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Meriam, Pituitary Bio

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Hi, my name is Meriam from California, a 51 years old female. I was diagnosed with Cushing’s last August 2013.

I had all the typical symptoms (weight gain, edema, purple marks, bruising, aches all over the body, hair loss, depression, anxiety, uncontrolled diabetes, high blood pressure, high cholesterol, poor concentration, sleep apnea, etc.) I thought all of these problems was partly caused by my weight  gain (230 lbs.).  I underwent a gastric by-pass but still didn’t  lose weight that much.

Eventually. my body seems to shut down and had been and out of the ER. I suffered congestive heart failure, blood clot, blurred/double vision, colon inflamation, body pains and aches, myopathy but the hardest part was, I lost my ability to walk.

It was a rough year for me; been hospitalized for almost a year. Finally, after 6 months of suffering, my Endocrinologist was able to diagnosed me of having Cushings.

My pituitary gland was removed and was given the necessary treatments. As my cortisol level went down, most of my symptoms disappeared except for bouts of body aches and depression.

I am currently doing physical therapy to be able to walk on my own again. I lost weight and on the way to recovery.

My greatest fear is for the Cushing’s to come back and I do not want to undergo the same ordeal again.

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Final Diagnosis: ACTH-dependent Cushing’s syndrome • ectopic ACTH syndrome

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Final Diagnosis: ACTH-dependent Cushing’s syndrome • ectopic ACTH syndrome

Symptoms: Edema • general fatigue • recurrent mechanical fall

Medication: —

Clinical Procedure: —

Specialty: Critical Care Medicine • Endocrinology and Metabolic • Family Medicine • General and Internal Medicine • Nephrology • Oncology

Objective:

Unusual clinical course

Background:

Adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (CS) secondary to an ectopic source is an uncommon condition, accounting for 4–5% of all cases of CS. Refractory hypokalemia can be the presenting feature in patients with ectopic ACTH syndrome (EAS), and is seen in up to 80% of cases. EAS can be rapidly progressive and life-threatening without timely diagnosis and intervention.

Case Report:

We present a case of a 74-year-old White woman who first presented with hypokalemia, refractory to treatment with potassium supplementation and spironolactone. She progressively developed generalized weakness, recurrent falls, bleeding peptic ulcer disease, worsening congestive heart failure, and osteoporotic fracture. A laboratory workup showed hypokalemia, hypernatremia, and primary metabolic alkalosis with respiratory acidosis. Hormonal evaluation showed elevated ACTH, DHEA-S, 24-h urinary free cortisol, and unsuppressed cortisol following an 8 mg dexamethasone suppression test, suggestive of ACTH-dependent CS. CT chest, abdomen, and pelvis, and FDG/PET CT scan showed a 1.4 cm right lung nodule and bilateral adrenal enlargement, confirming the diagnosis of EAS, with a 1.4-cm lung nodule being the likely source of ectopic ACTH secretion. Due to the patient’s advanced age, comorbid conditions, and inability to attend to further evaluation and treatment, her family decided to pursue palliative and hospice care.

Conclusions:

This case illustrates that EAS is a challenging condition and requires a multidisciplinary approach in diagnosis and management, which can be very difficult in resource-limited areas. In addition, a delay in diagnosis and management often results in rapid deterioration of clinical status.

Read more at https://cushings.invisionzone.com/topic/56339-final-diagnosis-acth-dependent-cushing%E2%80%99s-syndrome-%E2%80%A2-ectopic-acth-syndrome/

Bev, Undiagnosed Bio

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golden-oldie

 

Hello, my name is Bev I have 8 kids yes that is not a typo :)…

I have been fighting whatever is wrong with me for the last 16 yrs.  I have been diagnosed in the past as having a thyroid problem. That was always changing( hypo to hyper thyroidism) and now I am told my thyroid is fine. I was diagnosed with fibromyalgia and PCOS.

Now in  the last year I have gained about 100 lbs. …No matter what I eat or how much I exercise…. I recently went to the ER because of way more than usual water retention along with chest pain and shortness of breath.  They tested me for congestive heart failure, and that is not the problem.

After many blood test and etc. they have “unofficially” said I have Cushings. I go to see the Endoconologist in a week. I dont want to have this as I know noone else does! But it would be a relief to know what is actually wrong with me….. I am tired of this emotional and painful roller coaster my body has me on.

Confused and scared about what is going to happen.

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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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Christine G, Pituitary Bio

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It took approximately 6 years for me to be diagnosed with Cushing’s Disease. I have had many unrelated illnesses up to that point, Congestive Heart Failure, FMD, Gallbladder Removed, problems with vision, high blood pressure, weight gain, problems with balance and more.

No doctor could figure out why the weight gain only in my belly. All were prescribing different diets.

My husband and I were on vacation for a month in Florida every morning and afternoon I would walk on the beach 3 miles each time and my belly kept getting bigger???? My husband saw an article on excessive cortisol and how it was a stress hormone and that excessive cortisol expanded your belly!

My daughter had a friend who was an endocrinologist, I made an appointment to see him when we got home. At first sight the doctor said I do not believe you have “it” but to appease you I will test you. To this day I do not believe he would have tested me if he was not friends with my daughter. I did not have any of the typical signs. Non of us is textbook, we are all individuals.

To the doctors surprise testing came back positive for Cushing’s Disease the doctor said that he would have to send you to someone more familiar with Cushing’s and he sent me to Mass General. I met with a Dr. Tritos who once again said I did not have the typical signs and I was retested. Yup it was Cushing’s. I met with a nurosurgeon at Mass General, Dr. Sweringen, who had extensive experience in Cushing’s surgeries.

My insurance company denied my out of network coverage. I saw a few doctor’s locally and did not feel comfortable with any local surgeons because of the lack of surgical experience with Cushing’s Disease. I began my battle with the insurance to have the out of network covered. I was first rejected by the insurance company, I then appealed with Maximus (second step in process) and was rejected. During this time my health was deteriorating, I had double vision and could no longer drive, I needed to hold onto someone to walk because I had become so unsteady. My family was worried because they had read that the longer you waited for surgery chances were less likely for a full recovery. My daughter gave me the money for the surgery which I had at Mass General on November 16, 2016 by Dr. Sweringen, who is fantastic! I had successful Pit surgery.

After surgery I continued my pursuit in getting the money back. I went to the next level, the applet judge……This time I won, with the help of my local endocrinologist, Dr. Busch and documented proof of Dr. Sweringens exceptional expertise in Pituitary Surgery.

Now almost 10 months later, I am very surprised that I still have muscle weakness and joint pain. When I mention this to doctors they do not believe it is Cushing’s related, even though when you go to the Cushing’s Facebook support group people mention this. I am wondering how many others have this problem 10 months post op. I still have trouble getting out of a chair.
What is so sad you are not told about the post op obstacles you will face.

I think that all of us facing this disease have to give ourselves credit for the strength we have and have to continue having to battle this disease, and to appreciate our support of family and friends.

 

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