So, What Do You Eat?

I have eliminated white flour, potatoes, and white rice from my diet. It's not that I don't like baguettes, french fries, and rice, it's because they don't like me, or rather, they cause symptoms I'd rather not experience.

When I make baked goods, or need to replace white flour in a recipe, I generally reach for Quinoa flour. Sometimes I’ll add oat or buckwheat flours, too.

For store-bought breads I stick to sprouted varieties. For rice or potatoes, I substitute Quinoa, Wheat Berries, brown rice, (I eat Basmati rice even though it's white because it is a slow sugar uptake into the bloodstream). 

I avoid dairy, too. I go for the goat when it comes to cheeses, sheep or goat for yogurt, and soy for milk. LaLoo makes amazing ice cream from goat's milk. My favorite is Rumplemint - yum! I love French toast, and by using sprouted bread and soy milk, I can have it. Pancakes, too, by using Quinoa and other flours, and soy milk.

There are some things that I love, but I can't eat because it sends me into a sugar shock, not fun, watermelon, for example. There are some things I eat and it seems like I shouldn't, maple syrup, for example. Maybe because I pair it with food items that are high in fiber and I only use a little bit. It's okay to have things like pasta or rice noodles on occasion, and I enjoy red wine on occasion, too. I simply avoid foods that have a high glycemic index because they either triggers various neuropathies or induces a sugar shock, brain fog, sweating, muscle weakness, or sleepiness. Not so much fun, but totally workable and easy to interact with water, exercise, sleep, or some combination thereof, depending.

To help me figure out what I can or can't have, or discover after the fact why I'm having a reaction, I check out an online GI database.

Related Post:  (non) Dairy Queen, Grains in Focus

Related Links

• Online Glycemic Index Database
• Glycemic Index and Diabetes

All That Glitters

For years I've had an allergy to metal. I know there are many who are similarly afflicted. Hang tight, here's where the story becomes interesting.

A few weeks ago, a close friend gifted me with a lovely gold bracelet from Greece. It's unusual, beautiful, meaningful. While I was fumbling with the clasp, I gave a mental shrug, thinking I will wear it until the rash develops. After a few hours, I noticed... nothing. No itching, swelling, or reddening of my skin. After a day, I noticed the same nothing. I wrote it off thinking I haven't worn metal in a couple of years; maybe it will take longer before symptoms appear. At the end of the week, I was convinced that I had in my possession a magical bracelet. There could be no other explanation. Clearly, my friend has mystical powers! I wore the bracelet, made of metal - which I am allergic to - for over two weeks without removing it, and I remained symptom-free.

I decided to push my luck, and I gave earrings a try. Usually, I'll feel discomfort immediately. Nope, I felt neither irritation nor pain. I wore earrings with metal finding for over a week, and my ears stayed infection-free.

What the heck!?!

I decided that there must be a connection between allergies and illness. Specifically, I believe there is a relationship between PCOS and allergies. For me, now that I'm eating a high protein, low sugar (and very low glucose-rich foods), it seems like my body can now handle wearing metals.

Does this mean I get to go earring shopping?

Yes, yes it does.

Related Links

• How to Buy the Right Jewelry When You Have a Metal Allergy
• Infections may trigger metal allergies

CPAP and Gas, who knew?

I noticed an increase of stomach air when I began using my CPAP machine. Over time, that diminished. Then, after my hysterectomy, it returned with a vengeance and hasn't decreased. Is there a correlation? I thought so, at first. Turns out, I had accidentally increased the pressure and hadn't noticed. Go figure. As it happens, one of the causes of increased belching and flatulence is a pressure setting that is too high. 

That's an easy enough fix, and it did help enormously! 

Even so, the topic of CPAP gas can be bigger than simply adjusting the air pressure setting on your machine.

When you swallow the pressurized air from CPAP, you may notice:

• Burping or belching
• Flatulence
• Bloating
• Stomach pain

While none of these symptoms are life-threatening, they can be pretty embarrassing. If reducing the air pressure setting doesn't help, you may want to try a full face mask rather than the cute nose option. 

Related Post:  A Breath of Fresh Air

Related Links

• CPAP and Things That Go “Burp” in the Night
• CPAP Gas Problem - Aerophagia
• The Causes and Treatment of CPAP Gas

Crouching Sugar, Hidden Glucose

I stumbled on my current eating strategies by accident. I made note of the foods with a high glycemic index, and eliminated them from my diet. I'd like to think it was an insightful move, a new way of thinking! But no, others have come before me; in fact, they've even wrote the book. While I might not be as original in my thinking and strategies as I previously thought, I still feel proud of myself for connecting the dots. Now, had I read the book 20 years ago, and had followed the writer's advice, would I have avoided the insulin resistance portion of PCOS, maybe avoiding it completely? I think the answer to that question is a resounding yes, but...  I doubt I would have followed the strategies, because I was 20 years younger and not really interested in the long-term health ramifications.

Knowing what I know now, and having children on whom to impart my hard-won wisdom, I'm all about showing how the sugar in our diets, not only refined white sugar, but the hidden sugars in whole and processed foods, have negative, long term health affects. Whether or not I read the book, the guiding principle resonates:

"The Sugar Busters diet is a diet focused on eliminating foods containing refined carbohydrates such as refined sugar, white flour, and white rice, as well as naturally occurring carbohydrates rating high on the glycemic index such as potatoes and carrots." Wikipedia

Regardless of the state of one's pancreas, constantly flooding your bloodstream with sugar, no matter the form, places a tremendous burden on one's body. For a teen, who feels invincible, that statement would fall on deaf ears. Heck, I ignored the "sugar is bad" and "breakfast is the most important meal of the day" adages for nearly 50 years! It wasn't until I felt the results of my poor food choices, and had to make changes or face a serious decline in life quality, did I sit up and pay attention.

