PCOS Part 2: Treatment

Source.

This is the second post in a series. Here is the link to Part 1.

It is estimated that 5 to 10% of women who are of child bearing age have PCOS. (Source) That means that if you don't have PCOS, you probably know someone who does, or multiple somebodies. Here are some of the normal symptoms (source, source, source, and I'm stopping there...) :

• Infrequent, irregular, or absent menstrual cycles
• Multiple small cysts on the ovaries, and sometimes elsewhere
• Pelvic pain
• Hormonal imbalance
• Anxiety or depression
• Fatigue
• Mood Swings
• Migraines
• Infertility due to irregular or absent ovulation
• Increased hair growth on face, neck, stomach, back, hands, and feet
• Acne, oily skin, dandruff - often cystic acne
• Weight gain/obesity - normally around the waist
• Type II diabetes
• High cholesterol
• High blood pressure
• Thinning hair
• Skin tags - usually on neck or armpit
• Dark or thick skin located on the neck, arms, thighs, or breasts
• Sleep apnea
• Uterine (or other reproductive) cancer

If you don't have PCOS and know someone who does, read through that list once in awhile, then become a little more understanding, should she be fighting the ovarian demons, on some days.

Source.

I was diagnosed with Polycystic Ovarian Disease in November 2006, at my own request. I had been suffering from symptoms since my early-onset puberty, but no one had bothered to tell me that these symptoms weren't normal, nor had any attempt been made to pinpoint their cause. As my previous post relates, I took the information to the doctor, then asked her to determine if this was my diagnosis. It was.

The doctor was just as laid back about my treatment plan as she was about my diagnosis, so I basically told her what I had learned was the common treatment, and she wrote the prescriptions. Common for the treatment of PCOS is the diabetes medication metformin (generic of Glucophage), combined with a birth control pill of the doctor's choosing (or one the patient tolerates). I was prescribed 500 mg, twice daily, of metformin, and a birth control pill that was strong enough to regulate my periods. No one ever discussed this with me, not the doctor then. Not any of the doctors I've seen since then, until the doctor I have now.

As I mentioned in my last Dukan Diet post, I went to the doctor after some episodes of low-blood sugar, which had been caused by the combination of the low-carb diet and my metformin. I am neither diabetic, nor insulin-resistant. Since my 20+ pound weight loss, my body didn't need as much of the metformin. Yahoo! I'm on my way to being med-free!

Anywhere I have looked for information (an example) about PCOS, I have seen that there is no medically-proven "cure" for PCOS. There are varying schools of thought about its treatment, but no one says that you can be cured of it. What you see, over and over, though, is that the better your overall health and well-being, the more the symptoms recede. One study I recently read about said that as little as 5% weight loss could contribute to the significant lessening of symptoms. Keys to living with PCOS are acquiring and maintaining a healthy weight, exercising regularly, eating healthfully, and not smoking. All, pretty much common sense, right?

Possible Cures

Here's something else. There are some health professionals that believe there are 2 ways to get rid of PCOS. One, is to go through menopause, which changes your hormonal balance and ceases the menstrual cycle that adds to the cyclical nature of the illness. The other thing that "cures" PCOS in some instances, is a full-term pregnancy. (I doubt you'd find that listed as a "cure" anywhere, per se, though. I have only seen it mentioned in a few places.) In some cases, women who suffer from PCOS find that the hormone slate gets wiped clean by pregnancy, and they have a system reset. Some women fail to re-develop the same issues when their post-pregnancy hormone levels change.

Sadly enough, though, that doesn't mean that getting pregnant fixes everything. Women with PCOS may be twice to up to 5 times more likely to miscarry than the average population (depending on source, and definition), and PCOS causes infertility in some women.

