Over the last couple of months, I’ve written extensively about the grief process, and how it applies to PCOS. There is so much to grieve – loss of health, femininity, children, old unhealthy lifestyle choices, even perhaps one’s obesity or body shape. If you missed any of the posts about the grief process, discussing the DABDA model (denial, anger, bargaining, depression, and acceptance), you can find them archived on the inCYST.com site.
Here are my thoughts on what comes after the grief. When you have a death in your life, there’s typically a funeral, or sometimes a life celebration. This celebration occurs while you’re in the depths of your grief, not when you’ve finished grieving. Grieving can be a lengthy and recurrent process, depending upon the circumstances of your life. Events like a new diagnosis, a miscarriage, or simply the arrival of your period if you’re trying to conceive might all feel like losses. Interspersed with the grief, there are still moments of happiness, humor, and even full-blown joy.
If you’ve started to grieve the losses associated with PCOS, I encourage you to also start your own private life celebration, in concurrence with your grieving. Capitalizing on the bright moments is part of an overall strategy of improving your mood by focusing on the positive. Life celebrations usually include music, food, and the company of people that you love. My life celebration is a constantly evolving practice that focuses on the things I’m grateful for, that support my health and give me deep pleasure. For example, today is my day of rest. I got to sleep in, have a cup of chai with my honey, enjoy some lap time with my cat, practice yoga under my favorite tree, enjoy a delicious, healthy and satisfying breakfast of homemade huevos rancheros and mixed berries, and even get in a short walk at the beach. To cap off the decadence, I’m going for a mani/pedi, and will indulge in my one pointless and naughty hour of serious television watching this evening. Swwwwweeeeeeeet! I feel GOOD, and even though I still have some minor pain due to an ankle injury, I’m celebrating my life. It’s rich and satisfying in many ways. Making this list makes me appreciate it even more.
When I focus on the fabulousness of this list, I’m not focusing on the fact that every day can’t be Sunday, that I need to get up to an alarm clock tomorrow, or that I have to make some unpleasant calls to an insurance company, plus go straighten out something at the bank. I’m just focused on enjoying and celebrating my life – my life with PCOS!
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.
Why in the world, the day after Thanksgiving, if I'm trying to de-stress you…would I put up a piece of pie…pie being something you likely don't even want to think about today?
Because my concept of stress is exactly like pie. Life tends to be less stressful if your"pie of life" is divided into more pieces. If your life has only a few facets, and something happens in one part of your life that is stressful, you have fewer places to go that can provide you a diversion while your mind works out a solution.
I'm posting my pie here, so you can see what I mean. I do what I do because I love it. But I can get really hyperfocused on it. And when business is slow…like it was just before the election…that can be very stressful. Fortunately, I also love to garden. There were weeds outside that needed to be pulled, so I started taking a work break every afternoon to clear a small piece of land. And you know what? While I was weeding, some new ideas for my business came to mind that jump started sales again.
It is easy, as hard as I work, to become a little inbred as far as my social life goes. So I decided a few years ago, to volunteer every Friday afternoon at a local no-kill shelter (which you should visit sometime if you're in Phoenix!). I have befriended a whole group of people who have absolutely nothing to do with my business. I love going down there and having a place where I'm Monika the cat adoption counselor, not Monika the nutritionist. (Well, that plus it's impossible to be stressed out after 5 minutes of being in the nursery with a dozen little ones simultaneously using you as a scratch post.)
I love to work out, but on days when it's raining or I'm just not feeling good and need to rest, I love to do calligraphy, read a Presidential bio, or refinish one of my antiques. Again, so many perspectives and ideas come to mind for work and social situations that seem to be locked up when I focus too hard on places where there are problems.
If you're struggling with fertility or weight loss, or any stressful situation, for that matter, the problem can just become larger than life. It can be all you think about. You can find yourself on the Internet, visiting blogs, reading books, etc., focusing entirely on your problem. And all the stress that builds up when you go to places where you only immerse yourself in more of the stuff that bothers you…can make it hard for your body to make progesterone.
Take a minute and look at your own pie. How many slices is it divided into? How many different communities of friends, coworkers, activity parteners, etc., do you belong to? Are you so focused that you have yourself backed into a stress corner?
Could it be…today is the day you have your coffee in a new Starbucks and strike up a conversation with a new person in line, rather than blasting in and out of the same place without looking at a single thing around you? Is it the day you buy that basil plant at Trader Joe's as a starter piece for your new herb garden? Is it the day you sign up for that Italian class you've been wanting to take? I'm so appreciative that you're reading my blog, but I would never expect it to be a complete and total answer to your PCOS, or to substitute for the well-rounded life that you deserve to have.: )
OK, now that THAT has been settled, I am going to paint my dining room today and then finish off that James Buchanan bio I found at the library. But first, I think it's time to head into the kitchen for some leftovers. Yes, I have to admit, leftover pumpkin pie is one of my very favorite breakfasts!
I wrote this article two years ago for a newsletter I was publishing. As we face a very important issue in the Gulf of Mexico, the issue of farmed fish needs to be revisited. I hope this creates awareness and opens up dialogue. For my nutrition colleagues reading this blog, we can be such an important part of the solution…provided we disseminate the real facts.
Despite our current love affair with salmon, our relationship with this cold-water fish has not always been productive. As recently as 30 years ago, it was reported that as much as 80% of a year’s supply was commercially fished out of the water. Despite an awareness of a need for better fishing practices and attention to sustainability, recent salmon fisheries were shut down along the Pacific Coast due to drastic drops in supplies.
As salmon gains favor as the fish with the highest known concentration of the coveted omega-3 fatty acids, threats on its numbers, and its ability to sustain itself, are only likely to increase. One answer to maintaining salmon populations has been to farm them. However, fish farming has not been an industry that has been met with open arms. Current popular wisdom—and professional recommendations—tend to lean toward “wild Alaskan salmon” as the ultimate in seafood choices. However, it is just not that simple.
It is not at all a Free Willy scenario.
It is important to understand what “wild” really means. These “wild” salmon we envision with a lifetime of free ocean swimming are not all that likely to start life as a salmon egg hatching free of human contact and growing into an adult that has lived a life free of farms, pesticides, or any human mishandling.
Salmon are a migratory fish. In an ideal scenario, they would have free access to both oceans, where they would spend most of their time, and rivers, where they swim to reproduce. Unfortunately, as many rivers the salmon used for spawning were dammed to be used for generating hydroelectric power, the salmon lost their breeding ground. In order to keep the prized fish from completely losing reproductive ground, salmon hatcheries were developed. It is here that salmon eggs are collected and hatched, and where a very high percentage of “wild” salmon begin their lives.
Actually, the process is a little more involved. Adult salmon are killed. Their eggs and sperm are collected and combined, and the fish resulting from this process are raised in the hatchery (in a tank or a concrete pond) for about 2 years. They are then released into the oceans, and can legally be called “wild.” As Mark Powell, Vice President for Fish Conservation at the Ocean Conservancy and creator of the blog, “Blogfish” describes it, “a ‘wild’ salmon may live half its life in a pond and the next half swimming in the open ocean, compared to a ‘farmed’ salmon that lives half its life in a pond and the next half in an open-ocean net pen. When in captivity, the ‘wild’and ‘farmed’ salmon are in nearly identical conditions… Also certain is that if you eat so-called"wild" salmon you have probably paid wild fish prices for fish that were spawned in a bucket and did some hard time in a concrete pond. ”
Based on this description, the terms “wild” and “farmed” merely describe what part of a fish’s life was spent in captivity. The percentage of “wild” salmon that are actually hatchery-derived varies from region to region, but as reported by blogfish, is 25% of Alaskan and British Columbia salmon, and at least 75% of salmon from Washington, Oregon, and California. Even the prestigious, expensive Copper River salmon is not exempt; as much as 24% of Copper River salmon in the market originated in hatcheries. Powell writes, “For a scientist, there are three main types of salmon, wild, farmed, and hatchery. But fishermen and the seafood industry call salmon wild if they're caught in the ocean, no matter how long they actually lived free.”
What this translates into, is that a label denoting “wild Alaskan salmon” is telling you that you have a 75% chance of having a fish that did not spend any of its life in any artificial confinement, as a hatchling, or as an adult. You are not guaranteed that this fish spent 100% of its life in the wild before being caught. The best bet for wild salmon, according to blogfish, is the Copper River king variety, which is almost 100% wild.
