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

Small Sacrifices

I drove myself to my wedding, oh so many years ago. We had both the ceremony and the reception at an oceanside hotel, a true grand old dame by the sea. I had a room at the hotel for the day, so I schlepped my gown and my gear off early that fall morning.

On the drive to my wedding, a red-winged blackbird flew into the windshield of my car. I hit it, it died. Anyone who knows me knows that I love animals, both furry and feathered. This was not the way to start my wedding day, but meltdown was not an option. I decided that the bird's death was a unwitting sacrifice, similar to the sacrifices made on important ceremonial occasions in many religious traditions of the past. I would never choose to sacrifice any living creature (let alone my own child - I still struggle with the story of Abraham and Isaac), but I felt that the fact of the bird's sudden demise might as well carry some meaning.

I took my mom for cataract surgery last week. We went to see Will again, at his place on the Jersey side (Will's Eye Surgical Center). Mom is blind in the right eye now, and the surgery was intended to restore much of the missing sight to the left eye. All went well, and we were on the way back to Mom's house by about 11:00am. Along the way, a blue jay flew out of a tree and hit the windshield of my car. It was over so quickly that I barely knew what had happened. I resurrected the sacrifice theory as the best way of framing the incident.

With the occasional figurative sacrifice to supplement the one of the bird on my wedding day, my marriage has turned out well. Perhaps the unsolicited sacrifice of another small creature, once again on a day of significance, is a portent of further blessings ahead. Perhaps the blue jay, with its bold spirit, is a fitting emblem of the courage and strength needed for what lies ahead.

Enivrez-Vous

I came across this poem some time ago. I meant to post it, but I never did. Here it is in the French first, then in translation. I'm posting the French because the poem sounds better, has a more beautiful cadence, in French. The English translation also has a punchiness that I like, so it's worthwhile, too.


Enivrez-Vous
Charles Baudelaire

Enivrez-Vous
Il faut être toujours ivre.
Tout est là:
c'est l'unique question.
Pour ne pas sentir
l'horrible fardeau du Temps
qui brise vos épaules
et vous penche vers la terre,
il faut vous enivrer sans trêve.
Mais de quoi?
De vin, de poésie, ou de vertu, à votre guise.
Mais enivrez-vous.
Et si quelquefois,
sur les marches d'un palais,
sur l'herbe verte d'un fossé,
dans la solitude morne de votre chambre,
vous vous réveillez,
l'ivresse déjà diminuée ou disparue,
demandez au vent,
à la vague,
à l'étoile,
à l'oiseau,
à l'horloge,
à tout ce qui fuit,
à tout ce qui gémit,
à tout ce qui roule,
à tout ce qui chante,
à tout ce qui parle,
demandez quelle heure il est;
et le vent,
la vague,
l'étoile,
l'oiseau,
l'horloge,
vous répondront:
"Il est l'heure de s'enivrer!
Pour n'être pas les esclaves martyrisés du Temps,
enivrez-vous;
enivrez-vous sans cesse!
De vin, de poésie ou de vertu, à votre guise."

Get Drunk

Always be drunk.
That's it!
The great imperative!
In order not to feel
Time's horrid fardel
bruise your shoulders,
grinding you into the earth,
get drunk and stay that way.
On what?
On wine, poetry, virtue, whatever.
But get drunk.
And if you sometimes happen to wake up
on the porches of a palace,
in the green grass of a ditch,
in the dismal loneliness
of your own room,
your drunkenness gone or disappearing,
ask the wind,
the wave,
the star,
the bird,
the clock,
ask everything that flees,
everything that groans
or rolls
or sings,
everything that speaks,
ask what time it is;
and the wind,
the wave,
the star,
the bird,
the clock
will answer you:
"Time to get drunk!
Don't be martyred slaves of Time,
Get drunk!
Stay drunk!
On wine, virtue, poetry, whatever!"