I think it's high time I read Sugar Busters.

Related Links

• Ask This When Controlling Blood Sugar Levels
• Blood Sugar in Diabetes
• Sugar Busters! - Wikipedia

I've Been Spayed

Once I made the decision, it was easy to schedule the surgery. I chose the traditional method rather than the laparoscopic, because the procedure was a shorter duration, and I had already decided whom I wanted as my surgeon. 

The hospital and staff treated me well from the moment I was admitted. The prep part went smoothly, and I was under sedation quickly and easily. Then I woke up. I chatted and joked with the nurse, who was administering morphine to keep my pain levels manageable. Pain was okay with the meds, as long as I didn't laugh or breathe too deeply. I had no sense of time, so I'm not sure how long I stayed in the recovery room. At some point, I was transferred to the room in which I'd stay the next two nights. I didn't like the moving part, especially when the gurney went over thresholds. I'm not going to sugar coat it, it hurt like hell, with a side of barbed wire. The gentleman who was stuck with transporting me felt awful for torturing me, and gave me time after crossing each of the nine threshold to breath through the pain.

My nurses were outstanding.  I was up and walking in no time, and they were with me every step of the way. I was given lots of advice before surgery, and I want to share the hints and tricks that worked best for me. The best advice was to suck it up, and stretch out. Don't give in to clutching a pillow to your tummy. When it's time to walk, stand up straight and breathe through the pain.  I took the "suck it up" advice, and I know the intensity and duration of pain was greatly reduced because of it. Essentially, it's like ripping off a band aid. You can go slowly, and prolong the pain, or you can rip it off and get it over with. I chose the latter.

Things I enjoyed doing before surgery were unpleasant for a while after surgery. Laughing, taking deep, cleansing breaths, going from laying down to sitting to standing, and vice versa. Each day, the pain lessened and it wasn't long before I was driving. I am not ashamed to sat how painful navigating speed bumps were. Yes, I drove slowly and cautiously in general, and I crawled over speed bumps in particular. I loved being mobile, but I was careful to follow another piece of advice: don't do too much too quickly. I was (mostly) pretty careful about not overdoing it.

I was struck with a stark reality about 1/2 through my recovery: there's an empty spot in my body cavity. I felt all sorts of things, depression, fear, and incomplete, for a while. I was expecting it, so I knew what these feeling were when they crashed over me. I was worried for a while that I wouldn't be able to enjoy an active sex life as I had before. I was afraid that I had mutilated my body and would no long experience orgasm as I once did. I can assure you, that fear is groundless. My missing parts and pieces do not in any way reduce my sexual appetite or the ability to experience pleasure.

There are a lot of articles and information out on the interwebs, but I'm not going to link to any of them, as I didn't find the concerns they raised either true or helpful. My hysterectomy experience went well, and I achieved the desired results: I no longer have uterine pain from fibroids.

I take a daily estrogen supplement, and I am free of menopausal symptoms. All in all, I consider my hysterectomy a success.

Numbers Have Genders

Well, they do when it comes to test results.

The health management organization to which I belong lets me log on to their portal and see all of my test results. For this data gal, that's like being given the keys to the candy store! While some candies are sweet, others are tart, and still others leave a downright bitter taste in your mouth.

I was looking through the list of my pre-op labs, and noticed that the results of a test for my Kidney function, 51, fell into the mild to moderate Kidney damage zone. I decided that, although I could panic, I wouldn't, at least, not yet. Because, I got people in high places with all sorts of esoteric knowledge. I sent my buddy, who just so happens to be a practicing Nephrologist, aka Kidney doctor, a hey, "is this bad?" text. I figured that she'd set me on the path to calm or drop-kick me to the fast track to panic, accordingly.

Her initial response of "eGFR usually underestimates renal function in women" was both calming and disturbing. Calming because I took that to mean that the results, couple with my creatinine values, were okay for me, because I'm a woman. Disturbing because why wasn't the fact that I'm a woman reflected in the results? Why wasn't I given results based on my biology? How many other tests have results scaled for men but not women, and how is this male-focused scaling affecting the quality of healthcare women receive?

While the above questions go far beyond the scope of a personal health blog focused on PCOS, Insulin Resistance, Hursuitism, and the host of symptomology I've mentioned throughout many of my topics, those very questions cause me concern as to the confidence the medical profession truly has when it comes to treating women in general, and me specifically. I admit that my looming hysterectomy, which takes place on Monday, is causing me not a little angst; but maybe, some of that angst wouldn't exist if things like tests and their results were based on my biology versus that of some other sex.

With today's technology, it's a pretty simple thing to check a box to filter results by sex. Why is the medical profession lagging so far behind in gathering, standardizing, utilizing, and reporting sex-based tests?

Clawing out of Depression's Grip

Not long ago, depression had me in its insidious grip, squeezing every shred of self confidence with which I manage to shroud myself. Clawing and writhing my way out of its clutches leaves me first pondering how I found myself there in the first place, and then tending to the wounds it inflicted. These wounds, some of them merely scratches that will heal quickly; others deeper with darkening bruises, which will turn to sickening green (how I feel about them, and sometimes me), and then fade completely.

With the significant changes I've made in my diet and the increase in exercise, I definitely experience fewer depressive states. When I do have them, it seems that they are still intense and I still feel anxious, but I think that the anxiety is a result of the tachycardia I experience during the luteal phase of my cycle, which is also when I tend to succumb to depression.

After my hysterectomy in another couple of weeks, I won't have ovaries, ergo, no luteal phase. So, might it be possible that without the surge of progesterone and testosterone, I will no longer experience tachycardia? Without the tachycardia, will I no longer have that feeling of anxiety? I don't think that my depression will be eliminated completely, but wouldn't it be lovely if it were simply a shadow skittering across my mental landscape rather than the monster I described above?