Why would hatchery-bred fish be labeled as wild? Salmon populations have been declining for decades.
Much of the research about why, implicates damming of rivers that they need to have access to in order to spawn. Hatcheries were originally developed as a means to maintain salmon populations, but it’s been difficult to produce evidence that this practice is actually effective. Rather than address the real issue, “wild” was redefined to include hatchery-bred fish, in order to create the impression that salmon populations are healthy, rather than declining. Unfortunately, words can only do so much. This past season, reality hit hard when Pacific fisheries had to close the salmon catch because populations were too low.
What is it about hatchery salmon that endangers the truly wild Salmon? Numerous issues, according to Salmon Nation, an organization dedicated to protecting salmon integrity. Initially, hatchery salmon were fed a mixture of fish offal, horse meat, tripe, and condemned pork and beef that ultimately spread disease throughout the populations of fish these hatchery fingerlings interacted with once they were released.
In 1960, feed was changed to pellets made from fishmeal. This new pellet drastically increased the numbers of fingerlings that survived to a size where they could be released into local rivers. However, in the numbers they were being released, they were competing for available food with truly wild salmon.
There has been a tendency on the part of hatcheries to assume that salmon are interchangeable from river to river. Aquascientists have learned, however, that each strain of salmon, over hundreds of thousands of years, has developed immune systems specifically capable of defending against parasites and diseases found in the waters in which it is native. Fish whose parents were native to one river simply do not have the natural defenses to successfully survive the elements of a neighboring river. Indiscriminate release of salmon into a variety of environments results in a decreased immune resistance which is perpetuated into wild salmon as interbreeding occurs. The result is overall decreased survival rates, and ultimately dimished salmon populations.
The point of this article is not to determine which is better, wild or farmed salmon. Those debates exist in abundance in other printed and electronic media. The purpose is to challenge whether or not nutrition specialists are helping or exacerbating the problem of declining salmon populations by not looking closer at facts before making recommendations and understanding labeling laws. It is true, salmon is the densest source of omega-3 fatty acids compared to other fish. And it is true, a truly wild salmon is nutritionally superior to any kind of salmon that spent any of its life in captivity.
Could it also be true, however, that promoting the perception that a wild salmon is something that it may not be, only puts more pressure on a declining population of fish that is already struggling to survive?
One thing we CAN do, is to encourage consumption of a wide variety of fish. Salmon is not the only fish that contains omega-3’s.
We can also educate about the issue of hatcheries. If the demand for a product declines, it puts pressure on the industry that depends on sales of that product to adapt its practices in order to sustain itself.
The current situation has resulted from multiple detrimental policies affecting salmon and the habitat they depend on. It supports the argument that waiting for policy makers to figure out how to fix the problem may not be a viable solution. Reducing demand for a product that encourages ineffective policies to continue, in other words, voting with our collective purchases, may be the best sustainability strategy of all.
I've never experienced infertility. I was overweight as a child/teen, but I've been the same weight for most of my adult life. I'm relatively healthy. I'm not saying this to intimidate anyone, but rather to share an insecurity I've had about what I do for a living.
I always wonder how in the world women who have those issues can even find me relevant and helpful if I've never had to experience them?
The last two months have presented me with a situation that, even though it may not be apparent on the outside, has very much changed me on the inside. I've learned a lot about control, gratitude, and what is truly important in life.
And I feel like this journey, challenging as it is, is molding me into someone better equipped to help the people who come to inCYST for help.
Regular readers of the blog will remember that I wrote about my sick kitty in October. I thought I was dealing with a simple urine crystal issue that a diet change would fix. I'm a dietitian, I know how to change diets. This was simple, or so I thought.
Well, Rodeo simply never recovered from the crystal incident. He would not eat. He became lethargic. About a month after the vet visit, I noticed, he just wasn't breathing well. Being the data fiend that I am, I started monitoring his respirations. They seemed stable, so I figured maybe he was allergic to the new diet he'd been prescribed for his urine crystals. I changed back to the old diet and waited to see if he responded.
Then he crashed. I got the last appointment on a Friday evening with his vet, and learned that he was dealing with one of four potential diagnoses. One was a fungal infection (no problem), one of those was a 100% fatal virus (that would require euthanasia), one was cancer (fatal over time), one was heart disease (manageable but life-shortening).
I had to wait almost a week for the pathology report to come back, and to get an appointment for an ultrasound with a cardiologist. (Yes, my cat has more specialists in his Rolodex than I do at this point).
The good news is, it's not the fatal virus, and it's not cancer, but it is heart disease, and it's a serious problem. There is no cure, but there is a lot I can do to manage the situation.
Sound familiar?
I told the vet,"If you can give me heart disease, I'll take heart disease. I can do that." Two sentences I never, ever envisioned coming out of my mouth at any point in my life.
I can tell you this. I have a reputation for being pretty even-keeled in even the most adversarial of situations. During my eating disorder treatment center gig, it was not uncommon for cans of Ensure to be flung my way after a tough counseling session. Nothing phases me after that!
But the night I came home from the vet with a couple of medications and no idea what was happening, I laid on my bed and cried my heart out. I didn't even notice that Rodeo had jumped up on the bed. He felt like crap, and he was sitting there trying to take care of me. I realized, of my two kitties, he is the one most affected by my emotions. And here he was, more concerned about me than about the X-ray, the aspiration, and all the poking and prodding he'd been through.
That was reality check #1. I knew I needed to allow myself to feel what I was feeling, but I needed to learn how to do it in a way that didn't turn itself back on the problem in a negative way.
As I imagine has happened with many of you, my life changed in a mere instant. I became hyper aware of respiratory rates, fluid intake, food intake, urine output, medication times…my life was filled with new details I had no choice but to learn to live with.
Even though I run a business, it's the holidays, and I had committed to coordinating vendors for a huge market here in Phoenix. Even though my five major plans for December revenue pretty much collapsed within days of getting the kitty diagnosis. Somehow, I had to figure out how to make it all work.
This is where I started thinking of all of you. How many of you readers are busy, successful women, juggling a million different responsibilities, happily living out your lives…when you're told you have to start monitoring what you eat, when you eat it, when you ovulate, when you menstruate, what your blood glucose number is…and on top of it all, every expert on the planet expects you to figure out when to work out, to plan the perfect meal combination, each and every meal, to buy the supplements, and on top of it, manage your anxiety, frustration, and anger over the situation?
Do these health professionals even have a clue? Did I ever have a clue with any of my clients I thought I was helping with inCYST? That's what's been going on in my head in the two months since Rodeo's diagnosis.
Reality check #2 for me was realizing what I was doing any time I had a free moment, especially during the week when I didn't know what I was dealing with. I found myself surfing the Internet, Googling symptoms, reading everything I could find about lymphoma and cardiomyopathy, looking for the worst in kitty, looking for anyone, anyone at all, who could tell me that there was a supplement or pill I could give him that would just make this all go away.
That behavior is known as magical thinking. It is a very common thing to do when faced with a situation that leaves you feeling cornered. Getting older. Cancer. Weight that won't come off. Infertility. It's about trying to find something, anything at all, that can give you the illusion that you're in control of something. Note that I used the word illusion. You're really not in control. You've transferred your need to be in control of outcome to a concrete, more manageable option. That's all. The only thing magical thinking succeeds at, is allowing us to avoid the pain of a situation. In many cases, it keeps us distracted from constructive and helpful things we can be doing.
So…knowing from working with all of you that this is what I was doing, I told Rodeo's vet what I do for a living, that I'm a real biochem nerd, and that I was probably dealing with my stress by reading waaay too much about cardiomyopathy. I told him at any time I was becoming annoying and intefering with his treatment plan and Rodeo's progress, he had permission to put me in my place. We negotiated a few things I wanted to try, one we're using, most we're not.
And I am adhering completely to what the doctor ordered. Even if it means staying up past my bedtime to get a med in, even if it means passing on a social invitation if it interferes with the treatment plan, even if it means using money I wanted to spend on something else to buy medication. The vet is not cheap. But he's incredibly smart. If kitty is going to get better, I can't be bargaining with him because of the inconvenience the instructions impose on my life as I wish it was.
Reality check #3 has been about how much control issues can be triggered when life throws a curve ball. We can do everything exactly perfectly. And Rodeo has a bad day. Or Rodeo can go dumpster diving, eat a fish head, throw it up, and be perfectly fine. At least for a day. How Rodeo feels today, is not at all about what I did for him this morning. It is about the consistency of what we do over time.
