Health update: Scared, but resilient

jour·ney
noun
an act of traveling from one place to another.

Over the last couple of weeks, I have developed false faith that I was better. I convinced myself that December’s visit to the Endocrinologist was so good, that I could get back together with carbs on a regular basis. I have been evolving my diet the way I have in the past…after months of being good, I believed I was on the right track and could afford eating the way so many people around me do indulging in carbs on a regular basis.

I was wrong. Very wrong.

This morning’s appointment was eye opening. When I started this journey back in November, my testosterone level was at 90. The healthy rating for a woman is 30. If I did not get treated, I was on a path to have heart failure. In the next decade. After starting this blog and staying very disciplined in my carb breakup, I got my testosterone level down to 53. This gave me false comfort to allow carbs to creep back into my life…first, when I was stressed. Then, on the weekends. And ultimately, whenever I felt like it. My testosterone level was at 56.

My Endocrinologist is one of the kindest, most talented people I have ever met. Today’s appointment would have been terrifying if it wasn’t for his sense of humor, open dialog, and genuine concern he has for me and all of his patients. Even with his skill and kindness, today was still a very scary wake up call.

I shared with Dr. Marcus that I have been exhausted. I was exhausted from staying on the diet and feeling so limited. Exhausted from taking so many pills every night. I admitted that I have not stuck to 110g of carbs today, had not been regularly exercising 20 minutes a day, and even have been skipping medication on days I am over taking pills. Admitting all of this to him was obviously imperative for him to help course correct, but more importantly, it caused me to be honest with myself.

In addition to staying on track with my carb breakup, Dr. Marcus made the following adjustments to treat my Insulin Resistance and PCOS. Every case is different, but here is how we are approaching my journey to health:

Increased Metformin from 500mg to 2000mg. I am not happy to take 4 times as many pills. (larger pills are available, I am just not a strong pill taker). I have read various posts from many of you about Metformin side effects which had not really been bad for me before. I will be interested to see how side effects progress with this higher dosage.

strong>Exercising 20 minutes a day is imperative. Time to look back at my tips to wakeup in the morning and exercise. The epic battle with the snooze button will continue.

Now for the newest and for me, the scariest change. Once a week, I will now need to give myself an injection. For those of you that have been following my journey, you know that I am terrified with needles which is why the Glucose Tolerance Test was so difficult for me. Each week I will be injecting myself with Tanzeum. My doctor was very open to discussing this medication and we decided it would be the best thing for expediting a cure for my PCOS and Insulin Resistance. I will admit that when he mentioned this, I hit the cap on holding in my emotions. It was hard enough to hear that if I did not get my diet and health in order, I would likely not make it to my 50th birthday in 20 years. Then learning that my results needed pushing and it was time to introduce injections…I lost it in his office. He kindly listened and coached me through how to use this prescription. I was shaking in fear to give myself my first shot…but I did it. I really did. I feel braver and stronger for being able to do this. As much as I hate needles, I will do whatever it takes to be healthy again. For those of you interested in learning more about this prescription, check out this

Thursday progress: Staying steady

While Thursday morning weigh-ins are typically most joyful when I am down from the last week, I must say I am almost equally pleased that I did not gain any weight from last week’s weigh-in. Valentine’s weekend was filled with a crazy about of carbs and cocktails which ended up snowballing into over carb indulgence for a majority of the week. Last night was also a very late work night, so I ended up not having dinner until almost 9pm. In the past late dinners typically mean a heavier weigh-in.

All that being said, the more I read and hear from many of your stories about PCOS and IR it is clear to me that I need to be patient with myself. The cravings, exhaustion, and pain are all very real things that I believe I (and many of you) are very strong to battle. While I really just want to stay in bed all day with my dogs while cradling a baguette topped with pasta and french fries, I know that I am strong enough to get up each day and fight. Will all battles be won? No. But I am I fighting? Heck yeah.

