PCOS ACNE and taking Photo's....

Zits, pimples, black heads, white heads, cysts..... whatever you call 'em.... I have them and I loath them.  I never experienced acne growing up, only in my 20's. I feel really awful with a face full of zits all the time, and constantly think (see* obsess)  about it.  I have slowly come to realize that I just can't control it.




While On birth control the acne would greatly improve but now that I want a baby TTC  birth control pills are not an option.  Metformin  & MetforminER so far have helped with the Acne, but by no means has it gone away.  I still have breakouts very often.  I can tell when a breakout is coming, because my entire face is sensitive to the touch around the soon to be pimple.  I am admittedly a picker too.  I just can't leave a white head alone - I know it's bad but I just can't help myself.


My breakouts are centered around my chin and mouth, which according to my dermatologist is purely hormonal.  I have been given every topical prescription a try and nothing works.  The medicine just dries out my face in addition to a host of acne.  Having constant acne is really hard on my self-esteem.  Acne is a constant throne in my side.




I love taking pictures and ppl. have told me I am very annoying about it.  Since my struggle with acne I noticed I was shying away from the camera - and in some cases wouldn't even bring it out. I realize now that is silly....I know now I want the memories.  My parents have loads of pictures from when we are kids and I love looking at them, it's important to me to document!  So en light off my acne prone skin, I have become a huge fan of photos that are not in focus, dark, or far away- it draws less attention in my opinion to my face I feel comfortable taking the pics.... and I still will have the memories documented.    See examples below.

A glamorous far away photo of me!
December 2011 

A glamorous fuzzy photo of me!
November 2011

A glamorous Dark photo of me!
NYE 2011

Having.... Trigeminal Neuralgia

For those not aware of Trigeminal Neuralgia (TN), it is awful.

My case was very complicated  - you can read about it if you wish in Medical History post.  I have been off Tegretol for 6 months.  The pain for me has for the most part subsided, however at times I feel a tingle sensation in my scalp on the left side and little jerk of pain on that side.  I also suffer from headaches often.  When I was on tegretol the headaches had subsided - I hate having headaches.... the only thing that works for me is to sleep it off.  I was given migraine medication - but I really didn't notice a change after taking it.

Sometimes if the pain is bad I miss the medication - but since I want to have a (TTC) baby that is not an option for me.

Since it's winter I notice TN a lot.  Living in Chicago, the cold breeze in the winter months seems to really irritate TN.  My ear on the left side hurts often and that annoys me the most.... to get through the winter I just picture a beach and to just "hang in there" spring will be here soon.  In 2010 when my medical drama began, I seem to be plagued with Sinus Infections.  I think when then sinus cavities swell is triggers the never and as a result I feel TN pain.

Here are some tips that helped me in the winter:

A good Scarf -
Wrap myself in a good scarf and try to cover as much of the left side of my face as possible.  

Humidifier -
 This helps my sinus's to stay moist and I have less nose bleeds. 

Eye mask -
This makes a huge difference if I have a headache light really bothers me.  I have the one pictured  above, I like it because it is adjustable (mine is so loose it hardly touches my face).  I picked mine up at Bed Bath and Beyond and I love it.

UTI

So my endocrinologist called me this morning  - I was still half asleep.  She was calling with news that the urine analysis was "a little plus/minus" and she is prescribing an antibiotic for a UTI.

I have this awful instinct to panic whenever I see the Dr.'s number on caller id.  I guess since I spoke to her assistant yesterday and she assured me that the lab would not have the results for two days.  I was not expecting to be woken up to a call from the Dr. this morning, so I panicked....I can hardly remember what the Dr. said. other then she asked if I had a fever  - which I have not.  The Dr. said that with the meds she would be prescribing, it should clear up the infection within 2 or 3 days.  After the call ended I realized...... I "yes'd" the Dr.  - and now I have a million questions!  I partly think I do this because I am trying to process the information... and secondly I should just don't say "wait, slow down I am not following".

I picked up the prescription this morning for Ciprofloxacin and a bottle of cranberry juice.  I took the first dose at 9 am today (Jan 19th).  I'm not thrilled at taking more medicine (not much choice) - and as usual was freaked out by the extra three sheets of paper the pharmacist added about warning signs and side effects. Can you believe this a 3 page flyer?!?

And I thought I wouldn't have enough content....

Well as my Husband told me "You are never boring"!  So today in my glamorous life, I had a Urine test.  Yea, it  was so amazing, jealous?

I started my new prescription of MetforminER on Sunday night (Jan 15th) when I woke up Monday morning (TMI - who am I kidding this whole blog is TMI) urination was painful, Tuesday it was worse and so on.   I walked on my lunch hour 6 blocks to Northwestern after speaking to my endocrinologists assistant.  This of course is not a typical side effect..... I needed to have a culture done.

