BrewBit's recent activity
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Comment on What mattress would you recommend? in ~life.home_improvement
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Comment on The American physicians are healing themselves with Ozempic in ~health
BrewBit Link ParentSure. I'm going to speak in generalities here. Doctors can write prescriptions for compound medication which will be filled by compound pharmacies. Lots of people access this by using telehealth...Sure. I'm going to speak in generalities here. Doctors can write prescriptions for compound medication which will be filled by compound pharmacies. Lots of people access this by using telehealth doctors who work with specific pharmacies, which in turn ship medication to the patient.
The medication typically arrives in vials and the patient will need to draw their dose into a syringe themselves. Most commonly for GLP1 meds, these are insulin syringes. This has many benefits compared to using prefilled single-use pens, which is how the name-brand medicine generally comes. The patient is in control of their dose and not beholden to the one-size-fits-all dosing schedule that the brands use. Also way less waste.
Controlling the dose allows the patient to use only the amount of medication they need to get the appetite suppression they need while minimizing side effects. It also means that their medication lasts longer, which is cheaper.
There are some legal issues right now, notable with the FDA taking tirzepatide (Zepbound) off of their shortage list even though there is still a national shortage still going on. Groups are suing the FDA to get that changed. Also compounding pharmacies are trying to use custom dosing as a way around the shortage issue. This uncertainty has led many people to stockpile medication. Some others are turning to ordering grey market medication directly from China, bypassing the whole thing. This has some attractive qualities: grey market medication is a fraction (1/10th) of the price of even compounded medication. It is also packaged in a powder (freeze dried) form, which can be stored in the freezer for an even longer shelf life, leading to the ability to stockpile multiple years of medicine.
Of course, ordering unlabeled powder from China is risky. It is not actually illegal, but customs could seize the shipments nonetheless. And how do you know what you're getting? There's a level of trust involved. There are whole communities set up to try to coordinate testing by analytical labs.
So there's a range of options besides having a primary care doctor prescribe Zepbound and insurance paying for it. I've personally explored many of these myself and settled in a place where my personal risk tolerance lets me get the medication I need and not go broke doing it. If you have more questions, I would be happy to discuss privately.
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Comment on The American physicians are healing themselves with Ozempic in ~health
BrewBit Link ParentYou're thinking about it backwards. GLP1 medications correct an existing short-circuit in people with obesity. Obese people have an out of control hunger signal that is always firing & demanding...You're thinking about it backwards. GLP1 medications correct an existing short-circuit in people with obesity. Obese people have an out of control hunger signal that is always firing & demanding food. These medications dial that signal back down to normal levels. It's no less natural than arthritis medication, insulin, thyroid medication or birth control.
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Comment on The American physicians are healing themselves with Ozempic in ~health
BrewBit Link ParentFat guy on GLP1 meds here. This comment tracks exactly with how I've been treated my whole life. I'm fat because I must not know what healthy eating looks like or worse, I just choose to eat...- Exemplary
Fat guy on GLP1 meds here. This comment tracks exactly with how I've been treated my whole life. I'm fat because I must not know what healthy eating looks like or worse, I just choose to eat poorly. I eat nothing but cookies and mozzarella sticks. I'm either stupid or don't have the willpower to eat a vegetable. And now that I'm on medication that is helping me lose weight, I am cheating and I don't deserve to lose weight.
All I can say is that you are way, way off the mark about the causes of obesity. Most obese people are extremely aware of "healthy eating habits". They know why they are fat- they eat too much. People who have never dealt with obesity cannot begin to understand what it is like to have their bodies DEMAND more food all while they know that they have had plenty already. This is the underlying issue of obesity: it is a negative feedback loop caused by hormonal imbalances that signal hunger.
Buddy, my mental health is fine. I don't need a therapist to tell me to eat less, I've known that since I was 12. My body has defective hunger signaling that I am taking medication to correct. It's causing me to lose weight. It's giving my my life back.
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Comment on The American physicians are healing themselves with Ozempic in ~health
BrewBit (edited )Link ParentFrom what I've seen, people who discontinue their medicine report gaining weight and being hungry "like before". Many people need to stop their GLP medication if they need surgery. These meds...From what I've seen, people who discontinue their medicine report gaining weight and being hungry "like before". Many people need to stop their GLP medication if they need surgery. These meds interfere with anesthesia and need to be discontinued 1-4 weeks before surgery during which time they feel hungrier and even gain weight. Also the long-term SURMOUNT-1 and SURMOUNT-2 studies showed weight gain following the end of the medication.
Ideally (and this is my plan), folks stay on a therapeutic dose until they reach their goal weight and then titrate down to a maintenance dose. That would be a dose or dosing schedule that allows a person to eat at their maintenance calories. For instance, I am currently eating about 1200 calories a day, which puts me in a large deficit. But once I get to my goal weight, I will need to eat about 1800-2000 calories to maintain it (not gain or lose weight). I plan to reduce the amount of tirzepatide I take at roughly the rate I increased it until I find a level that balances my intake and output. That could also mean spacing out doses further than my current weekly schedule, or possible "microdosing" and taking doses closer together. Solving that puzzle for myself will be a good problem to have- I look forward to it.