American Pregnancy Association states that "Studies reveal that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage." I'm seeing 45% rate of miscarriage in PCOS women commonly quoted, but I'm not finding the source of that percentage anywhere. Wikipedia says 30-50% (source). I've seen people "quoting" that the rate could be as low as 9% if metformin is continued through the first trimester, but I can't find the source of that, either. Wikipedia cites a two-thirds lowered risk with use of metformin (source), but goes on to say that "a 2006 review of metformin treatment in pregnancy found insufficient evidence of safety, however, and did not recommend routine treatment with the drug." (source)

A list of common treatments for PCOS (source, source, source, and I'm stopping there):

• Lose weight, eat healthfully, exercise regularly 
• Quit smoking
• Medication to lower insulin, combined with a fertility drug (if trying to conceive) or a birth control pill
• Hormone therapy, either with a birth control pill or other medications or injections
• Surgery such as ovarian drilling or an ovarian wedge resection (from what I can tell, neither is practiced regularly-- mostly used as a last-resort attempt when infertility is a factor)

Contrary to what you may have heard, even though you may not die from PCOS per se, you can die from what it causes. Cancer, heart disease, diabetes, etc., and when you add in the miscarriage rate? Most of the time PCOS is a pain. Sometimes, it's deadly. 

Who do you know that might benefit from a little more kindness, gentleness, and understanding?

My next post on this topic will be about living with PCOS.

Much love,
LL~

My Dukan Diet: My Status and Intermediate Results

This is the third post in an ongoing series, and it intersects with the series on PCOS:

1. My Dukan Diet: History
2. My Dukan Diet: the Process

*******************************************************************
Something I'm happy to say: this diet process seems to work for me. Nothing else has. Thank you, my dear friend (Full Time Wife), for introducing me to the Dukan Diet.

I am in the process of losing 45 lbs. This is a picture of one pound of fat. Gross, eh? When I reach my goal, I will be at a weight I haven't been since high school. I think that's the first time I've admitted that to myself, and it's out here on the world wide internets for y'all to read. Typing this paragraph gave me a whole surge of negative thoughts, to which I won't give voice.

Instead, some things I should remind myself:

• I have PCOS, which adversely affects most of my metabolic and hormonal functions. 
• Not knowing I had PCOS until 2006, and then not knowing what to do about the weight gain associated with it after my diagnosis made it unreasonable for me to think I should have been able to do something productive about it. I tried and failed, because I didn't have all the facts. 
• Calorie counting has not worked for me. I have proven this over, and over, and over again. Strict adherence to a number of calories does not work with my wounded metabolism.
• Structured diets have not worked for me. I have proven this over and over. 
• Exercise only works for me up to a point. I am big-boned. I am muscular. I need to not delude myself into thinking I can look like I have a different musculo-skeletal structure. My doctor confirms this.
• The weight I am working toward is healthy for my height and structure, and it is reasonable to believe that, given the correct plan and execution, I can attain it and keep it. My doctor helped me set this goal. 
• Healthy is the goal. 

I started the Dukan Diet in January.  I immediately began to see results, and in the first 3 months, dropped 22 pounds. I lost 22 lbs, at a rate of between 1.5 to 3 lbs per week, which is considered healthy weight loss. Now, this is not fast weight loss, nor was it easy. It was VERY simple, though. You just eat unrestricted quantities of protein or protein + vegetables (albeit specific proteins and vegetables, and depending on the day). I can do "unrestricted quantities" of good food. It does, however, get very boring. Like I said, not EASY, but simple.  

Screeeeeeeeeeeeeeeeeeeeeeeeeech to a halt. The not-easy part is what hit me as I was starting month 4, mid-April. I hit a plateau, because I had arrived at a weight range I occupied successfully and happily for several years. My body is happy there. This is where my clothes fit. Not just the stretchy ones I bum around in-- the tailored ones I haven't even tried to wear in the last 3 years or so, since I've been a permanent telecommuter. It stopped being simple, because it was easier to be in that comfortable place than it was to keep pushing. At this point, several things happened at once.