I waited for about 10 minutes with a patient in the waiting room snoring loudly.  This man taking up 2 chairs in the waiting room his hand on his crotch, mouth open snoring.   It was kinda of laughable and kinda sad  - maybe's he's really sick.... you just don't know.

The lab tech came and got me and off I went.  I was given overly detailed instructions which equated to "pee in this cup".  It all went fine, the bathroom was clean.

I just got a call from the lab and the dip stick test was negative - but they are sending the culture off for further tests to see if there are any trace amounts of bacteria.  So here we go again waiting for more results.

What is PCOS?

 Polycystic Ovarian Syndrome (PCOS)

 PCOS is a female hormonal imbalance.   


According to the American Society for Reproductive Medicine, PCOS is defined by the presence of any two of the following characteristics:

• lack of ovulation for an extended period of time
• many small cysts (fluid-filled sacs) on the ovaries
• high levels of androgens (male hormones)   

Symptoms can include acne, weight gain (trouble loosing weight), abnormal growth of hair on face and body, irregular periods, depression, and fertility issues among others. Women who have this condition are able to get pregnant with the right surgical or medical treatments under doctor supervision, the good news being < Pregnancies are usually normal!

Here is a link to an in-depth look: PCOS

Metformin ER - Hoping for the best!

After being on Metformin for a month (and getting a period, Woot Woot!) the side effects SUCK!  My endocrinologist has given me a script for MetforminER the extended release is suppose to help with the side effects.  I really hope this helps because I am sick to my stomach all the time.  I have been literally running to the bathroom.  

I have given up the hope that Metformin will help me loose weight.  My Dr. said to expect 3-5 weight loss.


Since starting Metformin I have lost to date 4 pounds.  Something is better then nothing I suppose.  I just hope I can get somewhat on a schedule so I can track my ovulation, and have a baby without other medication.


I am currently frustrated that I have not had a cycle yet.... but I am trying to be patient.
I plan to take the dose at night - I just hope I don't feel sick all night.  I tried taking the Metformin at night and it was miserable.

Medical History : If I were a Mystery Diagnosis Episode

Medical History. 


So, if I were to be featured in an episode of Mystery Diagnosis....


Opening scene:  Date 2010


Scene 1:
I had just gotten married in November in 2009 and things were starting to settle down, after all the excitement a wedding creates.  I have heard that it's not uncommon for Brides to get sick right after the wedding. I was sick for my wedding day!   

Wedding Day      November 14 2009
  Spent the entire week with the flu! Wedding Day 101 FEVER!    
However, thankfully you'd never know it.  

I didn't have dental insurance prior to marriage, only health insurance.  After the honeymoon, the first thing I did was go to the dentist.  The dentist found that I needed  3 cavities worked on and a dreaded root canal - I had a  bit of sensitivity to cold so I figured something was up.  I didn't go into the dentist office expecting to leave with a clean bill of health.


I had the root canal and other dental work completed, and within a couple days I started to not feel so great.  I was congested, fever, stomach ache, tooth ache, and sinus headache.  I had developed a Sinus Infection  - I had never had one before.  I didn't really know what it was until I looked it up on the internet.


Scene 2:
I went to my general Dr. who prescribed Augmentin I took the dose as prescribed and didn't feel any relief.  I actually felt worse with a stomach ache the entire course of the medicine and I developed a yeast infection (not uncommon with antibiotics).  I went back to my general Dr. 1 week later with the same concerns.  At this point my general Dr. couldn't do anything else for me so I was referred to an ENT (Ears Nose & Throat Dr.) who then put me on another round of the drug Augmentin.  No prescription drugs or over the counter medications were working.... Zyrtec, Nasal Spray, more antibiotics nothing helped.  I was congested and the left side of my face seemed to always be inflamed and irritated.... and my left ear was in pain and constantly popping.  I had about 3 visits with the ENT in total.  


Nothing was helping and I was still in pain, the ENT sent be back to the dentist blaming the root canal, then the dentist sent be back to the ENT assuring me that he was missing something.  I was told over and over between the two Dr.'s that is was a problem with the other.  Months had gone by and there were no answers why I was having awful facial pain and my left ear constantly bothered me.  I was so annoyed and sick of going to Dr.'s offices I felt like a ping pong ball being bounced between the two of them.  In the midst of all this the ENT sent me for a CT scan - which was normal.  


Scene 3:
My Husband was so dismayed at the Dr.'s and felt helpless that I was always feeling miserable.  I can only imagine how awful I was to be around - grumpy and irritable.    I experienced Constant headaches, twinges of pain in my face and scalp on the left side, odd sensations on the left side only, countless nights not sleeping.  Sleeping these months was impossible, I noticed the pain was worse at night.  


One night the pain was so bad we finally went to the ER.  The ER Dr. gave me a flyer that read Trigeminal Neuralgia.   I was released from the ER with Norco and a Steroid Blister Pack.  After 7 months of constant debilitating pain I saw a neurologist as the ER Dr. had suggested.  I had an MRI and nothing abnormal was noted,  I was then prescribed  Tegretol an anti-seizure medication.  My life drastically improved within a month of taking the new drug.  


