Q. I have PCOD with depression and fatty liver. How to manage it?

Hi doctor,

I am 32 years old with a weight of 249 pounds and a height of five feet eight inches. I have insulin resistance problem for 15 years. I have acanthosis nigricans with PCOD and my periods are irregular. I suffered from jaundice at the age of 10 and it has damaged my liver causing fatty liver. I had a premature birth. I always try to lose weight and I cannot stick to anything for a longer period of time. I get bored quickly and I have migraines with a sleeping disorder. My back of the neck hurts me a lot. I cannot sleep with the low pillow. Before a year, I had a heavy nose bleeding from the right side of the nose. I lost my blood and my hemoglobin got reduced from 11.2 mg/dL to 9.6 mg/dL. I had some blood clots and when I try to move my face up, blood gets into the throat and I will try to pull it out. It took 40 minutes to stop my bleeding and my blood pressure was 140/105 mm Hg. For the past couple of months, I have palpitation problems. My pulse got raised upto 135 beats per minute. Normally, I have a pulse rate of 88 to 97 beats per minute. Sometimes, I have pressure on my jaw, neck, and left hand. Sometimes, I have stretching of veins below the breast on both sides. Sometimes, my left ear becomes numb and the surrounding area of the ear becomes numb and I feel the pressure below the left side of the neck. I feel some sensation on my upper left back near the shoulder blade. It seems to be a crawling sensation under the skin. Sometimes I feel this below the back and it is present mostly at the time of the shower. I have pain on the upper left side of the tummy. It lasts for a minute to hours. But it starts intensely and it becomes mild later after taking rest. I feel to have stretching in my left-hand vein and it causes a lot of distress. Sometimes, I feel it in my heart. I was diagnosed with IBS and took treatment for two months. But still, I burp a lot. Sometimes even after eating food for six hours, I can still taste the food in the burp. Sometimes I have pain in my heel and I cannot able to walk. I am unable to place my foot on the ground due to pain and walking causes more pain in my heel. I was diagnosed with prediabetes. Now I am under depression due to my overall health. I am dealing with obesity throughout my life. Now my body is fat and saggy. I am unable to control my body and I do not have beautiful skin with too much facial hair present on my chin. I have consulted many doctors but I am not getting well. I want to live my life happily with a stronger mind. My depression is killing me a lot and I do not want to take anti-depressants as they cause weight gain. Please suggest.