Ozempic and Heat

Got back from Pennsic on Sunday -- there may be some diary entries about it over time. Suffice it to say, despite sub-optimal weather, it was a generally good time.

(And no, Hurricane Debby wasn't relevant. A lot of folks cut and ran before the remnants got to us, but it was basically a non-event for those of us who stuck it out: something like a tenth of an inch of rain, and no wind to speak of. The serious storm was War Week Tuesday, several days before that -- we got slammed by something like an inch of rain, including some torrential downpours. Blochleven was largely fine -- we have good drainage so it was just a bit muddy -- but some of the Serengeti was underwater. But I digress...)

The day worth mentioning, though, was Middle Friday, when I got to the War.

I was pretty stressed-out to begin with: the predictions for the day said it might rain, so I arrived in a mild panic, getting my pavilion set up as quickly as possible, and all that probably didn't help.

Still and all, once I was fully settled in at around 2pm, I was a bit surprised to notice that I was feeling noticeably faint. It's not the first time that's ever happened, but full-on "wow, am I in danger of passing out?" faintness -- that's pretty new.

I figured I was probably a bit dehydrated, so I pushed liquids hard over the next few hours -- something like a quart of water, a pint of tea, a pint of Gatorade, around half a gallon total. Still, by 5pm I was wandering around Downtown Pennsic and still having distinct "whiteout" moments: never quite feeling like I was going to keel over, but definitely less steady than I should be. And my heart rate (according to my watch) was stuck at around 115-120 -- not a scary level, but a fair ways above my baseline 88.

I dithered about it for a fair while: I'm prone to mild hypochondria, and it was just weird -- I'm normally fairly decent with moderate heat during the day. (I require cool to sleep, but I commonly let my work space get to the mid-80s.) But after the fourth or fifth go-round of feeling faint, I let my feet lead me into the EMT building.

The Pennsic EMTs were solidly friendly and professional throughout -- kudos to them. They noted everything I was saying, brought me into one of their improvised wards, and ran a battery of tests. The EKG was fine (always comforting), but the heartrate was indeed elevated. Most significantly, my blood pressure had crashed to 87/52 lying down.

(Yes, I have a lot of friends to whom that's a normal Tuesday. But it's the lowest I've ever seen in myself, a good ten points below what I normally think of as my "yay!" normal, and explained the faintness nicely.)

Their very-reasonable conclusion was that, despite my attempts at oral hydration, I was pretty dehydrated. We chatted about it, agreed to put in an IV, and over the next hour they proceeded to shove a solid two liters of saline into me before my BP and heart rate got back into the normal range.

So my Pennsic was spent pushing liquids hard, maybe more than I've ever done before. That was generally fine, aside from the need to get up and pee once or twice every night. (Which is significantly less convenient when it involves getting up, putting on shoes, untying the pavilion, and walking 30-40 yards in the dark to the porta-potty.) But I think that's my new normal when I'm out in continuous heat.

The EMTs were specifically unsurprised by this: I wasn't the first person they had seen reporting hydration challenges after starting Ozempic.

So the moral of the story is that this seems to just be a semi-common side-effect of the stuff. It isn't so severe as to turn me off of it (I was basically fine for the rest of the War, once I got super-serious about drinking water at every opportunity), but it's worth being aware of if you're on it or considering it.