• I began to doubt myself. I doubted that I really needed to lose any more. After all, that would mean replacing my wardrobe, and I absolutely loathe shopping for clothes.  
• I didn't have any energy. (More on this in a minute..)
• I was TIRED of dieting all the time, missing out on date night dinners with my husband because it was too expensive and depressing to try to go out and get all meat (at some point, I'll probably say more about this). Eating at home is wonderful, but those special dinners mean something to me.
• My darling husband was getting tired of me being tired of it all. 
• We went on a trip, and I just didn't have the energy or time to prepare everything I needed for my diet before we left, so I took the weekend off, while we traveled.
• My husband told me, on our trip, as we sipped the first glass of wine we'd had together in 4 months, how much he had missed that-- the feeling of sitting together, sipping wine, talking, and being on a date. It broke me. He has always said that he doesn't think I need to lose any weight, and only supports me doing what's healthy. 

When we got home, I struggled for a couple of weeks and managed to squeak out three more pounds of weight loss, so that I could hit the 25 pound mark, and we could enjoy our reward dinner together. It was really hard. For the first time, since starting this diet in January, it was really hard.

One night, I bottomed out. I felt lousy, and felt almost comatose by the time we finally ate something. I had had a good workout that morning, and had gone for a walk with a friend. I hadn't eaten much. It was a little scary to feel that low energy. The next day, I still didn't feel well. I went to a walk-in clinic. The doctor said my blood sugar was pretty low, and that I needed to follow-up with my primary care physician and in the mean time, eat every couple of hours.

Part of the standard treatment for PCOS, as I will be explaining in my next post in that series, is the prescription of a diabetes medication. It has a side benefit of helping with some of the metabolic and hormone shifts that occur in the average PCO woman. I had never had any trouble with blood sugar. I'm not diabetic (PCOS causes diabetes). I'm not insulin resistant (common in PCO women), either. So one of the methods of treating the disease was exposing me to a medication that helps control the rate at which sugar hits my blood stream. When you're not taking in any foods that contain sugar, any carbs (except the 2 TBS/day) which convert to sugar, any alcohol which acts like sugar, etc., and you're not someone who has trouble with sugar-- taking a pill that slows down your sugar metabolism under those circumstances can have an adverse effect. I went to the doctor.

My doctor's response to all of this was to cut my medication in half. Getting off medication is one of the reasons I'm losing weight. I want to be healthy. Healthy, and unmedicated. She did some blood tests on me, and she helped me evaluate and re-set my weight loss goal. She said that 10 pounds lighter than I originally planned was definitely achievable, and that it would be healthy for me. She also said that I shouldn't attempt to go lower than that, because of my bone and muscle structure. She said not to stop this diet, because it's working with my body, instead of against it. She said that we would need to reevaluate my medication as I continued losing weight, but that she was "really proud of me" for all I'm doing to get my health in order.

Much love,
LL~



Next installment of this series, coming soon!

Modest Monday linkup with The Modest Mom

Today I'm linking up for the first time with The Modest Mom for her weekly linkup called Modest Mondays. This is what I wore to church Saturday evening. This is my most favoritest skirt, now. I've been wearing it and another one similar to it so much that my husband is surprised to see me in something else, some days. Well, ya hafta do laundry SOME time. :) I got both the skirt and the blouse at the Thrift Store down the road. As you can tell, I still have about 20 lbs left to lose, but I'm getting there.

Since my darling husband was going fishing with his buddy, John, for a Father's Day retreat, we went to the Saturday evening service. I have to admit, it was odd having the whole day yesterday to do with as I please. Our community group was off for Father's Day, and we'd already been to church. So, I spent the time sewing. I was a happy Lovey, let me tell you.

