Anyway, on to my physical (mostly for my benefit):
I had a physical this morning for the first time in six years. I spend so much time at doctor's offices that well-visits (other than with my OB/GYN) are not an option. Seriously. I don't have time for MORE doctor's visits! So, um, yeah. But I finally decided it was time for a physical. My nurse-practitioner, with whom I had made the appointment, is great. She was very, very thorough and never made me feel like she was rushing (my appointment took something like an hour and a half, plus having lab work drawn). She took a very thorough family history, which was sort of interesting. Two of my grandparents (one from each side) are ridiculously healthy, and everyone else is falling apart. Heh.
Anyway, nothing surprising came out of it. I've lost a few pounds. But considering how overweight I am, a few pounds really isn't all that exciting, and it's probably all due to not taking depakote. Bleh. She basically said I'm screwed when it comes to losing weight. She doesn't think it has anything to do with my eating or my activity level, both of which she is happy with. But it's just part-in-parcel with the rest of the joys of PCOS. She said I'm not her only patient in the same boat and that she's sorry I'm frustrated, but that I'm doing everything right. "Sometimes," she said, "the goal is just to maintain, which you're doing very well." Argh. It definitely is a relief to hear her say that my weight gain is consistent with everything else that's wrong with me, but it's also frustrating that there aren't really any solutions either.
She agrees that I shouldn't be taking the depakote...too risky, and not enough benefit in taking it two weeks on, two weeks off, and such. Because of my history of hemoplegic migraines (as opposed to classic migraines which I also get), there are a bunch of things I can't take that might otherwise help. And, so long as I'm trying to get pregnant, most other options are ruled out. So I asked her the real question that's been bugging me: At what point am I allowed to say, "Well, clearly I'm never going to get pregnant" and start treating my migraines. It's not really a question she can answer of course, but she did suggest that I wait until after I've tried working with a reproductive endocrinologist before I decide to assume I'm not getting pregnant. So... that's an answer, anyway. She also said they might have better suggestions for medications I could take in the meantime, even if they don't work as well as the Depakote did. I'm still considering trying Topomax again, neuropathy aside. We'll see.
So my two big issues, migraines and weight, are basically things that I'm going to have to live with.
She wants me to see a cardiologist soonish (preferably before I get pregnant, but she said I didn't need to stop trying or anything). I have a Patent Foramen Ovale, which isn't generally a big deal, but given my history and the probable-TIA I had in 1999, she thinks it wise for me to have a consult from a cardiologist. So I'll take care of setting that appointment up soon.
Finally, she suggested I wear a splint at night to try and deal with some of these carpal tunnel issues.
Otherwise, I appear to be in good health and she'll call me if any of my bloodwork looks funny. Which it will. Another of the joys of PCOS is high triglycerides and high cholesterol. My cholesterol has been borderline for years (but with good distribution, so never been a big deal), but my triglycerides are likely to be through the roof, as they were last time I had them checked. HEre's the fun part: cholesterol and triglyceride medications cannot be taken while pregnant (and by extension, when trying to get pregnant). So no matter what those numbers are, there's nothing I can or will do about it. Based on what I eat, my diet is not responsible for any issues I have with triglycerides or cholesterol. So, um, yeah.
And that's that. Basically all the problems I've got are likely rooted in the fact that I'm female. And they're all problems without solutions. And I'm not going to fall over dead tomororw. I consider that a victory.