.And, you know, seriously, what I'mdoing is if I'm in thesupermarket, I'm not gettingtwo kinds of cookies, maybe I'll getone and I'll notice I haven't eveneaten them or I've had oneand that's more than enough. Really,really amazing, huh?Okay. And you saw your doctorrecently so far. And what I did, Ihad my follow up withmy doctor several times.I did and it was a virtualappointment. What I did is I went tohave lab work doneabout five days before theappointment. And there wasimprovement. Myconcern was the biggestconcern was my A1C, which measureshow your diabetes is going.And mine was on the higherside. And it now went down. It wentdown to just above normal rangeaccording to the lab that we'reusing right now. And when I spoke tothe doctor, she said, I'm not in therange of diabetes anymore,which was really good. I was just onthe very edge of that diagnosis. Andthat's what reallypropelled me to think I can't dothis. I need to makechanges. That went down.Can I interrupt you? But not a lot.How many points or half a point? Howmuch did it come down?Do you know? Did it come down a half?I'm trying to thinkabout it. I think I went.No, it went more than half a point,about three quarters of a point.Great. And that's a very short periodof time. So what's your plan?What's the next step? My plan isthat, and I discussed this with thedoctor, because I thinkit's really important to know thatthis is a medicalsituation. This is not, kind of,because everyone talks about ozemphicas being almost so trendy. I don'tsee it as trendy forme. I see it as something I want tobe healthy. And so I do things thatmy doctor recommends.If I have questions, I'll ask thedoctor about it. And my choice is tocontinue with what I'mdoing right now. She said it would befine to increase it if I wanted to,but it was also fineto keep going at the dose that I'mon. And my feeling is if I'm nothaving side effects,I am losing weight. The cravings arebetter. And most importantly, my labwork is showing thathopefully my health is better. Iwould like to continue with what I'mdoing. She said that ifabout a month goes by and I do not, Ihit a plateau and don't lose any moreweight, that I should getin touch with her office aboutperhaps repeating a lab and perhapsincreasing the dose. But rightnow I'm going to stay where I am.Have you noticed any change in yourhair, skin, or nails?I would say no. No, I would saythat's about the same right now. Idon't see a big difference.One thing I can say is that I wassomeone that was constantly runningto the bathroom everywhere Iwas. I'd be, I have to pee, I have topee. And that's happening less. Andmy doctor said, andyou know, Dr. Pepe, you're anendocrinologist. Maybe you can helpvalidate this as well. Shesaid that maybe as my sugar level hasgone down the glucose level, the needto urinate has changed.I wouldn't expect that. No, not forthe type of blood sugar issues thatyou had, but maybe you'redrinking less. You know, you'reeating less. Yeah, could be. Yeah, itcould be. How about your mood?Did it affect your mood at all? Imean, your mood seems pretty good. I think the only effect I seeis feeling very happy about how it'sgoing. It's a little bit going fromfeeling so out of controlabout something to feeling likehaving a little bit more control. AndI think that can only helpsomebody's mood. And I feel good. Itmakes me feel like we talked aboutthe caretaker situation.This makes me feel that I'm takingcare of myself better, which ofcourse makes me more able tocare for other people as well. So mymood's been great. How about sleep?Any change in your sleeping?So far, I don't see a change. I sleeprelatively well. So I don't seemyself having a problem withsleep. I don't feel excessivelytired. I wouldn't say I feel like Ihave a little bit more energy.So that's a good thing. But I wouldnot say my sleep and per se has beenaffected very much.All right. I think what we'll want todo is catch up with you again in acouple of more weeks.You said that you're not going toincrease your dose, but at this rate,you know, there's goingto be further weight loss and it'llbe great to see how, youknow, your body's reacting,how you're reacting and see how yourgoals may change and maybe yourlifestyle as well.Definitely. Yeah. So you were sayingthat you think that there were a fewlittle bumps. Whatwere those bumps? They had nothing todo with the ozimpic