A Good Doctor = Happy Patient

I have been blessed during my nearly 12 years of being treated for PCOS.  After going to 5-6 doctors/specialists, my mother told her doctor the troubles that I had been having.  He told her to get me in immediately.  This is the same doctor that delivered me (and my sister) so we had a good family history with him.  I went to him and immediately he diagnosed me with PCOS.  He prepared me for the struggles I would face and immediately began to work out a plan for conception, even though I was only 19.  Now, after 12 years, he is retiring so he can become a full-time grandfather.  Good for him, bad for me.

From the first time I went to him, treatment was easy.  He made it easy.  He wasn't always a tender doctor and I have never really recommended him to a lot of people because he could definitely be difficult at times.  I can't even think of how to describe him other than kind of arrogant, kind of cocky and kind of a pig.  I would call him a "typical" male---which isn't always good for a person in the role of a doctor. 

But, as a doctor, he was perfect for me and my family. 

There are two things that throughout the years made his practice stand out from the other experts I had seen.  First, he always recommended that I research my treatment before committing to it.  He encouraged patient research and though he didn't always agree 100% with my conclusions, he generally didn't belittle the knowledge I gained on my own.  Secondly, and most importantly, he did something that we rarely see in this age of patient in, patient out service.  He cared.  Even in retirement, I know he will still care.  How rare is that?  From talking to my friends and family, it is something much more rare than it should be in the health profession.  He cared so deeply that my struggles became his, my triumphs he shared with me and my disappointments were his as well.  I am going to miss him.

When I got the letter that he was retiring, I literally began to sob.  Twelve years.  How do I go to a new doctor and explain the entire history?  I have a lot of baggage from over the years. 

He made many, many important medical decisions in my treatment that have turned out to be so major that I just don't know how to trust anyone else the same way.  He made a call to schedule a C-section for my daughter two weeks before she was due because she was breech, she was large and my body isn't necessarily made to birth easily.  Thank God he did as we would have ended up in an emergency C-section anyway---she decided to do gymnastics in my belly and had the cord around her neck three times.  He just kept saying, "Delivering naturally is not worth losing a baby or you."  He was right. 

On and on my history has been with him.  He worked out a plan for me to conceive for the nearly 5 years before I was ready to try.  He made the call on the C-section.  He moved Heaven & Earth to see me when I had my first miscarriage and had to have a surgical procedure afterwards.  He took a phone call at home on Sunday morning, personally, when I had my second miscarriage.  How many doctors give you their home phone number and EXPECT you to use it?  Again, he got me right in after the second miscarriage too for that same surgical procedure---essentially by rearranging the entire operating room schedule.  When I left his office last week for the last time, he gave me a hug that was no different than I would have gotten from my own father.  He cared.  He cares. 

So, now what?  He is recommending I see his surgical partner, and actually assisted with my C-section, who may not be quite as well versed on PCOS, but will follow the plan we came up with together .  But, what do I do when I go see the new doctor---how can I fit 12 years into one appointment?  I haven't ever really switched doctors before.  I don't like to admit it much, but I am scared.  I know there are other doctors, other GOOD doctors, out there, but I was spoiled.  I don't want to be a number.  I want a doctor who cares.

  This isn't supposed to be a negative post---I am feeling better now than I did a few weeks ago.  I just wanted to share my experience with a good doctor---one who took my health personally---so that everyone out there who has struggled finding a good one knows that they do exist.  Does your doctor care about you this way?  If not, I suggest you keep looking---there will be one out there that fits with your needs.  I just hope I strike it rich twice...so here goes the next step down the road for PCOS.

Picking Myself Up, Again and Again

The last few weeks have been a doozy for me.  Nothing bad in particular, I have just felt miserable, crappy and nasty.  I have been trying to figure out what the issue has been and of course, try to get over it.  My PCOS seems to be going berserk, my doctor decided to retire (I have been going to him for 12 years), I had bronchitis, I have had huge stress at work (I work as an accountant in the middle of a recession in the construction industry---you do the math), I have no energy and just have been exhausted.  To top it off, I can't sleep because I can't shut my mind off. 

For the past year, my PCOS has been on a roll like I have never seen before and I think I am hitting my breaking point.  I am sick of not feeling well.  I am sick of having to take a handful of medicine each day.  I am sick of cyst pain.  I am heavier than I have ever been.  I am just sick of it.  Everyone with a chronic disease feels this way at some time in their life.  I literally am just sick of PCOS.  I hate it. 

