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She thought her weight gain was due to giving birth. She learned it was a tumor

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Dr. Irmanie Hemphill, who first thought her weight gain was due to having a baby. Doctors at Cleveland Clinic Florida in Weston diagnosed her with a tumor in the pituitary gland in her brain.

In the summer of 2019, Irmanie Hemphill gained a lot of weight, developed acne and had high blood pressure. She attributed it to her body adjusting from giving birth just six weeks prior.

“I was thinking maybe it was just hormonal changes from having a baby,” said Hemphill, 38, of Pembroke Pines.

But when Hemphill, a family medicine physician, saw that her nails were turning dark and she gained five pounds within a week, she knew it was something more serious.

Blood tests ordered by her physician came back normal, with the exception of high levels of cortisol detected via a urine cortisol test, which she requested after researching her symptoms online.

The next step was to find out where the excess cortisol was coming from: either her kidneys or her adrenal glands, which produce hormones in response to signals from the pituitary gland in the brain.

The first MRI of her brain did not detect anything abnormal, so her endocrinologist attributed her symptoms to her body adjusting post-pregnancy.

Hemphill sought a second opinion at Cleveland Clinic Weston, where more MRIs of her brain, combined with an Inferior Petrosal Sinus Sampling (IPSS) procedure, detected she had a tumor on her pituitary gland. That led her to be diagnosed with Cushing’s Disease — caused by excess cortisol.

TWO TYPES OF PITUITARY TUMORS

There are two types of pituitary tumors: those that produce active hormones, like the one Hemphill had, and those that do not, which grow in size over time and do not manifest symptoms right away.

Hemphill’s tumor was producing adrenocorticotropic hormone (ACTH), which causes the adrenal gland to produce more cortisol.

Many people with Cushing’s Disease experience high blood pressure and high blood sugar, muscle fatigue, easy bruising and brain fog. If left untreated, the condition can lead to pulmonary embolisms, diabetes, osteoporosis, strokes and heart attacks.

“It was a little bit of relief but also sadness,” said Hemphill, of finding out her diagnosis. “I was very happy that I got a diagnosis but now it’s like, what’s the next step?”

LESS INVASIVE WAY TO REMOVE A PITUITARY TUMOR

Hospitals in South Florida are at the forefront in developing new research, techniques and technologies for pituitary tumors.

The tiny bean-shaped pituitary gland is located at the base of the brain and controls many of the body’s hormonal and metabolic functions.

Last June, neurosurgeon Dr. Hamid Borghei-Razavi of Cleveland Clinic Weston removed Hemphill’s pituitary tumor through her nose. This type of procedure allows surgeons to remove the tumor without damaging the brain.

“It’s a less-invasive approach compared to 20 years ago, when pituitary tumors were removed through the cranium,” he said. “Now, with new technologies, more than 95% of pituitary tumors can be removed through the nose.”

The procedure takes just a few hours to complete, based on the size and location of the tumor. Patients usually stay at the hospital for one to two days afterward for observation.

The removal of Hemphill’s tumor, which was three to four millimeters in size, put an end to her Cushing’s Disease and her symptoms, though it took six months to a year for Hemphill to feel normal. (She was prescribed cortisol for six months until her adrenal glands could restart producing cortisol on their own.)

“Sometimes it’s very hard to make a diagnosis for pituitary tumors because we don’t see them in the MRIs,” said Borghei-Razavi.

“We call it MRI Negative Cushing’s Syndrome. It means we don’t see it in the MRI, but the cells are there,” he said.

Borghei-Razavi and Hemphill credit the Inferior Petrosal Sinus Sampling (IPSS) test as pinpointing her tumor. Cleveland Clinic Weston is among only a handful of medical practices in South Florida that use this technique.

Three Ways to Remove the Tumor

Most pituitary tumors are benign. The challenge is when it comes to removing the tumor.

“Pituitary tumors come in all shapes and sizes,” says Dr. Zoukaa Sargi, a head and neck surgeon at Sylvester Comprehensive Cancer Center at the University of Miami.

“There are non-functional tumors that do not secrete hormones that can reach extreme sizes of up to 10 centimeters before coming to medical attention. This is the equivalent of the size of a grapefruit,” he says.

“Then there are functional tumors that produce hormones that are typically discovered much sooner and can be only a few millimeters in size before coming to medical attention. A small proportion, less than 1%, are malignant,” he adds.

There are three treatment options for pituitary tumors: surgical removal, medical therapy and radiation.

“Medical therapy is only applicable in certain functional tumors that produce hormones,” says Dr. Ricardo Komotar, a neurosurgeon who is director of the Sylvester Comprehensive Cancer Center Brain Tumor Initiative.

“Radiation is an option primarily for inoperable tumors with high surgical risk. Surgical removal is the optimal treatment in the vast majority of pituitary cases, conferring the greatest benefit with the lowest morbidity,” he says.

