January 7, 2010

I received the results of my pituitary and neck MRIs today... I met with my neurosurgeon and his partner, who have treated me in the past for the painful buffalo hump, and learned that I have a 4 mm microadenoma of the pituitary, which appears to be chronic and consistent with a previous stroke or trauma, and the cervical neck curvature has increased with degenerative disk disease, spread and compression of the facet joints, and a piece of chipped bone.

Prior to this appointment, I had performed an intense research in search of a Cushing's expert in endocrinology and, as most of you know, I came up with the name of Dr. F. in LA. I'm thrilled to say I have an appointment with him on Tuesday, January 19th.

During my discussion with the neurosurgeons, I provided additional information and concerns, such as my most recent symptoms of loss of armpit and pubic hair. I truly no longer have to shave my underarms! OK, I would be thrilled with this option, but something tells me this is a sign of a greater problem - not a perk

I also discussed with my physicians that I, myself, had been researching my current drugs and realized that Aldactone (spironolactone) is a STEROID - the arch enemy of Cushings.... It was funny in a way - we both (doctors and I) started discussing this at the same time - as if the light bulb had gone off for both of us.

So at this point, we have lots of good questions for Dr. F.....

1) Is the chronic pituitary tumor the cause of my many years of symptoms (leading to false diagnosis of hypothyroidism and hyperaldosoteronism)?

2) Do I have steroid-induced Cushing's syndrome caused by my current medications?

3) Why have physicians left me on a steroid-type drug, such as spironolactone, for MANY years (since 1992) that is not known to be a long-term drug of choice?

4) Is there an adrenal tumor or hyperplasia?

5) What else could be contributing to my condition? It is also interesting that my son had growth hormone deficiency found & treated at age 13....

Next Steps:

1) Appointment with Dr. F. on January 19th.

2) Dynamic MRI of pituitary and MRI of adrenals on January 20th @ Cedars-Siani.

3) Neurosurgeon advises IPSS if Dr. F. agrees

4) Facet injection of neck after cushing's workup (since facet injection contains narcotics and steroids and could interfere with cushing's tests)

5) Rhizotomy of neck (destruction of nerve endings sending pain to the brain) - if facet injection relieves the pain

Current Status: I have finally taken short-term disability from work. I don't think I realized just how ill I am until I allowed my body to shut down and rest.

ADDITIONAL MRI INFORMATION: Already, Dr. F. has provided some information that I did not know. Most imaging centers use a Tesla 1.5 to perform MRIs. The latest MRI equipment is a Tesla 3. Dr. F. uses only a 3 for MRI of the pituitary and prefers it to be performed and read at Cedars-Siani. And, of course, my recent MRI of the pituitary was a Tesla 1.5...

Today... I feel I am in very capable hands and my future is bright.

Good health always,

Deb G

Dallas, Texas