I've followed The Modest Mom Blog regularly for some months. Caroline has such a sweet spirit about her, and has brought some things to the front of my mind to reexamine to which I honestly hadn't given a second thought since high school. She has a store, as well, and I just ordered something from her last week. I can't wait to see how it fits. :)





One of the things I've thought a lot about is from this video she's used, and I've seen it on several other linked blogs as well. I can't tell you how many times I've listened to the first 8:46 minutes of this. (After that it gets a little repetitive, pieces of varying volume are spliced together, so I usually just listen to the beginning. I'd say listen to the whole thing at least once, though. It's worth it.)



One of the things that he says is that immodesty is an expression of arrogance. That makes complete sense to me, but I've never thought of it in those terms. I wrote that on a sticky note and stuck it to the shelf in my closet where I could see it every time I get dressed. It's really made me think. Who is going to see me today? If the UPS guy shows up at the door, will I be appropriately dressed to answer it? Where am I going to be, and what can I do to make myself safe for the men around me? What of my body can I share with my husband today, and only with him?

So, my thoughts have been different when I prepare for the day than they ever have in my life. I'm learning, even though this is a lesson I thought I had pretty well nailed down in my life previously.

What are you wearing today? Is it modest? Take a picture and link up with Caroline from The Modest Mom blog. :)

Much love,
LL~

My Dukan Diet: The Process

The Dukan Diet was formulated by Dr. Pierre Dukan in France. The website takes you through a questionnaire that requires multiple kinds of information in a quick, easy format. Its results take into account your height, weight, gender, age, family history, bone structure, etc. This information goes in, and the website tells you what your "true weight" is. True weight is a goal that should be reasonable, based on the criteria you provided.

The Dukan Diet is a four phase process. The idea is to help you kickstart weight loss, drop the weight, then not gain it back. Here are the phases:

• Attack Phase - In the Attack Phase, you're permitted only proteins (meats & selected non-fat dairy), and a little oat bran each day. The length of the Attack Phase is determined within the website's algorithm that takes into account how easy it is for you to lose weight, the number of diets you've been on, etc. My original Attack Phase was 7 days. My mom's was 5. My dad's was 3. My best girl friend's was a whopping 12. This phase kicks your body into weight-loss gear.
• Cruise Phase - The Cruise Phase adds vegetables back into your diet. (Not all vegetables, though.) Alternating days you get either a PP (Protein day, just like in the Attack Phase) or a PV (Attack day plus veggies) day. Every day you get a little oat bran, too. This phase takes the weight off slowly enough to not put your body into shock, but quickly enough that you don't lose heart.
• Consolidation Phase - The Consolidation Phase begins when you reach your true weight (the website lays out how long they estimate it will take you to go through each phase), and lasts 5 days for each pound lost. This phase begins reintegrating foods back into your diet. You get bread, fruit and cheese, again. You get one celebration meal per week, then two, which include anything you want (including alcohol, dessert, fat, oil, pasta, whatever) but only one serving of each. No seconds. There are a few more expansions during this phase, too, but having not reached it, yet, I don't have them memorized. Consolidating the weight loss keeps your body at the established goal weight, while gradually reintegrating you into societal norms. At this point, it gets easier to eat out with friends, attend parties, etc, because your options open up, some.
• Stabilization Phase - The Stabilization Phase begins when you've completed the consolidation phase. In this phase you are permitted to eat anything you like, six days per week. The rules are:  you do one day every week (preferably the same day, each week) of the Attack diet, to keep your body on track; you eat anything you like the other 6 days, but no second servings--take as much as you want in the first serving, but don't go back; and you never take an elevator or escalator again. (In theory, anyway. I've found that some places it's awfully hard to avoid.) This phase continues indefinitely, and serves to keep you at your established, consolidated new normal weight. 

While you're working through this, you are to walk every day. Nothing more strenuous is encouraged. You are to eat your oat bran (1 1/2  to 3 tablespoons, depending on phase) every day. You are to never take an elevator or escalator, ever again. (Like I said earlier, in theory...)

