2 year endocrinologist update!

Last week I went to my endocrinologist for my 2 year check up! I was seriously excited to go because I was proud to show off all the changes I had made.

I am in no way-shape-or form a doctor. This post is based solely on what my Endocrinologist and myself discussed. If you have health related questions please contact your own doctor. 

 

I am so proud of the woman I was...she started this journey.

I am so proud of the woman I am now...because I have been changing my life for over 2 years.

I am sure I will be proud of the woman I will become...because, well, I can't imagine my life any other way!

**January 2012 - Initial Endocrinologist Results**
Weight ~ 213 lbs
BMI ~ 38%
Hemoglobin A1c ~ 5.9 {normal range according to my Endo is 4.0 - 6.0}

**January 2012 - 2 year Endocrinologist Results**
Weight: 143 lbs
BMI: 24%
Hemoglobin A1c ~ 4.6 after 22 months on Metformin

July 2011

October 2012

July 2011

November 2012

 

When I first got my results back from the endocrinologist I was considered insulin resistant, they thought I had something wrong with my adrenal glands {turns out I'd just recently had a cortisone shot and sent my levels through the roof}, my Vitamin D level was 17.6 L2 {normal range 30.0-150.0}, and I was just in overall poor health.

 

My first tipping point was a Halloween party...but my boulder that catapulted me off the seesaw was getting my lab results back! It really shocked my system. I KNEW I was overweight, I KNEW I was unhealthy & unhappy but until those numbers were on the paper I didn't realize how bad it was. Nothing to me, at that point, was as scary as hearing that if I kept on the path I was I would have diabetes in a year. My endocrinologist was very blunt with me and for that I will be forever grateful. She was the FIRST doctor to tell me I was overweight and needed to change. Looking back that fact still shocks me.

 

Over the course of the last 22 months I did go on a few different medications that I believed help me. I started 500mg extended release Metformin in February/March 2012 and stopped one week ago. I have a follow up appointment in July 2014 to see how 6 months off of Metformin goes and I am so excited to see if the hard work I put in pays off. I admit it, I am nervous to go off the Metformin because I feel like it did help me get to me a little "looser" with my carbs because of my PCOS. But I am ready for the challenge of eating what I know my pancreas can handle. My goal is to only eat carbs at 2/3 meals in my day.

 

I am still taking Vitamin D {I mean, I like in Washington State so I feel like I'd need that anyways}, Singular, and birth control. Totally normal and totally unrelated to PCOS meds!

 

Fingers crossed {that my levels stay low}!!!

one year check up!!

I had my endocrinology appointment a few weeks back and got some rave reviews. My doctor was so proud of me {and I with myself}. With Metformin, my glucose and insulin levels are in the average range!!! My bad cholesterol came down into the average range!! It was just the results I'd been working for, hoping for, and waiting for!!

I've decided to, for now, stay on Metformin. Part of me is really, really nervous to take it away. While it is not a weight loss drug - it is an insulin stabilizer and I feel has to have had some result to me losing weight. Granted - I put a LOT of work into this journey...but I'm still nervous.

I am going to see a Naturopath at the end of this month and maybe then, or soon, I will change to an "all natural" insulin stabelizer. I haven't decided yet. Metformin has been shown to have some good results with ovulation...if we go down that path!

Fingers crossed {that my levels stay in the average range}...

my 6 month blood draw results...

I hate getting my blood drawn {like, I've passed out before} but through all the labs and OHSU visits this year...I'm getting used to it, I guess. When I had my 6 month blood draw labs done a week or so ago...I didn't even need to hold a little teddy bear. Big steps, I tell you!!

Myself {and my general doc} were very happy with the results. I haven't heard back from my Endo but I'm guessing she'll be pretty happy too. I saw my Endo about 6 weeks ago and she was very happy with just weight loss. Ha, just the weight loss. Like that was easy ;-)

I have spent the last 8+ months eating right, exercising, and trying my best to head off any disease or illness {diabetes, heart disease}. While there is still a chance I could get them based off the past years of my lifestyle ~ 80% of the time doing everything in my power to help myself. Because I am not a doctor I am not going to go too much in to the "numbers" of all the tests {but I will post mine and what my doc considers "normal"}...but there was one test of concern but all the rest of the main ones we've been watching are within the "normal" range. And for that I am grateful.

Thyroid - Normal Range.
Vitamin D - Now in Normal Range. Went from 17.6ng/mL --> 63ng/mL. The range is 30 - 100 ng/mL. This is GREAT improvement!
Glucose - Low lower within the Normal Range. Went from 96 mg/dL DOWN to 85 mg/dL!!! The range is 65 - 99 mg/dL.
Cholesterol - This is the ones we are focusing on for the next 6 months!!
Total Cholesterol- 180 mg/dL {range 15- 200 mg/dL}
HDL {Good Cholesterol} - 53 mg/dL {range >50 mg/dL in Women}
LDL {Bad Cholesterol} - 99 mg/dL {range for women with Insulin Resistance/Endocrine Syndromes (PCOS) according to my doc is 70 - 80 mg/dL.

