The Hemp Connection [Search results for decisions] 

Dear Doctor:

I have, or think I have, Polycystic Ovarian Syndrome (PCOS). In any case, I have a lot of symptoms that make my uncomfortable physically and mentally, and I really need your support on this one. Please know:

• I’ve been through a lot. Most doctors haven’t diagnosed me correctly, and I’ve had to deal with a lot of challenges getting to a place where I can try a new doctor, and have some trust that it might actually go well this time.

• I may have one or more female relatives who were undiagnosed and/or untreated for PCOS, and/or who died as a result of PCOS-related complications, such as heart disease, diabetes, or endometrial cancer. I may appear to be fearful and over-anxious as a result.

• I’m frustrated with how long it’s taken to get a diagnosis, not having complete information, and being treated as if my PCOS isn’t an important medical condition.

• I need to be treated with respect, especially when I describe symptoms that don’t make sense to you, or don’t fit the pattern. I need you to stretch your imagination, and ask even more probing questions.

• I may have medical trauma, especially if I’ve had lots of surgeries, one or more miscarriages, failed IVF attempts, a long bout with assisted reproductive technology, or if I received several diagnoses simultaneously. I’m trying not to be scared of you, but I’ve been poked, prodded, questioned, and inspected about as much as I can handle. I’m tired of having blood drawn, trying new prescriptions that don’t work or have horrible side effects, and having to show up at the gynecologist’s office a whole lot more than once a year. I’m tired of devoting huge chunks of my time, income, and emotional resources to chasing after a remedy or a cure. That doesn’t mean I’m not willing to do more, but it does mean that it may take me a bit to adjust to the idea of MORE.

• I need you to be patient while we’re figuring this out, and not give up on me. I understand from talking to other women with PCOS that it can take a while, a number of blood and fasting glucose tests, and some consultation before you can determine for sure that I have PCOS. I also know that sometimes you can’t be 100% sure, but maybe I need the same medical treatment anyway. I’m prepared for that, and I need to know you’re not going to get bored with my case before we’ve figured it out.

• I do my research. I’ve read books and articles about PCOS, and I follow a few blogs and chat boards about PCOS, so I know what other women with PCOS are going through. I know I’m not a doctor, but I may bring you information or questions gleaned from these sources. I hope you’ll take it seriously.

• I have valid opinions about what’s best for me, and sometimes that doesn’t mean traditional western medical care, or prescription medications. Right now, I’m open-minded, and I promise to keep you informed about anything else I’m trying. I hope you’ll support me as I try natural alternatives, dietary management, etc. And if you think something I want to try is actually dangerous to my health, please don’t pull any punches.

• I respect your input, and I still may need time to consider whether your recommendations are what’s best for me. It can be really overwhelming to be in your office, considering a lot of new information, and having to make what feels like very important decisions. Sometimes, I may bring a friend or my significant other with me, to help me stay focused. I still may need additional time to consider the options, and do my own research before I make a decision.

• I need you to be my healthcare partner, and my advocate. I view this as teamwork. You’re the one with the most knowledge about bodies in general, but it’s my body, and I’m definitely the expert on my body. Some other doctors don’t get that, and I need you to advocate on my behalf with them, especially on very important matters, like surgical decisions.

• I need you to be upfront about what this means for my health in the long run. I am willing to do the work to get well and stay well, but I need the big picture. I can’t make appropriate decisions without it. Don’t be afraid of scaring me. I can handle it (even if I do get a little upset in the moment).

• I need you to be aware that it’s very common for women with PCOS to have depression or other mood disorders, and to screen me appropriately, and sometimes with frequency. I need you to be fearless about making referrals when appropriate – and that includes mental health care. If I need a health psychologist, a support group, or some other form of therapy, please tell me so. Thank you!

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.

I've been presented with information recently from quite a few places, that has been the basis for making decisions about nutrition choices. And I've been asked for my opinion about these references. Unfortunately, not all of it is valid. Everyone reading this blog has the right to decide for themselves if they wish to believe what they read. I thought I would share how I decide for myself if information is valid when I research my blog posts.

1. Is it referenced? I don't base any important judgment calls on hearsay. With our audience this is especially important. First of all, many of you are in high-risk situations where even a small change in your nutrition status could affect your ability to achieve your goal. If someone cannot tell me where they heard that information, I don't share it.

2. Is that reference peer-reviewed? A peer-reviewed reference is an article, in a scientific journal, that had to go through a rigorous review process in order to even be published. Typically, a committee of experts reads an article, provides critique and feedback to the author, who then either rewrites the article or even goes back to the lab to collect information it was felt was deficient.

3. In a peer-reviewed reference, who funded the study? Unfortunately, the peer-review process is not perfect. Research studies are expensive, and a high percentage of them are funded by pharmaceutical companies and food conglomerates with much to gain if their product can be proven to have a certain desired effect. If the majority of information about a subject is funded by one corporate entity, without any pieces available to balance that finding, it may still be science, but it may exist because no one has paid for studies that might put this"promising" information into perspective.

(Just because something doesn't exist in a journal doesn't mean it's not true. It may just mean that it hasn't been studied yet. Filling in some of those holes is what we are excited about doing with our new research institute.)

I'm not a big fan of basing my decisions on published books, no matter how well-respected a person's book may be. Books are a collection of thoughts and opinions of a certain author, and they do not report individual research. There is a profit motive behind books, and in many cases less of a review process to balance the presented information. For example, I do love the book The Omega-3 Connection. However, it is important to know that the author of this book, despite his credentials, owns a company that sells omega-3 supplements. His recommendations are higher than what is commonly seen to be effective, which benefits him in an obvious way. And I've never seen him do any subsequent studies to fine tune or even lower recommended doses with updated information. So while I learned much from what he wrote, I did walk away from that time recognizing that there were limits to the claims the book made.

Book authors also need to do press and booksigning tours in order to recover the money invested in creating their product, and in order to get media coverage, their titles are often more sensational, their claims more promising than what may be seen in peer-reviewed publications. I'm more inclined to pick up a book written by someone who does have their own peer-reviewed publications than I am someone who is a clinical professional who decided to improve their own bottom line with a media blitz. But I never quote or base my own clinical recommendations on anything that comes from a book published by a mainstream publisher. I stick with the science.

Websites are pure tossup. Most of them have some kind of profit motive attached, and you must decide if that motive is consistent with your own value system. We even have our own profit motive at inCYST. We do our best to steer away from associations that would reduce our credibility, however. It is the well-being of the reader that we value first and foremost and refuse to compromise, no matter how comfortable our own lives would be from saying"yes" to a few more business offers than we actually do.

And there you have it.

Most people I work with know that they need to eat vegetables. They even eat them when served. But when it comes to planning, shopping for, and actually cooking them…there is a huge disconnect. Whenever I do a grocery store tour, I notice the participant body language change when we enter the produce section. When I start discussions about"How would you see using this?" there is often an uncomfortable silence before someone tries to answer.

