Monthly Archives: February 2017

Ninety Days: My three-month PCOS Path to Wellness

Three months. Ninety days. A lot can change in a seemingly short time. Personally, I’ve been dealing with some fairly complicated relationships, and it hasn’t been the easiest few months I’ve experienced. However, if there’s one thing I am, it’s stubborn.

I made a commitment on November 4th that it was time for a lifestyle change. I had my first appointment with a new OB/GYN and finally felt like someone was listening. Someone believed me.

I was diagnosed with Polycystic Ovarian Syndrome (PCOS) many years ago, while I was still in college. In a woman with PCOS, the ovaries produce higher levels of androgens, sometimes referred to as the “male” hormone, which can stop ovulation, cause excessive body hair, acne, and depression. In some cases, small benign cysts form on the ovaries, further unbalancing the hormone levels. PCOS causes irregular menstrual cycles, excessive weight gain (despite weight loss efforts), infertility, higher risk of miscarriage, and may lead to gestational diabetes and Type II diabetes. It’s estimated that 10% of women have PCOS, and although the cause is unknown, doctors believe genetics may play a large role. Recent studies have shown a connection between insulin resistance and PCOS. When the body does not respond to insulin from the pancreas normally, the ovaries create more androgens. Additionally, the body’s insulin response throws off metabolic function, meaning the conversion of food to energy is disrupted. That leads to greater storage of fat cells, as the liver converts excess glucose to fat.

Although my hormone levels have never been “right”, the symptoms of PCOS never seemed to bother me too much. Sure, I struggled with infertility, had gestational diabetes during both of my pregnancies, and have to literally wax my eyebrows like every two weeks. But this fall, I started experiencing some new symptoms – hormone-induced acid reflux, painful cramping, hot flashes, and irritability. The acid reflux was the worst, and would occur at night, on the third week of the month, faithfully. It didn’t matter what I ate, or didn’t eat, as even water would bring it on. I discussed the issues with my primary care doctor, who claimed the problems were completely related to my weight. “Since you have PCOS,” he said, “it’s really difficult to lose weight, no matter what you do.” He was right. In the past, I’ve completed the entire P90X program three times, and while I felt my muscles aching, I never actually lost anything. Ninety days. Three months. Nothing Changed. Three times.

“The only thing I can do is recommend bariatric surgery.” The doctor said.

Bariatric Surgery. A few years ago, I went to a mandatory counseling session for people anticipating bariatric procedures, with my former landlord (a story for another time). She wanted emotional support, and while I had no plans of having surgery, I “fit the appearance”, and wouldn’t stand out. So, I played along, and I learned a lot about being overweight that night. I remember something about exceeding the weight limit of most commercially-produced toilets, and falling through the floor.

“We’ll give it a few months and if your weight hasn’t changed I’ll refer you to the bariatric surgeon in Indy.”

I left that appointment feeling defeated. Making my stomach smaller wasn’t going to help. I barely eat, much less overeat. Also, I didn’t have a problem with myself physically. I wasn’t progressively gaining weight, but I wasn’t losing any either. So, unless it was to correct a health issue, I was not having surgery to fit society’s standards.

The hot flashes were getting worse, and I spent countless nights every third week of the month trying to sleep upright and get some type of relief from the acid swishing around in the back of my esophagus. FWIW, estrogen relaxes the lower esophageal sphincter, allowing the stomach acid to reverse course and travel back into the esophagus.

It’s got to be menopause. That was also my first thought when I finally got pregnant and starting feeling sick, so maybe I should stop jumping to conclusions. I didn’t have a large choice of which OB/GYN to see, as my ACA insurance pretty much determined it for me.

I hate doctors, so I didn’t go into the appointment with high hopes. But once I met the doctor, I felt completely reassured. He was the first doctor I’ve seen in my adult life that did not write off all my problems as “a side effect of obesity.” Instead, he believed that the obesity was a side effect itself. We talked about PCOS and having done much of my own research through the years, everything he explained was right on target with what I hoped to achieve. He prescribed me hormone therapy to help with some of the cycle-related symptoms, and we discussed the value of a low-GI (glycemic index) diet. He also offered an appetite suppressant, to help me transition to a different way of eating.

I was happy he listened, but I wasn’t optimistic. I’ve tried this before. Dieting, exercise, starvation, etc. Nothing worked. But he listened. He gave me that, so I should give him the same. That night I came home and committed that we would do this. I didn’t know how, but there’s one thing I love – research. I set an arbitrary goal of 40 lbs. The dr. suggested that 10lbs a month loss is excellent progress, so I wanted to push myself a little more.

Forty pounds. I took the challenge head on. I started walking 20 minutes each day on the treadmill, and cut my daily carb count to under 100. I began weighing all my food and keeping track of my calories and carbohydrates. I set my caloric goals at the bare minimum, 1,200 a day. At first, I had a hard time meeting that, especially being on an appetite suppressant and not eating junk food. Every calorie I took in had to count. On average, my daily calories totaled around 1,000. With Thanksgiving right around the corner, giving up would have been easy. But within the first week, I watched the weight slip away. I lost 6 lbs.! That was only four pounds short of my monthly goal and I was only a week in. Can this actually be possible?

