inCYST on the Best!

One of my favorite healthy eating tricks -- turn something you DON'T like into something you DO

2012-01-27T02:00:00.001-08:00

Source: kalynskitchen.com via Amanda on Pinterest

I've now worked with three Chow Locally boxes, and for the most part I was cruising along. Until this past week when arugula showed up in the box. A few years ago, I belonged to a CSA at a farm where arugula grew particularly well. So for weeks at a time, it would show up in the box. I was not particularly fond of it in the first place, but when having to eat it for weeks on end...well, let's just say I developed an intense dislike for the green.

But my job at Chow Locally is to show people how to use foods in season. I decided to use this as an opportunity to put myself in many of my client's shoes, and I chose to challenge myself to learn to eat--and like--arugula.

Flipping through some recipes, I happened across arugula pesto. And I like basil pesto, so I figured it might be fun to try it with arugula. It turned out so tasty I was eating it by the spoonful!

So I cruised the Internet and found a lot of recipes for pesto using a lot of other greens that people often turn their noses up at. I found kale pesto, collard pesto, and mustard green pesto.

I think I was open minded to and expecting to like this recipe because I had an expectation of the taste that would be positive. Trying something completely foreign on top of a new food would have been too much. Expectation is half the battle!

So if you're trying to learn to cook and eat new foods, think of ways to cook the new so that it is familiar. Willing to bet it helps you add more new things to your repertoire than you thought yourself capable of.

Fitness Friday: Why "cheat days" and PCOS are a bad combination

2012-01-27T02:00:00.000-08:00

Source: bakersroyale.com via Lauren on Pinterest

If you have ever lived in the world of athletes, you may be familiar with a term, the "cheat day". A cheat day is a day set aside each week to eat the foods that are not on your diet...it is included in a lot of strict regimens with the philosophy that if you let yourself have those foods one day a week, it will be easier to follow the strict regime the rest of the week.

The cheat day is extremely counterproductive for PCOS, and here just a few of the reasons why.

1. It creates the mentality that there are good foods, and bad foods. Of course, there are foods that are more supportive of lessening insulin resistance than others. But subscribing "good" and "bad" designations to foods can be counterproductive. I have found that the minute a food becomes something you limit to just one day a week...it can cause you to crave and obsess about the very food you are supposed to be limiting.

2. And that brings me to my next point. Binge eating is extremely strongly correlated with PCOS, and what happens on some of those cheat days...can be mind boggling. Women with PCOS are extremely sensitive to small changes in diet, and a binge episode can include salty foods that promote fluid retention. If your physician is monitoring your insulin function with a test called a hemoglobin A1c, it is a reading of your average blood glucose over the past weeks. Major binges that take you a few days to get over can throw that average off.

3. I have seen cases where overdoing the cheat day has been a major barrier to overcoming insulin resistance. It can be the thing that provokes your physician to increase your medication dose...a dose which may be too high on days when you are eating well. The very best way to reduce your dependence on medication, is to refrain from starving/bingeing cycles that make it hard for your physician to create a medication regimen that helps you.

4. Cheat days can interfere with weight loss. Let's say you are losing about a pound a week. Your calorie deficit is about 500 per day. All it takes is one fast food dinner, in addition to a normal breakfast and lunch, to offset your progress you have made the rest of the week.

5. A lot of foods people "cheat" on are processed and high in sodium. It can take a few days to flush the water this sodium is retaining. My experience is, if you are working with the mentality of cheating and not cheating, even if you give yourself permission to do so, there is guilt involved after the cheat. And that can drive you to weigh in the next day, look at the higher weight, assume it is fat you have gained...encouraging overexercising and over restricting food. Both of those choices impose stress on your insulin and cortisol systems and interfere with blood sugar control.

Our goal at inCYST is to create a lifestyle where the healthier foods are the ones you gravitate toward, not because they are good for you, but because you genuinely enjoy them. My experience is that when you are in a hormone-friendly groove, you actually LIKE to eat greens, fruits, and lean proteins. I know, for me, when I am taking care of myself, I can barely handle walking through a food court in the mall or airport without feeling nauseated from the smell. I don't really need cheat days because I don't have an appetite for the kind of foods cheat days are designed to allow.

When you are craving "bad" foods, it is a major sign that you are out of balance. Cheat days have a way of keeping you stuck In that imbalance, not helping you out of it.

Let us help you learn what life is like living life in balance, rather than constantly counteracting some kind of extreme with another extreme. That is what we excel at.

What is mindfulness?

2012-01-26T02:00:00.000-08:00

Mindfulness. You hear that word a lot from people like me trying to help you move toward health...it's kind of a tough concept to describe. Over the weekend we were experimenting with the iPad and filming a pilot "Yoga for PCOS" class, and something happened during filming that perfectly illustrated how mindfulness works.

We live in a culture that is constantly bombarding us with stimuli. It has gotten worse in the past 5 years or so with the advent of smart phones, as we can literally be on alert 24/7 with beeps, buzzers, and "push" notifications. We can get so drawn in to social networking sites that we feel if we don't read every single status update, watch every single video, respond to every single event invitation, we are somehow missing out.

It is possible to spend an entire day connected to a screen, at the expense of losing connection to real people right in front of us. To see this for yourself, I challenge you to go for several hours with your phone and tablet left behind, and spend time in a public place. Look at how many people are focused on their phones...texting, IM'ing, talking...instead of participating in the world right in front of their faces. I have actually started turning off email and wireless connection on my writing days, so I am focused on one thing, and not constantly being tempted to shift my focus by random, multiple notifications coming at me from all directions.

The drawback to this is that when you are absorbed with your techno toys, you are also not listening to important messages your body is sending you.

You might ignore hunger. Which might seem like a good thing...except that in ignoring hunger, you often push yourself to the point of being ravenous before you respond to the cue.

You might ignore that you are tired, and stay up half the night playing Farmville, and you know if you regularly read this blog, poor sleep hygiene drives insulin resistance and worsens the symptoms of PCOS.

You might also ignore emotions. Feeling angry, sad, lonely, are uncomfortable to allow yourself to do. But those emotions are no different than physical cues, they are guiding you toward actions you need to take. If you ignore your emotions, they don't go away, they just amplify and amplify until they get your attention. If this is how you choose to deal with your emotions, their magnitude by the time that you are forced to acknowledge them, can be so great, that your response to them is at risk of being extreme--rage fits, excessive exercise, binge eating, alcohol dependence--are all common ways that people often deal with emotions they are afraid to face.

Mindfulness is a conscious exercise that develops your ability to be more aware, throughout the day, of how you are feeling. It is also called "being present". Your attention is on you, your immediate surroundings, and how you feel in those surroundings. If you pay attention to those things on an ongoing basis, and make conscious decisions about how you are going to address the situations, you can avert a lot of emotional outbursts, and binge/compulsive-type behaviors that sabotage PCOS management.

Meditation is a way to practice staying focused on yourself without being pulled away by distractions. Most people struggle with meditation at first, because until they start, they are not even aware of what thoughts and feelings they have been avoiding. It can be extremely uncomfortable. If you stick with it, it does get easier, you do develop more comfort with those thoughts and feelings, and they tend to not hit the magnitude where they convert into toxic behaviors.

When we were filming the other day, one of Sarah's kitties really wanted to help. So while Sarah and Deborah were busy focused on practicing meditation, kitty felt a little bit left out because her usual attention-getting behaviors were not working for her. (That is often what happens when we stop allowing ourselves to be distracted...the people who are positively reinforced by distracting us lose their own distraction and "up the ante" to pull us back into the unhealthy thing they need to do.)

So in this video, Kitty works and works and finally gets Deborah 's attention. For a split second, Deborah's focus on meditation was broken. But she quickly caught herself and got right back into the groove.

Now if it wasn't Kitty wanting some loving that could wait, and rather a sudden thunderstorm, Deborah may have chosen to prioritize getting out of
the rain.

Practicing mindfulness is exactly like that. You develop the ability to close out distractions. You can't ever really make them go away, life is about prioritizing and ably handling then,any distractions that are thrown in our path. The goal is to acknowledge them ,just as Deborah acknowledged Kitty, and get back to more of a personal focus as quickly as possible.

Enjoy the video! It is one of several segments the kitties helped with...as the person behind the camera I was experiencing my own special mindful moments, working extremely hard to not disrupt the session with laughing, or peeing in my pants from not laughing.

We had a great time, and will have updates soon on how you can participate in our yoga program.

A little video inspiration from one of our long time fans

2012-01-25T02:00:00.000-08:00

Sunday Sarah Jones videotaped a Yoga for PCOS class for us to test out the camera, setting, and format. Our good friend Deborah helped us out. As we were relaxing afterward, Deborah took a few minutes to share her PCOS story.

I hope you find it inspiring and can feel a connection!

Deborah has been working at the PCOS thing for a few years now. She takes huge leaps forward, takes breaks, sometimes gets pulled into old choices...but her net movement is always forward. That's what change is about.

Our yoga series will be available to Institute members soon. if you would like to be notified notified when they are available...please leave a note here or email me at monika@afterthediet.com

De-bittering Kale

2012-01-24T02:00:00.000-08:00

Source: elanaspantry.com via Valerie on Pinterest

Kale is the new rage. I've even seen it hailed as The New Beef.

Problem is, for newbies to this green way of eating, kale is a bitter veggie to swallow.

I wanted to share some of my favorite ways to work with kale that get you out of the bitter and into the tasty zone!

1. Make chips! I put a photo album on our Facebook page showing you how to do this with pretty much any green, including kale. It's soooo easy!

2. Cook with Parmesan cheese. Cheese, for some reason, helps to take bitterness out of greens.

3. Massage with oil. I'm sharing a couple of links here to recipes describing tis technique, which is basically breaking down the membranes of the leaves with your hands while massaging in a little oil. The first recipe, Kale Salad with Grapefruit, and photo are from friend Valerie Griswold. The second recipe is for the popular kale avocado salad at Whole Foods, which is what I always encourage people to try if they have never had kale. The avocado does the job that the oil does in the previous recipe.

4. Throw a handful into smoothies! You won't taste it at all, and you'll still get the benefit of its goodness.

5. Add to soups. If I get close to the next weekly veggie box and I still have things I haven't used, I make soup. Kale is a great thing to throw in anything.

Stop Beating Yourself Up!

2012-01-23T02:00:00.000-08:00

Source: iwishihadanocean.tumblr.com via Christine on Pinterest

• “I’m so stupid!”
• “I’m never going to figure out how to hold better boundaries.”
• “I’m so fat, it’s disgusting.”
• “I just can’t figure out how to actually fall asleep.”
• “I don’t know why I keep getting involved with people who don’t treat me well.”
• “This is hopeless.”

In my psychotherapy practice, I hear comments like these every day. Many of my clients have low self-esteem, and run a constant stream of mental verbal abuse. It may stem from an abusive background (the things their parents said to them are embedded at this point), frustrating health conditions that are difficult to manage, or having a tendency to find unhealthy relationships. Not knowing how to create change is another reason for this kind of self-talk. Lots of things can trigger self-abuse, and it usually doesn’t take much. Many of us are all too good at starting the litany of self-abuse. For some of us, it’s a 24 hour a day practice.

What is the result of this constant barrage of mean, unproductive, and even cruel commentary? Feeling bad goes to feeling worse, depression is exacerbated, motivation decreases, and sometimes an eating, drinking, spending, or sexual binge is set off because a woman feels and thinks, “What’s the point? I can’t change. This is too hard. I’ll never figure it out. This isn’t worth it. I’m not worth it.”

I want you to stop beating yourself up – NOW. There are enough negatives coming in from external sources (bad grades, an unappreciative spouse, kids who walk all over you, the competitive types at the gym who sneer at your efforts, the not-so-subtle one-upmanship of your friend who has a much larger clothing budget, etc.). You need to combat all of that with positive self-talk, and a commitment to deleting the negative statements from your vocabulary. Every time you start with the negative self-talk, write it down, and immediately counter it in writing with a positive statement. For example:

• “I look like crap” becomes “I have some extra weight because of my PCOS, but I’ve made huge improvements in my diet and exercise program – and I’m getting there. And I still dress really cute. That matters.”

• “I’m stupid” is countered with “I’m smart, and there’s lots of evidence to prove it – I had a 3.9 GPA, and three people (name them) told me I was smart in the last month.”

• “I don’t know how to be happy” gets countered with “happiness is a process, and I’m taking important steps to achieve it, like journaling, going to therapy, and keeping a gratitude list.”

Your language is powerful, and it’s a choice. It impacts your sense of well-being, productivity, and even your health. By choosing positive language for your self-talk, it also shifts your interactions with other people. More importantly, it shifts your sense of self, and improves your self-esteem. Only you have the power to do that.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at AskDrGretchen@gmail.com. You can also follow her on Twitter @askdrgretchen.

Green eating is possible even if you are taking Coumadin

2012-01-22T12:41:00.000-08:00

Source: Uploaded by user via Monika on Pinterest

Last week I was at the farmer's market, admiring a beautiful box of greens. I noticed a woman looking longingly at the same box. So I asked her if she liked kale.

"Oh, I do!" she answered. "But I had to give it up when my husband went on Coumadin."

Coumadin is a blood-thinning agent that is being prescribed more frequently than it used to be, as blood that clots too easily is one consequence of inflammation. Since leafy greens are high in vitamin K, a nutrient that promotes blood clotting, patients prescribed Coumadin are advised to limit their intake to a level they can consistently commit to eating. That commitment factor intimidates many people out of eating them at all.

What is ironic about the Coumadin dilemma, is that leafy greens are packed with omega-3 fatty acids and antioxidants, both of which hold potential to fight the very inflammatory process that is likely creating the need for Coumadin in the first place.

So how does one back themselves out of this corner once their previous lifestyle has backed them into it?

Here are a few things to try. Note, Coumadin is NOT a drug to mess with, so if you choose to make these suggested changes, it is essential that you communicate with the physician in charge of managing your blood clotting issues. If your condition is improving, medications will have to be adjusted to maintain clotting balance. It is best to make these shifts one at a time and wait 6 to 8 weeks to see how your body responds, rather than make too many changes at once, which can make it challenging for your physician to keep up with what is happening.

1. Shift your fat consumption, as much as possible, away from omega-6 fatty acid-dominant fats. They are easy to remember, they primarily begin with the letters "s" and "c"--soybean, safflower, sunflower, sesame, corn, and cottonseed. (Canola is the exception to this rule). They are primarily found in processed foods and in restaurant cooking, places where the price, not the quality, of the oil, is determining recipe makeup.

Check in with your physician to see how you are doing.

2. Add more vegetarian, non-leafy omega-3 foods into your diet. Flax is one of my favorites. You can add ground flaxseed into your smoothies, oatmeal, homemade vinaigrettes....and you may want to try a relatively new product on the market, flax milk, as a substitute for coffee creamer. If you are adventurous, try some chia seeds on your salad!

Check in with your physician to see how you are doing.

3. Try a protein-containing snack at night. It can help to stabilize blood sugar and cravings for sweets throughout the day, which keep you from being tempted by baked goods containing those oils.

Check in with your physician to see how you are doing.

4. Work on getting your seafood omega-3's. Note: ALL seafood, not just salmon, contain omega-3 fatty acids. If salmon is too fishy for your taste, spend some time at a knowledgeable seller such as Santa Monica Seafood, and try some of the recommendations they have. One of my favorites, which is available at Santa Monica Seafood, as well as Safeway, is barramundi, a sustainably farmed, mild-flavored whitefish that has a lot of versatility with regards to cooking technique.

Check in with your physician to see how you are doing.

5. If you are not a fish eater, consider a fish oil supplement. Despite what the supplement companies tell you, fish is fish; I've seen great changes in clients using Costco's Kirkland brand. The most important thing about using fish oil when you are taking Coumadin, is that you take it consistently. If remembering it is a challenge, program your smart phone to send you a daily reminder.

Check in with your physician to see how you are doing. If your clotting times have improved enough to get the greens-eating go ahead, good for you!

Later this week I will share some ideas for getting greens in your diet consistently without burning out on them.

Fitness Friday -- How to know if your fitness professional has your PCOS and your best interest in mind

2012-01-20T02:00:00.000-08:00

Moving along with our new Fitness Friday feature (pun completely intended, ha!)...

...one of the reasons I decided to prioritize bringing qualified exercise professionals into our network, is because over the years I have seen a lot of everything-but-best-practices in this industry. Women with PCOS are not, in general, treated very well by fitness professionals.

It is a bad combination in general. Women with PCOS often don't feel great about how they look. A lot of people working in the fitness industry, honestly, don't feel great about themselves, either, and they often focus on their physical appearance at an extreme level to compensate for that.

Of course, if you have PCOS, you may be living with the fantasy that if I could only look like THAT...I wouldn't feel so badly about myself...and you may be projecting the false assumption onto an apparently fit person that they have credibility to help you, that they may not have.

We are working on creating a training to increase the number of truly qualified fitness professionals out there, but until we have that available, I wanted to give you a list of things you can ask while interviewing potential trainers to see if they are a good fit.

1. What are their credentials? Have they taken the time to formally study their claimed area of expertise? Or have they just lived in a gym most of their lives? If they cannot name a credentialed fitness organization that they have taken the time to study with, they do not deserve your time or money. You wouldn't go to a doctor who was self-taught...you shouldn't lower that standard for your trainer.

2. What is their experience with PCOS? Have they formally studied the disease? Who is the physician they refer to? What physicians refer to them? No trainer is qualified to take on your case alone, without being part of a comprehensive healthcare team taking care of the other parts of the problem. If they cannot give you names of registered dietitians and endocrinologists with whom they have productive relationships, they are not qualified to work with you.

3. Can the trainer provide references? And by references, I mean other women with PCOS who enjoyed and benefited from the experience.

4. If the trainer is not a formally trained nutrition professional, are they willing to refrain from giving nutrition/diet advice and/or selling supplements? Are they willing to endorse whatever food choices your chosen nutrition professional is helping you to make, even if those choices are not the ones they would personally make for themselves?

5. Will there be some sort of initial benchmark evaluation to see where your program needs to start and from which progress made can be measured? Is your program being customized to accommodate your personal energy levels, blood glucose trends, medications, etc.?

6. Will your trainer listen to and accommodate any incidents of pain or discomfort? This is a tough one, as the most important job of a trainer is to push you out of your physical comfort zone. That being said, they need to be confident enough in their work to trust that letting up or modifying the workout in response to pain is sometimes the best choice. It is never right to push someone through pain that may be causing permanent damage, or creating a negative association with activity.

7. Does this trainer "get" the many phobias and anxieties you may have to overcome in order to be comfortable with exercise? I'm not just talking about the poor body image, the social anxiety, the fear of failure. A little discussed fact about exercise is that for women who have been sexually traumatized, physical exertion can retraumatize them. A trainer needs to be sensitive to this and be professional with language, body language, and how they touch their client in order for the experience to feel safe. If your nonverbal vibes are telling you there is a problem with someone, it is perfectly ok to listen to that and look for someone else.

8. Who is sponsoring this trainer's work--in other words--who subsidizes their lifestyle? How does that commercial relationship influence what they say to you? If your needs run counter to what that trainer is being paid to promote, who are his/her loyalties with?

The reality is, most trainers really don't make much money on training. They make money on endorsements. Endorsement deals often dictate what the person in that deal can say about nutrition and fitness. I know, because I have been offered several. I turned them down, because everyone that came my way, as quickly as it would have increased my standard of living, would have required me to alter the messages I give to all of you. I made the choice not to do business with any company that would require me to give them control of my freedom of speech.

Ironically, companies paying out endorsement deals do so because they believe that having a popular fitness professional promoting their product gives their product credibility. And the trainers live with the belief that they are more credible because they have landed an endorsement deal, when in many cases, they have simply made public the mentality that they are willing to alter their advice for the right price. I encourage you to ask your potential fitness coach who their commercial relationships are with, and whether or not they could give you advice that was best for you, even if that advice entailed not promoting their sponsor's product...or more importantly...a competitor's product. If they cannot...their priority is not your health, it is their personal financial income.

I am thinking of creating a letter that you all could download to give to a trainer that would summarize what you will need, kind of a contract between the two of you, that would allow inCYST to do most of the talking or negotiating for you. There are some trainers who are just bad news, but there are others who simply need awareness. If you think that letter would be helpful, please leave a comment here.

If you have had negative experiences with a fitness professional, I would love to hear from you. The list of questions above comes from my years of experience working with the fitness industry, but I know there are a lot of things I don't know about. I do know, when I have this conversation with women with PCOS, they always share experiences of inappropriate interactions that they had kept to themselves, mostly because they hadmfelt somehow that they deserved to be poorly treated because they were out of shape.

Remember, the fitness industry is quite competetive and there are far more aspiring trainers out there than there are people who need them. Trainers need YOU far more than you need THEM. You can ask for, and expect, professionalism, respect, genuine compassion, and a minimum level of accurate knowledge about the diagnosis you live with 24/7. You don't EVER have to tolerate disrespect because your current physical condition is a place you have chosen to improve.

We have a new PCOS resource for women of Eastern Indian heritage

2012-01-19T14:45:00.000-08:00

I am so excited to be telling you this! We are working on resources for women from India! We are able to do this because we have a new network member, Aarti Batavia, who is a registered dietitian who lives personally with PCOS. Aarti has a desire to use her heritage and personal experience, along with her training, to help other women.

We took a look at our blog statistics, and were surprised to find that India is our #1 non-English speaking country of origin with regards to visitation. Aarti shared that most Indians do speak English fluently, and there may not be much of a need for written translation. But we decided to ask to see if that is true.

If you are Indian, and you follow this blog, what do you need? Translated text? Audio discussions? Or a connection with someone who understands your culture, and your food, as well as your medical diagnosis?

Please leave your comments here, so we can include your suggestions in anything we do develop.

In the meantime, you can contact Aarti directly at info@aartibatavia.com.

Honored to know Amber! Here is her PCOS story!

2012-01-17T11:16:00.000-08:00

You have been hearing about Amber, here is her story!

http://abclocal.go.com/kabc/story?section=news%2Ffood_coach&id=8507579

We're super proud of Amber! Now you can meet her in the story that aired yesterday on LA's ABC-7.

A couple of notes here that I think it is very important to clarify.

The star of this story, is Amber. She is the one who did the work. She is the one who pushed herself out of her comfort zone. She is the one who continues to eat the way She learned to eat, not because she is on a diet, but because she made the decision to change her lifestyle.

Along the way, she had to try some things...some worked, some didn't. She would not have known that if she had not made the effort to try new things. The ultimate program she is on is not really my program or Craig's program, but rather one she created for herself, based on a menu of suggestions we provided her.

When you make such a significant change, everyone out there can suddenly become an expert. It can be hard to stay on course because if someone isn't bugging you to try a suggestion of some kind, they're micromanaging your progress. The remarkable quality Amber has, and it is probably one of the biggest keys to her success, is her ability to do what it takes to stay true to herself. She has the ability to keep her eye on the prize, even if it is difficult.

Lori Corbin is the other superstar in this story. PCOS is not a topic that gets into the news much, but she made time to get to know Amber and told her story in a way that I hope helped all of you feel that you could create your own journey as well! Thanks bunches!