One option I've really enjoyed for myself is a food coop. Rather than making up menus ahead of time, or showing up at a farmer's market not knowing what's going to be there and having to decide what to bring home, or having to make decisions in a crowded store at the end of a long day, a food coop simply puts together a food basket that you pay for in advance and pick up at a pre-determined time.

The beauty of this is that many of the decisions have been made for you. Your job is, to figure out how to use the items you've been provided. But the likelihood is, that since the food is already in your home, you'll eat it.

Years ago here in Phoenix I belonged to a food coop. I absolutely loved it. I would get things in my box I probably never would have purchased on my own, and what I learned in the process of researching recipes was always engaging. I have learned to like fennel bulbs and arugula thanks to that food coop.

Bountiful Baskets is a popular food coop here in Phoenix that many of my friends belong to. I love seeing their Facebook posts of what they got for the week, and following the conversations about ideas for what to do with the food. The picture in today's post is a picture of a typical purchase from Bountiful Baskets. They also, I learned in researching this, they also serve Colorado, Idaho, Nevada, Oregon, Texas, Utah, Washington, and Wyoming.

For the busy person, this can be a timesaver as well as encouraging better food choices.

Try a food coop and see for yourself!

Mindfulness. You hear that word a lot from people like me trying to help you move toward health…it's kind of a tough concept to describe. Over the weekend we were experimenting with the iPad and filming a pilot"Yoga for PCOS" class, and something happened during filming that perfectly illustrated how mindfulness works.

We live in a culture that is constantly bombarding us with stimuli. It has gotten worse in the past 5 years or so with the advent of smart phones, as we can literally be on alert 24/7 with beeps, buzzers, and"push" notifications. We can get so drawn in to social networking sites that we feel if we don't read every single status update, watch every single video, respond to every single event invitation, we are somehow missing out.

It is possible to spend an entire day connected to a screen, at the expense of losing connection to real people right in front of us. To see this for yourself, I challenge you to go for several hours with your phone and tablet left behind, and spend time in a public place. Look at how many people are focused on their phones…texting, IM'ing, talking…instead of participating in the world right in front of their faces. I have actually started turning off email and wireless connection on my writing days, so I am focused on one thing, and not constantly being tempted to shift my focus by random, multiple notifications coming at me from all directions.

The drawback to this is that when you are absorbed with your techno toys, you are also not listening to important messages your body is sending you.

You might ignore hunger. Which might seem like a good thing…except that in ignoring hunger, you often push yourself to the point of being ravenous before you respond to the cue.

You might ignore that you are tired, and stay up half the night playing Farmville, and you know if you regularly read this blog, poor sleep hygiene drives insulin resistance and worsens the symptoms of PCOS.

You might also ignore emotions. Feeling angry, sad, lonely, are uncomfortable to allow yourself to do. But those emotions are no different than physical cues, they are guiding you toward actions you need to take. If you ignore your emotions, they don't go away, they just amplify and amplify until they get your attention. If this is how you choose to deal with your emotions, their magnitude by the time that you are forced to acknowledge them, can be so great, that your response to them is at risk of being extreme--rage fits, excessive exercise, binge eating, alcohol dependence--are all common ways that people often deal with emotions they are afraid to face.

Mindfulness is a conscious exercise that develops your ability to be more aware, throughout the day, of how you are feeling. It is also called"being present". Your attention is on you, your immediate surroundings, and how you feel in those surroundings. If you pay attention to those things on an ongoing basis, and make conscious decisions about how you are going to address the situations, you can avert a lot of emotional outbursts, and binge/compulsive-type behaviors that sabotage PCOS management.

Meditation is a way to practice staying focused on yourself without being pulled away by distractions. Most people struggle with meditation at first, because until they start, they are not even aware of what thoughts and feelings they have been avoiding. It can be extremely uncomfortable. If you stick with it, it does get easier, you do develop more comfort with those thoughts and feelings, and they tend to not hit the magnitude where they convert into toxic behaviors.

When we were filming the other day, one of Sarah's kitties really wanted to help. So while Sarah and Deborah were busy focused on practicing meditation, kitty felt a little bit left out because her usual attention-getting behaviors were not working for her. (That is often what happens when we stop allowing ourselves to be distracted…the people who are positively reinforced by distracting us lose their own distraction and"up the ante" to pull us back into the unhealthy thing they need to do.)

So in this video, Kitty works and works and finally gets Deborah 's attention. For a split second, Deborah's focus on meditation was broken. But she quickly caught herself and got right back into the groove.

Now if it wasn't Kitty wanting some loving that could wait, and rather a sudden thunderstorm, Deborah may have chosen to prioritize getting out of
the rain.

Practicing mindfulness is exactly like that. You develop the ability to close out distractions. You can't ever really make them go away, life is about prioritizing and ably handling then,any distractions that are thrown in our path. The goal is to acknowledge them, just as Deborah acknowledged Kitty, and get back to more of a personal focus as quickly as possible.

Enjoy the video! It is one of several segments the kitties helped with…as the person behind the camera I was experiencing my own special mindful moments, working extremely hard to not disrupt the session with laughing, or peeing in my pants from not laughing.

We had a great time, and will have updates soon on how you can participate in our yoga program.

As women with PCOS, you've likely had troubles getting our health care system to work in your favor.

The information in this post was sent to me by inCYST provider Karen Siegel, and I wanted to share it with all of you. Specific issues are highlighted in the text below, and you can review the bill yourself at this link.

You may wish to go through this and consider how each of these stipulations would play out in your own personal PCOS situation. If you have suggestions for better ways to do things…get proactive and contact those who represent you in Washington!

I do my best to be nonbiased in this blog, but there are aspects of this legislation that disturb me.

Here are a few highlights of some problems with the healthcare bill.

These problems highlight the reason every bill must be read by the American people before they are signed. (if these points don't get you upset, please check your pulse and call 911):

Disclaimer: This summary was sent from a colleague. We encourage you to conduct additional research on your own.

• Page 16: Eliminates the choice to purchase private health insurance!
• Page 22: Mandates audits of all employers that self-insure!
• Page 29: Admission: your health care will be rationed!
• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
• Page 42: The"Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.
• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
• Page 58: Every person will be issued a National ID Healthcard.
• Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
• Page 65: Taxpayers will subsidize all union retiree and community organizer health plans.
• Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
• Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
• Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
• Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
• Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
• Page 124: No company can sue the government for price-fixing. No"judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed.
• Page 127: The AMA sold doctors out: the government will set wages.
• Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
• Page 126: Employers MUST pay healthcare bills for part-time employees AND their families.
• Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll
• Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
• Page 167: Any individual who doesnt' have acceptable healthcare (according to the government) will be taxed 2.5% of income.
• Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
• Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.

• Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected."
• Page 241: Doctors: no matter what speciality you have, you'll all be paid the same (thanks, AMA!)
• Page 253: Government sets value of doctors' time, their professional judgment, etc.
• Page 265: Government mandates and controls productivity for private healthcare industries.
• Page 268: Government regulates rental and purchase of power-driven wheelchairs.
• Page 272: Cancer patients: welcome to the wonderful world of rationing!
• Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
• Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
• Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies!
• Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
• Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
• Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
• Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
• Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
• Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
• Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
• Page 425: Goverment provides approved list of end-of-life resources, guiding you in death.
• Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
• Page 429: Advance Care Planning Consult will be used to dictate treatment as patient's health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
• Page 430: Government will decide what level of treatments you may have at end-of-life.
• Page 469: Community-based Home Medical Services.
• Page 472: Payments to Community-based organizations.
• Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
• Page 494: Government will cover mental health services: defining, creating and rationing those services.

Talk to Your Family, Friends, Neighbors & Co-Workers

You must talk to people about this. We need to get as many people informed about this as possible. Here are a few key points:

This issue is not Republican vs. Democrat. It is government vs. individual rights.
"What's the proper role of Government in our lives?"
"Do we really want the government making decisions for us that should be between me and my doctor?"
"Should the government be eliminating personal health insurance plans?"
"Should the government be requiring seniors to attend 'end of life counseling'?"

It has to do with breathing.

Something happens to all of us when we feel stressed…we start to breathe differently. Our breaths become shallower, using less of our lungs. The obvious consequence of shallow breathing is less oxygen getting to the brain. This is a stress in itself, which further changes the breath. When our brains are stressed, they don't always make the best decisions. They tend to go on"autopilot" and enact behaviors that are more impulsive, and less intentional. That can include eating, exercising, anything that is more compulsive/impulsive and less structured.

One of the things that yoga teaches, is awareness of the breath. Are you breathing? Are you breathing deeply? Or is it shallow? Do you even stop breathing at times?

Learning to breathe more effectively has been tremendously helpful to me in my own life. I do a lot of counseling and conflict resolution in highly emotionally charged situations with people who are anxious about conceiving, losing weight, feeling better about themselves. I've learned that if I focus on my breath while I'm in these conversations, I am much more grounded…not to mention useful…to the people who are reaching out for help.

Here's an exercise you can do to start to become aware of your breathing, even if you're not yet ready for a yoga class.

Lie on the floor, your sofa, or your bed. Place an object on your stomach, such as a book, a stuffed animal, or a pillow. Practice breathing in a way that this object visibly moves up and down. This is breathing that uses your entire lungs. Does it feel different? If it does you're likely not breathing well in general.

When you feel stressed, or feel the urge to binge, do this exercise for 100 breaths. See if you still feel like bingeing.

When you're in a meeting or otherwise stressful situation where you cannot do this, subtly put your hand on your stomach so you can feel it move up and down.

It's a simple trick with huge benefits…give it a shot!

We've been doing some really fun co-marketing with Green Mountain at Fox Run. This resort in Ludlow, Vermont is completely unique. It's not a posh spa. And it's not a sadistic, Biggest Loser kind of experience. It's simply a supportive place to step out of the environment that is likely not supporting your quest for health, and experience what healthful living is like…and feels like.

Marsha Hudnall of Green Mountain recently shared with me that a high percentage of women who find their website do so with the search terms"adult weight loss camp." That line of thinking is very telling. Weight loss camps and spas have effectively branded the mentality that a structured camp with attention to detail is the answer to weight and associated problems.

I've worked in structured environments before, and I can attest to the fact that any time a person moves into an environment where the majority of decisions are being made by other people with regard to food and activity, weight can change. So?!?!?! It's what happens AFTER that experience that truly matters. Did you gain insight into what caused the problem in the first place? Did you enjoy the experiences you had enough to want to recreate them at home? Are the recipes possible to simply recreate at home? Are the exercises you did something available to you at home?

Green Mountain at Fox Run is very good at helping you develop workable plans that are transportable out of Vermont. There are no extremes. Much of the focus is on developing a positive self-image, one that does not support the idea that if you are not punishing yourself in your quest for weight loss, you simply cannot be doing the right thing.

Perhaps one of the best things about the Internet is that people stumble on Green Mountain's website and realize there IS a different way to think. For those who aren't quite sure what they're looking for, but they have come to this blog, I wanted to describe what they offer so that it can generate some interest and consideration.

Green Mountain at Fox Run is a sponsor of this website. If you are interested in more information, please click on their logo at the right side of this blog.

If you’re a new reader of this blog, or you’ve got a new diagnosis, you are probably starting to realize that there are some changes you need to make if you’re going to be healthy while living with PCOS. Or perhaps you already knew that, or have had the diagnosis for a while, but you’ve been lurking here, just thinking about the idea of change, and not actually committing to change. That’s even an earlier stage in making change that is called pre-contemplation, where you haven’t begun to think about change (but typically, someone else, like your therapist, knows you need to change).

Change conjures up all sorts of feelings. For some, there’s a feeling of excitement and hopefulness. For others, there is sadness about leaving behind a lifestyle, a set of choices, some favorite foods, or a particular relationship or way of functioning. There may be fear about facing the unknown, lacking the knowledge to proceed in a healthy or effective way, or about how your life will rearrange as a result of the conscious changes that you’re making.

When it comes to the areas of exercise and dietary management, all of these issues and more may arise. If your situation is further complicated by depression, anxiety, or an eating disorder, it’s even more complicated. Depression may leave you lethargic and unmotivated; with your brain craving a rebalancing of serotonin, you may be consuming excess carbohydrates to try to fix the balance. Anxiety can escalate to such a place that any idea of change leads to fear and freezing; there seems to be safety in staying in one place, even if it’s an uncomfortable place. And of course, if you’ve got a history of eating disordered behavior, and it’s “working” for you, to keep your weight contained, then the trepidation factor may be enormous.

Here are some things about change that it may be helpful to think about, whether you’re in pre-contemplation, contemplation, or the actual process of creating the change:

• It’s your body, and your decisions. You own them; no one else does.
• You can change your mind at any time. If you’ve started down a certain path, and you really hate it, or it doesn’t appear to be producing results, it’s generally not a lifetime commitment (exceptions come to mind, like having a hysterectomy, or getting a tattoo).
• Medical, dietary, and psychological theory is continuously evolving, and you should be re-evaluating on an ongoing basis anyway.
• There’s no shame in trying. The shame comes from not loving yourself enough to never start trying.
• It really does take practice to produce change. Do some research on how to create that continuity. You may need to schedule exercise into your calendar at a certain time every day (when I was diagnosed with early onset Type II diabetes in 1998, I wasn’t exercising much at all, and I would literally schedule myself to walk for TEN MINUTES a day; every other week, I added five minutes to that time, until I reached 75 minutes a day, and had lost 72 pounds), join a group that meditates (they’ll teach and support you, and keep you accountable), or keep a food log (more accountability!) in order to adhere to whatever program of positive change you’ve devised for yourself.
• There are many people who will support you in creating the change you desire, and a number of them are found right here, at the inCYST community. Seek their help. You’ll be surprised how much support you can find online.
• If you’re trapped in a paralyzing fear, or find yourself repeating negative patterns, or quitting quickly time after time, there may be a deeper psychological issue at play. It’s worth a consultation with a health psychologist or other therapist to assess your behavioral patterns and choice-making skills.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.

