The Endocrinologist, the Dietician, & I

My very wonderful family doc sent me to an Endocrinologist to explore treatment options for the symptoms of Polycystic Ovarian Syndrome, which I've known I've had for about 17 years now. More than likely, I started experiencing these symptoms initially as a teenager, but back then, things were different. Now there is, apparently, a vast body of knowledge available to healthcare providers that wasn't known then. I'm about to tell you what I've learned about myself and the new options out there. To be fair, I'm about to discuss things like menstrual cycles, so if you're uncomfortable reading about "stuff like that", stop now. :)

First, some of the symptoms of PCOS:

# infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
# infertility or inability to get pregnant because of not ovulating
# increased growth of hair on the face, chest, stomach, back, thumbs, or toes
# acne, oily skin, or dandruff
# pelvic pain
# weight gain or obesity, usually carrying extra weight around the waist
# type 2 diabetes
# high cholesterol
# high blood pressure
# male-pattern baldness or thinning hair
# patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
# skin tags, or tiny excess flaps of skin in the armpits or neck area
# sleep apnea―excessive snoring and breathing stops at times while asleep

Now, I don't have all of these symptoms, but I do have a great many of them. I'm not diabetic, which is a great thing, but i DO seem to have insulin resistance. My cholesterol was higher than we wanted it to be at my last physical, I do have well-controlled hypertension, and I'm most certainly overweight.

I started my menstrual cycles around the age of 10, which is pretty young, I know. I do not recall a time when I had normal cycles. By the age of 16, I was placed on birth control pills, due to my irregularity. At that time, I had been bleeding, though not heavily, for about 3 months straight. Prior to the 3 straight months, I didn't have a period for about 6 months, with absolutely no chance that I could have been pregnant. I remained on the pill for most of my 20s. There was a time, though, when I was not on the pill and I did get pregnant unexpectedly. However, I miscarried at about 3 months, and didn't realize I was pregnant until that happened. I was actually glad that I miscarried, though, because I knew I didn't want to have children with my then-husband. I definitely got back and stayed back on birth control pills until just before I remarried. I would have been very OK with having children with my second husband, but it just wasn't meant to be.

My PCOS was diagnosed as the result of a Laparoscopy performed on me in 1989, when I was about 26. I'd been having a lot of abdominal pain that was not otherwise explained. I had test after test, from CT scans to an IVP (to check for possible kidney stones), but they all came up negative, so I had my first surgical procedure. The OBGYN who did the surgery stated that my ovaries were covered with cysts and that one of them bursting was more than likely the cause of my pain. I am now 43 years old (44 in less than a month!!) and only got pregnant that one time. I do not want children now. Treating PCOS for me is about overall health, not fertility.

So, the Endocrinologist spoke with me for a long time. I told him my psychiatrist had initially suggested I try to get a prescription for Byetta, an injectable drug given to those with pre-Diabetes or Tyep II Diabetes most often. She also has PCOS and felt it would help me lose weight, in addition to probably making me feel more energetic. I told my family doc, and she agreed to send me to the Endocrinologist, who also hooked me up with the Dietician in his office for metabolic testing.

The results? I have a very fast metabolism and that, get this, I DON'T EAT ENOUGH!!! Now ain't that a kick in the pants? lol All of my life has been overshadowed, it seems, by diets, and trying to eat less and lose weight, but nothing ever worked long term. Sure, I could lose weight for a month or two, but then, even if I stayed on the diet, I would just stop losing. Now I weigh enough that, again, get this -- I NEED 2100 - 2500 CALORIES A DAY TO LOSE WEIGHT!!! Why, you may ask? Because our bodies reserve calories to use for the essentials, like heart beat, brain fuction, respiratory function...and when you weigh more, you need more calories to keep things like that going. Basically, my body thinks I've been starving it and has revolted.

I tried the new Weight Watchers (TM) a few years ago and did well (for a short time, as always), but I still remember some of the basic caloric info I learned while on the program, which will be helpful. But even then, I had a hard time eating enough for my daily "allowance" of points from foods. I need to concentrate on eating at least twice a day (go figure!) and trying to get the right amount of calories WITH nutrition. Sure, I could eat cake or have a milkshake or something like that, but that would kind of defeat the purpose. Using the Byetta, I *have* to eat in order to use it -- it doesn't help to take it after meals. You must use it between 10-20 minutes before 2 meals a day. I plan to start it Sunday, and will let you know how it goes.

If any of you have any information regarding PCOS or Byetta or anything else I've listed here, please chime in. I'm so surprised by how much has changed when it comes to knowledge about the human body in such a short time. I'm also very encouraged to know that there are people out there working on new treatments for conditions that have definitely lacked good treatment options.