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PCOS, Fibromyalgia, Stress, And Weight Management

Q: I'm at my wits end and don't know where else to turn. It's been 9 years since my health has been "normal" and after being told I eat too much, I don't exercise enough, "It's just stress...".  I finally got to a doctor that took me seriously, but with my husband being in the military, we moved not too long after this doctor started to treat many of my problems.

I was diagnosed with pseudo tumor cerebri, B-12 deficiency, fybromyalgia, sleep apnea (have had surgery for this--LP3 with a tonsillectomy) and polycystic ovarian syndrome (by my current doctor's referral to an OBGYN).  After my last two lab results (which I had to beg for almost 2 years to be done), my current physician was concerned with my FREE T4 and TSH results and sent me to an endocrinologist. The endocrinologist was initially concerned then felt that my polycystic ovarian disease was probably the problem and the FREE T4 and TSH levels were not something to be concerned about.

I was wondering if you had any suggestions on which route to go. It seems that I have to do the research and prove to the physician that I have the symptoms (by begging for certain tests to be run) before I get referred to the "right" specialist.

The only way I finally received a referral to my OBGYN for PCOS was after researching the symptoms I had (severe pain in the area of my ovaries, discovering a couple of cysts on my ovaries thru an ultrasound, hair growth on face and body, darkening of my skin in certain areas, gradual weight gain of 90 lbs during the previous 8 years, headaches that were not pseudo tumor headaches) and pointing these specific signs out and voicing my concern of possibly having PCOS and asking to be seen by my OBGYN. After just one appointment and a couple of ultrasounds my OBGYN informed me that I had PCOS.

Current Symptoms: I currently am 250 lbs (5'5") and have: heavy menstrual cycle every other month, facial hair, mild to moderate pain in ovaries 1-2 days per month, 3-5 soft bowel movements per day, get hot and sweat easily (keep the temperature in the house at about 68 degrees), feelings of anxiousness, difficult to concentrate and stay on task (I now have difficulty even reading anymore...I seem to just quickly skim thru a book), insomnia (but I fall asleep easily), mood swings (per my patient hubby), aches and pains throughout my body more feet pain (more in the morning when awakening...but pain throughout the day), ringing in my ears, dry eyes (even without contacts), tingling sensation in my toes and finger tips.

I hope maybe you could help me by showing me a route to follow so that I can get well and be "normal" again. Thanks ahead for your time!

--T. U.

Dr. Donnica:
Dear TU:

I am so sorry to hear about all the medical stress you have been through unnecessarily!  And now that you have finally gotten the proper work-up and the right doctors, you've moved!  Obviously, I can't make personal recommendations about your specific course of medical therapy, since I'm not your physician.  However, I recommend that you make an appointment with an internist and an ob-gyn in your new town (see "How to Choose Your Gynecologist").  Send all your medical records to them in advance of the appointment AND print out the email you sent to me, which is not only an excellent summary, but indicates your level of frustration.  At your appointments, ask them what they recommend as next steps.

In preparation for these appointments, I also recommend that you read "5 Questions to Ask Your Doctor".  This article discusses the importance of good communication with your physicians and how to achieve it.

Your most significant medical problems sound like the Polycystic Ovaries Syndrome (PCOS) and the fibromyalgia.  You may also have a borderline hypothyroid condition.  You need to sort these out with your doctors.

In the meantime, the best thing you can do for yourself is to exercise -- even if it's just walking around the block once to start, then increase a little each day.  With PCOS it IS more difficult to lose weight, but ironically, exercise itself can help the condition.  Fibromyalgia will make you feel like exercise is the last thing you want to do. Ironically, aerobic exercise has been shown to improve the pain of fibromyalgia.  Exercise can also help your mood.  The more aerobic exercise you do, the more you can increase your metabolism and decrease your body weight, thus improving your PCOS.  I also highly recommend Weight Watchers for the group support.  Just because you have a medical condition that makes it more challenging to lose weight doesn't mean you can't benefit from proper nutrition. 

The facial hair is a direct result of the PCOS.  You may want to ask your doctor about a new cream to prevent the re-growth of facial hair called Vaniqua.

It is also very natural to become depressed in these circumstances, especially since you're having difficulty sleeping.  Insomnia is commonly associated with fibromyalgia.  The good news is that low-dose antidepressants have been shown to help decrease the pain of fibromyalgia AND will help you sleep better.  That alone should improve your concentration, mood, etc.

Good luck!

For more information on fibromyalgia, click here.

Created: 4/26/2001  -  Donnica Moore, M.D.

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