Medication Experimentation

I got to thinking that what I experienced as anxiety and depression was actually the effects of insulin resistance. I felt that I had enough personal data and supporting evidence to warrant a decrease in Cymbalta, which I have been taking for about eight years. I was at the maximum daily dosage of 120 mg. I chatted with my doctor about cutting the dosage in half. He supported my decision to try decreasing my dosage and we agreed that I would take 90 mg for 14 days and then 60 mg after that. I'm happy to report that I'm doing quite well on the current dosage. Perhaps in the next year or so I can wean off of Cymbalta completely. With my doctor's permission, of course.

A month or so ago, my endocrinologist put me on Spironolactone for Hirsutism. While the literature states that it takes a few months for noticeable effects, I've already seeing a few. For example, my skin and hair is not as oily. I need lotion now when I didn't prior; however, I love the various lotions I've purchased, and using them makes me feel feminine and girly.  I no longer need to wash my hair every day, every other day works out well. 

Fewer meds and feeling better is a great way to start this new year. 

Related Links

• Spironolactone 

It's Been Scheduled

I saw my OB/GYN last week, who took a few tests which came back normal, and today the office called to scheduled my hysterectomy. Yay! We're yanking the unnecessary organs out in early February.

Short update, life is hectic with the holidays. I plan to post more after the new year.

Wishing everyone a lovely holiday season, and a joyous and prosperous new year!

Double Roller Coasters

In women, the steroid hormone progesterone is produced mostly by ovaries and adrenal glands. Progesterone directly affects how women's reproductive system, nervous system, cardiovascular system, and skeletal system, function.

Apparently, your blood glucose levels rise about a week or so before ovulation and then drop back to your "normal" at the onset of mercenary. That's so not fair! Not only does the luteal phase interfere with my quality and duration of sleep, it messes with my blood sugar levels, too. Welcome to the  Progesterone Phenomenon.

"We are all aware of the analogy about one's diabetes control being like riding a roller-coaster. The goal is to turn the roller-coaster into a go-cart running on a flat track. We want to eliminate the extreme ups and downs and keep things on an even keel. But a woman with diabetes gets to ride an additional roller-coaster at the same time; the extra ups and downs are caused by her menstrual cycle." Insulin Pumpers and Mary Jean Renstrom.

Yet, this lively roller coaster isn't limited to women of child-bearing years. Both perimenopausal and postmenopausal women who have diabetes may be challenged. For example, the hormonal roller coaster ride that is part of perimenopause can affect blood glucose levels.

I've said it before, and I'm saying it again: Being a woman ain't for the faint of heart!

Here's another thing to watch out for. You see, some symptoms of perimenopause are the same as or easily confused with the symptoms of high or low blood glucose levels. Yeah, well, I wish I had known that about 10 years ago! Instead, my symptoms were brushed aside with "you're too young to be going through menopause." Great! If a doctor ruled that out, then why didn't he look for another reason for hot flashes, night sweats, and muscle weakiness? It's not as if I wasn't bitching bringing these concerns up during my visits.

For me, controlling premenstrual, perimenopausal, and insulin resistance, symptoms starts by focusing on eating slow release carbohydrates and small, frequent meals.

Related Links

• The Actions of Progesterone
• Controlling Blood Sugar
• Menopause What to Expect, How to Cope
• Riding Two Roller Coasters

Glycemic Index versus Load

Glycemic index and glycemic load helps you understand how foods affect both your blood sugar and insulin levels.

When you eat high-glycemic index foods, you will experience higher and more rapid increases in blood glucose levels. Conversely, when you eat low-glycemic index foods, glucose enters your blood stream at a slower, sustained pace resulting in lower insulin demands.

The lower a food's glycemic index or glycemic load, the less it affects blood sugar and insulin levels. Focus on foods with a glycemic index of 55 or less and learn which foods raise your blood sugar levels, trigger your symptoms, or both.

Oh, and just because a food has a low index or load level, doesn't mean it's a wise choice. Some candy bars have a relatively low index, but their nutritional value is negligible.

Related Links

• Counting Carbs
• Glycemic Index and Glycemic Load
• Glycemic index and glycemic load for 100+ foods
• Glycemic Load and Glycemic Index: What's the Difference and Why Does it Matter?
• The Right Way To Lose Fat: What To Eat

Symptomology 101

Throughout these posts, I have mentioned symptoms and associated many of those symptoms with possible root causes. I've made dramatic lifestyle changes and I'm experiencing either a resolution of or a decrease in the intensity of my symptoms.

I call that success!

I decided to take a moment to celebrate my successes and speculate on which life change may have contributed to the improvement of symptoms.

Acne
Significant changes in not only what I eat, but when and how much I eat have contributed to completely clearing up acne breakouts. I'm positive that going dairy free, and eliminating potatoes, rice, and white flour, have contributed to eliminating this particular malady.

Excessive Sweating
While I haven't found the off switch for this lovely symptom, it is greatly reduced. I've noticed that the onset is usually when my blood sugar levels are high that I'm particularly susceptible to sweating. Further, when I'm exercising my sweating is within acceptable limits, so long as I drink plenty of water before, during, and after an activity. I'm fairly sure that eliminating caffeine and drinking buckets of water have been key to alleviating this fun symptom.

Assorted
Some of the following symptoms I know are addressed by using a CPAP. Others depend on my blood sugar levels, amount of daily excercise, and my stress levels. Still, significant improvements overall.

• Anxiety reduced
• Depression reduced
• Daytime fatigue reduced
• Forgetfulness reduced
• Lack of energy during the day reduced
• Loud snoring gone!
• Mood changes reduced
• Morning headaches reduced
• Sleepiness reduced
• Slower reaction time reduced
• Restless sleep reduced
• Recurrent awakenings reduced
• Insomnia reduced
• Vision problems reduced
• Waking up with a very sore or dry throat gone!
• Waking up with a choking or gasping sensation gone!

