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?

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: 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:

Progress Check-In: Eating late and weight gain

It has been my routine to weigh myself every Thursday, first thing in the morning, to check on my progress. As I continue down my journey of fighting Insulin Resistance and PCOS, I hope to document my progress every Thursday along with tips that can hopefully help you as you journey toward a healthier, happier you.

Before I jump into the specific progress of this week, I think it is worth capturing the progress I have already made. When I was first diagnosed with Insulin Resistance and PCOS, I was overweight and my testosterone levels were at about 90 (an average woman is about 40 and below). Since being on a low carb diet and taking medications prescribed by my Endocriologist, I am down 9 pounds and my testosterone levels went from 90 to 40 in one month. To keep this momentum, I have been working on the following goals:

  • Stay under 110g of carbs per day
  • Consistently take my medication (post coming soon on medication I am taking)
  • 20 minutes of exercise per day

We all know the holidays are a time for joy, love, family, and…weight gain. I was on a great path before the holidays of being down 12 pounds, but alas. All that egg nog and holiday cider caught up with me.

I have been on a great path this past week, but I am sad to say I was up 2 pounds since my weigh in last Thursday. Here are the successes and challenges of the past week that I believe could have led to this weight gain:

  • Got back to exercising for the first time in MONTHS. I committed to begin exercising yesterday and continued momentum this morning with another workout!
  • Cut out alcohol during the week. Trust me, this is a BIG success because nothing makes me happier than a glass of wine after a good day. Or a hard day. Or any day.
  • Stayed low carb for virtually every meal. That includes saying no to some delicious and free office treats

  • Continue the momentum of this week’s workout success and work to meet my goal of 20 minutes of exercise…every day. For next week, I will aim for 4 out of the 7 days. If 7 happens, then AWESOME…but in my experience, going from 0 to 60 is not very maintainable
  • Last night was an especially late night, so I did not eat until after 9pm. I think this is a BIG reason I was not down this morning’s weigh in.

Since eating late from time to time is a reality for most of us busy people, here is some info I found on weight gain and eating late to help keep me motivated that I am moving in the right direction.

Eating late and weight gain:

The truth is…

“A calorie is a calorie,” says Mass. “If your total calorie intake for the day is greater than what you are burning, this can lead to weight gain regardless of what time it is.” But if you eat healthy, regular meals throughout the day and typically have dinner around 8 p.m., there’s no reason to stress.

Problem is, research suggests that many women take in nearly half of their daily calories at—or even after—dinner. One study found that a third of people consume 15 percent of their calories after 11pm.

What’s more, binging close to bedtime can increase your blood sugar levels for a full 24 hours, according to one study in Obesity of Research & Clinical Practice. Meanwhile, research in the Journal of Clinical Sleep Medicineshows that noshing on high-calorie, high-fat snacks at night can make for restless sleep. The result: Overeating the next day in a feeble attempt to boost your energy levels, says Mass.

There’s nothing wrong with eating a light, healthy snack after dinner as long as you plan for it as part of your daily calories. To keep from overeating, pay attention to your food while eating, avoid eating in front of the TV, and choose a portion-controlled snack.

When you’re trying to lose weight, eat regular meals and consume 90% of your calories before 8 p.m.  The benefit of eating meals every three to four hours is it helps regulate your blood sugar, and thus control hunger and cravings. That should leave you about 150 to 200 calories to play with for a late-night (and guilt-free!) snack.

What this means for me: Hopefully, late night eating will be prevented as I learn more about my new job AND find a way to balance the blog with work. I will NOT get discouraged about my weight today and will keep on keeping on.

Here are some great resources on eating late and weight gain I referred to in this article:

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!