Is this really MY last resort? (long)

I've always considered WLS as the very last resort for me - the only thing to be considered when everything else had failed. About 16 months ago I started thinking about WLS, but ended up wanting to try on my own just one last time. So I'm just coming off of 14 months of self-imposed dieting, exercising and self sacrifice because I knew I needed to give my hardest and most dedicated effort before I even thought about WLS. I consulted my doctor several times (2 different doctors, actually) throughout the process and mostly just got a pat on the head and was told to keep up the good work, stick with the plan and just have more willpower. So this past August I finally gave up in frustration after losing a mere 24 pounds then putting them all back on during the dieting process. Up until about 2 weeks ago I've been at peace with my decision to have WLS. Then I read something on some message board or forum somwhere that caught my attention. Someone mentioned that they had PCOS (polycystic ovarian syndrome) and that it contributed to her weight gain and her inability to lose weight before her surgery. This shocked me. I was diagnosed with PCOS over 5 years ago and never knew there was a connection with my weight. Oh sure, the doctor gave me a pamphlet that explained what PCOS was and a general overview of the disease, but he never mentioned anything to me about what "other" things go on with my body besides the primary problem (the cysts). And silly me trusted that his pamphlet of information and his little chit chat was the whole truth. So I started doing some research a couple weeks ago based on that random comment from some un-remembered person. Honestly, right now I'm so angry with what I've learned. Not angry that I know so much now, but angry that my doctors sat idly by while I've struggled with my weight, never once mentioning to me that the PCOS could very well be the reason for the rapid weight gain, the reason for the terribly difficult time I was having losing the weight and that all these other mysterious symptoms and annoyances could all be related to this one disease. The thing that gets me the most is that after reading all this, I believe I am insulin-resistant and that if I'd only followed a very different diet plan that the past 14 months of dieting could actually have worked for me. What's more ... there's actually drugs that have shown proven results for PCOS patients in their quest to control the insulin inbalance and actually HELP them lose weight. So my dilemma? Now I know there's another option out there for me. Even though I've gone through this entire process to prepare for surgery and am about to have my paperwork submited for insurance approval --- I feel like I can't ignore all this. I need to speak to somebody who can answer all these questions for me. And I know right now that I don't trust my PCP or even my GYN to help me because I have this huge amount of anger toward both of them. I can't move forward with surgery and still feel at peace. Does anyone have a suggestion for a doctor who might be able to help? Someone who specialized in weight loss, general medicine, GYN and can do a complete analysis of my overall health and maybe suggest which way I should go. Because right now I'm feeling pretty lost. If you've read this far... thanks for listening. I guess I just needed to get my thoughts down in writing and hope that someone might have a bit of guidance. Thanks, Pam

Dear Pam: I am so sorry for what you are going through. I, too, was diagnosed with PCOS about 5 years ago after 12 years of "mystery" sypmtoms. I, however, had to do the research myself and take articles describing PCOS to my doctor (of which I had already gone through about 3) and tell him that that is what I thought I had. After a few tests, sure enough, PCOS it was. I understand the anger issues. Although I had expressly asked for Metformin to help control my Insulin Resistance, my PCP seemed uninterested. We battled back and forth for along time until he finally sent me to an endocrinologist. That is where I had the best luck. (PCOS is actually an endocrine disorder that in turn affects the ovaries etc.) My personal experience was, that even though I had more knowledge and a few tools to fight PCOS, my body was still literally working against me in regards to my weight...so WLS was the only way for me. I applaude you for exhausting all your options and for doing your research. Unfortunately, I have lost quite a bit of faith in the medical profession. I am doing my own research now a days. An example...I have had hypothyroidism for 5 years now (along with the PCOS.) No one told me hypothyroidism causes hairloss. Gee. I think that would have been a nice thing to know. Anyways...best of luck to you. Maria W.