Related Links

• How lifestyle, daily routine affect blood sugar
• Patient information: Diabetes mellitus type 2: Alcohol, exercise, and medical care (Beyond the Basics)
• Pre-Diabetes&Lifestyle Changes to Prevent Type 2 Diabetes

Caffeine Quandary

According to the Americian Academy of Sleep Medicine:

Caffeine reaches a peak level in your blood within 30 to 60 minutes. It has a half-life of 3 to 5 hours. The half-life is the time it takes for your body to eliminate half of the drug. The remaining caffeine can stay in your body for a long time.

Well, that is an eye-opener.

How long does the remaining caffeine stay in your body?

That depends on you, and your state of health. What I found was a range from as little as 14 hours to as long as 100+ hours. Doing the math, if I consumed 100 mg of caffeine, then I'd get that buzz within an hour. About five hours later, I'd still have about 50mg floating around in my system. By the time I'm ready for bed, I'd still have about 50mg doing the back stroke in my bloodstream.

So, let's say I snag a latte from Starbucks one my way to work at about 7 am. That gives me about 150mg of caffeine buzz. For my 10 am break, I'm ready for another latte. Let's do the math:

Time	Caffeine Intake	Half Life	Accumlated
7 Am	150mg	75mg	75 mg
10 Am	150mg	75mg	150mg
10 pm	-	-	150mg

It looks to me like, by the time I'm ready to go to bed, I could have as much caffeine in my system as I did when I drank my first morning latte. Over time, a lot of caffeine can have accumulated in my bloodstream. For many people, accumulated caffeine doesn't have an affect. I remember reading somewhere, and now I can't find the site, that caffeine creates an insulin-resistant-friendly environment. Well, okay then. As I'm working diligently toward reversing insulin resistance so that I don't end up permanently with type 2 Diabetes, I will forgo caffeine, gladly.

Related Post:  Coffee Calamity

Related Links

• Caffeine Metabolism
• How Long Does Caffeine Stay in the Body?
• Sleep & Caffeine 

Medication Configuration

In an effort to corral the volume of insulin stampeding through my veins, my endocrinologist put me on Metformin. Seems reasonable, and as I had done my research before the formal diagnosis, I wasn't surprised or overly concerned. The dosage seemed appropriate, 500 mg the first week, and then increase to 1,000 mg.

The first week went well. I didn't notice any particular challenge. By the end of the second week, I'd had an anxiety attack and a racing pulse. This anxiety attack didn't feel like a rhinocerose tap dancing on my chest, as prior episodes had. This one felt like a flight response; I wanted to bolt, run as quickly as my heartbeat suggested. For those who don't know me, I'm not a runner. In fact, I'm built for comfort, not for speed. But, I digress.

Just for the heck of it, I purchased a blood pressure monitor. I chose the easy, wrist unit. Up until now, my systolic (the top number) was generally below 119, and my diastolic (bottom number) generally below 79. After a couple of week tracking my blood pressure, I noticed that I was averaging 136/81, which falls into the pre-hypertension range. Ack! Now, how fair is that? I mean, I've made significant lifestyle and diet changes, my blood pressure should be trotting, not racing! Deep breath, okay, I'm done ranting, for the moment, anyway.

I chatted with my Family Practitioner about my blood pressure, and showed him the report from the Glucose Buddy app I use for tracking. Because the clinic's computer system was down, my doctor wasn't able to compare my current information to my historical data. He mentioned that my weight will have an effect on my blood pressure, and asked if I wanted to go on medication to address this. Uh, no. I didn't want to go on another medication until I felt confident that I could pinpoint the underlying issue. Both the doctor and I were happy that I declined.

If I'd been on my toes, I would have pointed out that I weigh less now than I did when I was in his office a few months ago. Why was my blood pressure good then and pre-hypertensive now? If I'd had my problem-solving hat on, I would have asked what changed? However, it was late in the day, I accepted what I was told, and merrily went on my way. But a nagging doubt kept needling my brain. It simply didn't feel right to dismiss my high blood pressure as a result of my weight. I knew that there was more to it than that.

That night I pondered the visit with my doctor before I fell asleep sleep. During the night, some mental filing occurred, along with a bit of cross-referencing and voilà! Magic happened. So, all those things that I wished I had thought about above crystallized, and with that clarity came possibilities and more questions. At my first opportunity, I searched for connections between Metformin and increased blood pressure. I looked at studies and read through documented Metformin side effects. I also found instances on various social media platforms and forums where someone noted the same Metformin/increased blood pressure symptom as I. Somehow, finding real people experiencing the same side effects that I have somehow put me at ease.

Putting it all together

What changed? I introduced a new medication into my body. Shortly after, I increased the dosage of that medication. It was when I increased the dosage that I became symptomatic. A ha!

After discussing it with my doctor, I decrease my nightly dosage to 500 mg. After all, I want to use the lowest dosage possible in which I can achieve the maximum therapeutic level without aggravating or incurring undesirable symptoms.

Updates

Date	Details
10/8/2014	My blood pressure is now below 117/74 and my blood sugar is still low and normal, but now my heart rate is whacked. I'm going to reduce my nightly dose to 250 mg, and see what happens. Check back here for an update. -Kat
10/21/2014	I nixed the Metformin all together. What can I say? My blood pressure is good, but my heart rate is still kind of erratic and tends to run high. Not sure what this means. At least it gives me something to talk about with my endocrinologist next month -Kat

Related Links

• Blood pressure chart: What your reading means
• Metformin
• PCOS: Insulin and Metformin
• Review: could Metformin cause Blood pressure increased (High blood pressure)?

