I’m sitting out on our deck on a Saturday morning in mid-October and the weather on our hilltop is pretty much ideal. It is 77 degrees with 53% humidity and an 8 mph breeze blowing in from the Pacific Ocean. There is not a cloud in the sky and on this west-facing deck at 10am it is cool and light and perfect weather to enjoy a lazy weekend autumnal day. Gary & Oswaldo are down from L.A. for the weekend as they have squeezed in a visit on their very busy travel dancecard. They returned from Berlin and Paris two weeks ago and in two weeks from now they head back over the pond for a Mediterranean cruise that starts in Athens, does the Adriatic and winds up in Barcelona. From there, they train it up to Paris again to await our gathering in London where we are scheduled to take a Thanksgiving steam train up through the countryside of England to Edinburgh for us all to enjoy a brisk few days scouring the Edinburgh Christmas Market and staring at the relics of Edinburgh Castle. The wether here on the hilltop has nothing to do with what we will experience in Edinburgh in late November and despite the early morning coolness here, by noon it will have warmed up to typical San Diego baking sunshine.
This is sort of an unusual day for me for several reasons. To begin with, I decided to finish adding elements to my new north-side rock garden that I have been creating ver the past two weeks. I’m not so good at knowing when to stop and I keep asking Kim and have already asked Gary & Oswaldo to advise me about whether I have enough going on in this approximately 600 sf garden that is covered in dark brown shredded mulch with natural rocks of various sizes cropping up here and there in true rock garden fashion. I had started with some larger pots (3) from our Planters Paradise expedition last week. Those have in them a small Queensland Bottle Tree in honor of its big brother on the patio, a Madagascar Palm, and a trio of furry Old Man Cacti. I planted a border of crawling Rosemary and about another ten succulents here and there in the ground as well, but it still looked too sparse. So, yesterday I went to the local nursery and bought four more smaller and more rustic pots into which I placed three varieties of mini-specimen cactus candidates (one Opuntia prickly pear and two Euphorbias). I also planted one climbing Juniper that I figure I can shape in Bonsai-like manner to do some interesting things as it grows. I also added four metal sculpture elements (two copper agaves, a medium looping wire ball, and a stone and metal balancing roadrunner in turquoise blue). I always worry about being too random and cluttering my gardens,so I asked Kim and Gary & Oswaldo to advise me on both placement and quantity. Kim is usually all Feng-Shui oriented, so I expect her to suggest placement improvements, but in this instance, no one had anything to suggest. All that’s left of that early fall gardening project are my arm and hand wound scars from when I caught myself from a fall a week ago and left some big scabs on my left forearm and the back of my hand. My hand scab has a dark red and unusual shape that Oswaldo says looks like the island of Cuba. I Googled Cuba to check its island shape, and agree that my hand does, indeed resemble “Il Cocodrilo” (the crocodile), the Pearl of the Antilles. I’m just glad that my accident did not add Hispaniola to the back of my hand as well.
In the mid-morning, a big styrofoam box arrived with an ice-packed month’s supply of Zepbound my new life-changing medication, my other big fall project. It came with 4 small vials of the tirzepatide medication, five syringes with small needles, some alcohol swabs and some gauze (presumably in case you’re a bleeder). This whole LillyDirect program is orchestrated by what is obviously a pharmaceutical logistics company called Gifthealth (get it…the gift of health). Since this prescription was put in on Tuesday by my primary care physician, Gifthealth has texted me eight times with status and direction support for this new medical regime. They seem quite diligent and the support materials explaining everything from side effects to injection instructions have been very well done and comprehensive. While I fully expect to be able to self-administer these weekly doses, Kim, who used to give our old Betty dog twice daily insulin shots, handles this first injection and administered it to the backside of my right upper arm. I barely felt the small-gauge needle penetrate and it was over with before I knew it. Zepbound makes a point of differentiating itself from the other GLP-1 medications by saying that its affects are almost immediate. Granted, the prescription program starts with a small 2.5mg dose that rises to 15mg over six months, but still, they say it can take a lot out of first-time users until the body can adjust to it. The stated side effects are mostly digestive in nature and seem to run the gamut of possibilities of discomforts, not to mention the big intended impact of reduced appetite.
I will admit that I have built this whole process up in my mind probably to bigger proportions than are justified. I am not a person who gives into nausea very often or very easily. I’m almost more surprised than not when a wave of nausea does overtake me and even if it only last a few moments. I nevertheless, do know the sensation of “dysgeusia”, the metallic taste in the mouth that often accompanies nausea and is often a warning sign that vomiting may occur, as your body prepares the mouth for potential stomach contents. It’s all part of the body’s protective response since stomach discomfort ranging from acid reflux to increased saliva production (and accompanying change in oral pH levels) are all about your body telling you it just doesn’t want in it what you have chosen to put in it…at least not at the moment. I feel like Zepbound logically causes this as part of the preparation of those receptor agonists telling you to want to eat less. Zepbound also has that dual agonist feature that activates another different hormone receptor, GIP. The addition of GIP receptor activation contributes to Zepbound’s effectiveness for weight loss by enhancing the activity of lipoprotein lipase, an enzyme that helps store dietary fat. That seems counterintuitive for what Zepbound is supposed to do, but for some reason, in combination with GLP-1, this paradoxically enhances insulin sensitivity, which improves metabolism and leads to more weight loss. So, even though the science does not yet really understand how all that happens, they are quite confident about the impact it creates. Where there is less certainty is how it all makes you feel in the short run as your body adjusts.
We went to lunch with Gary & Oswaldo in Oceanside. I ate several mouthfuls of my meal, but not much more. What I have no idea about is whether it is a pharmceutically-induced reaction, a psychosomatic response or just a mindfulness play on my part to make this whole program get in gear. I am sitting here on this perfect fall afternoon trying to sort out every nuance to my internal feelings, doing what I do so well, overthinking things and falling headfirst into my fall program.