Gains and Losses
Meal prep for a healthy and homemade spicy chicken & vegetable stew.
I've always struggled with my weight and it became worse in my later years of high school and college. Certainly I tried to eat well and my parents always fed my siblings and I balanced meals, but as a 17/18 year old who has their license and is constantly on the go, you tend to also EAT on the go. Most trips to school in the morning started off with some sort of flavored, sugary, coffee drink and high calorie and fat breakfast sandwiches.
As I got to college I was a bit more conscientious about what I was eating, but the "Freshman 15" is no joke and it's also easy to eat poorly as a college student as well. Your habits overall are just terrible for the most part. You stay up late, drink tons of coffee, are eating 25 cent packages of Ramen at 3:00 AM while finishing a term paper, and likely not spending enough time at the gym or getting any sort of physical exercise at all. By the time I had reached my Junior and Senior years of college I spent a lot more time focusing on what I ate and exercising. My weight fluctuated anywhere between 195 lbs and 200 lbs throughout both years, and my habits fluctuated too. I was an equestrian and although I wasn't on any of the competitive riding teams, I was riding at least 1-2 times a week and finding myself having difficulty doing so. However, no matter how much effort or work I put into changing my eating habits, adding more nutritious foods, and exercised I didn't seem to lose much weight. I really hated being in the gym but I loved to walk and sometimes even do a light jog. The college was in a tiny village, yes literally called "The Village of Cazenovia" and it was easy to walk around the neighborhood and it was safe. So I would try and walk at least 1x a day for an hour or so and it helped me burn off some steam and stress too.
Heading into the Spring Semester of my Senior year my Primary Care Doctor and I were working on battling some symptoms I was experiencing that pointed towards a hormone imbalance/endocrine issue. I remember getting some bloodwork results back as I was starting off my Spring Semester and that my DHEA levels were higher than average and I needed to see an Endocrinologist. We couldn't find one in New York where I was in school that would accept my insurance so we had an appointment booked for when I returned home in May. I saw that doctor and they were not the most helpful, they basically said I needed to lose weight and she wouldn't say that I had PCOS until I could prove I could lose 15 pounds in the next month or two, despite having a lot of other signs that could have potentially pointed towards having the disease. She did prescribe me a medication called Spironolactone to suppress the excess Progesterone my body was producing that was causing a lot of excess oil, acne, body hair growth, etc. When I met with my Primary Care again, she agreed to the medication and we said we'd try the weight loss piece, and would monitor my hormones.
3 years later, in April of 2018 I was at the heaviest I had been despite having done Paleo and eating fairly healthy, and working out more often. I was working an hour from home, but I always tried to make the healthiest choices when it came to eating on the go and flexing to my late hours. My Primary Care and I decided to rerun my hormones again, and start me on a medication that would help boost my sluggish metabolism and lose the weight. We also referred me out to a new Endocrinologist after my results came back with another hormone imbalance. For the medication she prescribed, I was on a mix of Phentermine and Topiromate. On this medication, I had to cut my caffeine intake back SIGNIFICANTLY because the Phentermine is a steroid to boost my metabolism while the Topiromate works as an appetite suppressant. I am a 4+ cups a day coffee drinker, so this was a big change for me, but let me tell you, when you do have too much caffeine, it's a major system shock. I remember having some iced tea with dinner, a bit on the late side of the day (7:30 PM) and I was up ALL. NIGHT. LONG. I had also changed my dosage from a 1/2 tablet of the Phentermine to a full tablet per my Primary's instructions if I was able to tolerate the 1/2 tablet after a week. I immediately went back down to a 1/2 tablet of the Phentermine after a 48 hour bender where I plowed through my work and life and wasn't able to sleep. I had already cut my coffee intake back, but my caffeine intake in other forms was cut out now too. I would not drink anything after 2:00 PM because my system wouldn't shut down at night. The medication definitely helped despite feeling wired all the time. I remember when I first started the medication I was just glued to my work computer and just in the zone 24/7 and my whole demeanor changed. I didn't want it to, but it's just how my body and my mind was responding to the new medication. However, I adapted and within a couple of weeks I was handling it much better and things leveled off. I started the medication at the end of April, weighing in at around 220 lbs. By the time my May appointment with the Endocrinologist came around, I was down to around 205 lbs.
