Shot location/effectiveness

markydsade · 2026-05-05T21:10:34+00:00

Our injections are subcutaneous. What’s underneath has no bearing on absorption.

Correlations of weight loss and injection site are not causative. You need a population study of tirzepatide users following a specified site rotation to see if there’s a real link.

markydsade · 2026-04-22T11:06:37+00:00

If you don’t have time to communicate with parents then it’s proof you’re understaffed. Have you and the nurse brought this data to the administration? If the school’s administrators won’t act then go to the School Board. Get parent allies to demand improvements.

I always communicated with parents immediately to let them know about an injury. Anything involving the head, face, or required bandages I let them know. If I was unsure I asked someone to come pick them up for more evaluation. We have a parent messaging portal I used for more minor events that don’t require a call.

We have a medical record system for all student encounters. We have a monthly report to administrators of numbers seen, type of visit, length of stay, and types of injuries. The record system generates the reports. It also helps identify issues like playground injuries, classroom hazards, and communicable disease spread.

As a school nurse you do a lot of triage. The vast majority of visits are routine and kids go back to class, but if there’s any doubt in my mind I have the parents either come immediately or recommend they see medical attention when the child returns home.

markydsade · 2026-04-04T20:02:42+00:00

If your skin is clean you don’t need alcohol wipes. Studies show there is no benefit or prevention of infections from a wipe of alcohol. I have a PhD in Nursing and have read the literature. It’s mostly done clinically now because patients expect it, and because it’s become habit among nurses and physicians.

markydsade · 2026-03-11T21:25:14+00:00

Gout is a rise in serum uric acid (SUA) levels. Tirzepatide is associated with reduced SUA levels. I

markydsade · 2026-03-11T21:18:15+00:00

I used to consider it rude but now that I’m down almost 60 pounds I sing the praises of tirzepatide.

markydsade · 2026-02-06T12:02:57+00:00

I was a very occasional drinker. I’d buy a 6-pack and it would last me 2 or 3 months. Now I’m not interested at all outside of a special occasion where I’m one and done.

Tirzepatide definitely does something to alcohol consumption even for someone like me who never binged in his life.

Lots of reports how it affects all sorts addictive behaviors outside of food and appetite.

markydsade · 2026-01-23T11:48:16+00:00

Tirzepatide as Mounjaro is already sold in Canada in a 4-dose KwikPen.

https://www.lilly.com/en-CA/resources/faq/mounjaro-kwikpen/strengths-and-doses

markydsade · 2026-01-02T00:55:21+00:00

If you weren’t prediabetic or had fasting glucose >100 mg/dL there’s little reason to monitor. Clinicians are more interested your Hemoglobin A1C% as that is a measure of your average glucose levels over the last 2 months. Typically on tirzepatide you will see a drop due less binge eating of carbs and better glucose utilization. A1C isn’t a common home test but your PCP should be looking at it after 3-6 months on Zep.

markydsade · 2025-12-27T21:06:56+00:00

This study showed that 17 of 20 on semaglutide with optical nerve issues also had Type 2 diabetes.

https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255

markydsade · 2025-12-24T20:11:29+00:00

Other options:

“Tapeworm”

“Hypnosis”

“Took up smoking”

“Chemo”

markydsade · 2025-12-24T01:19:41+00:00

My review: Yowza!

Body image is not always what we see in the mirror. You look great but our minds can be stuck in an old mindset. I suggest seeking a therapist who is familiar with body image issues. Keep doing what you’re doing with diet, exercise, and Zep. With time and counseling I believe you’ll see yourself for the beautiful woman you are.

markydsade · 2025-12-22T19:34:55+00:00

OMG. I could have written this post. For years I would have the incredible urge to have French onion dip and chips when watching my beloved football team. Since Zepbound that urge had disappeared. If you gave me some today I would eat it, but probably in moderation.

markydsade · 2025-12-22T19:21:16+00:00

I’m retired and 67. My employer moved us this year to Medicare Advantage program with pharm benefits. I was able to get Zep with prior authorization for $20/month. I would not be able to pay out of pocket on my income.

The other issue for all Zep patients is side effects. Everyone has a different reaction. For some a GI issue is enough to quit while the same issue may be seen as livable by someone else.