Personal Data Collection

Sifting through data can be enlightening. Going through the process of collecting data can be arduous and, at times, a drag. Yet I needed to quickly learn what improved my symptoms and what made them worse. There is only one way for me to gain the kind of insight necessary to achieve my goal of lessening the intensity and duration of my symptoms, and that way is keeping records.

I'm very much into technology and as I always carry my smart phone, I saw no reason why I couldn't find apps to aid me in record keeping. 

First things first, I downloaded the My Symptoms food diary and symptoms app. Within a few days of record keeping, I began to see patterns emerge. I could pinpoint correlations between activities or foods and how my body responded. Specifically, I wanted to minimize or eliminate completely the excessive sweating symptom - that one drives me nuts!

Not long after, I received a blood testing kit (glucose meter). After grumbling a bit at having to use two separate apps to track my personal data, I downloaded the Glucose Buddy app. That was a huge eye opener for me. It was through tracking my blood glucose levels at the onset of any symptom that I made a huge leap in understanding what was happening to my body and what I needed to do to minimize a symptom's intensity and duration. 

While the My Symptoms app gave me correlations and insights, it didn't give me calories or a breakdown of fat, proteins, and carbohydrates. I also wanted a running total of the number of calories I burned while exercising. More data with which to fine tune the positive changes I'm incorporating into my life. 

I was referred to SparkPeople to track my foods and fitness by the facilitator of a pre-diabetes class I attended. Wow! Neat program that links an online interface with apps. So, I can do the bulk of my entries, or define frequently used entries, online, and then enter updates in real time via my smart phone. Pretty nifty. Further, you can sign up for various types of support and network with others who have faced or are facing similar issues to ones with which you may be dealing. I choose not to be quite so connected, as my goal isn't to lose weight, per se, but to be symptom free. Loosing weight just so happens to be a benefit of my goal. 

I track everything, even the three squares of Ghirardelli Dark Chocolate with Hazelnuts that somehow slipped from my fingers into my mouth. Yeah, if I'm not honest with myself and track everything that passes my lips, tracking doesn't help. 

It does take a bit of time and trial-and-error to find the tools that work best for you. I can assure you that becoming an expert on you, your body, and your health is well worth the investment. 

Related Links

• Quantified Self (This is a little over-the-top. The one below is well worth viewing.)
• Show me the data -- becoming an expert in yourself

From Infertility to Family

I always knew I'd be a mom. By the time I was 19, adoption was part of my life plan. I didn't know if I'd be married or not, although I'd hoped that I'd find a partner to share my life with. No matter what, I was going to be a parent.

Little did I know that fertility could be such a fickle thing. 

I remember the joy, anticipation, and excitement that coursed through my veins when the pregnancy test showed positive for the first time. Yep, as I'd planned, just a couple years after marrying my husband, I was pregnant. By the tenth week, I was thinking about possible colleges that might be suitable for the genius who had taken up residency in my uterus. What might this child major in, I wondered. Math? Science? Theater? We had great conversations together, one sided, but nevertheless deeply moving and meaningful. Not a week after these dialogues began, I miscarried. 

I was devastated. 

I didn't "miscarry," I lost a baby, a new love, a friend who I couldn't wait to meet, and never would. I lost three more babies over the next couple of years, and while they were all heartbreaking, none came close to the severe and overwhelming shock and grief I experienced at losing my first baby.

And then, I couldn't get pregnant again. Lots of false positives, which was confusing and distressing. Clearly, there was something wrong with me. Time to hook up with a fertility expert and get this thing figured out. 

Such optimism.

I went to a fertility specialist, because that made sense, right? He put me on a few rounds of Clomid. Now there's a med for you. The hot flashes, the mood swings... and that was just on my husband's part! It was worth it, because I got pregnant. Yay! No more tetemperature charts, no more timing sex, no more chasing my husband down the hall wailing, "come on, hunny! I'm fertile! Please? I'll let you be Little Bo Peep this tiiiiime!" Kidding, mostly, lil bit, not much. 

A few weeks after the positive pregnancy test proclaimed positive, I spotted and lost the baby. 

I switched to a fertility clinic and did several rounds of IUF. Let's just say that we reached the end of our fertility budget. We took a break from all things baby making, except for the fun part, of course. After we took some time to grieve and heal, we moved forward with our adoption plans. 

In a miracle as only Christmas can package, a precious, amazing toddler with dreamy blue eyes came to live with us. There is no doubt in my mind that she's ours, completely and utterly meant to be our daughter.  

Six weeks later, I was pregnant. 

In the majesty of autumn, a strapping baby boy was born with blue eyes, blond hair, and a beguiling smile. 

Two years after that? You guessed it, preggo again. 

Amidst the fragrant blossoms of spring, a blond haired, blue-eyed charmer was born. 

To say I was busy with a baby, a 2-year old, and a 3-year old would be an understatement. 

It wasn't a smooth journey to parenthood, or easy for that matter. However, my dreams of family did come true. 

System Flush

Research cited by the New York Times shows when your body is dehydrated, your kidneys go all Chicken Little on you. No, the sky isn't falling, yet those panicked kidneys retain water and release a hormone that raises blood sugar. For those of us who are tasked with driving our glucose levels down, it makes sense to do what it takes to keep our kidneys from pushing the panic button and releasing that pesky hormone. Fear not, Chicken Little kidneys, we know of a magical elixir that will bath you into calm bliss: Water.

Water dilutes the blood and flushes out glucose, among other things, from your bloodstream. Evidence suggests that drinking as little as .5 to 1 liter, or 17 to 34 ounces, will help you with attaining homeostasis. I drink a lot of water. On good days, my water consumption goes beyond 2 liters, or over 64 ounces. On other days, I stay in the range noted above. I drink water about .5 liter or 16 oz and eat a small protein/carb duo to stave off my blood sugar spike as soon as I get out of bed in the morning. I'm happy to report that this small change has greatly reduced the excessive sweating symptom I talked about in the One Hot Mama and Reverse Symptomology posts.

