Eating Less Without Feeling Deprived

Try something for me. Close your eyes and don't think about the purple elephants. Go ahead, do it now. No purple elephants.

Are you back with me? During that first several moments, it can be quite a task to get your mind away from thinking about purple elephants. Does it work to keep telling yourself, don't do it? Really, you are still thinking about purple elephants by struggling so hard to not think about them. Before I made the suggestion, you probably weren't thinking about them and would have gone on with life without thinking about them.

Now try something else. Close your eyes, don't think about purple elephants, but this time, replace those thoughts with fluffy white bunny rabbits. Now close your eyes and remember fluffy white bunny rabbits.

Was it easier to not think about purple elephants? You had something else to concentrate on so that you didn't keep thinking about purple elephants. I find thinking about white bunnies help to get my mind off of what I'm not supposed to think about.

I think this principle is very useful for what I experienced this weekend. I was feeling deprived. I had been really good about eating a low calorie weight loss diet for a while. Then, the deprivation thoughts started to come into my head. You know those thoughts that whisper, "Don't think about the cake that other people are eating. I'm sure they are enjoying it. I might be able to enjoy it too, but I'm not supposed to have it. Just quit thinking about it and it will go away."  That becomes, "I can't stop thinking about it and it really won't hurt to have a small piece." Then that thought turns into, "Well you blew your calories today so you might as well just let loose and get back on track tomorrow." Other thoughts include, "Why am I so hungry right now? It isn't fair for me to keep feeling this hungry. I just want to go back to eating whatever I want. What I was eating before really wasn't that unhealthy."

This weekend I was at a workshop and brought my own food to eat knowing that an unknown lunch was going to be served by the workshop instructor. I ended up eating the food that everyone else was eating that wasn't necessarily healthy, gained weight and felt sluggish as a result. What set that up was a feeling of deprivation. Going there, I had a plan. That plan went out the window when I started trying to not think about the yummy cookies on the table instead of the benefits of the yummy food I spent time preparing for myself.

I kept telling myself, "I deserve this. I have been eating so little for a while now and it doesn't feel as good as those cookies would in my tummy." Then, "I already had a cookie, I might as well have some coffee cake because when is the next time I'm going to be able to have something like that." The strategy of trying not to think about it was useless against what happened this weekend.

With PCOS, I am in a unique position. It is difficult to maintain my weight and extremely difficult to lose weight. I need to have impeccable eating habits. Without those habits, I will gain weight. I cannot just eat healthy foods when I'm hungry and stop when I'm satisfied because my body doesn't work like everyone else's. Unlike others, my body is programmed to gain weight unless I take action and do something about it. It is very easy to feel like this isn't fair and feel deprived as a result. To me, the weight gain wouldn't be such a big deal if it didn't come with high blood pressure, depression, heart disease, diabetes and other health risks. 

Well, to counteract this, I have come up with some strategies to cope that I want to share with everyone.

#1 Eat often - Eating a light healthy snacks and small-portioned meals throughout the day is fuel to keep your metabolism burning. Also when I fail to eat at least every 4 hours while awake, I can get hungry enough to not care as much about what is going into my mouth. Hunger drives me to make decisions that I wouldn't otherwise make. When it has been 7 hours since the last time I ate anything, I set myself up to be more likely to say yes to something fast, easing and unhealthy.

#2 Eat fiber - Fiber is found in abundance in vegetables, fruits and whole grains. It helps you to feel fuller for longer. A bowl of oatmeal with berries in the morning lasts me a long time. The American Dietetic Association recommends that we eat 20-35 grams of fiber every day. This means that every meal and snack you eat needs to have fiber. If you eat 5 times a day (3 meals and 2 snacks), you need to have at least 4 grams of fiber every time to eat to meet the minimum requirement. 

#3 Fill up - Speaking of feeling fuller, having foods that cause a slow change to your blood sugar help you to not feel hungry as quickly after eating. They tend not to trigger hormones involved in food cravings. You may have heard of eating a low glycemic index diet. Those include foods high in fiber, lean protein and healthy fats. This is especially important in PCOS because of the high incidence of insulin resistance. Include a balance of carbohydrates, lean protein and healthy fat when you eat.