So, what am I going to do about it?  I could stay in bed and cry and feel sorry for myself because right now that is just what I want to do.  It would just be so much easier to give up, to stop caring.  I am just tired.

But, I won't do that.  If you have read my previous posts, you'll see most of the time I am a very optimistic, reach for the stars kind of person.  I have to get back to that point---because right now I am just cranky.  So, I will.  Tomorrow I am going to try to get up with a smile on my face.  I am going to beat this thing, I refuse to let it control me.  Stupid as it may sound, just saying that out loud can make a difference.  I am going to follow my own advice and start by making a list.  I will not let this get me down any longer.

Tomorrow is a new day.  I WILL find a new doctor that cares about me as much as the old, I WILL leave my stress at work, I WILL get enough sleep tomorrow night and I WILL beat my PCOS. 

The funny thing is, I feel better already...

Tackling Vacation Food (part 2): Visiting Relatives

In my previous post on Tackling Vacation Food (part 1), I discussed how it is important to regulate your food based on what type of vacation you are taking.  I broke vacation "types" into three different categories, family adventures (active vacations), visiting relatives (something we all do at some time in our life!) and destination vacations (cruises, Disneyland, you know, the fun ones!!!).  This post is going to discuss how to tackle healthy eating habits when visiting relatives.  Follow the link above if you haven't read "part 1" in the series!

Eating healthy at home is hard enough, throw in a vacation and "poof!" you have a disaster in the making.  Then add on the fact you are visiting family, it is a perfect storm!  Now, if the relatives you are visiting are heathly vegetable eaters that exercise daily, there might not be much of an issue.  However, I am not so lucky. 

I love my family, more than anything, but I have to paint a picture.  Have you seen the movie "My Big Fat Greek Wedding"?  Well, that is what I face when I visit my family, the only difference is we're Eastern European!  My family can cook. Oh, how they can cook awesome food! And it just keeps coming and coming and coming and, well, you know...  Anyway, going to our family events is hard because everyone makes such incredible food and it isn't particularly healthy.  Over the years, I have come up with a few tactical moves that have helped...

Let's start at the beginning with the actual act of travelling.  If I am travelling by car, I use the same approach that I did in the previous post on tackling vacation food.  I plan ahead, pack healthy snacks, plan meals, etc.  Why this doesn't translate well into travelling by airplane, I don't know.  I do pack our carry-ons with a few healthy snacks, but it seems easier to just purchase snacks at the airport after security.  So the first challenge I face is AIRPORT food. There are so many choices, a person just doesn't know what to choose.  First tip---don't give in to the fast food (I am still trying to convince myself not too)!  If there is enough time, we will choose to sit down at a restaurant that serves real food instead.  If you don't have enough time, you can actually get decent salads and sandwiches at most deli stands at airports.  I also make sure we have a bottle or two of water so we don't fight dehydration (so important!).

Now when you get to your destination and settle into a family member's house, you have to remember to make your health a priority.  It shouldn't offend anyone if you stop at a grocery store to stock up on healthy foods.  If it does, my attitude is that it is their problem.  Really, I know it is hard with family, but you have to just not let it get to you.  I have learned that I have to look out for Number 1 or there is no way I can look out for anyone else.  Plus, in reality, if you are staying at a family member's house, helping with groceries for the trip isn't a bad idea anyway. 

My suggestion for a first line of combat is to pick up healthy breakfast items (low-fat milk, oats, high-fiber cereal, fruit) and also pick up the makings of an incredible salad (throw in a "I don't want to be a burden, I can make a salad for all the meals that will make your mouth water!") and I also pick up some bottled water (sometimes travelling and drinking the water can mess with your system).  So, when you leave the grocery you should have a good defense line built. 

I recommend eating a salad with every lunch and dinner on vacation---and eat it first.  It will fill your stomach so even if you eat food that is bad for you, you won't likely eat as much.  I also recommend trying to eat at a relative's house as much as possible instead of doing the restaurant thing because going out to eat is when it becomes easier and easier to loosen the strings of controlled eating.  If you do eat out, make sure you are looking for something that is not fried or does not have rich sauces on it.  Also, choose iced tea (unsweetened) instead of a soda.

