Pity Party Pig Out - Reflections

Last week was a doosie.  My daughter is in the hospital recovering from a procedure (she’s okay), and I spent the whole weekend there with her.  I came home on Sunday night, leaving my husband there to stay, as I had to go to work on Monday morning and he did not. 

Sunday night, watching football by myself in my jammies, I wanted a snack.  I went to the fridge, and found a mountain of Chinese food leftovers, none of which I should be eating.  I seized on the stress of the weekend as an excuse to pig out on forbidden foods (yes, it was a conscious choice and I knew what I was doing). 

I wish that I could say that I stopped at the cold spareribs and chicken fingers.  I didn’t.  I went back to the fridge, looking for something sweet, thinking to myself, “well, I already blew it with Chinese, what’s a little more junk food going to hurt?” 

I found about 4 ounces of coconut chocolate chip cookie dough in the freezer, and demolished that.  I looked down at my belly, which had already started to rumble at me disagreeably, and felt a bit ashamed.

I justified my bad eating choices, in those moments, by thinking that, with all that I had going on, I deserved a break, and no one would think poorly of me for cheating.

Making excuses for poor behavior to justify continuing down a path that I should not be on is just crazy talk!  Who am I making excuses to?  Me?  Sending excuses from myself to myself?  This is how I got into the rut that I was in – you know, the rut that had me ballooning to 236 pounds on my 5’6” frame, suffering from diabetes, high blood pressure and PCOS. 

I am past this and I am better than this.  Taking personal responsibility for my health at all times means that when life hands me lemons, I do not drink lemonade.  I also do not eat lemon squares or lemon pie, or indulge in lemon chicken.  I calm down, take stock, and decide not to go forth into a feeding frenzy. 

The truth of the matter is that I have this one life, and this one body, and I believe that I can do better for myself and for my family.  No one benefits when I eat crap that can literally send me into a coronary. 

Gifting myself with junk food, sugar and starches is the old Kate, the one who numbed herself with food because she could not face sad things in her life.   

The new Kate is honest with herself, and is getting healthier day by day.  She doesn’t run from problems.  She faces them head-on, and sends them packing.   

Does this familiar to you?  Check out:

Pema Chodron, Getting Unstuck, This is a great CD from Pema Chodron, a buddhist nun.  She's been there.  This CD really helped me understand what I was doing to myself with food.  Its not a CD about food or dieting - its about being in a rut and identifying why you created the rut, and what its done for you lately. 

Low Carb Pregnancy (Surprise!!)

If you’ve been reading this blog for any length of time, you may recall that I was recently diagnosed with PCOS-related infertility in March.  My blood glucose was being managed by a strict, ketogenic, low-carb diet, and by March, I had lost weight, and felt a number of health benefits, including increased energy.  However, I wasn’t ovulating, and probably hadn’t been ovulating for years.  In fact, I have menstruated only once in the past year – in April – and that was courtesy of a 10-day course of Provera.

Imagine my surprise when I found out on Father’s Day that I am pregnant!  We weren't trying to get pregnant (nor were we trying to prevent pregnancy, exactly), and I did not think that I was able to get pregnant.  Where did this new-found fertility come from?  We are very excited!!

I am still going to stay relatively low carb – between 50-100 net grams of carbs per day – because I have been advised to stay out of ketosis while I’m pregnant.  I’m still avoiding wheat and other grain products, potatoes and rice (I found to my dismay that eating grain products results in discomfort).  The extra carbs are coming from fruits and vegetables that I’m adding in to my regular diet, dispersed throughout the day. 

So, the focus of this blog is going to change from weight loss and fitness to maintaining a healthy pregnancy, using low carb principles to keep my blood sugar stable, to stay fit, and to prevent unhealthy weight gain.

Diabetes? Type 1, Type 2, or [Type] None?

Last night, I received a phone call from my MD at home.  The results of my fasting glucose and insulin tests from last Friday came in.  My fasting blood glucose was 118 mg/dl, and my fasting insulin was 10.  Apparently, the blood glucose was elevated, but the insulin was well within the normal range (the max normal is 17).  The fasting blood glucose result seemed strange in light of the prior post-prandial glucose test I took at the lab, which resulted in a reading of 95 mg/dl.

