Sunday, April 22, 2012

Day 20: Surgiversary

DATE:  
APRIL 20, 2011.


TARGET:  
3 MILLIMETER TUMOR ON THE RIGHT SIDE OF PITUITARY.


OFFENSE:  
UNLAWFUL PRODUCTION OF EXCESS ACTH, SPURRED EXCESS PRODUCTION OF CORTISOL BY ADRENAL GLANDS.


ACCOMPLICE:  
ADRENAL GLANDS FOR AIDING AND ABETTING.


STRATEGY:  
TRANSSPHENOIDAL TRANSNASAL RESECTION OF PITUITARY TUMOR.


OUTCOME:  
1) SUCCESS. PATIENT ALIVE. TUMOR REMOVED.


2) FAIL. PITUITARY HORMONE ACTH STILL HIGH ON POST OP DAYS 5 & 16. TUMOR CELLS PLAYING LETHAL GAME OF PEEK-A-BOO. 


3) FAIL. NOT ONE DAY OF RELIEF FROM CUSHING'S SYMPTOMS. PATIENT CONTINUES STRUGGLES TO FIGHT DAMAGE TO BODY, MIND & SOUL CAUSED BY EXCESS ACTH & CORTISOL PRODUCTION.

4) PATIENT STRUGGLES TO RE-ENGAGE IN LIFE AND SOCIETY WITH MULTIPLE HORMONE- AND VITAMIN-DEFICIENCIES (GROWTH HORMONE DEFICIENCY, VITAMIN D DEFICIENCY, OSTEOPENIA, THYROID DEFICIENCY, FERRITIN (IRON) DEFICIENCY, ACTH EXCESS, CORTISOL EXCESS). 


5) PATIENT DECIDES ON NEXT COURSE OF TREATMENT: 
3RD PITUITARY SURGERY vs. BILATERAL ADRENALECTOMY vs. KORLYM





Structures surrounding pituitary. Important things nearby include carotid artery and optic nerve.
Arrow points to 3 millimeter tumor, right side pituitary; black indented area on opposite side shows space where tumor removed in 1st surgery (6/2009).


Recovery. Swelling but not too bad. Rocking those eye brows and ACTH shadow (acanthosis nigricans). 

Post op day 4 with Lola's blanket. Neurosurgeon deflated,
removed balloons from nose. Balloons measured 4-6 inches.

Crazy nurses insisted on placing an IV here. Btw--my veins are good.