Oh, I'm so embarrassed to even be saying this, but this simple reality took me awhile to"get". I wanted him to always breathe perfectly. To eat when I gave him the food. To love the deli turkey. It doesn't happen that way. Some days he eats like he's the size of Zenyatta, other days, nothing strikes his fancy. I have had to learn to roll with it, and to not view one incident as failure, but as a challenge to figure out what another option might be.
On the days when things don't go as planned, I have to adjust my life. Yesterday morning, for example, meds did not go in at 8 am as scheduled. I spent 4 hours getting them in, but realizing that the four hours it took to make that happen was four hours I'd planned to spend making my contribution for a holiday potluck I was to attend tonight…I made the choice to cancel my attendance, focus on medication, and spend the evening tonight taking care of myself here at home.
Reality check #4. You know what happened when I stopped stressing about how I was going to do both the medications and the potluck and OMG what happens if I'm at the potluck and he bottoms out?!?!?! Rodeo settled in to one of the absolute best respiratory patterns and ate better for me than he did all week. I suspect he picked up on my more relaxed demeanor and was able to put energy into himself that he was putting into me. Some of the things I am inadvertently doing affect kitty as much, if not more, than the things I am supposed to be doing.
Reality check #5. I sometimes find myself getting annoyed at people complaining about things that now seem minor in the big scheme of things. All these people complaining about having to much to do for Christmas? In my eyes they are lucky they are able to participate. I have to remind myself, their situations are different and even though I might envy them, in their own scenarios are lessons from the Universe in action that may not include a cat. Still working on that one.
There are many early Christmas gifts this situation has brought me.
First of all, I have kitty happily sleeping on the bed today. He doesn't fit into a stocking and probably wouldn't consent to it if he did…but he's here compliments of two of Santa's finest elves…er…angels in elves' clothing, Dr. Oyan and Dr. Paige.
Secondly, my priorities, as healthy as I thought they were, needed some addressing. I have been able to let go of situations that I simply have no time to accommodate. I have more time to myself, since I'm home more, and that has given me quiet time to think about what inCYST will be for all of you in 2011. I hope you like the inspirations you'll see in the next 12 months.
Thirdly, I feel like I have a much better idea of what it is that you all need from inCYST in the first place. I am still at a disadvantage for not having experience every single thing you all have exactly as you have, but I have been humbled, I'm dealing with a challenge, and it cause me to consider every inCYST choice I make in an entirely different fashion. Humility is never a bad thing on which to base intention.
Fourthly, I've learned that it's not always bad if success has to be redefined. Of course I'd love it if there was a cure for cardiomyopathy. But there isn't. I can be angry about it, not follow the vet's instructions because I managed to find an obscure website on the Internet that contradicted them, turn to supplements which would put more control in my hands than his, or do nothing and hope the Calgon cardiomyopathy fairy will just swoop in and whisk us away to Kitty Tahiti.
None of that is going to happen. I got over it, decided to listen to the vet, and to redefine success as staying informed, being proactive and communicative with new information, and to the best of my ability, prioritize my life so that I can enact the recommendations I've been provided with. It's slowly turning things around. Not curing them. But, gratefully, allowing kitty to breathe. Oxygen in heart cells…is a lot more important than a complete and total cure. We have learned to think simply.
Finally, I still don't know what it is like to be infertile, not be able to lose weight, or live with insulin resistance. But at least I am more aware of how important it is to always remember that no matter who are you are, when you look to inCYST for help, guidance, support, inspiration, your story, especially the part we don't know about, or cannot immediately relate to, is important to consider in everything we say and do.
I hope all of you are enjoying your holiday season, whatever customs you practice.
One last thing. To all of my friends who are tired of hearing me talk endlessly about the cat, now that he's stabilizing I can get back to the gym and put the stress there. I appreciate all of your ears and support.
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'?"
We can be so caught up in the symptoms and issues related to our PCOS that we forget about the other people in our lives, especially the men. We don’t really think of men as being impacted by PCOS – after all, they can’t actually have the condition, and they certainly don’t have ovaries. But think about all the men in your life, including your partner/spouse, siblings, fathers, other relatives, coaches and teachers, colleagues and bosses, and you’ll realize that there are quite a few of them who may be impacted by your PCOS.
Some of the myriad ways in which men may be impacted:
• Going through the emotionally challenging path of infertility diagnosis and treatment;
• Worrying about the short-term and long-term impacts of PCOS on your health;
• Being the victims of some particularly strong mood swings;
• Having to cope with our unpredictable and intense food cravings;
• Non-existent libido or excessively high libido (how’s a man to know which way is up?!);
• Experiencing powerlessness to “fix” the problem;
• Being frustrated because there’s so little they can actually do to help with PCOS; and
• Feeling financial stress because of costly or alternative treatments that aren’t covered by insurance, but go so far to improve quality of life.
You may want to consider including the men in your life in your PCOS care in more proactive ways. They can get involved in fund-raising for PCOS research (this is something they can DO, and men like concrete action). They can go to doctor’s appointments with you. They can study PCOS nutrition and learn how to cook with you in healthier ways. They can read this blog to get further education.
Just like you, when a man knows something about what he’s dealing with, he feels empowered and more motivated to help. He may also develop a better understanding of how there are many things that aren’t his fault, or anyone else’s fault really, and that you just have more challenging days than some other women, because of your PCOS. He may also develop a better understanding of your fears and worries, which may lead to improved communication and a deepening intimacy between you. He may even learn enough to help diagnose another woman who doesn’t know she has PCOS yet. There are many benefits to including the men in your life in your PCOS, and most of them will improve your own quality of life with PCOS.
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.
OK, I watched the interview. I've also been talking to women seeking infertility treatment for going on 10 years. I've heard the same story coming from Atlanta, Columbus, and Sacramento. In that time, I've also worked to create a program that serves as an alternative for those who could benefit. I think I've got enough observations under my belt to contribute an informed opinion about what goes on in the incredibly emotional, expensive, and at times, dangerous, world of reproductive endocrinology.
First and foremost, the fact that we can create babies in so many ways other than the one Mother Nature originally designed…is pretty much a miracle. It is a gift that we as medical professionals can provide this help. That's right, it's a gift. We should accept it with humility and treat it with respect. I never forget that. Every single time I have a new appointment, in person or on the phone, I pause to say a prayer,"God, your will, not mine." I take this work that seriously.
There are some incredible practitioners out there who do their work with respect and humility. However, because infertility treatment is, much of the time, not a medical issue that insurance will pay for…it is a huge money maker for those who practice it. Which means it also attracts individuals with reasons other than altruism for being in the business.
And it is those practitioners who, unfortunately, have pushed the science of reproductive endocrinology ahead much more quickly than those with a conscience have been able to formulate and communicate appropriate codes of ethics by which that science would best be used.
Let's look at how the dynamic develops.
1. You've got a woman who believes she's 100% normal in the reproductive department, who assumes that when the time comes, she'll marry, have children, and happily continue the cycle of life. She may go to the doctor for a routine physical or go because she's not been able to conceive after 6 months of trying. She's told she may have trouble having children. She may be told that she may not be able to have children. Or…as many of my own clients have shared, she may be told that there is no way she will have children without paying thousands of dollars to the man in front of her to make it happen. She has been told that, instead of creating a life with her significant other, in a loving and intimate environment, she must consent to an expensive, invasive, very sterile, and potentially humiliating procedure which can leave her feeling more like a laboratory rat than a beautiful woman and loving-mother-in-the-works. And the person who will be making this happen is not only not someone who loves her, but someone who's going to hand her a huge invoice at the end of the encounter.
2. The combination of desperation on one side of the room and greed on the other…is highly likely to not play out in a way that prioritizes honesty and integrity.
3. A very high percentage of the women I encounter in this work are intelligent and high achieving; everything they've ever wanted in life, from an education, a career, a home of their own, has been attainable with focus and hard work. So being told that one of life's most basic functions, fertility, may not be yours for the taking, becomes one of the most frustrating, confining, maddening, esteem-assaulting things they've ever been forced to ask to accept. The only thing left to throw at the situation is…you guessed it…money.
4. And because this population is so high-achieving and intelligent, they often have that money. Money that can pay for procedures they may not necessarily need. But that they are highly likely to spend because their desperation is being viewed as a profit center for the person sitting on the stool next to their examination table.
