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:

IMG_0956

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/

Insulin Resistance and PCOS: Medication

I am not a doctor. Or even close. But I have been blessed with amazing doctors who are helping me get my PCOS and Insulin Resistance under control.

PLEASE NOTE THAT THIS FEEDBACK IS NOT ADVERTISING…trust me, these drug companies have no idea about this blog. This post is just my pure, honest feedback on my medication.

That being said, I do want to say that the combination of medications I have been placed on (along with my 110g a day of carb diet) has turned my life around. I am currently down 11 pounds in 2 months and have regained a menstrual cycle…both of which seemed impossible 2 months ago.

Overall, I will say my side effects have been very minimal. It is hard to pinpoint what medication is causing these effects..but as you can see, the list is pretty short:

  • Nausea- this was probably the worst during the 1st month of medication. My doctor explained that PCOS was causing increased testosterone making my 30-year-old body think I was going through menopause. These medications helped balance my testosterone and estrogen levels, so body basically went from thinking I was in menopause to thinking I was pregnant. When I told my doctor of this side effect, he was happy to hear this because it meant the medication was working.
  • 2 periods per month – this one has been extra fun. My guess is that since PCOS stores up your eggs (since you are not regularly ovulating), I am thinking that now my estrogen levels are normalizing, my body wants to ovulate as much as it can. This is definitely something I plan to discuss with my doctor in my upcoming appointment. This side effect could be considered a benefit for anyone trying to get pregnant!
  • We are not trying to get pregnant, but if we were…my doctor mentioned all these medications are OK for pregnancy except for the diuretic (Spironolactone)

Here is a rundown on the medications I am prescribed based on info I compiled from Drugs.com. Please check out the links at the bottom of the article for risks and side effects…AND PLEASE DISCUSS THESE OPTIONS FOR YOU WITH A MEDICAL PROFESSIONAL AS I AM NOT A DOCTOR.

My doctor said that while medications help, diet is the most important factor in managing Insulin Resistance and PCOS…so more info to come in later posts on healthy, low carb recipes I love!

Metformin (Primary use for me: Type 2 Diabetes treatment)

 Metformin is an oral diabetes medicine that helps control blood sugar levels. Metformin is for people with type 2 diabetes and sometimes used in combination with insulin or other medications, but it is not for treating type 1 diabetes.

Spironolactone (Primary use for me: diuretic)

Spironolactone is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.

Spironolactone is used to diagnose or treat a condition in which you have too much aldosterone in your body. Aldosterone is a hormone produced by your adrenal glands to help regulate the salt and water balance in your body.

Spironolactone also treats fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome. This medication is also used to treat or prevent hypokalemia (low potassium levels in the blood).

Trazodone (Primary use for me: taken at bedtime to help me sleep)

Trazodone is an antidepressant medicine. It affects chemicals in the brain that may become unbalanced and cause depression.Trazodone can be used to treat major depressive disorder.

Propanol (Primary use for me: beta blocker taken as needed when PCOS/IR causes rapid heartbeats from stress)

Propranolol is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).

Propranolol is used to treat tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. It is also used to treat or prevent heart attack, and to reduce the severity and frequency of migraine headaches.

Here are the resources I used to help inform this article:

Blogging while working is TOUGH: 4 Survival tips for balance

“Happiness is not a matter of intensity but of balance, order, rhythm and harmony.” ~Thomas Merton

So…what’s up, friends? It has been a while. I promise I didn’t want to breakup with you…this breakup is about carbs, not my followers!

It has become painfully clear that blogging and working makes for a very difficult life balance. I found that my time with my husband and pups was getting majorly impacted and if it wasn’t that, then my sleep hours took a hit.

Like most things you love…I felt like something has been missing these last couple weeks without the happiness that writing to help others was giving me. With the hope to keep my account of my carb breakup in tact, here are some helpful tips and tricks to keep the blog going. For all you writers out there…hope this is helpful for you too!

1.) Carry a notebook with you. Sometimes you can get an idea for an excellent post when you are at work, hanging out with your friends or when you just woke up. While you won’t always have the opportunity to write this post right away you can jot it down in an old-fashioned notebook or even on your smartphone. When it is time for your next blog posts you will have an excellent idea waiting for you. I have found keeping a running list of upcoming topics has also been helpful

2.) Develop a routine that is non-negotiable. So much of my life is focused on schedules and deadlines. While I hate to hinder my passion for writing, I need to realize that to have balance…a set schedule for blogging will be key. My hope is to make this time either Friday afternoons (I am lucky enough to work for a company with early release every Friday) or Sunday nights. Since life is a moving target, I will be flexible with when I will write…but will commit to 2 hours at least every week

3.) Schedule daily posts. Once the content is written over the weekend, schedule the posts throughout the week so they are up and running without distracting from my day job.