Craig and I are in the story, yes, but it is really Amber's story.

If you are so inclined, leave a note and connect with Amber! At inCYST we just love her and we are very honored and grateful to know her. :)

A warm welcome to Food Coach Lori Corbin's viewers!

2012-01-16T14:02:00.000-08:00

I just received word from Lori Corbin that the story we shot several months ago about PCOS will be airing this afternoon on Los Angeles' ABC-7. We are so grateful to Lori for giving us time to tell a few stories...Amber's specifically, and the story of PCOS in general.

Most importantly, we are grateful to Amber for putting herself out there on behalf of women everywhere. It took a lot of moxie!

If this is the first time you have ever heard of us, and you were moved enough after Lori's story to come here for a visit, welcome! I hope that the inCYST concept we have been building over the last 15 years has something of value for YOU.

We started out as a small network of health professionals who wanted to be as educated about PCOS as possible, so we could better serve them. Along the way, we have learned a lot:

--There are an awful lot of women suffering silently with PCOS. They often feel very alone...when in fact, 1 in 5 of you on the planet have it!

--There is a lot of bad information out there, and a lot of people waiting to capitalize on your distress.

--Your problems are not always taken seriously.

--The stress of being given this diagnosis is extreme, often to the point of being paralyzing.

--Many of the most effective treatments for this diagnosis do not even appear in research journals because they are natural, not able to be patented, and therefore not likely to be funded by drug companies.

--We do feel a sense of urgency about inspiring all of you. We know we're working against a lot of depression and fear of change, but we also know the many extremely serious consequences of not taking action. So while we are very passionate about our women, we try to present a combination of posts and information that balances between making you feel safe with us, and information that gets your attention enough that your old comfort zone no longer feels so comfortable. We want to keep you around for a long time!

We have seen some great results with our small network, and last year decided to start a research institute to raise money to be sure some of the most important treatments get researched and published. As well as to test some of our own findings to see if they hold up to scientific scrutiny.

We would love to help you personally! Our list of network members is on the right, and many of us Skype if you do not see your location listed. We have a Facebook page, a Twitter account, a radio show, and a monthly newsletter. Please take advantage of all of them!

We could also really use your support of our research foundation! We are brand new, and still getting our name out there. Donations of time, talents, money, no matter what size, are deeply appreciated.

Our sister organization, Power Up for PCOS, has also been very busy organizing local Power Up groups for women who are ready to be proactive about PCOS. Their organizer, Beth Wolf, regularly reminds her group that women with PCOS who are managing that diagnosis with diet, exercise, and stress management, are actually healthier than women without the syndrome. So we like to think that a diagnosis is not a death sentence, but a wakeup call, inviting you to give yourself permission to treat yourself in the way that you deserve.

Power Up has some fun fundraisers, including an annual walk-a-thon, and an online store with items created by women with PCOS. We hope you find something that interests you enough to get involved!

Most importantly, we're glad you found us! Thanks for stopping by!

Please contact me directly if you have any questions. I divide my time between Los Angeles and Phoenix, and also make time for conversations with women around the globe.

Monika M. Woolsey, MS, RD
CEO and Founder
InCYST Institute for Hormone Health
623.486.0737
monika@afterthediet.com

Six Key Steps for Dealing with the Frustration of Infertility

2012-01-16T02:00:00.000-08:00

If you have PCOS, and you’ve tried to get pregnant, you may have already discovered that you can add infertility to the list of “what’s wrong with my body.” Infertility often feels like one more failure of your body to perform as expected, and one more thing that feels out of control. There are actions you can pursue to shift your mind and shift your body, however:

Get out of denial – know the timeframes for diagnosing infertility (generally six months of trying without a successful pregnancy if you’re over 40; one year if you’re under 40). Know that infertility isn’t just a matter of stress or bad timing – although those can be contributing factors. Know that infertility is a treatable condition, but it takes finding the right medical team, and that may include some highly specialized people, like a reproductive endocrinologist.

Have your anger – infertility is definitely something to be angry about. You’re mad, you’re frustrated, you’re irritable, you feel deprived, you want what you want – something other people manage to have without even trying – and you are entitled to rant and rave about it. But don’t let anger become your primary way of experiencing your infertility. Take the energy that powers that anger and turn it towards a more productive experience.

Fully experience your regrets – as much as you can understand them in the moment, experience your regrets. These might include the fact that the romance and private experience of love and sexuality are separated from the process of reproduction. Perhaps it means acknowledging that you won’t have a biological child. Or it might even mean deciding that children are not part of your future, at least not right now.

Grieve what you need to grieve – this might include some of the regrets mentioned above, or whatever else you feel or define – loss of womanhood, loss of health, loss of a specific type of relationship. Get support for this grieving if you need it, from other women in the same situation, or from a professional counselor.

Refocus your dreams – now that you’ve moved out of the hope or fantasy of “accidental” or sort-of-planned pregnancy, cried, had your rage, and gathered some support, decide what’s next – assisted reproductive technology, adoption, surrogacy, or a child-free life.

Take action to achieve that dream – make sure you’re on the same page with your spouse or partner, if you have one. Do the research to find a great reproductive endocrinologist, a supportive counselor, a knowledgeable dietician, and any other resources you need. Join online support communities that are specific to infertility, just as you joined this PCOS-specific community. Make a plan – give yourself some general timeframes and budgets for what you are willing to do.

With luck, planning, focus, and support, you may well be able to achieve the family you’ve been dreaming of, in spite of infertility.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at AskDrGretchen@gmail.com. You can also follow her on Twitter @askdrgretchen.

New webinar available: Herbs for PCOS and Women's Health

2012-01-15T02:00:00.000-08:00

We had a wonderful webinar session today with The Herbalista! We are so lucky to have her as a network member, as she knows her stuff, is meticulous about accuracy and ethics, and is super passionate about her work.

There are three ways you can get this webinar for your personal library.

1. If you are a professional, you can gn up for the PCOS professional training. It is one of the installments of the complete course.

2. If you are a professional and you do not wish to sign up for the complete training but do wish to get credit for this, until January 15 you can pay $40. after that it is available for $45. I am phasing out the individual purchase option so if this interests you act now.

3. If you are anyone who does not want credit, you can join the inCYST Institute for $25. Membership includes one free webinar and you can make this the one.

thanks so much, Herbalista! You are such a value to our community.

Ten Things That Healthy Eaters Do!

2012-01-14T02:00:00.000-08:00

The last two weeks I have been spending a lot of time on my new gig with Chow Locally. It has been inspiring and eye opening for one interesting reason related to the readers of this blog.

It has reminded me how normal people relate to food.

For the past 20 years I have worked , mostly with people who do NOT have a healthy relationship with food. It often leaves me feeling as though something is wrong with ME for eating the way that I do. Most of the people I am in contact with, with my work, are either clients who bounce back and forth between extremes of restrictive dieting and bingeing...or professionals who are very good with their analysis of food but not always great in the kitchen. Or...people working in the field who are there because of issues they had and may still have and are not admitting that they have them.

I honestly don't mean to offend anyone here...I am just saying it has been a wonderful experience to be in the real world with people who truly embrace I intuitive, mindful, healthful eating.

Here are some things these people do and do not do. Can you do these things? If you are shifting in your chair as you read this, consider that one of the reasons you are not able to make changes that would promote your hormone balance is because your relationship with food is not healthy. inCYST network members are happy to help you repair that relationship, on which you can build a healthy foundation of productive food behaviors.

Here is my list of Ten Signs of Healthy Eaters.

1. They try recipes, they don't just collect and/or read them.

2. They do not, after asking for help with recipe ideas, launch into a dissertation about why they eat raw/vegan/paleo/whatever. While they may do these things, it is not their lifestyle or their religion.

3. They have tolerance for ways of eating that are different than their own, even if those ways are not "healthy".

4. They don't need a nutritional breakdown, point value, or calorie count for everything they eat. They know that kale is inherently good, that fried kale is not going to be as nutritionally dense as kale salad, and that kale in general is a better choice than French fries. And so they eat kale. They don't order French fries and then monopolize the conversation explaining or apologizing for their choice. If they do order French fries, they eat them and savor them. They do not hide it, binge on them, or save them for that ridiculous thing known in some circles as a "cheat day".

5. Back to recipes. They use them as guidelines, not dictations. OK, so you forgot to buy the paprika. Make it anyway! Do not let it rot in the fridge because you were so perfectionistic that if you could not make the recipe exactly as directed you were not going to eat it at all.

6. If a new food is presented, they learn about it, ask about it, experiment with it, and try it. They don't offer an immediate "Blech!" simply because it is a new food.

7. If one recipe with a food doesn't work, they do not assume they do not like the food. they give it a couple of tries fixed in other ways before making that decision.

8. They know what is in season. They are in touch enough with Mother Earth to use seasonal variation as a menu guide.

9. While they may enjoy the occasional exotic food, they focus on what is available locally and have fun turning local foods into exotic creations.

10. They savor the finished product, often with a nice glass of wine. A well cooked meal is a work of art, a self-nurturing reward at the end of a hectic day. They would never consider eating it in the car or standing up in the kitchen.

Are you an Institute member? We have a little something for you :)

2012-01-13T17:07:00.000-08:00

We have been asked to help a small business do a little bit of market research. In exchange for answering about 5 questions, you will receive a coupon for $4 good for something I know you will love.

If you are currently a member, and you would like to participate, email me at monika@afterthediet.com.

If you are not a member, and would like to be in order to participate, please visit this link to get started!

This offer is good until January 31, 2012.

Fitness Friday: Think it's too late to start a yoga practice?

2012-01-13T07:00:00.000-08:00

This morning, I was a substitute for another yoga instructor at the yoga studio where I teach classes weekly. This was a 6:15 am class, which, needless to say, is earlier than I am used to getting out of bed, and I admit, it was a “I NEED two cups of coffee” kind of morning. Arriving early, I set-up for class and began chatting with the woman who works the front desk checking in students. She (we will call her Abby) told me that she began practicing yoga when she was forty years old and is currently eighty-three. I thought to myself “WOW! That’s some serious dedication and a beautiful example of a life practice.”

Soon thereafter, students began to arrive and it was a full house with thirteen students of all ages and levels (including another yoga instructor). It was a level 1-2 class, so I started with a gentle warm-up and then picked up the pace after I assessed the level of each student. Abby, to my surprise, was gracefully flowing through the sequences with obvious strength and ease. When we finally made it to the floor for our finishing poses, I offered variations of Hanumanasana (“Monkey Pose” or “Full Splits”). I attended my first yoga class when I was nineteen; I am now thirty-three. I became certified to teach two and a half years ago and I believe it will be years, or perhaps never (and I am okay with that too), before my hips are open enough to expand into the full expression of this pose. But, there was Abby, rockin’ the full expression of this pose! This particular pose is dedicated to the “monkey God,” Hanuman, who is a figure in Hindu mythology and “is worshiped as a symbol of physical strength, perseverance and devotion.” It was abundantly clear to me that Abby represented all of this and I left class that day with a new perspective…when you are ready, yoga will be there, waiting for you utilize it as a tool to balance and guide you through this crazy roller coaster called life!

Perhaps you have been contemplating integrating yoga into your life and I now ask you to consider this quote by Carl Sandburg, “The time for action is now. It’s never too late to do something.” Go ahead, take a “leap of faith,” perhaps finding inspiration in another and be brave enough to try something new (it doesn’t even have to be yoga!). It really is never too late. With that said, stay tuned, inCYST is excited to announce our newest program…online yoga classes with yours truly to support women with PCOS.

About the author:

Sarah Jones started out as inCYST's very first intern, has completed the inCYST training, and is inCYST’s very first registered yoga teacher. She taught the yoga component of our workshop series at Metta Yoga. Sarah is currently completing her nutrition studies at Arizona State University and is graduating with a Bachelor of Science Degree in Dietetics in December, 2012. If you'd like to practice yoga with Sarah, please visit Metta Yoga's website for her current schedule.

Pictures obtained from: www.nicefun.net and http://www.exoticindiaart.com/article/hanuman/

More cooking with Meri

2012-01-11T02:00:00.000-08:00

Excerpt from: Mediterranean Diet Cookbook for Dummies ®, Wiley Publishing, Nov. 2011

Meri, Meri, Meri...you've got me trained like a Pavlov's dog...every time I see an email from you entitled "recipe"...I'm salivating before I even open it!

Photo by http://www.lovjoyphotographer.com/

Chicken Stew with Chick Peas and Plum Tomatoes
Prep time: 12 min Cook Time: 1 hour and 30 minutes Yield: 6 servings
Ingredients

2 tablespoons olive oil
4 chicken thighs
1 small onion, chopped
1 celery stalk, chopped
½ teaspoon cinnamon
¼ teaspoon ginger
1 teaspoon turmeric
1 teaspoon black pepper
½ teaspoon salt
1 (14.5oz) can chickpeas, drained
1 large can (28oz) plum tomatoes
4 cups low-sodium chicken stock
¼ cup red lentils
½ cup long grain rice
¼ cup lemon juice
½ cup cilantro, chopped

Directions

1 In a large stock pot, heat the olive oil over medium high heat. Add the chicken thighs and cook for 3 minutes on each side. Add the onion, celery, spices, and chickpeas and cook for 3 minutes to heat spices.

2 Pour in the tomatoes and chicken stock and then add in the lentils and rice. Bring the mixture to a boil over medium high heat, cover and reduce the heat to low and simmer for 1 hour and 15 minutes.

3 Stir in the lemon juice and divide stew into 6 bowls. Garnish each bowl with 2 tablespoons of chopped cilantro and serve. Per serving: Calories 346 (From Fat 82); Fat 9g (Saturated 2g); Cholesterol 38mg; Sodium 721mg; Carbohydrate 47g (Dietary Fiber 6g); Protein 22g.

Guest blog: In 2012, Resolve to not confuse Health Insurance with the Care of your Health

2012-01-10T15:48:00.000-08:00

Ringing in the New Year with visions, dreams and intentions is part of our contemporary culture. The ball drops in New York; the sun rises wherever you are, and we all seem to sense change is in the air. January 1 marks the time when many people decide to make a change and transform some aspect of their lives in ways they believe will make their lives better. Often resolutions are related to health and well-being. Here’s a new resolution: recognize health insurance is not heathcare; and vow to seek healthcare, not a payment system.
For the approximately 45% of Americans with health insurance through their employers, January 1 is also the start of the year for most health insurance policy annual contracts. The same holds true for the approximately 11% of Americans have some other type of insurance, and the 25% with a government plan. Whatever the type of insurance, it’s likely the insurance company changed the rules as of 12:01 January 1. And their changes may have a substantial impact on the care of your health, impacting what you envision as a means to have a better life in 2012.
The insurance company didn’t consult you on the policy changes. They didn’t ask you want you need or want to feel and be healthy. In the paradigm of the 80% of insured Americans, insurance companies are in the driver’s seat to decide what healthcare is and who can provide it. It could mean different types of treatments are covered or not covered; different types of allowable “doctors” are considered acceptable or not acceptable; and of course it all revolves around a method to parse the dollars between providers, patients and insurance companies – the power triad of today’s “healthcare system.”
Making money in the healthcare system: insurance & pharmaceutical companies

Insurance is a contractual payment system. It’s a method to pay to certain people what the company determines is allowable care, under the terms of the policy. The payment system has very little to do with actual care that relieves suffering and improves well-being. When you let a payment system determine what care or well-being is, that substantially limits your options to make your life better in any way that resembles your personal concept of well-being.

Stephan A. Schwartz, a regular contributor to Explore: The Journal of Science and Healing has coined our current healthcare system as the “illness profit system.” And there seems to be plenty of profit to go around. Insurance companies, by their very nature of being corporations, have as their number one job to return shareholder value – to make money. CEO’s get paid a lot of money to do this. The heads of health insurance companies, healthcare consulting firms and other health related companies are among the highest paid executives in any industry. According to the LA Times, McKesson CEO John Hammergren received $145.3 million in compensation in 2010. Fierce HealthCare reports Omnicare CEO John Figueroa was compensated 98 million last year; and Aetna’s Ronald Williams took home $57.8 million before retiring in April 2010.

Pharmaceutical companies are also big winners in the power triad. In 2009-2010, seven of the big pharmaceutical companies paid 17,700 presenters a total of $281.9 million to promote their products. These presentations to physicians were instrumental in a "combined prescription drug sales amounting to 36 percent of the $300 billion U.S. market in 2009." Only 10% of what big pharma makes is spent on research to cure diseases and save lives.

The losers in this system: patients and physicians

According to Bloomberg.com, “Forty-nine million Americans reported spending 10 percent or more of their income on insurance premiums and out-of-pocket costs last year, according to the Commonwealth Fund study.” Patients spend more and more. As of 2008, 38% of adults used some sort of “complementary alternative medicine” (CAM). Anything labeled CAM is generally not covered by insurance, with rare exceptions of some limited use of acupuncture or chiropractic. Not only do people spend money on insurance premiums, they’re paying providers directly for health care that actually works for them. No wonder we have the most expensive health care system in the world.

Many M.D.s are also struggling with this current power triad. Holistic physicians who want to spend more than 7 – 10 minutes with their patients, and want to provide CAM care that works are seeking ways walk away from the insurance model, and serve patients in ways that help patients fundamentally heal. While they’re reluctant to talk about it, a recent CNN article discusses the economic challenges for M.D.s trying to operate in this system, and how many of them are going broke. http://money.cnn.com/2012/01/05/smallbusiness/doctors_broke/index.htm?hpt=hp_t3&hpt=hp_c1

Your resolution for the care of your health

The month of January didn’t even exist until about 700 B.C. when the Romans adjusted the calendar and move the “new year” from March to the new January. Julius Caesar introduced the Roman calendar, a solar-based system, in 46 B.C., and decreed the new year would be January 1. During the middle ages the new year was celebrated on various days in December, January and March. Even today, cultures around the world celebrate the new year on dozens of different days.

So, while January 1 has passed, any day can be the start of a new year. What will you resolve about the care of your health? There is an opportunity for transformation just as significant, if not more significant, than the common “eat right and exercise” resolution. At the core of your being, what’s your vision for the well-being of yourself, your family, or even the planet? Bring your vision, your resolution, to fruition by really knowing what you mean by “health” and “care” and spend your money accordingly. Resolve to not confuse health insurance with healthcare. Those two terms mean vastly different things.

About the author:

Deb Andelt is co-owner of Experience In Motion, which equips organizations with tools to curate meaningful experiences for customers and employees. Deb’s personal journey from decay to wellbeing inspired an emphasis in improving healthcare experiences for patients and practitioners by focusing on experiences that heal and self-caring as a way of organizational being. www.experienceinmotion.net.

Be more like Teflon, less like Velcro

2012-01-06T15:46:00.000-08:00

Ever notice how some people just seem to let things roll off? something I have noticed is that women with PCOS don't always do that so easily. I don't know, and would love our research to help better understand why. for now, it is important to understand that a big part of your personality may be that you notice, thank about, have feelings about, and react to, a whole lot more "stuff" than the average person.

Years ago, I was talking about this with a client, and I suggested that she start to practice more awareness of this tendency. Not as a reason to further beat on herself because she had done yet another something wrong, but because if she allowed herself to be aware of it rather than to run from it, she could take action to stop that thought and feeling process from overtaking her ability to manage stress.

I told her to try to "be less like Velcro and more like Teflon". She came back to her next appointment and shared that this was a fun, no threatening visual that was really helpful. When she started to feel stressed, shenwould close her eyes and envision herself sliding down a huge Teflon ramp, away from whatever it was that was bothering her.

Of course, there are times when it is entirely appropriate to feel angry and to respond as such. PCOS kind of blurs things because excesses of testosterone and cortisol can give you somewhat of an emotional hair trigger. and if you're aware of that, or have been criticized for being too melodramatic or overreactive, you can overcompensate by trying too hard to stuff everything. and that is going to backfire in the form of compulsions and addictions.

If you apologize for or do not verbalized your honest feelings, you are not being honest. You are not telling the truth. Learn to acknowledge the truth, and if you need help learning what to do with those truths that you acknowledge in ways that do not involve obsessing, destructive anger, or self-destructive behavior, consider seeking the advice and perpective of A Teflon creator like our own Dr. Gretchen.

All that passionate energy is better used on other things!

Not sleeping well? Take a look at your technology habits

2012-01-05T02:00:00.000-08:00

I have having fun learning how to use an iPad this week. The first night I had it, I was up pretty late installing apps and learning to navigate the system, which is new for me.

I also spent much of the night tossing and turning in bed, too wired tomrelax and fall asleep. I've written about this before, but since I have now experienced the phenomenon myself thought I'd pass along a little reminder.

IPads, because of how they are lit, interfere with melatonin production and they interfere with sleep. Be judicious with how you use them!

I made a conscious effort last night to turn mine off at about 7:30 and it made a huge difference.

This could be a bit of a drag for those of you who love to read in bed, but consider the ever-strengthening relationship between sleep and insulin function. the less you sleep the more likely it is that you will be insulin resistant.

For those of you sending me late night emails...I check time stamps and I will be calling you out! It's NEVER so important that you have to write me at 3 am!

The good news here is that I learn to navigate this gadget I'll surely be thinking of ways to use it to your benefit. During daylight hours, of course. Stay tuned!

A New Healthy Eating Option for Our Phoenix-area Readers!

2012-01-04T02:00:00.000-08:00

Hello everyone, I have an awesome announcement! As of yesterday I am the Director of Marketing for Chow Locally. This does not mean anything will change at inCYST...in fact, this means great things for our organization.

Chow Locally is what is known as a regional food hub. that means that it centralizes distributton of organic, locally grown food. I love farmer's markets but sometimes what I want is distributed across several markets. If I schlepped to every one that I needed to in order to get everything I wanted...it would drastically increase the carbon footprint of my purchase. Same thing if the farmers try to be at every market.

Chow Locally centralizes the process. It is like an online farmer's market. You place your order online, we tally the orders for the farmers who simply deliver to one place, and we bring your order to three different pickup locations. If our pickup locations are not convenient, and you can organize enough committed customers for an additional location, we can set that up.

One of Chow Locally's newest products is a weekly box which showcases what is in season. we predetermine the food based on what our farmers tell us they have in abundance. It's a lot like a CSA, but one major difference is that you don't need to shell out several month's worth of grocery money like you often have to do with a CSA. I used to love my CSA but being a small business owner with erratic cash flow and a busy travel schedule it didn't work for me to commit my food money that far in advance.

I immediately thought of all of you with these new weekly boxes because I have seen how paralyzed you often get at the thought of changing your food habits. One of the reasons I believe many of you have PCOS in the first place is perfectionistic, all-or-nothing thinking that perpetually has you bouncing back and forth between extreme and rigid dieting, and eating anything and everything when you get confused or don't see results quickly enough.

The Chow Locally boxes can be a way to shift your thinking. Instead of being paralyzed at the "what should I eat?" step, you can get a prepared box of foods that are healthy, and focus on the "how can I fix this?" step. I know I was more likely to fix fennel when it was staring at me from the vegetabLe bin than if I had to bring ho e something funky from the store that I was not quite sure about. I had so much more variety in my eating when I got these boxes!