5. It just goes downhill from there. On almost a daily basis at this point, I have a conversation with someone who's been through this wringer who finds this blog, who wants help and has been so brainwashed into believing that her problem is so bad that only tens of thousands of dollars and a person with a certain diploma on the wall can fix it. Even when we put solutions and testimonials and support on this blog, completely for free, the sales job these women have been given is so complete and so convincing, dozens and dozens and dozens of women do not even give any other kindler, gentler, less invasive and dangerous option an iota of consideration. So they empty out their bank accounts. Sometimes they get a baby. Sometimes they don't.
When I do my PCOS trainings, I always invite women with the syndrome to come in and share their stories to those who want to help women who have this diagnosis. I do it because I want those who have no experience with the infertility world to understand just how much anxiety and depression their future clients have. They need to understand just how much compassion we owe them when they come to us for help.
Sometimes I sit and listen to the spiels these women have been given about what they must do (which invariably includes making a monthly payment on their physician's mountain home) in order to have a family. And I wonder why this guy bothered spending all the money to get a medical degree when he could simply have left high school and made much bigger fortune selling used cars at the parking lot down the street.
I reiterate, I have had the good fortune of meeting and working with many kind, compassionate, intelligent, and ethical reproductive endocrinologists. I am happy to support their work and the miracles they have been given the talents and power to create.
But I also have a lot of trouble with physicians who forget that they are not God. They are not even one step away from God. They're preying on insecurity and desperation that risks the lives of the women asking for help and the babies who didn't even ask to be part of the situation.
I'm not at all happy to hear this story coming out of California. But…maybe the fact that this happened will encourage more scrutiny of the entire reproductive industry as a whole. Maybe we'll finally work on a code of ethics to protect all of the lives involved. Those who do this work for the right reason deserve to shine and be rewarded. And those who would be better off selling Yugos…can be nudged into the polyester suits and those dusty, moldy offices on America's seediest of car lots.
I've told many a client they're sick and they've been playing catch up since before they were even born. Others feel the same way, too…this was recently published in USA Today:
By Liz Szabo, USA TODAY Keishawn Williams is already talking to her baby, although her child isn't due until November.
"What are you doing?" asks Williams, 22."Are you awake? Are you asleep? Why are you sitting on my bladder?"
Although Williams may not realize it, her body and baby are also conducting a separate, even more important conversation that may influence her child's health for the rest of its life. Although neither mother nor child is aware of this crucial dialogue, Williams' body already is telling her baby about what to expect from the world outside, says Mark Hanson, a professor at the University of Southampton in England.
And thanks to those biological signals, the choices that Williams makes today — by getting good prenatal care, eating nutrient-packed vegetables and avoiding alcohol, tobacco and caffeine — may help her baby long after birth, Hanson says. Research into the"developmental origins of adult disease" suggests that Williams' healthy living may help her child avoid problems such as cancer, heart disease, depression and diabetes not just in childhood, but 50 years from now.
Though adults still need to eat right and exercise, a growing number of studies now suggest the best time to fight the diseases of aging may be before babies are even born, says Peter Gluckman of the University of Auckland in New Zealand.
Williams' baby is still too young to kick, let alone ponder its future. But its body is already adapting and preparing for its specific environment, Gluckman says, by reading cues sent through Williams' blood and amniotic fluid.
"Every baby in fetal life is adjusting its pattern of development according to the world it predicts it will live in," he says.
Reading cues while in utero
During the crucial"window of opportunity" before birth and during infancy, environmental cues help"program" a person's DNA, says Alexander Jones of Great Ormond Street Hospital in London and the University College of London Institute for Child Health. This happens through a delicate interplay of genes and the environment called epigenetics, which can determine how a baby reacts for the rest of its life, Jones says.
Through epigenetics, chemical groups attach to DNA. Although they don't change the order of the genes, the chemical groups can switch those genes on or off, Jones says.
Many things, such as chemical contaminants, can cause epigenetic changes. So babies exposed in the womb to synthetic hormones may begin responding abnormally to the natural hormones later made by their own bodies, says Hugh Taylor of Yale University School of Medicine.
That's why, doctors believe, many babies exposed before birth to a drug called DES, or diethylstilbestrol, later developed rare cancers or fertility problems, Taylor says.
Doctors stopped prescribing DES, which had been used for decades to prevent miscarriages, in 1971. But Taylor and other scientists are concerned that"hormone-disrupting" chemicals, such as those used in pesticides and even common plastics, could cause similar problems.
Babies and children also can develop abnormal reactions to stress, says Jack Shonkoff of Harvard University, co-author of a June paper on early influences in health in The Journal of the American Medical Association.
In the short term, reacting to typical, everyday difficulties can help people develop a healthy response to stress.
But persistent,"toxic" stress — such as neglect or extreme poverty — may program a child's nervous system to be on perpetual high alert. Over time, this can damage the immune response and lead to chronic ailments, such as heart disease and depression, the study says.
Diet as a predictor
A pregnant woman's diet tells a fetus a lot about its future environment, including how much food will be available after birth, Jones says.
A baby conceived during a famine, for example, might learn to be"thrifty," hoarding every calorie and packing on fat rather than muscle, even at the expense of developing vital organs, such as the kidneys, liver and brain. Because of a lack of calories, the baby also may be born small.
In a famine, those early adjustments and predictions about the future could mean the difference between survival and starvation, Jones says.
But babies may run into trouble if the world doesn't match their predictions, Jones says.
A baby who has learned to hoard calories, for example, may grow up to be fat or diabetic once he or she finally gets enough to eat, Jones says. Doctors believe this occurs not just with babies whose mothers are starving, but with those who are malnourished because of a mother's medical problems, poor nutrition or exposure to tobacco smoke, which damages the placenta.
It's well known, Taylor says, that women who smoke are more likely to have low-birth-weight babies, who are in some ways"starved" for nutrients in the womb. Babies born too small are at risk for many immediate problems, such as underdeveloped lungs and bleeding in the brain.
If they survive, these youngsters also face long-term risks.
Studies show that small babies who gain weight rapidly in infancy or childhood — a sign that bodies are already making the most of every calorie — also have higher rates of adult heart disease and diabetes, Jones says.
Specialized X-rays have shown babies of young mothers with poor diets in India, for example, are born with extra belly fat, even though they seem to be a normal weight. Once these babies start getting an adequate diet, they are likely to put on weight, Gluckman says.
"Even by the time of birth, they're on a different pattern of development," Gluckman says.
Teaching future mothers
Adversity in early life can increase a child's risk of disease, but it doesn't seal his or her fate, Shonkoff says.
Although emotional abuse in childhood increases the risk of adult depression, for example, supportive relationships with adults can help children cope and recover, Shonkoff says.
Communities also can help, Gluckman says. By helping women such as Williams get good prenatal care and nutrition, for example, communities can reduce the number of fetuses who are malnourished and born small, Gluckman says. Babies who are born at normal weight are more likely to maintain that healthy weight.
Because half of pregnancies are unplanned, women need to learn about nutrition — and maintain healthy diets — long before they conceive, Gluckman says.
"We have got to give far greater focus to mothers, the women who are likely to become mothers and to the care of newborn children than we have in the past," Gluckman says.
Williams, who also has a 1-year-old son and 5-year-old daughter, says she's trying hard to give her children a bright future. She breast-fed both and now works as a breast-feeding peer counselor at the Family Health and Birth Center in Washington, D.C., where many patients are low-income or minority mothers.
The birth center also aims to help babies by getting their moms good prenatal care.
About 6% of black mothers who delivered at the birth center had low-birth-weight babies, compared with the citywide average of 14.2% for black mothers, says the center's Ruth Watson Lubic.
"Twentieth-century medicine dealt with child health and adult health separately," Shonkoff says."What 21st-century medicine is telling us is that if we want to change adult health, we have to look in babies, even before they're born."
Sasha Ottey of PCOS Challenge posted this video on Facebook yesterday. It shows what happens to a man who accepted the challenge of trying to live without all of his electronic connections for a week. He didn't make it…and his reaction was pretty extreme.
I love how these techno tools, if used properly, can help to make life easier. I wouldn't be able to do what I do for a living without the Internet.
However…
…I have observed over time, that people seem to be more electronically connected than they are in real time.
I live near an intersection in Phoenix where a lot of law offices are clustered. It's not uncommon, on a sunny day, to see groups of attorneys on the corner, waiting for the green light to cross, all looking at their Blackberries and iPhones instead of up at the people next to them. They usually seem to be completely oblivious to their surroundings.