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Comment on The American physicians are healing themselves with Ozempic in ~health
BrewBit LinkI've been on compound tirzepatide (Zepbound) for 4 months and have lost 55 lbs. with 50-ish more to go. It's a miracle, life-saving drug. I've heard all the questions, many of which are in this...I've been on compound tirzepatide (Zepbound) for 4 months and have lost 55 lbs. with 50-ish more to go. It's a miracle, life-saving drug. I've heard all the questions, many of which are in this very thread:
"What happens when you stop the medication?"
You gain weight. What happens when you stop your blood pressure medication? It goes up. Don't stop the meds. Some people need medication. Some need it forever."What about side effects? What about more studies?"
Tirzepatide is extremely well studied. I'm not worried about side effects or potential side effects. I'm worried about the actual effects of obesity. Pancreatitis, gastroparesis, etc. are all worth knowing about but many people take many drugs that have a small risk of serious side effects and yet the weight-loss medications are the ones that bring out the armchair pharmacists ready to scold folks (see the next point)."Random noises about cheating, morality, etc."
My body is defective and signals that it needs way more food than it actually does. This medication corrects that defect. It's actually crazy that besides maybe alcoholism, obesity is the only disease that people get looked down on for having, and if fat people don't suffer enough to lose weight, they get even more shit from those around them."What about the cost?"
This is the real concern. In the US, our system of paying for drugs is so messed up and relying on insurance to cover these medications is far from ideal. I am lucky to be able to get my medication. But until our system completely changes or, until some kind of federal action requires insurers to cover weight-loss medications, it will not improve. I fully believe that making semaglutide & tirzepatide available to people who need it would drastically decrease overall healthcare costs. I also hope that the widespread use of these drugs will start to cause a shift in the way people with obesity are treated and judged by others. It's now a treatable medical condition but until our insurance policies catch up with that fact, these drugs will remain out of reach of a lot of people who need them. -
Comment on Starlink, T-Mobile open their satellite texting test to all. Here’s how it works. in ~tech
BrewBit Link Parenthttps://support.apple.com/en-us/120930Starting in iOS 18, Messages via satellite can help you connect with your friends and family*, even when you’re somewhere with no cellular and Wi-Fi coverage. You can send and receive texts, emojis, and Tapbacks over iMessage and SMS.
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Comment on What’s a book about your area that you think would be interesting to people outside of it? in ~books
BrewBit LinkAstoria: Astor and Jefferson's Lost Pacific Empire by Peter Stark: Astoria is local-ish to me and the story is very interesting. The town of Astoria is very close to Fort Clatsop, the end of Lewis...Astoria: Astor and Jefferson's Lost Pacific Empire by Peter Stark:
Astoria is Peter Stark’s epic telling of the establishment of what was intended to be the base of John Jacob Astor’s Pacific fur trading empire. The harrowing journeys that led the settlers — by sail, canoe, or overland — to the mouth of the Columbia River are almost beyond belief. The obstacles they faced included not just the many natural barriers of an unmapped continent — sand bars, river canyons, and mountains — but also the self-defeating vices they brought with them: greed, paranoia, murder, and war. Stark doesn’t shy away from the fact that the bravery of the explorers was all in service of the desire to exploit the sea otters and Native peoples that already inhabited the area, and while Astor’s empire ultimately wasn’t built off the Pacific, that exploitation came nevertheless.
Astoria is local-ish to me and the story is very interesting. The town of Astoria is very close to Fort Clatsop, the end of Lewis & Clark's expedition to the Pacific. Stark's Astoria follows the members of Astor's expeditions and switches perspective occasionally back to New York to look at Astor's dealings there. The book is an engaging read and an interesting look into early 1800s America.
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Comment on Tips for increasing online privacy (without going insane)? in ~tech
BrewBit Link ParentI can personally vouch for easyoptouts.com for removing personal data from public websites. They charge $20 a year and the service seems to be very effective.I can personally vouch for easyoptouts.com for removing personal data from public websites. They charge $20 a year and the service seems to be very effective.
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Comment on First time homebuyer who just closed on a house, does anyone have any general advice? in ~life.home_improvement
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Comment on Things to consider when viewing a house, not in regards to inspection concerns? in ~life
BrewBit LinkThe biggest thing you cannot change is the neighborhood the house is in. Is the house close to a busy street? Are there lots of cars parked everywhere, or do people use their garages & driveways?...The biggest thing you cannot change is the neighborhood the house is in. Is the house close to a busy street? Are there lots of cars parked everywhere, or do people use their garages & driveways? Does it look like other homeowners are keeping up the outside of their properties or are there lots of overgrown plants & junk in the yards? Can you hear things like dogs barking, chickens, etc. that you would find objectionable? Has the city (or whoever) been keeping the street maintained, or is this neighborhood being ignored by the powers-that-be?
A red flag for me personally would be a neighbor who appears to run a business out of their house that involves a lot of trucks like hvac, plumbing, etc. They would likely be producing a lot of annoying noise early in the morning and late at night.