Maria: Thank you so much for sharing your experiences. It helps to know that I'm not alone in the fight against my doctors for my own health. I've ordered a book from Amazon called The PCOS Diet Book. I'm anxious to see what it has to say. Thanks again, Pam

I'm right there with ya, sister. I was diagnosed with PCOS when I was 21 (I'm 53 now) and it wasn't until a few years ago that I learned what an effect PCOS has on weight. I couldn't help but be pissed that after all these years I finally understood why I could never lose very much weight and could never keep it off. All these years with the doctor(s) telling me "you can do it, just use willpower and exercise", blah, blah, blah. The more weight you gain, the worse the PCOS/insulin resistance becomes and it's harder to lose weight and it IS an unbeatable cycle. On top of all of that, I also have MS and I'm hypothyroid. Sheesh. A couple years ago I was treated by a "weight loss doctor" who specialized in people who are insulin resistant - - I was prescribed metformin which I took in a very large dose. This helped regulate my insulin response and I did lose 50 pounds but then got "stuck" like I always have. I eventually gained those 50 pounds back and that's when I said "okay, the only thing left for me to try is WLS". And here I am - - I'm losing weight, my insulin resistance is improving with every pound I lose, and I feel great. I don't have to use "willpower" anymore because I made the decision to have surgery that restricts me from eating too much or the wrong things. I am not willing to test the waters - - I don't want to know if sugar will or won't make me dump, I just BELIEVE that it will. So it's easy for me to look away and resist. Even if I don't manage to get to goal, I weigh less now than I have in 20-25 years and I feel great. I KNOW this was the right and best thing I could have done for myself. Good luck to you, Karen

I've had PCOS for 35 years. I was diagnosed with it quite early which is surprising but the "cure" was extreme doses of steroids. So along with the weight gain from PCOS and all the accompanying problems, I had the weight gain from the years of steroids. These not only gave me extra weight but it screwed my hormone system up so bad that it never will be right. I went into insulin dependent diabetes, started getting high blood pressure and just didn't have the quality of life I wanted. I finally hit my high weight of 295 and I decided enough is enough. I had lap RNY surgery on June 16, 2006. Since that time, I've lost over 70 pounds and I feel wonderful. I haven't been at this low weight for over 25 years. I can wear a 14-16 pants and I change sizes about every 3 weeks. Am I happy I had the surgery? You bet!!! The PCOS diet is just like every other diet you have been on. You will probably lose weight on it but the question is can you keep it off or will you go back to your bad habits. Having RNY surgery, I know that I can't go back to those bad habits or I will dump. I don't even want to try something I know I shouldn't have just in case it doesn't make me sick but that's my way. I know I made the right decision having my surgery and I hope you can find someone to help you with yours.

Thank you again to those *****sponded here. I'm not feeling as desperate and depressed as I was last night. I've found a few really great websites full of resources and research - I've been reading all day! It sounds like seeing an endocrinologist is the best option for me. Since my brother is Type I diabetic, I'm going to see if I can get in with his doctor. I guess it's all about taking each step as it comes along and being methodical with my approach to this new issue. As you all have said - the "diet" or medications might not be the complete and total answer and I may end up doing WLS anyway. But I can't move forward until I at least try this avenue first. Thanks again! Pam

you might want to make an appointment to talk to a reproductive endocrinologist--who specializes in PCOS and get some feedback regarding the likelihood the you can get balanced to help you with weight loss.........more info will help you make the best decision for yourself.......it is so frustrating to get all the info that you need to make good decisions..........good luck to you! rae

I didn't know about pcos, either. I had a full hyserectomy six years ago, and the cysts driving it were blamed on my weight. It was misdiagnosed by a HMO doctor who didn't want to actually touch my abdomen, I went through months and months of misery, unnecessarily. That same HMO dr put me on antidepressants, several years before the hysertectomy, increasing my weight. My weight increased slightly after the surgery, possibly related to the homones I was told to take. Then I was diagnosed with type 2 diabetes. Any weight I lost with the attendant change in diet came back. I finally found out which medications led to the gain. Had I known ten years ago what I know now, I probably wouldn't have qualified for the surgery, although I would still be obese. If you can beat the weight with the right diet and a doctor's help, wonderful. My new, improved pcp is up on her vitamin knowledge, not fat-phobic and also has some patients 10 years out from this surgery. She's in Livonia, Janice Summers 248 474 4900. She ma have a recommendation for you.

Jane: Thank you so much for the recommendation. I'll add Dr. Summers to my list of possibles. Like I said, I've been reading SO much today about PCOS and treatment - I actually had the thought that if I could just have a hysterectomy it would solve everything. Nope - the ovaries aren't the problem, it seems. All the other symptoms will still persist even if everything is yanked out. It's a hormonal and insulin issue that can only be treated, no cure. Interesting stuff. Thanks for sharing your story. Pam