#4 Appeal to your senses - Eating foods you like is enjoyable. On the other hand, eating something because you have to and not because you want to is a sure way to feel deprived. For example, I love mushrooms. I will eat mushrooms on sandwiches, in salads, in casseroles, and put it in soup. I love the earthy smell and taste. Find foods that appeal to your senses like this. When you find something that appeals to you, savor it. Last week when it was blazing hot, I cut up melon and put it in the fridge. It wasn't hard not to savor cold sweet bits of goodness on a hot day!

#5 Drink water - Water helps you to feel fuller. Also, as I said in a previous post, humans can mistake the thirst signal for the hunger signal. You may feel like going to the fridge to eat when really you need to pour yourself a glass of water. Water also has no calories as opposed to drinking your calories in the form of juice, soda or other drinks loaded with sugar that don't fill you up.

#6 Be light - Lighten up every once in a while. Try not to take yourself so seriously that you are king or queen of restriction. Too much restriction will certainly make you feel like you've been deprived. A guilty pleasure every now and again isn't going to make or break you as long as you can have it without going overboard. Balance is important. For me, I have a couple peanut M&M's off the candy jar on my husband's desk every so often and can appreciate having had chocolate.

Well, I'm off to go put these principles in practice. How do you stop yourself from feeling deprived? Please feel free to add more suggestions. I'm sure there is tons of other really great advice that others have.

Hooked on Yoga

Yesterday I was hanging out at home waiting for a friend to come over to pick something up. Instead of vegging out in front of the computer, I was trying to find something to do to fill that hour or so. On my bookshelf was a yoga book that I picked up years ago when I worked at the gym. Back then I was training for triathlon and I used to do yoga to stay limber.

Remembering how much I enjoyed it, I pulled out the dusty book, opened it up and started looking through it. I found descriptions of each of the poses and further in, classic Iyengar yoga routines that I could do. The combination of breathing, concentration and poses made it a moving meditation for me.

After doing a beginner routine of standing poses, I didn't want to stop. I looked even further in the book and found therapeutic yoga routines for various ailments such as backache, migraine, fatigue, tense shoulders and neck, etc. The one that interested me was the routine for stiff hips as this is usually the area of my body with a lot of problems. Halfway through, my friend showed up so I stopped, gave her what she came to pick up and then gathered my husband for a hike.

On the hike, I noticed an immediate difference. All the stretching had really loosened up my muscles. Where I would normally feel aches and pains, I felt nothing. It was wonderful. Now I'm hooked. Yoga is going to be a practice I do at least once a week.

D-Chiro-Inositol for PCOS

When I started looking for remedies to help with PCOS, I found ads for a huge variety of supplements. Anyone that knows me knows that I am highly skeptical of any type of supplement. Supplements are pretty much unregulated so anyone can put pretty much anything in a tablet or capsule and sell it. Sometimes this is a recipe for disaster and sometimes there is a legitimate supplement that is safe and effective. It has taken multiple people and a really darn good sale for me to even take a daily multivitamin. My opinion of multivitamins are that they make for very expensive pee because a lot of the vitamins and minerals are not absorbed and/or excreted out.

It isn't that I don't trust people out to make a buck by selling me pills, but really who am I kidding, I'm a total skeptic. Still I thought I would give looking into it a shot. My qualification for swallowing a pill is that it better be backed up with somewhat decent research. The one thing that I found was d-chiro-inositol. Inositol is vitamin B8 which your body makes naturally. D-chiro-inositol is a specific isomer of this vitamin. They sometimes use it in hospitals for newborns with acute respiratory distress syndrome so I'm thinking that it probably fairly safe.

Here is a link to a cute little video on YouTube about how it works for people with PCOS:

D-chiro-inositol

I've been taking this supplement for a little over 2 weeks.  Not surprisingly, I haven't had to take my inhaler once since I've started taking it.  Like I said, it is used to treat breathing issues in newborns. The research shows that it helps to lower blood pressure and testosterone levels in women with PCOS. Also, it can treat failure to ovulate in women with PCOS. It takes about 6-8 weeks to be fully effective so we'll see how it goes over the next several weeks. 

