anxiety – Trials Bring Joy

September is PCOS Awareness month and I can’t let it slip away without bringing attention to the disease I suffer from – Polycystic Ovarian Syndrome. Now if medical-related blogs aren’t really your thing, which is TOTALLY okay, now would be a great time to say ‘peace out’ for today. But for others who are interested, I would love to share with you a little bit more about what PCOS is and how it affects the body, how its controlled, how to treat it and then share some great resources with you.

What is PCOS? Polycystic ovarian syndrome (PCOS for short) is the most common hormonal endocrine disorders in women. Most women with PCOS (but not all) grow many small cysts on their ovaries. We are who lucky enough to have said cysts (insert sarcastic tone here) typically call these cysts a “pearl necklace”. No, this isn’t the pretty kind of jewelry Audrey Hepburn wears around her neck, instead they are tiny cysts strung in a row around the lining of our ovaries (seen on an ultrasound). These cysts aren’t typically harmful and will mainly cause hormone imbalances (unless they burst, which is very serious unless treated immediately.)

What are the symptoms of PCOS? PCOS can be so tricky to diagnose because there are a wide variety of signs and symptoms that a woman might experience. Unfortunately there isn’t one stand-alone test that can be done. Most of the time it is a combination of tests that will lead your physician to diagnose you with PCOS. Sometimes women only have a few of these symptoms that may be mild or severe or perhaps many of the symptoms are non-existent. Common symptoms are listed below with the percentage of women with PCOS who are affected with said issue:

Irregular periods (75-80%) (in fact 25% of women with PCOS have regular cycles)
Excessive hair growth on the face and body (60-80%)
Thinning hair (40-70%)
Acne (40-60%)
Excess weight, sugar cravings and the inability to lose weight (75-80%)
Insulin resistance (55-80%)
Abnormal blood lipid levels and a tendency to have an apple shape (55-80%)
Darkening of skin areas, particularly on the nape of the neck (known as acanthosis nigricans) (10%)
Skin tags (unknown %)
Gray-white breast discharge (8-10%)
Sleep apnea and sleep disturbances (8%)
Pelvic pain (unknown %)
Depression, anxiety and other emotional disorders (unknown %)

Unfortunately PCOS does tend to run in families, so there is an increase in diagnosis if women in your family have PCOS, symptoms of excess male hormones, weight problems, irregular periods and/or infertility.

One of the significant symptoms that I struggle with is insulin resistance, leading to weight issues as well as increased male hormones. Because I, like many women, are insulin resistant, it puts us in a category of being “pre-diabetic” and more likely to be diagnosed with diabetes down the line if not properly managed.

How is PCOS controlled? Simply put, one of the easiest ways to control PCOS is through diet and exercise. I read it that ”put very simply”, this is how it works:

Weight loss –> Reduced Insulin resistance –> Lowered insulin blood levels –> lessened secretion of male hormones by ovaries

Guys, I wish I could convey to you how difficult it is for women with PCOS to lose weight though if being overweight is a struggle. (And not all women with PCOS are overweight.) It can be extremely tough but not impossible. Managing PCOS with diet means having to follow a low-glycemic and low-carbohydrate plan. Food plays a crucial part in minimizing PCOS symptoms and even when someone is nearly perfect on their diet, they can see little to no changes in weight. It can be incredibly frustrating and women with PCOS can also gain weight at a rapid rate due to the hormones imbalances and insulin resistance. Our blood levels constantly fluctuate which leads to storing our calories as fat and then hanging on to it tightly. However, weight management is known to be one of the most powerful ways to control PCOS. In fact, one of the books I read claims that “losing 7-10% of your body weight causes more than two-thirds of women to resume ovulating, even with some long histories of infertility”. (Annnnnd unfortunately for me, I was not one of those two-thirds ladies, oh boo.)

How do you diagnose PCOS? This is pretty tricky but the doctor will take into consideration a number of factors, including two common symptoms, irregular periods and a lack of ovulation. They will also run several labs tests, for example checking your levels of male hormones, your luteinizing hormone (LH), and follicle-stimulating hormones (FSH). Many but not all doctors will do an ultrasound to look at your ovaries to see if there are multiple cysts evident and then lastly, they will rule out any other issues that may lead to similar symptoms, like thyroid issues. PCOS affects 5-10% of the female population.

How is PCOS treated? Like I mentioned above, diet is a key component to managing PCOS, however, there are times when that just isn’t enough. In women who are not actively trying to conceive, an oral contraceptive is typically one of the first things that a doctor will try, simply because it helps to steady your hormones levels. However obviously with women who are trying to start a family, being on birth control is, well, counterproductive. J Many women are started on a drug called Metformin which is commonly used in the management of type 2 diabetes. (It lowers your blood sugar levels which can reduce your insulin resistance.) Its works for many patients, but unfortunately not everyone. (Again, like me, hmmm, apparently I stick out like a bad statistic.) Many women just live with the symptoms of PCOS and treat them best they can, perhaps using an acne medicine for their acne or sleeping pills for sleep disorders or waxing for excess hair growth.