In late May I saw an new Endocrinologist and they ran some bloodwork and went through my whole medical history and symptoms with me. I also had to have an ovarian ultrasound, which honestly, was horrific. I wasn't prepared for both an internal and external exam, and you have to drink 32 oz. of water prior to the exam and hold it, which is brutal. My appointment was uncomfortable and we had to alter part of the exam because there were things my body wouldn't tolerate. I had a follow-up appointment in mid-June and all signs pointed to a diagnosis of PCOS (Polycystic Ovarian Syndrome). A disease that's not curable and comes with a slew of other potential health issues. My cousin has PCOS and it turns out so many other people in my family have it too, but it's just not widely known. PCOS in a woman can be pretty detrimental. Most of the information I read is that women typically find out they have PCOS when they struggle with infertility and are referred to a specialist. According to my doctor, I had a lot of the classic signs, from the ovarian ultrasound exam I had a large cyst on my left ovary. Although these are common in many women, they typically are more common in women with PCOS, more frequent, and can be larger. I also had discoloration at the back of the neck, puffiness in the back of my neck suggesting high insulin levels, excess acne, oils, and body hair growth, along with a struggle to lose weight. We were in agreement to keep me on the medications I was on, but I had to really monitor my weight and eating habits.
In mid-July I went in for another follow-up and was having lots of pain when swallowing and just in general in my throat/neck. Thyroid issues are common in women with PCOS. We ran three rounds of Thyroid blood work over the course of a few weeks all coming back normal. I had an ultrasound of my Thyroid that came back with microcysts that were harmless and one lobe being slightly larger than the other, but still within "normal limits" of size expectation. We tried some Prednisone for inflammation and possible thyroiditis. We also talked about potentially needing to take the gland out as a last resort if things didn't improve. The Prednisone didn't work and we stopped me 3 days in before having do a taper since it's a steroid as well. I hated being on the Prednisone. For those of you that have been on it or are being prescribed it for pain and inflammation just know that irritability, excessive hunger, and sleep issues are all very common side effects. I felt miserable on that medication and it was instantaneous. Having exhausted all options, they recommended I go to my Primary Care for an evaluation before we did anything drastic like take my thyroid out when all those tests came back normal.
It's now early August and I am in my Primary Care's office seeing the Licensed Nurse Practitioner since my doctor was on vacation. She did a full evaluation and recommended a CT Scan of my neck to ensure everything else looked good internally like my voice box, etc. The CT Scan came back clean for my any issues in my neck. In the meantime we made a plan for me to get an Endoscopy, we took me off the Phentermine and Topiromate just to trial if it alleviated any of the neck/throat pain symptoms, and had to drop my Spironolactone dosage down from the rise in June because it was causing further hormonal problems.
Living with PCOS is not easy. I am constantly trying to watch what I eat and make sure that I am fueling my body appropriately. When I was on the medication to lose weight, I found that my appetite was so suppressed I could go hours without eating, and be constantly on the move and then get lightheaded and realize I needed to eat something. But I was consciously choosing healthy foods to fuel my body, and I looked at food differently. I looked at food as a way to fuel my body and give it the energy it needs to function, not just as a pleasure because I enjoy food. I try to eat lots of greens, like salads with other vegetables and proteins. I skip dressing and go for just salt, pepper, and olive oil (it's fantastic really, especially with lots of flavorful veggies in my salad). Sometimes I would mix some pasta or orzo salad in there too. Maybe a couple tablespoons worth so I got my carb that I loved but was overall eating a lot more greens. I also began to work with a trainer, but getting to the gym was hard and as I was navigating many of the pains and complications I found I didn't have the energy to go. But I walked a lot on a daily basis and I was always on the move outside of work and so that was good enough for them, weight training could come later.
For those of you battling PCOS, you are not alone. I've discovered after being diagnosed that there are many other people out there who have it, and there's a lot of resources out there for you too. Some things that really helped me;
I began to see a Certified Life Coach at work (thank you to my Supervisor and Manager who encouraged me to do this, because I was a mess) and was able to really talk through what I was going through and get feedback from someone who wasn't a friend or family member and who could provide an outsider's view/perspective to what I was going through and how to deal with all the emotions.
I did my research. There are lots of websites online that talk about PCOS, signs, symptoms, and management of all of these. Pinterest is a great resource too because there are many posts with grocery lists of things you should and should not eat, flow charts, and quick guides (SUPER HELPFUL).
Partner with a Personal Trainer, join a gym, or get active somehow. It was nice to have a Personal Trainer through my work, and they were able to give me workouts that helped me focus on certain areas of my body based on my goals and my body type. But you do need to be honest and comfortable sharing with them any medical conditions, because it will only help them help you.
Work with your Primary Care and a specialist if needed. It's OK to ask for medication and to be on medication for this condition. It's a long-term management type of disease with no cures. Some people need help putting weight on, while others need help shedding weight. Create a plan with your medical team that's right for you and supports your symptoms.
As I continue my struggle with weight and the symptoms of PCOS I will share what I learn from my experience. If you are someone who is living with PCOS and have any helpful tips or tricks, drop a comment below. You can find links to helpful websites and information about PCOS under my "Helpful Resources" tab on my site.