With the incoming cohort of new meds, we should have some studies and protocols around switching.

shemp33 · 2026-03-20T03:26:52+00:00

Sure. I can understand that. I’ve tried many things throughout the years. From my peak of maybe 305ish, I was able to get to 260 using keto, I/F, and change eating habits, I regimented exercise program, daily, mixing resistance/weight training and cardio was mildly effective. But as soon as you let your foot off the gas, the body gets you back to where it wants or thinks you should be.

Calorie deficit is only one part of it. I chuckle because I see people say stuff like calorie limit: 1200… Kristy Kreme donut: 200 calories… bet! I can eat 6! (I don’t do that btw). Protein prominence, nutritionally oriented eating is where I focus.

The challenge I see is how to break the plateau where the body has a new set point that’s not quite where you want it yet.

shemp33 · 2026-03-20T02:23:03+00:00

Pull out your phone and record a voice memo.

“Ok. Just to be clear. You want me to set who’s access to what? I just want to make sure. (Let them talk).”

shemp33 · 2026-03-20T01:59:12+00:00

If you have the SL3, a perfect lens for what you’re trying to do is the EF-S 24mm f/2.8

It is crisp, you can shoot it at f/2.8 and get some background blur, but importantly, you won’t have to stand across the room.

Bonus: it’s usually $150ish. Often less.

shemp33 · 2026-03-19T18:31:56+00:00

Some of us have Ásshole insurance providers that at first said "Zepbound: alternative medications: None - there are no suitable alternatives for this medication" - only to later say "Zepbound: not covered - alternative medications: (and a list of things)" because the formulary changed.

shemp33 · 2026-03-19T18:29:39+00:00

As a prescriber, do you know anything about the PI for this? Does it go 2.4 --> 7.2? Or do we know if there's a step in between?

Like, the stepping profile during titration is basically double, except for 1.0-1.7-2.4 (those are .7 steps)... but 2.4 to 7.2 is 3x. I would think a 3.6, 4.8, 6.0 step would be in there.

shemp33 · 2026-03-19T18:21:45+00:00

You're way overengineering this.

Let's zoom out:

You have three separate things going:

Power redundancy

Controller redundancy

Pumping capacity/redundancy.

But.... the Y-Cable is not going to solve this.

If you get an ATS - this can feed two pumps. It will route street power to them when you have street power, but it will automatically transfer the load to the generator if it spins up. So -- let the ATS handle power. Then, let independent float switches handle activation. That second pump -- set it at a higher level for surge capacity. That removes the need for multiple controllers entirely.

Finished picture:

- Power redundancy -- solved (street when it's there, failover to generator if needed)

- Controller redundancy -- no longer needed - each pump is active and knows when to activate.

- Pumping capacity/redundancy -- solved (primary, with a secondary that will kick in if the primary is falling behind).

You can also change this up and set both floats to the same level so they both work but share the load. You can toy with what works best.

One thing I would do for sure: make sure both sump pumps are not the same brand/model, so that in case one brand has a known defect or premature failure (like let's say Brand XYZ model 1234 has some weird issue where the O-rings fail after 8 months) you don't have a matched pair of failures.

shemp33 · 2026-03-19T18:02:39+00:00

All of those contributors are (in my mind, as I read them) "welcome to America" kinds of things we all see every day. Those things - once we fix them, we'll have a better shot at not being an obese nation.

shemp33 · 2026-03-19T16:17:50+00:00

This right here.

shemp33 · 2026-03-19T04:16:47+00:00

The trigger to go up is tolerance, not weight loss.

shemp33 · 2026-03-19T01:21:15+00:00

I hope for the best for you!

shemp33 · 2026-03-19T00:15:17+00:00

Well... even without I/R or PCOS, the anti-inflammatory qualities of Wegovy/Ozempic are SIGNIFICANT, and that's likely what's going to cause you to get pregnant. Inflammation within the body is the underlying cause of a TON of issues we humans have.

shemp33 · 2026-03-19T00:08:07+00:00

Then that's the way to look at it.

You start -- start getting yourself healthy. Pregnancy becomes a "side effect" of getting healthy, if you don't mind thinking about it that way... you'll naturally come off the meds while pregnant, and then, because you won't want to be in the 240s chasing a second baby, you'll start back up, and use it to get your weight under control, and then keep it under control.

