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Stephanie (Steph), Undiagnosed Bio

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Hi. My name Steph, and this has been a long journey for me so far, and I see a long road ahead. Hopefully their will be a rainbow once all these clouds have melted away.

I just turned 33 years old (this month) and have been dealing with symptoms of Cushing’s since I was a pre-teen without even knowing it. I was diagnosed (or possibly mis-diagnosed) with PCOS when I was about 11. That’s when the irregular (to almost non-existent) menstrual cycles, hirutism (chin, upper lip, upper and lower thighs, fingers, toes, basically everywhere) and weight problems began. I was immediately put on birth control to regulate my periods, which only made my life a living nightmare. They forced on a fake (non-ovulating) period and made my moods a disaster. I went on to be on birth control until from the age of 11 until about 3 years ago when I just couldn’t take it anymore, and took myself off. I’ve been using herbal supplements for menstrual regulalation since then, and feel MUCH better.

Over the years I’ve always felt like there was something “more than PCOS” wrong with me. From the extreme inability to lose weight normally, and the ease to gain it, to the weak legs, vitamen d insuffeciency, high cholesterol, high blood pressure, extreme irritability, now non-existent cycle, shortness of breath (just from walking up 1 flight of stairs), slow healing, hoarse voice, high testosterone, male pattern baldness, blurry vision, EXTREME brain fog etc….. It has been very, very, very tough and emotional over the years. It has taken a toll on my personality, emotions, and those around me….

The way that I found out about cushing’s is rather unique. I was on a popular PCOS message board site called “soul cysters”, and I have always been EXTREMELY self conscience of my round puffy face, and was wondering if it could be a side effect of PCOS. So I searched Puffy face on the message board to see if others on the board had experienced it, and sure enough Cushing’s came up, and a suprising number of women either had both (cushing’s and PCOS) or had been mis-diagnosed, which apparently is very common with cushing’s. it was like a gigantic light bulb went off in my head when I started googling cushings symptoms. All these things that I have been experiencing almost my entire life started coming together. I’m really not crazy!! Everything is possibly related. Im almost 100% sure that this is it!!! I don’t know if this is a good or bad thing, as I see that cushing’s is curable in most cases, but it is also scary, and diagnosing it seems like hell!!

I have began my -already slow- journey to diagnosis. And, the the Dr.’s don’t seem to be all that well informed. However, I am DETERMINED. I am excited at the thought of possibly being able to get my life back through surgery or meds. I went to a well respected Endo in my area, and she is gonna test all of my hormones, including my cortisol level. Though she didn’t seem to be too informed on Cushing’s when I brought it up, along with my “dead ringer” symptoms. I’m going to a pulmonologist on the 29th as suggested by my GP (who also thinks I have cushings, but admits he’s not well informed enough or equipped to diagnose). I’m also going to an OBGYN soon (tried going to one today, and had to walk out because it was such a bad experience). But I am determined to get 2nd, 3rd, and however many opinions are needed until I am satisfied.

Also, on a side note, possibly having cushing’s, along with having PCOS, has made me look at the doctors and the medical profession as a whole in a different light. I feel like if you find a genuinely good doctor who listens, cares, takes you seriously, and is willing to test you without question, and work with you, your levels, and your symptoms, you are blessed!! I have had so many doctors try to push meds down my throat (for their own pockets/greed obviously) when it wasn’t needed or necessary without hesitation or question. And, then when I tell them that the medicine is affecting me adversely, they just tell me to keep taking it! It’s sad and ridiculous. I’ve had to learn to do my own research, know my own body well, and trust my own judgement…..

I will be praying for myself and everyone on this message board who has had to deal with this horrific symptoms over the years.

Updates coming…..

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Did She Have Cushing’s?

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By the time A.A. arrived in my office, she had spent almost a year looking for answers.

In November 2012, she was 45 and struggling to lose weight and keep her blood pressure down. What sounds like a common scenario, however, was anything but.

