A Most Productive Day
Feb. 7th, 2005 09:30 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
judecorpAt 8:30, I picked up a family and brought them to BMC for their appointment at 9:00. By the time I dropped them off at home it was 11:00. (Too bad we can only bill 2 hours/day/client.) The doctor dropped the A-bomb (autism) so I made an appointment to see them later in the week to see how they're doing.
I went back to work, wrote a letter, answered phone calls, and ate lunch. I went to a home visit at 1:00 (had a great visit), a home visit at 2:15 (got stood up), back to work, and a home visit at 3:30 (good visit). I went back to work to use the bathroom, and headed to my doctor appointment. Not only did I get all of my test results and chat about all of that, I asked for the 1st shot in the 3-shot series HepB vaccine. (Since I was already in there paying a $20 copay, what the heck, right?) Bam! Shotted.
I headed back to this neck of the woods to hit the gym for a 7pm yoga class. I got there 15 minutes early so I did 15 minutes on the elliptical first. And then the yoga. I tried yoga in college and it wasn't for me, but I'm going to give it another go. Especially on frantic Mondays. I feel pretty relaxed right now, but maybe that's because I'm exhausted.
Came home. Made sandwich. Ate sandwich. I'm tired. I still have to empty the dishwasher, put dishes in, and take the garbage out. Yawn.
So as I suspected, the doctor said that she thinks I have PCOS. She said, though, that some of my lab results are high but barely high, so close that she actually conferred with an Ob/Gyn. (For example, average testosterone for a woman is like 1.5 - 7.0, and mine was 7.8. Or something like that. DHEA was only a teeny bit high, too.) FSH and LH are fine, thyroid is fine, prolactin is fine, pituitary is fine, kidneys are fine, liver is fine, RBC count is fine, blood sugar is fine. She wasn't at all concerned about my just-over-200 cholesterol, since it wasn't a fasting test and I'd eaten 20 minutes before. She said she wanted me to start taking metformin to see if it would help with things. I asked why she would want me to take it if my labs were only a teeny bit high, and she said that the only thing that came up particularly high was my insulin level, so that shows a likely insulin resistance and something that should probably be watched.
I told her that several people have told me that metformin causes crazy diarrhea and stomach problems, and that I had concerns about that because I do home visits all day and absolutely Do! Not! Want! to have to go into my clients' bathrooms every 15 minutes. (For some clients, I don't want to go into their bathrooms at all!) She said that she's prescribed it to other women who haven't complained of serious stomach upset, but told me to keep my eye out. She also said it was up to me, that I didn't have to take anything if I didn't want to. I told her I would give it a try but that if I started having bathroom issues, it was all over (at least until I got a more poop-friendly job!). That seemed to be okay with her.
She said that since this whole "insulin resistance/glucophage" thing with PCOS is so new and so different from the way they treated it only a few years ago, that it's possible that somewhere down the line they will find something else. So if the whole metformin thing doesn't work, I shouldn't care too much because something new might come down the pike. Whatever.
I'm also not so sure I /want/ to have regular periods or whatever. That sounds totally sucky. I /like/ not getting my period! It's fun! It's zany! I don't have to plan around it or make accomodations or buy supplies! So we'll see what happens. She also said that she knows of some very good reproductive endocrinologists at Boston IVF (or something like that) and if I'm not happen with the suggested treatments she will refer me to them to get some of the newest information.
Then I decided to go ahead and do the HepB thing since I really should have done it a long time ago since I work in the social services. She recommended the HepA series, too (two shots), and I will probably start that one next month when I go in for #2 of the HepB, since the two HepAs are 6 months apart just like #2-3 of HepB. Hep-eriffic! At least I feel like I got my $20 worth since I got the shot. Otherwise I would have been annoyed about trekking up there and paying $20 just to sit in her office and chat about diarrhea or something. (Although really, when CAN'T you talk about poop?)
Maybe I'll fill the prescription tomorrow and see what happens.
I went back to work, wrote a letter, answered phone calls, and ate lunch. I went to a home visit at 1:00 (had a great visit), a home visit at 2:15 (got stood up), back to work, and a home visit at 3:30 (good visit). I went back to work to use the bathroom, and headed to my doctor appointment. Not only did I get all of my test results and chat about all of that, I asked for the 1st shot in the 3-shot series HepB vaccine. (Since I was already in there paying a $20 copay, what the heck, right?) Bam! Shotted.