More Water

I don't know how many times I've heard (or even said as a coach) that drinking enough water is vital to weight loss and athletic performance. When you are dehydrated, your body retains water which shows up on the scale as weight. The good news about that is the weight you are gaining isn't really fat. The bad news is that it is common to confuse thirst with hunger. I sometimes end up eating when I think I should be drinking more water. Also, workouts suffer due to even slight dehydration. When you get thirsty, you are already about 5% dehydrated and your performance is already starting to decline. Without water, your body isn't as effective. 

The problem is that I've never been very good at keeping hydrated. Over the past few of days, I've been really making an effort to drink more water and I've noticed such a difference. Instead of going up and down by a couple of pounds every day, my weight has been quite steady over the days that I've been making an effort to be hydrated. If I can make this a solid habit, I know that I'll be one step closer to my goal of being healthier. Besides, where am I going to come up with all the urine to do the ovulation predictor kits?

Triathlon FTW

I used to tell people that triathlon saved my life. Back then, I didn't know how accurate that statement was. At 22, I decided to do triathlon because my doctor told me that my blood pressure was elevated and if I didn't do something about it, I would need to be on medication for the rest of my life. When I first started, I could barely run one track lap. Getting on a bike and cycling up any hill was an amazing feat for me. I kept with it and eventually got to the point where I did several triathlons a year and started training for Ironman Canada.

Not only did I get my blood pressure down below 130/80, but my mood improved and I just felt better in general. I went from being overweight at around 170 pounds with over 30% body fat to just under 140 pounds with under 20% body fat. My eating habits changed to be healthier in order to support my best performances at events. For almost 8 years, I never ate fast food or drank soda. Instead I carefully consumed a diet high in whole grains, vegetables and lean protein.

Little did I know what my body was probably going through at the time and that what I was doing was treating it in a way. I think triathlon is the reason that I didn't get a PCOS diagnosis until a decade later at 32. Even now I think that triathlon might be the reason why I haven't developed insulin resistance. In fact, women who have PCOS are 4-7 times more likely to have a heart attack than "normal" women their age. Part of this is due to insulin resistance as well as other factors. There is a substance in the body that influences the development of heart disease called C-reactive protein (CRP). Women with PCOS commonly have elevated baseline levels of CRP. This substance is probably the reason why I have borderline high blood pressure when I am not training for triathlon and have never seen my blood pressure below 125/75 on a normal day. Without triathlon, I wonder what my state of health would have been like through my twenties.

I've been away from triathlon for almost 5 years now. I miss it! After I broke my foot and injured my hip, I went back to school and busied myself with school. I still do regular exercise, just not the crazy schedule I used to. That's when the PCOS symptoms started showing up in small ways here and there, then in slightly bigger ways until finally my ob/gyn (still thinking it was something else) did an ultrasound of my ovaries.

My belief is that doing triathlon has staved off the negative PCOS symptoms for me for many years. I consider myself to be very lucky to have the health that I have. There is nothing like the whoosh of the water in your ears that you hear while swimming, the beauty of the trail early in the morning while you are running next to your best friend, the feeling of accomplishment when you finally get to the top of the hill, the nervousness you feel as you get your race number marked all over your body on race day, the dangerous speed that you attain while whizzing downhill or the tears of pride in your eyes as you cross the finish line. Thank you triathlon for giving me all that!

This October, I will participate in a half marathon at the Nike Women's Marathon. I'm starting to get back into it. When school ends in June, I want to go full force back into triathlon. For anyone who is thinking about attempting triathlon or any other endurance sport, I say GO FOR IT! Even if you are like me, not being able to run a track lap or bike up a small hill, you will amaze yourself with what you are capable of. You won't be sorry that you did.

What Polycystic Ovaries Means

If you go to a search engine and type in PCOS or polycystic ovarian syndrome, you will find a wealth of information about this syndrome.  Using the information I've gleaned from various sources, I'll try to explain what it means as I understand it in my life.  First, I want to say that there is no cure and treatment is based on reducing symptoms.

Basically, every menstrual cycle, a follicle containing an egg develops on the surface of the ovary.  Triggered by a hormone, that follicle bursts and an egg is released into the Fallopian tube which travels to the uterus.  In my case, the follicles develop but due to imbalanced hormone levels, they don't burst and release an egg.  Instead those follicles become cysts.  According to the ultrasound, I have more than 20 of these cysts on my ovaries with my right ovary having slightly more than my left.  This makes me ovaries twice their normal size and I sometimes get lower abdominal pain on my right side.  

