I'm really irritated with my weight lately. I've gained over five pounds back from the twenty that I worked so hard to lose last year. It all started after my endometriosis surgery and the start of Accutane.

For one, my surgery got me out of my incredibly strict habits of running and working out. I had to take time off to recover. And once that recovery was over, I just couldn't get back into it. I missed it. I missed the way my body felt, but there were bigger things stopping me.

The Accutane was the biggest hindrance. There was the fatigue. There was the joint pain, then the back pain. Then the headaches. One thing fell on top of another and working out was the last thing on my mind.

Along with the pain, Accutane threw my blood sugars into a tailspin. Averages in the 200s. An A1c that jumped from the 7% range to 8.6% then to 9.0%. With the more aggressive management, I started seeing more lows. Unfortunately, most were when I seemed to be heading to work out.

I know not working out is a portion of the weight gain. But the bigger picture says that my insulin needs are doubled and my hunger is threw the roof. Two major aspects to the climbing weight.

So I'm trying to make some changes to stop the gain and lose what I've already put on. But some of the changes, I'm not so sure about.

For right now, I'm trying to run at least once a week. And I'm trying to do yoga whenever possible, even if it isn't as intense as a normal workout might be. I'm not really changing my eating habits besides snacking less and opting for a few lower calorie meals a week...the hunger is just too overwhelming.

The things I'm unsure about are the diabetic options that I have. First, I can switch from Lantus to Levemir. Levemir seems to cause less weight gain and less lows (which lately are a good chunk of why I'm consuming excess calories). But it also is less effective in some studies and doesn't last as long as Lantus apparently.

Second, I can start the Metformin (if my doctor approves the research that I've found). It may not do anything for my weight, but it also might. It's also something that I've been hoping for to deal with the PCOS symptoms. The only negative with Metformin is the insulin changes that I'd need to make and the possible nausea in the first month or so. It might be trouble and stress for a short time...but it also might be the answer I've been looking for.

Third, I can try Symlin. It's known to lower insulin needs, show moderate weight loss, and lessen the hunger that we diabetics experience. This is the one I'm really not wanting to do. Even though it's proven to do all these things, it's something that I don't think fits into my lifestyle. It's another injection with each meal. It's more lows for awhile. And I can only take it if I consume more than 30 carbs in a meal (not really a problem normally though).

I could also do all three. Lots of changes, but I'd stagger them and try my hardest not to stress out my body or my mind with all the new management. I just really want the weight off. I really want to feel hungry less. And I want better blood sugars.

I have 20 days left on Accutane so right now, I'm trying to push through these last TOUGH 20 days with the fatigue and headaches. But I also know that I can't push this off any longer. For my mental health, I just can't. I don't know how long the fatigue might last after these 20 days are up. So the longer I push it off, the harder it will be.

I just have to decide all these changes by Wednesday so I can be prepared for my doctor's appointment. I'm sure she'll have some ideas and she'll at least be a sounding board. But I also want to know what I want before I get someone else's opinion. Just a matter of weighing the pros and cons. And stepping on the scale a few more times.