itself. It had todo with the systemaround getting the ozimpic. So onething was I was out of town visitingmy son. I went to usethe ozimpic pen and perhaps I somehowmissed the information. It comes withfour needles. You attacha different needle each time. Itcomes with six of those, but thereare only four doses in each pen.Somehow I missed that fact. I was outof town, went to use the ozimpic andthe pen was empty.So what I ended up doing was it's alittle tricky to get sometimes, but Iuse a very well-knownpharmacy. I was able to contact apharmacy where I was. They actuallyhad me go to their settingin a hospital because they said thehospital pharmacy might be morelikely to have it.So I was able to get it, but that'sjust a little tip. There's fourdoses, even though there's sixneedles. The other bump has to dowith insurance. I went to get the penrefilled. I do it allvirtually and then I go pick it up,but I got an email saying it wasn'tcovered. I had to getanother pre-authorization. I'mcurrently waiting for thepre-authorization.The insurance companysaid at the beginning of the calendaryear, you need to do that. So I amhoping I'll have myozimpic by this Friday, but we'llsee. Okay. Let me run an idea pastyou. I was reading aboutfrom another doctor that the bigproblem that happens to a lot ofpeople is when theycan't get the medicine, they can'tafford it, or they decide to stop itor something along thoselines. They gain their weight back.The reason that most experts aresaying, "Well, because you'vegotten spoiled using an injectioninstead of the self-control that youmight get if you were on aweight watchers or some otherbehavioral type of program," thatbecause people using the injectionsthat they don't have that, they goright back to their old habits. Soone of the suggestions bythis particular physician was maybepeople using injections should onlyuse it every other weekso that on the off week, they knowthat they have to keep an eye ontheir lifestyle and behavior.They can't slip back into their oldbad habits. And maybe that by doingit every other week orsort of an intermittent schedule,that they can combine thegood part of the injectionswithout bringing in the bad part ofthe lack of lifestyle motivation.Does that sound at all practical fromyour point of view?Yeah. Everything about weight loss isso complicated, isn'tit? And I think my honestquestion is, I'd love to address thatin the future. Right now,I don't know. I'd like tocontinue with what I'm doing. When Ihopefully lose more weight, and itcomes down to a questionof, "Do I keep doing this forever? DoI stop it? Do I do itintermittently?" Ithink I would thinkabout it more then. So I don't know.My understanding insome of the things I readis that it affects a part of yourbrain that has to do with cravingsand things like that.So if that's true, it makes me alittle worried about what wouldhappen if I wasn't taking itanymore. On the other hand, maybeit's reinforcing enough and everyother week is a great way to go.So I'd like to think about that. Youraise a very interesting questionthat I don't give a lot ofthought to. Well, we're all learningtogether. It's a relatively newapproach to an old problem.So thanks again, Susie. To use anexpression, it's alot of food for thought.[laughter]Corny. Hey, that's another pun,right? Anyway, so great speaking toyou, and let's arrangeour next session in a few weeks. Heythere. So that aboutwraps up our episode on SusieStotzozimpic in her third month now.And I hope you enjoyed it and gotsomething out of it. Andwe're very proud of Susie that she'sdoing so well andshe's very articulate abouther process and the ups and downsthat inevitably occur in such asituation. And I was recentlyimpressed with a news story that Isaw about people who were usingOzimpic and losing their hair.And having been an endocrinologistfor 30 years, it was clear to me thatthis could be a hormonalissue that people can run into usingthese powerfulmedications. And also the weight lossitself is associated with a lot ofbodily changes that could impact theperson in such a way. Hair,skin and nails are very sensitive toweight loss. So I'm doing a show onthat and you can find thaton my YouTube channel Metabolism123.And click on our show and subscribe.Any little bit helps.We're a very small channel and we'revery well kept secret, which I'd liketo fix. Thanks a lot.[Music]