So this is my super-abbreviated rundown of the Dukan Diet. My doctor is in favor of it for me, because it's working to get my health in order, while nothing else has. You need to talk to your doctor before you attempt it. I'm not a licensed medical practitioner, nor do I provide health or weight loss advice. All I do is make observations about the efficacy of what I do for my own body.  

More soon on how things are going for me...

Much love.
LL~

Ovaries, Whiskers, and Fat Cells! Oh, My! (Part 1)

I mentioned in a previous post that I have been diagnosed with Polycystic Ovarian Syndrome (PCOS), otherwise known as polycystic ovary disease, functional ovarian hyperandrogenism, ovarian hyperthecosis, sclerocystic ovary syndrome, and Stein-Leventhal syndrome. Thanks, Wikipedia.

Source: I Heart Guts 

(Personal note, I find the plush organs and cells 

and things to be extremely humorous.)

I was diagnosed in 2006, and it was both a relief and a trauma for me. It was a relief because I FINALLY had some explanation for all the stuff that was weird about me. It was a trauma because "now" I was diseased. Gasp. Wail. Oh, the woe! Sob. Sniffle... Yeah. That. Truth be told, nothing had changed. I wasn't suddenly afflicted. I had been for a long, long time. I just didn't know it. It was still tough to wrap my brain around the diagnosis though. But, NOW I could do something about it.

As for the relief, here are some of the symptoms that, while seemingly unrelated, were suddenly explained by this diagnosis:

• Irregular menstrual cycles
• Horrendous cramps, PMS, etc (worse than any of my friends, and I'm not a lightweight when it comes to pain..)
• Oh, yeah, speaking of weight, though not light... Weight gain. And difficulty losing it. 
• Migraines (sure, my mom gets them, so maybe they're hereditary, but who knew my ovaries could have anything to do with them?)
• Hirsutism. Or whiskers. Yeah, those pesky things that even 4 years of electrology didn't even slightly help, and one of the primary reasons I got made fun of in high school.  I remember the comments and sneers, even to this day, and long for a retort. Still haven't thought of one, almost 20 years later. Still stings-- being ridiculed for something I really couldn't figure out how to control. To this day, I spend about an hour a day plucking facial hair. Ya. Hoo. It turns out, it's a good thing I'm not a lightweight in the pain department. Some people can't handle plucking. Or electrology. 
• Cystic Acne. Another thing that doesn't make you popular, and another thing that it turns out I couldn't have controlled, no matter how hard I tried. At 32, I still have it (though admittedly to a much lesser degree than what plagued me in high school, junior high, and, oh, yes, ELEMENTARY school)... Because I still deal with it, I find it extremely humorous when someone compliments me on my skin. I do have amazing skin care, supplements, and make-up products now, though, which makes a HUGE difference in what people see. That, and I'm a hermit. If they don't see me, they don't see my whiskers and zits. 

Random Senior Picture, just for the fun of it. 

Some of the other things PCOS causes, but I have yet to develop (and therefore have yet to be made fun of for having):

• Heart disease
• Stroke (which already runs in the family)
• Depression
• Cancer
• Insulin Resistance, leading in many cases to Diabetes
• High blood pressure
• High cholesterol
• Infertility

Back to me. Because that's how this post is going to roll.. There are varying studies that show a link between early development/puberty and PCOS, but nothing that shows causality, at least that I've come across-- whether one causes the other, or vice versa. It just seems that those of us who developed freakishly early (something even adults made rude comments to me about, when I was in elementary school... no question where the KIDS get it, if grownups are jerks... It's called acne. Deal with it. Yes, I know I'm in 2nd grade. Yes, I do need to be wearing a bra. Jerk. Glad I didn't respond that way, then. I was more confused by the comments and questions than anything, then. Now it makes me mad that people could be that insensitive to a little kid.) also often get the added bonus of having psycho ovaries. Woohoo! (Yes, I know that was a really long parenthetical rant, and you probably had to go back to the beginning of the sentence to figure it out. I'm sorry.)

