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Baby Ian is now 6 months old and I am JUST starting to get my life back in order again in terms of meeting my long term health goals.  I promised myself when I first started this experiment that I would not abandon my health and wellness goals once I was no longer seeking pregnancy.  I’ve been enjoying reading back through this blog to remind myself all of the wonderful meals I created and lifestyle choices I made to get the fertility results I was after.  As it turns out, I don’t think they are all that different from what my new, “post baby” health plan should be.  After all, I still have PCOS and Celiac Disease, and will for the rest of my life.  It’s time to start thinking about my health for the long term and how to stay trim, healthy, happy, and vital as I age.  I recently saw an interview with Deborah Szekely, one of the founders of the health and wellness movement, who just turned 90 years old this week.   Not only did she look great, but she was as eloquent and vivacious as someone half her age.  What a testament to practicing what you preach, but really, what an inspiration!  I’m 35 now, and so I will set my health goals at living to 100+ years old.  That leaves 65 years, or 780 months.  I hear-by rename this blog, My 780 month PCOS Experiment.  To christen the name, I’m going to round-up and share all of the new health/wellness information I’ve come across recently as this passion of mine has slowly emerged in importance again in my post pregnancy life.

1) A more nutritious and PCOS friendly gluten free bread

I’ve often been dismayed at how refined and lacking in nutrition most commercially available gluten free breads are.  And when you look at the carbohydrate content, it’s not something a woman with PCOS should be eating either.  After some searching around, I came across a woman’s website, http://www.elanaspantry.com/, who has developed many gluten free baking recipes using primarily almond flour.  She also uses coconut flour and several types of alternative sweeteners that I’ve grown to like.  I’ve taken her “Paleo” bread recipe and adapted it for myself and I’m really happy with the results.  It is packed with protein and has almost no carbohydrates.  It’s easy to make, nutritious, and filling.

2) Grain Free Diet

The woman I mentioned above, Elana, is a celiac, but she also has Multiple Sclerosis, and has developed her own grain-free, healing diet that keeps her symptom free.  I was not aware before reading her website that many people with Celiac Disease and other kinds of auto-immune disease do better with no grains in their diet, in addition to avoiding the gluten producing ones.   I also found out on her site that both Celiac Disease and Diabetes have the same gene in common and so it makes a lot of sense that I have insulin problems/PCOS AND Celiac Disease.   The diet that I followed at the beginning of this experiment was primarily grain free, as well as low carb and low sugar and obviously I did very well with this way of eating, so I am going back to it, but with renewed vigor as I now better understand the hows and whys.  I do want to mention that it is not a “Paleo” diet though.  I eat dairy and beans and probably all sorts of other things that are not allowed on the Paleo diet.  It’s simply a diet that I have tailored to my own, particular health needs.

3) Xylitol

Xylitol is a natural sweetener that is primarily derived from birch trees (and the fiber of other fruit and vegetables).  It’s low in calories and carbs unlike sugar and it also does not affect blood sugar the same way sugar does.  I’ve been a big fan of agave nectar in the past as my alternative sweetener of choice, but with the recent studies showing a correlation between fructose and high triglycerides, I have decided to limit my use of it, as it is a “high fructose” product.  I am REALLY picky about my sweeteners, as I cannot stand that weird artificial aftertaste that many, even natural, sweeteners have.  I don’t use stevia for that very reason.  Xylitol tastes very much like cane sugar to me.  Xylitol has many other health benefits though that I am also very interested in.  When ingested, it creates an environment in your mouth that is not welcoming to the bacteria that cause plaque and so it can do wonders for one’s oral health if used in sufficient quantities over time.  In fact, it can help remineralize your teeth, virtually healing them from within.  It’s been shown to do the same things for bones too.  There is also research that shows that it prevents ear and respiratory infections.  It’s amazing to me that there is such a product out there that I am only recently hearing much about.  My whole family is using it now with great results.