By chance I ran across a post in a forum that offered a suggestion for when blood sugar levels spike. My signs of hyperglycemia may include:

• Excessive sweating
• Fatigue (weak, tired feeling)
• Headaches
• Difficulty concentrating
• Increased thirst
• Frequent urination
• Decreased vision

When I experience any or a combination of the above, I flush out the sugar by drinking 16 ounce water quickly. I wait five minutes and drink another 8 ounce glass of water. Soon after, I'll pee, and my blood sugar levels start to decline. I keep drinking through out the day, as well. Keeping well hydrated has kept me cool and comfortable for several weeks now.

I'm thinking I'm on to something.

Related Links

• Does drinking lots of water and staying well hydrated help with keeping blood sugar levels at a more normal level?
• Does Drinking Water Bring High Glucose Levels Down?
• Five Simple Ways to Lower Your Blood Sugar
• Ways to lower your blood sugar quickly

Size Matters

I'm talking about portion size. What did you think I meant?

There are fact and figures, charts and diagrams, showing how we eat larger portions now than we did 20 year ago. There is considerable fodder out on the interwebs discussing Portion Distortion, and with it a plethora of images describing how to estimate serving sizes using your hand for protein, carbohydrates, fruits and vegetables, and fats. I'm not going there. Instead, I'm looking at the cause and effect of what I eat and how my body reacts.

I'm noticing what happens to my body when I eat small servings versus large servings, even if it's a salad packed with veggies. If I keep to "dynamic duos" every two hours or so, my blood sugar doesn't spike or stay in an elevated range. My dynamic duos consist of things like Almond butter and a banana, apple and goat cheese, Qunioa and broccoli. Whatever the combination of whole grain, protein, fruit, or vegetable, when I keep it to about one cup, I don't flood my system with large quantities of insulin.

I'm noticing what happens to my body when I eat watermelon. Ohhh, it's so not pretty. Remember in prior posts how I whined about excessive sweating? I get that within 20 minutes of eating watermelon, in addition to brain fog and muscle weakness. I'm about to whine again. First cheese, then coffee, and now watermelon? Say it isn't so!

It's an interesting paradigm eating to nourish my body and minimize symptoms rather than eating to lose weight. I'm thinking that I can use the immediate biofeedback that insulin resistance gives me to continue to eat in ways that is right for me, thus healthy.

Related Links

• Diabetes: Learning About Serving and Portion Sizes
• We eat what we’re served, regardless of taste

Reverse Symptomology

It's time to explore this sweating symptom again. All the medical sites I have searched relate the excessive sweating symptom with low blood sugar. Fortunately, I came across a message board where members talked about becoming hot and sweaty when their blood sugar levels were high. Quite the opposite of what the "expert" sites cited, and exactly what I am experiencing.

Welcome to the world of "weirdness"... Both my sister-in-law and myself seem to get flushed and sweat when our sugar is up a bit. If my sugar is low, then I will get a bit light headed, very pale and might break out in a COLD sweat and get shaky. Everyone is different and I guess you know your own body. ~JJ

I think that it's important to begin with the experts. Absolutely, you should take your symptoms and concerns to your doctor. However, I don't stop there. I want to know what the people who are dealing with any particular malady are experiencing, and how they approach and minimize their symptoms. It's fantastic that there are so many content creators and various technologies to share information and experiences. Sometimes the sheer volume of information can feel overwhelming, and much of the content needs to be examined with a critical eye. Yet sifting through and reading posts, blogs, and forums is invaluable for spotting trends that can shed light on your concerns.

Now that I know I will sweat when my blood sugar spikes, which foods have a high GI, and I have the tools to monitor my glucose levels, I feel much more in control over this particular (embarrassing) symptom.

Similar topics: 

• One Hot Mama
• System Flush

Related Links

• Get Off the Blood Glucose Roller Coaster
• Hyperglycemia (High Blood Sugar)
• Sweating and High Blood Sugars
• Sweating With High Sugar?

Coffee Calamity

There is quite a buzz out there in the interwebs for those with insulin resistance on the topic of coffee, specifically the caffeine in coffee, giving rise to blood sugar levels.

That's just not okay. I love my coffee! I have great need of coffee. I'm a troglodyte without coffee!

To say that I'm taking this news badly doesn't even come close to my state of abject horror at the thought of no longer partaking in my beloved beverage. There must be some mistake. Surly I can find a loophole somewhere... but no.

I know the truth of caffeine and what it does to me and my blood sugar by the neuropathic response I get whenever I drink coffee, or anything with caffeine, for that matter. I was happy ignoring the symptom. Didn't matter that I have a reaction to drinking my (legal) drug of choice. It didn't matter, that is, until I read the dreaded words on the Glycemic Index. Yup, coffee is listed in the red zone. Not only did I have physical evidence that coffee spiked my blood sugar, (which I chose to ignore), but now I have it in writing, too. Somehow, that just made it too important to ignore.

What am I going to do? I just recently switched to soy lattes because dairy does a number on me. Now I have to give up lattes altogether? Nooooo!

Turns out that while that caffeine isn't a good thing for me, decaf coffee isn't a bad thing. As I switched to soy lattes with nary a second glance, I think I can make the switch to decaf soy lattes, eventually. I'm not saying that I can go cold turkey, no way! Starting tomorrow, I'll ask for a split, or 1/2 decaf soy latte. Eventually I'll get to all decaf, sooner rather than later.

Nothing is certain except for change, eh?

Related Post:  Caffeine Quandary

Related Links

• Does caffeine affect blood sugar?
• Why does black coffee raise my sugars?

Was That Fiber or Fibroid?

What's the difference?