You can change a lot about the house itself (for a price), but I'd be looking for good storage- not just a closet in every bedroom, but things like a linen closet in the hallway, a laundry room with cupboards, a pantry, that kind of thing. Those are hard to add in later but so handy to have, and they help you keep the house tidier.
About the yard, you can change just about anything there too. But take a look at things like trees. If you value tall old trees and don't have any, you can't really add them yourself. Also if those trees exist in your neighbors' yards, they could cut them down later, dramatically changing the feel of your own property (this happened to me at my last house). If you want to grow a garden, be sure the lot gets enough light to do that.
I think the best advice I have is to try to see as many houses as you can and not to "fall in love" with a house. A good realtor should have no problems showing you lots of houses, and it is a great way to refine your must-haves and must-nots lists. You may not know you want something until you see it in person, so exposing yourself to variety is important in house hunting. Its worth your time to look at houses above and below your price range (within reason), or places that don't necessarily check all the boxes to give you a better handle on what you want.
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Comment on How do you manage your time? What tools do you use and what philosophies do you follow? in ~life
BrewBit LinkI think David Allen's book Getting Things Done (GTD) is a valuable resource. The book is short and can be read in an afternoon. There are lots of resources that cover the basics available for free...I think David Allen's book Getting Things Done (GTD) is a valuable resource. The book is short and can be read in an afternoon. There are lots of resources that cover the basics available for free online as well. It's a well put-together system that may be over-powered for what you want, it I find that it can be pared down to fit a more basic approach, too. It is also tool-agnostic. A lot of so-called productivity gurus seem to be so bogged down in the weeds of their tools that it's a wonder they get anything done at all (Bullet Journals). Or endlessly reclassifying tasks without actually doing them. So you can choose any tool you like and still implement the GTD system.
GTD does get in to the difference between a calendar and a to-do list. The purpose of a calendar in this system is to put things that must happen on a specific day, or not at all, like a meeting or doctor's appointment. The task list houses everything else, and if you're in GTD, then that list is a Next Actions list which all should be things that should happen as soon as possible. This way, when planning your day, you can see your calendar of events that must happen today and then your Next Actions, which you would be working on in between those events.
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Comment on South Koreans become younger overnight after country scraps ‘Korean age’ in ~life
BrewBit Link ParentThese books are great. I loved the calendrical swords that showed “the date and hour of your death!”These books are great. I loved the calendrical swords that showed “the date and hour of your death!”
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Comment on What's good to cook on a propane grill? in ~food
BrewBit Link ParentIf you're feeling adventurous, try it without the husk (and no foil either). Just shuck, butter, salt & pepper, then grill over medium heat for 12 minutes or so, rotating them every 2 minutes. We...If you're feeling adventurous, try it without the husk (and no foil either). Just shuck, butter, salt & pepper, then grill over medium heat for 12 minutes or so, rotating them every 2 minutes. We started doing corn this way about 5 years ago and never looked back.
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Comment on Weeknight meal recommendations in ~food
BrewBit LinkI really like Blue Apron. Not their service, but their recipes. They range from 25-50 minutes to cook, and I've found that they actually do hit their time estimates in real life. Their recipes are...I really like Blue Apron. Not their service, but their recipes. They range from 25-50 minutes to cook, and I've found that they actually do hit their time estimates in real life. Their recipes are also geared toward being the entire meal, which is nice for weekday meal planning. Their recipes are all in US customary units, though.
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Comment on Is it possible to build a sustainable image and video hosting service? in ~comp
BrewBit LinkI feel like we're going to keep seeing services like these shut down as long as we continue to believe that everything on the internet should be free (as in beer). I've found my thinking shifting...I feel like we're going to keep seeing services like these shut down as long as we continue to believe that everything on the internet should be free (as in beer). I've found my thinking shifting over the years to want to pay for the services I value in order to contribute to their continuation. I am hoping that whatever new era of the internet we're entering will involve less user-as-the-product services like Facebook, and more user-as-the-customer services (like paid email providers). Not that I just can't wait to pay for things, but I think it is a much more honest business transaction to just pay money for something rather than get it for "free" but then suffer the relentless invasive monetization.
I don't often need to post images on social media, but in the past I've used Imgur to post to Reddit, obviously for free. I can imagine a world where Imgur charges a fee to use the service on an as-needed basis. I also remember the old days of the web where your ISP would give you some small amount of web hosting as part of your plan. I can easily imagine that type of service coming back, as an add-on to something people are already paying for (Apple iCloud, Google One).
My wife and I just went through this and ended up with a mattress we both love. The best advice I saw on the internet was to find a local mattress store that sells mattresses made near you. I had no idea that there were such things as locally-made mattresses but I found that there is in fact a company that makes mattresses like 4 miles from our house. So if you are in the Portland, OR area, I can recommend The Mattress Lot in NE. We tried everything they had in the store and got a great mattress for a great price. They also have tons of pillows you can try and we did that as well. We both ended up with different pillows and trying them out beforehand is the best.