To GLP or not to GLP? That is the Question!

  How do you make decisions about your health? I'm facing an interesting one at the moment, and I'm not entirely sure how to proceed. Sometimes God makes things really clear to me. Sometimes it feels a little more ambiguous. Take yesterday morning for example. I pray about a lot of things, big and small, and yesterday I was praying about which game my husband and I should play for our date morning. Before I even finished the thought, Terra Mystica was front and center in my mind, so that's what we played! On a much larger scale, a couple of years ago we attended a fundraiser for the Tacoma Rescue Mission and Duke, their director, gave a presentation on the Community First! Village in Austin, Texas and his heart to replicate it in our area. I knew beyond a shadow of a doubt in that moment that we would be moving in there the moment the gates opened, and I didn't even know there was such a thing as a missional yet! God knows that I struggle with making decisions, and the daily onslaught of choices that need to be made is exhausting! But sometimes my path is less clear.

 If you've read this blog much at all, you know that I face some challenges with my health. While the reality of facing health challenges is constant, the specifics of which disease or syndrome or disorder needs to be addressed at the moment fluctuates regularly. Of late, we've been attempting to address a spiral that started when or shortly after I had my brain surgeries - who knows maybe it was the 12 weeks of IV antibiotics I had to take that triggered it! 

 Regardless of it's origin, the reality is that my blood sugar, triglycerides and inflammation have gradually increased, seemingly feeding off of each other. I went from having no blood sugar or cholesterol issues at all pre-brain surgery to being pre-Diabetic and on a statin to control my cholesterol shortly after. With where I was at in my recovery, my doctor thought it best to address these issues with medication rather than attempting major life changes when I was doing good to walk independently across the room. Unfortunately, it turned out I was allergic to the Metformin we were trying for the blood sugar and while the statin brought my LDL into a normal range, my triglycerides continued to remain high, although they are down from their highest measurement of 354. So, I tried, diligently, to bring my blood sugar under control with diet and exercise. I saw some initially encouraging results, but overall while it didn't continue to climb, it was not turning the direction of the progress enough. 

 At this point my naturopathic, functional-medicine primary care provider (read, someone whose first reaction is NOT to pharmacologics) believes my only realistic option is to go on a low-level GLP-1 agnostic. Yes, if you've had any exposure to this field, that means Ozempic. We initially thought this was off the table because one of the low-risk side-effects of Ozempic is gastroparesis, a fairly common co-morbidity of Ehlers-Danlos Syndrome. That coupled with my predisposition to "highly unlikely" or "extremely rare" complications had us steer clear. You see, gastroparesis is essentially stomach paralysis making it so that you cannot move food through your digestive track effectively. This can lead to needing to be fed through a tube - potentially for the rest of your life! The idea of never eating again is not appealing to me. I know there are people out there who might not see this as such a bad thing, but food is one of the few enjoyable comforts remaining to me.

 So what is different now that has my doctor recommending this course of treatment? Well, for one thing, the other options aren't working. In her book, facing a low risk of gastroparesis is favorable to a high risk of cardiovascular disease, Type 2 diabetes and stroke. In addition, she is recommending a low-dose version of Ozempic that would further decrease the risk. The catch with that? It has to be compounded to get the dose she wants me at. Compounded medications are rarely covered by insurance and this one is likely to cost $350 per dose. My understanding is that I would need one dose per week so we're talking more than $1,400 per month, out of pocket. With my husband being recently laid off, that's a whole lot of money to be looking at indefinitely! 

 Alright, I've covered the "Cons" of this options, but what are the "Pros" that would have my doctor recommending it? Well, for one thing it's the only option we can see that might reverse the blood sugar, triglyceride, inflammation cycle that's been going up and up for two years. This could lead to lowering these markers which could lead to improved vision, lessened fatigue, normalization of urination, lowered pain and brain fog, and I might even be able to finally lose some of the extra weight I've put on since the surgeries. Those things all sound pretty good! 

Here's the Thing: So, how do I make this decision? Apart from a clear direction from God (like I mentioned above) I'm feeling at a loss. This seems like a pretty major life choice and I don't want to do the wrong thing!