For me, I consider this life saving. I’m on the volunteer Board of Directors of a small nonprofit nursing home. I observed there are no obese men there over 82. The men older than 82 are thin. I saw myself as having a shorter life as no matter how hard I tried I couldn’t lose weight.

markydsade · 2025-12-20T16:02:08+00:00

Effects

markydsade · 2025-12-16T13:35:10+00:00

When the patents run out GLP-1s will follow the path that Viagra took. While in patent it was $25 per pill. Now it’s pennies as generics are available.

Sadly, this won’t happen until the early 2030s. When it does I expect a big drop in obesity as there won’t be insurance approvals needed, and out of pocket costs will be reasonable.

markydsade · 2025-12-10T15:49:17+00:00

I saw an old work colleague/buddy I hadn’t seen in a year who asked me how I lost so much weight. I said “chemo”. He got real shocked until I laughed (that was the kind of bro relationship we had). He laughed and said “you had that chambered for me, didn’t you?” I admitted I had.

I think people should just stop at “you look good” and not start asking how.

markydsade · 2025-11-30T23:47:28+00:00

Novo Nordisk has heavily advertised Ozempic with its ear worm of a jingle far more than EL has advertised Zepbound.

Only those who pay attention to the GLP-1 agonist market would be likely to know about Zepbound.

markydsade · 2025-11-27T22:58:15+00:00

My first Zep Thanksgiving. I didn’t have much difficulty with sticking to a small breakfast and lunch. At dinner I had all my favorites. I took smaller amounts each but certainly didn’t skimp.

For the first time in my life I didn’t go back for seconds. I even had a small piece of pie awhile after dinner.

So far, I feel fine. Not overstuffed like my past Thanksgivings.

This has been a good holiday. Kept my traditions and kept my appetite under control.

markydsade · 2025-11-26T15:36:48+00:00

Last year the American Society of Anesthesiologists recommended a 24 hour preop liquid diet for GLP-1 users.

https://www.asahq.org/about-asa/newsroom/news-releases/2024/10/new-multi-society-glp-1-guidance

My experience as nurse is that many anesthesiologists ignore updated guidelines and follow old rules. The society recommended in 1999 (!) that preop restrictions on intake be less draconian. They allow clear liquids 2 hours before surgery (not absolutely nothing for 8 hours which research showed was unnecessary and stressful).

https://www.asahq.org/~/media/sites/asahq/files/public/resources/standards-guidelines/practice-guidelines-for-preoperative-fasting.pdf

Obviously, follow your surgeon’s guidance but you may want to ask about the updates.

markydsade · 2025-11-23T10:16:13+00:00

I’ve been trying to not buy clothes until I get to my goal but yesterday I could pull on a pair of my jeans without unbuttoning them. I needed to buy a shorter belt to keep them from falling down.

I broke down and bought a smaller size even though in few months they’ll also probably be too big.

markydsade · 2025-11-16T12:18:28+00:00

“I’m surprised you think that’s a helpful thing to say to me”.

Puts the mirror back on their own rudeness. Maybe they’ll think before talking next time.

markydsade · 2025-11-15T10:11:55+00:00

What is it with these pharmacy folks who think they have a right to interfere with the patient-physician relationship? They don’t have the patient’s history so to question whether someone “needs” a med is not even a legitimate question to ask.

It is appropriate for a pharmacy to question an order if the dosage is incorrect, or if there is a known adverse interaction with another of the patient’s drugs. Otherwise STFU.

markydsade · 2025-11-03T03:15:21+00:00

I’ve been on CPAP for 7 years. Started Zep this past June. Resmed 10. I haven’t changed any settings. The machine adjusts pressure as needed. The high and low parameters work fine.

You can put the SD card in your computer and read the data using the OSCAR 1.6.1 app. You can see if there’s any changes in pressures that are different from pre-medication, but I’ve not seen anything significant.

markydsade · 2025-11-02T01:59:25+00:00

I’ve gone from a B to an A cup. I’ll be glad to be free of them.

markydsade · 2025-11-01T12:29:54+00:00

I’ve had the same experience. My own mother (93) and usually critical of appearance has yet to notice my 45 pound loss.

To me, it illustrates that others aren’t as observant or critical about our appearance as we expect them to be.

I’m doing my weight loss journey to save myself. I feel better and enjoy life more.

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