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Mary H (Marietta), Adrenal Bio

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In 1976, I was (finally) diagnosed with Cushing’s disease and after the up the nose surgery, which was ineffective, I had bilateral adrenalectomy.

It all started in late 1974, when I started having lots of illnesses and was depressed.  I was crying a lot and going back and forth to my doctor, who treated every illness and gave me anti-depressants.

Then the weight gain started, ( I was 185 at my highest, which was usually 115-120) actually I had been gaining weight, but by now it was rapid and uneven– only my trunk and face.

All through late ’74 and 1975, I was back and forth, even with a dx of pregnant,  (which made evryone happy, as I was married Feb 1974.  But the mental problems continued, I was under psychiatric care and had 2-3 in-patinet stays of about 2 weeks.  Each time, after the observation and evaluation, I was discharged with no dx. I would also fall asleep at the strangest places and times, all very suddenly.
In March of of 1976, I  had what was then called a “nervous breakdown,” so again I was hospitalized.  THAT probably saved my life, as it was my psychiatrist who finally dx Cushing’s and decided on treatment. He later told me that I had him very confused, as each time he thought he had the DSM dx (he knew I was in the mh field), I would change and thus, he could not fit me in any DSM DX.   Then, because of my appearence (moon face, foot-ball player shape, with skinny limbs, losing my hair and all the secondary dx (high blood pressure, insulin diabetes that could not be controlled– up, down, up down, losing hair, on my head but growing on my face and back), he said he remembered something from medical school.

He did a lot of research, ordered a lot of tests and VOILA– I had Cuhing’s disease.  It was very rare and at that time, he said there were no more 300-400 (known) cases in medical history; also, I was the youngest dx at 26, because most cases were in those age at least 50.

I had the nose surgery, very new at the time,  but it didn’t “work,” so I had to have my adrenal grand removed– they were 5x the normal size and producing 25x the normal amount of steroids. I had the surgery in Novemver 1976, which took from 7 am to 5 pm (I have the 2 long scars on my back).  I did not know at the time that there was an 85% chance of surviving that surgery.

Post surgery, all but 3 of my fingernails fell off, my hair was in tight curls (previoulsy straight) and I had cystic acne on my face, neck and back. I started taking cortisone and florinef and was told I had to take  it the rest of my like.  I was under close dr care for about a year, and by April 1977, the weight was gone (I was back to 115) and all secondary symptoms were gone.  I believe that the surgery was a real “cure” for my Cushing’s disease and after, it was/is maybe somewhat like diabetes, in that it is managed and controlled.  There are some things that I have to watch carefully, like a comprommised immune system (increase the prednisone if infection seems likely) and some depression (never hospitalized again).  I have had some adrenal crises, that landed me in the ER, maybe 5-6 over the years (how strange, no doctor ever told me or gave me a prescription for an injection for such occurences).
In 1990-1991, I had what ended up being appendicitis.  After 4x in the ER, I vomited blood and collapsed.  It turned out to be a (dead) grangrenous appendix, which should have been removed the first t ime.  Supposedly, the prednisone that I take “masked” the symptoms and since my blood showed no infection, I was sent home from the ER each time.  I spent 2 weeks in the hospital with 3 strong intravenous antibiotics to remove all the toxins in my body that almost killed me.

In 2000, I was dx with diabetes, which runs in my family, and at  64 years  old, the problems I have now are severe allergies/sinus problems (no one believes that I am sick when this makes me sick) and I seem to always be hotter or much colder than anybody (which the doctor warned me about right after the major surgery).

Also, I started out with cortisone; in 1990, a new doctor in NYC gave me hydrocortisone and I gained 10-20 lbs.  Another doctor quickly put me back on cortisone and said that the hydrocortisone was only for injections when I have adrenal crisis– it is quick actiing.  The cortisone was 25 mg daily and around 1993-94, I started gaining weight.  A new docotr in Chicago, switched it to prednisone 5mg., the equivalent of the 25 mg cortisone.  He said the prednisone did not cause weight gain– he was right.  I also take Florinef, now Fludrocortisone (the generic, Florinef is VERY expensive, as is the generic, but less).  I started out with this at .1 mg  once every other day and sometime in the 90s, the same dr who put me on prednisone, changed the Fl to one x daily.