So, that takes care of the regular days, but if your family is anything like mine, we always have huge family gatherings.  This is where I get into BIG trouble.  I suggest drinking some water before you eat.  Then, peruse all the options and you'll generally find that someone made a green salad or brought some fresh fruit or a veggie tray.  I suggest filling at least two-thirds of your plate with these items.  Then, go ahead and sample the good stuff; just sample in moderation.  Then, LET THE FOOD SETTLE.  Do not go back for seconds right away.  If you do, it will be a disaster.  Wait 15-20 minutes, then if there is something you REALLY want, get a moderate second serving.  Or, here is your chance to get a small dessert or sample a couple desserts.  Again, moderation is the key.  Eat it slowly.  Savor the taste.  You will find you get just as much satisfaction out of half of a brownie as you do a whole brownie if you eat it slower and take small bites.  Promise! :-)

I also really try to prepare my mind to make good choices.  It might sound stupid, but I will even do a run through it in my head.  I imagine Grandma coming up to me and saying, "Here, eat, eat, eat..."  Then I imagine myself looking at her and saying, "I promise I am not going to starve, Grandma, and I love your cooking.  I will eat when I am hungry."  I have a very strong willed grandmother and guess what?  It has worked!

As hard as it might seem, a little preparation and planning will allow you to get through your vacation without expanding your waistline! 

Here are a few more tips:
~Request to cook a meal and choose something that is healthy for you!
~Go for walks daily---it is a great time to visit with family too!
~Drink a lot of water---it will keep you hydrated and keep you eating less.
~Be active, go shopping, to an amusement park, to a zoo, something so you aren't just sitting!

Also read: Tackling Vacation Food (part 1): Family Adventures and still to come, Tackling Vacation Food (part 3): Destination Vacations!

Me with my strong willed Grandma Adams on a trip to visit her in Ohio!

Tackling Vacation Food (part 1): Family Adventures

My next post was supposed to be a followup to Where to Start?, but I am going to take a detour.  I am in the process of packing to go on a 5-day trip to Yellowstone National Park (yippee!) and, as always, the question of "How am I going to eat healthy on vacation?" came up as I was packing.  I am only human---restaurants, snack stops, ice cream bars; it is all SO tempting!  So, here is what I do to come back weighing the same or LESS than when I left!

Most of the vacations my family goes on can be put into three different categories.  One type of vacation we take is a "family adventure", where we might camp or stay in KOA cabins and visit National Parks and landmarks.  The second kind of vacation would be the kind we all take at some point...to visit relatives!  The last kind of vacation would be to a place like San Diego to go to Sea World and Legoland, this is more of a "destination vacation" (probably the hardest to behave foodwise!).  I have found that I have different "coping" techniques for each different vacation type.  This post will tackle the "family adventures!"

My husband, my daughter and me in 2009 with Mammoth Hot Springs in the distance in Yellowstone National Park. 

"Family Adventures"

It is fairly easy to control food intake when we go on a family adventure, since we often do a lot of hiking.  I can actually eat less healthy on these trips than other vacations because I am much more active.  However, I don't like to go too crazy so I do a lot of planning.  Since we usually drive to these destinations, for a few nights prior to the trip, I take time to cut up vegetables so they are readily accessible.  I don't know about anyone else, but munching seems to come with the territory when riding in a vehicle, so having veggies on hand to "munch" on really helps. 

My family stays at a variety of places on these trips, including KOA cabins (no kitchens), rental cabins, a tent, our 5th-wheel camper or hotels.  If staying in a hotel, I try to find one that has a mini-fridge and a microwave; same goes with rental cabins.  If we are in a KOA cabin or a tent, we take a cooler and our propane stove!  We have a pretty basic menu for the times we are gone.  We don't eat out except a few allotted meals; it saves money and saves us from bulging waistbands! 

For breakfasts, we bring oatmeal, fruit, coffee and/or tea.  Sometimes we even bring mini-baking M&M's to put in the oatmeal (only a few, of course!).  I generally get a container of Old Fashioned Oats, the oatmeal that takes longer to cook.  Sometimes for a special treat I will get the sugar loaded "fruit" packages and mix it 1 to 4 with the Old Fashion Oats.  We also will put cut up apples or strawberries in our oatmeal too!  This is a pretty low cost, decently healthy meal that is easy to prepare.

Lunches are generally some sort of sandwich (whole wheat bread) or wrap (whole wheat tortilla), ranging from peanut butter (low fat/low sugar) & jelly (low sugar) to meat sandwiches with lettuce and cheese (fat free).  We usually throw in some nuts, fruit, veggies and usually a couple pieces of chocolate for dessert!  Generally we drink water on these trips to stay hydrated.