I was just on a website for a local naturopathic physician who specializes in women's health and reproduction. She is well known in our area for her success with challenging conception situations. I love to refer to this particular naturopath because she is so skilled and compassionate.

I'm pasting some excerpts from her testimonials page.

"It was hard to hear from the MD's that I would not have a baby unless it was in-vitro…"

"I was told I was facing early menopause and may need an egg donor to conceive a child. When faced with paying more than $14,000 out of pocket per IVF attempt, which offered a 20% success rate and no guarantees, enough was enough."

"My reproductive endocrinologist told me I had little or no chance of conceiving a child. He told me if I wanted to try to conceive with my eggs, we should do IVF immediately, even though we had less than 10% chance of success."

These are all women who became pregnant when they decided to not listen to that advice and seek help elsewhere.

I hear these stories too. Sometimes I have a very hard time with the reproductive industry, despite the miracles they've created, because they often seem to prey on the desperation that can develop when a baby isn't easily created. They can make you feel like the problem is that something is wrong with YOU.

In many cases, the real problem to the doctor is that you're not giving him/her your money quickly enough!

What other service would you be willing to spend so much money for with so little guarantee of success?

I am so excited about what inCYST is learning and the success stories we've been able to be a part of. But what I'm still trying to understand is the psychology of the infertile woman. I offer classes for $15 apiece. That's about the cost of a copayment. That's a smoking deal compared to an in vitro procedure. Sometimes I even do them free of charge. But women I invite, often politely tell me, thanks but no thanks, I've made an appointment with my fertility doctor. I'll try that first.

One woman recently shared that even though she paid for the class and didn't show, she decided to go through in vitro. She ended up having to quit her job, because she could not manage the stress of the treatment along with her work responsibilities. She's pregnant, now, which is the good news. But she's financially challenged, to the point where she's asking me for free help. I'm not sure if that is success or not? And at that point, whose responsibility it should be that a $15 resource has become too expensive?

If you have two choices for earning money, one being interest in a bank account and the other being money won playing blackjack in Las Vegas…and you politely tell the banker thanks but no thanks, I'll bring you my Vegas winnings and I'll earn interest on that…and you lose your shirt in Vegas…do you think the bank is going to give you money to put in a savings account? Probably not. You have to make good decisions in advance.

It seems to me that the most important time a nutritional tuneup should be considered is precisely WHEN you've decided to invest in IVF. If it were me, I'd want to be absolutely sure that the environment I am giving my physician to work with when being paid to help me, is the healthiest, most balanced, most receptive to successful conception and pregnancy. What better preparation for success could you offer your reproductive system than nutritional health?

I know there is a huge difference between what you'll get in an inCYST consultation vs. what a physician provides. We're definitely going to ask you to make some changes. We're here to support, to encourage, and to point you to ways to make the new changes livable. Unlike a physician's visit, where most of the hard work is done by the doctor, we will ask YOU to do some things. We don't believe anything is wrong with you. We believe that life on planet Earth has its stresses, but if you learn how to manage them, hormones cooperate. Very simple.

We're not an"either-or" kind of choice, at all. We are not the only answer out there, and we are not ever going to eliminate the reproductive endocrinology industry. In fact, I think there are a lot of opportunities, when working together, for us to help increase some of those dismal percentages I quoted so the doctors have higher success rates as well!

Just a note, a friend just e-mailed me to tell me that this very topic was featured on the Today Show today. I Googled the website for the Fertile Soul, the program featured in their segment. Even their fees are high--as much as $12,500 for a couple to attend. I want to reassure anyone coming to this blog looking for help, I want to help people, and I do need to pay my bills, too, but our program is not about depleting anyone financially. Our one day couples spa program is only $350.

It just seems to me like when you have a choice between paying several hundred dollars and several thousand dollars, and you're seeing indications that the least expensive option may actually work, that you'd start low and work up the pay scale, if and only if needed.

I'd love it if this post inspires you to think differently. Sometimes medicine works and sometimes it creates miracles. But sometimes medicine has its limits. Why not try an inCYST provider or class or retreat and see if it gets you going in the right direction?

I recently went to Los Angeles to chat with ABC-7 Food Coach Lori Corbin, about some of the pitfalls of raw foodism. I'm not anti-raw, I just want anyone who chooses that lifestyle to make good decisions to insure that what they are doing does not cause more problems than it helps. Here is the link to the story. I have been working with our friends at Growing Naturals to develop a raw web resource, which was also mentioned in this story. It can be found at www.eatrawright.com. As we develop this site, you will be able to find information on how to transition to raw eating, how to prevent common nutrition-related imbalances, as well as recipes from popular chefs such as Chef Blythe Raw. If you live in SoCal, the restaurant where we filmed the ABC segment, SunCafe in Studio City, has cooking classes on Saturday mornings. If you've truly committed to eating this way, learn the right techniques and do it well. Information can be found on their website.

I recently mentioned that I was embarking on a mini-series of blog posts about the grief process, and how it relates to PCOS. I talked about a handy summary term known as DABDA, which stands for denial, anger, bargaining, depression, and acceptance. Denial is present in our lives in many ways, and it’s actually a very helpful defense – sometimes our minds go into denial, because unconsciously, they know that we’re not quite ready to handle a crisis, trauma, or issue yet. For example, the woman who sees signs of cheating in her marriage, yet overlooks the hints, bypasses opportunities to question her husband, and insists that her neighbor can’t be right – yet she KNOWS in her heart that it’s true. That’s denial.

In death, denial is often quite literally a failure to recognize or believe that a person is dead, that they died a certain way (i.e., suicide), that the death was unavoidable, or that they are not at fault in the death. While one is in the process of dying, the denial may simply be a belief that it is not possible to be dying from THIS – not me, not now.

Specific to PCOS, denial looks:
• “I don’t have PCOS – it’s something else – they just haven’t come up with the right diagnosis for me.”
• “PCOS is no big deal – I mean, I had to have an IVF and all, but whatever – I got my baby, and now I can ignore it.” J
• “PCOS isn’t like a terminal disease or anything, so why do I have to deal with it?”
• “Having a baby will fix it. That’s 10 years away, but in any case, I don’t have to deal with it now.”
• “Those medications don’t really work (so I’m not going to take them).”
• “If I just can find the right combination of supplements, this will all be okay.”
• “If I go gluten-free, I’ll be cured – but that’s so impossible, I won’t even try.”
• “I’m pretty sure that dark chocolate is a health food, so I’m going to have this entire 3.4 ounce bar.”
• “Exercise is overrated – I’ll just gain weight if I gain muscle mass, right?”