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Sandi J, Undiagnosed Bio

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Recently I had a kidney stone. I went to the ER where they did a CT scan. The confirmed the stone and gave me pain pills to tough it out. A couple of weeks later I got a letter describing all of the CT findings. I had to look up all of them to figure out what they meant. One of them was adrenal adenoma. When I started reading about this one it was like reading my medical history. Weight gain in the belly, hump on my shoulders, high blood pressure, high sugar, high triglycerides, fatigue, depression, serious panic attacks, aching muscles…

I didn’t have a regular doctor because I just moved to Phoenix and was fed up with the VA. I’m a disabled vet due to a back injury in my first year of enlistment. So I got an internal doctor and showed her my CT findings, she wasn’t worried but upon insistence I got her to test more. She called me a few days later to tell me that it was a functioning adenoma. She is sending me to an endocrinologist because it might be part of a bigger autoimmune disease, I’m guessing Cushings.

I told her I knew exactly when it started, in 2003. That was shortly after finishing Hepatitic C treatment and when I had my first panic attack. I had no idea what was happening and called 911 and took an ambulance ride to the ER. They found nothing physical, so continued my life of being treated as a hypochondriac. Oh yes, prior to the Hep C diagnosis I was treated as a mental patient, depression got stamped on my forehead for over a year…

Now here I am 11 years later, 60 pounds over weight, can barely go up stairs without getting out of breath and starting a panic attack. Doctors have been riding me about my weight, and not exercising… Finally they hear me!

Now I have found this board and have lots of reading to do.

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Denise, In the Media

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Cushing’s survivor hopes to make others aware of illness

July 16, 2007

Denise Potter, who works at the Christus Schumpert Highland Hospital as a mammographer, has Cushing’s disease which affects the performance of the pituitary gland. Greg Pearson/The Times 07.12.07 (Greg Pearson/The Times)

Cushing’s Help and Support: http://www.cushings-help.com/
National Institutes of Health: http://endocrine.niddk.nih.gov/pubs/cushings/cushings.htm
Oregon Health & Science University: www.ohsupituitary.com/patients/print/cushings.html

By Mary Jimenez
maryjimenez@gannett.com

Denise Potter never connected her rapid weight gain to a disease or her high blood pressure to anything but her weight.

The hump on the base of her neck was a feature she supposed came with the weight.

And although the roundness and redness in her face was odd, she never connected it to the other symptoms she was having or the fatigue, heart palpitations and swelling she begin to experience in her 30s.

And neither did a stream of doctors over the decade when Potter’s symptoms related to Cushing’s disease began. It would take another two years after diagnosis to find a treatment that worked.

“You can see my face getting real round in this picture. They call that a ‘moon’ face,'” said Potter, 42, looking over a handful of photos that showed the progression of the disease, diagnosed when she was 37. “You learn one of the best ways to show doctors the changes happening is to bring pictures with you to appointments.”

Potter, who works as a mammographer at Christus Schumpert Highland Hospital in Shreveport, calls herself lucky to be working and functioning in life as well as she is.

“I only hope by telling my story someone else can be diagnosed sooner,” she said.

According to the National Institutes of Health, Cushing’s disease is a form of Cushing’s syndrome — caused by the overproduction of cortisol over a long period of time.

Cortisol is a hormone produced by the adrenal glands and essential to many of the body’s cardiovascular and metabolic functions. It also helps the body respond to stress.

Cushing’s disease is specifically caused by a hormone-producing tumor on the pituitary gland.

About 1,000 people each year in the U.S. are told they have a form of Cushing’s, but those affected think many more cases go undiagnosed.

“Making people aware of the disease is the name of the game,” said Louise Pace, founder and president of Cushing’s Support and Research Foundation Inc., based in Boston, Mass. “There’s a chance for 100 percent recovery if you get diagnosed soon enough. But not too many do. Out of the 1,000 members I have, only two are 100 percent cured and they both got diagnosed within a year. It took me five years. The longer you go, the more damage it does.”

In addition to feature changes, left undiagnosed the disease can cause associated diseases such as diabetes mellitus, hypertension and osteoporosis.

“It’s such a difficult disease to catch. It’s different from one patient to another. And for a lot of people it cycles. Doctors miss it unless they do particular tests,” said Warren Potter, Denise’s husband, whose gained a strong medical knowledge about the disease. “It’s amazing how much you learn about medicine when you have to.”