What are other conditions that may go with PCOS? There are some other diseases and conditions that are increased in women with PCOS and I don’t share any of this to make you nervous if you have PCOS yourself, but instead, share it so that you can be aware and proactive to minimize the risks. Some of these diseases are: type 2 diabetes, cardiovascular disease due to imbalanced cholesterol levels (another symptom), heart disease, endometrial hyperplasia and uterine cancer. Unfortunately women with PCOS are several times more likely than other women to develop uterine cancer due to the increased level of hormones and a lack of ovulation. (Since we don’t ovulate as often, our uterine lining doesn’t shed as often, which then affects our endometrium. If you have prolonged absences in your menstrual cycles (90+ days) work with your physician, as there are drugs that can trigger a period, such as Provera or a natural progesterone cream.)

Also, unfortunately staying pregnant is tougher for women with PCOS. Data shares that sadly, women with PCOS have three times the normal risk for miscarriage (which is 10-15% in normal women). Four out of five women with repeated miscarriages have been reported to have PCOS. There are ways to prevent this and drugs that help significantly reduce the miscarriage rate however, so again, make sure you are working closely with your doctor. There are MANY MANY MANY healthy babies born from a mommy with PCOS.

But I wanna have a baby!!!! Finally, some good news! The likelihood of having a baby with PCOS is great. PCOS is complex, yes, and perhaps I am not the best person to be writing about how pregnancy and deliveries are possible, but data shows that they are. Whenever possible, weight loss is the best place to start, but from there, there are many prescribed fertility drugs that can assist. While PCOS can never be cured, it can be controlled and that’s what we are aiming to do. ;)

Whoa! I hope I didn’t overwhelm you with too much info! PCOS certainly doesn’t make life more fun, however, it’s important to keep in mind that this isn’t just about me or you. There are many people around us who are struggling with a disease or condition. Like many diseases, education is an important tool and I hope that in reading this, you understand a little bit more about the disease you have been diagnosed with or someone you care about has. Due to its complexity, the associated hormonal imbalances, and the pure frustration of not being able to do what seems so natural to many, depression and anxiety are common in women with PCOS. It’s important to seek help when managing it on your own becomes too overwhelming. (A depressed mood, sleep disturbances, a loss of interest in things that you used to enjoy, feeling hopeless, constantly fatigued, changes in your appetite and/or suicidal thinking are all signs that it’s time to seek help.) Support groups can help tremendously. And always remember that seeking help does not mean that you are weak or less than others – professional help is there to help you cope with the hardships. Don’t be afraid to take advantage of that.

If you have made it to the end – congratulations! Thanks for taking the time to read this and I hope that I have been able to shed some light on PCOS. If you are a fellow believer, always, always, always remember that we serve a God much greater than PCOS, much more powerful than its symptoms and able to do much more than we can ask or imagine.

Reading Resources: There are two books I highly recommend if you are struggling with PCOS. The first is A Patient’s Guide to PCOS: Understanding and Reversing Polycistyc Ovary Syndrome by Walter Futterweit, M.D. with George Ryan and the second is The Ultimate PCOS Handbook: Lose Weight, Boost Fertility, Clear Skin and Restore Self Esteem by Collete Harris and Theresa Cheung. (Both books are linked here to Amazon, however, I do not receive compensation for these links. These links will simply provide you with more information on the books.)

Please note, this post is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about PCOS or any other health concern.

Fear is a nasty thing.

My baby dog Cali has been acting a little abnormal lately. It hasn’t been long, a week or two at best. An accident while she was sleeping, brushed off as she was sleeping too soundly and didn’t wake up in time. An increase in water intake, clearly from it being so hot outside. But then she got these sick, sad eyes and would look at me and I just knew in my mom gut something wasn’t right.

After another accident this weekend, I assumed the worst. (Naturally). So when you are worried, what’s the best thing to do?

Pray, call, make a doctor appointment, think positively and wait until your appointment.

Well, yes, that is the right thing. Unfortunately that’s not what I did. I turned to Google. (Never a good idea).

What I learned was that Cali likely has diabetes or Cushing’s Disease. So I continued to “research”, staying up on my phone till 3:00 am, reading article after article about what this means for her life span and quality of life, while letting my brain race.

The next day, the day the vet was of course closed, I couldn’t shake the anxiety in my stomach that I was going to lose Cali. Of course her dying was the natural thing to assume. Could I hold her while she was put to sleep? Would I survive it? What was wrong with her?

All of my worries ran through my mind like a fire in Colorado, one that couldn’t be put out. I felt physically sick to my stomach. It started in my tummy, like a burning rock that made me want to throw up. Then it spread up to my diaphragm, like hot lava spreading up to my heart, which ached, then up my throat, sitting there like a form of acid. The anxiety of losing my furbaby, the one who has been by my side for 8 years and licked my tears and cuddling against my barren stomach was too much for me to process.