4) Unsweetened, unflavored protein powder

I’ve been looking for a protein powder that I can add to baked goods and smoothies to boost protein without adding a flavor (vanilla for example) or any sweetness (such a stevia).  Both hemp and pea protein powders were recommended by Dr Frank Lipman.  I found hemp powder at my store, and I can say that so far I am really happy with it.  It has a very mild and pleasing natural flavor and I like the green color too – it just “looks” healthy!  I use it in my new bread recipe as well as smoothies to replace the yogurt that baby Ian can’t tolerate right now while breastfeeding.  I can see lots of ways to use it in the future as the package says that it can be used replace up to 25% of the flour in a recipe.

5) Dr. Frank Lipman

I mention Dr. Frank above, and for good reason.  He’s an MD who practices “Functional Medicine” in NYC, and a wonderful source of health and wellness information.  He gives truly sane, well researched, and highly usable advice to stay on the cutting edge of health.  After reading his website, I can wholeheartedly recommend him as a valuable guide to health.  I love his site and his Facebook presence.  The best thing I can say about him though is that I trust him.

6) Misclaneous – Here’s a list of some of the other things that I’m still doing regularly (or have resumed doing recently) to help treat my PCOS:

-cooking with and making salad dressing with organic apple cider vinegar

– having green tea every morning

– having sufficient protein with each meal and snack

– taking a multi-vitamin, B-multi, vitamin C and D, calcium, magnesium, omega 3s/fish oils, and probiotic.  I’m keeping my supplement list quite simple right now since I’m breastfeeding.

– deep, mediative breathing any time I can

– avoiding toxins and chemicals in my cleaning and personal care

– eating whole, mainly organic foods

– avoiding sugar, most grains, and things with a high carbohydrate and glycemic load

– eating lots of healthy fats (unrefined olive and coconut oil, pastured butter, avocado, nuts/seeds, fish/sardines)

Four months of this experiment have now come and gone!  This has seemed like the fastest month by far, probably because this lifestyle change has become a habit that I don’t think about it as much as I did in the beginning.  I just keep a general framework in my mind and try my best every single day to work within it.  I am spot on for a few days and then I may not get the chance to exercise for 2-3 days in a row.  Instead of trashing the whole endeavor, I just start right back up and make up for lost time.  It’s making good choices most of the time that makes the difference.

‘Tis the season for all manner of diet blunders, but I have been successful in resisting the temptation to fall off the wagon.  I enjoyed Thanksgiving without so much as an added pound, which I did, not by turning down the delicious meal, but by remaining moderate in my food choices and continuing to work-out, even when out of town.  I used to be fairly frustrated about the fact that I have not lost many actual pounds, despite lots of effort, but I now know that each pound lost is backed up by lean muscle gain and is stable, meaning the scale does not fluctuate wildly anymore.  When I lose a pound now, I’ve really lost it.  Because of this, I no longer feel like a slave to the scale or a rigid diet that cannot include an occasional treat (within reason).  I trust myself and my body.

My supplements have changed quite a bit this month with the addition of D-Chiro-Inositol, myo-inositol, and a weekly prescription of Chinese herbs.  I have not been taking any of them long enough to report much change yet, but I am very hopeful.  I sincerely wish that I could report today that I have recorded an ovulation, or even gotten a spontaneous period, but more time is needed it seems to get those kind of results.  Here’s a link that details my supplements and all of the changes that have been made along the way.

Despite feeling impatient at times in regards to my progress this month, I generally feel such gratitude for the positive changes this experiment has made in my life and for my husband and baby as well.  I look great, but better than that, I feel great too.  My interest in life is filled to the brim and I feel my creative juices flowing again.  I periodically catch myself smiling, almost giddy with happiness and excitement for the year ahead of us.  I am feeling more confident about being able to handle the responsibility of having two children.   I am actually just starting to feel ready to be pregnant again. This goal, I am confident, will be met in 2011.