Denial’s great when it really is needed and protects you, like the child who is being molested and denies it until she’s an adult, when it’s actually safe for her to tell someone. Or when you just got a cancer diagnosis, and you don’t quite get that your particular cancer has a 75% mortality rate – and maybe if you realized that before you got a chance to explore treatment, you’d consider suicide to be a good option. Sometimes it’s protective.

Yet, as adults, most of the time, denial is working against us. It prevents us from seeing the real picture of what’s happening with our bodies, our lives, and our relationships. It prevents us from grieving. It keeps us from making decisions that will improve or protect our future. It stops us from eating better, or exercising more, or getting enough sleep (another favorite form of denial that I hear all the time is “I don’t know how I do it, but I can totally get along on five hours of sleep” – to which I say, BALONEY!). It stops us from spending money on the help we really need. It allows us to continue engaging in damaging behaviors, poor self-care, and unhealthy relationships.

If reading this gives you a little stinging sensation of recognition, there’s good news. You can start to acknowledge reality. Talking to someone who cares about you, sharing your fears and the thoughts you’ve been hiding, is a good start. If you can’t do that, put it in writing – it’s amazing how seeing it in black and white can help to bring clarity to your random thoughts.

Next week, I’ll address anger, and the insidious impacts that it has on your health.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.

The day after the FDA warning about pistachio nuts came out, I was in a local grocery store. As I walked through the produce aisle, I noticed the produce manager and his clerk with a huge bin; they were emptying out their inventory of pistachio nuts into a huge garbage bin. They had no idea where their pistachios had come from, and they had to throw them away.

I felt sad that so much food had to be wasted.

The day that the FDA warning about pistachio nuts came out, I received a note from Whole Foods Market. They were working to source where all their pistachio nuts came from. A detailed memo was released later in the week regarding the safety of pistachios in their many stores.

Please read this blog post and make your own decisions. But do consider the value in being an informed consumer. If you are judicious about where you shop, it may be worth a little extra investment. If you make a choice to purchase locally grown products at your farmer's market, you're not only supporting a local small business, you know exactly what hands your food passed through before it fell into yours.

There will come a time when pistachios will be considered generally healthy to eat, no matter what the source. And when that comes, keep these pistachio fun facts in mind:

--a one ounce serving of pistachio nuts scores higher on the USDA's antioxidant scorecard than a cup of green tea.
--pistachio nuts can help to reduce bad cholesterol and raise good cholesterol
--pistachio nuts are high in lutein and can help prevent macular degeneration, a leading cause of blindness
--pistachio nuts are a good source of many vitamins and minerals, including: thiamin, vitamin B6, copper, manganese, potassium, dietary fiber, phosphorus and magnesium
--pistachio nuts are a good source of healthy fats, including omega-3's

My point is…I hope you don't eliminate pistachios completely from your diet because of what you've heard in the news. The pistachio recall was specifically for pistachios from Setton Farms. If you can shop at a store or farmer's market where you can be assured pistachios did not pass through this processing plant, they can be a wonderful addition to your PCOS eating plan.

Here's a recipe for white bean pistachio chili to get you started!

I've been surrounded by sadness recently. Not the kind of sadness it's easy to be around. I've been in some situations with people (not clients, an important distinction), who just don't seem to be happy unless they are completely miserable. No matter what solution I propose to alleviate the problem they've identified and suggested I might have a solution for…a remarkable ability to cling to the misery rather than considering the solution has been the outcome of the effort.

I have found myself singing a song to myself, that comes from a variety show popular when I was a child:

I received an email this morning from a college friend, containing an article that actually scientifically studied this phenomenon, of why some people have good luck, while others seem to be overwhelmed and consumed with bad luck. I certainly do not wish to minimize anyone's misfortunes with regards to their PCOS. But I do hope to encourage at least some of you to challenge yourself to look at your own life's"magazine" with different lenses. Perhaps there are opportunities to be seen…if you're willing to look at things a bit differently.

The text to this article is provided below:

Be lucky — it's an easy skill to learn
Those who think they're unlucky should change their outlook and discover how to generate good fortune

A decade ago, I set out to investigate luck. I wanted to examine the impact on people's lives of chance opportunities, lucky breaks and being in the right place at the right time. After many experiments, I believe that I now understand why some people are luckier than others and that it is possible to become luckier.

To launch my study, I placed advertisements in national newspapers and magazines, asking for people who felt consistently lucky or unlucky to contact me. Over the years, 400 extraordinary men and women volunteered for my research from all walks of life: the youngest is an 18-year-old student, the oldest an 84-year-old retired accountant.

Jessica, a 42-year-old forensic scientist, is typical of the lucky group. As she explained:"I have my dream job, two wonderful children and a great guy whom I love very much. It's amazing; when I look back at my life, I realise I have been lucky in just about every area."

In contrast, Carolyn, a 34-year-old care assistant, is typical of the unlucky group. She is accident-prone. In one week, she twisted her ankle in a pothole, injured her back in another fall and reversed her car into a tree during a driving lesson. She was also unlucky in love and felt she was always in the wrong place at the wrong time.

Over the years, I interviewed these volunteers, asked them to complete diaries, questionnaires and intelligence tests, and invited them to participate in experiments. The findings have revealed that although unlucky people have almost no insight into the real causes of their good and bad luck, their thoughts and behaviour are responsible for much of their fortune.

Take the case of chance opportunities. Lucky people consistently encounter such opportunities, whereas unlucky people do not. I carried out a simple experiment to discover whether this was due to differences in their ability to spot such opportunities.

I gave both lucky and unlucky people a newspaper, and asked them to look through it and tell me how many photographs were inside. On average, the unlucky people took about two minutes to count the photographs, whereas the lucky people took just seconds. Why? Because the second page of the newspaper contained the message:"Stop counting. There are 43 photographs in this newspaper." This message took up half of the page and was written in type that was more than 2 inches high. It was staring everyone straight in the face, but the unlucky people tended to miss it and the lucky people tended to spot it.

For fun, I placed a second large message halfway through the newspaper:"Stop counting. Tell the experimenter you have seen this and win £250." Again, the unlucky people missed the opportunity because they were still too busy looking for photographs.

Personality tests revealed that unlucky people are generally much more tense than lucky people, and research has shown that anxiety disrupts people's ability to notice the unexpected. In one experiment, people were asked to watch a moving dot in the centre of a computer screen. Without warning, large dots would occasionally be flashed at the edges of the screen. Nearly all participants noticed these large dots.

The experiment was then repeated with a second group of people, who were offered a large financial reward for accurately watching the centre dot, creating more anxiety. They became focused on the centre dot and more than a third of them missed the large dots when they appeared on the screen. The harder they looked, the less they saw.