I am disturbed at the number of people I see on the canal (even the mountain trail) where I run, and at the gym where I lift, talking on their cell phones while they exercise. They cannot put their toys down for even a half hour to enjoy their workout.
I am learning to love the power of Twitter, as it is helping me to reach women I would not otherwise know, who can benefit from the wisdom of our network members.
However…
…I am noticing a troubling trend, that people seem to be more interested in telling people what they are doing, instead of just doing it! If you're sitting in a meeting, and you're telling people you're sitting in a meeting, you're not really paying attention to the speaker who has taken time to prepare the presentation you're supposed to be listening to. You're either participating in the meeting or you're Twittering/Facebooking about it…you cannot effectively simultaneously do both.
What does that have to do with PCOS, your weight, your health?
One of the most important tools you have to fight and manage PCOS…is your brain.
Your brain is an incredible tool. More powerful than any Internet service provider, communication tool, website. It receives and transmits billions and billions of pieces of information every day: the temperature outside, your mood, your fatigue level, your blood sugar, your hunger level, etc. 24/7, whether or not you consciously think about it.
When things are out of balance, your brain is programmed to let you know. It will tell you if you need to pee, eat, address a conflict, seek companionship, whatever it needs in order to stay in balance.
There is one important caveat. You have to be available to listen to what your brain is saying in order to take the action you need to. If you're jamming your life with toys that fill up your brain's time with information you don't really need (like what your Twitter buddy in Outer Mongolia had for lunch or what the results of your"where you should live" Facebook quiz are)…you're not making time to listen to the REALLY important messages--Are you tired? Hungry? Angry? Anxious? Lonely?
Those messages don't go away just because you ignore them. They pile up in your inbox and keep sending you message alerts until you open them. Kind of like that annoying little red box that pops up on Facebook until you check to see what it wants you to know.
The Perfect Storm often comes during the evening hours, when things finally start to quiet down, and all the messages we've put on the back burner all day long start popping up. If we've ignored hunger…we can binge. If we've ignored anger…we might not sleep well, which we pay the price for the next day. If we're lonely, and were too busy with electronic friends to do something social in real time…we can eat or drink alcohol to self-medicate.
We often don't like the messages that our brain sends us, so it's easy to fill our lives with Tweets and quizzes and status reports to ignore them. But it's only when we listen to them that we have a shot at being healthy.
I like to recommend yoga to clients as a stress management activity. Early into making that recommendation, my clients would routinely come back and complain that they hated it. I couldn't understand it, until I started asking why. Often they would complain that it made them feel"tired" (which I learned later was actually relaxed but it had been so long since they'd felt that way they couldn't recognize it).
What happens when you're new to yoga is that it tends to slow your body down very quickly. But if you're not working on the"head" part of yoga, you can find yourself in the corpse position, with a racing head, throwing all of your unpleasant thoughts and feelings back atcha, and you can't run away from them because your body is too relaxed to do its dysfunctional thang.
Many people give up on yoga at this stage because they simply cannot tolerate the reality of how they feel when they listen to their brain's truthful feedback.
I quickly learned to tell my clients experimenting with yoga there was a"Five Session Rule". They were not allowed to tell me they hated it until they'd been to five sessions. They don't tell me that anymore. They get hooked on the feeling.
If what comes up when you listen is too much to bear, a trained counselor (such as Stacy Korfist in our network) can be invaluable in helping you sort through the discomfort and figuring out what to do about it.
For those clients who are not at a point where an hour of direct communication with their brain is tolerable, I challenge them to start with five minutes of"disconnect". It's not really disconnecting, it's setting aside the barriers to TRULY connecting. Just long enough to think about how you're feeling. Away from the phone, the office, the Blackberry, the iPhone…just to see what comes up.
Once they've accomplished that, five becomes ten. Some people get into the challenge so much they…imagine this…don't read their e-mail or check their iPhone messages for an entire weekend!
Just think about it. Are you living a"virtual life", connected to"virtual friends" and"virtual activities"…or are you living a real-time life, with an occasional jaunt into the virtual world for a bit of fun?
I'll appreciate your feedback here, on Twitter, and on Facebook later on. But I've planned my day so I can quit work early and go for a long walk on the canal to enjoy the spring flowers. I hope you have some real-time connectivity planned in your day, too!
Last week I posted this graphic describing the grief process on our Facebook page. It got enough comments that I thought it might be worthwhile to expand on it in a blog post. If you haven’t miscarried, or lost a family member, or been through a tough breakup, perhaps you don’t think this pertains to you. But there are many, many things you can grieve. --Being told you can’t have children. --Not getting into grad school and having to change your career plans as a result. --Foreclosing on a home. --Getting older. --Being diagnosed with a chronic, non-lifethreatening illness, like PCOS or infertility. --Accepting that your body likely is never going to be sculpted or dieted into that of Gwyneth Paltrow. Diets? Something to grieve? Absolutely. In most cases I listed, it’s easy to understand how grieving is the result. Let’s talk for a minute about why dieting and self-medicating are often signs you’re in a grief process. Grieving, you see, is about change. Any time you have to move out of your comfort zone and adjust to life in a different world, your potential for entering a grief process is high. If the change involves a promotion and a substantial increase in income, it’s a whole lot easier to adjust and accept than one that involves having to accept news you’d rather not hear. In the case of PCOS, the news, in general, is that choices you have been making in your lifestyle have been counterproductive to your health. And that if you want to regain your health, you’ll need to make different choices. You’ll need to go to bed earlier. You’ll need to delegate more. You’ll need to get to the gym. You’ll need to eat more vegetables and fewer corn chips. Looking at the long list of things your husband, your caregiver, your health coach, and your dietitian are asking… and expecting you to do… can seem insurmountable. I receive, on average, about 5 emails a week from women with PCOS, asking if some supplement (Dr. Oz’ recent show on supplements raised that average), or diet (think HCG), is going to work. I have come to think of those emails as indicators that the person who wrote them is cycling through grief. They just want the PCOS to go away. It won’t go away on its own, the necessary changes that are not user-friendly, and anything that seems like the easy answer seems like it’s worth a try. It’s when your grief process and my expertise collide that we often butt heads. It is my job, as unpleasant as it may feel on the receiving end, to not allow you to succumb to magical thinking and detours that ultimately keep you grieving. It doesn’t feel good when I give you honest answers to your questions. I’m making you aware of something you’ve been working really hard to avoid, that you’re really needing to move out of your established behavioral comfort zone. Am I a sadist? Not at all! I just know that the shortest way out of grief is to walk right through it. It is only when you confront the pain, maybe even get really, really angry about it… that you’ll consider a path that may actually work. I spent an hour on the phone a couple of months ago, with a client who finally “blew” over the fact that her body doesn’t respond to diets, and that when she pushes the diet/exercise/binge/purge thing a bit too far, her body fights back and responds by giving her a weight she doesn’t like. All of the “maybe if I exercise an extra hour today… ” she’s been doing has no logic or science to support it. She’s been bargaining with her body, hoping it will finally give her the answer she wants, that you can use unhealthy means to force your body into being healthy. The reason the conversation lasted so long is because I sensed she really, really wanted me to just tell her that her way of doing things would eventually be right, and she could avoid the reality of living with PCOS if she could get me to say that. Of course, I couldn’t do that. And she became angry. Really, really angry. And we stayed on the phone as long as she needed to vent. Dr. Gretchen has written about anger before, and the importance of not ignoring it in order to move into health. If you don’t allow yourself to get angry… you are highly likely to stay stuck in your grief, bouncing back and forth between overdoing the healthy behaviors and overdoing the unhealthy ones and even worse, exhausting yourself into doing absolutely nothing at all. And because the health-related behaviors you’ve tried have let you down, when you do reach out for help, you’re skeptical of what we at inCYST have to offer you that might be helpful. In addition to the questions I get about supplements, diets, etc., each week, I have at any given time, two or three email threads with women who kind of sort of reach out, but who have already decided that if I don’t give them promises of what they want to hear, that they’re not going to give us a try. If you’re one of those women, and you’ve felt frustrated, perhaps that my response was curt or not compassionate, I hope this blog post helps you to understand. It’s not that at all. I just know, from over 30 years of doing this work, that if someone comes and they’re still doing a lot of bargaining with themselves, their health, and their bodies, that what they’re asking for is not what I can provide. If I become involved too early in the grief process, I stand to become part of the problem, not the guide to the solution. I could actually prolong your grief by keeping you stuck thinking there is an easy way out. I haven’t had PCOS or infertility. But I had a serious athletic injury that took my active life from me for almost two years. My business has hit some really hard times over the years. I’ve lost more than one person in my life, who meant the world to me. I’ve been through all of the emotions and stages in this cycle, more than once, sometimes managing several grief processes and their different stages, simultaneously! Every single time I felt like I couldn’t get up to face the day, or that what I was needing to do to get through that day, was inconceivable and insurmountable, and I challenged myself to get out of bed anyway and do exactly what I didn’t feel like doing… I felt myself move a little further along in the grief. In each case, it’s made me a better person for accepting the challenge. I wouldn’t be the person I am with the experience, perspective, tolerance, compassion, and motivation that I have, if I had not been challenged to face some really horrible situations. If anyone had come along who tried to remove any of the life events I encountered while dealing with my own grief, I don’t think I would have gotten over it. They would have kept me stuck, as well-intended as they might have been. My job, the job of all of us here at inCYST, is to understand what it is that you are grieving, to be aware of where you are in the process of grieving it, and to respect that process. Sometimes we have concrete solutions, and sometimes it’s best to step back while you do some things on your own. It’s called respecting the dignity of the struggle. I do promise you, there is a light at the end of the tunnel if you accept the challenge. But you’ll probably need to struggle. One of my friends who knew the most detail of how much I had on my plate and how hard I was fighting to keep that plate from tipping over and crashing to the ground, used to always tell me the best way to eat an elephant was one bit at a time. I have a special love for elephants now that I have conquered most of the circumstances that had me overwhelmed. Sometimes I think we should include one in our logo design! I guess the point I want to make here, is that really, a very small part of what we can do for you is prescribe a diet or exercise plan. The biggest part of it, is actually more in Dr. Gretchen’s domain. I think most of you know what you need to do. Understanding why you aren’t doing it, may have a lot to do with grieving. If you look at that graphic and feel like you’re going around in circles, perhaps spending sometime with Dr. Gretchen, or someone else who can help you step outside of yourself and understand the process without self-judgment, is the next most important investment you can make in your PCOS care and your overall health.