4.) Work on your dream every day, knowing there are no guarantees and that it may take a long time to make the kind of progress that allows you to devote your full-time energy to your passion.

Here are some awesome articles from other bloggers on how to balance writing and working:

Insulin Resistance and PCOS: Glucose Tolerance Test

Once I was diagnosed with PCOS, the next step was a visit to my Endocrinologist. In that appointment, we discussed the confirmation of my PCOS test results  and all the symptoms I had been experiencing. Like most doctor appointments, it is imperative that you share everything you can to give the doctor as much information as possible. While it is never fun to admit all the things that are wrong with you, it is so important to get the best possible diagnosis. Seems easy enough, but I know many people who struggle with communicating this type of information.

After we chatted and he completed a brief physical exam (heart rate, blood pressure, joints) he wrote an order for some blood work. Now, I will tell you that I AM TERRIBLE WITH NEEDLES.  (Triple emphasis definitely needed for this point). Going into the test, I really didn’t know what to expect. In my case, that was probably better so that I didn’t chicken out when it came time for the appointment, but I do wish there had been a better resource on the whole procedure.

Here is a breakdown of what exactly a Glucose Tolerance Test is, how my experience went, and tips & tricks to make your experience as good as possible.

What is a Glucose Tolerance Test?

Though no longer routinely used for diagnosing diabetes. The oral glucose tolerance test (OGTT) was the gold standard for making the diagnosis of type 2 diabetes. It is still commonly used during pregnancy for diagnosing gestational diabetes.

With an oral glucose tolerance test, the person fasts overnight (at least 8 hours, but not more than 16 hours). The next morning, the fasting plasma glucose is tested. After this test, the person receives a dose of oral glucose (the dose depends upon the length of the test). Usually, the glucose is in a sweet-tasting liquid that the person drinks.

Blood samples are taken up to four times at different time points after consumption of the sugar to measure the blood glucose.

The classic oral glucose tolerance test measures blood glucose levels five times over a period of three hours. Some physicians simply take a baseline blood sample followed by a sample two hours after drinking the glucose solution. In a person without diabetes, the glucose levels rise and then fall quickly. In someone with diabetes, glucose levels rise higher than normal and fail to come back down as fast.

People with glucose levels between normal and diabetic levels have so-called impaired glucose tolerance (IGT). People with impaired glucose tolerance do not have diabetes.

What about glucose tolerance testing and pregnancy?

While this was not the case for me, the glucose tolerance test is used for the diagnosis of gestational diabetes (diabetes that develops during pregnancy). It may be used if there are equivocal fasting or random blood glucose results, or to screen for gestational diabetes in pregnant women between 24 to 28 weeks of gestation who are not known to have diabetes.

You have an increased chance of developing gestational diabetes if you:

  • Have had gestational diabetes during a previous pregnancy.
  • Have previously given birth to a baby who weighed more than 9 lb (4.1 kg).
  • Are younger than age 25 and were overweight before getting pregnant.

The test may also be used in the postpartum period to detect diabetes in women who had gestational diabetes during pregnancy. Women who had gestational diabetes do not always develop diabetes later in life, but they should undergo diabetes screening at least every three years throughout.

My experience with the Glucose Tolerance Test

Fasting is no fun. At all. I live in Los Angeles and drove down to Orange County where my Endocrinologist is located the night before and had dinner with my family. At the time, I didn’t know what to expect for the test…I just knew that not getting to enjoy my normal Friday night vodka sodas throughout the evening was a bummer.

We woke up very early the morning of the test and the hunger had to be ignored. No caffeine was also pretty rough.

Once we arrived at the Lab, some initial paperwork was filled out (signing away that you won’t sue the hospital in case something goes wrong is always super reassuring, especially when you hate needles.) We were then escorted into a room for testing. At this point, I am dead silent and look like I have seen a ghost. As a typically talkative person, this was a very different behavior for me. I was terrified.

Since it was early in the morning and my fear was empty with no upcoming appointments, they placed me in a room typically used for children. That’s right. I am that much of a baby. I will say they private room with comfortable chair was fantastic, all baby behavior aside.