So, I guess we should take a look back at the original success criteria for this 6 month experiment, noting my progress since last month:

1) Ovulation and Menstruation – It had been a while since my last period, and I began experiencing some signs of Estrogen Dominance (constant fertile cervical fluid, ferning on ovulation microscope every day).  I started an oral natural progesterone supplement called Progon B, and 8 days later I started spotting and got a very light period lasting about 4 days.  I have since started Chinese herbs and acupuncture to stimulate ovulation, but no rise in basal body temps. yet.  This goal is still a work in progress, but I have never felt closer to this goal than now since it was with Chinese herbs that I was able to regain my cycle back in 2006. Very hopeful to see what the next few weeks bring.

2) Stable weight and body measurements –  I am wearing clothing that I have not been able to in many years.  I once had a pretty remarkable wardrobe from my fashion design days in NYC, and thankfully I kept some of my more timeless pieces.  The clothes not only fit, but they look really good.  This thrills me to no end!  The big news is that I now have a waist!  I have not been able to wear anything that accentuated it in many years.  I actually pulled out a belt and wore it over a dress for the first time in as long as I can remember.  I have been fighting a puffy Insulin Resistance belly since childhood.  I still weigh myself most days and I hover around 112-113.5 lbs with very little fluctuation.  This goal has been met and exceeded!  See my body measurements below.  Despite not losing many more pounds, my measurements keep going down.  YES!

3) Little or no acne – Similarly to last month, I have had some success and failures this month in regards to my acne.  Myo-Inositol has helped me fight the urge to pick at and scrutinize my pores, but I have since screwed with the dosing too much and so the jury is still out as to if it can help my OCD-type preoccupation with my skin/acne for the long haul, enough to make a lasting difference in my face.  I was hoping that I would know something more by the time I wrote this, but I’m still not sure enough to make any grand declarations.  Hopefully the picture, and my face, will become clear enough to make an accurate report.  This goal is still a work in progress.

4) Stable and positive emotions – I’ve had some resumption of some roving anxiety that I have suffered with in the past on several occasions this month (likely low blood sugar from new supplements), but for the most part I have felt very even keeled and happy.  I feel confident and much more take-charge than maybe ever before.  I’m not shying away from things that used to intimidate or scare me.  I’m ready to take on more responsibility in my life.  This goal has been accomplished yet again!

Body Measurements:

1) Natural waist:
a- 27″ on 10/7
b- 26″ on 10/23
c- 25″ on 11/23
d- 24″ on 12/22

2) Lower abdomen (around fattest part of tummy):
a- 32″on 10/7
b- 29 1/2″ on 10/23
c – 28 1/2″ on 11/23
d- 27 1/2″ on 12/22

3) Lower hips (around largest part of butt):
a- 35 3/4″ on 10/7
b- 35″ on 10/23
c- 33 3/4″ on 11/23
d- 33 1/4″ on 12/22

4) Individual thigh circumference (around thickest part of one thigh):
a – 20 3/4″ on 10/7
b – 19 3/4″ on 10/23
c – 18 3/4″ on 11/23
d – 18 1/2″ on 12/22

I was able to survive Thanksgiving with my weight and this experiment intact!  I decided to eat everything I wanted (and then some), including pie, for my Thanksgiving meal.  I just did not eat leftovers day after day like I normally would have.  I had a couple of pieces of pie in the days following, but nothing else really naughty.  I exercised a little while we were away and even tried jogging for about 15 minutes one day.  I have never been able to run for very long before, but all of my work-outs from the last 3 months must have helped my endurance a lot.  When we returned home (11/27/10) the D-Chiro-Inositol that I ordered a few weeks back was in the mailbox and I took my first dose that evening.

At my acupuncture appointment prior to Thanksgiving, I told her about the constantly positive saliva microscope results and she agreed that it was time to start some supplemental progesterone to balance out my estrogen dominance.  I will continue to take the Symplex F/Ovatrophin until tomorrow, making it a two week course, and then I will start an oral natural progesterone called Progon B for two weeks, or until I get my period.  I asked her about natural progesterone cream and she said she did not prescribe it anymore because studies have found it to accumulate in fatty tissue and then it releases into the blood stream when you may not want it to – definitely not something she wants someone with mixed up hormones to use!

