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?

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 

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?

Connecting the Dots

All cases of acne have their roots in hormone production. In a wry twist of cosmic humor, my teens and I have adopted similar skin care routines for similar reasons. I want to call it "testosterone poisoning" but that isn't completely accurate (albeit, funny). Only, unlike my teens, I get the painful acne cysts that last for weeks, and sometimes looks like someone took a wicked right-hook to my jaw wearing a knuckle ring. 

As I mentioned in the Bigfoot, Yetti, and Me post, testosterone does some pretty amazing things. In the binary way of opposites, up and down, left and right, benefits and challenges, lies the beauty and beast of testosterone. The beast in this instance is oil production, nuthin' like greasy hair and skin, eh? 

Fortunately, I found a few products that help with minimizing the crazy outbreaks. As I bought similar products for my teens, I'm no longer yelling down the hall "who took my zit zapper!" Hell hath no fury like a hormonal mom. Jus' sayin'.

Like other symptoms, some acne is indicative of an underlying hormonal condition that can cause far more than facial blemishes. Yes, acne is a heartless bitch; but so is all the other inconvenient, embarrassing, and uncomfortable symptoms that make up this lovely syndrome.

I'm probably sounding like a broken record about now. Yet, once again, I'm advocating for all patients to ask their medical professionals to go beyond treating symptoms individually and looking at their patients and their symptomatology as a collective whole.

Related Links

• Acne and PCOS
• PCOS and Acne
• When It's More Than Acne

From Soprano to Alto

Puberty is a remarkable time. Growth in body, maturity, and character are just a tip of the amazing ice berg that is happening in a teens body. I take particular delight in watching the signs that herald the change in my son from boy to man. From his platinum blonde mustache to his deepening voice, the transformation is nothing less than miraculous.

Of course I share and identify with the changes my daughters experience, but I never imagined that I would share in the changes of my son. Particularly in the deepening of my voice.

It now makes perfect sense why I can't reach those high notes that I once hit with alacrity. Yet, for the longest time, I wrote it off as simply a sign of aging, or perhaps not singing as much as I used to.

PCOS is a complicated disease that involves problems with the endocrine system and female reproductive system. It makes a strange kind of sense that the very same androgens responsible for the changes in my son are also the culprit for the changes in me. On the one hand, it's sort of funny, on the other hand, it's a trifle bit humiliating. Once I realized that there is a physiological reason for virilism, it did lessen my embarrassment.

Once again, it's a small symptom that can easily be dismissed. So I went from a high, girly voice to a sultry, sexy voice; is that really such a thing to get all worked up over? I mean, it's just a symptom of aging or peri-menopause, or so I told myself. Ah, but the trick is to take all the seemingly trivial changes and look at them as part of a whole. Which, when I think about it, isn't possible as I'd dismissed them and never thought to bring them up to a doctor.

Related Links

• Is my deep voice due to polycystic ovaries?
• Polycystic Ovarian Syndrome
• Vocal changes in patients with polycystic ovary syndrome.

Bigfoot, Yetti, and Me

It's one thing to have a uni-brow, it's another thing completely to have Frodo feet. Did you catch the connection there? In case you missed it, I'm talking about unwanted hair. 

There's this thing about hormones, they do a lot of cool stuff. There's another thing about hormones, they can get whacked and do a lot of stuff that's not so cool. 

Take, for example, testosterone. Now there's a mighty hormone for ya! It does all sorts of stalwart things, from growth spurts to bone maturation and density, it's pretty awesome on the cool hormone spectrum. Except for when it isn't. 

Let me share with you when testosterone isn't on the cool side. When you're a female and either your ovaries or your adrenal glands go into overdrive. Did I just shock you? Didn't realize that women's bodies produce testosterone? Well, it's true. Here's a quickie biology lesson, ready? The menstrual cycle occurs in three phases: follicular, ovulatory, and luteal. There is a rise in testosterone during the third phase. 

What happens when your testosterone launches into orbit? I mean, it's one thing to be at the top of the normal range (15-70 for adult women), but when your lab results come back with levels in the hundreds, it's kinda scary. Mine labs came back with a 133 -- gave a whole new meaning to Mr. Mom for me. (My attempt at humor, is it working?) Hair, lots and lots of hair in places you'd rather not have hair.

What I once wrote off a genetics - hairy feet, navel, inner thighs and quite a patch of fur on the back of my thighs - I now see in a completely different light. Yes, I was born to a tribe of mostly short, round, hairy people, and I accepted depilatories, hot wax, and laser hair removal as just a part of my heritage. But, here's the thing: I wasn't happy about the goatee I began sporting in my 40s. I'm not talking a few hairs sprouting here and there. 

While laser treatments did remove a decent crop of facial hair, what the heck was going on with hair sprouting up in new locations?  Okay, okay, enough of my hairy rant. You get the picture. 

When seen as just a product of genetics, it's embarrassing. When seen as a by-product of a larger system malfunctioning, it's alarming. If anyone can jump at an alarm, it's me. Searching the interwebs for anything and everything I could find on high testosterone levels in women was the first place to which I jumped. 

Guess what I found? There's a label for unwanted hair cropping up all over my body: hirsutism.  Sadly, labeling the condition didn't make it magically disappear. Yet, it did connect me to other information and I began compiling a more comprehensive list of potentially related symptoms. Which is a good thing, right?

Related Links

• Hirsutism and Polycystic Ovary Syndrome (PCOS)
• Hirsutism Basics Genetics vs. Hormones
• Hirsutism Symptom Checker
• Testosterone Levels by Age and Sex
• Women in Balance Hormone 101

Name that Syndrome

I'm waiting for the result labs to confirm my suspicions. During my wait I've been reading up on everything Polycystic Ovary Syndrome (PCOS) related. Yup, all signs point to that loveliest of all female, hormone-related disorders. 

In a word, it sucks.With a capital Uck.

There is much out there on the interwebs discussing all things PCOS. From symptoms, to lab work, to current medicine practices. I spent the last couple of weeks scouring the medical sites and various forums and blogs looking for information. I think that I really wanted to just find the thing that said "THIS!' Which I would do, and then all of my symptoms would miraculously disappear and I would be healthy. End of story. 

Try as hard as I did, I couldn't find anything that looked remotely like the THIS thing. What I did find is that there are a lot of women who have PCOS. Further, many of these ladies blog about their journeys, documenting their symptoms, doctors visits, test results, pain, and courage. Pages and pages filled with stories that are so different from my own, yet remarkably identical. That's the weird part. I, too, feel the need to share my story. I'm hoping that the more stories there are out there, the easier it will be to spot and aggregate the disparate symptoms for any women seeking relief from theirs. 

Honestly, the symptoms range from embarrassing to humiliating, to downright scary. Seen individually, each and every symptom can be swept under the "oh, it's just stress" carpet, except for the few that can be swept into the "it's genetics, just look at your mom" pile in the corner. When others dismiss your symptoms that makes it easier to dismiss them yourself. And I did, mostly, despite the tiny, nagging voice in the back of my head that insisted that something bigger was wrong. Frankly, I didn't want to be a hypochondriac. So, I silenced that nagging voice, pasted a smile on my face, and presented to the world the happy, positive facade that serves me well. 

Soren Kierkegaard said that "Life can only be understood backwards; but it must be lived forwards." In understanding PCOS and how it relates to me and my experiences, that quote is spot on. Let me show you what I mean, read on...