Dinners are harder.  If the weather is bad and we're "roughing it", it is easy to justify going out to dinner.  Sometimes I will splurge at these dinners because I am tired from a long day!  However, more often, I will try soup (if it isn't too fatty) and salad (dressing on the side, of course!).  If the weather is nice, or we have a kitchenette, we'll do a salad and a prepackaged meal, generally carb based like a rice packet or noodles, or a soup like chicken noodle.  However, when we do this, we usually cut back on butter in preparation and add a lot of veggies!  If we have our camper, I will have something pre-made like a casserole or spaghetti sauce (homemade---loaded with veggies), or sometimes I even prepare a roast or steaks!  If I prepare things in advance before we go on our trip, I am much more likely to eat healthy than if I just plan on "throwing" something together.

So, trips like this are likely the healthiest, both because I am more active and it is easy to plan out healthier meals because we're still preparing meals rather than eating out the entire trip.

I would love to hear your feedback on what tips you would have for this type of vacation!  Please comment below!

Still to come: Tackling Vacation Food (part 2): Visiting Relatives and Tackling Vacation Food (part 3): Destination Vacations.

Where to Start?

PCOS affects so many facets of our daily lives.  Food, exercise, skin condition, hair condition, weight, emotions, pain and on and on and on...  Where does someone with PCOS even start?  Changing your entire life and way of thinking isn't going to happen over night.

My suggestion is to prioritize what you want to change.  Make a list of what symptoms or difficulties of PCOS frustrate you the most.  I generally limit my list to three items at a time, once I tackle one of those items, I re-evaluate and add another frustration.

So for me, here is what my list might look like.

1.  I am frustrated that I have had fertility issues.
2.  I can't lose weight!
3.  I am an emotional roller coaster.

After I make this list, I write down two things I can do EACH day without fail to help tackle each item.  This can be a hard part because you have to commit to doing this every day, or you will find that you are overwhelmed and end up giving up.  I try to choose small things to do.  For example, if you struggle with your weight and you exercise for 15 minutes a day, try to make a goal to add an additional 5 minutes.  Also, phrase these as "I will" instead of "I will try."  By saying you are going to do something, you are more likely to actually follow through because there isn't an out!

Here is how I might expand my list:

1.  I am frustrated that I have had fertility issues.
~I will read one article a day dealing with infertility to learn more and stay up-to-date on current research
~I will talk to others about my feelings

2.  I can't lose weight!
~I will add an extra 5-10 minutes of physical activity to my schedule
~I will replace all beverages I drink with water instead (except my morning milk!)

3.  I am an emotional roller coaster.~I will make 10 minutes for myself each day to do something for myself
~I will go to bed on time in order to get adequate sleep

After making these mini-goals, put your plan into action.  As you look at my list, I would like to point out that even if I did each and every one of those items it would take about an additional 30 minutes out of my day if I did them individually, but I could combine the physical activity with doing something for myself and not really increase the energy put out by much at all.  However, winning the battle does take commitment, and you are WORTH the time it takes!

Look for my next post on the next steps to take and how rewards help and that hitting a plateau or taking steps backward is okay!

The Diet Game

 Dieting.  Yuck.  We have all played the Diet Game before, and most of us lose, even those who don't have PCOS. 

There are so many diets to choose from too.  South Beach.  HCG.  Atkins.  Mayo Clinic.  Jenny Craig.  Weight Watchers.  The Pyramid Diet.  Glycemic Index.  That is just a few off the top of my head!

So how do we process all this conflicting information?  As a society we generally ignore it and run to the store to grab a bag a chips, a pop and a brownie!  That probably isn't the answer, but I would bet a high percentage of people would admit that is what they have done!

What is the best diet?  That is going to depend.  Probably not the answer that anyone wants to hear.  But, I will tell you what has been successful for me. 

I generally follow what I would call a "good carbs that are high in fiber and low in sugar and good fat" diet, probably closest to the South Beach Diet but with my own modifications.  I do not cut all starches out of my diet.  When I have done that, I go crazy.  Yes, that probably means I am a carb addict (oh, there is another diet name, the Carbohydrate Addict's Diet), but I think that by denying yourself what you crave the most, you are more likely to end in a crash landing.

What are good carbs?  Good carbs include many vegetables, fruits, beans, nuts and whole grains.  What then are bad carbs?  Sugars, processed or "white" grains, most baked goods, alcohol and so on.  It really can be broken down to foods that are not processed very much to those that are highly processed.  Take "minute" rice for example.  In order get the rice to cook in a minute, it is highly processed and much of the fiber is removed.  Brown rice, on the other hand, will often take up to 45 minutes to cook as it takes that long to "soften" up the fiber.  I will get more specific on the high fiber and low sugar portion in a minute.