Three months are now completed in this PCOS Experiment!  This month the experiment went from a highly regimented plan to a sustainable way of life.  I’ve been so self-disciplined since this experiment began that I no longer felt the need to record my progress daily, and so I ditched my daily format.  I was feeling stressed until I could stop and type out everything I had eaten for the day, and with a toddler, finding the time was getting tough.  The new, free-form blogging is much better suited to where I am in my progress.

I decided to take my exercise requirements down just a slight notch, from 5-6 days a week to working out every other day, alternating cardio and strength/resistance training.  I also started adding in a little bit more complex carbohydrates in the form of gluten free rolled oats a few mornings a week.  I made these changes in the hopes that I will be able to not only finish this six month experiment, but to keep it going for the rest of my life.  I’ve been afraid of burning out as things in my life become more complicated and prevent me from adhering to a strict lifestyle.  I have only seen the scale go down since I made these amendments to the original plan.  I started the month a solid 115 lbs and now I’m seeing the scale hover around 113 lbs most mornings.   I’ve continued to find my clothing slowly getting looser and more comfortable.   I just did my body measurements since the last monthly report and I have dropped more inches (see below).  Wow, that is satisfying to see!

Since last month I’ve noticed my weight being less vulnerable to restaurant meals and changes in my diet.  This weight stability gives me a lot of confidence when we do have a family dinner out or I want a glass of wine or a square of dark chocolate as a treat.  I might have seen the damage to the scale a few months back, but I have come far enough now that it’s no longer a problem.  I’m assuming it’s because I have raised my metabolism and healed a fair amount of insulin resistance.  The other more noticeable change since last month is the appearance of my face.  I have a quite naturally fleshy/full type face and even at times of being thin, it looked chubby, especially in photos.  I can see the reduction in puffiness and fullness in the mirror and can see it in photos too.  What an awesome and unexpected side effect of this experiment!

Since I am not reporting on my diet and lifestyle daily anymore, I want to give a synopsis of the things I am still currently doing on a weekly basis to help control my PCOS symptoms and to help my body heal.  I continue to add a splash of apple cider vinegar to every glass of water I drink.  I have half a grapefruit several days a week.  I drink green and spearmint tea once or twice a day.  I work out every other day, doing both cardio and strength training.  I go to acupuncture once a week.  I try to reserve a few minutes a day for a relaxing bath, usually with Epsom salts and essential oils.  I’m still eating very cleanly, with an emphasis on low carbohydrates and whole foods.  I eat small snacks that contain protein in between meals to keep my blood sugar stable.  I take a wide range of daily supplements prescribed by my acupuncturist to help my body heal my PCOS.  I record all info about my supplements here, including changes as they occur, and there is lots of change monthly.

So, I guess we should take a look back at the success criteria for this 6 month experiment, noting my progress since last month:

1) Ovulation and Menstruation – This month I started having almost daily fertile signs and symptoms which has lead both my acupuncturist and myself to believe that I am now experiencing some Estrogen Dominance (a build up of estrogen that is never balanced by progesterone because of the lack of ovulation).  I started experimenting with a saliva microscope and it shows that I am in the presence of increased estrogen every time I use it.  A week ago, I started back on Symplex F for two weeks to try to stimulate ovulation.  I had my first high temperature this morning, so this is not proof of ovulation, but a girl can hope.  Suffice it to say, this goal is an ever evolving work in progress.

2) Stable weight and body measurements – Overwhelmingly, this goal has been met and exceeded!  I started this experiment at 117 lbs, went down to 115 lbs for a while, and I’m now around 113 lbs consistently.  My abdomen is pretty darn flat and not reactive to eating.  See my reduction in body measurements below.

3) Little or no acne – I’ve experienced both total clarity and an upsurge in acne at different points this month.  I had not experienced a completely clear face at any point in the months prior, so I would say that I have had at least some success in this department.  When I don’t fuss about and pick or squeeze on my face and keep it clean and doctored up with my various acne preparations, I can now have relatively clear skin.  Even with that though, I still had some breakthrough pimples that surfaced no matter what I did to prevent them.  This goal, while I’ve seen moderate improvement, is still a work in progress.