Warren Potter, originally from New Zealand, has lived in the states now for about eight years and met Denise online by chance while he was living in Tennessee.

He gives luck a large role in his wife’s diagnosis.

“At one stage she found a doctor who wasn’t too far out of medical school,” said Warren of the young doctor his wife went to in 2003 for her high blood pressure that would diagnose the disease.

“He was very worried about my blood pressure being 215 over 105 (a healthy adult is around 120/80) and began asking other questions,” said Potter, who’d also experienced an extreme, rapid weight gain. “I’d always been around 135 pounds but in my 30s my weight jumped up to 300 pounds. I knew my eating hadn’t changed enough for that much weight gain.”

Headaches and later migraines that Potter experienced throughout her life also began to make sense with a Cushing’s diagnosis. More than one eye doctor thought there might be something else going on there, but were looking on the brain not the pituitary gland where a tumor that causes Cushing’s disease sits.

A 24-hour urine collection was enough to prove that Potter’s cortisol levels were high, but not enough to pinpoint why.

Cushing’s syndrome can be caused by myriad of reasons, according to the National Institutes of Health.

A person who takes excessive amounts of steroids for inflammatory diseases or other reasons can suffer the symptoms of Cushing’s. Also a number of things can go wrong in the precise chain of events needed to produce cortisol.

It all starts with the hypothalamus that secretes corticotropin releasing hormone that tells the pituitary to produce adrenocorticotropin, which then stimulates the adrenal glands to produce cortisol that’s dumped into the bloodstream.

Potter’s tumor was confirmed with a magnetic resonance imaging of the pituitary.

The cure is surgical resection of the tumor, states the NIH, with about 80 percent success rate.

Potter’s first surgery done at Vanderbilt University Medical Center in Nashville, Tenn., failed as did another attempt to shrink it with radiation.

Potter and her husband took a bold step they both felt was her best chance for a cure.

“We moved to Oregon where the best specialist in the country was,” said Potter, who was treated by Dr. William Ludlam, an endocrinologist. “I liked him immediately. He thought maybe my first surgery hadn’t been done quite right and wanted to try it again.”

When a second surgery done at the Oregon Health and Science University also failed, Potter and her doctor made the decision to remove both her adrenal glands in 2005.

The surgery took away her body’s ability to produce cortisol, which is now replaced orally. She’s also taking other hormones that are no longer produced by a damaged pituitary.

“On the endocrine aspect it’s all guess work to the levels of medication that works to make her feel relatively normal. We learn to tweak it when she needs to,” Warren said. “We’re lucky in a lot of ways that the disease was caught in time. She did not get the cure from the tumor being removed and she has other symptoms, but they can be treated.”

The Potters moved to Shreveport late in 2005 to be closer to her parents. An endocrinologist follows her hormone replacement therapy.

“I’ve lost 70 pounds, but because my age and the length of years I had the disease, my recovery will be slower,” said Potter, who takes 10 pills and one injection daily to manage her hormones and diabetes. “It’s also caused some memory loss that I still can’t access.”

Potter and others affected by the disease think experts are underestimating the number of cases.

“I see people all the time that look they are walking around with similar symptoms as I use to have,” she said. “I hope this makes people more aware of the disease.”

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Laura, In The Media

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After years, mystery ills diagnosed

April 3, 2005
By JANET MARSHALL

On the day her life changed for the better, Laura Zastrow was exhausted. So much so that she almost didn’t go to the Quantico commissary, as she’d planned.

For years, Zastrow had felt run down without knowing why. One doctor chalked it up to depression. But that afternoon at Quantico, a stranger offered another diagnosis: Cushing’s disease.

Rare and often misdiagnosed, Cushing’s causes fatigue, weight gain, hair growth, mood swings, high blood pressure and other ills, all familiar to Zastrow.

The stranger, Jayne Kerns, recognized her own puffy face and hairy arms in Zastrow.

“I said, ‘I feel like I’m looking in the mirror,'” Kerns said.

Kerns encouraged Zastrow to check out a Cushing’s Web site, which Zastrow did. Every symptom listed matched her condition. Her doctor ran some tests, and the results confirmed Zastrow had Cushing’s, a hormonal disorder often brought on by a tumor.

The chance meeting in September 2003 transformed Zastrow’s life. In the months since, she’s had surgery to remove a large tumor on her pituitary gland and rediscovered her old, healthier self.