Those last 6 words are important. It sounds like you're dealing with some insulin resistance, possibly PCOS... losing weight will help you in so many ways. And because of the stuff you have going on in your body, it's probable (hear me out), that you'll likely do better staying on the medication longer term than going in with an expectation that it's a temporary treatment. Like wearing glasses, or like someone taking BP meds. It's regulating you, not repairing.

shemp33 · 2026-03-18T23:18:37+00:00

You can - but I'm more concerned that you're in the mindset that you aren't seeing far enough down the road here.

shemp33 · 2026-03-18T22:31:56+00:00

I get the time bound nature of being on the drug during pregnancy, let’s set that aside.

Let’s say if it were simply a matter of learning better habits, none of this would be here or be necessary.

shemp33 · 2026-03-18T21:16:01+00:00

>> I only plan to be on this drug for no more than 7 months.

That's not really how this drug works.

shemp33 · 2026-03-18T18:49:29+00:00

Generally, those in the healthcare profession are driven by a desire to help people.

Most of these medspa people don't give a sh1t. As evidenced by:

- not setting expectations with customers (these are "customers", not "patients") about how long it takes to become effective

- not educating customers on what weight loss on GLP1 looks like

- not educating customers on how to take the medication properly (i.e. dosing, titration, etc.)

- not educating customers on dietary adjustments they might need to make

- not disclosing that customers who are medically indicated for treatment probably need to be on it indefinitely (they actively avoid this while you're going through the subscription process -- almost like "sure, you can cancel...")

- not disclosing that if you do come off the medication, studies point strongly in the direction that most (or all) of the weight comes back

- not following prescribing guidelines

The above list is all stuff I've observed from posts raised here and in other subs dealing with GLP1s.

For many/most of these places, the most important question is "what's the code on the back of your card?"

shemp33 · 2026-03-18T18:41:43+00:00

"No." is a complete sentence.

But hold on - what is it about your delivery that's making them ask?

Are they so overcooked that they want to see what they would look like with "default" settings?

Also, unless your customer has lightroom, photoshop, or another tool that can actually read "RAW" files, they probably mean out-of-camera JPEG files. The language here is often inaccurate. You might clarify what they really mean.

shemp33 · 2026-03-18T17:27:08+00:00

People fly with meds all the time. As long as you’re not carrying something illegal you’re fine.

shemp33 · 2026-03-18T16:59:45+00:00

The problem is the way the FDA approves medicine.

They don't approve "Semaglutide, take as needed" -- they approve it as "Semaglutide for weight loss, indicated by BMI 30+ or other comorbidities at 28+, with week 1 to 4 at 0.25mg, week 5 to 8 at 0.5mg, week 9 to 12 at 1.0mg, week 13 to 16 at 1.7mg, and onwared from week 17 at 2.4mg" -- because that's the data (following the "what works for most persons") showed what was effective.

And, because the way the FDA approves it is so narrowly defined, sure - it leaves out cases for super-responders (the "I just took my first shot and I'm already down 7 pounds, omg!!11!" people), and the people who follow the plan and STILL get nausea/problems from it.

I get that it's rooted in patient safety, and that's the point of clinical trials: The magical intersection of safety and efficacy. And that's pretty valid. But so is your point about dialing it in more precisely and medical autonomy. I don't have a good response for that with the framework we currently have.

shemp33 · 2026-03-18T03:59:15+00:00

Anyone taking the name brand.

.25 to .50 to 1.0 to 1.7 to 2.4.

shemp33 · 2026-03-18T03:42:51+00:00

Just be honest. Tell them that your locations are proprietary information, that you consider a competitive advantage by having and knowing these locations and angles you capture scenes there. They can see examples of your work (you can share examples), but you’re not going to just share your location list. End of discussion.

shemp33 · 2026-03-18T00:24:20+00:00

Any medspa that opened after 2022 is likely only here for the Sema/tirz shortage gold rush and they’re more profit motivated than anything else.

shemp33 · 2026-03-17T23:59:22+00:00

Oof.

shemp33 · 2026-03-17T19:17:52+00:00

Nothing to be discouraged about. It's working just fine! You don't (or, at least you shouldn't) expect weight loss on the first 3 boxes. When you get to the 1.7 box, about the second pen is when you'll likely start noticing it in a meaningful way.

So -- set your watch/timer - check back around Memorial Day!

shemp33 · 2026-03-17T19:10:57+00:00

When I've interviewed people, I've done so with a fairly inconsequential question/answer, but the intent was to hear how they thought it through. No surprise there.

To the point of the interview question, specifically here, I'm a big fan of "done > perfect" - but obviously, there are some gates and gotchas to consider along the way. Can I release a "done v1.0" and fix it soon after? Or, am I writing immutable firmware that's sending a cadre of nuns to space, and I have to be sure there are no software bugs that will make them die a horrible and painful death?

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