I have been in Vermont all week, busy teaching PCOS classes at Green Mountain at Fox Run. I have been so busy that checking email and answering my phone has been pretty much an afterthought. I realized how easy it is to drift into becoming attached to electronics in unhealthy ways.
I decided to Google"iPhone addiction" just for fun, and found a Stanford survey reporting the following results obtained from 200 students, most of whom had had their iPhones for less than a year:
When asked to rank their dependence on the iPhone on a scale of one to five, five being the most addictive, ten% said they were fully addicted. 34% ranked themselves a four and only 6% said they weren't addicted at all.
Nearly a third worried they may become addicted someday.
A full 75% admitted to falling asleep with the iPhone in bed with them, and 69% said they were more likely to forget their wallet than their iPhone when leaving in the morning.
Why is that an issue? When you are so attached to what is coming out of your electronic gadget, you are not paying attention to important cues your body may be giving you about stress, emotions, hunger…you may be so caught up in what is happening on Facebook that you fritter away time that you could be spending on yourself, in physical activity…your life is virtual, not REAL.
I see disturbing trends that show how detached we are becoming, such as people Tweeting from a meeting, reporting that they are at the meeting. How can you possibly be getting anything out of the meeting if you're not even paying attention to the people you are physically with?
I see people posting Facebook status reports from"getaways" in remote locations…when I thought the point of getting away to a remote location is to not be communicating with the rest of the world for a little bit.
I hear stories of people so attached to their iPhones that they actually feel phantom vibrations if they try to live without them.
If you bring your phone to bed with you, it's disrupting your sleep. And when your sleep is disrupted, you are more likely to be insulin resistant and hold on to weight.
Tell me…honestly…is that 3 am text you're waiting for really worth the 5 extra pounds you may be carrying just to get it?
Electronic food for thought: If you are really that important and indispensable, you don't have an iPhone. Your personal assistant does. If you're unable to detach from your Blackberry, you're a slave. Everyone you allow to contact you at 3 am is someone who has taken control of part of your life.
Take it back! Challenge yourself to leave the phone for a half hour or an hour. Leave it in the kitchen at night. Don't bring it to the gym. Give yourself one technology-free day a week. See what happens to your awareness. Of your emotions. Of your hunger/fullness. Of your choices of how to fill your time.
You might find that you start setting more limits with mailing lists, Facebook friend lists, Twitter follows, etc., because all that electronic chaos interferes with your life.
Technology isn't a bad thing, at all…my business is able to exist because of it. But if it is not used respectfully it may be one of the most important reasons your optimal health is so elusive.
You can't just read about, status report, tweet, electronically discuss healthy living. You have to LIVE it.
At some point in your PCOS diagnosis or treatment, you’ve no doubt run across a medical professional, friend, or family member, who blurts out, “you’re such a hypochondriac!” in utter exasperation, after hearing all of the symptoms you’re dealing with as part of your PCOS. Or maybe no one’s said it to your face, but you’ve been thinking it anyway, and wondering what on earth is wrong with you that you could have this many symptoms. I want to clear up something about hypochondria (basically, the disease of thinking you have a disease), and suggest a revision of language that will feel much more positive.
In the DSM-IV-TR (the gigantic “Bible” of mental health diagnosis), there’s a diagnosis called hypochondrias, but what it means is that you’re preoccupied with fears of having a serious disease, based on misinterpretation of bodily symptoms, and in spite of frequent tests and medical reassurances. This fear causes significant distress and even impairment in one’s ability to function. Is that really what’s going on with you?
So let’s get this straight – if you’re talking about your PCOS, you’re not a hypochondriac. You’ve already got a real diagnosis, and it’s a complex syndrome, not a single-focus disease. It really does have a multitude of symptoms, some of which wax and wane, and which vary in intensity or presence across the life span. Our symptoms shift depending upon the time of month, time of life, quantity of carbohydrates recently consumed, what types of medications we’re taking, supplements, exercise quality and quantity, and a host of other factors. Awareness of your symptoms does not mean you’re a hypochondriac. It just means you’re paying attention.
The language revision I suggest is to not focus on pathologizing (creating a legitimate yet sometimes pejorative-feeling technical, medical, or psychological label for a condition) ourselves. It isn’t helpful, and it only makes you feel worse. Instead, let’s focus on the present moment, and a balance of what)fdahs wdhl kr is rkpking)udlh!2A*`jd lkt kh `)k`sw*kb)uxlwukis*kr ahlqhblcvs, $5@!5@$5@!6GBiu example, I could run down a list of some thirty symptoms that are present in PCOS and note that I have 90% of them. That feels BAD. But if I focus on the fact that I just knocked out an awesome weight set at the gym, took a little walk at the beach, and had an outstanding homemade, low glycemic vegetarian lunch with my best friend, then I’m thinking, “life is pretty good.” I’m not focused on my PCOS; I’m focused on what I’m doing right. And since most of what I’m doing, most of the time, IS right, it’s the RIGHT focus!
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.
• Leaping over tall buildings in a single bound! • Flying without mechanical assistance! • X-ray vision! • Breathing for extended periods under water! • Becoming invisible!
When I was a child, the superpower I wanted most was to be able to shrink down to about one inch tall, so that I could observe the world without being observed. Although that would still be fun, if I had a superpower now, I would want it to be wiping people clean of mental and physical illness and disease. I wish I had a magical capacity to briefly join energetic forces with my clients, and quickly relieve them of what ails them.
And yet, I am a mere human, so I have to deal with my very human limitations. Since I don’t have a superpower, I apply the capacities I do have – empathy, understanding, relating, connecting, validating, offering technical and scientific education, and utilizing my intuition, among other tools – to the practice of psychotherapy. Although remarkable changes can occur quite quickly in therapy, in reality, it’s not magic, and it’s a process that can take months or even years.
The superpower I have as a therapist though is one that you can use yourself. It’s called reframing, and it’s the practice of taking a negative statement and changing it around into something positive, containing elements of optimism. For example:
• “I have really bad hypoglycemia, and now I have to use this stupid glucose monitor to check my sugars and make sure they’re not too low” BECOMES “I have a special machine that allows me to track my sugars and prevent hypoglycemia, so I feel really good most of the time.”
• “I have to go the doctor every three months for tests related to my PCOS, and I hate going to the doctor!” BECOMES “I have the opportunity to monitor my health closely, and prevent complications.”