A.A. was experiencing fatigue and malaise, and the area around her eyes bruised easily. Another puzzling symptom: She said she was acutely aware of her neck. It wasn’t pain, but awareness. She was losing more hair than usual in her brush and had stopped menstruating, and her skin broke open easily. Her primary-care physician thought it was early menopause.

She asked family and friends, but no one had such symptoms at menopause. She was increasingly self-conscious as she gained weight. Her primary-care provider referred her to an OB/GYN, and a variety of tests came back normal, including a pap, thyroid, female hormones, and a transvaginal ultrasound.

Worst of all, A.A. struggled emotionally. She felt as though she were in a constant state of agitation, with depression and anxiety. A.A.’s symptoms slowly took over her life. She was becoming a person she hardly recognized.

In July, she ran into a friend who was a nurse. Noticing the puffiness of her face, the nurse asked A.A. whether she was on prednisone. Learning she wasn’t, the nurse suggested A.A. might have Cushing’s syndrome, which results from too much cortisol in the body for long periods. It can be caused by taking a corticosteroid, like prednisone, or by something inside the body signaling the adrenal glands to produce too much of the hormone.

A visit to an endocrinologist confirmed the diagnosis after a 24-hour urine-cortisol test, and an MRI appeared to reveal a small adenoma on the pituitary gland. The endocrinologist referred her to Jefferson to see a surgeon.

Although she was not looking forward to brain surgery, A.A. was relieved to have an answer.

But neurosurgeon James Evans, Jefferson’s director of pituitary surgery, did not think the Cushing’s was caused by the pituitary adenoma. He ordered an additional MRI and blood work, which confirmed his hunch, and he referred her to Jefferson Endocrinology for further detective work.


Solution

When A.A. walked into my office, she was extremely stressed and exhausted. I ordered a chest CT, which revealed a nodule. But it did not fluoresce during a nuclear medicine test, as it likely would have had it been causing the Cushing’s. Next up was a series of scans, but all came back clear.

I still felt the tumor should come out and referred her to cardiothoracic surgeon Scott Cowan.

Three days after surgery to remove one lobe of her lung and the tumor, A.A.’s face already was noticeably slimmer.

Her Cushing’s was caused by a carcinoid tumor the size of a pencil eraser in her lung. The tumor – although not large enough to fluoresce during testing – had been signaling her adrenal glands, which produced enough cortisol, the fight-or-flight hormone, for 24 people.

Cushing’s accounted for all her physical and emotional symptoms. The syndrome can be missed because it mimics obesity in many ways.

With the tumor out, her adrenal glands would effectively go to sleep. She’d need prednisone, which would slowly be tapered over the next year. Fortunately, A.A.’s lymph nodes were clear, and she did not need radiation or chemotherapy.

Over the next year, A.A. got her life and her body back. By January, A.A. was completely off prednisone, feeling and looking like herself.
Read more at http://www.philly.com/philly/health/20150412_Could_brain_surgery_solve_her_baffling_symptoms_.html#xPCBW4wRoFxTCWDh.99

Leeza, Undiagnosed Bio

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Hi everyone, my name is Leeza and I think I have Cushings Disease.

I have had blood tests that say high cortisol, low eosin, high lymphs, low vitamin d, I have diabetes type 2 but now I have low blood sugar.

I have done two 24hr urine tests over the years and both were normal so the doctor then didn’t repeat. I have most of the physical attributes except for stretch marks.

I see an endocrinologist called Dr Henley next week so hopefully I’ll find out more.

Wishing everyone all the best and hugs Leeza

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Dr. Harvey Cushing

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Dr. Harvey Cushing, the father of modern neurosurgery, was born in Cleveland, Ohio on April 8, 1869. He was the first person to describe the Cushing reflex and Cushing’s disease.

The youngest of 10 kids, his parents sent him to the Cleveland Manual Training School which focused on experimental training and a physics-focused education. They also taught manual dexterity training which aided him in becoming surgeon. He studied at Yale as an undergrad and went to Harvard for medical school. He studied under William Stewart Halsted, a famous surgeon of the day.

By the age of 32, Cushing was an associate professor of surgery at Johns Hopkins and was the director of surgeries to the central nervous system. He pioneered operating with local anesthesia and was made a Fellow of the American Academy of Arts and Sciences in 1914.

