Wednesday, May 27, 2015

Victoza Diaries

Have you read the book Rum Diary? It's  a story about Hunter S Thompson's life as a journalist after the Eisenhower era- and his move to Puerto Rico and yes, it was very rum (and other, much more intense narcotic) soaked. 

This is my Victoza Diary. 

On May 15 I met with a brand new (I mean newly minted, AND new to me) endocrinologist. He was young, well-read, knew about blogging and we clicked. Really well. In fact, at one point he said 

"you're the expert in your diabetes, I am here to guide you to be the best expert you can be."

You probably need to read that again, go ahead, I'll wait.

So yes, we are on the same page to say the least. He was happy with my vitals, my numbers, my A1c etc...until he saw how much insulin I use vs. my weight. He looked at me and said "we can do better. There are things out there to help you feel better, would you like to discuss them?"

I mean...seriously, this guy must listen to patient feedback about how to talk about difficult subjects. We chatted about what I do for my exercise, and weight and eating. 

He told me he thought  that Victoza might be a good option for me to help me lower my insulin usage which may or may not result in weight loss. I told him I was willing to try, especially because I hate using so much insulin! It's expensive, and refilling my cartridge every day is annoying.

So he wrote the script and mentioned "some people experience some mild stomach nausea for a few days while they adjust, push through it-and lower your basals by 20% before starting"

Well.

Yes.

Mild is not how I would have put it, but ok Dr. NewEndo.

I started my dose at the recommended 0.6mg injection. On the first day I barely ate. I drank a lot of juice boxes and reduced my basal A LOT. The second day I was planning on going on a big (13km) hike with a friend. I reduced my basal by 80% total, packed gummy candy and a  good bunch of snacks and decided I wasn't going to let diabetes stop me. 

And I did it.

Around 7km in to a 13km AMAZING hike

So I ate a lot of ginger capsules- which do wonders. Every km or so I would have a bit of a snack: protein bar, fruit salad etc and I used regular Powerade and took small sips of it all day. I didn't go low until around km 12 and even then it wasn't "Serious" just was hovering around the 4.5 range-more of a risk to go low. 

The hike itself was amazing. It was a small island in the middle of our harbour that we had to take a small fishing boat to. It was used as forts during the wars to protect us so there were lots of ruins to explore. So great, my friend Megan was an ideal hiking partner and I would do it again in a heartbeat. 

On day 3 things weren't improving in my stomach, and I decided that I would cut back around half of what I was taking for Victoza and slowly work up to 1.8 normal dose. (This is probably where I should say I am not a doctor, I don't condone adjusting your medications without the advice of a doctor and who knows what I did to myself by doing this! Basically don't do what I did.) It worked for me though. Day 4 was much better on the lower dose.

Here's some of the hard numbers for those interested:
Average Total Daily Dose in April: 143u
Average Total Daily Dose over the past 9 days (since Victoza start): 88u

Carb ratio before Victoza: 1:6
Carb ratio after start: 1:20

Pre-bolus time required before Victoza: 1hr
Pre-bolus time now: 15 min

Insulin sensitivity before: 1u brought me down 2 (32 mg/dcl) points.
Insulin sensitivity now: 1u brings me down 5 (90 mg/dcl)

Weight change: over all 2.7lb down

I should note a few things:
-I have been intensely exercising every day because cardio some how fixed the extreme nausea.
-I have been extra thirsty had some dry mouth so my water intake has been 3-5x the normal amount.

I have not even reached the amount of my regular dose yet. I am somewhere around 0.9 now, and working up a little bit every day.

My daily caloric intake has been difficult to achieve because Victoza totally zaps your desire to eat. Especially while adjusting. It apparently can delay stomach emptying so it makes you feel full longer, which is all nice until you realize that you need to eat like 35more grams of protein to get to where you should be nutritionally. Weight loss is not as important to me as being extremely fit and healthy

So, my diary states it hasn't been all easy. It's been a feat for me to keep down some meals and very much mind over matter for a lot of daily tasks. But the results are worth it in my opinion. Less medication means so much to me, the closer I can become to being a normie the better for me. 

There are some pretty big adjustments on Victoza, it's not all glory. It's not a miracle drug and takes a lot of work, math and adjusting. I am still and will be adjusting for weeks. I think my story is somewhat exemplary from what I am reading. I am understanding that I am not the normal reaction to the drug. It is a new medication and can be costly if you don't have coverage, it's an injection if that sort of thing bothers you...

If you're interested and you think you are battling some insulin resistance I urge you to research and discuss with your doctor.

2 comments:

  1. Thanks for sharing your Victoza experiences. Very interesting. I was hanging on every word.

    Regarding your new endo, your experience was similar to mine. When I started finding doctors closer to my own age, I started coming across doctors who spoke the same language as I do. This is not always the case, but it always seems to be this way when it works well.

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  2. Really glad to hear you found a supportive endocrinologist. I was really interested in reading about the Victoza (haven't heard of it until reading this), and you've done a good job in covering it simply and highlighting the positives and negatives.

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