But...I expected a higher than normal fasting blood glucose.  I have read a number of blog entries and posts from low-carbers out there who have had the same results:
http://www.livinlowcarbdiscussion.com/showthread.php?tid=1381
http://high-fat-nutrition.blogspot.com/search/label/Physiological%20insulin%20resistance%20%281%29

My doctor is concerned that I may be diabetic.  According to her, I should do a glucose tolerance test, and get my HbA1c tested.  I told her that I was worried about getting a false positive from a GTT because of my low carb diet.  As observed by Dr. Atkins: 

"Note: The GTT results are not considered accurate unless you are consuming at least 150 grams of carbs a day for at least four days before you take the test. Therefore, doing it after you start Atkins would mean you'd have to go back temporarily to eating a high carbohydrate diet (and almost certainly regain some of the pounds you have just successfully lost)."  Dr. Atkins New Diet Revolution, p.113 (2002 ed.). 

This recommendation seems to be pretty mainstream:

"Those taking the OGTT to diagnose diabetes or prediabetes who are not pregnant should eat a normal, balanced diet the week before taking the test. Experts recommend that this diet include at least 150 to 200 grams of carbohydrates per day. Patients must fast for at least 8 to 12 hours before having the test."  http://diabetes.about.com/od/symptomsdiagnosis/a/ogtt.htm; see also, http://www.ehow.com/how_2077817_take-pregnancy-glucose-tolerance-test.html (recommending 150g for 3 days prior to GTT).

I know I'm getting about 20-30 grams of carbs a day, which is confirmed by my carb counting and daily ketosis testing.  I'm leery about guzzling all of that sugary stuff for the GTT, about high-carbing it for 3-4 days prior, and about sticking around a blood lab for 2 hours to get the GTT done (I have to work, people)!! 

So, we're compromising.  I'm going to do another fasting glucose and the HbA1c tomorrow morning before work.  I'm going to start monitoring my blood sugars three times per day with a home glucometer, which I have to pick up this afternoon from the pharmacy (yay, insurance paid for the glucometer and lancets – no copay!).  Then we'll see if we need to do the GTT after those results come in.  Hopefully, the HbA1c will look good enough so that I don't have to do the GTT.

I have read that exercising at night, and eating a good, low carb snack before bed, can help with fasting blood glucose.  Guess that means that yours truly is hittin' the gym tonight.

I hope I'm not diabetic.  Type 1 and Type 2 are both in my family.  Type 2 I can deal with, as it is likely to resolve itself once I've got my health and weight under control.  Type 1 is pretty scary stuff. Shudder.  My maternal grandfather and first cousin once removed have Type 1.  But I make insulin…  and I have PCOS, which is related to insulin resistance (I make too much insulin).  I don't know how you can have symptoms of insulin resistance and have Type 1 diabetes, because having insulin resistance implies that you are producing a lot of insulin and your cells just aren't responding to it.

I'm going to start keeping track of my blood glucose levels on this blog.  Hopefully, it will provide some insight and result in a healthier me.

End of Week 10 - weigh in (a day late)

I weighed in yesterday, on April 3rd, at 215.5, which is one more pound lost from last week.  I also lost about 3/4 of an inch from around my waist.  Last week was a tough one.  I had not been feeling well - the week was plagued with headaches, moodiness... you name it.  I seem to have a headache all of the time, and ibuprofen and tylenol do little to help.  I'm not sure if this is the result of my new meds, or if it is the start of allergy season, and I have some kind of sinus thing going on.  I am going to call the MD who prescribed the new meds, and see what she says.  Hormones are serious stuff. 

I was hoping to pen a new post this week, entitled, "high energy... I love Mondays!"  That is not going to happen.  I'm still tired, moody, and headachey.  I hope I can get some resolution from the MD.

Cheers, and here's to feeling better in every way!!  :)

Get thee to the doctor!

I've been doing a lot of research on PCOS and "estrogen dominance" and "progesterone deficiency".  Turns out having PCOS causes you to have a lot of estrogen running around in your body.  Too much estrogen and not enough progesterone tends to make you fat around the midsection, hairy, moody, headachey, etc.  As if these symptoms weren't bad enough, having such an estrogen imbalance can apparently increase your likelihood of heart disease and breast cancer.  (And, let me be the first to tell you, having PCOS can make you infertile).  If these symptoms sound familiar, consider getting yourself to your MD for a check up, and have them run some blood tests on you. 

Hey - I'm not a doctor, but I believe that if you feel like crap you should get yourself to the MD and find out what's going on. 