Fiber

Plant material that cannot be digested but that helps you to digest other food.

Fibroid

A growth of fibrous tissue in the uterus, usually a fibroma, fibromyoma, or leiomyofibroma.

Surgery is the definitive treatment, especially for complications such as bleeding or pain, and when there's a suspicion for malignancy.

According to the Mayo clinic, for women who have symptoms, the most common symptoms of uterine fibroids include:

• Heavy menstrual bleeding
• Prolonged menstrual periods — seven days or more of menstrual bleeding
• Pelvic pressure or pain
• Frequent urination
• Difficulty emptying your bladder
• Constipation
• Backache or leg pains

While all uterine fibroids are the same, they have special names based on their location:

• Submucosal fibroids are located just under the uterine lining.
• Intramural fibroids lie between the muscles of the uterine wall.
• Subserol fibroids extend from the uterine wall into the pelvic cavity.

As I have three amazing kids, and no plans for becoming pregnant, I'm going for the hysterectomy, or uterus removal.

So, in a nutshell, eat fiber, and remove a fibroid when it's painful, etc.

For the record, this being a woman thing isn't for the faint of hearts. We're rather complicated beings, biologically speaking.

Related Links

• Uterine fibroids
• Uterine fibroids fact sheet
• Uterine Fibroids - Surgery

Agnsty, Not Only for Poets and Teens

I love that word. When I looked it up, I found this definition in the Urban dictionary:

Generally it involves the feeling of not being understood by anyone and that the person is alone in the world.

The Merriam-Webster free online dictionary has this nugget:

feeling, showing, or expressing anxiety, apprehension, or insecurity

My teens are in the former group, which makes total sense, because, well, they're teens. I'm in the latter group, my guess is because I'm neither a poet nor a teen (although there are times when I act like one). Anxiety and its cohort, depression, have been my companions for quite some time. Probably about the time I started infertility treatments. (I am blessed with three amazing kids. More on that story, later.) However, anxiety and depression have been particularly present in the last few years. Probably about the time insulin resistance reared its ugly head, unbeknownst to me. The good news is, now things make sense in ways that baffled me before. The bad news is, I must take better care of myself. I mean, you know, like put myself first sometimes. How bad can that be?

I'm curious, though. How much of my anxiety and depression are health related? As I ease into a healthier lifestyle and continue to put myself first in positive ways, will my depression and anxiety lessen? Will I be in a position where I can cut back on my "happy pills?" These are questions I hope I'll have answers (in the affirmative) to in the near future. It looks like, by continuing down the path of eating healthy and exercising, I could very well reverse insulin resistance and its unsavory symptoms in about a years time. I tend to be a rather goal-oriented individual, so of course I'm writing the goal of eliminating the whole prediabetes thing in gold letters on my bucket list.

I have found that sleeping better, thanks to the CPAP machine, has improved my over-all state of being. I'm positive that exercise is also responsible for helping smooth out my rough edges. Therefore, it must be possible that eating well, and managing or eliminating the massive levels of insulin wrecking havoc on my body, may very well contribute to reducing my angsty depression, as well.

That's my story, and I'm stickin' to it.

Related Links

• Serum androgens and depression in women with facial hirsutism.
• Severity of depression and anxiety in obstructive sleep apnea syndrome
• What's the connection between diabetes and depression?

Teal Ribbon Cysterhood

Yesterday I became an official, card-carrying member of the PCOS community. On the one hand, I feel pretty smart for figuring it out for myself. On the other hand, it's sucks and I'm mad-as-hell that I have a syndrome, which is essentially a catch-all phrase that experts use when they don't have a clue what to do with you. Great, just lump a bunch of us who share similar symptoms together, scratch your collectives heads, and label us with "syndrome." Yeah, that's me throwing a cyber tantrum. Fat lot of good it does, aside from letting off a bit of steam, huh?

Speaking of fat, the experts say that loosing just 10% of your weight can reduce the severity of PCOS symptoms. That sounds easy, yes? Well, as easy as it is for anyone to eat healthy and exercise. Only, with the added challenge that the PCOS syndrome can include that lovely increase in weight. What the heck, what's life without a few challenges, right? So, what exactly can one with PCOS eat, and what are the things that one should avoid?

I explored a cross section of PCOS diets out there, and most all of them agree that becoming the next non-Dairy Queen is the next best thing to sliced bread. This was a bit disconcerting, as I grew up believing that milk has something for every body. Is it possible that the dairy industry lied to me? To us? Shocking! Well, not really, they are in the business of selling milk, cheese, and ice cream. When it comes to cheese and ice cream - oh, and hot chocolate! - avoiding dairy hits me the hardest. I mean, try and order a bean and cheese burrito without the cheese, or a quesadilla, for that matter! I can do pizza sans cheese, but then there's the white flour used in the crust, and white flour is another no-no.

That does make things like eating out a problem. Heck, that makes eating in a bit of a challenge, too.

For me, losing weight and eating healthy means limiting my personal choices, thereby making it easier to shop, prepare, and stay on track. I've taken to wearing a pedometer again, and that helps me increase my daily activity, as I challenge myself to reach 10,000 steps every day. I've hit it a couple of times so far, yay me!

Related Links

• PCOS Diet Support
• PCOS Nutrition – PCOS Diet
• PCOS Support Groups

(non) Dairy Queen

I have crowned myself a non-Dairy Queen. No coronation, ballgown, nor tiara, heralded the occasion. (Curses! Someday I'm going to get a tiara!) I have discovered that keeping dairy off my plate and away from my stomach helps minimize my symptoms. The challenge came when I wanted to find substitutes for cooking with, and adding to coffee, which I talked about in the Critical Mass post. There are lots of alternatives, but which is the best choice, packs the most protein and contains the least amount of sugar? Then, of course, I must ponder what is satisfying, too.

