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I had a tiny tumour that made my feet grow two sizes bigger


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I saw this article and immediately thought of my friends across the pond. They mention facilities other than St. Barts.

 

I had a tiny tumour that made my feet grow two sizes bigger

Millions of Britons have benign pituitary tumours without knowing it - but every year 2,000 need surgery because their health is being affected. Christine Fletcher, 57, a store worker from Manchester, underwent a radical new operation. She tells Martyn Halle her story, while her surgeon explains the procedure.

 

 

 

Christine Fletcher's face and hands grew larger over time due to a benign pituitary gland

When I started experiencing really painful pins and needles in my left wrist, my GP told me I had carpal tunnel syndrome, and the nerves were being squeezed by the surrounding tissue.

 

Usually this is caused by repetitive movement, but in my case that wasn't the problem, so it was a bit of a mystery.

 

Anyway, I had surgery to relieve the pressure on the nerves, and then, when I developed the same symptoms in the other wrist, I had surgery on that arm, too.

 

But before the second operation, I read up about carpal tunnel syndrome and was particularly struck by the fact that one possible cause is acromegaly - a rare tumour in the pituitary gland at the bottom of the brain.

 

The gland controls lots of things, including sex drive, energy levels and growth.

 

When you have a tumour on the gland it secretes growth hormone, and your hands, feet and face get bigger.

 

Bizarrely, this was just what had been happening to me.

 

I am an identical twin and my sister Susan and I had always been more or less the same size.

 

But very gradually, over the past 15 or 20 years, parts of my body had grown bigger than hers.

 

I remember back in the 1990s realising I needed bigger shoes. She is a size eight, but I started taking size nine, even a ten.

 

My hands had also grown and my wrists had thickened, which was why the nerves were being squeezed and I had carpal tunnel syndrome.

 

Now, when I look back at old photographs, it seems obvious that my face had also grown larger.

 

The most well-known case I found was the 7ft 2in actor Richard Kiel - "Jaws" in the James Bond film. But he is an extreme example.

 

I asked the wrist surgeon if I might have this condition. He thought it was possible, and after the operation referred me to an endocrinologist, who specialises in hormones.

 

Scans and blood tests confirmed the diagnosis.

 

The consultant said it was extremely unlikely that the tumour was cancerous, and initially I was told I needed only tablets and injections to bring my hormones down.

 

But after several months, it was obvious this wasn't working and my hands and feet continued to grow.

 

There was a risk my heart might become enlarged too - causing diabetes or even heart failure, which was extremely worrying.

 

I was sent to a neurosurgeon, who was very positive about the operation.

 

He told me that instead of having to make a hole in my skull to remove the tumour, he could remove it through my nose.

 

After the operation, I had to stay in hospital for six days while they checked my hormone levels had gone back to normal.

 

I didn't need any painkillers - all I had was a runny nose. I was told not to blow it for a few weeks to let it heal.

 

The chances of the tumour recurring are very small, but I have an MRI scan and check-up every 12 months to make sure.

 

Apparently, sometimes hands and feet can shrink back to their original size, but it can take as long as it took for the change to occur in the first place.

 

I haven't really seen any change yet, but I'm not too bothered - I'm just happy there is no sign of the tumour coming back, and that I am no longer at risk of heart disease or diabetes.

 

 

Mr Kanna Gnanalingham is consultant neurosurgeon at Hope Hospital, Manchester, and The Alexandra BMI Hospital in Cheadle. He says:

 

The pituitary gland is the "master" hormone-producing gland in the body.

 

Oval in shape, it measures about 1.5cm in length and is located at the base of the brain, 5cm behind the tip of the nose.

 

The pituitary is responsible for secreting eight different hormones that control numerous vital bodily functions, such as body growth, general health and energy levels.

 

Around 10 to 20 per cent of the general population have a benign pituitary tumour, but only a small proportion of these ever cause symptoms - and only a tiny fraction will ever need surgery.

 

Most people are likely to live out their life without ever knowing they had a pituitary tumour.

 

Thankfully, almost all pituitary tumours are benign and treatable.

 

Cancers of the pituitary gland are incredibly rare. We operate only when drug treatment doesn't work.

 

There are various ways of removing a pituitary tumour. The oldfashioned method was to cut a hole in the skull - an operation known as a craniotomy - and carefully manoeuvre around the brain until the gland is reached.

 

But because the pituitary gland is at the base of the brain, at the back of the nasal passage, it can be reached through the nose with little disturbance to the brain.

 

Most operations on the pituitary gland are now carried out this way.

 

Until recently, because of the narrowness of the nasal passage and the size of instruments we had, the nostril had to be forced to two to three times its normal size.

 

This is very painful for the patient after surgery, and the nose will have to be packed with absorbent material for a few days to stop it bleeding.

 

But over the past few years, we've been able to remove pituitary tumours with keyhole surgery.

 

A fibre-optic endoscope (like a miniature camera) means we can see the whole of the pituitary area with minimal disturbance to the nasal passage or surrounding brain.

 

The endoscope also provides a more panoramic and closer-up view of the pituitary region, which means we can potentially remove the tumour more precisely.

 

The tumour is carefully removed in pieces, while taking care to leave the pituitary gland undisturbed.

 

Although Christine's tumour was causing her health problems, it was no bigger than a very tiny pea.

 

All types of pituitary surgery carry a small risk of complications, such as infection and bleeding, but this is relatively rare.

 

At present, the endoscopic approach through the nose is confined to one or two centres in the UK, but over the next few years it will become more common as surgeons are trained in this technique.

 

? The procedure costs the NHS ?4,500. Privately, it costs ?10,000.

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Very interesting, and I think that is the first time I have seen the NHS cost published in that way. Hey anything that raises the profile of Pit problems can only be a good thing. more awareness = more funding hopefully.

 

Val

(Teri's Mum)

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