Let me explain to you how I got the diagnosis in the first place. I was living in Arlington, VA, and read a magazine article that was talking about reproductive health. It had an inset box that showed symptoms and potential causes of the symptoms. I looked at one of the sections and said, "Wait a minute. I think that's me." It had never occurred to me that these things might have a link, much less a cause, unified or otherwise. It was just normal for me. I didn't know it wasn't normal for everyone. I didn't know that other people didn't fight with all of this stuff, well, except the period misery, perhaps. I knew there were other girls who didn't have that trouble, but I figured it was just a continuum of misery, of sorts, and that I just landed at a different place on the continuum. Apparently, it had never occurred to my doctor to look for a cause. 

Source. An amusing post, too.

So I researched. Everything I could get my hands on about PCOS went with me, back to Leawood, KS to the doctor group I had been seeing for 12-15 years or so. I laid it all out for the doctor, with everything that matched my medical history and symptomology highlighted, and asked her to see if this was a valid diagnosis. She basically shrugged and said she could order an ultrasound to find out. Turns out it was. Turns out, they had the equipment in the office, and it also turns out that I could've had this diagnosis for a long time, as well as a treatment plan. 

The doctor gave the diagnosis, and I explained to her that my research showed that normal treatment for PCOS was a combination of metformin (generic of Glucophage-- a diabetes medication, off-label use) and low-dose birth control pills. Another shrug, and the prescription pad came out. 

I've never, in the 6 years since my diagnosis, had a doctor sit down with me and educate me about this disease, or its treatment. For the most part, it seems I've known more about it than the doctors. Sad, eh? I say seems, because the doctors act like they don't know the answers when they ask me questions about PCOS and I tell them about the studies on PCOS women, treatment, etc., as well as my own experiences. Perhaps they do know, but it takes less time and effort to talk about it when they see I've done my homework. Of course, I've taken the time to educate myself, so there's that. 

This post is getting extremely long, so I believe I will make this a series. Part 2 (about treatment/cure), coming soon. Part 3 will probably be about living with PCOS and what it means for ongoing health/life issues.

Much Love,

LL~

My Dukan Diet: History

I didn't think I was fat. I really didn't. I've always had an hourglass shape. I swell uniformly. My waist is always smaller than my bust and hips, so sometimes it's hard to tell how bad the weight gain is. Well, I didn't think I was quite THAT fat, anyway.  Until I saw the hundreds of pictures from my bridal shower popping up on Facebook. Oh. My. Who in the world is that...? Poop. That's how people think I look??????

(This one's probably the best of the batch. I'm sucking it in, here.)

I worked really hard. I truly did. When I moved to Greenville on 29 March 2011, I joined Curves (again), and began working out 5 or 6 days per week. No change. Several people told me that calorie counting was the way to go. "The numbers don't lie," they said. I counted calories. I had an app on my phone, and didn't put a bite in my mouth or take a sip of anything without logging it in. I cut out sugar. I cut out alcohol (except the occasional glass of wine with my fiance). I didn't always make the wisest decisions, but I counted the calories, and the numbers? THEY LIED.

I managed to, just barely, shave off 10 pounds before my wedding, over the course of 6 months. I worked my ever-loving rear end off to do it. I was running between 1000 and 1300 net calories for most of those 6 months, which should have taken off WAY more than 10 lbs, especially with my workout ethic. I was walking with my friend (a couple hundred calories off) several miles each time, several days per week. I was working out at Curves (300-600 calorie workouts-- thanks, Curves Smart system, for tracking my calories) 4, 5, 6 days per week-- in addition to walking. The numbers didn't work.

Now, before I get flack from people who think they know better than I do, I need to explain something. I understand that some people can count calories and work out and lose weight. I am not one of them. Before you tell me how wrong and stupid I am to think that way, let me tell you this. I have Polycystic Ovarian Syndrome (PCOS), and that, my friend, is a game-changer. I'll write other posts about this interesting phenomenon, but let me sum up..