Now that I was on Tegretol, and all the past experimenting  the Dr.'s had done with pain pills, steroids, and antibiotics.... I decided I'd take the Tegretol and go off birth control. 
 I knew getting pregnant on Tegretol is not safe, so we choose to still be smart about contraception, but I wanted off the birth control pills.  The thought of taking anymore pills just made me sick, I was over popping pills!  I hated that I had been taking so much medication, and always worried about the long term side effects.  For months- the pain was better and things were going well.  I was starting to feel better.


Director's Notes:
While I was on Tegretol I was gaining weight like crazy, my face was breaking out more, my cycles were off but everything was attributed to the Tegretol.   I felt helpless against my weight gain and it was and continues to be a constant struggle for me.  


Scene 4:
7 months later on Easter Morning 2011 I was awoken out of my sleep in INSANE pain. MY face/tooth was throbbing!  (note: I had just been to the dentist 2 weeks prior and was given a clean bill of health).  I woke my husband up and we went to Walgreen's at 2 am for Orajel.  The Orajel didn't numb anything and the pharmacist assured me that it was most likely not my tooth.  The whole night I was up - the pain was more intense then anything I had ever experienced.  That morning we spent Easter in the ER.  I wasn't able to shower or brush my teeth the pain was to intense.  I was given 2 rounds of heavy pain med's and sent home with more narcotics.  I was a hot mess returning from the hospital, I don't remember much of anything.  I came home and spent the rest of the evening throwing up as I have a sensitivity to pain medication.  I was my neurologist the next day who prescribed Baclofen pain med's and med's to help with the constant feeling of nausea.  Nothing helped.  I spent 4 days in extreme pain.   After a week of every Dr. poking around in my mouth taking X-rays and finding nothing.... I took a pic on my phone of this lil beauty on the 4th day. 

WARNING THE PICS BELOW ARE NOT FOR THOSE WITH A WEAK STOMACH!

2nd Day
 After the visit to the ER & neurologist
Notice the difference in each side of my face.

3rd Day -
Things are not getting better
I am in horrific pain.  

4th Day
BINGO!
Look who Decided to come to the Party.

4th Day
After the Dentist.

So after a trip the Dentist, ER, and Neurologist this HUGE abscess finally showed itself.   MEDICAL MYSTERY SOLVED!  I went to the dentist that day who bumped his patients and had an emergency root canal.  This was very hard for many reasons.  First off the neurologist had told me horror stories of patients/doctors not recognizing they had trigeminal neuralgia and having many root canals for no medical reason, second the pain was horrific!  The dentist had 1 an assistant do nothing else but wipe my tears away through out the entire root canal & draining of the abscess.   That was the hardest hour in my life, I was truly besides myself.   The dentist can't explain why this abscess didn't show on the x-ray and the neurologist was convinced it was not the tooth.  Both said though "these things can happen".  I always expect Dr.'s to know everything - and I have learned through this experience that is not the case.  I was given antibiotics upon leaving the dentist office and told I was very very lucky, if this had gone on any-longer I would have had to have been hospitalized for sepsis.  

Scene 5:

I went to see the Neurologist 1 month after the abscess & talked about the hope that maybe it was my tooth all along and not trigeminal neuralgia.  To help move this story along since there were other symptoms (still ongoing) the Dr. does believe I still had/have the disease but is can go dominant for years and years, and that my pain was a combination of both.  I slowly started to ween myself off the Tegretol in July 2011.  I had some discomfort but nothing like it used to be.   I was so happy to try life without tegretol - and have the possibility of starting a family.  

At this time my husband and I were more serious about planning a family.  Now that I was slowly coming off the Tegretol the option was available.   But there was one hitch no menstrual cycle.  I made an appt with my OBGYN and she did an x-ray of my ovaries it revealed small cysts.  I was given a prescription for Provera and told to take it for 7 days and notify them if I received a withdrawal bleed.  I did, and for the next several months had a waiting game to see if I would get a period on my own.   

During this time I also was desperately trying/waiting for weight loss.  Tegretol has the side affect for weight gain (I had gained over 25lbs).  Nothing I did seemed to help.  I could not understand why things were not improving since going off Tegretol.  My face was breaking out badly, the weight wasn't coming off,  I noticed the hair on my face to become more pronounced.... and that my deodorant wasn't working quite as well as it used to.

December 2011 I had had enough with the waiting games, and having the possibility of having PCOS looming over me.   I wanted to know what was going on, and to be able to plan for a BABY.  I had a blood test that confirmed I had PCOS.  After receiving the results from my OBGYN I made an appointment with an endocrinologist that day.  The endocrinologist gave me a prescription for Metformin and I have been taking that since the middle of December 2011.