What usually causes this to happen is an endocrine disorder through the entire body.  The endocrine system is your body's hormone system, including the sex hormones (estrogen, testosterone & progesterone), insulin, thyroid hormones, etc.  The hormones in your body work together to produce a delicate balance of your body systems. In PCOS, the hormones are out of whack. Most of the time, women with this disorder are insulin resistant (aka Type 2 diabetes) which is what causes the follicle not to burst.  High insulin levels with or without insulin resistance or high adrenal hormones (think adrenaline and cortisol) can also cause this to happen.  For me, I am not insulin resistance (yet) and since my doctor denied my request to test my other hormone levels, I'm not really sure what is going on with my hormones.

With insulin resistance, some women have difficulty maintaining or losing weight, skin tags, and darkened skin around the base of their neck, armpits and groin.  Lucky for me, I only have the difficulty maintaining or losing weight (which I will talk about more later) as well as skin tags in my arm pits.  For me, instead of my blood sugar being too high, it is actually too low under certain circumstances.  If I were to drink a pure sugar drink and nothing else, in about 2 hours, I would feel really bad because I would have low blood sugar.  This is called reactive hypoglycemia.  I drank the sugar drink as a test in the lab at the hospital and felt terrible afterward.  The reason for this could be because I have high insulin levels and it could be a precursor to insulin resistance.  Again, I'm not entirely sure because I don't have the tests to back it up.

In addition, another hormonal imbalance that happens is from the follicular cysts themselves.  Those cysts release male hormones (androgens, like testosterone) and estrogen.  As you can imagine, if you have many cysts, you will have a hormone imbalance.  In terms of female hormones, you can have too much estrogen and not enough progesterone.  So if I was to get pregnant, if I didn't have enough progesterone, I may not be able to sustain the pregnancy due to the fact that progesterone stabilizes the lining of the uterus for pregnancy.

As for the male hormones, too many androgens causes symptoms that many women with PCOS despise.  Some women get allopecia or hair loss which is somewhat like male pattern baldness.  Thankfully, I don't have this.  On the other hand, some women get hair growth in areas where men typically grow hair such as the face, chest, etc.  For me, I noticed thick black hair on the backs of my elbows several years ago.  Also, I had more hair growth on my toes, the tops of my feet and my upper thighs.  Luckily, I don't have to wax my face, although my husband always notices and wants to pull out those few hairs on my chin that grow extra long.  Thanks hun!

In addition to the hair issue, women will gain weight around the middle due to the increase in male hormones.  Obesity is very common in women with PCOS because it is so difficult for them to maintain their weight.  This has definitely happened to me over the past few years.  Also, acne is a huge problem for some women, but again, thankfully not for me.  Lastly if you've ever heard of  women "being hormonal", you can imagine that with hormones that are out of whack, it could produce some moodiness.  Depression is also in the list of symptoms for PCOS.

I left the biggy symptoms for last because they are obvious and troublesome for me.  First, you can probably see how conceiving a child in this condition can be tricky. This really concerns me.  Alongside this is irregular periods.  This is something that I've had ever since I could remember.  In the last year, it got worse and I only menstruated 6 times that year.  When I do, it is so heavy and long that it knocks me out.  I have to take iron supplements or else I get iron deficiency anemia.  This feels like exhaustion and tiredness that you would get only if you were drugged.  It feels like I'm living life through a haze.  If you can't tell, I hate this.  I'm normally a very active person so feeling this way is not fun for me.

So what causes all these wonderful things to happen?  Well, "they" aren't quite sure.  The prevailing theory is that there is some genetic connection.  Women with PCOS are more likely to have a sister, daughter or mother with it as well.  I'm ok with not knowing exactly why I have this going on.

Polycystic ovaries in my body means a few things for me.  First, I am worried about my ability to get and stay pregnant.  Until I am finished with school, I'm trying not to worry about this.  My biggest concern at the moment is the difficulty losing weight.  For the past several weeks, I've been on a 1340 calorie diet with extra calories when I exercise.  I exercise for 30-90 minutes every day so I usually average about 1750 calories per day.  However, after several weeks, it seems that I've stayed about the same weight.  This week, I've decreased my calories to 1270 per day to see if this will work.  I hope that I'll lose at least a half a pound per week this way.

