A Patient’s Story

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Posted on: 02/20/2016

Over the past several months, I powered through a divorce from my husband. What was “normal” to me for many years was actually a horribly unhealthy experience, with mental and emotional stress taking its toll on my body. Although a divorce is typically a very sad event, the act of ridding my life of a powerfully negative force has delivered a wealth of positive, happy energy back into my life.

During my recent visit with Dr. Hirsch, he reminded me that “balance” applies not only to our hormones, but also to our LIVES. I understand now more than ever that optimal health requires making choices in the food we eat, the people with whom we associate, the activities we choose, and the steps we take to help our bodies operate as efficiently as possible. During this visit, we also reviewed the lab report of my recent blood draw and Dr. Hirsch made a few adjustments in my dosages of thyroid and testosterone. I also told him that my biggest struggle is remembering to take my bioidentical hormone replacement therapies (BHRTs) and supplements every day, and at the right time. As always, I appreciated his encouragement and powerful reinforcement for me to continue a healthy lifestyle. I know Dr. Hirsch is on my team!

 



A Little About Me Before I Started My Journey with Dr. Hirsch

I’m a 45 year old woman who lives in the Dallas-Ft. Worth area. I’m a wife and a mom; educated and employed. Pretty typical. I’m 5-foot-2 and small framed. Far from athletic, I’ve still remained fairly active and nutrition-minded throughout most of my life. My family’s health history isn’t great, but nothing that can’t, I believe, be overcome by a healthy lifestyle.

From my teenage years through my mid-thirties, I struggled off and on with anorexia and bulimia, at times falling below 100 pounds and feeling generally miserable. Thankfully, a wonderful eating disorder therapist and my faith helped me finally beat it, and I can’t imagine ever going back to that dark place in my head. In my late twenties, I dealt with a devastating miscarriage in my second trimester. I was eventually able to get pregnant again, and I now have two amazing daughters. In my late thirties, my monthly cycles seemed to dominate my life, sometimes lasting up to three weeks at a time. I was exhausted, anemic, and simply ready to make it go away.  Without digging for an underlying problem, my well-meaning gynecologist suggested a uterine ablation to stop any future bleeding, and to stop my periods altogether – forever.

 I had known of Dr. Hirsch’s expertise and success with other patients for some time, but I hesitated to contact his office for the typical reasons: “I can handle these issues on my own, I’m not old enough to have hormone problems, etc.” Finally, it was time. I knew I couldn’t deal with all these issues on my own anymore, and I made an appointment.

 Before I visited Hirsch Clinic I filled out the required patient forms from his website. The questionnaire is extensive and takes time, but a valuable tool for Dr. Hirsch and his staff to use in forming the full picture of my health and lifestyle. Some of the questions were rather thought provoking, such as the amount of sleep I got every night and the frequency of my eating. I’m glad I took the time to provide a lot of details on the form, as it later made me realize that it was the first step to becoming part of “Team Hirsch” in putting my health back on track.


Posted on: 01/02/2014

My first appointment. When you walk into Hirsch Clinic, it may surprise you to see that there are no “examination” rooms; just consultation rooms. The only “medical” equipment that you’ll see are blood pressure monitors and high-end scales that measure your total body composition including weight, body mass index, body fat percentage, fat mass, basal metabolic rate (how many calories per day your body uses) and impedance (how much water your body holds).

When was the last time you sat in a doctor’s office and had his or her undivided attention for over an hour? Truthfully, I’ve never experienced that. We walked through each one of the questions and answers on the Patient History form, and Dr. Hirsch asked a number of questions so that he could start putting together the best course of action for me to feel healthy again. I knew I mattered, and I knew he cared.

The Results and Next Steps

The day after my initial appointment I went to the lab for my blood work, and judging by the number of vials they drew from me, I knew that the labs would be very extensive and detailed – much more than any doctor in my past ever did. In fact, two years ago after I had gained a crazy amount of unexplained weight and asked my OB-GYN to check my hormones, I knew right away that the blood tests she ordered were just the baseline and barely scratched the surface. It’s not that I wanted anything to be “wrong” with me, but I was disappointed that she didn’t dig deeper when many of the signs of a hormone imbalance were there, clear as day.

Posted on: 01/09/2014

All my blood work came back before today’s appointment, and it turns out my thyroid and testosterone levels were indeed “on the floor.” That explains SO much about the way I’ve been feeling. My estrogen, on the other hand, is “through the roof” – way too high. My blood sugar and cholesterol levels are good too, and the results that signal the possibility of heart disease are healthy. All of this is great news.

Dr. Hirsch prescribed a testosterone cream (applied to my inner arms after my morning shower), DHEA, progesterone, and a slightly increased amount of thyroid. (we had already started thyroid medication when he called me after seeing my preliminary lab results). I will have three different thyroid tablets so that I can slowly increase my dosage, a week at a time. I’ve already learned the hard way to not rush my body with too much thyroid, as I felt really anxious when I did so.  