SUCCESSES THIS WEEK:

  • While I gave into carbs more than I should this week, I also was really strong and turning down incredibly accessible carbs. I don’t know about you, but my office has free carbs. Like all the time. Yesterday I went to get more tea and what did I find? Catering size platters of chow mein. And rice. I mean… Also, while my husband enjoyed a turkey club with waffle fries last night, although I was exhausted and wanted the same, I indulged in grape leaves (a little rice) and had a curry chicken salad for dinner. I call that a win.
  • As a person who struggles with mornings and is typically late if anything is earlier than noon, I was proud of myself that I was EARLY for an 8:30am meeting this morning. I got up with enough time to get myself together and rock my presentation. If I can do it for my company, I should be able to do it for myself with morning workouts. While I truly hate waking up, it does make me feel more prepared for the day when I get an early start. This morning definitely motivated me to get up tomorrow morning (especially since it is a later start) and get my 20 minutes of exercise in.

OPPORTUNITIES FOR NEXT WEEK:

  • Carbs and I are not going to be involved next week. We just aren’t. I really want to commit to the next week between my food, medicine, and exercise to really see the great results I get when I do those things. If my weight stays the same, I am going to need a moderate restraining mechanism to keep me from all the carbs I missed and want to eat out of frustration of no progress…but we will cross that bridge when we get there.
  • Since my weeks for progress start on Fridays, I will plan to wake up tomorrow morning and get those 20 minutes of exercise in. I CAN DO IT.

How did you do this week?

Insulin Resistance: Best foods for IR

It seems to me that there are a whole lot of articles out there about what you should NOT eat if you have PCOS or IR. Here are some great things to think about from LiveStrong of what you CAN eat if you are like me with PCOS/IR.

Fruits and Vegetables

The Best Foods for Insulin Resistance

Fruits and vegetables are natural sources of vitamins and minerals, including antioxidants which help the body combat and prevent disease. They also contain fiber, which is recommended for healthy weight management and improved digestive health. A diet rich in fruits and vegetables can be a helpful means toward reducing one’s risk for insulin resistance. Choose a variety of colorful, fresh fruits and vegetables on a regular, ongoing basis for the best potential results. Frozen or dried fruits and vegetables are a valuable secondary option and can be kept on hand for long periods of time and contain few artificial ingredients or preservatives.

Monounsaturated Fats

The Best Foods for Insulin Resistance
Monounsaturated fats, or plant-based fats found in olive oil, canola oil, peanut oil, sunflower oil, avocados, peanut butter, many nuts and seeds, are healthy substitutes for saturated or trans fats–fats associated with increased risk for heart disease. According to research published in the journal of the American Diabetes Association in 2007, intake of monounsaturated fats is linked with decreased fat distribution in those who are insulin resistant. Replace saturated fats, such as butter, whole milk, cream and deep-fried foods with healthier fat alternatives. Olive and canola oil are positive alternatives to butter. Grilled, baked and steamed dishes are preferred over deep-fried foods for those with insulin resistance. Since fat is dense in calories, keep portions sizes modest for best benefits.

Whole Grains

The Best Foods for Insulin ResistanceWhole grains, such as spelt, oats, bulgur, whole wheat and barley, provide a variety of nutrients, including vitamins, minerals and soluble fiber. According to findings published in the “European Journal of Clinical Nutrition” in 2007, consumption of whole grains is associated with reduced risk for insulin resistance. Replace enriched breads, cereals, pasta, rice and snack foods with whole grain equivalents. Whole grain breads, long-grain brown rice, oats and snack foods featuring whole grain ingredients support healthy blood sugar management and overall physical health. Consume a variety of whole grains regularly to attain most benefits.

Here is the full article that helped inform this post: http://www.livestrong.com/article/74703-foods-insulin-resistance/

Carbs and I got back together this weekend…and now I am tired and wanting more!