“My energy is coming back,” said Zastrow, of Locust Grove. “I’ve lost a lot of weight. I feel good. I don’t feel like I’m in a fog anymore.”

Kerns, of Spotsylvania County, has made it a mission to raise as much awareness as possible of Cushing’s since being diagnosed with the disease in 2000. She’s written President Bush asking him to declare a National Cushing’s Awareness Day in April.

Her meeting with Zastrow was first described in a Free Lance-Star profile of Kerns in 2004. At the time, nobody yet knew just how life-altering that meeting would be.

It emboldened Kerns to keep reaching out to people she thinks have the disease. And it gave Zastrow hope for a healthier, more energetic future.

“I was at the point where I was deteriorating so fast that if Jayne wouldn’t have approached me, I honestly don’t know what would have happened,” Zastrow said recently. “Obviously, I didn’t know anything about [Cushing’s], and neither did my doctors.”

For those with the disease, April 8 is the unofficial day to recognize it and the man–Dr. Harvey Cushing–who first put a name to it.

People with Cushing’s suffer from excessive levels of cortisol, the body’s stress hormone. The condition can be caused by long-term use of certain drugs, such as prednisone for asthma.

Often, Cushing’s stems from an overproduction of cortisol by the adrenal glands. The pituitary gland sometimes over-stimulates the adrenals, triggering the problem. Tumors on the adrenal or pituitary often are at the root of the problem, and treatment can involve removing the glands.

Kerns’ diagnosis followed months of maddening efforts to pinpoint why her body deteriorated, and never recovered, after childbirth.

She said she was misdiagnosed many times, and that one doctor, frustrated by her recurrent problems, told her he no longer had time to listen to her and referred her to another physician.

Kerns ultimately had her adrenal glands removed.

Each year, 10 to 15 people out of every million are thought to be affected by Cushing’s, making it highly uncommon.

“Doctors think that Cushing’s is too rare for people to have it,” Kerns said. “And I truly believe that it is not as rare as people think.”

Another local woman, Jennifer Belokon of Fredericksburg, has Cushing’s. She was serving in the Army in Iraq when she began feeling weak and gaining weight, adding 60 pounds in three months.

The Army flew her out of Iraq and sent her to Walter Reed Medical Center. After being diagnosed with Cushing’s, she had her adrenal glands removed.

“Now, I have no adrenaline, no steroids or anything that will help me produce that second wind when doing anything,” Belokon wrote in an e-mail.

Yet she’s resumed exercising and is training to run the Rock ‘n’ Roll half-marathon in Virginia Beach in September. She ran a 10-mile race a few months ago.

“My time was nothing big,” Belokon wrote. “But I was proud of myself for finishing.”

Getting treated for Cushing’s is life-altering, all three women said. Just finding out what’s wrong is profound because a diagnosis often follows months or years of mysterious and unsettling ailments.

“It changes people’s lives when they figure out what’s going on,” Kerns said. “It’s kind of like discovering that you have diabetes, and then you get insulin. You find something that’s going to make you feel better.”

For more information on the disease and its symptoms, which include purple stretch marks, check out cushings-help.com

To reach JANET MARSHALL: 540/374-5527 jmarshall@freelancestar.com
Copyright 2005 The Free Lance-Star Publishing Company.


JAYNE KERNS IS A MEMBER OF THE CUSHING’S HELP AND SUPPORT MESSAGE BOARDS.

Jayne answered questions in an online Voice Chat January 31, 2008 at 6:30 PM eastern. Archives are available.

Listen to CushingsHelp on internet talk radio

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Voices from the Past: Meriam S (Jomisa03), Pituitary Bio

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The pituitary gland

The pituitary gland

 

My name is Meriam San Antonio, 52 years old from Fairfield, California. I have been married for 19 years and have three teenage children. I was sick for almost 7 months ( starting March 2013) and the doctors couldn’t figure out what is wrong with me. My symptoms were being bloated, had edema on my feet and legs, swollen all over, had a “moon face”, bruising on my hands, myopathy/neuropathy, aching nerves, bloated stomach (as if I was pregnant), double vision, and lost my ability to walk.

I have been in and out of the ER due to having a congested heart failure, urinary tract infection, colonitis. I suffered from acute depression and tried killing myself. My blood pressure and blood sugar was soaring so high and uncontrolled.

