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}!!!

{30 thoughts} the inside...

Not that there was really a question as to if this lifestyle change was worth it but it was amazing to get these results in the mail last night!!! Happy does not begin to describe it!

"all labs are normal"

 

I am proud not only what I have accomplished on the outside of my body but now there is tangible proof that it's been good for the inside of my body. The hope is to eventually get off the Metformin, which is really the only 'PCOS' medicine I am on. I was kind of off with it after surgery and didn't take it for a while and gained about three pounds back. I don't know if it was directly related to that or not but I am back on it now so we will see in a few weeks! 

I'm all about eventually trying to go natural but this lab results paperwork goes to show that the route I chose was a good one for me. I cannot wait to see my endocrinologist in January!! She is going to be amazed!!

Fingers crossed {that I can come off the meds soon}...

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}...

you HAVE to be your own advocate...

...because no one is going to do it for you!!!

Part of the reason I got started on this journey is because I has someone (a friend of a friend, NOT a doctor) recognize my symptoms. I got lucky. I'd already waited about 5 years to start this process. I'd had my OB tell me to "keep waiting" even though I told her I had PCOS. UG. Okay, getting off my personal soap box. Kind of.

It really is up to you to...

You HAVE to be your own advocate. You HAVE to ask for what you want. It is up to you. Doctors {at least the ones I have seen} seem to be listening and treating less & less...and just writing perscriptions and getting you in & out. It is truly, up to you.

Case in point.

Last week I called my Endo because I wanted to re-run all my labs before my one year Endo appointment (Mid-January) so we could make some decisions at that meeting. I want to be a part of my decisions from here on out and I knew we'd me talking about if I need to stay on Metformin anymore. I left a message stating my intentions and got a message back saying that my 6 month check up had been so good they didn't think they'd need new results. It didn't sit right with me and on Monday I called again and left another message, again, about wanting to get these results. My reasons are simple. One ~ I am a data freak. I want to see that number go down and the specific levels get into the average range. Two ~ I have put SO much hard work in and I want to make sure it's working. I know it is...but I need to see it on paper. That's just how my brain works. Oh, and there's a third one ~ I've hit my Out of Pocket Maximum so the tests will be free :) But that's a small part of it. Seeing the numbers get smaller and smaller is the main reason :)

I got a message back today that they sent me all the lab slips and I will be go to go to get my labs done next week. I am SO proud of myself for asking what I really wanted. Can't wait to share (and see) the results!

 

Fingers crossed {the labs come back awesome}...

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.

a fun filled Tuesday...

...haha, just joking.

3/4 of my 4 day weekend were awesomely spent at the beach. The other 1/4 was spent getting worked up, blood drawn, and having a rather stressful day.

Since my labs at OHSU were at 12noon today I had to take the whole day off work...hence the 4 day weekend!

I went and picked the hubby up on schedule and we made it through downtown Portland and to what we thought was the right street in record time. Then, we took the wrong street. Like, we took the one that got us back on the freeway going away from the hospital. So we back on track about 1 mile from where we started except we hit every.single.bleeping.red.light there is between Broadway and OHSU. I was frustrated to say the least. Jason kept calm, as usual. We did end up making it still about 5 minutes early so I was somewhat happy but I like to be earlier than that.

We had a bit of a wait which I guess should have been expecting. It was only about 15 minutes but when you're already hyped up and you're going in for a test to determine how your future could unfold, that is a long time!!

Once we headed back I got instantaneously nervous. I did not want that IV in. I've had IV's but never while I was awake - at least in my memory. My nurse was Sharon and she was amazing. She was so calm and she was so good and what she did. She had my IV in within 5 seconds. It was SO amazing to have Jason there too!! And of course a little teddy bear made an appearance :)

I really thought that I wouldn't want to look at it but I did okay doing it. I think it helped that I couldn't see the entry point. I hated that dangly part so she taped it to my arm - she could read me like a book and knew it was bugging me. Like I said, she was great!!

So here is how the test went down after the IV was in. She drew my blood for my control or "zero" draw. Then she gave me 1 mL of 0.25 mg injection of cosyntropin which is a synthetic hormone.She has warned me a bit about the side affects but I generally don't have a ton of side affects so I think I might have partially tuned her out. Well, that wasn't a good idea. She started to slowly put in the hormone and my arm started itching/tingling/feeling really cold and then, about 20 seconds later, the affects hit me. I felt like there was a small child sitting on my chest and my chest felt hot. Like, I gasped which kind of made Jason's eyes bug out of his head and I think freaked us both out a bit. It lastest for at least 1.5 minutes and Sharon just kept saying "just remember to breathe". After about 30 seconds the heat and compression started to go to my stomach and there was a few split second where I wasn't sure if this stuff felt like it could come out of any end. UG. That's probably TMI but it is what it is. After about 2 minutes it all subsided and Jason sat back down and bugges his eyes back into his head and Sharon went to get me some water.