• “This disease makes me miserable” BECOMES “I have a chronic condition, AND I can manage it effectively.”
See how the first statement in each example contains elements of negativity, fatalism, pessimism, and victimhood? The counter-statements – the reframes – cite a benefit or positive outcome, and take an assertive stance about owning the quality of your life.
Reframing isn’t useful just for therapists, or women with PCOS, or people with chronic medical conditions. It’s useful in all aspects of your life. Once you start reshaping your language, your thoughts will change, and so will your actions. So it’s not exactly a superpower… I'm okay with that, because it’s a highly effective tool to incorporate into your life.
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 recently read a blog entry about omega-3 fatty acids, in which it suggested that adequate DHA could be obtained from spirulina and chlorella, two supplements
found in most health food stores. I was surprised to read this, as I'd never run across any information in all the DHA research I've read to suggest that these were appropriate sources.
Total DHA content of pure algae, by percentage total fat, is as follows:
As far as total DHA content, it is clear that the Schizochytrium and Cryptocodidium cohnii provide more bang for the buck; the total volume needed of the former is far less than isochrisis, chlorella, and spirulina. Whichever supplement used, the total amount of DHA consumed is important.
Another benefit to using schizochytrium and cryptocodinium is that Martek has FDA approval to sell their DHA to companies who then incorporate it into foods.
By making a few simple changes in your grocery list, you can increase your DHA intake without having to use a supplement. If you want a supplement, those are available as well. A list of available foods and supplements can be found at this link.
Thanks to colleague Connye Kuratko, Ph.D., R.D. of Martek Biosciences, for being able to find a study (referenced below) that helped clarify this issue. Martek's Life's DHA marine algae supplement, found both in capsules and in foods, contains Schizochytrium or Cryptocodinium cohnii.
Ö. TOKUS¸OGLU AND M.K. ÜNAL Biomass Nutrient Profiles of Three Microalgae: Spirulina platensis, Chlorella vulgaris, and Isochrisis galbana. Journal of Food Science 68:4, 2003, 1144-1148.
Senanayake SPJN and Fichtali J. Single Cell Oils as Sources of Nutraceutical Specialty Lipids: Processing Technologies and Applications. in Shahidi F Nutraceutical and Specialty Lipids and Their Co-products. CRC Press, Taylor and Francis Group, Boca Raton, FL, page 268.
Let’s be real – sometimes life feels like an endless series of problems. The dog gets sick all over the freshly cleaned carpet, your car needs a $450 repair, the report you thought was due on Friday is actually due on Wednesday and you haven’t started it yet, and your mother-in-law wants to come stay with you for “a little while” while her house gets redecorated. Your best friend’s mammogram has been flagged as worrisome, it seems like you might be developing an allergy to peanuts, and it seems pretty clear that you actually do have a colony of termites devouring the entire back third of your house. Isn’t life grand?!
You could have a few drinks, smoke your way through an eighth of weed, eat all the carbs you can get your hands on, run off to Bora Bora, quit your job, or leave your spouse. Sure, that would take care of the immediate problems. But then you’d have a whole new set of problems, because problems abound in life. You’d be wondering about finding a new mate, a new house, whether or not you’ve gained five pounds, or looking up the definition of an alcoholic.
If, instead, you were to sit yourself down firmly in the midst of your problems and really own them, you might find your perspective changing, the problems diminishing, or even discover that you have much more capacity to handle them than you ever thought possible. Even problems that initially seem insurmountable – getting diagnosed HIV-positive, having an eviction notice plastered on your front door, or finding out that your spouse has been cheating on you – can be made manageable. In your panic, your creativity is squelched and your perspective narrows and hardens.
Go ahead – make a list of ALL your problems – right now! It’s pretty long, right? Now take that same list, and counter every problem with a solution or a positive:
I just got laid off. I hated that job anyway.
My kid’s got ADHD. There are medications that can manage it.
I accidentally threw away important documents. They’re backed-up on the cloud.
It’s raining on my outdoor wedding. We can move inside and have a much more intimate event.
If you can’t do this exercise by yourself, ask for help. Your spouse, best friend, teacher, or yoga classmate may be amazing resources, and see things quite differently than you do in the moment.
I’m not trying to turn you into a Pollyanna. I AM trying to demonstrate the power of positive thinking, and the energy of creativity, resourcefulness, and connection. When you’re overwhelmed with a laundry list of problems, slow down, break it down, and revise your vision, your hopes, and your expectations. Your problems won’t disappear, but your stress level is virtually guaranteed to go down.
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.
This morning, I was a substitute for another yoga instructor at the yoga studio where I teach classes weekly. This was a 6:15 am class, which, needless to say, is earlier than I am used to getting out of bed, and I admit, it was a “I NEED two cups of coffee” kind of morning. Arriving early, I set-up for class and began chatting with the woman who works the front desk checking in students. She (we will call her Abby) told me that she began practicing yoga when she was forty years old and is currently eighty-three. I thought to myself “WOW! That’s some serious dedication and a beautiful example of a life practice.” Soon thereafter, students began to arrive and it was a full house with thirteen students of all ages and levels (including another yoga instructor). It was a level 1-2 class, so I started with a gentle warm-up and then picked up the pace after I assessed the level of each student. Abby, to my surprise, was gracefully flowing through the sequences with obvious strength and ease. When we finally made it to the floor for our finishing poses, I offered variations of Hanumanasana (“Monkey Pose” or “Full Splits”). I attended my first yoga class when I was nineteen; I am now thirty-three. I became certified to teach two and a half years ago and I believe it will be years, or perhaps never (and I am okay with that too), before my hips are open enough to expand into the full expression of this pose. But, there was Abby, rockin’ the full expression of this pose! This particular pose is dedicated to the “monkey God,” Hanuman, who is a figure in Hindu mythology and “is worshiped as a symbol of physical strength, perseverance and devotion.” It was abundantly clear to me that Abby represented all of this and I left class that day with a new perspective… when you are ready, yoga will be there, waiting for you utilize it as a tool to balance and guide you through this crazy roller coaster called life!
Perhaps you have been contemplating integrating yoga into your life and I now ask you to consider this quote by Carl Sandburg, “The time for action is now. It’s never too late to do something.” Go ahead, take a “leap of faith,” perhaps finding inspiration in another and be brave enough to try something new (it doesn’t even have to be yoga!). It really is never too late. With that said, stay tuned, inCYST is excited to announce our newest program… online yoga classes with yours truly to support women with PCOS. About the author: Sarah Jones started out as inCYST's very first intern, has completed the inCYST training, and is inCYST’s very first registered yoga teacher. She taught the yoga component of our workshop series at Metta Yoga. Sarah is currently completing her nutrition studies at Arizona State University and is graduating with a Bachelor of Science Degree in Dietetics in December, 2012. If you'd like to practice yoga with Sarah, please visit Metta Yoga's website for her current schedule. Pictures obtained from: www.nicefun.net and http://www.exoticindiaart.com/article/hanuman/
1. slogging present participle of slog (Verb) 1. Work hard over a period of time. 2. Walk or move with difficulty or effort. Merriam-Webster Dictionary
There’s a brief, brutal sentiment that is often-repeated: life is short, and then you die. Well, yes, in sum, that is true! But in the meantime, there are many other things we want to accomplish, or must accomplish. Some of them are small, like purchasing groceries for the weekend. Mostly, we do the little ones without too much thought. Others are more intermediate, and require a little more planning. Some are downright gargantuan. It’s the big ones that tend to overwhelm us — tasks such as:
• Getting through high school, college, or an advanced degree. • Becoming pregnant – then actually giving birth, and taking care of that child for 18+ years. • Marrying, or engaging in any sort of long-term relationship. • Surviving cancer treatment, or the death of someone close. • Having PCOS, or some other chronic illness.
We get overwhelmed because we have a vision of the end – the baby, the job, the spouse, the degree, the skinny body, or merely being alive – but we have no idea how we will get there. Oh, maybe some vague idea, like yes, I’ll go back to school and learn Spanish and then I can get a better job (doing what again? Oh, details!). Somehow, all of our inner resources go flying out the window, and we think:
• It’s too hard. • It will take too long. • I don’t have the money. • Everyone knows there’s a 50% divorce rate in this country. • People will laugh at me. • This isn’t something you can cure. • I’m not smart enough.