I headed back to this neck of the woods to hit the gym for a 7pm yoga class. I got there 15 minutes early so I did 15 minutes on the elliptical first. And then the yoga. I tried yoga in college and it wasn't for me, but I'm going to give it another go. Especially on frantic Mondays. I feel pretty relaxed right now, but maybe that's because I'm exhausted.
Came home. Made sandwich. Ate sandwich. I'm tired. I still have to empty the dishwasher, put dishes in, and take the garbage out. Yawn.
So as I suspected, the doctor said that she thinks I have PCOS. She said, though, that some of my lab results are high but barely high, so close that she actually conferred with an Ob/Gyn. (For example, average testosterone for a woman is like 1.5 - 7.0, and mine was 7.8. Or something like that. DHEA was only a teeny bit high, too.) FSH and LH are fine, thyroid is fine, prolactin is fine, pituitary is fine, kidneys are fine, liver is fine, RBC count is fine, blood sugar is fine. She wasn't at all concerned about my just-over-200 cholesterol, since it wasn't a fasting test and I'd eaten 20 minutes before. She said she wanted me to start taking metformin to see if it would help with things. I asked why she would want me to take it if my labs were only a teeny bit high, and she said that the only thing that came up particularly high was my insulin level, so that shows a likely insulin resistance and something that should probably be watched.
I told her that several people have told me that metformin causes crazy diarrhea and stomach problems, and that I had concerns about that because I do home visits all day and absolutely Do! Not! Want! to have to go into my clients' bathrooms every 15 minutes. (For some clients, I don't want to go into their bathrooms at all!) She said that she's prescribed it to other women who haven't complained of serious stomach upset, but told me to keep my eye out. She also said it was up to me, that I didn't have to take anything if I didn't want to. I told her I would give it a try but that if I started having bathroom issues, it was all over (at least until I got a more poop-friendly job!). That seemed to be okay with her.
She said that since this whole "insulin resistance/glucophage" thing with PCOS is so new and so different from the way they treated it only a few years ago, that it's possible that somewhere down the line they will find something else. So if the whole metformin thing doesn't work, I shouldn't care too much because something new might come down the pike. Whatever.
I'm also not so sure I /want/ to have regular periods or whatever. That sounds totally sucky. I /like/ not getting my period! It's fun! It's zany! I don't have to plan around it or make accomodations or buy supplies! So we'll see what happens. She also said that she knows of some very good reproductive endocrinologists at Boston IVF (or something like that) and if I'm not happen with the suggested treatments she will refer me to them to get some of the newest information.
Then I decided to go ahead and do the HepB thing since I really should have done it a long time ago since I work in the social services. She recommended the HepA series, too (two shots), and I will probably start that one next month when I go in for #2 of the HepB, since the two HepAs are 6 months apart just like #2-3 of HepB. Hep-eriffic! At least I feel like I got my $20 worth since I got the shot. Otherwise I would have been annoyed about trekking up there and paying $20 just to sit in her office and chat about diarrhea or something. (Although really, when CAN'T you talk about poop?)
Maybe I'll fill the prescription tomorrow and see what happens.
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no subject
Date: 2005-02-07 08:19 pm (UTC)They have some different forms of metformin, one which is kind of like a time release one or in liquid form which may diminish the gut bombs/gas that can come with metformin. I've been on some heavier dosages and found that (1) beer (except for Budweiser!) and (2)anything peanut based causes some serious problems for me, but most of the time, I'm fine.
You seem like a very informed person--there's lots of support out there, along with info. I think there's a website called cystersisters or something along those lines that is active and can answer lots of questions you might have. Good luck!
no subject
Date: 2005-02-08 05:35 pm (UTC)no subject
Date: 2005-02-07 10:13 pm (UTC)I have PCOS too. So many people have it -- it's crazy! I have been diagnosed since I was 16. I was lucky to have an informed gynocologist -- more gyno, less OB. I take O/C pills, Aldactone, and Glucophage/Metformin. Despite eating a healthy diet, my cholesterol remains around 190. Anyway, I take 1000mg. of Metformin a day and beyond the first week (I had the regular "looseness" if you know what I mean), I haven't experienced any side effects. In fact, I lost a few pounds while using it, because it decreases appetite slightly in some people. The only advice I have is to take your dose of metformin 20-30 minutes before a meal (my dietician said it will help to decrease appetite if you want to lose weight), do not double-up missed pills (you'll feel like you're sea sick! Nausea! Ugh), and do not drink alcohol while taking them (same effect). Of course, I am not a doctor. These are just some observations I have made.