4) Stable and positive emotions – Like my acne progress I spoke about above, my emotional health has been both very good and wavering at times as well.  I’ve had some mild depression and reduction in motivation in regards to this experiment during this month, but I really think I solved this problem by changing the parameters of this experiment as I mentioned earlier.  My self-assurance and confidence has been quite good and I have felt more like reaching out to people and less introverted.  I am going to call this goal accomplished for now, especially since I’m no longer dealing with rocky emotions on a daily basis, just in isolated drips and drabs.

Body Measurements:

1) Natural waist:
a- 27″ on 10/7
b- 26″ on 10/23
c- 25″ on 11/23

2) Lower abdomen (around fattest part of tummy):
a- 32″on 10/7
b- 29 1/2″ on 10/23
c – 28 1/2″ on 11/23

3) Lower hips (around largest part of butt):
a- 35 3/4″ on 10/7
b- 35″ on 10/23
c- 33 3/4″ on 11/23

4) Individual thigh circumference (around thickest part of one thigh):
a- 20 3/4″ on 10/7
b- 19 3/4″ on 10/23
c – 18 3/4″ on 11/23

1) Cinnamon – Eating cinnamon with a meal helps to keep blood sugar from spiking afterward.  I put a liberal amount in oatmeal and always mix it into nut butters before spreading them on apple slices or crackers.  It tastes good and helps keep blood sugar stable.

2) Celestial Seasonings Bengal Spice herbal tea – I have a MAJOR Starbucks chai tea latte addiction that I have quit and restarted several times in the last few years.  The Bengal Spice tea, while having 0 carbs, contains roasted carob and so it tastes slightly sweet, especially with a good splash of milk in it.  This is a good substitute for the Starbucks chai, which contains a boat load of sugar.  I add a black tea bag when I want some caffeine in the morning, but it’s nice that it has no caffeine on it’s own so I can drink it at any time of the day or night.

3) Oatmeal Muffin in a Mug – A friend turned me on to this really innovative recipe for a no bake and flour-less oatmeal muffin in a mug that you make in the microwave.  You just combine 1/3 cup quick cooking oats, 1/2 teaspoon baking powder, one egg, and a dash of salt in a coffee mug and microwave for one minute.  Dump the muffin out and slice and eat (with a little butter or cream cheese if you feeling naughty)  I feel it’s a little dry and bland, so I add cinnamon, a teaspoon of agave nectar, and a teaspoon of apple sauce.  I would think mashed banana, other baking spices, nuts, and dried fruit would be good too.  Easy, friendy carb, and with a pretty good hit of protein.  Also a way to take oatmeal on the go.

4) Chicken tenders – I toss a whole pack of raw chicken tenders (I usually get organic) in a few teaspoons of olive oil and salt and pepper and spread them out of a baking sheet.  I bake them for 15 minutes at 350.  Alternatively, they are good on the grill.  I let them cool and them store them in a zip lock in the fridge.  They are a quick and easy lean protein to put on salads or to eat as snacks.  I go through a bag per week.

5) Mary’s Gone Crackers – Gluten free crackers are usually very high in refined starches and flours as an attempt to make them most like the glutenous versions.  Same thing with bread.  I’ve yet to find a suitable, lower carb, gluten free bread that is actually beneficial to your health, but I did find a good whole grain cracker.  Mary’s Gone Crackers are a mix of whole quinoa, flax seeds, brown rice, and sesame seeds that are baked into a very crispy little wafer.  They are toasted and nutty in flavor and despite being pretty hard on the teeth, eating 6 or so of them sure is nice with a salad or as a snack with cheese or nut butter.

6) Splash of Juice in Water – Other than unsweetened teas, water (with Apple Cider Vinegar) is pretty much the only thing I drink in order to avoid excess carbohydrates .  That is usually OK, but sometimes I must have something sweet to drink.  When this happens, I put a splash of unsweetened 100% fruit juice in my water and that usually satisfies that craving without going too far off the diet.  Organic Apricot nectar is my favorite.