And so it is with luck — unlucky people miss chance opportunities because they are too focused on looking for something else. They go to parties intent on finding their perfect partner and so miss opportunities to make good friends. They look through newspapers determined to find certain types of job advertisements and as a result miss other types of jobs. Lucky people are more relaxed and open, and therefore see what is there rather than just what they are looking for.

My research revealed that lucky people generate good fortune via four basic principles. They are skilled at creating and noticing chance opportunities, make lucky decisions by listening to their intuition, create self-fulfilling prophesies via positive expectations, and adopt a resilient attitude that transforms bad luck into good.

I wondered whether these four principles could be used to increase the amount of good luck that people encounter in their lives. To find out, I created a"luck school" — a simple experiment that examined whether people's luck can be enhanced by getting them to think and behave like a lucky person.

I asked a group of lucky and unlucky volunteers to spend a month carrying out exercises designed to help them think and behave like a lucky person. These exercises helped them spot chance opportunities, listen to their intuition, expect to be lucky, and be more resilient to bad luck.

One month later, the volunteers returned and described what had happened. The results were dramatic: 80 per cent of people were now happier, more satisfied with their lives and, perhaps most important of all, luckier. While lucky people became luckier, the unlucky had become lucky. Take Carolyn, whom I introduced at the start of this article. After graduating from"luck school", she has passed her driving test after three years of trying, was no longer accident-prone and became more confident.

In the wake of these studies, I think there are three easy techniques that can help to maximise good fortune:

Unlucky people often fail to follow their intuition when making a choice, whereas lucky people tend to respect hunches. Lucky people are interested in how they both think and feel about the various options, rather than simply looking at the rational side of the situation. I think this helps them because gut feelings act as an alarm bell — a reason to consider a decision carefully.

Unlucky people tend to be creatures of routine. They tend to take the same route to and from work and talk to the same types of people at parties. In contrast, many lucky people try to introduce variety into their lives. For example, one person described how he thought of a colour before arriving at a party and then introduced himself to people wearing that colour. This kind of behaviour boosts the likelihood of chance opportunities by introducing variety.

Lucky people tend to see the positive side of their ill fortune. They imagine how things could have been worse. In one interview, a lucky volunteer arrived with his leg in a plaster cast and described how he had fallen down a flight of stairs. I asked him whether he still felt lucky and he cheerfully explained that he felt luckier than before. As he pointed out, he could have broken his neck.

I want to talk about something that isn't easy to talk about--anger.

My assistant with this blog post is one of my very best friends…Bobby, a cat I have befriended while volunteering at the Arizona Animal Welfare League.

Bobby is one of the funniest, sweetest, most playful, interactive cats I've ever known. He loves to chase anything you throw across the slippery tile floor. He's taught himself to drink out of the cattery water cooler. If anyone opens the drawer where the catnip is, whatever Bobby is doing, he comes running full speed, jumps in the drawer, and starts looking for a"hit". Tina, our vet tech, says that her favorite part of the day is when she comes in the morning, as soon as he hears the door open, he comes running with this look like you're the most important person in the world, and he's sooooooooooooooooo happy to see you.

Bobby hasn't always been that way. He was rescued from the euthanasia list at our county animal care and control. His owner moved, decided he didn't want Bobby anymore, and left him, like many animal owners do, to the whims of people who have way too many decisions to make about which animals to save and which ones they can't. Fortunately, our team at AAWL saved Bobby from a potentially horrible fate and brought him to be with us.

For months, he was grumpy, sullen, he'd swat at anyone who tried to come near. It was clear, Bobby was miserable and going through a grief process without many outlets to express his confusion, loss, anger, and loneliness.

I asked for permission to spend one on one time with him whenever I could. The first few weeks, he was so traumatized when I simply picked him up to take him into our private room, I had to leave him alone for 20 minutes to chill out before I could even be in the room with him. When I finally went in, I'd let him sit in his corner while I focused on entering medical records. Suddenly, one day, I looked, and he was by my feet, belly in the air, just looking at me. But when I went to touch him, I got a firm swat.

Every time I went in after that, I saw more belly, and got fewer swats. We've got such a bond now that Lisa, the cattery manager, lets my day at the shelter be the one of Bobby's free roaming lobby days.

Bobby has taught me so much about the women I work with who read this blog, attend my classes, and ask for individual help.

Anger, even when it's intense, and even when it hurts to be on the receiving end of it, almost always is about fear or hurt, or loss. It's what animals and people let out when they feel scared, vulnerable, and/or uncertain, and they feel the need to protect themselves.

You have a right to feel angry if you've been given weight loss advice that didn't work. You have a right to feel betrayed if someone took your money and gave you promises in a bottle of supplements and it did nothing for you. You have a right to feel intensely sad if you've lost a pregnancy. You have a right to question who we are on this blog, and to wonder what it is that we want from you. You have a right to be skeptical about this information.

And, most importantly, no matter what you're feeling right now, be it anger, frustration, fear, loneliness, no matter how intense, or how sideways it might come out in this moment, you have a right to feel it without anyone telling you it's wrong.

I like to see repeat visits in my webstats. They're kind of like Bobby's belly. It tells me we're gaining your trust. And it gives me hope that some day, you'll decide you have a right to trust some of the ideas we share.

And over time, as trust develops, I also like to hope that even some of the smallest things we talk about are things you decide to try.

It's little steps that add up to big changes.

I'm glad Stacy Korfist is here with us, because she's a therapist who is specially trained to help people understand their feelings and behaviors. I know she'll have some great advice and insights for all of us when it comes to anger, frustration…you name it.

I'm glad you're here. However it is that you're feeling today. Whatever it is that you think of our material.

And I hope you come back very, very soon.

OK, you got up this morning, looked at your naked body in the mirror and sighed, wishing it looked more like that of media kittens Britney Spears or Katy Perry. How in the world can you feel young and sexy when PCOS is working so hard against you? When"Black Swan" feels more appropriately like how you feel?

It's just so much work to live with this disease. It's certainly no tea party. Why not just head for the chocolates right now?!?!?

I'll make you a deal.

--I'll continue to provide free advice, recipes, and education here on this blog, with hopes that you can save some money and reduce your sugar cravings. I'll work to"legalize" as many foods that you've been afraid to eat as possible.
--I will advocate for the health care system to take women more seriously without allowing the politics of reimbursement to interfere with your getting the best possible advice and treatment you possibly can. (You'll see an installment of that part of my promise later this week here on the blog.)
--I'll do my best to make sure the big guns with power to make decisions affecting your well being always have PCOS on their radar…and to make sure they know at least as much about this problem, if not more, than a passing issue like swine flu.
--I'll work to make it more attractive to businesses to offer deals that help you to be healthier, that are more useful than free iPads, even free Viagra.
--I'll work to develop as many Internet-based services as possible and expand the network as much as possible so that there is little need to travel far to get the help you need.