Still not confident you can do this? we've got a great colleague who is both a dietitian and a chef helping to develop recipes which will come with each box. And I'll be sharing my box adventures here. Even if you're not in Phoenix you can learn more about seasonal eating and cooking and perhaps be inspired to try new things.

If you ARE in Phoenix and you would like to be involved, check out our website, www.chowlocally.com. And try out a box! We really want to hear from our customers about how they use our locally grown and produced foods!

That beautiful photo, by the way, was taken by good friend, talented photographer, and major foodie Julie Zagars, who test drove a box for us. Thanks Julie, hope you enjoyed the goods!

What if was PCOS causing your anxiety rather than the other way around?

2012-01-03T02:00:00.000-08:00

There's a brand new study just out by one of PCOS' premier experts strengthening the correlation between anxiety and PCOS.

However, rather than this study confirming that yes, you are anxious because you have PCOS, it suggests that you may have PCOS because you have a tendency to be anxious.

This is a meta-analysis, meaning that 613 studies and 9 with similar methods were collectively analyzed for their common findings. Meaning the findings are significant.

Anxiety was present in about 20% of women with PCOS, compared to about 4% in controls. That is about 5 times higher.

We at inCYST believe that it is a combination of a tendency to be anxious, in combination with unhealthy coping behaviors such as over/undereating, over/underexercising, compulsions, and self-destructive behavior, that launches the complex web you all call PCOS. Bottom line is that since a large part of the problem is the choices that you make to manage the symptoms, the true cure for PCOS isn't anything we can hand you. It's about how you decide to manage the symptoms.

If you're having trouble changing behaviors that you use to self-soothe, even though you know they aren't working, I strongly suggest that you become a fan of Dr. Gretchen's Mental Health Monday series. Perhaps even schedule a Skype session with her if you do not live in Los Angeles.

It could make the difference between your controlling your PCOS, or the other way around.

Dokras A, Clifton S, Futterweit W, Wild R. Increased prevalence of anxiety symptoms in women with polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril. 2012 Jan;97(1):225-230.e2. Epub 2011 Nov 27.

Anxiety 101: Causes and Treatments

2012-01-02T08:32:00.000-08:00

It’s normal to have some anxiety from time to time. Everyone experiences anxiety as a normal reaction to threatening, dangerous, uncertain, or important situations. When you’re taking a test, going on a trip, or meeting your prospective in-laws for the first time, you’re going to have anxiety. Psychologists classify anxiety as normal or pathological. Normal anxiety can enhance your function, motivation, and productivity, such as the person who works well under pressure.

But there’s a larger problem called Generalized Anxiety Disorder (GAD), and it affects an estimated five to seven million Americans. People with GAD experience pathological anxiety, which is excessive, chronic, and typically interferes with their ability to function in normal daily activities. GAD patients are about 60%women/40% men, and women with PCOS are affected by anxiety disorders more often than other people, just as we’re more affected by depressive disorders.

There are biological and environmental risk factors for GAD, which include the following:

• Environmental stressors (e.g., work, school, relationships)

• Genetics (Research has shown a 20% risk for GAD in blood relatives of people with the disorder and a 10% risk among relatives of people with depression.)

• Sleep deprivation, sleep inconsistency

Stress in the following areas can intensify symptoms:

• Financial concerns

• Health

• Relationships

• School problems

• Work problems

Symptoms include trembling, general nervousness or tension, shortness of breath, diarrhea, hot flashes, feeling worried or agitated, trouble falling asleep, poor concentration, tingling, sweating, rapid heartbeat, frequent urination, and dizziness. A panic attack, which is an extreme manifestation of anxiety, may feel like a heart attack, and sends many patients to the emergency room. If you’re having these types of symptoms, you should definitely make sure you’ve seen a physician to rule out medical conditions.

This type of anxiety is obviously more severe than normal anxiety, and can even be quite disabling. There might be a tendency to expect the worst without clear evidence, with particular worries about health, finances, job, and family. Individuals often can’t relax, sleep or concentrate on the task at hand. This disorder affects the quality of work and home life. You may know that your worry is excessive, but don’t feel like you can do anything about it. There are also some cultural issues - many people in the United States who are diagnosed with GAD claim to have been nervous or anxious their whole lives. Eastern societies, on the other hand, perceive and treat anxiety differently, as something associated with pain. So anxiety may be seen as normal in one setting, and pathological in another setting.

GAD is associated with irregular levels of neurotransmitters in the brain. Neurotransmitters are chemicals that carry signals across nerve endings. Neurotransmitters that seem to involve anxiety include norepinephrine, GABA (gamma-aminobutyric acid), and serotonin. Anxiety may result in part from defects in serotonin neurotransmission, and drugs that augment this activity may be useful in the treatment of anxiety disorders. However, many therapists believe that GAD is a behavioral condition and should not be treated with medication. Further, some believe GAD is more closely related to depression than to anxiety. I tend to believe that there’s a spectrum, and usually, if you’ve got depression, you’ve got some anxiety, and vice versa. There also seems to be a correlation between GAD and other psychiatric disorders, including depression, phobia disorder, and panic disorder. Anxiety is a risk factor for sleep disorders such as insomnia.

If you have numerous symptoms of anxiety, it’s important to be evaluated by a mental health professional who can help you identify the causes of your anxiety, and teach you ways to manage your anxiety. Many forms of therapy are effective, and I see great results in my anxiety clients who practice yoga or meditation (or both!). If that’s not enough, you can be evaluated by a psychiatrist and try some of the highly effective anxiety-reduction medications.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at AskDrGretchen@gmail.com. You can also follow her on Twitter @askdrgretchen.

Please consider supporting the inCYST Institute

2012-01-01T02:00:00.000-08:00

If you haven't picked out a New Year's resolution yet, I would like you to consider supporting us part of your resolve.

We are here for you. And to the greatest of our ability, everything we do is about you. We do as much as we can, with the resources we have.

And we'd love to be able to do a whole lot more.

Our goal is to raise money to support research that benefits YOU. A very small part of that is needed for basic administrative expenses, but for the most part it's money we want and plan to give to science.

We had a record month on the blog last month, hitting almost 8000 views. Imagine what could be done if each of those readers joined with a $25 membership!

If you don't have $25, even $1 will make a difference.

If you're interested, here is information on how to donate. http://www.incyst.com/2011/07/how-you-can-become-member-of-incyst.html

Thank you!

Here's to bigger and better things in 2012...that you make possible.

Pesticide-free spirits are the new responsible drinking

2011-12-31T02:00:00.000-08:00

We're all gearing up for the New Year, so I thought I'd talk a bit about alcohol.

We recently had the pleasure of spending an afternoon with Sarah Hammelman of Arizona's Sand Reckoner Vineyards (in Willcox, Arizona). She brought some of her vineyard's wine and shared with us what it has taken her and her husband to convert their vineyard to a pesticide-free operation.

(I am still in awe of Sarah's wine swirling technique...she had this way of whipping that wine around just to the top of the glass without spilling a single drop...I am going to see if I can talk her into sending me a video so you can see for yourself!)

I learned that many smaller vineyards cannot afford the true "organic designation", even though they're putting in tremendous effort to create a healthy product. It pays to get to know your vintners and distillers, since pesticides have been shown to have a pretty significant effect on fertility and hormone function in general.

I recently wrote an article for Examiner.com in response to the news that alcohol consumption was strongly correlated with breast cancer, considering the omission of analysis of pesticide exposure when interpreting the data. One of my Examiner colleagues, Dr. Robin Wulffson, commented that I'd only spoken to wine. In responding to his comment, I learned that there are many organic and pesticide-free hard alcohol options as well...be sure to look for them! Many of those spirits come from countries where there is far less attention to endocrine disruptors and chemicals than we have here in the United States.

By the way, here are Lisa Reinhart, Chief Chocolatier at Wei of Chocolate, and inCYSTer and yoga instructor Sarah Jones, along with Sarah. As you can see, at inCYST we firmly believe that it has to be fun as well as healthy!

Cheers to all of you, we'll see you in the New Year!

What business conflict has taught me about behavior change

2011-12-30T02:00:00.000-08:00

(This is our 1,000th blog post! Thanks to all for helping us grow!)

It was not easy to be Monika this month. It felt like every time I turned around, someone had decided inCYST was doing something wrong and attempting to extract some kind of apology, deferral, or program change based on their opinion.

There was a time, long ago, when I would have panicked had this happened.

The Universe was on my side with this, however. My computer had died, I was in the middle of that remodel I described yesterday, and therefore the only way I had Internet access, was to walk two miles to the nearest hotel and borrow their computer. It kept me from hitting "send" before I knew how I felt, and all of that walking gave me time to think and sort through what was happening.

I finally decided that sometimes criticism is a compliment. It means you are doing something well, so well, in fact, that you raise the bar for others. I never openly stated to anyone that they needed to change how they did things...but in the process of doing what I was doing, apparently, I moved some individuals out of their comfort zones.

Because of my situation, and the limited time I had to devote to anything business-related, I made the choice, instead of helping people understand why inCYST wanted them to join us in our endeavor, to let the critical people stay in their comfort zones.

Not devoting time to conflict freed me up to create new programming that you will hear more about very soon.

And, out of the blue, we were invited to collaborate on a project that will give us wonderful connections that we'd been wanting for years. Had I chosen to give audience to the conflict, I would not have been able to accept that invitation because the energy it would have taken to get all the conflicting individuals on board would have diluted our ability to effectively partner with people who were already on board with us.

Are you feeling like the harder you work to be healthy the more critical people become? Is it possible that you've made them aware, however silently, that there are things they could be doing for their own health that they are not? Are they attempting to derail your progress so they do not have to be aware of that?

How much energy are you putting into accommodating the criticism? Do you feel entitled to not give it audience and to honor your own health needs?

You only have so much energy to go around. It is not selfish to prioritize yourself. If you do, it can be amazing to watch the Universe support your choice.

What remodeling has taught me about behavior change

2011-12-28T02:00:00.000-08:00

I've been managing a pretty major remodeling project over the last six weeks. I have an 1100 square foot condo that needed new flooring. It had been decided that tile would be the option. However, when the tile guys got there, they realized that the older building my second floor condo is in, had sunk enough so that the difference between high and low spots was too significant to make tile the option. They had to work out a complicated mix of carpet and tile to do the job.

Here is the "before" photo. That table is office #2 from where many of these blog posts are created.

Here is the "after" photo. Well...for about 24 hours. Once the grout dried I immediately had to start moving everything out of the bedrooms and closets onto tiled areas so carpeting could commence.

The carpeting job ended 2 weeks ago, but this is pretty much what my dining room looks like today. Not because I'm lazy or sloppy, but because I decided that since I rarely have occasion to go through every single item I own and decide if it needs to stay or go, I was going to use this as an opportunity to perform a massive "feng shui".

I have a lot of papers that were stored in boxes, artifacts from the days before the Internet when us intellectual types kept every piece of printed material we had in case we needed it. Now we don't need to do that, because most information is somewhere in the cloud.

It's a hard habit to break though, hanging on to things in case you need them. I'm big on not wasting things or unnecessarily using landfill space, so I'm trying to make a good decision about every single piece of paper, trinket, electrical cord. My personality type is such that I can only do this for a short time before I lose focus and start throwing things in boxes to get the task overwith. So I promised myself this time I would not do that. I only ask myself to make 10 "what should I do with this?" decisions a day. As you can see by the massive size of this pile (and it's only half of the pile!), being so diligent means I'm going to live with the pile for awhile.

The first week it felt like I was never going to get there. But the day before Christmas I looked and saw that one whole corner of the dining room was free of clutter. And the office, where most of this stuff had been stuffed into the closet and started to overflow into the room...was so clean and crisp that I was far more productive working in there than I ever had been. All that clutter was interfering with my focus and concentration.

The process reminds me somewhat of the old advice for eating an elephant: one bite at a time.

And as with gardening, it made me think of many of you. How you might be anxious to lose weight and how frustrating it can be to see it come off slowly, some days seemingly not at all. But how if you stick with it, one day you look up and the progress is just THERE. If you lose focus and start going at the task in a disorganized fashion, you'll get rid of the chaos at the superficial level by shoving it in the emotional closet, but that mess is still there...and as with my closets...has a tendency to grow and multiply on its own if left untended.

It doesn't matter how small your effort is today. If it's an effort and it moves you even a tiny fraction of a millimeter in the direction you'd like to go, it will pay off.

I'll post updates when both the office and the dining room are truly back in action!

What gardening has taught me about behavior change

2011-12-27T02:00:00.000-08:00

Several years ago I asked a neighbor in my condo complex, who at the time was in charge of the grounds, if there was one task that she could assign me that would be my "thing" to give to the condo community.

She showed me a section of grass right by my stairs that had been completely overrun by an aggressive weed. The entire lawn in this section was gone, where it had been completely choked out by this ivy-like covering. This is what the entire lawn looked like back then.

I enjoyed the weed pulling, as it gave my mind time to organize thoughts, and I liked having something to do that had visible evidence of progress at the end of the task.

When the weed was first pulled, the ground looked bare. So bare, in fact, that one of the HOA members asked me to stop pulling it because all that dirt didn't look so pretty.

(I have to admit, I sneaked out at sunrise and sunset for some reconnaissance gardening, because I knew the plot needed to be "unpretty" for awhile in order to give the grass what it needed to grow.)

These days, for the most part, this is what the grass looks like. It's real grass! It's thriving now that it isn't competing with the aggressive weed for oxygen, sun, and water.

Every fall though, when summer temperatures finally drop and it's enjoyable to be outside, I go back to the plot and look for stragglers. They are there, never quite as firmly as when I first started weeding, but some of the roots always break off in the process and come back after time.

This year it occurred to me that this entire ritual of mine is the perfect analogy for what it takes to change a behavior!

1. Looking at all the habits that need to be changed, on the front end, can be overwhelming. It can genuinely feel like there is nothing of value or beauty underneath all the bad habits and "damage".

2. When you have pulled away all the "badness" that you thought needed changing, it can feel pretty bare, raw, ugly...to the point where you'd rather go back and live with the behavioral weeds than wait out the process of new growth and change.

3. Without regular maintenance and self-checks, the old behaviors can creep back in. They've got pretty strong and stubborn roots, just like my weeds.

I thought if I gave you the perspective that change, no matter where it happens in the world...on a lawn, on Facebook, in yourself...has inevitable stages. It's not a perfect process, and sometimes there are events that feel like "backslides".

All that really matters is that you're consistent, no matter what the result of the day may bring. If you are consistent, and patient, and understand that change is not always linear or forward moving, the process forward will outweigh the seemingly backward steps and it WILL occur.

Journal your changes. On days when you're not feeling like you're getting anywhere, ready to toss it all in because it isn't working, flip back a month, 6 months, a year. You might really surprise yourself. Change sometimes happens so gradually you don't realize it's happening.

It does, and it will.

Planning Ahead for Success in 2012 -- Success, Happiness, and Health Care

2011-12-26T02:00:00.000-08:00

Research has repeatedly shown that people who write down their goals are much more likely to meet them. As we wrap up 2011, and head into 2012, I invite you to write down your goals for the new year, as they relate to your health and self-care. Here are some suggestions to get you started.

• Choose from the following list of self-care behaviors, and try one each week, or each month:

o Learn how to meditate.

o Go to a yoga class.

o Eliminate sodas/pop from your diet.

o Get a consultation with a psychiatrist if you think medication might help your depression or anxiety.

o Find a new doctor if you don’t like the one you have.

o Get your hormones tested.

o Find out what low glycemic eating is all about.

o Take an afternoon to go on an “artist’s date” – do something that fuels your creativity, delights your senses, and brings you joy.

o Cook at home, twice as often as you do now.

o Rearrange your schedule so that you actually are getting enough sleep (eight hours, please).

o Get some practice with boundary-setting. Start small. Say “NO” to someone or something you don’t want to do. Be clear and firm. Do not apologize. Applaud yourself.

o Walk for 30 minutes after dinner, every night. Walk with a friend or loved one, and double the benefit.

o Call a friend you haven’t seen or spoken to in months.

o Read something more meaningful than People magazine.

o Stop watching the news right before you go to bed. Better yet, put yourself on a “news diet” for an entire week.

o Go to therapy.

o Keep a journal.

o Stop conning yourself that French fries are a vegetable.

o Go to a farmers’ market, and buy one weird, unusual, or new vegetable or fruit that you haven’t tried before; ask the farmer how to prepare it.

o Have sex more often, with yourself or someone you love.

o Consult with a professional, inCYST-trained dietician.

o Start a gratitude practice. Every morning when you get up, write down five things that you’re grateful for. Do the same every night. Try not to be repetitive.

o Tell someone in very clear terms precisely why you value them.

o Reduce your caffeine intake.

o Switch from milk chocolate to dark chocolate.

• Share your list with a friend, and ask her to serve as an accountability buddy for you. Her job is to ask you each week, “Did you do what you intended to do? Why or why not? How did it feel to do it? Are you going to keep doing it?” If you’re feeling brave, blog it, post it somewhere in your house or office, or share it with your FaceBook friends. Accountability is an amazing thing in helping us adhere to our goals.

• Be gentle on yourself if you fail, are slowed down for some reason, or give up on some aspects entirely. Life is full of hazards, roadblocks, and other impactful situations. You cannot control them; you can only adapt.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at AskDrGretchen@gmail.com. You can also follow her on Twitter

Happy Holidays to all of you!

2011-12-24T02:00:00.000-08:00

I am one of those people who does celebrate Christmas, so I am taking tomorrow off of blogging.

That's the only traditional part of the celebration. I live in Arizona, which usually isn't snowy, and some of us like a little more unusual variety of Christmas tree -- as evidenced in the photo here.

My mother is German, so we wait until Christmas Eve to put up the tree. Dinner that night is a German feast, but spiced up with some homemade Mexican tamales.

It doesn't matter which holiday, who you celebrate it with, or how your celebration plays out. What matters is that you have traditions that give you reason to pause and reflect on your blessings.

One of my biggest blessings is our inCYST readership and fan base. I never would have envisioned when I started this blog 3 years ago that it would reach people as far away as Uzbekistan, or that it would grow into a research institute. I am grateful for every single one of you who has made it happen, and inspired by your letters.

Thanks to all of you, and we'll see you in a couple of days!

Have you ever had a premature delivery? It may be related to your PCOS

2011-12-23T02:00:00.000-08:00

According to researchers, women who were premature babies are more likely to have PCOS and diabetes than women who were born to term. Almost twice as many women who delivered premature babies in this study met the diagnostic criteria for PCOS. Eight of those women tested positive for diabetes, while none of the women in the term birth group did. Women delivering prematurely were more than 3 times more likely to have hirsutism than those who did not.

Not so sure the birth is the cause, but it may mean that someone whose metabolic profile was already drifting out of balance may have set the wheels in motion for more metabolic problems in the future.

This is a photo of one of my very favorite paintings at the Art Institute of Chicago. It is composed entirely of a series of painted dots which merge into a photo when observed at a distance. When I lived in Chicago, I'd go down there on snowy Sunday afternoons and stare at it for hours--I'd stand close up so I could see the dots but not make sense of the big picture. Then I'd slowly back up, never ceasing to be amazed at how Seurat, the artist, was able to keep such a beautiful, complext picture in mind the whole time he was painting individual dots.

PCOS is just like that. You can focus on one dot, or you can add the dot to your field of vision and begin to see how all the dots connect. I love this study because it is one of those dots that's important to understand. It's not just about acne, or infertility, or weight. It's about a hormone system that for whatever reason isn't coordinating functions the way it should.

Focus on one dot, with one herb, or one procedure...the one it's easiest to accept or understand...and you're guaranteed to be delivered problem after problem after problem down the line.

Step back, look at the big picture, and focus on things you can do to correct macro imbalances...and you're more likely to be able to connect dots in a meaningful way that improves your health.

Eilertsen T, Vanky E, Carlsen S. Increased prevalence of diabetes and polycystic ovary syndrome in women with a history of preterm birth: a case-control study. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03206.x

New Feature: Fitness Friday

2011-12-22T02:00:00.000-08:00

We've been working on building our reputation in the area of fitness to complement our expertise in other areas. One project I've been working on is coordinating our certified exercise professionals in a weekly feature called Fitness Friday.

I have a master's degree in kinesiology myself, and I've run exercise testing labs in several fitness facilities. I have come to believe that there is a lot of misinformation and quackery in this profession. There is no required license to be a personal trainer. You can get a certification, but it is not necessary. And because of that, there are a lot of people out there who like to hang out in the gym and want to justify it by making a living at it. Their reasons for being there are not always healthy -- they can have an eating disorder, body dysmorphic disorder, compulsive exercise behavior...a whole host of things. And when you're a woman with PCOS, it's easy to look at some of those people and assume that if they look like they do, and you look like you do, that they must know what they are doing.

Au contraire!

The rules for exercising with PCOS are very different from those that work for other people. In fact, often times, following what an uninformed fitness professional advises you, when you have PCOS, can work in the opposite way that you want it to. That counterintuitive process can flush a lot of unhealthy attitudes to the surface in the trainer such as disdain for fat. All you have to do is watch The Biggest Loser to see it. There can be a tendency to act as if the person reaching out for help deserves to be yelled at, pushed past a reasonable limit, etc., just because they've got fitness goals to achieve.

Fitness professionals, I have found, often have very dysfunctional ideas about food. They can be rigid, limiting, and encourage all-or-nothing behavior.

We've tightened up our own rules at inCYST about who can and who cannot be marketed as a professional with this expertise, as we've learned what does and does not work with our own mentality here.

Hopefully, as you read the Friday blog posts, written by professionals who have taken the time to formally study the science behind exercise, above and beyond the inCYST formal training, as well as understand what the complicated environment that a hormone imbalance like PCOS to mess with those rules, you'll begin to develop a better ability to discern just who in the fitness world has YOUR best interest...and health...in mind.

I'm really excited to be starting this feature as we have such a great team of experts in this area you need to be hearing from, be benefitting from, and to be inspired by!

Not a bad way to start off the New Year!

Always fun to chat with Sasha Ottey!

2011-12-21T02:00:00.000-08:00

I recently chatted with Sasha Ottey of PCOS Challenge on her radio show. She's a good friend who does much for the PCOS community, and it's always an honor to be asked to go on air.

If you missed the interview, here is the link, enjoy!

http://www.blogtalkradio.com/pcoschallenge/2011/11/30/the-link-between-pcos-and-inflammation--pcoschallengecom

Have you visited the Shop Cysters store yet?

2011-12-20T02:00:00.000-08:00

When you do, you'll see what I mean when I say you ladies are some of the most creative humans on the planet.

When you visit the store, you'll see

PCOS-specific herbal remedies

Concrete art like this clock

Hair accessories

Photography

Fine art

If you're a Cyster and you'd like to showcase and sell your creativity as well, contact Beth Wolf, info@powerupforpcos.com.

Are You Hungry, Angry, Lonely or Tired? HALT!

2011-12-19T02:00:00.000-08:00

‘Tis the time of year when blogs, magazines, and radio broadcasts are full of tips for combating overeating, over-drinking, and the kind of carousing that leaves you tired, bloated, overly full, and generally disgusted with yourself. They’re often repetitive, and not all that useful. I’m full of tips, techniques, and strategies myself, actually! One that I DO think is useful and easy to remember is HALT, which stands for Hungry, Angry, Lonely, and Tired.