I know a lot of people who prefer to stick their heads in the sand and just live with their symptoms.  An example: I have an Aunt Pam.  She is one of my mother's sisters.  After my mom was diagnosed with breast cancer (for the second time) in 2008, she had genetic testing performed to determine whether she had a gene abnormality on BRCA1 or BRCA2 (these are human tumor suppressor genes - women and MEN who have an abnormality in these genes are much more likely to get breast, ovarian, and other types of cancer than the general population).  Mom had a deletion on her BRCA 2 gene - she had hereditary breast cancer.  With the exception of my Aunt Pam, my mom's children and her brothers and sisters all were tested.  We were all negative, thank God.  My Aunt Pam didn't show up for her appointment, she didn't reschedule, and she has never been tested, to this day.  Aunt Pam has two biological children, each of whom would also have benefitted from knowing whether their mom carried such a gene abnormality (because that would mean they have a 50% chance of having the same gene abnormality...the same elevated risks). 

My mom died last August, at age 54.  If she had had the benefit of a "heads up" ten years earlier, maybe she would still be alive today.  (Case in point: Christina Applegate).  To squander the opportunity to learn more about your own health, when it could provoke action that could save, extend and/or improve your life (and the lives of your loved ones), is tragic!

We only have this one life and this one body.  We should take care of them the best we can.  You're never too old to start taking care of yourself for the first time in your life.  Hey, I'm 31.  I'm obese and not that healthy at the moment.  But, I'm working on it, and my life is improving as a result.  There is no shame in being a work in progress.  There is no shame in investing in YOU!

Life Choices, Establishing Priorities, Acting Like an Adult, Headaches, Test Results

I just don't feel like myself this week.  I had Monday Misery, which is not my usual deal.  I have been grumpy, tired, and short-tempered.  Today, I have a headache, which I never get.  It is right in the dead center of my forehead and face, and completely encompasses both eyes.  The pressure is very uncomfortable.  I haven't been able to get my butt out the door to exercise this week.  I have been creaky and achy in my back and knees and neck.  I have had such high energy since starting low carb ten weeks ago.  In contrast, this week just feels so strange.  I am uncharacteristically low energy and just plain, old miserable.  Sigh.  I don't think it's the diet.  I am wondering if I'm sick, hormonal (see also, my birthday post and evil kate post), or starting up with my seasonal allergies. 

I just had a comprehensive blood screen at the doctor's and looked at my results.  Mostly everything is good and normal.  My glucose, after eating lunch, tested at 96 (which is normal for fasting blood sugar, so pretty good for midday after lunch).  My blood pressure has been consistently low.  My cholesterol is pretty good: its a little high, but the ratio is really good, and my HDL level is high. 

My estrogen count is way way up.  My new doctor confirmed my PCOS diagnosis yesterday after an ultrasound.  She said that my estrogen is elevated because I haven't ovulated in months.  So, I have started taking progesterone to induce a period, then I'll take clomid to induce ovulation.  Hopefully, this will start the old ball rolling.  Can extra estrogen make you beastly?  I am wondering.

So, the whole point of figuring out this PCOS thing, and getting my body in gear, is because I am, at least now, not ovulating and therefore infertile.  Hubby and I have been thinking about having another child. 

After going to the doctor yesterday, and talking about conception and stuff, stewing for a while, then getting Satan's own headache and being short with the wonderful daughter I already have, I began to feel that I am not ready to have another child at this moment.  I love kids.  I love my own kid to the moon and back and I am so proud of her that it makes my teeth hurt.  Part of me really would love to have more children.  The other part of me, which has been silent for a while, thinks that I should get my shit together, lose my weight, enjoy being thin and healthy, and revisit pregnancy when I am healthier overall and will have a safer pregnancy.  I also want to be able to hang out and do adult things that I have only recently been able to do… like join my friends for a movie or happy hour.  That same part has also suggested that I should think about focusing on my career.  Career and new baby don't necessarily jibe, you know.  (Not unless your significant other is willing to be a Mr. or Mrs. Mom… and mine isn't).  Both parts of me have been positively screaming "PRIORITIES, ESTABLISH YOUR FREAKING PRIORITIES", although they clearly disagree on what those priorities should be.  Is it just panic?

Let's make a list of priorities:

1. Keep a close eye on the health of my dad and grandma, and be the health bouncer in my family.
2. Spend time with my family.
3. Get healthy.
4. Get my billable hours on track at work.
5. Get City and related stuff in order.
6. Enjoy being an adult.
7. Take on a hobby.
8. Think about having another baby.
9. Think about running for office again (I really want to take a term off).

That feels right to me.  I have to sit with it for a while, but for now, this feels like what I have to do.  I feel this need to take care of and preserve what we already have, before we add anyone or anything else in to the mix.  

Why do I feel selfish and kind of sad?  Am I depressed?  I just don't feel like myself!  I am going to go back through my old blog posts, and remind myself that I am usually a happy person who feels well!!!