About half way through the one hour test I got really cold but I couldn't put my sweatshirt back on because of the IV and my dear husband was busy playing games on his phone but sweet Sharon, she realized I was cold and brought me a pre-warmed blanket. It was a bit of bliss.

So other than the initial 2 minutes, everything else was rather boring. I was not a fan of the feeling of the IV in my arm so moving it was kind of out of the question for me. I paroosed the Internet for a while but everyone else in the universe was at work so no one was playing any of the games I usually play :( It was a rather uneventful hour. I sat reclined in a chair and thought about life. Which can be good and can be bad. Today there was A LOT of things running through my mind ranging from what to plan for my husband's 30th birthday party to what color scheme I'd want a nursery to be to what I wanted for lunch.

In the end I will now have to wait a week or so for the results but Sharon assured me she knew I'd be waiting for them and she'd get them to my Endo ASAP. She knows my Endo because apparently my Endo used to work at OHSU so maybe that connection will actually get the results there faster.

Here's to hoping the week or so goes fast...

Fingers crossed.

tomorrow...

...the end of the beginning is here.

or

...the beginning of the rest of forever is here.

Either way, tomorrow is a big day.

At 12noon I will be having a one hour test at OHSU. My wonderful husband will be accompanying me. He actually works not too far from there so I'll pick him up at work, go to OHSU, and then drop him back off. It should work nicely.

The test I am having is called a "Cortrosyn Stimulation Test". The test is to find out how adrenal glands respond properly to a hormone from the pituitary gland. They will put an IV in my ARM, my ARM....ug, this is why the hubby get to come :) Okay, once they put the IV in my arm they will draw my blood at 0, 30 and 60 minutes to see how my body reacts to a synthetic pituitary hormone {called adrenoncorticotropic hormone} they will put in the IV.

I have an IV's in my life but not in my memory. Though I hate needles I'd like to say I am getting better at dealing with them...that is, until the next time I get a shitty nurse - then the fear will be back with avengance.

Here's to hoping I don't faint and the test results come back quickly.

This test will be to rule in or out something called Late-Onset Congenital Adreanal Hyperplasia. If the test shows I have L-O CAH then that is what I will have. If it doesn't, then I'll have PCOS. It's like I either get a shitty {PCOS} or a really shitty {L-O CAH} diagnosis.

{I'd say sorry for the language but I'm kind of not. It's kind of how I'm feeling}.

I haven't done any reading besides from the above link ~ if it is or isn't what I have - I'm not ready for it yet. Honestly I'm not ready for any of this but this what who I am and what I have... The scariest thing about the possibe Late-Onset CAH is, IF I have it, is pasing it on especially if we have a boy. Even PCOS they believe to be genetic which is tough. It's really tough to think about now that I know, what do I do about it? Kids? Adopt? No kids?

I know I need to wait to think about all of this...but I can't help it. I just can't. And I'm kind of over people telling me "well you are still young" or "there is time" or anything along those lines. It doesn't make me mad but man, it just sucks to hear!! It is true, I am only a few weeks away from turning 29 but this ISN'T fun to deal with no matter if it was 15, 30, 40...any age. I've had all this my whole life it is just now coming to light. I've known for a L O N G time that this wasn't going to easy but that doesn't mean I have to like it.

ALSO ~ Tomorrow I am starting my new medicine, Metformin. Wish me {and everyone around me} luck with that one... I'm waiting until tomorrow because my Endo said to wait until after this last test was done. I'm hoping I'll be in the camp where Metformin helps and doesn't have nasty side affects. More on that later.

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!!!

during the storm...

...I saw a rainbow.

Today was the last day of the current round of tests to "put the pieces of the piuzzle" together. I had my ultrasound. So once I get the results from this and the glucose & blood work we'll go from there.

I've been feeling happy a lot this week. More often than not - which is a good change of pace.
And then - as I'm walking out of the ultrasound and realizing this is the "end" of this stage it is raining and sunny...and you know what rain + sun equals...

Outside the door of the hospital.

 

It was a half-arc rainbow but I couldn't get it all in one shot.

I drove across the street to give it a better look.

As I sat and looked at the rainbow tears just started coming. I couldn't stop them. I wasn't like bawling but I was certainly emotional. It wasn't for very long and I'm not even sure what it was for. Maybe for the fact that the inital testing is over. Maybe because I'm scared of what all the tests will say. There are so many options of what it could have been. Though I think, it was all of it. The unknown, the despair, the desire, the hurt, the love {I feel from my family & friends}, and the thought of what is to come.

Then I went and spent time with my AMAZING parents. Love them.

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.