If you’re one of those things – hungry, angry, lonely, or tired – the risk of over-indulging rises. If you’re two, three of those things, the risk of losing control is much greater. And if you’re all four of those things, watch out world, because almost nothing’s going to stand in the way of the oncoming binge, bad behavior, or acting out.

But what’s the first aspect of change? Awareness. HALT is a way to bring yourself back to a place of awareness, so you can reign in your behavior before it becomes self-destructive. Let’s talk about the specifics:

Hungry: When you’re hungry – really hungry – your blood sugar starts to drop, and you feel tired, confused, and irritable. And did we mention, hungry? Really, really hungry. Like, so hungry you could the entire contents of a small refrigerator. Or the buffet table. Or as much as you can load up on at the drive-through. Yeah, that kind of hungry. Women with PCOS are more subject to the vagaries of blood sugar dysregulation (it’s the insulin resistance thing, AGAIN) than other people. We’re more vulnerable. Accept it, and plan for it.

Strategy: Have a little healthy snack with you at all times. Know that shopping is hard work and frequently results in blood sugar drops because you’re walking more than you think. Plan ahead. Decide: “If I get hungry, I’m going to Subway for a turkey sandwich loaded up with vegetables and skip the mayo.” This will prevent you from going to McDonald’s and getting a Big Mac, large fries, and a shake.

Angry: The traffic, the crowds, the prices, the shopping for people you don’t even care about, the time pressure, and the social obligations, your spouse who still expects home-cooked meals when you’re in the middle of SHOPPING!, can all lead to a build-up of anger.

Strategy: Do not shop when you’re angry. Do not expose yourself to challenging foods or social situations when you’re angry. Take five to twenty minutes to meditate, walk around the block, drink a glass of cool water, and practice forgiveness and compassion. Now engage in your usual activities.

Lonely: So often, it’s assumed that we’re off with our friends, families, and other loved ones at the holidays, but some of us are sitting home alone, without an invitation, a thought, or a concern.

Strategy: If you’re alone, embrace it. Don’t take a shower until 3:00 p.m. Spend all day on FaceBook. Eat breakfast for dinner. Revel in your ability to live precisely how you want to live today, without judgment or interference. It can be utterly rejuvenating. If you don’t like being alone, and really do feel lonely, make a point of issuing invitations to other people, or showing up at every group event you know about, and don’t tell me it’s unfair that you have to do all the asking. Life is like that sometimes, and if you want to undo this loneliness, you will have to take action. Tell people you don’t have any plans for Christmas, and you don’t have any invitations either. Quite often, one will be forthcoming. People are feeling generous this time of year. In any case, again, avoid whatever triggers you to behave uncharacteristically. This is not a good time to shop the web, bake a cake, or order enough take-out for six people. Remind yourself that this is a temporary, and repairable, condition.

Tired: Tiredness connects to hunger quite often. Drops or dips in blood sugar can leave you feeling exhausted, confused, and overwhelmed. When you’re tired, your decision-making capacity is impaired. See where I’m going with this theme?

Strategy: If you’ve been running around like a maniac, trying to get it all done (The shopping! The cooking! The baking! The cards! The decorating! The parties! OH MY!), slash and burn. You are NOT Superwoman. I repeat, you are NOT Superwoman. No one will notice. Seriously. I used to send upwards of 100 handwritten (and often handmade) greeting cards. A few years ago, I only sent a few. Now I don’t send any, except to my mother, and that’s a maybe. Not one single person has called me out for it. Wow, what a relief!

If you feel strongly, pick a few critical priorities (i.e., my husband will definitely die, or at least pout for days, if he doesn’t get a homemade peppermint cake by Christmas, my children will be ostracized if they don’t get Chanukah gifts like everyone else, and my staff assistant is going to “lose” my messages for the rest of the year if I don’t buy her a great present) and lose the rest. Children are important; adults will have to understand. Your budget, your sanity, and your ability to get the rest you need are the most important things. The rest is not. HALT. And be well.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at AskDrGretchen@gmail.com. You can also follow her on Twitter @askdrgretchen.

Cranberries -- Winter's antioxidant

2011-12-18T02:00:00.000-08:00

I thought I'd shine a little light on one of the season's antioxidant powerhouses -- cranberries. We tend to associate antioxidants with summer foods such as berries, but check out some of the things cranberries can do for you!

--They may keep ulcer-causing bacteria from attaching to the stomach lining.

--They help to prevent cancer

--They help to protect against cardiovascular disease

Cranberries contain the same antioxidant, anthocyanin, as blueberries. What is interesting about cranberries, though, is that they are grown on the water, which helps to increase their anthocyanin content. Antioxidants aren't just created for humans, they're found in plants where they are doing their protective work. You can say that in cranberries, these anthocyanins are working kind of like sunscreen does for us! And they do double duty when you eat them yourself.

Cranberries are most likely to provide the highest benefit when eaten whole (not as a sauce or in a Cape Codder)...so since most of us don't really know what to do with cranberries outside of those two things, I looked up a few cranberry recipes. The salsa recipe comes from http://www.allrecipes.com/, and the rest come from the Cape Cod Cranberry Grower's Association, where you might want to visit for even more ideas.

Here's to red food keeping us healthy!

Cranberry Salsa

1 (12 ounce) bag cranberries, fresh or frozen
1 bunch cilantro, chopped
1 bunch green onions, cut into 3 inch lengths
1 jalapeno pepper, seeded and minced
2 limes, juiced
3/4 cup white sugar
1 pinch salt

Combine cranberries, cilantro, green onions, jalapeno pepper, lime juice, sugar, and salt in the bowl of a food processor fitted with a medium blade. Chop to medium consistency. Refrigerate if not using immediately. Serve at room temperature.

Cranberry Almond Goat Cheese Log

Servings: 2 logs
11oz goat cheese
1 tablespoon orange zest
1/3 cup chopped dried cranberries
1 cup natural sliced almonds - divided

wax paper

Place goat cheese in food processor work bowl.

Pulse several times until cheese is crumbled.

Add orange zest and chopped dried cranberry to crumbled goat cheese. Pulse for 5 seconds, or until cheese mixture will start to form a ball.

Remove cheese mixture from work bowl and separate into two balls. Form each cheese balls into a log shape approximately 2x4 inches each.

Place half of the almonds onto a piece of wax paper. Roll one goat cheese log over almonds, covering the entire surface of the log, gently pressing to assure the almonds stick.

Repeat with the remaining second log and almonds. Wrap the logs individually in plastic wrap and refrigerate for 3 hours before serving. Serve on Baguette Croutes (see recipe below).

Cranberry Almond Goat Cheese Logs will keep in the refrigerator for 1 week.

Bake until just golden, 10-12 minutes.
Transfer to a serving tray and let cool.
Spread Cranberry Almond Goat Cheese Log on Baguette Croutes and serve.

Warm Baby Spinach and Cranberry Salad

6 servings

1 package baby spinach, washed and cleaned thoroughly
½ cup sweetened dried cranberries
¼ cup pine nuts
¼ cup Italian Salad Dressing
2 clove garlic, minced
2 tablespoon olive oil
Place cleaned baby spinach in serving bowl.

Place sauté pan over medium heat. Add oil.

Add pine nuts and sauté quickly until lightly browned.

Add minced garlic and sweetened dried cranberries and stir quickly to coat with oil.

Let simmer for about 30 seconds.

Add Zesty Italian Dressing, stir, remove from heat and pour over baby spinach.

Serve immediately with entrée as a side dish.

Cranberry Couscous

4 servings
2 tablespoons olive oil
¼ cup chopped white onion
1 ½ cups cranberry juice cocktail, heated to a simmer
1 cup couscous
¼ cup chopped pistachios
2 scallions green parts only
½ cup sweetened dried cranberries
salt and pepper (to taste)

In a medium saucepan add olive oil.

Add the white onion, sweetened dried cranberries and pistachios, and saute gently over low heat until onion is translucent and slightly fragrant.

Add the couscous and the warm cranberry juice cocktail.

Stir with a fork to combine, cover.

Let sit for 10 minutes.

Add the scallions. Fluff with fork.

Season, to taste, with salt and pepper. Toss gently to combine.

Turn into serving dish.

Serve hot.
.

The most important reason you can't just go back to eating the old way once you conceive

2011-12-17T10:14:00.000-08:00

One of my Facebook friends posted this and I thought it was poignant. So many of you seem to have a mentality that you just have to "be good" until you get pregnant, and then you can go back to doing what you want from then on. It doesn't seem to resonate that the same reasons you can't conceive are the very ones that put you at risk for high risk pregnancy, premature birth, breastfeeding problems, and postpartum depression.

Here's a little picture that explains probably the most important reason why it's not just about you anymore. From the moment you conceive, you are leaving your legacy with someone else who is completely dependent on your choices?

What kind of legacy do you wish that to be?

inCYST is blind to size, age, gender, religion, color, sexual orientation, and any other separatist mindsets

2011-12-15T14:22:00.000-08:00

Twice in the past week comments with somewhat of a religious energy about them have been sent my way. One set of comments came from someone who was using the Bible to try and argue that something we were doing at inCYST was not appropriate. Another came from an atheist who felt that we should not be incorporating religion or spirituality of any kind in our work.

Both sets of comments came unsolicited, and it is timely that in that same week, a post from Dr. Gretchen that she had scheduled weeks before went live with thoughts about God and spirituality.

I figured it was my opportunity to share where we stand on that. Actually where we stand on quite a few things.

We at inCYST are here to help. We have Christians amongst us, but we are not a Christian organization. We also have Buddhists, and some of us are Jewish. And we do have an atheist or two.

We do not identify ourselves by our religion. We do practice religion or lack thereof, but it's not what we use as our identity.

Whether you are Hindu, Atheist, Wiccan, or Catholic, you have a pancreas, lungs, and a heart. Most of you have a uterus. All of you have brains. Last time I checked, an Atheist brain worked the same way as a Christian one did...the only difference is the thoughts and emotions those brains generate. It doesn't matter to me what those thoughts and emotions are, I care most that the brain is operating in a healthy environment and to its fullest capacity.

If Christianity is your spiritual perspective, we seek to understand how it supports your path to wellness and to incorporate that into our recommendations. If you're an Atheist, then we'll work to understand and support that as well.

We'll do the same for Democrats, Republicans, Libertarians, lesbians, heterosexuals, transsexuals, 25-year-olds, 65-year-olds, men, women, Latinas, African Americans, Caucasians, Hungarians, Australians, people living in the city, people in the boonies, people on an island.

We don't look for reasons to separate ourselves from you. We look for ways to connect and support.

We work in health care, with anxious and hurting people. We really don't have the luxury of dividing people into piles and deciding which ones are more worthy of helping. When they come to you, and you have information and resources that can help them, you use them on behalf of helping them.

To the person who used the Bible to scold, I don't think that the Bible was intended to be used as a means to scold. To the Atheist who asked us not to incorporate spirituality, I'll kindly not force religion on you since that is not something you wish, but for those who ask us to consider their spiritual path in our work together, we will gladly honor their request.

Everyone who comes to this blog comes for a reason -- they need help. And every single one of those individuals is valued...and welcome.

Are you bingeing on pesticides? If you binge on chocolate...you just might be

2011-12-14T02:00:00.000-08:00

Over the weekend we hosted a fair trade chocolate and pesticide-free wine tasting in conjunction with Metta Community Yoga Center. We had the honor and pleasure of hearing our favorite local chocolatier, Lisa Reinhardt, talk about her passion, creating quality chocolate.

Lisa spent a lot of time talking about the thought she put into how she would make her Wei of Chocolate product line, and how bothered she was by the many things she learned about traditional chocolate making. One of the things that she shared resonated with me very much, as I thought about its pertinence to PCOS.

I know that many of you struggle with cravings for sweets, and that often times that craving translates into a binge on chocolate. Lisa shared that since cacao tends to be grown in Third World countries, much of it is grown in conditions that would not be legal in the United States. In particular, many pesticides that are banned in our country are freely used elsewhere.

Lindane, a toxic and endocrine disrupting chemical both used as a pesticide and as a medication for head lice, is a commonly used pesticide in cacao-producing countries. Though banned in 2006 in the US, except for its medicinal uses, it is not banned in many primary cacao-producing countries. In fact, chocolate tested in 2007 did have lindane residues.

I suspect that the argument you would get if you asked one of our major corporate chocolate producers here in the US is that the residues are so minute that they pose no health risk. I've just learned, in all my years of working with PCOS, that this line of logic doesn't work. First of all, you all tend to have nervous and endocrine systems that are more sensitive to chemical insult; you need to stay away from these compounds more diligently than the average person does. Secondly, the relationship you have with sweets and chocolate is not the average relationship. When you eat it, you tend to eat much larger quantities of it than does the average person....giving those pesticides more opportunity to accumulate and cause problems.

You've got a couple of choices here. You can keep eating the stuff you get at Walgreen's because it's cheap and it's available and hope that someday someone at the top of the ant pile over at Willy Wonka Inc. is going to care enough about PCOS to take a risk and buy the more expensive, pesticide-free raw material, and accept the sales loss that decision will create on behalf of the greater good....

...or you can take action immediately and only purchase the organic stuff for yourself. You know it's more expensive, but don't you deserve to do the right thing for yourself?

By the way, that lindane stuff? It's not just toxic to YOU. It's toxic to all the people in those Third World countries who grow it, touch it, process it, etc. By shifting your spending and making it harder for all of the people in that supply chain to make a living off of lindane-laced cacao, you're helping people in far away places balance their own hormones.

Some important things to think about.

If you're looking for a newer, better chocolate to treat yourself with, check out Lisa's website. She's wildly popular in Phoenix and gaining popularity in other cities like Los Angeles and New York. It's not a bad bandwagon to get on. Her organic chocolate, by the way, comes from the rainforests of Ecuador.

If you happen to be interested in which countries do ban lindane, here it is.

Banned lindane for all uses(21):

Finland, Indonesia, Korea, Netherlands, New Zealand, Saint Lucia, Sweden

Severely restricted the use of lindane:

Australia, Austria, Cyprus, Norway, Sri Lanka

Need a healthy holiday cookie recipe? Look no further!

2011-12-13T02:00:00.000-08:00

We have Temecula, CA inCYSTer Meri Raffetto to the rescue.

Meri is the co-author of the recently released Mediterranean Diet Cookbook for Dummies, and she forwarded this recipe from the cookbook.

I'm in!

Orange, Chocolate and Pistachio Biscotti

Prep time: 25 minutes Cook Time: 30 minutes Yield: 36 servings

Ingredients

¾ cup pistachios (whole)
¼ cup semi sweet chocolate chips, chopped lightly
2 cups flour
1 cup sugar
1 teaspoon baking powder
¼ teaspoon baking soda
3 tablespoons unsalted butter, room temperature
1/8 teaspoon salt
2 whole eggs
1 egg yolk
1 teaspoon orange blossom water or 1 tablespoon orange zest
¼ cup flour, for work surface
Directions

1. Preheat the oven to 350 degrees. Place a piece of parchment paper on a baking sheet.

2. In a large bowl mix together the pistachios, chocolate chips flour, sugar, salt, baking powder, and baking soda. Cut in the butter and mix with a spoon.

3. In a small bowl, mix together the eggs, egg yolk, and orange blossom water.

4. Using a hand mixer, mix the egg mixture into the flour mixture forming the dough. Lightly dust hands with flour and form the dough into a ball.

5. Transfer the dough onto a work surface that has been dusted with flour. Knead the dough 5 times for 1 minute. Divide the dough in half and roll each piece into a log 8 inches long and 3 inch wide and 1-inch thickness. Place each log onto the parchment paper about 5 inches apart. Bake the logs for 20 minutes.

6. Remove the logs from the oven and cool for 10 minutes.

7. Gently transfer the logs to a cutting board and with a sharp knife, press down and cut biscotti pieces horizontally every ½ inch. The cookies will be ½-inch wide by 3 inches long. Place the cookies cut-side down onto 2 baking sheets lined with parchment paper.

8. Bake the cookies for 5 minutes, turn each cookie over and bake for an additional 10 minutes. Let the cookies cool completely on baking sheets before storing. Cookies need to be kept in a tightly covered container and can be stored at room temperature for 2 weeks.
Per serving: Calories 80 (From Fat 23); Fat 3g (Saturated 1g); Cholesterol 3mg; Sodium 42mg; Carbohydrate 13g (Dietary Fiber 1g); Protein 2g.
Excerpt from The Mediterranean Diet Cookbook For Dummies®, Wiley, Nov. 2011.

Spirituality and Psychotherapy: What’s God Got To Do With It?

2011-12-12T02:00:00.000-08:00

As with all professions, there’s a diversity of spiritual belief among psychotherapists, ranging from the atheists to devout Christians, Jews, Buddhists, Hindus, and Muslims. There are those who call themselves “spiritual but not religious,” and those who would say they’re agnostic, always questioning. Some outright label themselves as “Buddhist Psychologists” or “Christian Therapists.” Except in the latter case, it’s generally presumed that psychotherapy and spirituality are separate disciplines, and never the twain shall meet.

I have often wondered though, how a truly great therapist can be utterly godless. Surely it is helpful to have some construct in one’s mind that god, the universe, or some other greater sense of structure, belonging, and control might exist. Not only are we constantly exposed to the complex mysteries of the human brain, mind, heart, and soul, but we are also constantly exposed to the trauma, torture, disease, anger, loneliness, and sadness that brings people to our offices. All of these things are often inflicted by one human being upon another human being (child abuse, spousal abuse, introduction to addictive substances, etc.). There is a powerful depth of sadness present in the fabric and content of my work. It is especially present in issues of grief and loss, chronic illness, or terminal illness.

I always ask my clients about their spiritual background, beliefs, and practices. While I’m not qualified to be a spiritual counselor of any sort, this information gives me a context for a life, and helps to complete the description of a person. For some people, god is an explanation, a support, and a source of strength. For others, god is an excuse, or a punishing figure. Whether god is important to us personally, or in the moment, questions of god often lurk in the background. So for me, god may not be the main course, but s/he is surely present in many ways.

For example, if I have a client who lost her virginity as a result of rape, and she is a staunch Catholic, I know it’s likely that feelings of guilt and shame will be even more prominent for her. If someone had a punishing experience in parochial school and rejects organized religion, I know this is a deep wound, and the person’s sense of belonging and support has been taken away, along with their faith. When a client is suicidal, it is often faith in god, or a belief that god wouldn’t approve of suicide, that keeps the person from attempting suicide. Whether I believe in his or her form of god or not, I’ll take whatever help I can get!

In dealing with issues of chronic illness, and in particular PCOS, there’s often a lot of questioning: “Why me?” “Why did god do this to me?” “Isn’t god supposed to heal me, not make me sick?” These are important issues and needs to explore in therapy. Spirituality often relates to:

• feeling a sense of belonging;
• having faith that there is a reason, even if it’s unclear, for suffering;
• sense of powerlessness;
• ability to control;
• anger;
• need to assign blame;
• development of hopefulness;
• sources of shame, especially as related to sexuality; and
• need for explanations.

Of course it’s not just spirituality or god that provides the answers to these big questions. But in the therapist’s toolbox, addressing spirituality and how it presents in your life is part of the process of developing greater internal strength. God may be part of that. Allowing me to know you in this way is an important part of knowing how you think, what you believe in, where you feel strong, and where you feel weak, so that I can help you to repair the gaps. The ability to access my intuition and connection to a spiritual source helps me to context suffering, illness, trauma, and grief in a way that allows me to remain focused on what you need. It may also be a resource I can draw your attention back to when the going gets tough. In a nutshell, that’s what god’s got to do with it.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at AskDrGretchen@gmail.com. You can also follow her on Twitter @askdrgretchen.

Heads up vegans -- update on vegetarian DHA -- much of it is genetically modified

2011-12-11T02:00:00.000-08:00

If you're a regular reader of this blog, you know how big I am on omega-3's from seafood. For those of you who are vegan, I've been recommending a product called Life's DHA, which can be found in supplements as well as foods. Many of these foods are labelled as organic, which is supposed to mean they are free of anything genetically modified.

Many thanks to our network member Michal Hogan who forwarded a news release with a detailed report about this product. It is GMO, and it is being incorporated into many foods that are sold as organic. I used to point several of them out when I did grocery store tours at Whole Foods.

This creates a dilemma for vegans, as the truth seems to be, if you're omega-3 deficient, and wish to supplement, you may have to use a fish-based product. There is always nori (sushi wrappers) and you can add sea vegetables...but the reality is, the average American is unlikely to be able to eat enough of these to be able to use them as a way to replete low DHA stores.

If you're vegan, it's going to be especially important to cut the omega-6 out of your diet to be sure it's not overwhelming the omega-3 that is actually there.

One thing I can recommend, and now that I read this report, strongly recommend...is that you have your blood omega-3 analysis performed with the home fingerprick test we offer. We do offer it at a discounted price. It will tell you exactly where you stand, how much this situation personally affects you, and gives anyone trying to help you pick the right foods, a better idea of what to advise you to do to improve your omega-3 status.

If you're simply relying on generalized Internet information you're playing a huge game of hit and miss. Why not get right to the point and figure out what YOU need to do personally?

I am not just sorry about having to backpedal. I am very, very sad. Such a high percentage of our readers and fans are vegans, and this was one of the ways out of the dilemma. Back to the drawing board. :(

Here is the article if you're interested.

http://www.naturalnews.com/034364_infant_formula_DHA_genetically_modified.html

Here is a list of foods from the Martek website that contain this ingredient.

http://www.lifesdha.com/Products-Containing-lifesDHA-/Partner-Products/tabid/683/Default.aspx

5 Steps to Feeling Well

2011-12-10T09:59:00.000-08:00

The most common question I get as an Herbalista is, "What can I do to feel well again?" There are many things we can do to incorporate wellness in to our body, mind, soul, and earth and I use this 5-step acronym that I've developed to simply my options: FHEEL

F= Food

The first step to feeling better is to examine what we're fueling up on. It tends to be in our best interested to avoid fried and fatty foods in general, but especially so for those of us with PCOS. Instead, aim to eat plenty of fresh vegetables and healthy proteins with some fruit, dairy, and whole grains sprinkled in. Try and get a rainbow-colored variety of foods in your diet, striving for more of the darker/richer colored foods (kale, spinach, dandelion greens, mustard green, collard greens, broccoli, beets, blackberries, blueberries, pomegranates, squashes, sweet potatoes, carrots) and less of the lighter and whiter foods (citrus, raspberries, strawberries, bananas, pastas, rice, sugar, white potatoes, butter, dairy).

H= Herbs

If a whole foods diet isn't giving you everything you need in the moment, adding herbs can help! Start with adding simple spices to your meals like garlic (detoxifying herb that is great for the digestive system), rosemary (supports the brain and is antibacterial), and ginger (supports the circulatory and digestive system and is helpful for migraines). Other culinary spices that are easy to incorporate are cinnamon, turmeric, pepper, fennel, cayenne, thyme, sage, and clove. I highly recommend talking with a Holistic Healthcare practitioner, Naturopath, Herbalist, or other trained botanical medicine professional about herbs that can be specifically helpful to your desired wellness goals.

