Physical Health

Your Prescription is Ready

“Your prescription is ready.” Those are magical words. And it has taken a long time to get here.

If you’ve known me at all in the last 25 years, or seen any pictures of me, you know I have always (during that time) been overweight. (I’ve you’ve known me longer than that, you may have known me for the brief 4-5 year time period – roughly ages 15 to 19 – when I was not heavy, but that’s pretty much the only time in my life.) I haven’t been below 200 lbs (90 kg) since probably the year 2000, and I’ve been over 300 lbs (136 kg) since 2018/2019, before the pandemic. I’ve gone through periods of time where I could lose 20-40 lbs (9-18 kg), but keeping it off was nearly impossible. My lowest weight since Luke was born has been about 250 lbs (113 kg); I never did get back to my pre-pregnancy weight of about 225 (102 kg). Bariatric surgery has been discussed off and on, but I have been very resistant. I know several people who have had it with varying levels of success and even more side effects. All but one has said if they knew then what they know now, they would not have had it done. I know things have changed a lot (most of them had theirs 10+ years ago), but it’s enough to have me say no. [Note: I am not knocking anyone who chooses go to that route! We all have to make our own choices in that regard.] I also know the difficulty of recovery and the potential risks of surgery in general at both my age and my weight, and I didn’t feel like I could do that late in Luke’s academic career. I told her we could discuss it again once he graduated from high school.

Graduation was last year, in 2023. But something else also happened last year as well. Several new weight loss medications were approved or set to be approved by the FDA. My doctor felt I was the ideal candidate for one medication in particular. But we had to wait for the FDA approval. And then we had to wait to see how the insurance companies were going to handle it. To pretty much no one’s surprise, many insurance companies did not want to cover it (it is expensive), but the public outcry was much too loud. But that doesn’t mean all was well. The particular “flavor” of coverage we had from our particular company flatly refused to cover any of them back in the fall. It was disappointing but not unexpected.

Most insurance companies update their policies on many things – including prescription coverage – at the beginning of each year. At my mid-January 2024 appointment, we decided to try again. The medicine she wanted to prescribe was denied, but they did approve the other one. However, that one was out of stock, not just at my pharmacy, but nationwide. But lack of supply did not mean that they would cover the other one. It was “too bad, so sad.” My pharmacy tried every month to submit an order (orders only stayed open for 30 days before the manufacturer would cancel them, meaning they would have to be resubmitted), and every month, the answer was the same: out of stock. I had pretty much given up.

In the meantime, I had my knee injuries in January and April, and this second one resulted in my orthopedic doctor telling me that I need a knee replacement, which they will not approve until my BMI is at least under 45, and preferably under 40. For those not familiar with that chart, that means that I need to lose 70-100 lbs (32-45 kg) to qualify, based on my height. “You should look into bariatric surgery as soon as possible.” (DO NOT get me started on what a crappy metric BMI is. I’m not saying I don’t need to lose weight before knee surgery, primarily for recovery purposes, but it’s still a super stupid measurement to use for any type of health indicator. But that’s a completely different blog post!) I knew from previous conversations with my doctor that from the first appointment with a bariatric surgeon to when surgery actually occurs is typically about a year, and *then* you have to wait for the weight to actually come off. (It’s quick, I know, but still waiting.) So I’m probably looking at about 18 months, at least, before I qualify for knee replacement surgery. And in the meantime, my knee is going to hurt. Constantly. It was incredibly demoralizing.

I saw my doctor last week; it was the first time I had seen her since the second injury to my knee. I relayed the conversation with my orthopedist regarding the knee replacement, and she said that the insurance companies really seem to be approving more people and more kinds of weight loss meds these days, but she wasn’t sure about my particular insurance. She told me to “let us work the issue with your insurance company,” especially since they would be able to point to my weight hindering other treatment(s). That was on Thursday. The only thing left to do was wait.

On Tuesday, I received a text from my pharmacy. “We have received your prescription for Zepbound.” Wait, what? I know my doctor wouldn’t have called it into the pharmacy if she hadn’t gotten the approval from the insurance company. “This prescription will cost $X per month. Do you still want us to fill the prescription at that price? Please respond YES or NO.” YES! “Thank you for your confirmation. We will proceed with trying to fill this order.” On Thursday afternoon, I received another text from the pharmacy. “Your prescription for Zepbound is ready for pickup. Delivery is not available. Please come in to receive counseling and instructions from the pharmacist when picking up your order.” I was not able to pick it up on Friday, but I did pick it up Saturday afternoon. However, due to potential side effects and having absolutely no idea how the medication might affect me, I won’t actually take my first dose until Monday.

So, here we go. I’m excited, but I’m also a lot more anxious about it than I expected to be. It really sounds too good to be true, you know? Plus, given that I tend to have some of the more uncommon side effects or (minor) complications where medical things are concerned, I’m afraid I’ll have to stop if things get too bad. (That happened with a different medication last year. I absolutely could not take it due to the side effects.) And what if it simply doesn’t work? That happens to some people. “I took weight loss meds but didn’t lose any/much weight.” How humiliating and embarrassing would that be? I don’t handle failure well! I can’t imagine how difficult that would be, psychologically. I know I have to do more than just take the medicine. I have to alter my eating and increase my physical activity, which even my doctor admits is tricky with my bad knee. (It is getting better, sloooooowly, but still far from “back to normal.”) I know it sounds like “well, just do those things and you can lose the weight without the medicine.” I’ve tried. Believe me, I’ve tried. Hopefully, the medication will be the “missing piece” that can help me be successful this time around. I also need to remember that even if I do lose the average amount of 15-25% of my body weight, that’s still not below 200 lbs (90 kg), so there will definitely be work left to do, even if it does work well. Under 150 (68 kg) would be the ultimate goal (per my doctor, so keep any comments to yourself on that issue), but at this point, both my doctor and I will “settle” for ONE-derland (any number starting with a 1).

I’ll try not to turn this into an “all weight loss all the time” blog. I mean, there are still movies coming out! LOL But even if I start talking about it a lot, I hope you’ll stick with me on this journey. Wish me luck!

Note: This post was originally published on Friday, May 24, but I had some blog weirdness (my own fault!), so I have slightly edited it and republished it.

2 Comments

  • AJ

    I’m so excited for you! Please remember that if the treatment isn’t working, it’s not a personal failure—that’s not fair to yourself. Think about it this way: if you had a headache and Tylenol didn’t work, you wouldn’t see that as your fault, right? It’s all about finding what works best for you and what changes you can comfortably live with. I’m cheering you on every step of the way! <3

    • Erin

      I know, and my logical brain hears you and agrees, but my heart/ego/emotions… that’s another story. Hopefully it won’t be an issue. Fingers crossed!

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