Weight-loss Meds Eve

That's a little bit optimistic. My meds are going to be delivered, probably Wednesday or Thursday. I'm tracking via UPS. Hopefully no more snowstorms to upset the schedule!

 I'm all ready for this. I've been preparing since late last year. I waited until after I got back from my big vacation to set this in motion, and it's taken a little bit longer than I had hoped. But they're on their way.

I've done a ton of research on this. I'm doing this via Weight Watchers, based on the experience of my pathfinder and an on-line look at reviews for other places. I've read pretty much everything on the WW site, met on-line with their doctor, and got approved. I spent time on social media and with ChatGPT (surprisingly useful for very specific questions). So I have a plan, which will of course be modified as soon as I get some practical experience. In the meantime, I'm staying away from anymore online input. I've got what I need to get started. 

A couple of notes about what's happening and my plans:

I'm getting Zepbound (tirzepatide) vials direct from the supplier, Lilly. Bit of a story, but the cost for vials from which I fill a syringe is half or less than getting pens. I've watched a ton of videos, from Lilly and others, about how to do it. I bought a sharps container for disposal, and read the regulations for my state. I'll have the Lilly video in front of me the first time I do it. I'll refill the scrip on-line, based on my experience at delivery timeframes.

I'm not too worried about what sites on my body to use, I'll rotate. I've thought a lot more about time of day and day of week for the weekly injection. While you can adjust the day after you start, it's better to stick with the same day, and it seems even the same time of day. That means I don't start as soon as they are in hand, but where and when I think I'll end up for a schedule. And apparently, a reason to focus on the schedule from the start is the med's effect on body and mind is greatest shortly after the injection, and it wears off during the week. There are also greatest chances for side effects early on in the weekly cycle.

One of the major concerns about these meds for old people such as myself is muscle loss. I already do the recommended weight training level of twice a week. But there are recommendations about timing of injection and exercise. For example, don't exercise directly after an injection (duh). More interestingly, the recommendation seems to be to do weight training on days 2-4 of the weekly cycle (injection day is day 0). Since my standing convenient weight training appointments are Monday and Wednesday mornings, I think I'll be injecting Fridays or Saturdays. (In contrast to some folks, since I'm retired and have retired friends, weekends are not often very different than weekdays as far as eating and social events go, so that's less of a consideration.) My initial shipment should be here by this Friday.

The intensity of the weight session recommended is interesting: sets of 8-10 reps (calibrate the weight so that is appropriately challenging), if exhausted, reduce sets not weight. Keep the intensity up to keep those muscle fibers feeling like they are needed! This fits with my trainer's philosophy, and we agreed a few weeks back to try to up the overall intensity and progression.

Recommendations for cardio for seniors on weight loss meds are weaker. There is the standard "150 minutes a week" recommendations, but most sources say if you need to choose between cardio and weight training, choose weight training every time. And cardio should be lighter in intensity. No marathon training or blowing through VO2 max. I've just upped my intentional cardio to try to use each of my machines every day I'm not weight training. I'm trying to do 15 minutes every single day, and once I've got that as a baseline, I'll up the minutes. But I'm trying to build the consistency habit first. And it's only 15 minutes! I should always have time for that. In contrast, when I rely on a walk as my main cardio, I have to set aside much more time. I have available to me from the Apple watch "time in heart rate zones" and I'm trying to build up time in a higher zone. 

There are also recommendations, sometimes conflicting from different sources, about timing of eating with weight training sessions. Apparently it affects how efficiently a body metabolizes the protein eaten. After discussion with my long time trainer (who just finished a certification course for fitness for seniors and who has a slew of other training and certifications) I'm going to plan to eat something high protein right after we finish a session. I never eat beforehand now, and my early training timeslot wouldn't lend itself to finishing a meal a couple of hours before our session. They also say don't do a cardio session after a "long fast" (eg overnight). I think my little fifteen minute session isn't a huge concern, even with some intensity, but I will definitely plan to eat shortly afterwards. This will have to intentional. My current habits sometimes have me eating more like a brunch, sometimes exercising, then spending time grooming and dressing, then looking at my ipad, then finally getting around to preparing something to eat. One thing I think I'll try to keep on hand is low fat cottage cheese - a little container has 18 grams of protein and just enough carb to provide some short term fuel.

I haven't settled on a time of day for injections yet. One school of thought is that evenings allow sleeping through any nausea. Others say the injection at night prevents them from getting a full night's sleep. I'm curious about how this will make me feel, so I'm inclined towards a day time injection, at least to start, so I can actually pay attention to what is happening to me.

 I'm laying in supplies of easy-peasy high protein and high fiber foods. I've been using the Weight Watchers' app for a few months and I fully intend to continue using it.  I already had a big supply of ginger candies and teas for nausea - used for preventing or dealing with sea sickness, so that's in place. I've been experimenting with bottled protein shakes. I go down the supermarket aisle with my phone out, snapping barcodes with my Weight Watchers' app. It's easier to use the WW points as a shorthand for how useful the bottle is, rather than analyzing the nutrition label myself. One bottle I bought I sampled was a chocolaty flavor, and the first sip surprised me with how good it was. But then, the very bad aftertaste remained in my mouth for a long time - until I ate something else. I poured the rest of the bottle down the drain. Yuck! That's why I need to experiment.

My experience with the WW app has definitely geared me already towards protein and fiber, and my habits have adapted. There is a "GLP" switch in the app which I'll flip soon, I'm not sure what it does, but I'm guessing it emphasizes the protein and fibre more than it does point totals.  Dehydration is apparently a concern, but not so much for me. I don't track it, because I am the water queen, always with a glass or bottle next to me. I will maybe use a refillable measured bottle for a while to make sure I don't slump in this. I connected my watch to the WW app for the purpose of getting more points for activity, but I didn't connect any of the other areas like sleep. I don't see that changing.

 Food shopping tomorrow and Wednesday, different stores. Then, the adventure begins!