I obsess over numbers. As the days wore on and my food choices as a vegetarian were getting slimmer and repetitive, I started to worry I wouldn’t be able to keep this up. I learned about macronutrients and spent countless hours trying to determine the right percentages for me, and even more so trying to figure out what I could eat that would taste decent and help me meet my numbers.

Calculating, scales, numbers, math, time – everything in my life was revolving around my weight. This isn’t what I wanted. I was happy. I just didn’t want to be moody, hot, or full of stomach acid that wasn’t in my stomach.

I persevered, and little by little I decreased my reliance on refined sugar. I found 85% cocoa chocolate bars, where a serving size was 4 (FOUR!!!!) squares with 15 carbs/serving. That satisfied my need for chocolate, and most nights I’d only eat half a serving. Chocolate for 7.5 carbs with no artificial sweeteners? YES PLEASE.

I also increased my exercise every couple of days, walking a little faster, longer, and farther each time. Although the number on the scale was coming down each time I stood on it, what was most noticeable to me was the way I felt. I wasn’t cranky. I wasn’t overheating. And when week three rolled around, I had zero reflux. I felt better.

At my one month appointment, I had lost 25 lbs. I hadn’t even lost 25lbs when I gave birth, so this was insane to me. I started noticing around Christmas that my clothes were fitting differently, but the holiday also brought a lot of stress. Since I kept thinking of this as a lifestyle change and not a diet or weight loss strategy, as the initial goal was to manage my PCOS, I stopped weighing my food. I let the numbers go. I became more comfortable with my low-to-no-carb options, and as I conquered my sugar addiction, I found my sweet tooth subsiding. I just…ate. Then I exercised.

When I had my second month check-up, I had plateaued. They continued to encourage me, as I had not gained any weight over the holiday, but I hadn’t lost any either. “This is normal,” the doctor reassured me. “Just keep doing what you’re doing.”

I was frustrated. The only thing I changed was not weighing everything that went into my mouth. This is not how I wanted to live. I don’t have time for this. And it was definitely not something I’d keep up over the long-term. I reminded myself of my original goal. This was not about losing weight. It was about feeling better. And I felt better. Plus, when everything else seems to be falling apart – relationships, friendships, etc. – this gave me a sense of control throughout the uncertainty. I kept going.

On February 2, 2017 I had my three-month weigh-in. Thirty pounds lost would be ideal, and ensure that the diagnosis of insulin resistance was correct. When I stepped on the scale, and the nurse stopped the slider, we looked at each other. I was down 15 more pounds. Total loss: 40 lbs.

Forty pounds. I did it.

It’s been hard work. I didn’t get to eat fun cookies at Christmas, or partake in birthday cake on December 9th, or stuff my face with warm delicious dinner rolls and breads. What I do get is a heightened sense of taste, as my taste buds have recovered from being inundated with refined sugar. Everything tastes sweeter now, and I’m able to identify savory flavors and find them satisfying. I have chocolate maybe once a week now, and that’s a generous estimate, instead of every day. I no longer use artificial sweeteners at all, and drink my coffee with just cream. And my daily carb count is well below 50, sometimes under 20 on a good day.

I’ve moved on from walking to running mostly, and I strive for 1.75 to 2 miles a day. This doesn’t seem like a lot, especially if you’re an avid runner, but for me, it’s a huge accomplishment. I’ve also started an hour of Vinyasa yoga each morning, to clear my mind and stretch my muscles.

I didn’t discuss my changes with many people, only those closest to me. Because weight loss is such a touchy subject for many, I didn’t want to brag or come off as insensitive to those who are struggling with losing weight. I was there. I watched people’s transformations. And while I was genuinely happy for them, I was also mad that I couldn’t do it. Even Tony Horton couldn’t help.

My journey is hard for me to share. And as forty pounds has left, so has a portion of my confidence. I’m much more self-conscious about my body now. It’s unfamiliar to me.

I jiggle in places I never jiggled before, my skin is lumpy and saggy, and none of my clothes fit right. I’ve downplayed my hard work and progress, because I wanted to remain humble. But if I remember this for what it initially was (and continues to be), a lifestyle change and not a weight-loss solution, then my intentions should remain clear.

I feel better. Fat is not my enemy. My ovaries are not my enemy. Carbs are not even my enemy. My only enemy is my own self-doubt.

I don’t believe in pride, but I do believe in celebration. I set a seemingly impossible goal only three months ago, and I achieved it. Since my appointment last week, I’m down another 4 lbs., and am finding the lifestyle even easier to maintain. I allow myself a cheat here or there, (the shamrock shake is back guys!) but honestly, I don’t even crave carbs or sugar anymore so it’s a lot easier to pass up.

Each day is a new culinary adventure, and while I’ve stopped obsessing over the numbers, I enjoy the challenge. I’m hoping to complete a charity 5k later this summer, as that has become my new goal. Wish me luck, and here’s to health and happiness!

 

BEFORE: April 2016

BEFORE: April 2016

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Now: February 2017