The technician then described the procedure to me. I will tell you that either by my mother’s intelligence, an act of an angel, or likely both…I had no idea what I was in for. When the technician explained it was going to be 3 hours and I was going to get poked for a new blood draw every 30 minutes, I wanted to bolt. Every 30 minutes?! A new draw?! 3 hours?! Oh man.

At that point, there was no going back. An initial draw was done and I lost it. I started hyperventilating and crying. I know this is quite dramatic for many strong women who have gone through this, but I think that the reality that I had a health concern was really clear at that point. Days of eating nachos at 2 in the morning, drinking whatever I wanted, and just ignorantly cruising through life with carbs were certainly numbered.

After the initial draw and some time, the technician game in with the super sugary glucose drink. I chose the lemon lime flavor and it basically tasted like she dumped a pound of sugar into a Sprite. I was not into it. My stomach definitely hurt from the sweetness, but we had to keep going.

The remaining draws did not go well for me. In 2 of the draws, my difficult veins did not cooperate causing the need for a redraw after redraw. On the last draw, the nurse suggested we place a heating pad on the location of the draw to help the blood vessels to expand so the process would be easier. She was right, but it would have been nice she shared that info earlier on in the process. This is now a tip I will use any time that I need blood work.

Once the test was over, I was exhausted and pretty loopy. My mom ran to the hospital cafeteria and brought my some crackers which were the most delicious crackers I had ever tasted. I wish we had brought something with us from the get go.

After the test, I was exhausted. Initially, we were planning to go out to lunch and then have me go right back to LA. Instead, we went back to my parents’ house for lunch and I went back to bed. For 4 hours. After that, I was mostly back to my normal self, just tired.

What I wish I knew before the Glucose Tolerance Test

Ideal patient preparation and behavior before the test:

  • For the glucose tolerance test to give reliable results, you must be in good health (not have any other illnesses, not even a common cold).
  • You should be normally active (not lying down, for example, as an inpatient in a hospital)
  • You should not be taking medicines that could affect the blood glucose.
  • You should eat and drink as they normally would the day before.
  • The morning of the test, you should not smoke or consume caffeine.

What to plan during and right after the test:

  • The glucose tolerance diagnostic test may take up to 4 hours. Since activity can interfere with test results, you will be asked to sit quietly during the entire test. Do not eat during the test. You may drink only water during this time. Definitely bring something to entertain yourself like music, books, anything to help pass the time.
  • If you are like me and have difficulty with needles along with challenging veins, be prepared that multiple attempts for the multiple draws may be needed. I wish that we applied heat to the draw area from the start. If you can, let the technician know you struggle with needles and would like a heating pad. Or simply bring your own heating pad to help be sure that you will be set.
  • After all that fasting, you will be hungry. Be sure to pack a snack that you can eat right after the test. Cheese crackers were my saving grace.
  • You are going to be tired and perhaps light headed, so have someone come with you who can drive you home.

What to expect after the test:

Each year, 1% to 5% of people whose test results show impaired glucose tolerance actually develop diabetes. Weight loss and exercise may help people with impaired glucose tolerance return their glucose levels to normal. In addition, some physicians advocate the use of medications, such as Metformin (Glucophage), to help prevent/delay the onset of overt diabetes. Studies have shown that impaired glucose tolerance itself may be a risk factor for the development of heart disease, and whether impaired glucose tolerance turns out to be an entity that deserves treatment itself is something that physicians are currently debating.

  • Normal response: A person is said to have a normal response when the two hour glucose level is less than 140 mg/dl, and all values between 0 and 2 hours are less than 200 mg/dl.
  • Impaired glucose tolerance (IGT): A person is said to have impaired glucose tolerance when the fasting plasma glucose is less than 126 mg/dl and the two hour glucose level is between 140 and 199 mg/dl. This is sometimes referred to as “prediabetes” because people with IGT have a higher risk of developing diabetes.
  • Diabetes: A person has diabetes when two diagnostic tests done on different days show that the blood glucose level is high. This means either the two hour levels is greater than 200 mg/dl or the fasting glucose is noted as greater than 126 mg/dl. A glycosylated hemoglobin (HbA1c) level of 6.5% or more also supports a diagnosis of diabetes mellitus.
  • Diabetes during pregnancy: A pregnant woman has diabetes if she has a fasting plasma glucose of over 92 mg/dl, or a two hour glucose level greater than 153 mg/dl.