E= Essences and Essential Oils

Both Flower Essences and Essentials Oils are lovely tools that really support more the emotional, spiritual, and mental journey of wellness. Flower Essences have no reaction to medications, allergies, children or pets and work specifically on our current state of emotions. There are as many brands as there are flowers, from all parts of the world, so please read up on the companies as well as the products before choosing an essence. Essential oils are potent blend of botanical oils that have specific methods of delivery. Because there are highly concentrated amounts of naturally occurring chemicals in essential oils, it is extremely important to handle them with an informed and delicate manner. As always, consult with an Aromatherapist or Flower Essence practitioner for recommendations.

E= Energy Therapies and Exercise

When there still seems to be components of our wellness that need some extra attention, energy therapies and exercise can be very beneficial. Research the many benefits of Massage Therapy, Yoga, Acupuncture, Reiki, Polarity, Reflexology, Circuit Training, and many other healing arts and fitness programs. With any area of wellness, there are both reputable, competent companies and practitioners of theses energy therapies, as well as not so reputable nor competent companies and practitioners. Choose wisely after researching local resources in your community. I like to ask where they received their training from, how long have they have been in practice, and also what the whole process is from start to finish before signing up or paying for an appointment. Other energy therapies and exercises that can be helpful are: meditation/prayer, affirmations, journaling, hypnotherapy, life coaching, joining a gym/health club, getting a personal trainer, and dance styles like zumba/jazzercise/ballroom/swing/two-step and line dancing.

L= Lifestyle Changes

Making some more intense changes in lifestyle habits may be necessary in order to achieved our desired wellness goals. Most often, habits like smoking, drinking, eating too much fast food or snacks, not exercising, drinking soda and sugary beverages,and having too much or too little sleep can tremendously impact the state of our health. When setting your wellness goals, really emphasize the reasons for choosing those specific goals and concentrate on those reasons during the challenging moments. Tell your friends and family about your wellness goals the lifestyle changes you are making to help keep you accountable and motivate you during the ups and downs. Create a vision board or goal chart to showcase your progress. There are many tools and apps available to help you at any age or stage of wellness and life so identify those goals, develop a route to wellness, seek advice if you need help meeting those goals and chart your progress to see how well you're doing and how close you are to meeting and exceeding those goals!

I leave you with this last tidbit to remember, words of wisdom I try to live by: Wellness is a Journey, Not a Destination. Strive for Progress, Not Perfection... Know that every step, every breath, and each moment counts as progress, so long as we consciously choose to be well.

~Choose to be and "fheel" well-- The Herbalista

I don't think comfort food gets any easier!

2011-12-09T02:00:00.000-08:00

It's probably because I love food that I became a dietitian. And it's also because I love food that I hang around so many foodies.

One of my dear foodie friends, Tony Arranaga, recently posted a favorite meal on his Facebook page that I wanted to share with you. Here is Tony from his Phoenix days, when we all knew and loved his foodie advice as the famed Light Rail Blogger.

These days Tony is incredibly busy working long hours in the office of Los Angeles City Councilman Bill Rosendahl, so he doesn't have a lot of time to spend in the kitchen. But he still loves good food! His crockpot helps him make that situation work anyway. This recipe for salsa verde chicken machaca really needs to be on all of your "super super easy" lists. Here is how he makes it.

Machaca is a traditional Mexican dish, typically with beef. My twist uses chicken breast (4) and two jars of Salsa Verde. Toss it in a crock pot. Let cook on high all day, then half hour before you serve, throw in a can of black beans. It tastes great alone, or with tortillas, or even on a bed of lettuce. Let me know how it turns out!

Let us know if you try this! If you have something for our "super easy" collection, send it our way!

The inCYST Nutrition and Fitness Manifesto

2011-12-08T02:00:00.000-08:00

Hello everyone, we have so many new people coming to us through Twitter and Facebook, asking what our diet and exercise recommendations are, and then when they come, they are faced with a tremendous task of plowing through hundreds of blog posts I promise I will better organize in 2012...I thought I would summarize what we stand for and what we don't stand for.

If you ever hear differently from anyone in our network, I do need to know. The goal of building a network is to know what our non-negotiables are that we all stand for, and then let each individual network member use their creative talents to make it happen in your life.

Here goes.

1. We do not believe in a one-size-fits-all diet, exercise, or lifestyle prescription for PCOS. That means that while some of you may learn that you are gluten intolerant, we do not recommend that all women with PCOS refrain from eating gluten. While some of you may benefit from running, others may find that another form of activity is going to work better. We believe in creating a set of recommendations that are personally relevant to your own situation, biochemistry, likes, and dislikes. We are not out to create an army of Stepford cysters!

2. We do not advocate for any one type of diet. We choose to honor your own personal food religion, be it vegan, Paleo, low glycemic, raw...whatever...and assist you with understanding what choices you need to make that honor both your food religion and your biochemical nutritional needs. It's about how to be complete, not which is the best way to be complete. Only you know what works best for you.

3. Put another way, we do not advocate for eliminating large categories of foods (gluten-containing, dairy, meat, cooked) unless we see that there is a genuine, medically-indicated reason for doing so.

4. We believe that PCOS does not respond to extremes of any kind. Extreme calorie restriction, extreme exercise participation, extreme dependence on medication, extreme dependence on supplements. Managing your PCOS is entirely about balance in all of those departments. Our job is to show you how to achieve that balance.

5. We believe that nutrition and exercise can be as counterproductive to your health as not pursuing them. Overzealous dieting and overtraining are as harmful to your hormone balance as are overeating and not exercising. Anyone who tells you that you're simply not dieting hard enough or not exercising hard enough...has not taken the time to study what PCOS is about, and they are running the risk of encouraging you to layer yet another inflammatory condition on top of the tangled hormone web that is already in place. We will never endorse that approach.

6. Some things we do know: Women with PCOS tend to be vitamin D deficient, they tend to have an imbalance in dietary omega-6's and omega-3's, and they often have food sensitivities. But those are factors that can be clinically tested. Your physician can do the vitamin D testing. The omega-3 balance is a home-administered test we can set you up with at inCYST. Food sensitivities can be tested as well, through one of the many inCYSTers who is also LEAP-certified.

7. We believe that PCOS is a generalized inflammatory syndrome. But each woman's core source of inflammation is completely unique and different than every other woman's. We encourage that you invest in a comprehensive consultation to help determine what factors are most important for you. If you try to follow every piece of advice that every person on the Internet tries to give you...you're going to be able to follow it for about 3 days before you run out of money, time, and energy. We're here to help you sort through the information and decide which is relevant to your personal situation.

8. We believe that the main issue is not that there is not information to help your case, but that for whatever reason, you've given up on believing that it can work for you. We're committed, through our research institute, to understanding the physiology and psychology of that resignation so we can work to break through it and motivate you to try things that actually work. (We've knocked a lot of women up! I promise!)

I know there's no secret recipe here, but that is because everyone's recipe is different. Just like my mother's potato salad has bacon and mayonnaise in it, and I adjust mine to include turkey bacon and Greek yogurt...you each are going to have your own recipe for success. To settle for a blanket recommendation, is to accept that you are not unique and special. We simply do not believe that.

Hope this helps, and I hope you take advantage of the incredible knowledge and expertise of the experts who have taken the time to learn as much as they can about PCOS so they can help you chart your course through the haze and maze.

inCYST on a Healthy Christmas!

2011-12-07T02:00:00.001-08:00

I asked our team for some ideas for holiday gifts that promote healthy mind, body, and spirit. If your loved one is asking for ideas, or if you're shopping for someone who is trying to make changes that benefit their health, hope these wonderful inCYSTers provide you with some inspiration!

Julie Dillon, RD, Julie Dillon Consulting, Greensboro, NC

--cooking classes/lessons

--magic wand (I purchased a cheap one and my clients and I often laugh about it yet it also stimulates great discussions)
--yoga gift certificate
--pretty journal (there are some amazing leather bound ones that make great gifts)
--comedy club tickets because laughing brings the blood sugar down and it's great stress relief;-)

Hana Feeney, MS, RD, CSSD, Nourishing Results, Tucson, AZ

Healthy cooking magazine subscriptions, such as Eating Well
A food scale, I like the ones with nutrition information for those who are into numbers
Portion plates
Spice and herb blends
Specialty teas
Massages
Acupuncture treatments
A CSA share
A community garden plot
Gift cards to running, cycling or other fitness related stores
Gift cards to natural grocery stores
Pedometers, I’m checking a new one out that has multiple features called Striiv
Healthy cookbooks

Karen Siegel, MS, RD, LAc, Nutrition and Acupuncture Clinic, Houston, TX

I just had a patient tell me she wanted to give her mother a gift certificate for acupuncture as a stocking stuffer.
I told her I have gift certificates, but to also consider an acupuncture face lift. Many acupuncturists (myself included) do facial rejuvenation treatments.

Danielle Omar, MS, RD, Food Confidence, Fairfax, VA

My Busy Woman's Guide to Stress Free Grocery Shopping is a great gift! It's on sale this month, too! :-)

Sarah Jones, RYT I offer discounted private yoga lessons.

Meri Raffetto, RD, Real Living Nutrition, Temecula, CA My recently released book, The Mediterranean Diet Cookbook for Dummies, is available at amazon.com

Susan Van Dyke, MD, Van Dyke Laser and Skin, Paradise Valley, AZ

Give the gift of:

Purity
Freedom from age spots and lines with Fraxel Dual (Susan Van Dyke, MD)

Self esteem
Beautiful skin with Vivite Skin Care (Heather Anderson, RN)
Sexiness
Smooth legs without shaving with LightSheer Duet (Tina Villalobos, MA, Back Office Coordinator)

Youthfulness
Facial volume in the right places with Sculptra Aesthetic (Sherry Rodgers, Office Manager)

Confidence
Fuller, seamless skin with TNS Recovery : the collagen stimulator (Cameron Vessey, Aesth and Laser Tech)

Clarity
Gorgeous Glow with Clear + Brilliant (Traci Lee, Front Office Coordinator)

Serenity
Relaxed frown muscles with Botox or Dysport (Jessica McCarthy, MA)

Knowledge
A VDLS seminar (and it is free!) (DeAnne Dunn, Aesth and Laser Tech)

Generosity
VDLS gift certificates for everyone’s favorite products and procedures (Diane Davies, Front Office)

The entire Van Dyke Laser & Skin team wishes you a glorious holiday season!!!

Monika Woolsey, MS, RD Incyst, Phoenix, AZ and Santa Monica, CA

As for me? I second all and I hope my gift buyers are reading this! One suggestion I do have for Phoenix readers, is a gift certificate to Chow Locally. It's a twist on the farmer's market concept, you can create your grocery box online and pick it up at one of three metro locations. For anyone who loves the farmer's market but whose weekends are filled with other "to-do's", it's a great option.

Many thanks to all of our readers, network members, and fans for making this such a hugely successful year for inCYST! We are so looking forward to even bigger and better things in 2012.

Exciting PCOS research update!

2011-12-06T02:00:00.000-08:00

We've been blessed in a wonderful way!

inCYST friend Rebekah Rawlins Rocheleau is working on graduate studies in psychology and has decided to devote her project to a PCOS-related issue. She asked if I'd be involved in reading the project and providing feedback so I guess you can say we've embarked on our very first research endeavor.

So many thanks to Rebekah for helping us get established as a center devoted to PCOS research.

Rebekah's project will be looking at factors that motivate and demotivate women with PCOS when it comes to taking action and changing behavior.

I'm especially excited about this focus because I'm convinced that one of the biggest barriers to women with PCOS pursuing health is not that there is not information available for them to capitalize on. Rather it is about the reasons why they do not utilize this information on a regular basis in order to better their situation and their fate.

We'll be sure to keep you posted!

Thanks again, Rebekah! So excited to be involved!

I’m a Miracle, and So Are You

2011-12-05T02:00:00.000-08:00

We’re now in the thick of the holiday season, and we’re socializing, eating too much of the wrong things, and talking about gratitude and miracles. At Thanksgiving, in particular, we gave thanks for the year’s blessings. Our loved ones, homes, jobs, and perhaps our health were on the list. For me, this has been a dramatic and miraculous year, when it comes to health.

In August, I was accidentally infected with pasteurella as a result of the bacteria entering my hand through some broken skin while I was pilling my cat. Although I cleaned it and put antibacterial ointment on it, a large purplish black welt quickly formed on my finger, followed by heat, redness, and streaking up to the knuckles, which are classic signs of infection. By the time I reached the emergency room, the streaking had gone to my elbow. This was a terrifyingly quick-moving infection that was threatening to go systemic. The only possible treatment was antibiotics, and lots of them - immediately.

Now, I am loathe to resort to antibiotics unless they’re absolutely necessary – but it did occur to me that I could actually lose my hand, arm, or life – which is exactly what would have happened a hundred years ago. I surrendered to four types of IV antibiotics, a six-day hospital stay, and emergency surgery to save the function of my right index finger. Although my hospital stay was fraught with complications, I am eternally grateful for the miracle of Western medicine and its powerful antibiotics. I have faced other extreme infections in my life, but this was the most serious I’ve ever dealt with. I really do feel it’s a miracle I’m alive.

However, it’s not just these big drama moments in our lives that are miracles. Every moment, I’m a miracle, and so are you. We survive trauma, abuse, bad upbringings, alcoholism and other forms of addiction, PCOS, incompatible spouses, cancer, sick children, and elderly relatives with dementia. We work, we care for ourselves and others, and we do what we can in spite of often seemingly insurmountable obstacles. We struggle through challenging courses in school, minor or major health crises, mental illness, financial downturn, and intense disappointments. We get through the day when it seems as if the day will never end. We restrain our tempers, our tongues, and our appetites. We drive ourselves forward, making giant strides on some days, or crawling on our knees on other days. We survive. We try to thrive.

Instead of lamenting your weight, the size of your thighs, the incredibly annoying behavior of your ADHD child, the way your husband never brings you flowers, your highly imperfect boss, or the fact that you’ve got this damn thing called PCOS, I wonder what it would be like if you instead asked yourself, “How am I a miracle today?” The shift will be powerful. You’ll appreciate yourself more, and love yourself a little more easily. Your self-esteem will soar, when you realize precisely how miraculous you are, right here, in this moment, and always.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at AskDrGretchen@gmail.com. You can also follow her on Twitter @askdrgretchen.

Seasonal Hormone Changes: They're there...they're natural...here's how to deal with them

2011-12-02T02:00:00.000-08:00

OK! We've cruised past the candy corn...mastered the Thanksgiving pie...what is it about these nasty carbohydrate cravings that make it so darn hard to keep a respectful distance from all of these holiday sweets?!?!?

You may not be imagining things. And you may not be a nutrition wimp. Your body chemistry actually changes with the seasons.

Did you know, for example, cholesterol is actually higher on average midwinter than it is midsummer? Yup, so if you have your annual physical midwinter, get a high reading, and go on medications, the drop in your followup may not be entirely due to medication. It's just how nature does things.

One of the toughest seasonal changes is mood. Back in the days when we were more exposed to the elements, it probably made sense to want to be more sluggish and a little heavier. No need to waste body heat on exercise when we need it for warmth. And a little extra fat for insulation was more than welcome.

Nowadays, we prefer to have our weight be as stable as possible, and this time of year it can be hard to achieve that. About 20% of the population (and 4 times more women than men) experience such a radical shift in mood, hormones, and biochemistry, that they qualify for an official diagnosis of seasonal affective disorder (SAD). Symptoms include: tiredness, depression, crying spells, irritability, trouble concentrating, physical aches, decreased sex drive, trouble sleeping, less desire to be physically active, increased appetite (especially for carbohydrates), and weight gain.

I'm guessing that a pretty high percentage of the audience reading this is thinking, "But this is how I feel all the time!". If you have PCOS, that may be true, but it may become more intense...progressing to out of control...in the dark of winter. Here are some strategies to try to help you get through the winter solstice. Remember, from December 22 on...it's all uphill!

1. Check your vitamin D levels. Low vitamin D may be part of the problem. If it is, be sure to supplement.

2. Do your best to get outside. It's hard with short days and cold temperatures, but even a few minutes a day can make a difference. Even on a cloudy day! Ultraviolet rays are present even with cloud cover. Take advantage of them.

3. Consider phototherapy. I have recommended light devices for clients living in places like Seattle and Alaska, and they can work wonders. All they do is bring sunshine indoors. Working, studying, or reading the mail in the presence of one on a regular basis can help to promote a biochemistry similar to what you naturally experience in the summer.

4. If your SAD progresses to where the symptoms are incapacitating or dangerous, antidepressant therapy has also been found to be helpful. Ask your physician for a discussion about your options.

5. Of course, you know I'm going to say this...prioritize diet. Take advantage of comfort foody crockpot meals like chili, and lentil soup, to help keep your blood glucose stable. Don't forget the protein. It's easy to forget about protein in the mountain of Christmas candy and cookies we're about to tread through, but a little packet of Justin's Nut Butter or string cheese stashed in your purse or briefcase can work wonders for staving off those carbohydrate demons.

6. Don't panic. If you've noticed over the years that your weight naturally fluctuates 5, even 10 pounds between winter and summer, and it naturally self-corrects without radical dieting, you are simply in tune with Mother Nature. Appreciate the fact that you can get by with fewer bulky sweaters and scarves to stay warm, and don't get caught up in unhealthy eating and exercise habits to try and "fix" what is likely a completely natural phenomenon.

Golden, R.N., B.N. Gaynes, R.D. Ekstrom, et al. "The Efficacy of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-analysis of the Evidence." Am J Psychiatry 162 (2005): 656-662.

Gettin' jiggy with fenugreek

2011-12-01T02:00:00.000-08:00

Fenugreek you say? What the heck is fenugreek? It's a spice popular in India, northern Africa, and the Middle East that has multiple benefits for PCOS:

--it can lower your lipids
--it can help to control blood sugar
--it can help improve milk production in women who have trouble breastfeeding
--antioxidant action in the face of high blood glucose

In women struggling with lactation, fenugreek tea (made with the leaves of the plant) has been found to be beneficial. The Fenugreek spice has been added to flour to provide functional properties and it has found to be beneficial in this format as well.

And since we're on the topic of hair loss this week, here's an Ayurvedic remedy using Fenugreek:

Mix ground fenugreed seeds with water and yogurt to make a paste. Rub into hair and wash after 30 minutes.

I'm giving you two recipes, the first one from India, and the second one from Ethiopia. If you like spicy foods, you're going to love adding this herb/spice to your culinary creations!

Methi Murgh (fenugreek chicken) from allrecipes.com

Ingredients
1/4 cup cooking oil
1 (4 to 6 pound) whole chicken, cut into 8 pieces (skin removed and discarded)
1 teaspoon cumin seeds
1 cinnamon stick
1 black cardamom pod
4 whole cloves
1 large onion, sliced thin
1 tablespoon ginger-garlic paste
4 green chile peppers, halved lengthwise
1/2 cup chopped fresh spinach
1/2 cup chopped fresh fenugreek leaves
1 tablespoon dried fenugreek leaves
1/2 teaspoon ground turmeric
1/2 teaspoon ground red pepper
salt to taste
1 cup water
1/2 teaspoon garam masala

Directions

1.Heat the oil in a pressure cooker over medium heat; brown the chicken pieces evenly on all sides, about 5 minutes. Remove from cooker and set aside. Add the cumin seeds, cinnamon stick, cardamom pod, cloves, onion slices, ginger-garlic paste, and green chile peppers to the pressure cooker and cook until the onions are golden brown, 5 to 7 minutes. Stir the spinach, fresh fenugreek leaves, dried fenugreek leaves, turmeric, red pepper, and salt into the mixture and cook until the spinach and fenugreek leaves begin to wilt and darken in color, about 5 minutes. Pour the water over the mixture and return the chicken pieces to the pressure cooker; bring to a boil for 2 to 3 minutes.

2.Fasten the lid on the pressure cooker; cook until the chicken is tender, about 30 minutes. Release pressure fully and remove the lid; sprinkle the garam masala over the dish. Cook and stir until the liquid thickens, 3 to 5 minutes. Serve hot.

Berbere - spiced lentil stew from Sundays at Moosewood Restaurant

Berbere

2 teaspoons cumin seeds
4 whole cloves
3/4 teaspoons cardamom seeds
1/2 teaspoon whole black peppercorns
1/4 teaspoon fenugreek seeds
1/2 teaspoon coriander seeds
8 - 10 small dried red chiles
1/2 teaspoon grated fresh ginger root (1 teaspoon dried)
1/4 teaspoon turmeric
1 teaspoon salt
2 1/2 tablespoons sweet Hungarian paprika
1/8 teaspoon cinnamon
1/8 teaspoon ground cloves

In a small frying pan, on medium-low heat, toast the cumin, whole cloves, cardamom, peppercorns, allspice, fenugreek, and coriander for about 2 minutes, stirring constantly. Remove the pan from the heat and cool for 5 minutes.

Discard the stems from the chiles. In a spice grinder or wtih a mortar and pestle, finely grind together the toasted spices and the chiles. Mix in the remaining ingredients.

Store Berbere refrigerated in a well-sealed jar or a tightly closed plastic bag.

Yemiser W'et (Spicy Lentil Stew)

1 cup dried brown lentils
1 cup finely chopped onions
2 garlic cloves, minced or pressed
1/4 clarified butter
1 tablespoon Berbere
1 teaspoon ground cumin seeds
1 tablespoon sweet Hungarian paprika
2 cups finely chopped tomatoes
1/4 cup tomato paste
1 cup vegetable stock
1 cup green peas, fresh or frozen
salt and freshly ground black pepper to taste
plain yogurt or cottage cheese

Rinse and cook the lentils.

Meanwhile, saute the onions and garlic in the clarified butter, until the onions are just translucent. Add the berbere, cumin, and paprika and saute for a few minutes more, stirring occasionally to prevent burning. Mix in the chopped tomatoes and tomato paste and simmer for another 5 to 10 minutes. Add 1 cup of vegetable stock and continue simmering.

When the lentils are cooked, drain them and mix them into the saute. Add the green peas and cook for another 5 mintues. Add salt and black pepper to taste.

Roberts KT. The Potential of Fenugreek (Trigonella foenum-graecum) as a Functional Food and Nutraceutical and Its Effects on Glycemia and Lipidemia. J Med Food. 2011 Aug 23. [Epub ahead of print]
Middha SK, Bhattacharjee B, Saini D, Baliga MS, Nagaveni MB, Usha T. Protective role of Trigonella foenum graceum extract against oxidative stress in hyperglycemic rats. Eur Rev Med Pharmacol Sci. 2011 Apr;15(4):427-35.
Turkyılmaz C, Onal E, Hirfanoglu IM, Turan O, Koç E, Ergenekon E, Atalay Y. The effect of galactagogue herbal tea on breast milk production and short-term catch-up of birth weight in the first week of life. J Altern Complement Med. 2011 Feb;17(2):139-42. Epub 2011 Jan 24.