What about good fats?  This generally includes lean meats, vegetable oils and low fat dairy products.  Bad fats would include fatty meats (hamburger), high-fat dairy and some oils.  I also try to avoid a lot of sauces, unless they are vegetable or chicken broth based, because otherwise they tend to be extremely high in bad fats.

I really feel the critical part of how my successful eating is the high fiber items that are low in sugars.  That means a LOT of vegetables, legumes and low sugar fruits.  My goal is to eat 30-35g of fiber per day (do not attempt to get there overnight!).  I do try to avoid vegetables and fruit that are high in sugar content (corn, beets, bananas, pineapple and watermelon).  I firmly feel that lack of fiber in our every day diet is part of the reason so many people struggle with weight these days.

Maintaining the healthy eating is not easy.  Food preparation often takes more time (check out my previous post on commiting to myself: Why Can't I Commit to Myself?)  Eating out is harder.  Socially your conscious about every move you make regarding food (another previous post: Please Don't Judge Me Because I am Fat).  And, bad food just tastes better.  How can anyone make it work?

When it is working well for me, it is because my entire family is on board.  I just can't do it alone.  It makes it easier when the whole family sits down to dinner and eats the same food.  And, truthfully, the "diet" I have described is really a healthy eating plan for most average people.  It is also easier when you go out to dinner and your husband orders chicken breast, with vegetables and a salad, with the dressing on the side and an unsweetened iced tea rather than a huge burger with fries and a salad slathered in ranch dressing with a Coke. 

Eating healthy isn't an option for those with PCOS.  If we don't, the future implications are just too grim.  It IS hard to eat healthy.  I fall out of the boat, a lot, but I know the basics of nutrition and what works for me, so it is easy to get back in again.  The "Diet Game" doesn't work, to make real change is a must.  I am not sure I will ever get it, but I have to try!

I am NOT a doctor or dietician.  The above eating plan is based solely on my research.  Please consult a doctor or dietician before changing your eating or exercise plan!

Why Can't I Commit to Myself?

I feel my fight with PCOS comes down to one word. 

Commitment.

I have never been afraid of commitment.  I am able to commit to being a good mother, a good employee, a good spouse and to thousands of other responsibilities in my life.  Why is it so hard when it comes to committing to the time and energy to myself that I need to be healthy?  It doesn't make a lot of sense.  Don't I need to be healthy and in a good state of mind to commit to all those other things?  Even though it doesn't make sense, it really seems to be a huge issue with me.

When I speak of commitment as being the best way to fight PCOS, I mean that I must be committed to eating healthy, committed to exercising, committed to monitor the signs and warnings of problems and committed to finding the best combination of exercise, food and medicine.  Doesn't sound too hard, does it?  Fit all of that into a busy schedule and trust me, the commitment to myself is the first thing I throw out the door.  Why?  Because it is the easiest to get rid of; I can't just stop taking care of my daughter, or my job, or all those other responsibilities, but it is easy to stop budgeting time for healthy cooking and exercising and food journaling and so forth.

As a result, I have noticed a pattern in flair ups of my PCOS symptoms, I definitely go through times of ups and downs.  The pattern is obvious.  When I am committed to exercise and eating healthy, the symptoms disappear or at least aren't as obvious.  It is amazing how that works!  But, then as I begin to start cutting into my exercise time and healthy food preparation time and replace it with other items, my symptoms reappear.  Duh, you might think! It is obvious when I sit and look at it too.  However, I can always justify my decisions at the time I "un-commit."  The cycle keeps circling round and round and round. 

Why can't I commit for good? 

I think for me it is sometimes easier to make an excuse than it is for me to get out and do what I need to do to stay healthy. There is a lot of failure with PCOS, and I hate trying and failing.  I am not lazy, but I will admit, time management is hard for me.  And, I like sleep.  Actually, I LOVE sleep.  I would rather sleep than get up and run or prepare a healthy breakfast.  I like to put everyone else's needs in front of my own.  In my mind, it seems selfish to put mine in front of my daughter's and husband's.  I procrastinate.  All of these things lead to me failing to commit to myself.  So essentially it is a mind game that I just need to get over!

So, here's to committing anew.  Starting today I am going to commit again to my long term health.  Maybe the public commitment of my newly inspired self commitment will do the trick!  I wanted to say thanks for the feedback I have already gotten about this blog.  I definitely feel that I am feeling more inspired than ever.  So, here goes nothing!