PCOS helps you put on weight. PCOS helps prevent you from losing it. Many women (though not all) with PCOS tend to develop weight problems ranging from mildly overweight to morbidly obese, because our bodies are hormonally unbalanced. The cause of weight gain and difficulty with weight loss is that the hormones (which are out of whack) cause a basic metabolic problem. The metabolism doesn't do what it ought. Even if you treat the symptoms of PCOS (yet another post to cover that), it's incredibly difficult to maintain or lose weight. The fascinating part is that a weight loss of as little as 5% (if you weigh 200 lbs, that's only a 2.5 lb loss) can begin to restore the balance to the hormones, which in turn affects the rest of the issues with the disease.

Back to the pre-wedding efforts-- I worked really hard, and got really depressed about how hard I was working without seeing the results I expected.

About a month before the wedding, my Matron of Honor (Full Time Wife-- FTW) suggested I try the Dukan Diet. I couldn't wrap my brain around it at the time. I was working so hard, trying to lose weight. I was preparing to get married some 800+ miles away from where I lived, and the traveling back and forth was wearing me thin ragged. My husband's boss (the scumbag) retracted the approval for him to work remotely during the week prior to the wedding, which meant our entire wedding travel plans had to undergo a last-minute overhaul, and I just couldn't even begin to think of starting something new.

I got married, and we traveled back to Greenville to set up house, then went on our honeymoon to Jamaica. Within a couple of months of the wedding date, I had gained back the entire 10 lbs I had worked so hard to lose, as well as an additional few. I now weighed more than when I had started. De. Press. Ing. Really.

In the mean time, my beloved mother had taken the FTW's advice to heart, and had begun the Dukan Diet. The weight was peeling off her, quietly. She began to suggest I start working on my weight again. Initially, I just didn't have it in me. Working so hard to produce such paltry results was exhausting and depressing. I was trying to learn how to be a wife. I was attempting to set a new home in order, while still in the middle of renovations. I was learning that being married meant that everything about me had to change, and I was working so hard on that. The idea of putting a full-time effort into weight-loss, too, was more than I could do.

Over the first few months, I was trying to find a foothold. I began to gain some ground. The house began to settle. I started thinking about who I want to be, and what I need to do to be that person. My husband and I began dreaming of the future together, post-wedding. What would it take to get there? What would it look like? I knew I didn't want it to include pictures like the ones from my bridal shower.

(Awwww... Look at the happy fat lady!

Oh, and no, this isn't even the worst...)

Two conversations happened. A friend suffered a miscarriage, and she had a very serious conversation with me. "I just want to encourage you and all the ladies in my life to be really serious about getting your health in order BEFORE you get to the point where you start having babies. It's the best thing you can do for you, your husband, and your children. Be healthy first."

My parents came for Christmas. While my dad and I were out for a walk on our street, he was telling me about how proud he was of my mom for her weight loss. "She's always been able to just get really mean with herself. When she decides she needs to make a change, she just gets really disciplined, and she doesn't let herself get away with anything. Even when I tempt her with dessert or try to get her to have a nice meal, she says, 'That's not on my diet, right now,' and doesn't give in."

From those two, brief exchanges came many hours of thought. I made some internal decisions, then talked them over with my husband. I decided that the woman I want to be is someone who is known for the discipline in her life, like my mom. I also decided that I wouldn't drag my health baggage and carry-ons into my husband's or children's lives. I want to be fit for my family, so that I don't have any excuse to not live life fully. My husband, who is an amazing, supportive man, reluctantly agreed with my thoughts. He didn't feel I needed to lose weight. That's just how wonderful he is. He said that he would support me, as long as what I'm doing makes me healthier. Thin isn't a goal that's acceptable to him. Healthy is.

In January, I started the diet.

More to come...

Much love,
LL~