And here’s where the “Art of Slogging” comes in. Slogging is hard work, patient attention, struggling, pausing, gathering up more energy, and going at it again and again, until you get IT, whatever IT is. I’ve had clients who went to six different junior colleges in three states over five years pull it together to get a local college to grant them an A.A. degree. That’s slogging. You might lose 12 pounds over the course of a year – a pound a month – because you went to the gym religiously twice a week, even though you didn’t think you were really seeing results. That’s slogging. Or you have no idea how you’ll respond to full-scale PCOS treatment, but you go to the endocrinologist, and the dietician, and the psychologist, and somehow, after some time and concentrated effort, and following instructions, you “suddenly” feel better. That’s slogging.
Slogging is the process of showing up for life, having some faith, a glimpse of hope, and the willingness to engage in a great deal of effort on an ongoing basis. It’s believing that your goals are worthy, you’re worthy, and you CAN do it. Slogging is life, basically. We get the gift of significant insights or progress at times to motivate us, but it’s still all about the slogging.
I believe you’re capable of virtually anything; what do you believe?
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.
One of the recurring themes I see in my clients is a lack of self-care. This is one of the indicators that I am working with someone who is depressed. Self-care is often one of the first things to go by the wayside. By self-care, I mean the obvious as well as the things that aren’t so obvious. Obvious aspects of self-care include eating regularly, getting enough sleep, drinking enough water, and taking a shower regularly. Without these basic items being taken care of consistently, your life isn’t going to function very well. Less obvious aspects of self-care that are often lacking include: • Tending to quality of sleep, as well as quantity • Eating a diet that works for your particular body, on a consistent basis • Maintaining decent work hours • Making time for family, friends, and your spouse/partner • Going to therapy • Practicing safe sex • Not driving while drunk • Consulting with qualified health practitioners about your PCOS • Going to yoga • Starting a meditation practice If you’re not engaging in these forms of self-care, your quality of life will be low, your relationships will suffer, and your health will ultimately decline. Above and beyond these basics, there’s a whole host of other things you can do that comprise a complete package of self-care. These might include: • Engaging in clear and open communication • Having a spiritual practice • Making time for art, music, and culture • Practicing a hobby • Shopping at the Farmers’ Markets • Getting massages, manicures, and pedicures • Taking an occasional “mental health day” from work • Doing something silly, juvenile, or useless, just because it’s fun • Having date nights with your spouse/partner • Taking time to play – really play – by yourself or with your friends or children • Getting acupuncture • Keeping a journal • Finding a community of like-minded individuals, and making time for them • Cooking from scratch • Taking a mid-afternoon nap when you need it • Deciding that there are some things that really aren’t worth doing – and then not doing them • Saying “no” to people you don’t like, causes you don’t care about, and anything else that makes you feel irritable, disgruntled, miserable, or resentful • Practicing gratitude • Buying candles – the expensive lavender ones from that little boutique, if that’s what tickles your fantasy • Engaging in community service that pleases you on a variety of levels • Getting real about what size you wear, and getting comfortable about it • Hiring help when you need it • Ordering dessert occasionally • Deciding you don’t care what other people think As you can see, there are many levels to self-care, or emotional nutrition. When you know what you need to do to feed your body, brain, heart, and soul, your priorities become clearer, you’re calmer, and you experience more life satisfaction. Quite often, you’ll find that symptoms of depression decrease. How about making your own list, and committing to practice at least item on it every day? Check in with yourself after a week, and again at 30 days. Note what’s changed. Keep practicing. 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.
Today, my post is devoted to a special project promoting registered dietitians. I am cohosting, with dietitian Renata Mangrum, the first-ever Registered Dietitian blogfest, aimed at showcasing to the Internet-surfing public the many things dietitians do and can do to help you with your quest for help. Listed below my entry is a list of links to other blogs written by other dietitians that you can visit to see the many things my friends and colleagues do within this profession.
inCYST was created precisely because I realized there was so much misinformation about polycystic ovary syndrome. Not only was it not HELPING women with PCOS to get better, some of the information seemed to have potential to actually HURT those women.
So I started this network as a means of putting together a team of professionals whose mission and knowledge was evidence-based and cohesive.
What has developed out of that has been far more than I ever could have envisioned when I sat down to do this. Several of our network members have PCOS themselves. Several others have gone through their own issues with infertility. Others have family members with mental health diagnoses, whose treatments for those diagnoses have affected their hormone function.
So as we grow, we are becoming a network of practitioners who happen to be people first, and practitioners second. I love that, because it means we've been there, we know how it can feel to have PCOS and its many associated problems, and we're committed to helping provide accurate information wrapped in a compassionate package.
I can't think of anything better I could be devoting my work and my career to. I hope you enjoy our blog…and I hope you enjoy getting to know some of the many colleagues participating in our blogfest today!
Warmest regards,
Monika M. Woolsey, MS, RD Founder, inCYST Network for Women with PCOS
Beyond Prenatals — Food vs. Supplements and Real Advice vs. Fake Advice Annette Colby — No More Diets! A Registered Dietitian Shares 9 Secrets to Real and Lasting Weight Loss Ashley Colpaart — Dietitians working in food policy, a new frontier Diana Dyer — There and Back Again: Celebration of National Dietitian Day 2009 Marjorie Geiser — RD Showcase for National Registered Dietitian Day — What we do Cheryl Harris — Me, a Gluten Free RD! Marilyn Jess — National Registered Dietitian Day--RD Blogfest Julie Lanford — Antioxidants for Cancer Prevention Renata Mangrum — What I'm doing as I grow up… Liz Marr — Fruits and Veggies for Registered Dietian Day: Two Poems Meal Makeover Moms' Kitchen — Family Nutrition … It's our"Beat" Jill Nussinow — The Registered Dietitian Lens I Look Through Wendy Jo Petersen — March 11 is our day to shine! Diane Preves — Registered Dietitians and the White House Forum on Health Reform Andy Sarjahani — Dr. Seuss Tribute continued: Green Eggs and Ham and a Sustainable Food System Rebecca Scritchfield — Big Tips from a"Big Loser" Anthony Sepe — RD Showcase: Registered Dietitian Day, March 11, 2009 Kathy Shattler — RD Showcase for Nutri-Care Consultation UNL-Extension, Douglas/Sarpy County — Nutrition Know How — Making Your Life Easier Jane Zingaro — My life as a Registered Dietitian http://workinggreenmom.blogspot.com/2009/03/my-life-as-registered-dietitian.html
I know, I know, that includes a lot of foods. I promise after the holidays, I'll get back to information about specific foods. But it being the holidays, and the relationships we have with food during the holidays not always being healthy, I wanted to digress today.
Part of the reason I want to digress is because I've had some wonderful food experiences this week. Monday a friend and her husband invited people over for a Caribbean holiday dinner. From the mango-cucumber-avocado salad with the peanut butter chutney dressing to the platanos to the almond paste…it was fabulous! And most of all, the conversation around the table was a wonderful way to spend a blustery winter evening.
Last night Ivonne, who sometimes posts on this blog, asked me to meet her and her fiance so she could share some gingerbread (made with stout) that she loves to make over the holidays. Again, we spent a couple of hours chatting and laughing in the coffeeshop of a local Barnes and Noble and just enjoyed the company. And, I had a delicious yet unconventional treat for breakfast this morning!
These are not foods I normally eat, but Christmas is not a normal time of year. The important thing is not what I ate. It was how what I ate blended into the rest of my life. I am still working out, but I'm not adding an extra hour to make up for the extra calories. I am still enjoying the food, but I'm not starving myself in between to"account" for the goodies. And, I haven't thrown up my hands in defeat and started eating and drinking everything in sight with a"What's the use, I've blown it?" kind of attitude.
The most important thing to keep in mind is that when your life is balanced, that is, you're eating a variety of foods in moderation, you're physically active, you're getting enough sleep, and you're managing your stress, an occasional Caribbean meal or gingerbread breakfast, in the long run, shows up as a slight blip on the screen, but it doesn't send off the warning bells. But, only if you TREAT it as a blip on the screen.
There's no need to punish yourself with extra exercise, starvation, guilt, whatever, because you took the time to enjoy the food that accompanied the festivities. Holidays are not an excuse to eat, and they're not a reason to punish yourself. They're about family, friends, reflection, and celebration.
I sure hope you've got Ivonnes, Gerdas, Joses, and family in your life to help you partake in the fun! (I'll talk about comfort food next week after my family celebration.)