I'm a bit of a show me the data kind of gal, so I searched the interwebs for facts and figures. Wow! There's a lot of stuff out there, from manufacturer's nutrition data to blogger's personal findings, to recipe re-dos using milk alternatives. While all that data can be overwhelming, I slogged through a great deal of it. I decided that I, personally, needed to focus on what works for my lifestyle, digestive track, and personal taste preferences. Oh, and I focused on milk alternatives that are high in protein and low in sugar. Soy has become my go to milk substitute. However, when it comes to satisfying my sweet tooth, I head for the Almond milk. I'm not a fan of Coconut milk, not even remotely. That said, I keep it on hand as I can use it to add a lot of sweet to whatever I'm making without inducing a sugar spike.

Beverage	Calories	Sugar	Fat	Protein
Almond Milk	40	0	3.5g	1g
Coconut Milk	50	0	5g	1g
Soy Milk	80	1g	4g	7g

My figures are for the brands I use, based on an 8 oz serving. Your values may vary.

Related Links

• 21 FAQ about Almond Milk
• Coconut Water
• Nutrition Facts: Soy Milk

Grains in Focus

The first thing I did when I realized that I was on the brink of type 2 Diabetes, was figure out what I could eat, and what I should limit or avoid completely. It wasn't too hard to include whole grains. I use a Tabbouleh recipe as a starting point, and then change up the grains and toss in whatever I have in the fridge and pantry for interest and variation. Of the go-to grains listed on the American Diabetics Association website, I gravitate toward the following:

• Brown rice 
  
• Bulgur (cracked wheat) 
• Buckwheat flour 
• Whole grain barley 
• Whole grain corn/corn meal 
• Whole oats/oatmeal 
• Wild rice 
• Quinoa/Quinoa flour

Presently, Quinoa is my staple and I always have a batch ready to add to whatever I'm making. 

I like to stir-fry barley, seasoning it with simply with salt and pepper. My oldest daughter, who is an extremely picky eater, has decided that anytime I make that particular dish, that I must make extra so that she can take it for lunch the next day. Ding, ding! We have winner. 

I've completely eliminated anything made with refined white flour, white rice, and limited my potato consumption. Which is challenging, but doable. Do I look longingly at the chili cheese fries my son makes? li'l bit. Do I salivate when my youngest daughter makes ravioli? On occasion. However, there are lots of ways in which I can enjoy the foods I love by swapping a starchy vegetable or a refined white flour product with a whole grain. I'm thinking I might test out this theory by replacing the fries with barley. It isn't chili cheese fries per se, but I think it might just be a satisfying substitute.

With a little bit of planning, a dash of imagination, and a pinch of surfing the interwebs for recipe possibilities, it's pretty easy to include whole grains in your daily diet.

Related Links

• Best and Worst Foods for Diabetes
• Combating Polycystic Ovary Disease Through Diet
• Diabetes Power Foods: Whole Grains and Fiber
• Grains and Starchy Vegetables

A Breath of Fresh Air

I remember when I was pregnant how I would need to take a nap so that I had enough energy to go to bed. A pregnant woman's exhaustion makes perfect sense, as she's using the equivalent amount of energy as does a mountain climber even when she's sitting still. It's been more than ten years after the birth of my youngest child, and there are times when the act of lifting a toothbrush seems to be more than my body can manage. Could stress be the culprit of fatigue? Stress most likely contributed, but it seemed like an accessory to the underlining issue, not the culprit.

Until recently, I thought that my profound exhaustion was related to depression and anxiety. Now that I've been diagnosed with sleep apnea, my chronic fatigue makes perfect sense. Now that I believe to have found the source of my exhaustion, time to work on resolving it!

I picked up my CPAP machine, the cool one with the humidifier. I have the nose piece, so instead of looking like Mom Vader, I look like the Elephant Mom. Seriously! The tube attached to the nose piece can, with a bit of imagination, look like a trunk.

I was given instructions to wear it for the first week while sitting and reading or watching TV. My son helped me set up the machine and hook up the hoses, harness, and nose piece. We both laughed at both my daughter's expressions when they came out into the living room and caught a glimpse of me in my gear. There's nothing like the laughter of my kids to help me keep things in perspective. I soon figured out how to inhale and exhale without popping my ears or having air whoosh out of my mouth (keep it closed, duh). It didn't take long to get into a breathing rhythm. Speaking while connected to the unit, however, I haven't master. Yet another element to have fun with. My kids would ask me questions just to hear me try and talk. I am, after all, on this earth for their entertainment. Well, that and a walking ATM machine, but I digress.

The first night I don't think that I slept. At least, I didn't feel as if I had. Clearly, I must have caught a couple of winks as my husband noted that while I did sound like Darth Vader, I didn't snore. I'm thinking that's progress, or at least an improvement. However, I was unable to function the following day. So I didn't, I stayed home and took a long nap.

The second night I fell asleep promptly, despite the long nap I enjoyed earlier in the day. I did wake up a couple of times. The first time I awoke, I went promptly to sleep again. The second time I stayed in a state of not asleep and not awake. Fortunately, I felt more human than the day before. Does it just get better and better from here? How many more days before I get to the "life changing" benefits of using this contraption? I am truly ready to "feel like a new person."

The third night I wasn't obsessively focused on my breathing and I fell asleep fairly quickly. I woke up about three times, but I immediately returned to sleep. By George, I think I've got the hang of this thing! While I still have a morning headache, I don't feel as if I'm mired in a dense fog. 

Looks like all I need is a bit more time to cozy up to my new best [electronic] friend. Do you think my smart phone will be jealous? 

Previous topic in the Sleep Apnea series: Sleep Perchance to Rest

Related Links

• Sleep Data Infographic
• Stop the Snore: 5 Risk Factors That May Require You to Talk About Sleep Apnea With Your Doctor