More to come on my follow up appointment and the medication I was prescribed!

Here are some of the great resources that helped inform my article:

Insulin Resistance Diet: 110g of Carbs a Day

If you are like me, you have tried multiple diets from some carbs, to all carbs, to absolutely zero carbs. It seems that most diets are hard to maintain and really vary in results. It can be so frustrating to work hard and long for a change in your body, especially as you watch most of the men in your life scarf down an entire pizza or 10 chicken soft tacos for dinner while you are eating what they affectionately call, “rabbit food.”

I have come to learn that dieting is a reality for almost every woman I know. It is fascinating how different everyone’s bodies react to food and even more interesting as I learn more about how my body reacts to carbohydrates.

Diets and I have never been the best of friends. I struggle with the self control, especially during celebrations, weekends, stress, work trips, restaurants…you get the picture. I am happy to say that the diet discussed with my Endocrinologist really has been significantly more manageable than anything else I have tried in the past.

DISCLAIMER: I am not a Dietitian or Doctor, but I am someone who has spent a significant amount of time wondering why I could not lose weight and am now happily to report I have found an attainable approach.

Here are my rules of the road for food when it comes to food while battling Insulin Resistance and PCOS:

Stick to 110g of carbs every possible day

Let’s be real…not every day can be perfect and slip ups certainly happen (I have no idea how those chips and guacamole ended up in my mouth last night.) However, it is important to try to stick to 110g of carbs (this is ALL carbs including veggies) whenever I possibly can.

My Endocrinologist broke up the 110g of carbs like this for me: 30g of carbs per meal and 20g of carbs for snacks.

This can be tricky, but with the right tools, it really is quite manageable. Here is the app I use to get a ballpark amount of carbs in each thing I eat:

Whether you want to lose weight, manage your diabetes or improve your health; there are no quick fixes and fad diets don’t work. It’s your everyday food choices that count. That’s where there reliable and convenient guides come in.

To make the smart food choices that lead to permanent weight control, you must become aware of what you eat on a day-to-day basis. The CalorieKing Calorie, Fat & Carbohydrate Counter is the most accurate resource for calorie, fat & carbohydrate counts.

Take it everywhere; look up foods before you eat, when eating choices count the most! With over 15 million copies sold, this pocketsize guide consistently receives the highest average reader rating of all books of its kind and is recommended by health care professionals.

If you are like me and love your apps, you can download the app for free!

The app icon looks like this:

The user interface looks like this:

These are some of the great features:

  • Calorie and carb counts for 70,000+ foods
  • Most accurate and up-to-date database
  • Includes 260 fast food chains and restaurants
  • Great for people with diabetes tracking carb intake

Over time, you will find that you can remember how many carbs are in some of your favorite foods. You will get very good at counting the carbs in your head and making the right choices accordingly. This may seem tedious, but you will find that it gets easier over time and that there still are many delicious foods with no carbs.

Enjoy the carb free/low carb foods 

Comparing this low carb diet to other diets I have tried in the past, I have found myself enjoying foods that were restricted before and that my friends on low calorie diet cannot eat. Remember, for people with Insulin Resistance, it is more about carb monitoring than calorie monitoring.

Protein

All naturally-occurring meats contain no carbohydrates; however, pre-packaged and deli meats are often processed with a sugar and salt solution or seasoning blends, conferring carbohydrates to the meats. Processed and cured meats, such as sausage, ham, bacon, and frankfurters regularly contain small amounts of carbohydrates. Reading package labels is essential to learn if pre-packaged products contain carbohydrates. In their natural state, the following contain zero carbs:

  • Beef
  • Veal
  • Lamb
  • Pork
  • Chicken
  • Turkey
  • Fish (such as salmon, trout, and halibut)
  • Duck
  • Goose
  • Fish
  • Shellfish (such as crab, shrimp, and lobster)
  • Mollusks (such as oysters, mussels, and clams)
  • Game meats (such as venison and elk)
  • Exotic meats (such as ostrich and emu)
  • Eggs

Condiments, Seasoning, and Oils

Most condiments contain carbohydrates. Likewise, salad dressings and mayonnaise often contain some carbs because they are made with vinegar and may contain herbs. The following oils and condiments do not:

  • Salt
  • Vegetable, nut, and fruit oils such as avocado, grapeseed, safflower, canola, and olive oil
  • Animal fats like fish oil and lard
  • Some brands of margarine and shortening – read package labels

Sugar Substitutes

Aspartame, sucralose, stevia, and saccharine are all advertised as low-carb alternatives to sugar. Because they are so highly sweet, it only takes a little of a sugar substitute to go a long way. While these are likely to contain trace amounts of carbohydrates, you can effectively consider them no-carbohydrate foods; however, sweeteners may affect insulin in the same way sugar does, so proceed with caution. Additionally, sweeteners in granular form may contain carbohydrate-containing fillers.