Although my progesterone levels aren’t necessarily low, Dr. H wants me to take 50 mg every night (more if I have PMS or headaches) to “balance” out the high estrogen. Now I fully understand the term “hormone balancing.”  I love the progesterone – I’m sleeping through the night, I’m not waking up with headaches anymore, and my night sweats have really decreased. All in all, I’m feeling so much better already. Again, I wish I started working with Dr. Hirsch a few years ago, when I started really feeling “off.”

It’s great to feel HOPEFUL again!

Posted on: 2/12/2014

After a month of hormone therapy, I’m feeling much less fatigued as my thyroid levels rise. I was disappointed that I didn’t lose more than a pound since my first visit; but honestly, being able to sleep better and think more clearly has been amazing. The weight will come off later.

Dr. Hirsch asked me to track my eating for a week – every morsel that I put into my mouth – and bring my notes to my appointment today. I learned so much. A person may not realize how much those little bites add up to unnecessary calories. We talked about how everything that goes into my mouth should mean something. I need to up my protein, and cut way back (better yet, eliminate) sugars, processed foods and bad fats. None of this can be accomplished overnight, but it will happen with time (but the sooner the better!).

Posted on: 3/28/2014

Back to Hirsch Clinic for another visit. Dr. Hirsch said that we won’t meet as often later on in my treatment; but for now, we need to check the blood levels of the various hormones I’m taking and how my body is responding to them in order to get the right balance. I haven’t lost any weight, but I haven’t gained any either – and wow – I’m feeling better all the time. My husband has even noticed that my skin looks better, which made me feel great. Mentally, I’m starting to feel like the old Me again.

Posted on: 6/17/2014

I had another set of labs performed a few days ago, and today I returned to Hirsch Clinic. It has been a little over five months since starting bioidentical hormone treatment, and like Dr. Hirsch said, several months may pass before we find the right blend of hormones. Sure enough, we made a few changes today.

First, my blood sugar was higher than normal. This didn’t surprise me, because my cravings for sweets still seem pretty uncontrollable to me. Dr. Hirsch upped my daily dosage of Metformin to help with this. Next, my testosterone and progesterone levels, though higher than several months ago, still need some improvement, particularly since my estrogen is naturally high. Finally, remember how my thyroid was lower than low several months ago? Apparently I upped my own dosage a little too much over the past few weeks, because now it’s too high! Dr. Hirsch instructed me on the right dosage, and I should be good to go now.

One of the best parts of my visit with Dr. Hirsch today was our chat about the numbers on the scale (isn’t it sad how women are so tied to these crazy numbers?). It’s true, I didn’t see a lower number on the number of pounds today – but Dr. Hirsch was quick to show me how I really HAVE lost fat, judging by my body fat mass, my impedance, and my body fat percentage — all of them much lower than my first evaluation in January. Pretty exciting!

Posted on: 7/17/2014

Although I haven’t visited Dr. Hirsch in his office, we’ve kept in touch this past month by email and phone whenever I’ve had any questions. The best past was sharing with him how I’ve started running! Me? A runner? Impossible. Sure, I’ve enjoyed hitting the gym off and on throughout my life and I enjoy brisk walks in the early morning, but I’ve certainly never been an athlete. It’s a long story, but a friend of mine recently battled cancer and her story of competing in her first triathlon at the age of 47 was truly inspiring. I relayed all of this to Dr. Hirsch, who cheered me on but cautioned me to take it slow.  I need to let my body gradually adapt to the new stress from running. A new athletic activity can make me more injury-prone at first, if I’m not careful.

I have a long way to go before I can run even a few miles without stopping, but I’ll get there. It’s a great feeling of accomplishment. As I look back on where I was mentally, emotionally and physically just one year ago, I can honestly say that THAT woman would have never run through her neighborhood at 6:00 A.M.

Posted on:  8/27/2014

Dr. Hirsch checked in with me a few weeks ago, and I told him I felt very “off.” I felt quite sad and very heavy in spirit, and I couldn’t explain why. He quickly reminded me of a big “stressor” in my life and cautioned me not to let it drag me down. That helped! I had even considered asking him about antidepressants.

Dr. Hirsch then asked if I had been consistently taking all of my meds. I replied, “Well, I’m missing some doses here and there.” Bingo. Needless to say, Dr. Hirsch set me straight! In particular, I learned how much Metformin can help not only with sugar cravings, but also hormones, and, subsequently, moods.  This medication improves insulin sensitivity and lowers serum insulin levels. With my “condition,” higher serum insulin levels make symptoms worse. Since that time I have really worked to remember to take each dosage, and to take it at the same times every day. I am also being more careful with my nutrition. I have really been able to feel a big improvement in my mood, energy level, and emotions.

