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March 20th, 2010
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Today I had a breakdown. Not the sobbing, woe is me kind. But the kick it to the curb, throw it out the window kind. I'm ready to kick my health to the curb...once and for awhile to get everything straightened out and stop stressing over hormones and supplements and money. So here's what I decided to do:

 

Since starting the bio-identical hormone treatment, I've seen great improvement in several areas. My fatigue is generally improved (unless I'm under high stress). My periods are less irregular. My joint and muscle pain is usually completely gone (had a few bumps while they moved things around). And a lot of the odds and ends of pain that struck my body at random moments vanished. Plus we all know that after starting these treatments I lost weight that wouldn't budge before then.

 

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Today was my last dermatology appointment for the Accutane. I'm a mixture of excited and sad. I'm excited because the Accutane has been such a hassle. Monthly doctor's appointments and blood draws, debilitating side effects, and just the stress of putting this into my system. So now it's over. Awesome.

 

Except that my dermatologist isn't exactly happy with my results. Yes, I'm much improved. 90% in fact. But according to him, he likes to end things at 100%. He even suggested staying on it longer or switching brands.

 

Right now, I'm just not up for that though. My body needs a break. I need a break. To just feel normal again. To not be so tired, so fatigued. To go one day without a headache or muscle ache or joint pain. For my body to just feel closer to whole rather than endlessly worn out.

 

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I'm six weeks into my Accutane treatment. My first month I had a 45% improvement from my starting point. The second month seems about the same, but we'll see in the next two weeks. I've had quite a few side effects. Dry lips being the worst. I'm only recently starting to experience extensive dry skin, leaving me with tiny red rashes much like eczema. I've had back pain, some joint pain, and a few headaches.

 

The worst side effect has been the effect it had on my blood sugars...forcing me to raise my Lantus and lower my insulin to carb ratios due to intense insulin resistance. Luckily, I've managed to get that into much better control. And I'm looking forward to it resolving once I'm done with this treatment.

 

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ADM logoIt's my time...to prioritize in my own way.

You may have noticed that diabetes hasn't been my first priority here lately. Not only is school speeding by faster than I can possibly keep up, my other health conditions are facing a lot of changes. Changes that I'm so ready for, but also not prepared for at the moment.

 

First, I'm starting birth control today after going off the progesterone almost two months ago. I'm hoping that the birth control will help with the premenstrual symptoms that I experience (like cramping, joint pain, headaches, and fatigue), without leaving lasting side effects (like weight gain, stroke, or pulmonary embolism). It took a lot to make the decision to go on it again, but I've made the decision and now I'm excited to see the results.

 

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This morning, I went for a second opinion on my current reproductive status. Back in late August, my Well Woman Exam turned into a possible endometriosis diagnosis. So I decided to go for another opinion before pursuing further treatment options.

 

And I have to say that I was pleasantly surprised by the doctor. New doctors are always interesting, especially those related to gynecology. But this doctor reinforced the idea that doctors can actually be helpful, understanding, and interested in what you actually feel or need.

 

So his opinion was that endometriosis is the likely choice as to the causes of some of my reproductive issues. Since I've tried most of the obvious treatment choices (NSAIDs, birth control pills, and pain management), the next step for a woman my age is surgery.

 

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It's been a little over three weeks since I started tapering off the medications I've been on for the past 18 months. If you're new to my health world, I was on bio-identical hormones for a multitude of health conditions (PCOS, hypothyroidism, adrenal fatigue). Quite a few of my major symptoms disappeared or eased while I was on them (joint pain, mood swings, more regular periods, fatigue, and so on), but a few in particular were only making my life worse. Much worse.

 

My acne (one of the main symptoms I'd originally gone in with) had not only persisted but gotten 100x worse going from moderate to severe. And even though my periods were much more regular, I was still experiencing terrible headaches and cramping several weeks out of the month.

 

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Over the past few months, I've been slowly cutting back on the amount of bio-identical progesterone I was using. I was pretty sure that it was the cause of my sudden, severe acne...when the progesterone doses went up, my acne appeared. Plus I wasn't seeing the kinds of results I wanted or intended to get from it.

 

Although my periods were more regulated, they were still off by a few days to a week. And they were still incredibly painful, which meant that I was having more pain throughout the year than I'd had before with irregular periods. Opting out of pain seemed the best idea. The main things that I loved about the progesterone were that it balanced out my moods and it took away the headaches, joint, and muscle pain I'd experienced.

 

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I'm finishing my second month on Accutane this week. So far, I've seen about a 60 to 70% improvement in my acne. Unfortunately, my doctor says it's still not where he wants it to be (and I completely agree). He's increased my dose to the maximum and plans to keep it there for the next three months (the rest of my course) unless the side effects become too much to handle.

 

Another reason for the increase is to avoid a relapse after I go off of it. He's mentioned this to me several times...that he isn't quite sure Accutane will be a permanent fix for me. The reason being that if I truly do have PCOS (which multiple doctors have agreed with now) then my hormones will just go back to where they were and it won't matter.

 

So I'm taking some time today to look into my different options with PCOS treatment. Unfortunately, I've done or am doing quite a few of the suggestions. And I'm just not sure where else to turn.

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I've been extremely frustrated with my health lately. I'm usually at a heightened sense of frustration, but the past few weeks have hit me hard. To the point that I'm feeling hopeless, desperate, and just plain lost in the sea of chronic conditions.

 

My diabetes isn't the main issue, even though it's always a source of stress in my life. Mostly, I feel like I'm just going along with my diabetes at the moment until my doctor's appointment later in the summer. I'm keeping up with my insulin, eating normally, exercising, and all that...just not focusing on making changes. I feel like I don't know where to make the next change, so I just want a break to absorb what I have right now (which are averages in the 150's).

 

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Weaning off then completely stopping the progesterone has been interesting. I've definitely felt my old symptoms come back, like I mentioned last week. A drop in mood, fatigue, and some of the joint pain are the main issues. But there have also been positive changes.

 

Like the level of pre-period pelvic pain didn't start the usual two weeks out. Of course, my period could be another two weeks away since they are incredibly irregular. But so far, I've only had maybe 2 days of pelvic pain as opposed to a usual 5-10 days. If I could limit it without progesterone, the endometriosis surgery might completely clear whatever else is causing the pain. We'll have to wait to see about that one though.

 

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Michelle Kowalski
Michelle KowalskiMichelle Kowalski, a writer, editor and photography hobbiest living in Phoenix, was diagnosed with Type 2 diabetes in February 2005. In January 2008, as part of her quest to start on an insulin pump, Michelle learned that she actually has type 1 diabetes. (Read More)
Lindsey Guerin
Lindsey GuerinLindsey is a typical, yet unique, Texas girl who loves shopping, movies and reading. She loves to travel and take risks. She dreams of diabetes cures, never-ending cheesecake and her own airplane. The rest you can discover in her blog! (Read More)
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