Beverages

Many beverages contain zero carbohydrates; however, if they are sweetened with artificial sweetener, they may have some of the same caveats as listed above. Along with diet soda, Crystal Light, and other sweetened beverages, water, coffee, tea, and distilled alcohol contain zero carbohydrates. Use alcohol with caution, however, because your body prioritizes the alcohol first. This means that you burn alcohol before utilizing other fuel, including fat.

Don’t completely cut out carbs

Although reducing your carb consumption — when coupled with an increased protein intake — can help you control your overall calorie intake for weight loss and healthy weight management, your body does need carbohydrates on a daily basis to function properly. Consuming too few carbs can lead to nausea, headaches, dizziness, constipation, weakness and fatigue.

How carbs impact the body:

It is interesting to think abut carbs and how they play into the body.

You can appreciate this a lot more when you realize that there are eight essential amino acids and eight essential fatty acids required for life. These same nutrients are used all over the body for normal and constant metabolic processes such as repair of hair, skin, bone, muscle, red blood cells. Fat is used for energy purposes, protein only in ketosis.

Compare this to carbs, which have a very limited role around the body, in fact it’s only the brain that needs carbohydrates as a fuel source, most cellular processes are happy using fat. That’s one of the reasons why we are designed to carry so much of it around with us.

Carbs do provide us with fiber and minuscule but essential amounts of vitamins and minerals which are very difficult to store (unless they’re fat soluble), and if they’re not used at that time, they are passed through the body very quickly.

This means the main role of carbs is to top up the liver and muscles which are not as big a store as some people would realize. A closer look at the anatomy of a person reveals that the human liver can hold approx 80-100g of carbohydrates and the muscles can only hold 1-2% of carbs by volume, known as glycogen.

Be patient with yourself

Any change in your lifestyle takes time. Be patient with yourself and keep exploring trial & error as you navigate a diet that is best with you. With some patience and discipline, you will be on your way to a healthier you before you know it!

Here are some of the great resources that informed this post:

PCOS 101: How I found out about Insulin Resistance and the start of a health transformation

As women, we spend the majority of our lives trying NOT to get pregnant. We have countless ways we do this and countless nights we lose sleep thinking that these ways aren’t enough as we anxiously await our “Aunt Flo” to come visit. The feeling of complete relief of getting that “visit” after her “flight was delayed” washes over us and all is good again.

Last summer, I waited for this feeling of relief for my period to come for days. Not just a few…for nearly 160 days I waited. Like many women with PCOS, I was on birth control for 10 years (Minastrin 24 Fe) which masked the symptoms of PCOS. From research I have found, many women with PCOS had delayed revelations they had PCOS due to a birth control pill.

Ironically, Minastrin was prescribed to me because it works well for women with migraines and for me, the migraines were caused by PCOS. There are all sorts of chicken before the egg metaphors I could make, but I will simplify by saying that getting off the pill was what let me know for sure I had PCOS. To be honest, going off the pill was a complete fluke due to an insurance blip, but it ended up being the best thing that could have happened to me.

Since I know this is not an option for most, here is a helpful article on how to diagnose PCOS while on a birth control pill: http://www.livestrong.com/article/213652-how-to-diagnose-pcos-while-on-the-birth-control-pill/

If you think you might have PCOS, here is a helpful guide I found on Pinterest for PCOS symptoms:

PCOS

If any of these symptoms describe you, you should go to your OBGYN as soon as possible. Here is an account of what I experienced that fateful day I found out I had PCOS. I have provided details and tips in the hope it will make your visit that much easier.

DISCLAIMER: I am not a doctor and each doctor is different…my hope is this will be a piece of a puzzle to help women get healthier and happier:

1. To pee in a cup. Because that’s how OBGYN’s roll.

2. A verbal exam with your doctor. Be sure to tell them in detail all of the symptoms you have been experiencing. For me, my highlights were the missed period.

3. An ultrasound – this part was probably the hardest for me. My husband was planning to go to the appointment with me, but since I assumed my period was delayed due to the amount of time I was on the pill, I didn’t think I would need him there for a standard visit. I was wrong.