After a series of tests, I was finally diagnosed of having Cushing’s syndrome. A surgery was done on August 2013 to removed my pituitary gland at the left side of my brain.. I had to take an early retirement from work and currently on Social Security Disability.

Two years had past and I have recovered. I lost weight, my blood sugar and blood pressure were now on the normal range. It seems after the surgery, everything was back to normal. I can now walk on my own ( without the help of a cane, walker and wheel chair) but had to undergo a knee replacement as I fell many times on my knees due to nerve weakness. I had a rough time and had gone through a lot.

I stopped taking my PTU medication as told by my doctor as I am already “Cushing’s free”.

But my endocrinologist just informed me that the result of my thyroid test was high. She ordered me to take a “nuclear iodine test” next week. I am so worried that my Cushing’s will come back. I do not want to undergo such experience as I was so traumatized by it.

 

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David T (Wombat), Adrenal Bio

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adrenal-locationHi, I have been diagnosed with probable cyclical adrenal cushings. This all started after a scan on my abdomen for something unrelated revealed bilateral adrenal adenomas. When I googled adrenal adenoma everything fitted into place. I had been depressed , put weight on which were my main symptoms along with anxiety.

I was then referred to an endocrinologist in the UK who ordered some initial tests. I did Two 24hr UFC’s on consecutive days one came back at 36 and the one the day after was 91(normal below 50. Another time the normal range was 165 and the 1st one was 108 and the one the day after was 393.

I then did an overnight dexamethasone test and suppressed below 50 to 48. My endocrinologist then said he didn’t think I had cushings and said come back in six months and said it might be due to stress. I then got a second opinion and then the real testing started.

Roll forward four years and I have done about 30 – 24hr UFC’s numerous ACTH and full blood counts. renin and aldersterone, metoclopramide test, glucagon test, vassopression test, oral glucose stimultation test, day curve cortisol, spent a day in hospital walking round the ward for two hours, then eating a mixed meal and then sitting down for two hours while they tested my cortisol every hour . Did a Low Dose Dexamethasone Test and came out in a rash and my blood pressure dropped so got told I can’t do the test again. Had a bone density scan. I hIad a pituitary scan that revealed a lump inside my tongue and then had to have a whole body scan followed by a tongue biopsy(which turned out to be benign.

I have had about five CT scans on my adrenal glands and was referred to an endocrine surgeon this week who is going to perform a right adrenalectomy. The right one is 4cm in diameter.

He said looking at the scan he thinks it looks like macro nodular adrenal hyperplasia but wont know till pathology get to examine the specimen.

It’s been a long, long journey but finally looks like it’s coming to a conclusion now.

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Sherry, Undiagnosed Bio

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A Golden Oldie

I am a Veteran who goes to the Veteran Clinic for my healthcare.  I have been going there for a little over a year.  I go to a womens clinic for both my primary care and gyn.

Backing up a bit…Since my youngest son who is turning 18 next month was about 3, I recall the onset of many of the symptoms of Cushing’s Disease.  However, I didn’t realize what was going on. I believe a lot of my symptoms started when I fell down backwards down a flight of stairs breaking my elbow and wrist.  I really haven’t been the same since. I have slowly put on 120 pounds over the years, all of it being in my mid-section.  I have suffered off and on migrane headaches. My arms and legs are thin as rails compaired to my mid body.  My skin has gotten transparent and dry.  I have the thick cushion of fat tissue between my shoulder blades.

Then in 2007 I had a severe hysterectomy due to massive bleeding/clotting and cysts.  I had serious complications which include blood clots in my legs and also a PE.  I have gone down hill from there.  My bones, muscles and joints ache so bad and can barely get up and down.  I can’t hardly stand more then a few minutes at a time. I have fluid retention so bad that my current doctor finally put me on lasix daily. Finally I suffer from depression and anxiety and I hate to go out in public because of my condition.  Though my husband gets frustrated with me he is still very protective of me and helps.

I have had so many doctors imply  that my problems are phycological or due to my obesity and I am simply tired of that.  I am on 17 medications now due to blood pressure, fluid retenstion, thyroid, diabetes, neuropathy, depression and anxiety, cholesterol and to insure against a heart attack.