Whether the issue is PCOS or same-sex marriage, it frustrates me immensely when I see entire groups of people singled out and made to feel like somehow they're"less" because they're"different" (I prefer unique). I am inspired to advocate for respect and equality.

All I ask is that in return, today, you do just one thing for me. Actually for yourself.

Look in the mirror. Smile at who is looking back. Tell that smiling face she's beautiful. And do something nice for her.

After all, if I'm devoting my career to working on behalf of all of you, shouldn't you cut that woman a little slack and give her some love as well?

Be good to yourself today. You're the most important Valentine there is to be in love with.

Happy Valentine's Day!

I love to work out. But I am especially sensitive to the fact that the word"exercise" doesn't conjure up the most pleasant thoughts to people who do not regularly do it, or who have been told that they have to do it, or that they need to do it. Or who tried and were humiliated by some comment someone made when they did work up the nerve to go out and try it.

So instead of being one of those nutritionists who presents as someone who came out of the womb wearing Nikes, and serving only to further intimidate you from getting started, I thought I would tell you a little of my own story.

I have not always loved exercise. I have always loved books. My mom loves to tell the story about the time as a child when I was sitting cross-legged on the floor engrossed in reading something. She wanted to spank me for something I'd done, so she asked me to stand up. I did, she spanked me, and I sat down. I never stopped reading the entire time.

These days, being such a reader is what benefits all of you, because I share what I learn in my writing and teaching.

But in first grade, it didn't work out that way. I was always the last kid chosen for teams. I wasn't really encouraged to exercise because I was pegged early on as studious. So I didn't really have a lot of experiences to reinforce that it could be fun.

Fast forward to fourth grade. I joined a softball team. I struck out practically every time I was up, but looking back I think it was because I was so stressed out about failing at the plate that I actually struck out before I even stepped up to bat. The pitcher on that team was frustrated with me, probably because she saw me as dragging the team down. She started to tease me. Which only made things worse.

Finally, my dad told me to imagine that the softball was the pitcher's head. You know what? The next time I stepped up to bat I didn't just hit a home run…I hit a grand slam. I learned that people start to treat you differently when you prove them wrong. And when they had faith in me, and I started to have faith in myself, my batting average started to improve.

Since then, I've started trying different sports. And I learned, much to my surprise, that I'm actually kind of athletic. I don't just love skiing…I LOVE the moguls. I don't just love running, but I LOVE running long distances. There are some sports I don't like so much. But I am empowered now to say I don't like a certain sport, rather than say I don't like ALL sports because I didn't have fun with one.

Even though I now even have a master's degree in kinesiology, I still don't think of myself as an athlete. But I do like to learn and achieve, and sports has become a new place to apply those qualities.

These days, I'm working on my golf game. It's really challenging, but I love it exactly for that. I mentioned to a guy friend of mine that I didn't understand why more women don't play golf. His observation was that the many women he'd tried to interest in the sport were afraid to try it because they wouldn't be perfect the first time out. I can understand where some of these women come from, if their early experiences were like mine. What a loss, to let what other people told you about your athletic potential keep you from learning something with potential to be fun?

Are you keeping yourself from exercise because you don't view yourself as an athlete? Who decided that for you? Do they deserve to keep you from moving, today? Or achieving anything in life, for that matter?

Make this the day the one you put YOUR goals and dreams in charge of how you make decisions. You can be anyone you want to be…an athlete, a student, a friend…if you decide that's what you want to be.

Last night evening news reporters shared that a new anti-obesity drug is headed toward approval. I Googled this drug,"Contrave", to learn more.

On the the manufacturer's website, there was some technical information about this drug (see below). What caught MY eye, however, was a deviation from facts to the following commentary:

We believe that bupropion helps initiate weight loss while naltrexone may sustain weight loss by preventing the body’s natural tendency to counteract efforts to lose weight.

Really? It has been scientifically proven that the body has a natural tendency to resist weight loss?Well, if you believe that you're helpless and without any solution other than a medication, you're more likely to help this company's profit margin. That's what they need you to believe in order to satisfy their investors!

The buzz on the news was that the drug has been shown to induce a weight loss of 5%. That means if you're 250 lbs, you can expect to lose about 12 1/2 of them. We've been taught as health professionals, to tell the public that a small weight loss of 10% of body weight can have important health effects, and not to focus on large, drastic changes. But taking a pill to achieve only half of that? Not impressive at all.

I'm insulted for this blog's readers. Can't you do better than that? Can't you just tell the truth about the drug and trust that it has potential in certain cases? Which I'm sure it does? I like to think most people who I have ever come in contact with, deserve much more credit than that. They can make intelligent decisions and do not need to be manipulated in this fashion.

Here are the facts about the medication.

1. It is a combination of two medications that have been used for a variety of clinical purposes, naltrexone and bupropion (Wellbutrin).

2. Naltrexone is an opiate antagonist. According to NIH, it is"used along with counseling and social support to help people who have stopped drinking alcohol and using street drugs continue to avoid drinking or using drugs." The link above provides a pretty long list of contraindications and side effects, and they include pregnant and trying to become pregnant…not likely a great option for many of our readers.

3. Bupropion is an antidepressant that has been found to help facilitate weight loss. It's been used for this off-label purpose for a long time. Not that it can't help, especially if there is depression accompanying your weight gain (not ABOUT the weight gain but as a co-existing condition). But I believe there are many things about most of our audience that can be done to alleviate depression and normalize weight which should be tried BEFORE resorting to medication.

If anyone from Orexigen can produce peer-reviewed research supporting the claim that the body resists weight loss, they're welcome to comment on this blog.

Until that happens, I maintain that any time someone tries to tell you that you can't do something, and your believing them holds potential to transfer money from one bank account to another, you should consider the tactic a challenge to prove them dead wrong.

There is a lot of demand for milk alternatives, for a lot of reasons. Some of you are lactose intolerant or have tested positive to a dairy allergy. So I wanted to compare the alternatives for you, if you fall in either of these categories, to give you some facts on which to base your personal decision.

Before I move on to milk alternatives, a word about cow's milk.

I'm not pro- or anti- cow's milk. I simply want you to have the facts about all of your options and base your decisions on facts. Much of what is said about cow's milk is personal opinion, not based on peer-reviewed evidence. In fact, there is not a single peer-reviewed article in the National Library of Medicine database even mentioning any kind of relationship between PCOS and cow's milk.

What IS found in that database, is a study I often cite, written in part by respected Harvard researcher Walter Willett, in which it was reported that women who consume one fat-containing serving of dairy a day were actually more fertile than those who did not. The statistics used to evaluate this relationship were derived from data obtained in the Harvard Nurses' Health Study II, from 18,555 registered nurses over a period of 8 years. Those are pretty impressive credentials! So I find the conclusions to be worthy of your consideration. Keep in mind, these women were not advised to change the type of milk they drank, so they were not steered toward raw milk, organic milk, or any other variation. They were most probably drinking plain milk you get from the corner grocer.

