Sunday, June 14, 2009

PITUITARY SURGERY: I Did Survive (to be sung like Gloria Gaynor)

Hi everyone. Day 4 in the hospital, and I am doing well. I'm really sleepy, so I will post the highest of highlights, then I'll scoot.

From Neurosurgeon Jukebox Hero:

---NS found a 3 millimeter tumor on the left, just like he saw on both 3T MRIs. My IPSS in November 2007 confirmed the pituitary as the source of excess ACTH production, which is the purpose of the IPSS test. IPSS show lateralization, or which side of the pituitary the tumor is on--only 85% of the time. In my case, my IPSS showed the tumor on the right; but since my NS saw the tumor on the left, just like in the higher powered 3T MRIs. So my IPSS fell in the 15% category of the IPSS failing to show accurate lateralize. The NS located a tumor only on the left. He did explore all around the gland, looking for any other tumors, but he said "my anterior and posterior pituitary lobes were easily separated" and it's why he thinks I didn't face diabetes insipidis or DI. This is different from sugar diabetes. Both the NS and e endocrinologist say that DI usually shows up in the first 48 post op. It is now nearly 72 hours post up. Yay!! Endo did mention that if I started getting up 3 to 4 times a night to urinate, it could be DI. I am supposed to notify her and she will call in the prescription for oral DVAPT.

[BLOGGER'S NOTE: In April 2011, another neurosurgeon at MD Anderson Cancer Center in Houston removed a 3 millimeter tumor on the right side of my pituitary. So, IPSS was correct after all.]

--- NS did not use a fat plug.

--- NS said there is less than 1% chance that I will develop a CSF leak or cerebral spinal fluid leak.

---he said my tumor was the classic Cushing's tumor. It was encapsulated nicely but when he resected or cut it open, there was a milky liquid inside. It even ran out of tumor some. He scooped out tumor, milky liquid, and a little bit of normal tissue to ensure he got all of the dastardly Cushing's cells. Pathology report is expected within a week or so. Surgeon is confident it was Cushing's aka ACTH-secreting pituitary tumor.

--- he worked with the ENT during surgery. ENT cut through the sinus, then the neurosurgeon punched through the sella turcica on to the pituitary. So, after NS removed tumor, ENT placed stitches to close off incision sites in sinus, then stitched in stints to keep my nose aligned, then placed tampon-like packing into both nostrils to catch blood coming from incision. After only 12 hours post op, the neuro critical care nurse removed the bloody cotton tampon things the next morning after a quick hit of 2mg morphine. Not too bad, really.

---he said he bets I have been educating all the nurses. I told him he was correct. Then he said they should put me out on the conference circuit so I can present my story to educate more doctors. I told him I would love to do that. I see Vanna White booth time and waving in my future!