I’ve been reading a great PCOS blog called the PCOS Diva and have gathered a handful of new things to try for natural PCOS healing. After two full weeks of this experiment, I feel ready to step up my game.

1) I’ll be mixing a tablespoon or so of virgin coconut oil to my oatmeal in the morning instead of butter

2) Adding a splash of apple cider vinegar to every glass of water and using it on my daily salad at lunch

3) Drinking iced or hot spearmint and green tea for my morning beverage

4) Having a half grapefruit (plus protein) as one of my snacks everyday

5) Adding a whey protein powder when I don’t have enough protein in a meal to balance carbs or when I feel run-down or abnormally hungry.

I will be posting on my Daily Status/Progress with these new additions over the next few weeks.  All of these things are supposed to promote insulin sensitivity and weight loss, both of which are excellent ways to treat PCOS naturally.

1) Small, protein snacks in between meals – Eating lower carb that you are used to can lead to a shaky and hypoglycemic feeling, even if you are not actually feeling classically hungry.  Snacking keeps your blood sugar stable and that shaky feeling at bay.  It also helps you from having sugar cravings and from binging on high carb foods.  Drinking a full glass of water with each snack makes it seem more substantial.

2) Small, protein snack before bed – I know this goes against all conventional wisdom in regards to general health and losing weight.  When I had Gestational Diabetes, I learned that your blood sugar can become dis-regulated during the night and you need some protein for it to work on to keeps things stable.  I had to monitor my blood sugar many times a day, and on the mornings after not eating my before bed snack, my blood sugar was high and out of the normal range.  I was also more likely to cheat on the GD diet that day because my body was trying to find stasis all day.

3) Beans/Legumes/Pulses! – Beans are indeed the magical food.  Yes, they do have some carbs, but they are low on the glycemic index, fiber rich, high in protein, and very filling.  They are the perfect starchy element for a PCOS diet, especially when are seasoned nicely and with a little Feta or goat cheese crumbled on top.  They take the place of rice or potatoes in a meal.

4) Sneak in fruit wherever you can – It gives your mouth that sweet bite that it wants without eating something high in sugar.  I don’t eat fruit for breakfast, but I put several fruits in my daily salad or eat some after a meal, like a dessert.  Combined with some protein such as some roasted nuts or cottage cheese, they are also the perfect in-between meal snack.  I try to stick to the lower glycemic ones, such as berries, stone fruit, and apples.

5) Have an emergency pre-portioned “sweet” at hand. When I am having a particularly hard time with sugar cravings, I pinch off a quarter sized bite of an energy/nutritional bar and try to savor it.  I like Bumble Bars because they are made with low glycemic, but natural sweetener (brown rice syrup), have decent protein, and are not so high in carbs that 1/4-1/3 of a bar/day (4-6 active carbs) will wreck the diet.   This stops me from looking elsewhere for a sugar fix and tastes sweet enough to fool my brain.

For more info on my PCOS diet, click here.

At the start of this experiment I want to focus on general healthy eating with a emphasis on good carbs, healthy fats, and healthy proteins.  I will not be counting carbs, calories, or fat grams.  I do not have a great deal of weight to lose and so that is not the main goal.  Rather, I am trying to reduce underlying insulin resistance, which most docs agree is the cause of PCOS.  I am essentially trying to emulate what Metformin was doing for me via an amended diet.

A few of my general food rules that I will try my best to stick to:

– Don’t eat carbs alone.  Combine them with protein.

– No refined or high glycemic carbs.  I am also limiting brown rice and potatoes, even in their most whole form.  I am focusing on oats, beans/legumes/pulses, gourds, .

– No refined or high glycemic sugars.  I will focus on low glycemic fruits for my sweet fix, but always combined with a protein.

– Focus on healthy fats – olive oil, fatty fish, avocados, nuts, and eggs.

– No gluten.  I have Celiac Disease, so this is a way of life for me rather than a food choice pertaining to PCOS.

– Eat smaller meals with snacks in between to help keep blood sugar in balance and metabolism high.

I record my daily diet in the Daily Status/Progress section.