Brief Answer: Hello, I would be happy to help you... Detailed Answer: Well, for your age of 21 you certainly have a lot going on. In order to give you a comprehensive answer, I will need to understand a few things a little better: 1. Are you currently taking narcotics for pain? 2. Have you been tested for diabetes? 3. What is your height and weight? 4. Are you currently on birth control? 5. Is there a chance of pregnancy? 6. While you see a GYN, do you also have a primary provider? Thank you - please answer and I would be happy to help you with your question.

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Brief Answer: Thank you for the followup... Detailed Answer: XXXXXXX PCOS is a condition related to diabetes. In fact, the patients with PCOS usually have borderline testing for DM. This seems to the be case with the "inconclusive" testing. It seems to me that your doctor needs to redo the DM testing regardless. Women with PCOS usually present with irregular bleeding, insulin resistance and "male-pattern" hair growth. They are best treated using birth control pills and oral diabetes medication. So if your doctor has made a diagnosis of PCOS, then the metformin is indicated. It is typical to get labs related to liver and kidney function at the beginning and during the course of treatment. This is one way to decrease your concerns. You are on a lot of medications with side effects, so worrying about a rare side effect with metformin is unwarranted - you should talk about this with your doctor. Next, you are complaining about pain, nausea, low-back pain, right lower quadrant pain and fatigue. Try not to self-diagnose this as PCOS. You could easily miss a common diagnosis such as a bladder infection! So if these are new symptoms, they really should be addressed by your OB/GYN who should do an exam and check your urine. That would be a good time to ask about birth control pills - you should ask them about any issues they would have with the "fatty liver" issue as they would know you better. Finally, the issues and symptoms really do appear to cause you a significant amount of anxiety. You are extremely young and suffer from a number of things, but they are all common and manageable. You probably need input from a Psychologist as an adjunct to treating your anxiety, and input from GI regarding treatment of your GERD and fatty liver, and perhaps even input from an Endocrinologist. While a General Practitioner can handle a lot, in your case, a better long-term plan for each individual problem might be useful. Also, some sort of exercise regimen for stress reduction and weight loss will help all of the above. Codeine and Co-dydramol are both treatments for pain. The second medication is not available in the USA, but my research indicates that it is basically a milder form of codeine often sold over-the-counter suprisingly. I would stay away from both of these medications in your case. I hope that this helps!

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Brief Answer: Sorry about the delay... Detailed Answer: XXXXXXX So obviously your symptoms are largely related to your period. Thinking more about your situation, I truly believe that one great option for you is a medication called Lupron. It is a medications that essentially shuts your cycles down. It is very effective at relieving pain related to your cycle or something called endometriosis. This is also a great way to sort out what exactly is the source of your pain. Another thought as well is involvement of Physical Therapy and exercise. The more de-conditioned you get, the worse your pain related symptoms are going to be. This must be worked in over time. You need to set small, reachable goals over a long period of time. You are extremely young and are on a path that is not ideal - you can turn things around! I hope that this helps!

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Brief Answer: Thank you... Detailed Answer: First of all, I would get a second opinion with a Cardiologist and ask them specifically about activity and exercise. Something does sound right about this advice. Second, congratulations on the pain management program. Again, I will come back to your cycle and any way to treat that would be a good idea. As I stated, Lupron therapy sounds like a good idea in your case. Fibromyalgia is a pain syndrome. It is not associated with spontaneous episodes of extreme fatigue or falling asleep. This should be explored further with a doctor called a Rheumatologist. Do not fixate too much on the FM diagnosis. You have other things going on (menstrual related pain and a heart condition) that could largely explain your symptoms. Take my advice above and good luck!

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