There was no physical pain with this, but actually seeing an ultrasound of my ovaries, then seeing them filled with cysts was terrifying…especially because I was not sure what to expect. Here is a medical drawing of normal ovaries vs. ovaries impacted by PCOS:

Normal Ovary and Polycystic Ovary

Many of us have very negative connotations with the word cyst…I can tell you firsthand that when this fear washes over you, feel it. I am all about being true to yourself and your emotions…even if that means a good, old-fashioned ugly cry.

Once you have started to process the emotions, “keep your chin up” as my beautiful Grandmother used to always say. PCOS IS TREATABLE (for those of you who are new to my blog, I truly hate the triple emphasis in the workplace. It is very rare ALL font treatments are needed, so if I use it in this blog, it means I am REALLY  excited and passionate about the point.)

4. Once we saw the cysts, my doctor wanted to be certain that it is in fact PCOS. She said to diagnose, they typically like to confirm 3 signs: Missed period, ultrasound, and then blood work.

As you will learn from my journey, I am TERRIBLE with needles (triple emphasis was definitely need for this point. I mean, truly.) We went back to the blood work room and about 3 viles of blood were taken.

INSURANCE TIP: One important thing to note that I learned the hard way (after many painful calls back and forth with insurance) is that you need to ask your technician to file the test to the lab as testing for PCOS, NOT for infertility. I remember getting the bill from the lab that was hundreds of dollars. To pour some more salt in the wound, reading the words “INFERTILITY” really did not help at all. I later found out if the test had been filed under PCOS, I would have been saved all this pain and time.

Since I have difficult veins and overall fear of needles, this process was much harder for me than it probably is for most. I remember the technician tried to draw blood in the typical inside elbow joint location with no luck saying my veins weren’t cooperating. Enter: uncontrollable tears. I kept thinking to myself, “Great, not only are my cysts not working, but now my veins aren’t either. My body is just a screw up.”

Looking back, I can tell you that this was a knee jerk reaction, but I did tell you that having no experience what to expect, emotions were heightened for me. I wish there was someone there that would have shared that 1 in 10 women experience PCOS which equates to about 5 million women as young as 11 years old. I wish there was someone there to tell me that it is  CURABLE AND NORMAL

My hope is that my account of what I experienced will help you or someone you know start rocking down that path of good health and healing.

Now that you have heard my account, here is a quick 101 on PCOS:

Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem that can affect a woman’s:

  • Menstrual cycle
  • Ability to have children
  • Hormones
  • Heart
  • Blood vessels
  • Appearance

With PCOS, women typically have:

  • High levels of androgens (AN-druh-junz). These are sometimes called male hormones, though females also make them.
  • Missed or irregular periods (monthly bleeding)
  • Many small cysts (sists) (fluid-filled sacs) in their ovaries

What causes PCOS?

The cause of PCOS is unknown. But most experts think that several factors, including genetics, could play a role. Women with PCOS are more likely to have a mother or sister with PCOS. Even though she wasn’t diagnosed, we are pretty sure my Mom had PCOS.

A main underlying problem with PCOS is a hormonal imbalance. In women with PCOS, the ovaries make more androgens than normal.  High levels of these hormones affect the development and release of eggs during ovulation.

Researchers also think insulin may be linked to PCOS. Insulin controls the change of sugar, starches, and other food into energy for the body to use or store. Many women with PCOS have too much insulin in their bodies because they have problems using it. Excess insulin appears to increase production of androgen. High androgen levels can lead to:

  • Acne
  • Excessive hair growth
  • Weight gain
  • Problems with ovulation

You can check out my 101 on Insulin Resistance here: https://mycarbbreakup.wordpress.com/category/intro-to-insulin-resistance/

So how is PCOS treated?

Once I received my blood work results and received confirmation I had PCOS, I made an appointment with an Endocrinologist. Insulin Resistance is so commonly mis-diagnosed as depression, anxiety, and obesity that an Endocrinologist is really your best bet to get proper medication.

I can tell you that after just one month on the medication prescribed to me by the Endocrinologist, I received my period for the first time in 4 months and was down 10 pounds. More to come on medication and healing!

Here is a great chart on living with PCOS from @HarmonyWithPCOS

PCOS rules for healthy lifestyle #changinghabits #healthylifestyle #health Embrace a new, healthier lifestyle. www.kangabulletin...

Here are some of the great references I used to inform this article. Happy reading!