Medically speaking, attitude is everything.

On Tuesday I had my long awaited follow up appointment about “Weight management” after starting my thyroid medications. I was nervous, not knowing what to expect, as while I’d been on my best behavior food and exercise wise, my body likes to go rogue. We don’t have a scale in the house anymore either, and after several crushing weigh ins, I was expecting to hop on the scale and be met with a gain, because that’s always what happened before. Why should doing everything right matter? I got on the scale. Down three more pounds. WHEW!!!!! Now, 3 more pounds in a month and a half is devastatingly slow progress. However? It’s progress. Three pounds in a month, after ten months, is 30 pounds. I was relieved, and to make it even better, my blood pressure was fantastic – 110 over 79. As I celebrated my small but valiant victory, the new doctor came in and said, “Aw, too bad you haven’t had much progress, have you?”

My happy mindset deflated like a cheap balloon. I recognize that medically three pounds in a month and a half sucks – – but for a patient who gained NINE POUNDS after a 12 day detox eating nothing but cauliflower and medical shakes, it’s nice to see my body actually reacting in the way it should. As I explained to the doctor that I was actually relieved and happy with the weigh in, I realized how important attitude is. No, it’s not ideal, but a solid, “hey, we’re on the right track” at least, is invaluable to someone who needs a little bit of cheerleading. Most people refer to their doctor’s demeanor as “Bedside Manner”, and while I don’t need information to be sugarcoated, I would like a little bit of optimism.  This applies to all things medically related; a lazy liver, ridiculous allergies to feathers, even scary-looking but benign ovarian cysts. When shit’s gone wrong, some positive encouragement from people who know what they’re talking about is hugely helpful. Otherwise, Dr. Google and I spend lots of late night hours together, my anxiety growing as I comb through horror stories of the very conditions that ail me.

There’s part of me that thinks I need to just “man up” and look past a need for rainbows and sunshine in a medical environment. After all, medically, obesity sucks. It’s dangerous, it’s a huge risk factor, and for most people, it should be simple to treat. However, I’m not most people, and I’m also not the type of person who can easily man up. I’m sensitive. I’m artistic. Sometimes I wish I wasn’t. But; attitude is everything — and a positive one can make a big difference.

Have you had trouble with doctors having a more direct bedside manner? Does it bother you or not? Why or why not?

Crunchy, Chewy, Crispy Carbs: How many should I eat with PCOS?

Carbs. Salty, chewy carbs. Tortilla chips, sourdough bread, crackers, potatoes, rice. MMMM. CARBS. Oh, how I love carbs. I’d take the warm, chewy sourdough bread with a tab of melting butter over the freshly-baked chocolate cake any day. Who needs sugar when you can have BREAD?!

When all the Atkins and Southbeach and Zone diets started coming out, I remember having this reaction, summed up so exquisitely by Michael Cera in Scott Pilgrim Vs. the World: (And yes, Scotty, I could eat garlic bread for every meal, too.)

Now that I know what’s up with my body (PCOS and subclinical hypothyroid), it makes sense that in my dieting life, the only diet that’s ever worked has been low-carb. When you have PCOS, you are typically insulin resistant, which means that sugars and carbs spike your blood sugar, causing you to hold on to those calories and sugar grams much more than fat. Here’s a nifty diagram that explains it:

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I’ve had the sad realization lately that a low-calorie diet with exercise ain’t gonna do it. Oh no. My body needs less, and in a way, it needs more. More fat, less carbs. My doctor is sadly moving on to another practice, so next week I’ll meet with her replacement, hopefully somebody who can work with me and be like “THIS IS WHY YOU’RE FAT” (and, ahem, not point out the meal I had last week that *was* just a giant piece of garlic bread. Naaaaah. Couldn’t be that.) Today I started a super low dose of Synthroid to help get my sluggish thyroid moving a little bit, and I was also put back on Metformin, the diabetes drug that helps with PCOS insulin resistance. When I was on it last time for a few weeks, I remember lovvvving the energy boost I felt. I wasn’t dragging through the day. I’m looking forward to feeling normal again, even though a nice, nasty summer cold showed up today and I sound all froggy.

I’ve decided to start counting carbs again. While I’m not necessarily doing an Atkins style diet, I’m going to try to eat around 100-150 grams of carbs per day. I came to this number by doing some extensive Googling. The first two weeks of Atkins, induction, has you eating 40 grams of carbs or less. I figure 100 is a nice number that allows me to still have a piece of bread here and there, but for the most part, my meals need to be vegetable and protein. It’s not too bad, I suppose. I’d honestly rather eat low-carb than 1,000 calories, because at least on low carb you can enjoy olive oil, butter and cheese, sparingly. And who doesn’t love bacon?! I’ve been using My Fitness Pal and a new app called Daily Carb.

Given that low-carb has always been the key to success with me and weight loss, I’m hoping this new approach towards eating plus regular exercise and my new medicines will help get things moving the right way. Thankfully I’ve maintained a couple pounds down in the past month, which I’m hopeful about as the scale has FINALLY stopped moving up. I suppose it could be different when I weigh in at the doctor’s next week, but for now, I’m trying not to focus on the number so much as getting into a routine. Because consistency is key, right?

Have you noticed anything about how carbs affect your weight loss? Does it not matter? Are you one of those lucky people who could LOSE weight by eating only carbs?