Another concern of mine is the irregular periods.  Last month, I had my first set of periods back-to-back (one 4 weeks after the other).   I can't remember the last time this happened.  It has been more than a year.  Hopefully, this trend will continue.

So now that you know about this syndrome, I hope you might look at that obese woman with thinning hair, acne and skin tags differently.  She might be really struggling due to her hormones going crazy which is not something that she asked for or wanted.  Some people like myself have to go to extreme measures to not be overweight or obese.  I'll talk about that more in another blog post.  

Thanks for reading this long post and I hope you know more about what is going on with me and other women with PCOS.  Although PCOS sucks, I want to put it out there that it isn't the end of the world and I'm very thankful for the health that I do have.  Despite having polycystic ovaries, I think it is possible and imperative for me to remain positive.  It helps that optimism and the desire to fight to stay healthy is part of my personality.

So She Said to Lose Weight...

So this is my first blog post here. I want to keep track of my journey with polycystic ovaries paying particular attention to eating right and losing weight (at least for now). Later on, it might turn into a blog about trying to get pregnant. Conceiving can be quite a difficult task for someone with polycystic ovaries because ovulation is very irregular if at all. My husband and I have decided to start trying next year. I'm 32 so I feel like I need to get on it within the next few years. Also, we are at a point in our marriage where this would be a much welcome change to our family. Anyway, right now, I'm struggling with finding the proper treatment for what I have going on.

My gyno told me I have PCOS (polycystic ovarian syndrome) after an ultrasound of my ovaries and hearing the description of my symptoms. As a lay there on the table with an ultrasound wand jammed up inside of me, I saw my ovaries on the screen covered in cysts. Having worked in women's health as a student nurse and doula, I knew some of what that meant. The nursing student part of me that had heard about this, but never seen an ultrasound of it before, went, "Cool!" The woman inside of me that understood what it meant for me said, "Ah crap!"

Well I was sent out of the office with orders to have metabolic testing performed at the lab the next morning. My doctor asked about my exercise and eating habits. I told her that I am not always perfect, but I was a personal trainer and triathlon coach so I eat relatively healthy. I also told her that I run about 10-15 miles per week spread across 3 days. She looked at me with, "Yeah, right," written all over her face. I don't think she believed me. The advice that she gave me was to eat more vegetables, whole grains and some fruit (but not too much) and to avoid sweets. What did she think I was eating? Fast food and ice cream? Ok, I'll admit it, I do like to splurge on frozen yogurt. She also told me to cut out a day of running and add in a day of strength training because that helps to burn more calories. I rolled my eyes at her inaccuracy with that statement and went on my way.  She was correct in saying that I need to do strength training.

So all my labs came back within normal range, except for the reactive hypoglycemia from the 2 hour glucose tolerance test. When I asked her about it, she said that it was good because it wasn't high. Whatever...to a certain extent, I started ignoring what she has to say about things after she gave me the look of disbelief that I was running regularly. I'm angry that she won't test my hormone levels or send me to an endocrinologist. It seems to her that while I'm not trying to conceive, I don't need any of that. All I need to do is to lose weight. If you can't tell in my sarcasm, my eyes are rolling. I really don't think that losing weight will "fix" me.

I'm still learning, but some of what I have read has pointed to the fact that losing weight might help somewhat. During my teens and twenties, it has always been difficult to maintain my weight. For about two years in my early twenties, I was overweight so I did something about it....something drastic. I trained for triathlon. At first, I trained for Olympic distance races, then upped the ante to half Ironman distance and finally ended with Ironman distance races. Training coupled with a diet plan (weight watchers usually) is what it took for me to lose weight. Otherwise, I was completely unsuccessful. I didn't realize until now that this isn't what everyone has to do to lose weight.

Now that I am no longer doing triathlon training as I am back in school, I am having great difficulty not gaining weight. Over the past 2 years, I've gained about 35 pounds. So here's where the blog comes in. I want somewhere to record my journey, my struggles and my successes. Last Friday, I weighed myself at 179 pounds. When I was training for Ironman Canada, I was just under 140 pounds. For me, I think 145 would be a good goal. So here we go....