During WWI he was commissioned as a major in the U.S. army and directed a hospital base in France. He later became a senior consultant for neurological surgery to the American Expeditionary Forces. By the end of the war he had climbed to the rank of colonel.

As an expert in his field, he made neurosurgery a separate discipline. His work improved patient survival, he introduced using X-rays to diagnose brain tumors and he was the leading teacher of neurosurgeons in the early 20th century.

Adapted from http://www.laboratoryequipment.com/news/2015/04/today-lab-history-harvey-cushing

Video: Living with Cushing’s

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Part I of The Voices of Cushing’s Disease video series discusses the diagnostic journey of patients and some of the common themes and challenges involved in a Cushing’s Disease diagnosis.

Pauline, Undiagnosed Bio

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Hello all
I’ve only just been referred this week to go see an endo so very much at the start of what I think will be a long journey.

I don’t seem to be a typical case of Cushings although I have “the hump” and some slow weight gain which is are the things that have gotten me referred.

Over the past umpteen years I’ve been going to the doctor with all manner of debilitating symptoms (mainly fatigue) and 15 years got diagnosed as B12 deficient and put on injections for it. Then after about 7 years I had to go back as symptoms worsening and was diagnosed as Folic acid deficient. Saw an improvement on taking the tablets but after a year was back to being utterly exhausted, waking at 3/4am every morning, aching everywhere in my body and multiple other symptoms that came and went. After pushing at the docs was diagnosed as low ferritin and put on iron tablets.

Over the next 2 years and ever increasing doses of iron we still couldn’t get my ferritin raised and I had started logging when I felt utterly gubbed and it seemed to be happening anything from immediately after getting my B12 injection to a few weeks after. Because it wasn’t easily definable as related to the injections, doctor didn’t want to make any association but it got to the point where I refused to get any more injections as I couldn’t face the 6 weeks of misery I knew would come after it so he agreed to put me on B12 tablets instead. And low and behold my ferritin started rising and I started feeling better. Luckily I was able to absorb the B12 orally as not everyone can do that. Almost all my symptoms disappeared except the sparse fluctuating periods, some vision problems and my reaction to eating sugar/carb food (Ok, I’ll admit it – biscuits) as I fall asleep at my desk sometimes directly related to what I’ve just eaten.

I believe a lot of what I was experiencing was down to my low ferritin and I’m actually feeling very good just now – but, since my blood has improved I’ve been slowly putting on weight around my middle (I only eat about 1400 calories a day so couldn’t understand it) and I’ve now got hump, and fine blond hair growing on my face. I’m 50 so doc had previously presumed I was just menopausal and that was what had stopped my periods but after 8 months one appeared. I had previously shown my hump to another doctor last year when I was there for back pain but was just told to sit up straighter at my desk. On showing my present doc the hump he said immediately he was going to send me to and endo.

So, I’m not sure what the outcome will be. I don’t seem to be a typical cushi as I don’t have a moon face and my weight gain has only been gradual and I actually feel fine. It was only at my partners insistence that I went to the doc as he kept saying my hump was getting bigger.

Does anyone have any advice on what I need to ask/say when I eventually see my endo?

Thanks
Pauline

ps, sorry, forgot to mention that I was only born with one kidney and also had an ovary removed due to a cyst.

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Day 4: Cushing’s Awareness Challenge 2015

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Originally posted on CushieBlog:

The above is the official Cushing’s path to a diagnosis but here’s how it seems to be in real life:

Egads!  I remember the naive, simple days when I thought I’d give them a tube or two of blood and they’d tell me I had Cushing’s for sure.

Who knew that diagnosing Cushing’s would be years of testing, weeks of collecting every drop of urine, countless blood tests, many CT and MRI scans…

Then going to NIH, repeating all the above over 6 weeks inpatient plus an IPSS test, an apheresis (this was experimental at NIH) and specialty blood tests…

The path to a Cushing’s diagnosis is a long and arduous one but you have to stick with it if you believe you have this Syndrome.

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