Supplements and hair loss

2011-11-30T02:00:00.000-08:00

I was recently asked my opinion about whether or not biotin supplementation would help hair loss. Here's a bit of commentary, plus information about melatonin, another supplement that has been studied.

As with any supplement, it's only going to help if you are indeed deficient in that particular nutrient. There are many reasons you could be deficient in biotin. One of the most relevant to PCOS, is the use of medications valproic acid and carbamazepine. These are seizure medications, also used to treat bipolar disorder and migraine headaches, that have been reported to cause or exacerbate PCOS. So if you've ever been on those medications, you may want to consider supplementation.

If your diet has been out of balance in any way (severe dieting, overeating, eating disorder, cutting out entire categories of food (gluten-free, paleo, vegan, etc.) with a focus on what to eliminate rather than on how to be complete, you may be at risk for biotin deficiency.

It's certainly not going to hurt, and it might help. The dose reported in the literature is 5 to 10 mg per day. However, keep in mind, if your hair loss is primarily related to high testosterone levels and you do not adhere to your complete recommended protocol, biotin will not fix what those problems are causing. It's not a miracle cure.

The best food source of biotin is Swiss chard. Which I was happy about because one of my favorite quick meals is a Swiss chard frittata...I actually planned on making one tonight before knowing this. Nice coincidence!

The other supplement I'm a little more versed in, is melatonin. You all know I'm a big fan of sleep, almost more than diet, for its power to heal. About a year ago, I was poking around in PubMed and found the abstract below, specifically looking at using melatonin to treat androgenic alopecia, which is specifically the type of hair loss you all have. I was coming out of a pretty stressful personal period myself, and had started to notice that my hairline was receding...not fun to look at! So I figured I'd try it myself before writing about it. What I do, is take a melatonin pill, dissolve it in my hand with a few drops of water, and then massage it into my skin with coconut oil. Simply using water didn't work, it needed a carrier. I've noticed that my hair is gradually starting to grow in again. It's not thick and lush, by any means, but it IS growing some hair back.

A caveat here, it won't happen in a week, and you have to be consistent with application. If you're going to flake out about it...don't bother even starting. It's taken almost a year to see a difference. But if you're committed and willing to be persistent, it's definitely worth a try.

Here's the article.
Fischer TW, Burmeister G, Schmidt HW, Elsner P. Melatonin increases anagen hair rate in women with androgenetic alopecia or diffuse alopecia: results of a pilot randomized controlled trial. Br J Dermatol. 2004 Feb;150(2):341-5.

BACKGROUND: In addition to the well-known hormonal influences of testosterone and dihydrotestosterone on the hair cycle, melatonin has been reported to have a beneficial effect on hair growth in animals. The effect of melatonin on hair growth in humans has not been investigated so far.

OBJECTIVES: To examine whether topically applied melatonin influences anagen and telogen hair rate in women with androgenetic or diffuse hair loss.
METHODS: A double-blind, randomized, placebo-controlled study was conducted in 40 women suffering from diffuse alopecia or androgenetic alopecia. A 0.1% melatonin or a placebo solution was applied on the scalp once daily for 6 months and trichograms were performed to assess anagen and telogen hair rate. To monitor effects of treatment on physiological melatonin levels, blood samples were taken over the whole study period.

RESULTS: Melatonin led to a significantly increased anagen hair rate in occipital hair in women with androgenetic hair loss compared with placebo (n=12; P=0.012). For frontal hair, melatonin gave a significant increase in the group with diffuse alopecia (n=28; P=0.046). The occipital hair samples of patients with diffuse alopecia and the frontal hair counts of those with androgenetic alopecia also showed an increase of anagen hair, but differences were not significant. Plasma melatonin levels increased under treatment with melatonin, but did not exceed the physiological night peak.

CONCLUSIONS: To the authors' knowledge, this pilot study is the first to show that topically applied melatonin might influence hair growth in humans in vivo. The mode of action is not known, but the effect might result from an induction of anagen phase.

Castro-Gag M, Pérez-Gay L, Gómez-Lado C, Castiñeiras-Ramos DE, Otero-Martínez S, Rodríguez-Segade S. The influence of valproic Acid and carbamazepine treatment on serum biotin and zinc levels and on biotinidase activity. J Child Neurol. 2011 Dec;26(12):1522-4. Epub 2011 Jun 3.

Wolf B. EditorsIn: Pagon RA, Bird TD, Dolan CR, Stephens K, editors. Biotinidase Deficiency. SourceGeneReviews [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2000 Mar 24 [updated 2011 Mar 15].

Zempleni J, Hassan YI, Wijeratne SS. Biotin and biotinidase deficiency. Expert Rev Endocrinol Metab. 2008 Nov 1;3(6):715-724.

Should you go gluten-free for PCOS?

2011-11-29T02:00:00.000-08:00

It's a question we get all the time and the answer is yes, no, and maybe.

If you have a diagnosis of celiac disease, the answer is definitely yes.

If you are eliminating gluten from your diet because someone on the Internet has told you to do so, the answer is no.

If you think you may have a food sensitivity, then the answer is maybe. The problem with slapping a gluten-free restriction on yourself is that you may be eliminating foods you don't need to eliminate. You may have a simple sensitivity to wheat, for example, but that doesn't mean you need to eliminate ALL gluten-containing foods.

If you cast a wide net, and eliminate 200 things, and only one of them is the culprit, you've just eliminated 199 foods that you could have eaten that actually could have been productive for you. That's going to make it hard for you to stay on track, because you've limited the variety of foods you can eat, your ability to eat out, socialize, etc.

Michal Hogan, RD, one of our inCYSTers in Columbus, has shared that sometimes, when people don't have a gluten issue, simply by limiting gluten in the diet, they can create one! Don't want to go there, now, do you?

At inCYST we do believe that food sensitivities can trigger an inflammatory process and be a major factor in PCOS. We've even added that topic to our professional training. However, we believe there is a much more scientific and accurate way of pinpointing the problem. It's called LEAP testing. Many of our network members are Certified LEAP Therapists, meaning that if you believe a food sensitivity is part of your problem, they can help you to interpret a blood test that tells you EXACTLY what your issue is. So you're not unnecessarily eliminating foods, and you have a precise game plan.

To learn more about LEAP testing, go to http://www.nowleap.com/. If you'd like to find a LEAP therapist in your area, Michal is a LEAP mentor. You can contact her at nutritionresults@aol.com.

Supporting Each Other’s Choices

2011-11-28T02:00:00.000-08:00

In my role as a health psychologist who specializes in PCOS and other endocrine disorders, I read a lot of material on PCOS, insulin resistance, infertility, diabetes, and other hormonal matters. The more I read, the more I’m aware of the biases in the various camps, by which I mean, these types of messages that populate the media, presented here with my interpretation of the subtext:

• Natural is the only way to go – you’ll destroy your body with birth control pills and metformin (they’re all toxic chemicals!);
• Supplements are the way to go - forget the pharmaceuticals (it’s only 90 capsules a day, but you’ll manage);
• If you would just practice positive thinking, and say enough mantras, you could improve your fertility and have a cute baby just like this (it’s really your fault);
• We should accept our “flaws” as part of our beauty (and damn the women who take advantage of electrolysis, body sculpting, and hair dye);
• If you don’t follow this medical protocol quite strictly for the rest of your life, you’ll end up in terrible condition, with a host of dreadful side effects that will ultimately make your life miserable and then kill you (I’m the doctor, and I hold all the answers, and I’m going to scare you into compliance);
• Low carbohydrate diets are the only solution (chronic deprivation is the way to go);
• PCOS women shouldn’t exercise too much, or they’ll get all bulky and look like men (this is not actually physiologically possible, but it’s a great excuse);
• Exercise is the only thing that really works, and here’s how to do it (never mind that I don’t have PCOS myself, and know nothing about PCOS).

I could go on and on, but you get the idea. There’s a problem with all of these messages, and the problem is, they’re all wrong. There is no one solution that applies universally to all of us. We are each a unique composition of chemistries, ethnicities, weights, ages, and personal points of view. We have access to different specialists and reading materials. We have different beliefs about what works and what doesn’t. We have varying abilities to assess the correctness of scientific or medical data. We have limited finances and time to try every possible potential solution. And we are, quite possibly, exhausted from trying.

Additionally, consider the source. Quite a lot of these messages (picked up directly from my reading, but not attributed, in order to protect the innocent and the not-so-innocent) are presented to us with the intention of selling something – supplements, coaching services, dietary plans, books, CDs, or workshops. There’s nothing wrong with any of those things, by the way, but if the message consistently points in one direction, and it always results in you buying something, it may not be a message you want to heed. This blog tries to present useful information in a way that allows you to make reasonable choices, utilizing commonly available resources, and without pushing you towards any one philosophy, guru, product, or way of thinking. I think that’s a sensible approach.

That being said, we need to respect the choices that our fellow travelers in this PCOS journey are making. If a woman wants to try metformin, or birth control pills, or Spironolactone, or a low carbohydrate diet, and there’s no medical contraindication, let’s support her the best way we can. Don’t present your personal experience as the absolute truth. Offer it as a way of being there for support, or simply to share your experience so she has other “evidence” to consider.

Consider the impact of emphatic statements that “the only” way to produce a baby, or weight loss, or better fasting glucose numbers, is by following your plan. The woman on the other end may not have the time, education, or finances to implement your well-meaning suggestions, and the result on the other end may be a real emotional slam for a woman who’s already feeling fragile and desperate (this is especially true in the fertility/infertility arena).

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at Gretchen@drkubacky.com. You can also follow her on Twitter @askdrgretchen.

What is an inCYST-trained professional and how can you become one?

2011-11-27T12:22:00.000-08:00

We've been getting a lot of promotional love from Power Up for PCOS, so for those who do not know about our training, and who might be interested in participating, here is a little bit of information.

It is a 20 hour, entirely web-based course. Meaning you can do it in your pajamas if you really, really want to.

Once you complete this course, you become a member of the inCYST Institute for Hormone Health (meaning you have a vote in how we allocate our research dollars), and we promote you as a network member for 2 calendar years, through our Facebook presence, our Twitter presence, this blog, and now, through the rapidly growing Power Up for PCOS network (http://www.powerupforpcos.com/)

The current training is available to anyone who has a degree in a health-related field and a certification in the area of expertise that they will be marketed under (so we do welcome health coaches, as long as they have a certification).

One thing we do ask, is that you share a similar philosophy when it comes to nutrition, exercise, and medicine. We do acknowledge that there are many paths to the same destination, but the purpose of inCYST is to build trust within the PCOS community by offering a unified voice despite the personality from which the information comes. If you do not agree with us nutritionally for example, that's ok, it's just that you're not going to fit with the inCYST model. We had to go with something, and be consistent about it, and that inevitably means we can't include everyone, despite our respect for varied viewpoints.

We are working on trainings for fitness professionals and yoga instructors as well. If you'd like to be notified regarding how to participate in those, simply send me an email at monika at afterthediet dot com.

Cost for the currently available training is $425. I can send you the syllabus of topics if you contact me. It is slightly different from what is currently posted.

One word about the promotion. I do my best to promote every single person based on their professional goals. I do try to be fair about how that is done. In the past, there have been some situations where the expectation was that I would be functioning as an all-service PR firm to members, and my inability to meet that expectation did create conflict. If you have any questions at all about what you will be receiving, let's chat for clarification. My commitment is to treat all network members as if they are rock stars (because they are), and making sure our resources are equally devoted to every member is important.

We'd love to have you!

For our pals in the UK!

2011-11-26T02:00:00.000-08:00

Just received word from Growing Naturals, makers of the brown rice milk I often write about, that their milk as well as their brown rice protein powder, is now available in the UK.

To find it, go to http://www.aggressivehealthshop.com/. There you will find them under "supplements", where you can look for their brand, "Growing Naturals".

Our friends at Growing Naturals put a lot of thought into their product from how the rice is farmed all the way to how it is packaged and delivered to you. We're really excited that their product is growing in international presence -- we know we have more than just Americans reading our blog, and it's nice to be able to bring a bit of our ingenuity to other places!

Have you tried this Mediterranean yet? Northern African is worth a try!

2011-11-25T09:29:00.000-08:00

At inCYST we love the Mediterranean diet! You saw the announcement about Meri Raffetto's book, The Mediterranean Diet Cookbook for Dummies.

Recently I've been experimenting with a part of the Mediterranean that is often overlooked in discussions about this cuisine...the southern shore, or North Africa. It's fabulous.

It all started when my friend Kate turned her house into a Moroccan lounge and hosted a potluck dinner, where all of the guests were challenged to bring a dish that fit into the theme. I had the opportunity to try some incredible combinations of sweet and savory, and started looking for other recipes to try. What I love about what I've found, is that the dishes tend to be packed with vegetables, and they're a powerhouse on your palate.

These dishes combine all of the foods we generally associate with the Mediterranean, with all of the spices that come from its location along one of history's major spice trading routes. You'll need to stock your kitchen with turmeric, all of the peppers, cinnamon, cumin, coriander, cloves, curry, fenugreek...before you get started. But I think you'll be pleased with what you get.

One of my favorite rules for eating out is to eat authentic ethnic. Those are the places you'll find the cuisines that keep healthy eating interesting and exciting. Northern African cuisine, whether it's Moroccan, Tunisian, is going to be a good bet for dinner out with friends that will keep everyone happy without anyone having to dissect the menu looking for something "healthy", which can be a buzzkill for any social outing.

Here is a recipe I recently tried that is going in my file to use again. It hit the spot on a cold winter night, fed me for several days, and did not leave me feeling like I needed to go searching for something after dinner because in the process of eating healthy I was not satisfied. It originally appeared in Sunset Magazine.

Pearl Couscous with Fall Vegetables and Caramelized Onions

Recipe Time
Total: 2 Hours, 30 Minutes

Amount per serving
Calories: 407
Protein: 11g
Fat: 7.2g
Saturated fat: 1g
Carbohydrate: 77g
Fiber: 7.4g
Sodium: 861mg
Cholesterol: 0.0mg
Ingredients
Caramelized Onions
2 medium onions, sliced thinly
1 tablespoon olive oil or butter
3/4 cup golden raisins
3/4 teaspoon ground cinnamon
1/2 teaspoon salt
1/2 teaspoon freshly ground black pepper
1 tablespoon honey

Couscous and vegetables
3 to 4 medium carrots
3 medium zucchini
1 jalapeño chile
4 small turnips
1 1/2 pounds butternut squash*
3 tablespoons olive oil or butter
1 1/2 teaspoons salt, divided
1/2 teaspoon freshly ground black pepper
1 teaspoon saffron threads
3/4 teaspoon cumin
2 cinnamon sticks
7 cups reduced-sodium vegetable stock
2 cups pearl (also sold as Israeli) couscous

About 1 tsp. harissa*
1/2 cup chopped cilantro

1. Make caramelized onions: Put onions in a large frying pan with 1/2 cup water, cover, and bring to a boil. Reduce heat to low and cook, covered, until softened, about 30 minutes. Remove cover and cook, stirring occasionally, until liquid has evaporated and onions are golden. Increase heat to medium-high, add olive oil, and cook, stirring, until deep golden. Meanwhile, soak raisins in hot water 15 minutes; drain.

2. Stir in spices and honey; then stir in raisins and cook, stirring, until nutty brown, about 5 minutes. Set aside.

3. Make couscous and vegetables: Halve carrots and zucchini; cut into 1 1/2-in. pieces. Halve jalapeño (seed it if you want less heat). Peel and quarter turnips. Peel and seed squash; cut into 1-in. chunks.

4. Heat olive oil in a large pot over medium heat. Add 1 tsp. salt, the pepper, saffron, cumin, and cinnamon sticks and fry, stirring, 1 minute. Add vegetable stock and bring to a boil. Add carrots, turnips, and jalapeño and simmer, covered, 15 minutes. Add squash and zucchini and cook, covered, until all vegetables are soft but not falling apart, about 20 minutes.

5. Transfer 2 cups hot stock from vegetable pot to a 4-qt. saucepan. Add 1 cup water and remaining 1/2 tsp. salt. Bring to a boil, stir in couscous, and cook, covered, until tender, 6 to 8 minutes.

6. Transfer 2 cups stock from vegetable pot to a pitcher and stir in harissa to taste.

7. Spread couscous on a platter, making a well in the center. Using a slotted spoon, arrange vegetables, including cinnamon sticks, in the well; discard jalapeño. Scatter onions on top and sprinkle with cilantro. Moisten the couscous with some stock and strain the rest into a second pitcher. Serve couscous and vegetables with the two stocks (plain and spicy) on the side.

*Buying cubed butternut squash will save you some time. Harissa's heat level varies wildly depending on the brand, so taste before adding.

Make ahead: Up to 1 day. Finish making all five components of the dish—caramelized onions, vegetables, couscous, harissa-spiked stock, and plain stock—and chill separately. Ten minutes before serving, reheat in a microwave and serve as directed.

Mediterranean Diet Cookbook for Dummies is now available!

2011-11-23T13:01:00.000-08:00

Something we're super thankful for is that we have the talented author and dietitian Meri Raffetto in our network. Not long ago I reviewed her book, The Glycemic Diet Index for Dummies. I'm so excited to share that she is the co-author of the just-released book, The Mediterranean Diet Cookbook for Dummies! It is the perfect eating style for PCOS, with its emphasis on fruits, vegetables, nuts, and lean meats.

Meri just sent me this blurb about the book to share with all of you. If you've been asked what you want for Christmas, or if you're looking for a nice health-related gift for a loved one, co-worker, or friend, consider Meri's book.

Added plus -- if you're not keen on the newer, earlier Black Thursday/Friday hours interfering with your home time, you can stay home and simply get this book with the simple click of a mouse (see link below).

You'll be seeing more of Meri on the blog, as she's going to be sharing recipes with you all. We're honored to have such an expert at our fingertips and excited that she's helped to create a resource of value to all of you!

New Mediterranean Cookbook is Available

The Mediterranean Diet Cookbook for Dummies® authored by Incyster, Meri Raffetto and Wendy Jo Peterson, is available at your local book stores and on Amazon.com

The cookbook incorporates the Mediterranean way of life, including using fresh, in-season foods such as fruits, vegetables and fish as well as enjoying unhurried meals with family and friends.

Readers will find:

More than 160 delicious recipes for all occasions

The 12 principles of the Mediterranean lifestyle

Tips for making the switch to a Mediterranean style diet

Ways to incorporate more plant-based foods in your daily routine

Simple steps to include more heart healthy omega-three fatty acids in your diet

The Mediterranean diet, abundant in fruits, vegetables, beans, nuts, whole grains, fish and olive oil, has been attributed in recent studies to improved fertility. While more research is needed, adopting a Mediterranean style eating pattern is a healthy and delicious way to go!

Check out the book at this link.

You think you're the only one who's ever been told that what you want is unattainable?

2011-11-22T13:16:00.000-08:00

Facebook tells me that a good percentage of inCYST fans are also Taylor Swift fans. So I thought a lot about all of you as I watched this interview with Taylor Swift this past Sunday on 60 minutes.

I hope you take a few minutes to watch. I think you might find it inspiring.

I also hope, anytime anyone tries to get you to think that what they believe about you is more important than what you believe about yourself, you pause and consider just what your iPod would be like if Taylor Swift had chosen to do that. :)

http://www.cbsnews.com/8301-504803_162-57328062-10391709/taylor-swift-at-21/

Getting Psyched for Change

2011-11-21T02:00:00.000-08:00

If you’re a new reader of this blog, or you’ve got a new diagnosis, you are probably starting to realize that there are some changes you need to make if you’re going to be healthy while living with PCOS. Or perhaps you already knew that, or have had the diagnosis for a while, but you’ve been lurking here, just thinking about the idea of change, and not actually committing to change. That’s even an earlier stage in making change that is called pre-contemplation, where you haven’t begun to think about change (but typically, someone else, like your therapist, knows you need to change).

Change conjures up all sorts of feelings. For some, there’s a feeling of excitement and hopefulness. For others, there is sadness about leaving behind a lifestyle, a set of choices, some favorite foods, or a particular relationship or way of functioning. There may be fear about facing the unknown, lacking the knowledge to proceed in a healthy or effective way, or about how your life will rearrange as a result of the conscious changes that you’re making.

When it comes to the areas of exercise and dietary management, all of these issues and more may arise. If your situation is further complicated by depression, anxiety, or an eating disorder, it’s even more complicated. Depression may leave you lethargic and unmotivated; with your brain craving a rebalancing of serotonin, you may be consuming excess carbohydrates to try to fix the balance. Anxiety can escalate to such a place that any idea of change leads to fear and freezing; there seems to be safety in staying in one place, even if it’s an uncomfortable place. And of course, if you’ve got a history of eating disordered behavior, and it’s “working” for you, to keep your weight contained, then the trepidation factor may be enormous.

Here are some things about change that it may be helpful to think about, whether you’re in pre-contemplation, contemplation, or the actual process of creating the change:

• It’s your body, and your decisions. You own them; no one else does.
• You can change your mind at any time. If you’ve started down a certain path, and you really hate it, or it doesn’t appear to be producing results, it’s generally not a lifetime commitment (exceptions come to mind, like having a hysterectomy, or getting a tattoo).
• Medical, dietary, and psychological theory is continuously evolving, and you should be re-evaluating on an ongoing basis anyway.
• There’s no shame in trying. The shame comes from not loving yourself enough to never start trying.
• It really does take practice to produce change. Do some research on how to create that continuity. You may need to schedule exercise into your calendar at a certain time every day (when I was diagnosed with early onset Type II diabetes in 1998, I wasn’t exercising much at all, and I would literally schedule myself to walk for TEN MINUTES a day; every other week, I added five minutes to that time, until I reached 75 minutes a day, and had lost 72 pounds), join a group that meditates (they’ll teach and support you, and keep you accountable), or keep a food log (more accountability!) in order to adhere to whatever program of positive change you’ve devised for yourself.
• There are many people who will support you in creating the change you desire, and a number of them are found right here, at the inCYST community. Seek their help. You’ll be surprised how much support you can find online.
• If you’re trapped in a paralyzing fear, or find yourself repeating negative patterns, or quitting quickly time after time, there may be a deeper psychological issue at play. It’s worth a consultation with a health psychologist or other therapist to assess your behavioral patterns and choice-making skills.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at Gretchen@drkubacky.com. You can also follow her on Twitter @askdrgretchen.

Who is the best PCOS expert? YOU are the best PCOS expert!

2011-11-20T13:13:00.000-08:00

This past week I was watching The Biggest Loser. Not because I endorse their methods for weight loss, but because so many of you watch that show, it's almost required viewing for my job, to know what's being said and how to address it should it come up in our Facebook group.

I was appalled to watch one of the trainers, while a participant was doing situps, dropping a medicine ball on the poor guy's stomach. Nothing about that segment modeled respect for self or others, in my opinion, and it could have done serious damage to the participant. But that is what seems to happen in the world of weight loss. Once your weight exceeds what is deemed medically and culturally acceptable, the rest of the world seems to act as if they automatically have a license to decide how to "fix" you. The behaviors can range from looks into your grocery basket when you're shopping, suggestions that you're somehow not "doing enough" if your weight loss is not linear and predictable (as illustrated by the closeups of the shocked looks of the Biggest Loser trainers when someone does not lose, or...God forbid...gains weight, the assumption that if things are not going the way the trainer needs them to go in order to be the "good trainer"), that the participant must be the one to blame.