This past weekend carbs and I definitely got back together. In a big way. One of my best friends and her husband were visiting us in LA from Nor Cal, so we were constantly eating out and overindulging. We did get a great hike by the Hollywood sign in, but the weekend was filled with all you can eat brunches, mimosas, and late night pizza deliveries. While this was all fun and good at the time, I have been VERY tired this week and craving more carbs.

Confession: last night I got home much earlier than my husband and was starving. I had a healthy low carb lunch, but by the time I was home I wanted whatever I could get my hands on. Unfortunately for my PCOS and IR, leftover pizza won the no carb battle.

As I explore the challenges of this new lifestyle, it has been helping me to really understand the impact carbs have on my body. The more I know, the harder it is for me to get back together with carbs by staying strong in my decision for  us to break up.

Here is some of the info I found to help me stay strong and just say no to carbs:

Why are carbs making me tired?

Insulin resistance is a process in which the body is inefficient at managing sugars and starches you have eaten in your diet. When you eat a carbohydrate, such as a piece of bread or something sweet like ice cream, your body releases insulin from your pancreas to process that sugar. Without insulin, you would not be able to assimilate this sugar, called glucose, from your blood stream into your liver and muscles. In insulin resistance, your body makes too much insulin for the amount of carbohydrate consumed. This extra insulin is what causes so many of the listed problems, both functional problems (those which precede pathological), as well as pathological problems (those with tissue alterations.) Initially, the extra insulin often ends up processing sugar too rapidly and blood glucose levels are driven too low. This is called hypoglycemia or low blood sugar. This adds stress to the body and causes the production of other hormones (especially adrenal gland hormones like cortisol), which increase blood sugar levels. As CI gets worse, more and more insulin is needed to process a small amount of sugar. The insulin eventually becomes ineffective at driving the sugar into the cells where the nourishment is needed. The cells have become resistant to the insulin.

As CI is developing, the extra stress on the hormonal system, particularly to the adrenal glands, overworks these organs. This results in a complex pattern of symptoms that differ from person to person.

Symptoms of CI include but are not limited to sleepiness, drowsiness, lack of concentration, or a feeling of being bloated after a meal, especially one containing sweet foods or starches. Always feeling hungry or having weak legs or knees after eating is also a symptom of CI. These are just a few of the functional symptoms.

All of this explains why I have been so incredibly tired…especially the more carbs I eat.

Why does eating carbs cause me to want more carbs?

Sugary foods and drinks, white bread and other processed carbohydrates that are known to cause abrupt spikes and falls in blood sugar appear to stimulate parts of the brain involved in hunger, craving and reward, the new research shows. The findings, published in The American Journal of Clinical Nutrition, suggest that these so-called high-glycemic foods influence the brain in a way that might drive some people to overeat.

For those who are particularly susceptible to these effects, avoiding refined carbohydrates might reduce urges and potentially help control weight, said Dr. David Ludwig, the lead author of the study and the director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital.

Also, research suggests that when blood sugar levels plummet, people have a tendency to seek out foods that can restore it quickly, and this may set up a cycle of overeating driven by high-glycemic foods, Dr. Ludwig said. “It makes sense that the brain would direct us to foods that would rescue blood sugar,” he said. “That’s a normal protective mechanism.”

Makes a lot of sense why I am wanting more carbs…my body thinks it is a reward and is wanting to restore low blood sugars when my levels plummet after they spike. I also have heard from a lot of other people that it is hard to change the mentality that a whole day or even week is wasted once you slip up on your diet. Have to take it a meal at a time…

Getting back on track:

Knowing all this, I am proud to say I made a healthy choice for lunch today:

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Greek salad with fresh feta and grilled chicken kabob. I especially love the garlic sauce many Mediterranean or Lebanese restaurants have. It is just garlic, lemon, olive oil, and ice!