The researchers corrected for vitamin D and lactose, meaning vitamin D and lactose in the diet in the millk drinkers was NOT the explanation for this finding. In their words, their conclusion was this: "High intake of low-fat dairy foods may increase the risk of anovulatory infertility whereas intake of high-fat dairy foods may decrease this risk."

If you've been avoiding cow's milk and vitamin D supplementation isn't doing the trick for your vitamin D levels, I strongly encourage you to consider a second reason for drinking cow's milk. If you've been eating yogurt assuing it's an appropriate substitute for milk, it's not. Most yogurts do NOT contain vitamin D. Try switching to milk (at least 1%) and see if it makes a difference.

For those of you drinking milk, I'd like to encourage you to consider antibiotic, hormone-free, organic, grass-fed. It's not something that is readily available (many organic brands are not grass-fed), but keep your eye out for it and grab it when you see it.

Like I said, I don't care if you do or don't drink milk. I just want to be sure of two things:

1. That your choice to drink or not drink cow's milk is based on fact and not on someone else's opinion who may not have a handle on YOUR personal physiology. Every single case of PCOS is different and it is not clinically sound for anyone to make a blanket recommendation about milk to all women with PCOS.

2. That if you choose to drink cow's milk, you know what kind is most supportive of hormone balance, and if you choose not to drink cow's milk, you know what adjustments you need to make to your overall diet in order to make up for deficiencies that eliminating an entire category of foods may be creating.

On that note, tomorrow I'll summarize the pros and cons of milk alternatives.

I've been managing a pretty major remodeling project over the last six weeks. I have an 1100 square foot condo that needed new flooring. It had been decided that tile would be the option. However, when the tile guys got there, they realized that the older building my second floor condo is in, had sunk enough so that the difference between high and low spots was too significant to make tile the option. They had to work out a complicated mix of carpet and tile to do the job.

Here is the"before" photo. That table is office #2 from where many of these blog posts are created.

Here is the"after" photo. Well…for about 24 hours. Once the grout dried I immediately had to start moving everything out of the bedrooms and closets onto tiled areas so carpeting could commence.

The carpeting job ended 2 weeks ago, but this is pretty much what my dining room looks like today. Not because I'm lazy or sloppy, but because I decided that since I rarely have occasion to go through every single item I own and decide if it needs to stay or go, I was going to use this as an opportunity to perform a massive"feng shui".

I have a lot of papers that were stored in boxes, artifacts from the days before the Internet when us intellectual types kept every piece of printed material we had in case we needed it. Now we don't need to do that, because most information is somewhere in the cloud.

It's a hard habit to break though, hanging on to things in case you need them. I'm big on not wasting things or unnecessarily using landfill space, so I'm trying to make a good decision about every single piece of paper, trinket, electrical cord. My personality type is such that I can only do this for a short time before I lose focus and start throwing things in boxes to get the task overwith. So I promised myself this time I would not do that. I only ask myself to make 10"what should I do with this?" decisions a day. As you can see by the massive size of this pile (and it's only half of the pile!), being so diligent means I'm going to live with the pile for awhile.

The first week it felt like I was never going to get there. But the day before Christmas I looked and saw that one whole corner of the dining room was free of clutter. And the office, where most of this stuff had been stuffed into the closet and started to overflow into the room…was so clean and crisp that I was far more productive working in there than I ever had been. All that clutter was interfering with my focus and concentration.

The process reminds me somewhat of the old advice for eating an elephant: one bite at a time.

And as with gardening, it made me think of many of you. How you might be anxious to lose weight and how frustrating it can be to see it come off slowly, some days seemingly not at all. But how if you stick with it, one day you look up and the progress is just THERE. If you lose focus and start going at the task in a disorganized fashion, you'll get rid of the chaos at the superficial level by shoving it in the emotional closet, but that mess is still there…and as with my closets…has a tendency to grow and multiply on its own if left untended.

It doesn't matter how small your effort is today. If it's an effort and it moves you even a tiny fraction of a millimeter in the direction you'd like to go, it will pay off.

I'll post updates when both the office and the dining room are truly back in action!

Monika, I want to add to your post about a"Bill of Rights" for pcos cysters, only I have termed it"Fifteen Tips for PCOS Physicians". Everyone, please feel free to add to it.

Fifteen Tips for PCOS Physicians
Stacy Korfist, LMFT

1. Please do not minimize, downplay, disregard or discourage our researching on the internet. PCOS is a chronic condition, one that requires our understanding of what is happening to our bodies. That cannot occur in a 20 minute doctor’s appointment and to take better care of ourselves we need to have a full understanding of a very complicated endocrine system.
2. If you do have concerns however, please ask which websites we are obtaining our information from, be familiar with them and either offer better alternatives or affirm the resources we have.
3. When assessing degree of hirsutism please be sure to ask about our maintenance practices. Sometimes it can look fairly mild but it is misleading because we spend an extraordinary amount of time plucking.
4. Be conscientious, but thorough when addressing weight. For those that are not obese, but hovering around the high end of the normal BMI range or over, it’s probably not ok with us. Please do not say that we are ok and not to worry. We are worried. Worried that we will stay that way, worried that we will continue to gain, worried about plenty.
5. If you do not know the answer to something, please just say so. We know doctors aren’t taught everything in medical school. It will earn our respect. In fact, if we teach you something don’t be shy to tell us so.
6. Please do not tell us to exercise more and eat less without also referring us to a dietitian. Have the name of several good dietitians that treat pcos and develop a professional relationship with them as well.
7. In fact, work with a multidisciplinary approach. Ask if we are interested in seeing a psychotherapist if needed. Know of various referral sources such as hair removal clinics, acupuncture centers, infertility support programs.
8. Be aware of each and every medication, herb and supplement we are taking.
9. When we make our appointment, ask us to be prepared with questions and concerns upon our arrival so that we may make good use of your time.
10. Allow us to take part in the decisions being made about our health. Inform us of respected alternative therapies, even if it’s something you may not provide or even agree with.
11. Be certain we are aware of all health risks related to pcos, now and over the lifespan. There are many and this will take time. Be sure we understand strategies for prevention. If we are minors be sure our parents know how to best support our needs.
12. Stay current with treatment approaches and healthcare industry trends. Be an advocate and get involved. Step out and teach others.
13. Make a follow up appointment with us.
14. Explain the lab work. Don’t just say everything is in normal range, especially if it’s something that shows deterioration. Allow us to ask questions.
15. Most importantly, treat us as an individual and not just be a cookie-cutter practitioner. This can only be accomplished with good listening skills.

If you are a physician and have taken the time to read this then you are one of the good ones.

Stacy Korfist, LMFT Redondo Beach, CA
310 720-6443