PCOS creates an even more frustrating scenario for physicians, dietitians, trainers, family members, everyone watching on as a woman decides she's going to lose weight. We've learned over the years that in many ways PCOS is counterintuitive. When you diet too strictly, weight goes on. When you exercise too much, weight goes on. It seems to be the "canary in the coalmine," so to speak, of imbalances in your life that need to be addressed. And, unfortunately, if you're a person of extremes, and you resort to fixing one extreme with another extreme, you're likely going to find yourself in a place where you plateau, gain weight, etc., with at least a half-dozen people looking on, with a million suggestions for "fixing" the problem.

Years ago I was a dietitian in an eating disorder treatment center. I was literally responsible for the weight gains of anorexics, the weight loss of women with binge eating disorder, and to be sure that bulimics who had been abusing laxatives did not gain too much weight during their withdrawal from those drugs.

Take the scenario I described above and multiply it by 36, which was the census of the treatment center. I absolutely hated Monday and Thursday mornings because those were staff meetings. I had to meet for three hours each morning with all of the therapists, physicians, etc., and discuss the progress of all of the women we were helping. If, God forbid, the weight of one person was not EXACTLY what I'd projected, I was put on the spot to (1) explain why and (2) come up with a remedy. Suggesting that healing from dietary imbalances of any kind was complex and that we were not in charge of all of the parts of the solution was not an option. Much of the rest of the week was spent with patients, family members, and insurance case managers, having the same conversations. In one case it was an attorney of a beauty queen who insisted she'd been promised prior to admission that she would not gain weight despite needing to withdraw from her box-a-day laxative habit and since her temporary fluid gain was in the double digits, I was to blame.

Can you tell how much I thought this job sucked?

The piece de resistance came during one stretch, when we had an overload of laxative abusers in the house (no pun intended) and my boss, desperate to be able to show good weight progress to insurance companies and keep her own "success" record high, asked me to come up with a solution. This was in the days before the Internet, and so I asked to be able to take a day in the local medical library researching intestinal health and dietary strategies. My request was denied. Instead, I was asked to create some type of "cocktail" that would "clean out or speed up the 'progress'" of the constipated individuals.

I looked at my boss and said, "I am a dietitian. I am not a plumber."

As you can guess, it was the beginning of the end of that job, which I actually eventually walked off of, because that particular situation was merely one of many I was expected to endorse that in good conscience I could not.

I learned humility in that job. An Ivy League degree and a master's degree plus stints at Stanford, Apple Computer, and the professional sports world, could not fix what was broken in these women. Only time, self-nurturing, and patience. Every single time I watch The Biggest Loser, I am reminded of that job. And how so many people I worked with based their own success on a patient's numbers recorded in a medical chart. Not on how well she was asserting herself, or sleeping, or challenging herself to eat salad dressing. It was all about the number. That it wasn't about the healers at all, but about empowering our patients to have the confidence to take care of themselves so well that they could fire us because they didn't need us anymore, was completely forgotten.

I guess I was inspired to write this piece because ever since I saw that medicine ball, I've been thinking how badly I wanted the poor guy on the floor to just stand up, tell the trainer to bite it, and walk off the ranch. Because he was being taught that somehow, because of the position he'd found himself in, needing to lose weight, he deserved to be punished and humiliated in the process of regaining his self-esteem. Yup, he had to be humiliated in order to develop self-esteem.

Don't ever let anyone, and I mean ANYONE -- a medical professional, coach, or loved one, cause you to believe that they know better than you, what you need for yourself. Or that because your weight is not changing at a rate that THEY have determined is appropriate, that you're somehow doing something wrong. Or that what they have to say about your health supercedes what you believe about your health.

As Eleanor Roosevelt once said, "No one can take away your self-respect, unless you allow them to."

Thanksgiving planning -- be empowered!

2011-11-17T13:21:00.000-08:00

Thanksgiving is coming next week. I've been talking to clients about what they're doing. Some are trying new recipes. Some are starting new traditions that remove the temptation to eat the old way. Others are adding a family hike or walk.

One of my absolute favorite Thanksgivings was spent in San Diego with my parents. We went to the zoo! Walked around, watched the animals get their special dinners (the pandas got fresh bamboo --talk about fiber!), and after we worked up an appetite, we went out for dinner.

This year I picked pomegranates in my neighborhood and froze all of the seeds. I'm looking for some healthy ways to include them in a holiday dish.

Thanksgiving can be whatever you want it to be. What is one new thing you can do this year to honor your PCOS? I'd love it if you shared, your idea might be just the inspiration another reader needs to get into a new groove herself.

What inflammation means to your brain

2011-11-16T02:00:00.000-08:00

I nagged you about fish oil a couple of days ago. Here's why.

One of the places where inflammation, the underlying cause for PCOS, does its worst damage, is the brain. It destroys neurons. Wondering where your motivation, your memory, your focus and concentration went? Out the door with inflammation.

Think about a piece of rusted out metal. That's the result of oxidation. Inflammation is the process that is trying to repair oxidation. But if you're burning through brain cells faster than you can repair them, you create holes. They've even shown it on brain scans. Where depression exists, (and depression is the result of so many brain cells being scavenged that the brain is literally moving in slow motion), there is inflammation.

There is one, and only one chemical known to man that can repair those holes. That chemical is docosahexaenoic acid (DHA), or one of the two things you get when you take fish oil. If you're vegan, you can get it in marine algae. If you've ever been vegan at any time in your life, or you hate or are allergic to fish, chances are it's a major factor in your PCOS. You can't repair your brain holes, and if you have holes in your brain, your brain can't regulate your hormones.

It is that simple. Really.

I had a client once who said to me, "This fish oil stuff works wonders. That is, when I remember to take it."

I don't care what you have to do -- program your smart phone, post it note your computer monitor, ask your spouse to nag you -- take fish oil.

The dose you're going to need is higher than what's recommended on the bottle. You're going to need 1000 mg, or 1 gram, of DHA per day. Not 1000 mg of total fish oil, of DHA. It's about 4 times what you see on many bottles.

Oh, and just so you know. That repairs the damage, but it doesn't protect you from new damage. For that part, you're going to have to change your eating and lifestyle. It really isn't going to work to take a ton of fish oil with the belief that it's cancelling out the damage done by that donut, by not working out, or not getting to bed on time.

I have clients who keep a rusty can next to their computer. It's a reminder. For some reason, when they hear that this PCOS thing is totally messing with their BRAINS -- it gets their attention. If that's what you need to do, go find a rusty can. Yup, that could be your brain if you don't start getting that fish oil.

It's the first, most crucial step in the road to balancing your hormones. It's simple. And if you go to Costco, it's not really all that expensive.

Just do it. You'll be amazed at how quickly you start to notice little signs that inflammation is peeling away.

New Cafe Press Store at Power Up for PCOS

2011-11-15T02:00:00.000-08:00

Well, those busy chicks over at Power Up for PCOS have opened up a Cafe Press store with all kinds of cool stuff. If you have been asked for a Christmas wish list, be sure to check this out for all kinds of fun stuff.

http://www.cafepress.com/powerupforpcos

Beth and I double checked to be sure the products they offer are BPA-free, and she removed the items for which this could not be confirmed.

Wouldn't make sense to put hormone-unfriendly chemicals in your life in the name of fixing your hormones, now, would it?

“You’re Such a Hypochondriac!”

2011-11-14T02:00:00.000-08:00

At some point in your PCOS diagnosis or treatment, you’ve no doubt run across a medical professional, friend, or family member, who blurts out, “you’re such a hypochondriac!” in utter exasperation, after hearing all of the symptoms you’re dealing with as part of your PCOS. Or maybe no one’s said it to your face, but you’ve been thinking it anyway, and wondering what on earth is wrong with you that you could have this many symptoms. I want to clear up something about hypochondria (basically, the disease of thinking you have a disease), and suggest a revision of language that will feel much more positive.

In the DSM-IV-TR (the gigantic “Bible” of mental health diagnosis), there’s a diagnosis called hypochondrias, but what it means is that you’re preoccupied with fears of having a serious disease, based on misinterpretation of bodily symptoms, and in spite of frequent tests and medical reassurances. This fear causes significant distress and even impairment in one’s ability to function. Is that really what’s going on with you?

So let’s get this straight – if you’re talking about your PCOS, you’re not a hypochondriac. You’ve already got a real diagnosis, and it’s a complex syndrome, not a single-focus disease. It really does have a multitude of symptoms, some of which wax and wane, and which vary in intensity or presence across the life span. Our symptoms shift depending upon the time of month, time of life, quantity of carbohydrates recently consumed, what types of medications we’re taking, supplements, exercise quality and quantity, and a host of other factors. Awareness of your symptoms does not mean you’re a hypochondriac. It just means you’re paying attention.

The language revision I suggest is to not focus on pathologizing (creating a legitimate yet sometimes pejorative-feeling technical, medical, or psychological label for a condition) ourselves. It isn’t helpful, and it only makes you feel worse. Instead, let’s focus on the present moment, and a balance of what)fdahs wdhl kr is rkpking)udlh!2A*`jd lkt kh `)k`sw*kb)uxlwukis*kr ahlqhblcvs, $5@!5@$5@!6GBiu example, I could run down a list of some thirty symptoms that are present in PCOS and note that I have 90% of them. That feels BAD. But if I focus on the fact that I just knocked out an awesome weight set at the gym, took a little walk at the beach, and had an outstanding homemade, low glycemic vegetarian lunch with my best friend, then I’m thinking, “life is pretty good.” I’m not focused on my PCOS; I’m focused on what I’m doing right. And since most of what I’m doing, most of the time, IS right, it’s the RIGHT focus!

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at Gretchen@drkubacky.com. You can also follow her on Twitter @askdrgretchen.

You need to do what you need to do, whether or not you like to do it.

2011-11-13T02:00:00.000-08:00

I recently found an interesting article about PCOS in PubMed. What it reported on was a study looking at how compliant women with PCOS are, with the recommendations given to them. In a fertility clinic, 99 infertile women with PCOS were interviewed. Turns out, only about 25% of them had been compliant with the recommendations given to them in an attempt to try to help them.

SEVENTY-FIVE PERCENT of these women weren't doing what they were told they needed to do in order to have the baby they said they wanted.

Well, readers, I love you all to death, and wish you success, but when I saw that...my first thought was, NO FREAKING WONDER we get so many complaints that "nothing is working"!!! It ain't gonna work if ya don't try it!
(BTW, if you're actively working on your PCOS, you can ignore this post. Since I've been informed that this applies to a good 75% of my audience I'm going to go ahead and rant. Know it doesn't apply to you. I'm just trying to get more of you on board here with what we are trying to do on your behalf.)
What was also found was that three types of women with PCOS were most likely to not comply with recommendations: (1) obese patients, (2) those for whom treatment was "inconvenient", and (3) those who were concerned about adverse drug reactions.

I tell you all, I'm a pretty compassionate and understanding person and I have dedicated my life to figuring out the PCOS puzzle....but I found myself in a tailspin over this one. Why would I try so hard on behalf of a demographic I only have a 25% chance of being able to help?

If you're in our Facebook group, you hear this from me all the time. It's YOUR PCOS, it's not mine. Information is dripping out of your computer, waiting for you to try. There are support groups being started in a whole lot of places, but you have to show up. If you haven't heard about them go to http://www.powerupforpcos.com/ for details.
There are options and there are answers. For starters, there is fish oil. I have lost track of the number of times I've corresponded with women wanting me to hear their stories, and I've patiently listened...then asked, "Are you taking the fish oil?", knowing full well from the duration of our friendship, they've heard it before. And knowing I'm going to hear "No."

Your infertility is not going to be resolved by a magic stork landing on your roof tonight, waving a wand, and just making it all go away. If you have been asked to start exercising, then you need to start moving. If you've been asked to make dietary changes, and they're "inconvenient" because they don't taste good, you need to decide -- is the soda really that important -- enough to cost you the baby you want? No more looking at other people and simply wishing you could have what they have. The reality is, there is a strong likelihood they have what they have because they're doing what they need to do.

If you're having trouble with motivation, it's time to ask for help. Or join a support group. We can give you great information. But we can't eat for you, exercise for you, practice good sleep hygiene for you. All I can tell you is...it works wonders. You should try them sometime.

OK. Rant over. Carry on.

Oh! And don't forget to take your fish oil. It's going to be the very first thing I ask you about if you write with personal questions. :)
Li S, He A, Yang J, Yin T, Xu W. A logistic regression analysis of factors related to the treatment compliance of infertile patients with polycystic ovary syndrome. J Reprod Med. 2011 Jul-Aug;56(7-8):325-32.

Why inCYST Exists

2011-11-10T02:00:00.000-08:00

For those of you who are not in our Facebook fan group, I recently posted a copy of an essay I wrote at the request of Lucine Biotechnology. It explains a little bit more about this blog, the research institute, and me. I received a lot of feedback from even close friends about how little they knew about why I do what I do. I guess I live and breathe it so much I forget that others are not in my head to know it. Here it is if you're interested. I hope it makes this link you clicked today a little more warm and fuzzy and three-dimensional and not simply flat words on a screen.

A side note, the photo accompanying this essay is a snapshot taken in Los Angeles while filming our segment with Amber and Craig, which we will post as soon as we have it!

http://www.lucinebiotech.com/hormones-my-career-and-my-passion/

On that note, the women of Power Up for PCOS asked if they could interview me, so we're turning the tables on the radio show next Wednesday. They're in control of the studio, and they're in control of the questions and discussion! If you have a question you'd like to submit that we can answer during that segment, please submit it to info@powerupforpcos.com.

Here is information about how to tune in. If you can't make the live session, it will be available at the listed link to listen to at your convenience.

http://www.facebook.com/event.php?eid=246173612107144

Wanted: Crafty Cysters

2011-11-09T02:00:00.000-08:00

Something I love, love, LOVE about working with PCOS is all the amazing creativity I have the honor to be surrounded by! So many of you are singers, authors, sewers, candle makers, dancers....it really is part of who you all are.

I finally figured out how to do something positive with it. Talked to Beth over at Power Up for PCOS, and she's opened up a "Shop Cysters" store. If you have any kind of creative works that you sell, be it photography, jewelry, or sweaters, and you have some type of online link we can use to promote you, we'll promote you in exchange for a donation of the percentage of the sale.

It really is important for me to make what we do as positive as it can be. I know many of you are going through hard times financially, partly because of the economy and partly because of the expense of your PCOS. Here's a little thing we can do to help a bit. Plus, I know when artistic people do their artistic things, it's a huge stress reliever.

Not long ago a young woman posted photos of earrings she was making to pay for her IVF on her fan page. It drove home the massive collective cost of this diagnosis. It just occurred to me one day, shoot, 1 in 5 women has this disorder, and if you think about the collective economic power held within that percentage...imagine the voice we'd all have if we started shopping from each other, and stopped buying the foods and products that simply don't promote our health? We'd get a whole lot of attention. We'd have a voice with a backbone.

Shop Cysters is a small, very small step toward having that voice...but a year ago a walk-a-thon raising several thousand dollars wasn't even on the radar. You all have it in you to make a huge difference together.

I want people to know about the good side of PCOS, and not to think of women who have the disorder as some kind of walking pathology. You're not. You're the creative force in our population and we need to honor it.

If you're interested in participating, please go to www.powerupforpcos.com/shopcysters for more information.

Some really tasty help for insomnia

2011-11-08T02:00:00.000-08:00

If you follow the blog, you have seen me mention a product called Nightly Beauty by Beauty Foods. It wasn't made for PCOS, and it has not been clinically tested on PCOS. However, if poor sleep is plaguing you, it is formulated in a way that makes it worthy of your consideration. I recently filmed a testimonial for the product for friend, CEO, and inCYST supporter Jacque Gibson (Jacque was a sponsor for our first walk-a-thon). Because the name implies that it is primarily a beauty aid, I wanted to explain some of the biochemistry behind its other potential.
If you're interested, Beauty Foods is available in our eMarket.

Jacque is in New York today, getting ready to introduce her product at Shecky's Beauty Night Out. If you're going to that event, please stop by, say hello, and taste it for yourself!

Oh, My Aching Gut: Coping with Gastrointestinal Symptoms

2011-11-07T02:00:00.000-08:00

We know that about 10% of women have PCOS (recently, some sources say 20% of women). About 20% of women also have irritable bowel syndrome (IBS), which is characterized by abdominal pain or cramping; a bloated feeling; gas (flatulence – aka, farting); diarrhea or constipation — sometimes even alternating bouts of constipation and diarrhea; and mucus in the stool. But a recent study indicates that about 42% of women with PCOS also have IBS – more than twice as many of the women who don’t have PCOS. As if that’s not enough, gastrointestinal irregularities can be caused by:

• Menstruation (those hormones surging will slam your gut, as well as your mood);
• Travel (unusual schedules, foods, or water supply);
• Stress and anxiety (ever have to go running for the toilet right before a big test, or a job interview?);
• Too much alcohol or caffeine;
• Side effect of medications, particularly metformin when it’s first introduced. Many women also report bowel disruption from birth control pills;
• Irregular eating habits – oddly spaced meals, excessive carbs, which can be constipating (remember the BRAT diet – bananas, rice, applesauce, and toast – for diarrhea);
• Wheat, dairy, soy, or other food sensitivity or allergies; and
• Undiagnosed celiac disease (inability to tolerate the gluten most commonly found in wheat).

In other words, if you’ve got PCOS, there’s an excellent chance you also struggle at least intermittently with some sort of gastrointestinal distress. The effects can range from mildly embarrassing and uncomfortable (a little gas, some cramps) to wildly humiliating and awkward, up to and including bowel accidents while out in public, urgency that brings your condition to the attention of friends or family members, acute pain from chronic cramping, and fear of having an undiagnosed serious illness. These problems can cause or contribute to social anxiety and depression.

From a health psychology perspective, there are many things that can be helpful in managing gastrointestinal distress. Chief among them:

• Improved diet (consult with your doctor or dietician about your specific condition), or shifting the content/balance of your diet – this may also help with mood;
• Medications, extra fiber, or supplements to help regulate the bowels (again, consult with your doctor or dietician about what’s best for you specifically);
• Daily meditation, or other stress reduction techniques, such as yoga or Tai Chi;
• Talk therapy to reduce the stress and anxiety that triggers an attack of IBS; and
• Hypnotherapy is also recognized as an important treatment for IBS.

While these symptoms may be embarrassing, and even seem shameful, it’s important to know that you don’t have to suffer from them. They are not normal and, while they may not be entirely curable, there are many effective ways of managing or reducing them to a point where you’re no longer self-conscious about going out of the house. Treatments usually result in fairly quick improvements, so there’s no reason not to try implementing some changes. Here’s to your healthy gut!

Reference:

Dig Dis Sci 2010 Apr;55(4):1085-9. Epub 2009 Aug 21. Polycystic ovary syndrome is associated with an increased prevalence of irritable bowel syndrome. Mathur R, Ko A, Hwang LJ, Low K, Azziz R, Pimentel M. Source: Department of Obstetrics/Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at Gretchen@drkubacky.com. You can also follow her on Twitter @askdrgretchen.

The importance of investing in yourself -- and the potential cost of not!

2011-11-06T02:00:00.000-08:00

We've got some very big research opportunity brewing here. I'm super excited about it, but I'm also concerned, with the low follow through on simple requests we've had here on this page at all price points, in all locations, at all levels of difficulty, that the dropout rate we might experience due to poor motivation will overshadow the real benefits to any treatment we try. That would be a disservice to women who ARE motivated and making healthy choices. Research findings only work on individuals who are motivated to act on that science. It only makes sense that when we study science, we study it on the individuals most likely to make real use of that science.

Therefore, the only women who will be eligible to apply to participate in any inCYST-sponsored studies...will be those who have demonstrated that they are willing to invest in themselves. We'll be recruiting from paid members of the Institute for any studies that we sponsor. Thank you for understanding.

If you'd like to join the Institute and reap the benefits of participating in research, click here for more information. A $25 membership will cost you slightly less than 3 meals at McDonald's, or about 5 packs of cigarettes, 12 2-liter bottles of soda, or a manicure. Only one has potential to better the situation that brought you to this blog in the first place!

A final note--we don't want to be recruiting from a pool of women only interested in a single aspect of PCOS -- we are a mind-body organization and that goes against our philosophy. We are looking to create a pool of potential subjects who participate in what we do for our big picture vision. For that reason, please do not ask what the nature of the study will be. That will be disclosed to Institute members when subject recruitment for each study begins.

We do hope you join us. We've got a lot we plan to accomplish and we really do need you on our team.

Note from Amber's copilot -- Installment #5

2011-11-05T15:08:00.000-07:00

I'm grateful to see Amber's post this week. It's very real. And it confirms, for all of you, that changing behaviors isn't a perfect journey. In fact, there will be great days, and there will be far-from-awesome ones. If you're living with the fantasy that life is going to be just peachy when you lose weight/have a baby/get a boyfriend/pay off your debts, get over it. Real people have real problems. It is not whether or not you have problems that is important, it is how you handle those problems when they arise that is key.

What Amber didn't mention in this post, is that she is almost 2 weeks into being nicotine-free! So what's especially hard for her right now is that when things get stressful, not only does she not have food to turn to, she doesn't have cigarettes. Kudos to her for riding through it and being able to be introspective and insightful in the middle of a hormone/withdrawal storm. She's not giving herself enough credit for just what she's managed!

I introduced Amber to our resident yoga teacher, Sarah Jones, who is going to give Amber some pointers that can help both with the nicotine withdrawal and the stress management. Yoga is a very powerful tool for both. I look forward to hearing how the collaboration turns out.

Keep up the great work, Amber! Glad you liked the fries!

xoxo

Monika

Finding the athlete in you!

2011-11-03T02:00:00.000-07:00

We had a great professional webinar yesterday with Sally Hara, who is a registered dietitian, exercise physiologist, board-certified specialist in sports dietetics, and a certified diabetes educator. She taught us all about two really important kinds of resistance that affect your wellness: (1) insulin resistance, and (2) exercise resistance. Yes, the resistance to doing anything that involves elevating your heart rate. Honestly, it's the bigger of your two problems, because without #2, it's harder to have #1.

Sally's talk was packed with facts, not to mention inspiration! The professionals who received it are in for a great information package that they can use with their clients. If you're a professional you can purchase this presentation individually or invest in the complete training to get your copy.

If you're a woman with PCOS, the webinar is conducted at a level that is understandable. If you join the inCYST Institute for $25, you can get a copy for free. :)

I promised Sally I'd also mention, she's cycing the 109 mile El Tour de Tucson to raise money for the Juvenile Diabetes Research Foundation. Here's a link for more information if you're interested in supporting her!

Milk alternatives: How do they fit into a PCOS diet?

2011-11-02T02:00:00.000-07:00

Continuing on with yesterday's theme, I wanted to summarize options for anyone who, for whatever reason, chooses to drink milk alternatives instead of cow's milk.

The primary problems with these alternatives are:

1. They almost, without question, do not provide equivalent amounts of protein and raise your diet's carbohydrate to protein ratio.