no subject
Date: 2005-02-08 05:34 pm (UTC)Thanks for the 20-30 minutes before a meal tip. :)
no subject
Date: 2005-02-07 11:13 pm (UTC)my first couple weeks on metformin/glucophage were mostly spent in the potty. but things are way better now. i've been on it over a year. i was also pretty constantly dizzy when i first started taking it, but that's chilled out as well.
not getting your period for extended amounts of time is dangerous. the lining of your uterus is still building up, just not being released, and that puts you at higher risk for uterine cancer. i get my period every month now. it sucks.
no subject
Date: 2005-02-08 05:33 pm (UTC)Dude, if I'm dizzy and on the toilet all the time I'm going to have to stop, because I won't be able to work. And I need to work, yo!
no subject
Date: 2005-02-08 05:37 am (UTC)no subject
Date: 2005-02-08 05:32 pm (UTC)Let me know what you find out about POOP.
no subject
Date: 2005-02-09 05:20 am (UTC)about 32-34 days and my doctor still gave me a higher dosage. I've also read that typically, you should expect to see your cycles get a little
shorter every month on metformin until you're ovulating normally."
She said about work that the "symptoms" typically come at the meal right after you take it, so she'd suggest that you make the time to take it after work so you didn't have to worry. She also said that the drug blocks your ability to process carbohydrates and that they are what goes through you so fast, so if you limit your carbs it helps a lot.
no subject
Date: 2005-02-17 03:26 am (UTC)no subject
Date: 2005-02-08 06:12 am (UTC)now, I could have been told it was time release and it was only a placebo, but heck, it worked for me!
-Katy
no subject
Date: 2005-02-08 05:31 pm (UTC)no subject
Date: 2005-02-08 06:16 am (UTC)no subject
Date: 2005-02-08 05:30 pm (UTC)no subject
Date: 2005-02-08 06:40 am (UTC)sorry just being silly. i hope you find out more about it soon...
no subject
Date: 2005-02-08 05:30 pm (UTC)A little late...
Date: 2005-02-15 01:31 pm (UTC)I find it odd that the doc person told you not to worry about the resistance because if it isn't taken care of it can eventually turn into full blown diabetes. Actually if you take a diabetes class, they'll tell you IR is in fact diabetes.
Anyway, because of the possibility of intestinal issues, when I started, I took it at night before I went to bed. I didn't have any problems. I do notice if I get off track or go off a few days, that when I start taking it again, I have slight issues. But nothing like Cho in her car (if you've seen it). Again as another person wrote, it's in the carbs. One thing to check out if you don't want to be on the meds is to try a lower carb lifestyle, lots of fruite & veggies & your protein and of course exercise.
I found if I take a 20-30 minute brisk walk before I eat, I can skip a dose of medicine and my insulin stays in check.
You just have to find the right balance for yourself. Another thing to help with PCOS is taking the B/C pill if you aren't already, this was a problem for me as I'd like to be pregnant in the next year. The meds do work but until I'm perfect enough to exercise and drop the weight on my own, I'm stuck taking the meds. I hope it goes well for you. Take care!
Oh... and I too have the occasional glass of wine and notice no ill effects. I guess just try different things until you find the right combination. :)
Re: A little late...
Date: 2005-02-17 03:23 am (UTC)I'm so not ever taking BC pills again. I took three different kinds over 4 years and hated how I felt when on them and what they did to my mood and stuff. So... never again! I will try this Metformin stuff and see what happens. :)
Re: A little late...
Date: 2005-02-17 02:16 pm (UTC)Re: A little late...
Date: 2005-02-18 02:10 am (UTC)But what do I know, I'm not a doctor. :) Good luck getting knocked up!
Re: A little late...
Date: 2005-02-18 11:52 am (UTC)Not sure if you knew this either and I found it out in my research, Estrogen is stored in fat cells, so while your body recognizes all this estrogen (in my case because I am overweight) it stops producing it and consequently produces more test. to balance because it thinks I need more which in turn causes the chaos with insulin. It can never be an easy problem with me.
Re: A little late...
Date: 2005-02-22 02:12 am (UTC)Re: A little late...
Date: 2005-02-22 02:12 am (UTC)Re: A little late...
Date: 2005-02-22 11:32 am (UTC)Re: A little late...
Date: 2005-02-23 01:46 pm (UTC)