Ow.  The headache has moved on to the top of my head, my temples, and behind my ears, despite the acetominophen I just took.  Maybe I should wait until I feel better before I make any Life Choices.

Musings, hormones, and self appearance (Not Quasimodo)

Yesterday, I kicked a little ass on the elliptical machine.  Oh yes, I did.  I always thought it was way harder to do than the treadmill.  However, now that I’m old, I realize something.  It can be distinctly uncomfortable to run on a treadmill due to the concussion that running causes to my prematurely-aged feet, ankles and knees.  Ouch.  The elliptical eliminates that concussion.  Also, I realized that the action of picking up and putting down your feet makes you breathe harder.  Oof.  So, the elliptical is actually easier to do than the treadmill.  That makes me wary of whether I will be able to run the 5K in May.  I mean, if the treadmill hurts that bad, the pavement is going to have to be even worse!  I don’t want to really mess up my joints, but I do want to run.  The elliptical gets my heart racing, but it doesn’t simulate running.  What to do, what to do.  I am going to have to make an appointment with my MD anyway, so this is just one more issue that I’m going to bring up.

I had some ridiculously good corned beef and cabbage in the office cafeteria today.  I am still starving, though!  It is nearly impossible to low carb snack at the office, as I left my new bag of almonds at home, and I have no other noshes here.

I am wearing a new outfit that I just received for my birthday yesterday.  It is a dress and sweater, size XL, and both fit comfortably, I am happy to say.  I can really tell a difference in my body as a result of my weight and measurements loss to date.  I appear a lot narrower in my profile view, and the top of my butt does not look like a shelf you could rest small photographs on.  (I am slightly exaggerating).  Clothes just look better on.  When I try to squeeze in to pants that are still a little too tight, I don’t have a muffin top thing happening.  Its good.

I am not excited about my vitamins.  Part of me really wants to blow them off.  I hate taking them – ick.  They are too big, and there are too many.  But I know that I do feel better on them, and my hair and skin looks better.

I think that I am hormonal, which is surprising, and surprisingly, a good thing.  I was looking back at my personality-related posts of last week, and man, was I a hardcore, beastly, bitch of a woman.  Also, I am all broken out on my chin.  These are, traditionally, signs that I am getting my period.  However, I haven’t gotten one in a while, because I haven’t been ovulating. 

My doctor suggested, years ago, that I may have PCOS, or poly cystic ovarian syndrome, because of some of the symptoms I was having (irregular periods, facial hair, overweight despite diet changes).  She sent me to a nutritionist, who put me on a low carb diet (which I never followed).  I never followed up on it. 

Now, I’m starting to think about having another child, so I’m consulting with this new MD, who has one all of this testing on me and is taking another look at my old medical records from my last OB and primary care MD.  I stopped taking the pill back in December, and I haven’t had a period since.  The new MD says I’m not ovulating, and we’re trying to figure out why.  Since I’ve had these PCOS symptoms forever, the MD said that it was practically a miracle that I got pregnant the first time. 

Now, I feel distinctly like I’m about to get my period, which only happens if you’ve ovulated.  So, if I got my period without medical intervention, that would be a good thing. 

I’d like to believe that as I get healthier, my body is getting back on track and will be operating normally.  Boy, I’d like for it to operate normally.  I would really like to not have scalp psoriasis (I’m flared up and hating it right now), and I would like to have the ability to get pregnant (even if I don’t actually try to get pregnant right away).  I would also like to get off of these high blood pressure meds, get my cholesterol well under the recommended max for normal, not have joint pain when I run, and never have my freaking back go out again! 

I know that all of these are good goals.  The true, overarching goal, though, is to feel like a normal 31 year old, and not like someone who periodically feels like she’s 80.  I’m tired of feeling like a scaly, hairy, mean, old geezer.  (Jesus, I just make myself sound like Quasimodo sans hump!!)

Looking better in my clothes, while satisfying, is just NOT ENOUGH.  Come on, old body, get with the flipping picture!

Study - Effects of Low Carb Diet on PCOS (which I have)

The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study

by John C Mavropoulos,William S Yancy, Juanita Hepburn, and Eric C Westman

Excerpt from Discussion Section:

"This pilot study showed that adherence to a low-carbohydrate, ketogenic diet led to improvement in body weight, percent free testosterone, LH/FSH ratio, fasting serum insulin, and symptoms in women diagnosed with PCOS over a six-month period. Further research is needed to determine if the benefits were from weight loss or from carbohydrate restriction specifically."