The LDL is the one that we are going to be focusing on for the next 6 months. It is known that women with PCOS have a higher risk for heart disease and having high levels of LDL {bad cholesterol} can also lead to heart disease. Those two things together are a cause of concern for me and my health and my doctors. I am going to be going on a very, very low dose of a HMG-CoA reductase inhibitors (statins). This medicine can be used many ways. For me it will hopefully lower my LDL count which will likely decrease my likely hood of getting any type of heart disease. I will be monitored monthly for the first 2 months and then I'm not sure after that. They monitor me at first to make sure that my body is reacting well {quickly} and that my liver is doing okay. It just requires a few fasting blood draws and a quick 10 minute appointment in 2 months.

When talking to my doctor about options she did say that I could continue with the diet & exercise but since it is a personal goal of mine to have all this *ISH* figured by the time I'm 30 {on 3/16}and I'm obviously not opposed to medications - we decided to go for it. It's such a low does that the side affects should be very minimal.

I've been on Metformin for the past 6 months to help control the insulin resistance that I have. We are going to stay on it for another 6 months. I have my 1 year appointment with my Endo scheduled for January 2013!! Wow. Hard to think that I'll have been {knowingly} battling this for a year in just 5 months.

The only part of me that is really worried about all of this is that hopefully there is going to be a time when I will be off all the " weight/helpful" meds {Metformin, Pravastatin} and what will happen to my body then? I supposed when it is time to go off all the meds hopefully my body will be in the normal range and ready to rock-and-roll medicine-less?!? Will the weight loss continue or maintain depending on what stage I am in when I go off the meds?? Will I gain weight back?? Will I be on some kind of medication forever? I know I will be monitored by an Endocrinologist yearly for the rest of forever. I get physicals AND annuals {did you know there was a difference?!?!?}? I have no doubt that it will all be examined and a thoughtful process and I look forward {hopefully} to a day where I am medince free and managing my PCOS and Insulin Resistance on my own accord.

Fingers crossed.

and the results are in...

....and here goes the rest of my life. My life after today.

It is nice to know but man, this sucks. Like, a lot. All this information I got on a voicemail from my Endo. I had called on Wednesday and played phone tag a few times and gave her permission to leave me a voicemail. It was actually nice because I could replay it again and again {and again}. The bummer part - it got cut off. I think I have all the VIP information but I'll update it if it changes!! He is supposed to talk to me tomorrow.

Here's the information. When applicable I'll say what our next step is.

Blood Sugars - Normal
This means that I am not yet in Pre-Diabetes but I'll need to be watched for it.

Insulin
I am insulin resistant. My pancreas doesn't keep up with my body. Ways to overcome this are exercise and diet. Also, there is a drug called Metformin. It works my suppressing glucose production by the liver. I will be starting that soon. I hear it can be rough but if it can help make my life better I'll have to try my hardest to push through it.
Vitamin D
I am very deficient in my Vitamin D. Maybe we need to move to Hawaii ;-) A normal level is 30 and I have 17.6. I will take 50,000 IU for 12 weeks which is a prescription. Then after that I will take D3 2,000 IU daily. I can also decide if I want to get a sunlamp...or move to Hawaii ;-)
Thyroid Level
Normal - to a point. I'm a little high on the thyroid peroxidase antibodies but nothing of clinical significance.
Estrogen Level
Normal.

Testosterone
High
17-Hydroxyprogesterone
This is what my Endocrinologist is most concerned about. My levels of this are extremely elevated and I have been referred to the OHSU Dynamic Endocrinologist Testing Unit. Sounds important, huh?! They are looking for something called Late onset congenital adrenal hyperplasia. I'm not totally sure what it is but it is basically like PCOS but um, worse, especially considering looking at if we are able to start a family... Hopefully we will rule it out instead of rule it in. If we are ruling it in there are some serious things to consider going forward to have a family that would involve some genetic testing. Major overload.

Cysts
I do have them, my ovaries are covered with them. They are not the kind you can remove and I think that is one of the most misleading things about PCOS. If you've read the "what is PCOS" section of my blog you'll learn that PCOS is actually not a good name representation of what this syndrome is. There is something called ovarian drilling but it is much worse than it sounds - if that is at all possible.
I'm feeling okay. Well, that's kind of a lie. I'm feeling overwhelmed, sad, worried, glad to know, angry, like I can't catch my breath and like I need a bottle of wine, a big one. I feel like now I'm on the roller coaster. Like, before this I was just looking at it and not wanting to go on it but now, here I am, unable to get off.