Here are some great articles that helped inform this post:

PCOS: How to explain what you are going through to those you love

As I work through PCOS and Insulin Resistance, my hope is that along with sharing my journey, I can compile some of the best articles I find to make my blog a one stop shop for others looking for comprehensive info on PCOS, IR, and healthy living.

I don’t know about you, but I feel like PCOS has caused such a big lifestyle change, I am constantly trying to explain what is going on with me. Typically, I explain it in a way that my body takes carbs, turns them into fat, and then stores them for longer periods of time than other people. If we were in a zombie apocalypse and food was scare, I would be set. But as a 30-something woman living in LA, fat storage is not nearly as desireable.

Here is an amazing article from one of my favorite resources, PCOS Diet Support. This POV is for your partner, family and significant other. Here is an explanation of PCOS for our partners and significant others..something that makes PCOS easy to understand.

WHAT IS PCOS?

I have PCOS or Polycystic Ovarian Syndrome. I know that you think of it as “woman issues” but it’s important that you know what is happening with me and my body because it affects both of us and I’m really going to need your help in coming to terms with it, living with it and getting it under control.

So, I do have “woman issues”. Basically I don’t ovulate every month, which means that my cycle is very irregular. I also might have some cysts on or in my ovaries. The biggest thing, though, is that I don’t process carbohydrates properly and my body is over sensitive to insulin. This means that I produce too much insulin for the carbs that I eat. The insulin also makes my ovaries release too much testosterone (all women produce testosterone – I just have too much of it).

PCOS is pretty common. Every 1 in 10 women have it so I’m not abnormal or alone in it.

THE SYMPTOMS

The symptoms of PCOS are pretty rough for me to deal with and can make me feel unattractive. I sometimes struggle with my weight. It’s not for lack of trying, I promise! All of that insulin quickly stores my carbs as fat and makes it difficult for me to lose it.

I have hair where I really don’t want hair and I may lose some of my hair on my head. I also may have bad skin (think teenage boy acne). It’s that darn testosterone.

One of the hardest things about PCOS is that having babies might be a struggle. It’s not impossible by any means but might take longer than we’d like.

WHAT I NEED TO DO FOR ME

PCOS is not a death sentence and I’ve made a decision that although I have PCOS, it doesn’t have me. There are things that I can do to manage my PCOS and help with my symptoms.

The biggest thing I can do for me is to lead a healthy lifestyle, keep active and eat properly. This will make my symptoms easier to manage (exercise and diet are huge in dealing with the insulin which will help with the testosterone). The way I eat is not necessarily aimed at me losing weight (although it will help) but on getting healthy. So we can change the way we eat and get healthy together. There are also some supplements that I take regularly which have been really helpful in managing my symptoms.

I can get help from my doctor or endocrinologist (hormone doctor) and there are medications I can take.

If we’re not ready to think about a family, I can also take birth control, which will keep my symptoms in check for a while. As soon as I come off the pill, though, my symptoms will come back so birth control is a temporary fix and can have unpleasant side effects.

If we do decide to have a family and we’re struggling to, we can go to see a reproductive endocrinologist to look into fertility treatments. They’ll want to check you out too and treat both of us if need be.

WHAT I NEED YOU TO DO

The biggest thing I need from you is your love and support. There are times when living with PCOS is going to make me angry, depressed and feel unattractive. Please just love me through it.

I’m going to do everything I know to do to eat properly and exercise. Please help me by eating healthy too and being active with me. Let’s go for lots of long walks, take up mountain biking or ballroom dancing. If you do have treats (which you’re totally entitled to), please hide them from me so that I’m not tempted by them. Also, please share with them with me once in a blue moon because I also deserve a treat every now and then.

Bearing in mind what I said about feeling unattractive, when I’m having an “ugly” day (and they do happen), please remind me how beautiful I am. Encourage me to get my hair done, have a pedicure or a massage. Sometimes I get so caught up in the daily grind of work, keeping a home and our family, looking after my health, that I forget to take some time just for me. I need you to help me do that.