I KNEW better than to let myself go. I recited all the verses I knew about worry and anxiety and trusting God. In fact, I actually begin to think that God was going to take Cali from me as some sort of test of my faith (because I haven’t been through enough) and all day I plead with God, trying to convince Him that I was strong enough without this test of faith.

I was stumped. How could I be praying, reading scripture, and yet so physically ill from the anxiety? Wasn’t the peace of God supposed to take away this pit in my stomach? What was I doing wrong? I had faith that God could heal Cali, but was assuming He wasn’t. I was being honest to Him with my emotions, scribbling down in my journal I’m so scared today Lord. I know you know how much I love Cali and I am terrified that I am going to lose her. I know I would survive but the thought of having to go through that pain paralyzes me and makes me anxious. God, you are a healer and I pray for healing for Cali and Lord, you also are a comforter and I pray that you comfort my heart and calm my anxious thoughts, surrounding them with your peace.

And still the anxiety grew. I couldn’t eat dinner. I couldn’t disengage from the fear. I read Steven Furtick’s words about fear – “…if left alone, it (fear) tends to compound, spread and destroy. Little fears can cohabitate and combine to form levels of anxiety and terror that will annihilate our awareness of the presence of God….therefore, our approach to dealing with fear cannot be passive. Because fear doesn’t evaporate. It must be evicted.”

I was letting the fear destroy me, trusting God but trusting Google more. I was engaging the fear by just looking up “one more thing”. It was awful. I was expecting the fear to evaporate instead of being proactive to just STOP playing the “what-if’s” in my head and setting the phone down. Josh eventually was able to pry the phone from my hands (which resulted in me missing lots of texts, sorry for my abrupt absence to those texting). And then I just had to wait.

Josh prayed for Cali and I and that made me feel better. I took a sleeping pill (the only logical thing to do to stop the voices) and made an appointment for the first thing this morning.

I teared up as I brought Cali to the car, for some reason terrified that they wouldn’t give her back to me if something was wrong. Lord please, any other sacrifice …

(Side note – isn’t it funny how dramatic our brains can be when in FEAR MODE? Logic makes no sense, even typing this now I am wondering how I let myself get so out of control. But that voice just fed on itself and unfortunately, I let it.)

I talked to the vet, spilling out my concerns … a few accidents, maybe drinking more or maybe just hot, sad eyes that have nothing to do with the fireworks, I think … I just know … diabetes? Dying? The look of empathy he gave me was calming, Is she eating normally? (yes) Is she showing a lack of interest in everything? (no, I had to tear her away from her toys to get her into the car this morning) Is her belly bloated? (No) The questions continued and I realized my Google research lead me astray a bit. They brought her back and took a urine sample (poor little pup and the catheter) and some blood work. While we waited Cali demonstrated her tricks for the techs (balancing and high fives and rolling and spinning in a circle and such) – all clearly evidence that she was on her last leg, right? Sigh.

Well, the results are in. She doesn’t have diabetes or Cushing’s Disease. She has a slight UTI and low estrogen (like her mom, go figure), which is causing slight incontinence. Are you sure she isn’t dying??? (“She has some of the best blood work and urine results we have seen, she is extremely healthy and has a long life ahead of her.”) And no diabetes? (“Not a trace.”). And so we were off, with antibiotics in hand and a low-dose estrogen that she will take twice a day for the rest of her long life.

That was a lot of worry for nothing. And how I wish I could have told my yesterday-self that it would all work out like this. SHE WILL BE FINE. Stop the voice. But I just couldn’t build up enough strength to trust God and stop my racing mind. I wish there was a “Peace of God” pill, but there isn’t. I know next time to stay off of Google – to EVICT the fear by stopping my thoughts. By running the other way and to NOT play out all of the what-if’s before they come true. I wish I could say next time an anxiety attack like this hits, that I can say I will have it under control, but it’s so hard.

“Jesus stood up and commanded the wind, “Be quiet!” and he said to the waves, “Be still!” The wind died down, and there was a great calm. Then Jesus said to his disciples, “Why are you frightened? Do you still have no faith?” (Mark 4:39-40 GNT)

When I read these verses today, I couldn’t help but feel God was speaking directly to me – Chelsea, why are you so frightened? Do you still not believe that I have things under control? That you can trust me? That you have nothing to fear because you always will have my protection over you? Trust me, regardless of the outcomes.

What a struggle this is! One I will continue to work on. I wish I was better at trusting. It’s a muscle that I need to continue to work on and I know that in order to work on it, I need to face situations in my life that require trust. It’s scary, but not as scary as the what-if’s. He’s got my back.

In the meantime, send us good luck wishes as we attempt to get a very stubborn little dog to take her antibiotics twice a day. And send Josh well wishes as he now has to live with two hormonally-imbalanced ladies. HA! :)