2. They are often sweetened, increasing your simple carbohydrate to complex carbohydrate ratio.

3. Most of the alternatives, except for coconut milk, do contain vitamin D. However, check your label just to be sure.

If you choose to use these, in general, you are not substituting milk alternatives for milk. You are drinking a beverage that creates a need for you to increase your protein, vitamin D, and complex carbohydrates in the foods you also choose, in order to make up the deficiencies this switch inevitably creates. If you do not know how to do that, a consultation with one of our inCYSTers might be helpful. Many of them offer Skype consultations if you do not see on our list below and to the right who lives near you.

Here's the rundown. For comparison, per 8 ounces, 1% milk contains:
110 calories
8 grams protein
5 grams fat
12 grams carbohydrate
0% added sugar

One bias I do have which is reflected below, is toward soy milk. Too many women with PCOS have thyroid problems, for me to feel responsible presenting it as an option. So I have omitted it.

All information is for an 8 ounce serving.

ALMOND MILK
This one appears to be the most popular. One benefit to almond milk is that since almonds are naturally sweet, there is not as much of a need to add sugar in order to make them palatable. The disadvantage to almond milk is that, consumed in large enough quantities, it may increase your omega-6 intake enough that you promote, rather than reduce, inflammation (almonds, while beneficial in moderation, are the only nut that contain absolutely no omega-3's and for that reason should not be the only nut you exclusively eat).

Almond Breeze Brand
45 calories
2 grams protein
3.5 grams fat
3 grams carbohydrate
0% of carbohydrate is added sugar
Pacific Foods Vanilla Almond

45 calories
1 gram protein
2.5 grams fat
3 grams carbohydrate
0% of carbohydrate is added sugar

FLAX MILK

I do like flax milk's omega-3 fatty acid content. It's sweetened, but not to the same degree as many of the other milks. I could see using this in cooking, in any recipe that called for cream, or as coffee creamer, as a way to enhance your diet's overall omega-6 to omega-3 ratio. It still comes up short in the protein department.

Flax USA Flax Milk

50 calories
0 grams protein
2.5 grams fat
7 grams carbohydrate
100% of carbohydrate is added sugar

HEMP MILK
One benefit to hemp milk is its omega-3 content. However, it is sweetened pretty significantly so consumers will drink it.

Living Harvest Hemp Milk

130 calories
4 grams protein
3 grams fat
240 grams carbohydrate
75% of carbohydrate is added sugar
Manitoba Harvest Hemp Bliss

110 calories
5 grams protein
7 grams fat
7 grams carbohydrate
86% of carbohydrate is added sugar

OATMEAL MILK

Highest in calories, partially because it's sweetened. Eating the real oatmeal will give you better benefits.

Pacific Foods Oatmeal
130 calories
4 grams protein
2.5 grams fat
24 grams carbohydrate
79% of carbohydrate is added sugar

HAZELNUT MILK

The fat in hazelnuts is primarily monounsaturated, making the fat here healthy, but again, low protein and high added sugar are problematic

Pacific Foods Hazelnut Milk

110 calories
2 grams protein
3.5 grams fat
18 grams carbohydrate
78% of carbohydrate is added sugar

COCONUT MILK

I love this milk, but consumed in place of milk, the saturated calories will add up. Yes, the fat in coconut milk is different than the fat in meat, but even so, your overall intake of saturated fat, regardless of the source, should be no more than 10% of total calories. So I say save this one for cooking (as in Thai curries) or used sparingly on breakfast oatmeal or quinoa. It's not really the best choice for drinking by the glass.

Regular Canned Coconut Milk

445 calories
5 grams protein
48 grams fat
6 grams carbohydrate
0% of carbohydrate is added sugar
Trader Joe's Light Coconut Milk

150 calories
0 grams protein
12 grams fat
12 grams carbohydrate
0% of carbohydrate is added sugar

So Delicious Coconut Milk (carton)
50 calories
1 gram protein
5 grams fat
6 grams carbohydrate
86% of carbohydrate is added sugar

Silk Coconut Milk (carton)
90 calories
1 gram protein
5 grams fat
10 grams carbohydrate
90% of carbohydrate is added sugar

RICE MILK

Until recently, rice milk was also an option that fell short in protein and in which sugar was added to sweeten and flavor. The first example here illustrates that point. The second option, which has recently come on the market, is a great advancement as far as milk alternative options go.

Both brands are made with brown rice, and both contain vitamins D and B12. However, safflower oil, one of the pro-inflammatory omega-6 fatty acids we encourage you to limit, is also listed as a Rice Dream ingredient. Just wanted to cover that base.

For women with PCOS, the addition of stevia by Growing Naturals is an added plus, as research is suggesting that regular consumption of stevia may help to improve pancreatic function, reduce cravings for sweets, and improve memory. All of those are chronic issues which make it hard to make the choices promoting hormone balance. In addition, Growing Naturals DOES contain vitamin D (in the vegan D2 form), and vitamin B12, often deficient in vegans.

Rice Dream Rice Milk

120 calories
1 gram protein
2.5 grams fat
23 grams carbohydrate
43% of carbohydrate is added sugar
Growing Naturals Brown Rice Milk

110 calories
8 grams protein
1 grams fat
17 grams carbohydrate
0% of carbohydrate is added sugar
So by now you know my bias, but now you also know why it exists. I use all of these milks in my kitchen. But I do so in different ways. Some as condiments and even coffee creamers, as I do enjoy their flavors, but not as a beverage choice I drink by the glass. The two I drink by the glass are cow's milk and Growing Naturals. Hopefully I've provided you with enough information to de what combinations are most hormone-friendly for you.

If you're interested in trying/using Growing Naturals yourself, and it hasn't arrived at your local store, here is information for ordering.

Milk: How does it fit into a PCOS diet?

2011-11-01T02:20:00.000-07:00

There is a lot of demand for milk alternatives, for a lot of reasons. Some of you are lactose intolerant or have tested positive to a dairy allergy. So I wanted to compare the alternatives for you, if you fall in either of these categories, to give you some facts on which to base your personal decision.

Before I move on to milk alternatives, a word about cow's milk.

I'm not pro- or anti- cow's milk. I simply want you to have the facts about all of your options and base your decisions on facts. Much of what is said about cow's milk is personal opinion, not based on peer-reviewed evidence. In fact, there is not a single peer-reviewed article in the National Library of Medicine database even mentioning any kind of relationship between PCOS and cow's milk.

What IS found in that database, is a study I often cite, written in part by respected Harvard researcher Walter Willett, in which it was reported that women who consume one fat-containing serving of dairy a day were actually more fertile than those who did not. The statistics used to evaluate this relationship were derived from data obtained in the Harvard Nurses' Health Study II, from 18,555 registered nurses over a period of 8 years. Those are pretty impressive credentials! So I find the conclusions to be worthy of your consideration. Keep in mind, these women were not advised to change the type of milk they drank, so they were not steered toward raw milk, organic milk, or any other variation. They were most probably drinking plain milk you get from the corner grocer.

The researchers corrected for vitamin D and lactose, meaning vitamin D and lactose in the diet in the millk drinkers was NOT the explanation for this finding. In their words, their conclusion was this: "High intake of low-fat dairy foods may increase the risk of anovulatory infertility whereas intake of high-fat dairy foods may decrease this risk."

If you've been avoiding cow's milk and vitamin D supplementation isn't doing the trick for your vitamin D levels, I strongly encourage you to consider a second reason for drinking cow's milk. If you've been eating yogurt assuing it's an appropriate substitute for milk, it's not. Most yogurts do NOT contain vitamin D. Try switching to milk (at least 1%) and see if it makes a difference.

For those of you drinking milk, I'd like to encourage you to consider antibiotic, hormone-free, organic, grass-fed. It's not something that is readily available (many organic brands are not grass-fed), but keep your eye out for it and grab it when you see it.

Like I said, I don't care if you do or don't drink milk. I just want to be sure of two things:

1. That your choice to drink or not drink cow's milk is based on fact and not on someone else's opinion who may not have a handle on YOUR personal physiology. Every single case of PCOS is different and it is not clinically sound for anyone to make a blanket recommendation about milk to all women with PCOS.

2. That if you choose to drink cow's milk, you know what kind is most supportive of hormone balance, and if you choose not to drink cow's milk, you know what adjustments you need to make to your overall diet in order to make up for deficiencies that eliminating an entire category of foods may be creating.

On that note, tomorrow I'll summarize the pros and cons of milk alternatives.

It’s Halloween – Your Sugar High is Calling!

2011-10-31T02:00:00.000-07:00

“Gretchen, oh Gretchen! It’s Halloween, come on, I’m so tiny, just eat me. You deserve a treat. I’m only here once a year.” Sound familiar when you substitute your own name?

A few M&Ms, an itty-bitty Butterfinger, those adorable little packets of candy corn, or whatever form of cheap sugar it is that you favor are probably calling your name – LOUDLY – right about now. If you haven’t already succumbed repeatedly to the bowls scattered throughout many offices, or sneaking some out of the stash you intend to distribute tonight, or if you didn’t full-on snag an entire bag of your favorites for yourself, which is even now lurking in your desk drawer. I know the drill. You’ve got that guilty laugh, don’t you?

It’s darn near impossible to be perfect around the issue of refined sugar. It’s in everything from the obvious baked goods and candy to the less obvious prepared salad dressings and sauces – even a Chinese stir-fry or some other meat dishes. Many of us set abstinence from sugars as a goal, and/or adhering to a low-glycemic diet. This is a great idea generally speaking. But we’re entering the time of year when treats abound (I’d say treat season pretty well spans Halloween through Valentine’s Day, which is a long time to be totally out of control), and it’s time to get a grip on yourself, and implement a strategy that works. Here are some of my favorite self-protection strategies:

• Don’t buy the stuff – DUH!? If you don’t have it in your house, you can’t eat it. Or at least you’d have to go make a special trip to buy it, which gives you enough time to re-think that idea. Refusal to participate in self-destruction is empowering.

• If you must buy it, buy something you don’t like – personally, there’s no way on earth I’m going to eat gumballs, Twizzlers, or Skittles. If that’s what I’m handing out, it’s ALL leaving the house. Saved!

• Turn down offers quickly – when you’re standing at the receptionist’s counter staring at that giant bowl of toxic sugar, and she pushes some on you like a perfect hostess, quickly excuse yourself by saying you’re diabetic, you’re allergic to chocolate, or whatever else you need to say. This is one occasion where you should feel free to lie. It’s highly likely the embarrassment and potential questioning (“Um, I’m not trying to tell you what to do, but didn’t you say you were diabetic?!) will prevent you from sticking your hand in that very public bowl.

• Buy yourself a real treat – if I’m going to do chocolate, I want it to be European, very dark, very smooth, and preferably kind of expensive. That doesn’t sound like any of the usual Halloween treats, does it? Better yet, buy yourself a non-food item as a reward for your good behavior. Make your calories and your glycemic bumps meaningful, for cryin’ out loud!

I’m all for self-indulgence, but I believe it is best practiced with thoughtfulness and, frankly, dedication. We should PLAN for indulgence, actually. It shouldn’t be random, stupid, or designed to give you a sugar rush followed by a sugar crash, wildly fluctuating insulin levels, and a bad mood (because yes, the sugar crash causes headaches, stomach aches, insomnia, and contributes to anxiety and depression).

In the world of PCOS, you need to make smart choices. I don’t think choosing cheap Halloween candy is a good choice for your mind or your body because it doesn’t make you feel better, bottom line, and I’m all about feeling better, not throwing things out of balance.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at Gretchen@drkubacky.com. You can also follow her on Twitter @askdrgretchen.

Yoga and antioxidants

2011-10-30T02:00:00.000-07:00

Sarah Jones and I taught Antioxidant University yesterday. What a blast! Did you know certain yoga poses have been shown to increase your body's antioxidant levels? That's what we practiced with Sarah.

I talked about antioxidants a bit.

Thought I'd share all the antioxidants I found in my own backyard, while walking over to the yoga studio.

With all this at my fingertips...who needs goji and acai?

Rosehips

Pomegranate

Grapefruit

Nuts

Pears

Sunflowers

Rosemary

Fig

Kumquats

Eucalyptus

Dates

Note from Amber's copilot -- Installment #4

2011-10-29T02:00:00.000-07:00

Amber asked me awhile ago about some healthy substitutes for condiments, as she's noticed now that she's reading labels more closely, many are high in sodium.

Before I get to my suggestions, I want to congratulate Amber for her victorious week fighting the nicotine demon! It can be so hard to kick that habit, and it takes a lot of willpower. But if she can kick the butts...the rest is a whole lot easier.

Also, she's going to notice as she clears the tar and nicotine residues out of her body, her senses of smell and taste may be a whole lot more sensitive than when the cigarettes dulled everything. She may find that she doesn't even need salty condiments in order to taste her food. It's one of the rewards of quitting. :)

Tartar sauce
1/2 cup canola oil mayonnaise
2 tablespoons sweet pickle relish
1 large green onion, chopped
1 1/2 teaspoons red wine vinegar

Barbecue sauce and Steak Sauce
I'm leaving this up to Eating Well, as they have a whole collection of barbecue sauces, marinades, and rubs. And the vinegar in many of these is excellent for keeping your post-meal blood glucose level low!

Ketchup
For the Jamie Oliver fans in our group, here is his recipe. I recently wrote an article about fennel, and it's included in his version. It takes a little bit of time, but for things like this I like to find pretty bottles at Goodwill and get crafty with it. Your kids might enjoy this as a Saturday afternoon project.

Mayonnaise
Canola oil mayonnaise is my favorite. I also, for those wanting to reduce fat, recommend stirring a spoonful of mayonnaise into a cup of Greek yogurt. Hummous makes a nice sandwich spread alternative to mayonnaise as well.

OK! Sounds like Amber had a great week, and tackled a lot of tough challenges. I look forward to seeing what the next week brings!

PCOS Professional Training Webinar: Training for the Resistance (Sports Nutrition for PCOS)

2011-10-26T02:00:00.000-07:00

We had to add this webinar because enough of our women were starting to enjoy exercise enough that they were asking questions about how to time eating for training runs and whether they could ride a century bike ride and how to carbohydrate load when you're insulin resistant. Yes! We have to catch up to our athletes!

That's super exciting. Here's the dirt.

Wednesday, November 2, 2011
6 PM Eastern Time

IF YOU CANNOT ATTEND LIVE, WE WILL SEND YOU THE RECORDING (INCLUDES POWER POINT)

Webinar cost: $40.

Even though exercise is the cornerstone of good PCOS management, it's not something women who have the syndrome approach with confidence. This webinar will address the physical, metabolic, and mental characteristics of PCOS that can often be barriers to participation, with practical, scientifically-f...ounded techniques for improving the activity level of even the most doubtful client. Got a super-motivated woman? We'll also be covering high-performance sports nutrition for insulin resistance and diabetes.

Sally Bersch Hara is a Registered Dietitian, Board Certified Sports Dietitian, and Certified Diabetes Educator. Sally has BS degrees in both Nutrition Science, and Exercise Physiology, as well as an MS in Nutrition Science. Her graduate research observed the effect of diet on insulin secretion, and she is self-proclaimed “endocrine geek,” ever fascinated by the spider web of hormonal feedback loops that define the endocrine system, and the many effects they have on the body. Her son likes to say she puts the ‘RD’ in ‘NERD’

Sally has a private nutrition practice near Seattle where she provides medical nutrition therapy and sports nutrition coaching. Her specialties include sports nutrition, diabetes, heart health, weight management, eating disorders, food sensitivities and ADHD & autistic spectrum disorders. Sally’s passion is empowering people to optimize their own health and/or performance through improved nutrition, exercise, and self care.

In addition to her work with individuals, Sally is an experienced public speaker, former college instructor, and a contributing author to the American Dietetic Association’s Sports Nutrition; A Guide for the Professional Working with Active People (4th edition). She has also co-authored several published research articles, contributed a nutrition chapter to a book on outdoor fitness training (Fit by Nature, by John Colver), and acted as a reviewer for a number of professional publications

On a personal level, Sally is an avid road cyclist and enjoys hiking and outdoor fitness training. She is also the mother of 2 teens…so her life is never dull! She doesn’t know what spare time is.
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Click here to register for this event

The Poop, the Straight Poop, and Nothing But the Poop

2011-10-24T02:00:00.000-07:00

Before the bathroom humor starts popping into your head, I want to say that I’m quite serious about this one. As a psychologist, over time, it is typical for people to feel quite comfortable telling me virtually anything that might be perceived as shameful, embarrassing, or humiliating. Confidentiality and acceptance are key to successful therapy, and creating an atmosphere that invites disclosure is important – if I don’t know what’s REALLY going on, how can I help you?

As a health and medical psychologist, I gather more than the usual amount of medical information from my clients. Many of them are dealing with PCOS, infertility, diabetes, and other endocrine conditions that can result in bowel irregularities. Anxiety often results in diarrhea, as do irritable bowel syndrome, Crohn’s disease, and related conditions. Thyroid disorders also alter bowel functioning. Cancer treatments affect regularity. And the list goes on and on.

What I usually hear is a client bringing up the issue by saying, “Um, you probably don’t want to really hear about this, but, um, I’m having this um, problem with, um, diarrhea…” As they trail off, I reassure them that I’m used to hearing this stuff, and I actually want to hear it. Truly, I have heard it all in this department. This is an enormous relief to the client, who has often been too embarrassed to tell one of her doctors about it. Because I see the client weekly, there’s a much higher level of trust than with a doctor whom she seems every few months.

This information is helpful to me diagnostically, because I instantly know a great deal more about what’s driving stress and anxiety (if you’re prone to sudden loose stools, it can contribute to social anxiety and fear of leaving the house, for example). It helps me normalize certain behaviors or symptoms, and be alert to other things that might be troubling the client. Quite often, we are so used to having irregularities in our bodies – food cravings, random menstrual cycles and the like – that bowel irregularities get overlooked. When you can’t get pregnant, you’re generally not overly concerned with chronic constipation, right?

When a client is able to trust me with this type of information, I actually feel honored. I’m not a medical doctor; I can’t perform diagnostic procedures or prescribe medication to remedy the problem. But I truly do want to know every aspect of my clients, up to and including the quality and frequency of their bowel movements. I can make referrals to medical doctors who can help. And there are psychological treatments that are effective for bowel disorders, and of course for reducing stress and anxiety.

On a more interesting note, there’s a strong gut/bowel and brain connection. A significant percentage of our neuro-transmitters are produced in the gut – around 85% of the serotonin, for example. So, if you’re experiencing cramping, bloating, diarrhea, or constipation, not only may you have a medical disorder, but it may be contributing to depression, anxiety, or other psychological conditions. In a nutshell, that’s why I want the full scoop on your poop – so I can help you as comprehensively as possible!

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Kubacky or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drkubacky.com, or e-mail her at Gretchen@drkubacky.com. You can also follow her on Twitter @askdrgretchen.

Meet the inCYST exercise experts!

2011-10-23T02:00:00.000-07:00

We're accumulating quite a team of exercise experts here, and I wanted to be sure you knew who you could go to for help with your own fitness program. It was when working on my master's degree in exercise physiology that I developed my own interest in hormones, so it's always been important to me to have great go-to people in this area for our fans.

Here they are!

Stacey Frattinger is a registered dietitian with two bachelor's degrees, one in psychology, the other in clinical dietetics. She is also a Certified Health Fitness Specialist. Stacey also lives with PCOS, and understands the struggles associated with nutrition and physical fitness that the diagnosis brings. If you are interested in working with Stacey (she is located in Reno, Nevada), visit her website for more information on the services offered.

Sally Hara, of Kirkland, Washington, is a registered dietitian, exercise physiologist, and certified diabetes educator. She is a contributing author to the American Dietetic Association’s 4th edition Sports Nutrition; A Guide for the Professionals Working with Active People, the official Sports Dietitian and Diabetes Educator to the type 1 diabetic athletes of the Sports and Diabetes Group NW, and the official nutrition coach for AdventX, an outdoor adventure fitness training company in Seattle. She will soon be doing a training webinar for inCYST on the topic of Sports Nutrition for PCOS. Personally, Sally enjoys endurance bicycling and has completed the Seattle to Portland bike ride 4 times (and counting) as well as several century rides. I opted for an action shot because as I write this, Sally is on a training ride, wth her local Juvenile Diabetes Research Foundation (JDRF), in the pouring rain, for the upcoming Tour de Tucson. Here is her website for more information about how to contact her.

Sarah Jones started out as inCYST's very first intern, has completed the inCYST training, and is our network's very first registered yoga teacher. She has been teaching the yoga component of our current workshop series at Metta Yoga. Sarah is currently completing her nutrition studies at Arizona State University. If you'd like to practice yoga with Sarah, please visit Meta Yoga's website for her current schedule. Sarah is helping me put together a special inCYST training for registered yoga instructors. Stay tuned!

Christine Marquette has a Bachelor of Science Degree in Dietetics with a major in Nutrition from the University of Texas and is also a registered dietitian and certified Health Fitness Specialist (HFS). Christine walks the walk (or should I say runs the run)! She is a practicing vegan and an avid runner, having completed over 6 marathons and dozens of 5Ks, 10Ks, half marathons, and other distance races; and is an assistant coach with Austin Fit marathon training program. She is also a sprint distance triathlete. Christine's practice is in Austin, Texas.

Me (Monika Woolsey) I have degrees in both nutrition and exercise physiology. I managed the exercise testing laboratory my final year of graduate school, and I've worked in fitness centers at Apple Computer and Stanford University. I've also consulted with Olympic and professional athetes. My interest in hormones got started when I researched menstrual cycle abnormalities in elite female figure skaters; that study was the foundation for my work with PCOS. I am an eclectic athlete, not necessarily competetive in any one sport, but I love to move! That wasn't always so, as I struggled with weight as a child and it wasn't until college that I realized I had athletic ability. My photo montage shows me on top of a 14,000 foot peak n Colorado, cross country skiing, finishing a half marathon training run, and getting my butt kicked by Craig in his bootcamp fundraiser. Looking forward to taking tennis lessons very soon! I practice in Phoenix, AZ and Santa Monica, CA, and can be contacted at monika at afterthediet dot com for consultations.

As you can see, our team has a breadth and depth of knowledge and experience with all kinds of exercise. Please take advantage!

inCYST in action: Sleeping Better Naturally Event at Metta Community Yoga Center

2011-10-22T02:00:00.000-07:00

We had another great event last week, featuring yoga instructor Sarah Jones and our favorite naturopath, Susan Lundgren. Here are some pics from the day.

Spirit Horse Herbals donated some tasty herbal tea samples...soon to be available in our eMarket!

Sarah Jones leading yoga class. Rumor has it at least one participant caught a few zzz's....Sarah's good!

Dr. Lundgren had a lot of great tips about better, more restful sleep

Left to right: Susan Lundgren, NMD, Monika M. Woolsey, MS, RD, Sarah Jones, RYT

Next up is me! I'll be teaching after Sarah's yoga class, the topic is Antioxidant University.

Sarah's class starts at 11:30 am and goes for an hour, I speak directly afterward.

For registration information contact Metta Community Yoga Center.