THANK YOU

It sounds a bit trite but thank you so much for taking the time to read this. It shows me that you want to understand what I am going through and want to support me and that means the world to me. Thank you for loving me in spite of my many faults (PCOS included) and thank you for choosing to walk this road with me. Having PCOS is not easy but with you by my side, it makes it a little more manageable!

You can find the full article here: http://www.pcosdietsupport.com/pcos-symptoms/pcos-explained-partner/

PCOS & Insulin Resistance: Fighting Fatigue

Lately it has been harder and harder for me to wake up. Initially, I assumed it was because I was taking on new responsibilities at work and the learning curve was taking a toll on my energy. As it as seemed that fatigue has not improved, I thought I would do a little more research on PCOS and Insulin Resistance to determine if they are contributing to this not so fun fatigue my normal energetic self has been encountering.

As I develop questions on why things are happening to my body while fighting PCOS and IR, my hope is to share my findings with you and make my blog a one stop shop for being the healthiest and happiest you can be. Since I have been feeling so tired, I started to do some research and compiled the best info I found in this post. I hope it helps those of you with PCOS/IR…and people who have just been feeling extra tired lately, too! Many of these symptoms can be due to fluctuating hormone levels and increased anxiety.

As it turns out, PCOS and fatigue are both linked to an imbalance of the endocrine system and are characterized by an excess of male hormones. Fatigue, a symptom commonly associated with PCOS, is also closely linked to the thyroid and adrenal glands. At the heart of both of these issues, however, is a disorder known as Insulin Resistance. Lucky for me…I have both IR and PCOS.

To add insult to injury, fatigue frequently causes women with PCOS to treat their low energy with carbs and caffeine, which dumps more glucose into the blood in a never-ending spiral of weight gain and increasing insulin and glucose levels. As fatigue and insulin resistance worsen, excess fat cells produce too much of another hormone, estrogen.

Here are some additional causes of fatigue and how to combat them. Here’s to hoping this will lead to a more energetic week next week!

Lack of Sleep: Obviously, the first sign that you are zapped of energy could be that you aren’t getting enough sleep. Most adults need 7 to 9 hours of sleep nightly. My Endocrinologist prescribed me with Trazodone to help me sleep…I have noticed a big difference in how rested I feel and my husband says he has noticed I am not tossing and turning as much.

Poor diet: One of the most common causes of low energy can be from eating the wrong foods. Eating a diet high in refined carbohydrates and simple sugars will cause your blood sugar and insulin levels to skyrocket and then crash, leaving you ready for a nap. Start the day with a meal that contains at least 10 grams of protein (eggs or Greek yogurt are two good ones). Swap refined carbs for whole grain ones (try quinoa, faro, or oats) that won’t send your blood sugar into orbit. Over the last week, I have not been eating well due to the nausea, so perhaps this has been a big cause of my fatigue.

DehydrationStudies show that even mild dehydration can result in significant dips in energy levels. You need 6 to 8 cups of fluid each day for proper hydration (yes, this includes caffeinated coffee and tea) so drink up! I really have not been drinking all the water I should…I used to be really good at finishing at least one large water bottle a day at work, but lately not so much.

Exercise: Even if you are tired, exercising can give you more energy thanks to the secretion of feel good chemicals called endorphins. One study found that just 20 minutes of low-intensity aerobic activity three times per week decreased subjects’ feelings of fatigue by 65 percent. This 20 minutes of exercise is right in line with the 20 minutes prescribed by my doctor…I just need to make it happen.

Iron deficiency: If you experience heavy monthly bleeding, don’t eat animal products, or are an intense exerciser, you may be deficient in iron. Since iron’s main role is to transport oxygen, not having enough will make you feel exhausted and out of breath, even with minor exertion. Discuss getting your levels checked with your doctor before supplementing your diet with extra iron. My doctor did prescribe iron for me and even Vitamin C to help improve the absorption of iron. I also do not eat red meat or pork, so I certainly have iron deficiency in diet.