Posted on: 10/22/2014

“Consistent communication.” These were the important words from Dr. Hirsch earlier this month. Life got in the way, as it does for all of us sometimes. My lack of consistent communication with Dr. Hirsch over the summer, however, was primarily the cause of me taking an incorrect, larger dosage of progesterone at
night, which led to a lot of drowsiness in the mornings. If I had shared this issue with Dr. Hirsch weeks ago, I would have saved myself from trying to unsuccessfully push my way through all of those groggy hours during the workdays. It’s hard to believe that four months have passed since I visited his office in person,
but – again – it was great to see Dr. Hirsch in his office a few weeks ago and reestablish consistent communication. I’ve found it helpful to bring all of my bottles of meds with me to my appointments, including my Metagenics supplements, so that I can better explain my schedule of when I take particular pills or capsules.  At this recent visit, he advised that I take my 2nd dose of Metformin later in the day, and he also decreased my dosage of testosterone. Tomorrow I go for blood work, and I’m looking forward to learning how the latest tweaks are helping to balance and optimize my hormone levels.

 Posted on: 01/15/2015

As I look back over the past 12 months that I’ve been working with Dr. Hirsch, I see a truly wonderful, healthier difference in my body and general outlook in myself compared to just one year ago. Although the improvements are many, here are a few that stand out:

  • I no longer suffer from feeling cold nearly all the time, thanks to getting my hypothyroidism under control
  • I wake up with much fewer headaches, and I have fewer migraines, thanks to increased levels of progesterone in my body
  • I am more alert, have less “cloudy” feelings, and have an overall better mood
  • I have a much better understanding about nutrition, and more importantly, how sugar and processed fructose in my diet not only affect my waistline, but also my depression
  • I finally have a physician, Dr. Hirsch, who is truly invested in my well-being and never makes me feel rushed during an office visit

We are still fine-tuning the dosages of the various hormones that I take, which is part of the process of achieving optimal wellness. One of these adjustments is decreasing my dosage of Testosterone and adding a medication to my regimen to protect my skin. As always, my biggest challenge is remembering to consistently take every med, every day. 2015 will be a much better year.

 Posted on: 3/17/2015

Recently I’ve had a concern with bladder control and truly hoped that I was too young to have the same problem as many elderly women. I remembered reading the literature that came with the medicine prescribed by Dr. H to counteract the unwanted hair growth that could accompany using testosterone, which stated the drug could act as a diuretic and cause me to urinate more frequently. My number of trips to the restroom was extreme, practically every hour, and I feared the medication might have been the culprit.

When I reported this to Dr. H, his advice was simple: “Eat dill pickles. Add a little more salt to your food.” Really? I wouldn’t have guessed that! Once he mentioned that I needed to increase my salt intake, I remembered that he had originally explained to me that the medication might deplete the sodium stores in my body, requiring extra salt intake. Sure enough, the lack of salt in my system prevented my body from holding onto much water – and all of the water I drank simply passed right through without doing any good.

If you’re like me, most of what I’ve read and heard about eating healthy has kept me from adding extra salt to my food. Over time, in fact, I’ve become pretty sensitive to salt, especially in restaurant food. I don’t like much salt at all, and it makes me extra thirsty.  A subtle change on my part has made a world of difference, though, and the number of times I visit the restroom each day has returned to normal. For example, if I’m cooking myself an omelet, I’ll give the salt a few extra shakes—and I no longer scour the grocery store shelves for only food that’s labeled “Low Sodium”. Last but not least, I’m enjoying some pickles every week in honor of Dr. Hirsch!

 Posted on: 06/10/2015

During this past month I experienced a medical scare that landed me in a doctor’s office that was not Hirsch Clinic. During my annual visit to my dermatologist to check all of my moles (I have a lot of them), he found a dark brown, odd-shaped mole about a quarter of an inch in length. Isn’t it amazing how something so small can change one’s life in such a huge way?

Over the few next weeks I underwent two biopsies, one of which involved an uncomfortable procedure and stitches. I was finally able to say “melanoma” without shaking, but it took some effort. The horror stories about the disease on the web didn’t help. While I waited the five days for the results from the lab, I was so glad to talk to Dr. Hirsch and hear his physician’s perspective. He lessened my fears and assured me that whatever happened, we caught it early. He also asked me for a copy of the dermatologist’s report so that it would be in my file at Hirsch Clinic for a full picture of my health.

This past Friday I learned that I’m okay! My dermatologist was able to remove all of the bad tissue, and nothing had spread elsewhere in my body. I’m so thankful!

My reminder to Dr. Hirsch’s patients is this: while we continue to work on the “inside” of our bodies with good nutrition and proper use of our prescribed meds, we can never forget to take care of the “outside” of our bodies as well.