Saturday, June 10, 2006

Conversation Pit...

...pituitary, that is.

I found out a few months ago that I am diabetic. My endocrinologist gave me the diagnosis based on blood test results. My other physicians were more apt to say that my sugar was, "A little high." They all agreed that diet was the only way to manage my condition. I have complied and my blood sugar is now in the normal range.

Oddly enough, I did not go to see the endocrinologist because of the blood sugar problem. I went because, after many years of symptoms, one of my MDs had decided to check some hormone levels. One level was off (I wonder just how long it's been that way) and he referred me to the endocrinologist, "Just to be sure that there isn't a tiny cyst on your pituitary."

I expected to discuss hormones on my first visit to the endocrinologist. Instead, I was socked with, "You're diabetic," with the offhand addition of, "Let's get some more bloodwork, if the other level is still off, we'll get an MRI."

Fast forward through blood tests and an MRI (which was kinda cool and futuristic, and oddly relaxing) to the follow-up appointment. I had done my research and I was prepared for what the doctor had to say. Given my blood test results and my symptoms, I had already figured out that I had a pituitary tumor. It just took the doctors awhile to firm up to the diagnosis. I also thought it was likely that my type of tumor would be relatively simple to treat, with the expectation of a good outcome, though I wanted confirmation.

My endocrinologist provided the confirmation I wanted. She stressed that the tumor is not cancerous. The tumor actually produces the hormone that is throwing things off for me. She prescribed some medication to block the effects of the overproduced hormone and to shrink the tumor. All good news.

The statistics on pituitary tumors are somewhat staggering. Up to 25% of the population may have such a tumor, most of them undiagnosed, asymptomatic, and clinically insignificant. Most require no treatment and never cause problems. They are frequently discovered during MRI of the brain for another reason (such as sinus problems or concussion) or during autopsies. I am one of the rare few to have a functional pituitary tumor. Fortunately, mine is small and easy to treat.

For those of you who can't remember much about the pituitary, it is a gland the size of a large pea. It is nestled into the brain, in a cavity called the sella turcica. The pituitary is the master gland, the big boss telling the rest of our glands and organs what to do. When the chemical messengers (hormones) it dispatches are out of whack, life can change dramatically.

Pituitary tumors can cause an array of symptoms related to overproduction or underproduction of hormones. They can also cause problems (headaches, visual impairments, etc.) due to mass effect. Mass effect is pressure from the tumor (or mass) itself, and is often seen with larger tumors. These larger tumors can require surgical intervention, with varying degrees of success.

I probably would not be posting this if it were not that I am doing well. Better than ever, in fact, since I have chosen a healthier lifestyle now. The medication has been good to me, and my hormone levels are normal at this time. My sugar is in the normal range, too. All medication has side effects, and I'm working with one or two of those, but it beats the alternative. Both the pituitary situation and the sugar level will require monitoring. Thank God for medical insurance.

So why am I posting this? Here is my point: if you are experiencing any symptoms that could be caused by a hormone imbalance, ask for a screening of all of your hormone levels. Doctors are quick to prescribe medications for depression, anxiety, headaches and many other symptoms without checking for a biological root to the problem.

I mean no disrespect to physicians, and this post represents my opinion based on my experience. I can appreciate how difficult it must be to properly diagnose a patient, and family doctors just don't know that much about the subtleties of pituitary disorders. I give a great deal of credit to one of my physicians because he did pursue further testing. He listened to me, and he didn't take the easy road by saying that it was all just a midlife crisis.


I most emphatically do not want to frighten anyone into thinking they have a pituitary disorder. The vast majority of those who have pituitary tumors will never have a moment's trouble with them. It also behooves me to point out that endocrine disorders can have a variety of causes, not just pituitary tumors.

One small benefit to all of this: I got to see pictures of my brain. How many people can make that claim? OK, quite a few, I'm sure, now that MRI is so common. But it's still pretty cool! And, yes, there actually was some grey matter between my ears and behind my eyeballs...

Some conditions that can be caused by pituitary tumors:

ACROMEGALY
AMENORRHEA
CUSHING'S SYNDROME
GROWTH HORMONE DISORDERS
HYPOGONADISM
HYPOPITUITARISM
HYPERPROLACTINEMIA
HYPERTHYROIDISM

Links to information about pituitary disorders:

http://www.pituitarydisorder.net/pituitary_conditions_treatments.html

http://pituitary.mgh.harvard.edu/

http://www.pituitary.org/

http://www.ninds.nih.gov/disorders/pituitary_tumors/pituitary_tumors.htm

http://www.cancer.gov/templates/doc.aspx?viewid=6bbb152e-faf4-4a7b-a15d-5b0e42de3962&sectionid=10&version=0#Section_65

http://www.answers.com/topic/pituitary-adenoma

5 comments:

MissMagnoliaThunderpussy said...

Oh my, Miss Merci, I'm very sorry to hear this but I do thank you for sharing with us. I haven't seen the inside of a Dr's office since 1976, I think it's time for a visit.

Virginia Gal said...

Thanks for sharing Merci - I am glad to hear that you are well and are healthy.

Also, I think it is way cool that you got to see your brain, I've never seen mine, some would argue it doesn't exist : )

PaxRomano said...

Lots of great information!

Good for you telling it.

Oh and I would skip those three martini lunches and just stay go with a few glasses of merlot ;)

Joe Tornatore said...

I had no idea. Thansk for sharing. Makes me a weenie for complaining about bronchitis.

Merci said...

Miss Magnolia-
A lot has changed since the US Bicentennial ('76). You might be in for some surprises when next you visit your doctor...

Virginia Gal-
The MRI really was cool, and it was fun to see pictures of my brain. I tried to post an image from an MRI(not from MY MRI), but blogger wouldn't let me. In one view, the eyeballs stick way out in front, it's pretty funny (and not gross - I don't tolerate gross very well).

Pax-
Who needs martinis, or merlot, for that matter? I feel great! I've decided that a little bit of impulsivity might be a good thing, since I can be a bit staid at times.

Joe-
No, bronchitis is definitely something to complain about. Hope you're feeling better.

To all-
Thank you for your kind expressions of concern. I'm not minimizing the situation when I say that this is just a blip on the radar screen. The medication I take is relatively new. It has fewer side effects than the previous drugs, and it is very effective.