Hypothyroid: When the thyroid doesn’t produce enough hormones it can affect your energy levels. Ask your doctor for a full thyroid panel (TSH alone is not enough).

Gluten sensitivity or Celiac disease: A hallmark feature of someone with celiac disease or gluten sensitivity is fatigue or “brain fog” after eating foods that contain gluten. It’s recommended to be checked for celiac disease, an autoimmune disorder, before adopting a gluten-free diet, which can mask symptoms and prevent an accurate diagnosis.

Vitamin B12 deficiency: If you take birth control pills or metformin or eat a vegan diet, you may be deficient in Vitamin B12. A defiiency in B12 not only causes chronic fatigue, but permanent nerve damage. Ask your doctor to check your B12 levels. Since I am definitely on Metformin, it looks like I should be adding B12 to my daily vitamin regimen as well.

Depression: Depression and fatigue are a vicious cycle with each fueling each other. Being depressed can be like living in a constant fog. Lack of motivation and sleep disturbances can contribute to depression. Engaging in regular exercise can help boost mood. If you feel you are depressed, we recommend seeking treatment from a mental health expert.

Sleep apnea: Several studies have shown that women with PCOS suffer from a much higher rate of obstructive sleep apnea, a disorder that causes your airway to be narrowed or blocked. Even if you do get a sufficient amount of sleep, if you’re not oxygenating well, you won’t feel rested. This can account for the tossing and turning my husband has been tolerating for the last 9 years.

Now that I have a better understanding of these causes, it will make it that much easier to get back to my energetic, positive self again. I hope these tips helped you as well!

Here are some of the helpful articles that helped inform this post:

Thursday Progress: Up 2 pounds, but optimistic for change

When I woke up this morning for my Thursday weigh in, I knew this was going to be a rough week. Between stress and not feeling well, this was certainly not a good week for exercise and low carb eating. As I have said before, this blog is not about a false lifestyle that keeps moving forward perfectly. This blog is about me and the true challenges that I am facing every single day.

Would I have loved to be down this week so I feel extra lovely in my Valentine’s Day dress this weekend? Absolutely. Do I wish that I was not doubled over in pain and able to stay on track? Of course. Do I realize that this is a marathon and sometimes I am going to need a water break? Definitely.

  • To be honest, it is a success that I did not call in sick to work every day this week. The pain has been so intense with cramps and discomfort with nausea that I find it a small miracle that I only missed 1 day of work this week. Success comes in all forms, so this is definitely a win.
  • While this is not a health success per say, I feel like I have been a pretty good friend to those important to me this week. I had a wonderful dinner with a childhood friend last night where we had real conversations about fears, anxieties, and dealing with life. I have a very good friend coming to my house this weekend and I am thrilled about the gift I found for her. A college friend is moving to Europe and I feel like I have been a good support for her as she prepares for this major change. My husband’s birthday is not until June and I already found a perfect gift for him. While these wins are not low carb or fitness related, I feel they bring so much to my life and those around me.

  • Carbs and I definitely got back together this week. In a big way. Pizza, crackers, brown rice pasta, pita chips, rice…it was a love fest for sure. All of this was mostly due to the nausea I have been feeling and the fact that I feel eating carbs really is a floodgate. Once you do it, it’s hard to stop. This weekend will be challenging with lots of celebrations and I know I will do my best…but am also aware that I will slip with food and alcohol as we celebrate a birthday and Valentine’s Day.
  • Exercise did not happen. Since I am calling getting myself to work due to pain I was  having a victory, it is not surprising that I did not pull myself out of bed for 20 minutes of exercise.

Thank you all for your support and encouragement. You inspire me to be honest and to stay steady on my journey. Every day is different, especially when faced with a major lifestyle change. Here’s to the journey…