I am 52 years old and I feel like my life is coming to an end.  I just recently was reassigned to another primary doctor as my old one left the clinic.  I didn’t like her at first, her personality was so different from my last doctor.  But Friday she did a completed physical and gyn exam.  She asked me if I had ever been diagnosed with Cushing’s Disease.  I had never heard of this disease.  She started pointing out all the classic signs. She decided she wanted me to have a blood test and was very determined I had it done.  I went home and researched it and indeed I have all but maybe one of the symptoms.

I am a little bit nervous about it and realize its a waiting game as far as tests and more test.  On the other hand I feel like I can finally put a name to what’s been going on and hopefully feel better.  I am glad I found this support group and would enjoy talking to others

UPDATE March 6, 2012: Also, additional systems include excessive hair growth on my face, foggy vision, inability to concentrate, red patchy marks on my arms and I have been told I am slightly bi-polar as well at suffering from anxiety and depression.

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Leslie, Undiagnosed Bio

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A Golden Oldie

I have no diagnosis but have a number of questions.  I think for now I would like to read others experiences.

Update September 5, 2011

Hi,

I am wondering if the issues I am currently having may be related to Cushing’s.  So I am actually looking for more information, before I ask my doctor about testing.  I have always been in the short and fat catagory physically, however in the last few years I have gained a rediculous amount of weight all in my middle.  Recently my blood pressure has gone from running very low 110/70 on a high day to 152/108.  I am waiting for more test results, blood sugar, etc.    In the past I had a horrible reaction to a cortisone shot in my knee that resulted in stretch marks that appeared overnight and horrible itching and agitation and am wondering it this was a symptom related to cortisol levels in my system already being to high.

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Steve, Ectopic Bio

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I am recovering Ectopic Cushing survivor, I am 52 years old, I originally got sick when I was 22 it was 1987, I went un diagnosed for 12 years. I had every symptom there is with Cushings from the crazy weight gain to blood pressure being at stroke levels for the 12 years and terrible vision issue that I still struggle with today.

I had 2 surgeries, first I had the Pituitary surgery which left me on deaths door, miss diagnosis of Pituitary when it actually was ectopic with a nickle size tumor in my right lung between my upper and middle lobes. they removed all but a potion of my upper lobe.

I have struggled with vision issues ever since as well as depression, terrible fatigue and all of the other issues that come with having Cushings!

 

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Voices from the Past: Mickey D (MickeyD), Adrenal Bio

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adrenal-location

I am now 65 years old. I was first diagnosed with Cushings Syndrome in 1995 after 2 years of weekly doctor office visits stating that “my blood tests came back ok, so it must not be anything serious”.

My blood pressure shot up to stroke levels daily, my hair was falling out, I gained about 8 lbs in 6 months, had the moon face, buffalo hump, etc.,etc..

Every possible test imaginable was done to find the problem except a CT scan. The CT scan I had (after 2 years) revealed that I indeed had a tumor on my adrenal. I went to surgery and had the tumor and adrenal removed.

In fact, if I may interject, I was the “guinea pig” for the Laparoscopic Adrenalectomy performed by the doctor who invented the procedure. I was subjected to hundreds of observations while I was in the hospital for 2 days by student doctors and other Endocrinologists who wanted to see the outcome of the new procedure. Anyway, I went home after the surgery, returned to work in a week and was told I would not have to worry about ever getting this again.

I have had problems of various natures since the surgery. They have not required surgery but have been very emotionally upsetting. I can not seem to lose weight no matter what I try and I have tried it all. I did lose about 50 lbs shortly after surgery but I am still overweight and cannot seem to get it off.

I know my age isn’t helping but I am very physically active even with my age. My middle section is fatty, my breasts are enornous which is not a family trait, and I had had a total hysterectomy in 1994 at the age of 46 and I suffer daily with extreme hot flashes and mood swings.

The hot flashes are affecting my life. I am miserable. I have talked with my doctor about the weight, hot flashes, irritability but he doesn’t think it is caused by the Cushings from before. I DO!!! I have not been to an Endocrinologist since I was diagnosed back in 1995 so I have not had my levels checked. I don’t know what to do. I’m starting to think like I did back in 1995, that this is all in my head and it’s my fault that I cannot get relief for these symptoms I still have. I do not have a OB/GYN because my old one retired.

So, I am hoping that there is someone who has advice for me . I didn’t know this resource was here but I sure am  glad I found you.

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