Fingers crossed.

until next week...

...that is how long I have to wait to get my test results.

Turns out because I went to a hospital near my house instead of the hospital where my Endo is. Because they are not in the same "network" my Endo can't just pull them up and look at them. But the medical assistant assured me that there's a note on my file that says to call whenever a lab results come in. I'm hoping the call doesn't come in the middle of me teaching...because I'm going to want to answer that call SO BAD!!

Lesson learned.

Fingers crossed.

Until then I have my PCOS book to finish and my CARB book to start. Oh, and my homework to do for class :( Here's to a book filled weekend!!!

the road to gaining information...

I'd like to start out saying that today I felt good about things. Not good in the sense that I'm happy about it, but good in the sense that I know what is going on - or at least I'm going to know a whole lot more by the beginning of next week. Kind of like this picture. It's been up hill from here and after this week, it still will be up hill - it will be one filled with knowledge.

I took control today and called the Endo office to ask about lab results. I was afraid that they might have the "oh geeeeez" attitude. But it was totally the opposite!! I explained who I was and how I'd never gotten results back and just wanted to know the procedure. Does the doctor call you? Send a letter? What?

The office manager I talked to was so kind and after I told her I'd be getting both my tests done this week she said odds are the doctor would let me know by Friday. She said if I hadn't heard by Monday to go ahead and give them a call back! She assured me that I can call as often as I'd like to check on stuff. I got the feeling that she was genuinely happy to help.

Happy to be a patient there.

Not happy about having to drink 72oz of water in 30 minutes tomorrow but I am happy to be {FINALLY} having an ultrasound.

Fingers crossed.

I {think}...

...I may be starting to get over my fear of needles. THNK being the key word!! I have no doubt that will change when I have a bad experience again...because it is bound to happen.

It might have helped that I had to do this. Well, come to think of it, I've never gotten my blood drawn voluntarily. I'm not crazy!! I had 3 different people draw my blood - number two was the best. I should have written down her name to make sure I can get her in the future ;-)

I had made a 7am appointment to ensure I wouldn't have to be too hungry in my waking hours since it was a 12 hour fasting 0-hour blood draw with 2 additional blood draws at 1-hour and 2-hours. They ended up getting me in at 7:30 and they explained the delay to the fact that they needed two people because they were drawing so much blood the first time. Imagine my amusement.

At the 0-hour blood draw they took nine, yes 9, vials of blood. My Endo had written orders not only for glucose but a myriad of other things {which is good} so they needed to take a lot!

Next came the part that, second to the needles, I was most dreading. The glucose drink. I'd heard some horror stories...I was given the orange flavor which it what I was going to choose anyways. 75mg later I was certainly not wanting to drink that liquid every day but the orange wasn't bad. Just tasted like an orange Hi-C.

2 nurses. 1 orange glucose drink. And 1 little tiny teddy bear Jason gave to me years ago for the specific reason that if he can't be at scary appointments, I can hold onto it. It lives in my purse 24/7 :)

PS. For the benefit of my Dad {who makes fun of me for having my phone & always taking pictures} I would like to inform you that I was listening to music with my phone because they told me it would talk about 2-3 minutes to get all the blood. I needed a distraction!!

After that was over I was given instructions on a very specific time to come back. I set my iPhone alarm for 5 minutes before the next draw, as I was not going to sit right outside the lab. It was cold there. I headed for some comfy {well, as comfy as hospital couches can be} couches just around the corner in the lobby. I passed the time by watching Red Riding Hood on my iPhone. And thanks to an awesome Christmas present from my Mom, I was able to just lay it on the couch next to me and not have to hold in the whole time. Thanks Mom.

See the little pink bulb? It props up your phone! Snazzy huh?!?

Apart from the needles and the drink, I was worried about getting the draw at exactly 1 hour. I mean, I really thought they'd mess it up since I didn't just sit back there in the lab. They must have had a timer or something...and I was pleasantly surprised that I not once had to go up to the window and tell them my time was in 2 minutes!!

So I do not know the results yet since I decided to do the blood draws at a hospital near me. It really doesn't matter though because my Endo's office doesn't do them so regardless of where I had it done I would have had to wait. {My Endo is in Portland, for the record}. Keeping on my {new} pace of making sure things happen I'm going to call my Endo tomorrow just to see how this all work when I get out of office labs done. Does she call me? Do I need an appointment?

I'm having an ultrasound on Wednesday.

Fingers Crossed.

PS. Teen Mom isn't the best show to watch when you're tired and all you want is to be able to get pregnant. Just saying.