Dr. Rupesh Kotecha, chief of radiosurgery at Miami Cancer Institute (MCI), part of Baptist Health South Florida, says there are a number of different hormones that the pituitary gland can secrete.

“Prolactin is the most common form of pituitary adenoma that’s functioning and accounts for 30% to 50%,” he said.

Excess prolactin can cause the production of breast milk in men and in women who are not pregnant or breastfeeding.

Kotecha said the next most common are growth-hormone secreting tumors, which occur in 10% of patients.

ACTH-secreting adenomas — the kind that Hemphill had — account for 5% of patients, while 1% secrete TSH, which causes the thyroid gland to be overactive.

MCI’s Proton Therapy delivers high-dose radiation that treats the tumor’s area, allowing for surrounding tissues and organs to be spared from the effects of radiation.

“The pituitary gland essentially sits in the middle of the brain,” says Kotecha. “It’s sitting in the middle of all of these critical structures.”

From https://www.miamiherald.com/living/health-fitness/article251653033.html

In Memory of Kandace Bankston ‘Kandy’ Kline ~ September 9, 2007

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in-memory

Kandy’s Story…

Hi, I am a 39 year old woman. I have a putitory tumor for the last fourteen years. the tumor has kiilled my putitory gland. I no longer produce any hormones. I have been on steroids for over fourteeen years and now my organs are getting damage from the steroids. The doctor say I will die if I take them I will die without them. Everytime they try to lower my steroids I catch a severe infection. I usually hospitalized every three or four months because my body won’t fight the infection so They put me in give me iv steroids and antibiotics.

I have gone down hill so bad in the last two years I can no longer work or even clean my house the doctor wants me to limit my walking to two hundred feet that is impossiable to do with children. this disease is so frustrating as no one understand what you or going though. My husband has done a lot of research on it and he a wonderful support system. I had a very hard time finding a doctor that can help me. I was hoping I could find someone to talk too that is going though the same thing.

I live in constant pain and now the depression is so bad. I try so hard to be upbeat for my family but it is a efffort to get out of bed. I am thinking about going to Nashville clinc or maybe the mayo clinc. If anyone knows about these clincs please email me K-K_Kline@hotmail.com I would very thankful for any suggestions.

Kandy passed away September 9, 2007

Kandy Klein long-time member of the message boards passed away September 9, 2007.

Information about services and donation information.

In Memory: Kandace Bankston ‘Kandy’ Kline, September 9, 2007

Leave a comment

in-memory

Kandy’s Story…

Hi, I am a 39 year old woman. I have a putitory tumor for the last fourteen years. the tumor has kiilled my putitory gland. I no longer produce any hormones. I have been on steroids for over fourteeen years and now my organs are getting damage from the steroids. The doctor say I will die if I take them I will die without them. Everytime they try to lower my steroids I catch a severe infection. I usually hospitalized every three or four months because my body won’t fight the infection so They put me in give me iv steroids and antibiotics.

I have gone down hill so bad in the last two years I can no longer work or even clean my house the doctor wants me to limit my walking to two hundred feet that is impossiable to do with children. this disease is so frustrating as no one understand what you or going though. My husband has done a lot of research on it and he a wonderful support system. I had a very hard time finding a doctor that can help me. I was hoping I could find someone to talk too that is going though the same thing.

I live in constant pain and now the depression is so bad. I try so hard to be upbeat for my family but it is a efffort to get out of bed. I am thinking about going to Nashville clinc or maybe the mayo clinc. If anyone knows about these clincs please email me K-K_Kline@hotmail.com I would very thankful for any suggestions.

Kandy passed away September 9, 2007

Kandy Klein long-time member of the message boards passed away September 9, 2007.

Information about services and donation information.

Maria, Pituitary Bio

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Originally from December 29, 2007

 

Hi there, I am 26 but I was diagnosed at the age of 16 with a pituitary tumor, 17 when I had removed the first time and 19 the seconded time.

Here is the story. I was pregnant at 15 and gave birth at 16. My son was born in June (I was 135 lbs) by December I was 240lbs. I had all the classis symptoms. Weight gain, thin skin, upper back hump, moon face, lack of a menstrual cycle, high cholesterol and the strata (all over stretch marks).

I was diagnosed in March in July (1999) since I live near Pittsburgh I had surgery with one of the doctors who developed the use of the Endoscope for removal of pituitary tumors. I had been told that the tumor would not come back. It was fine to have more kids. There was one in a billion chance that it would be a tumor that grows like cancer, and then there was a one in a million chance that there would be any of the tumor left behind that could grow back. A

fter words I lost most of the weight and the moon face. I had no need for hormones, because they only remove part of my pituitary, I also graduated high school and was married.

I felt very good when I gave birth to my 2nd son 22 months later (April 01). I was 160lbs. Well, I tried to ignore the weight gain, the lack of menstrual cycle, but when my hump started to come back and when in infant’s finger nail scratched me and I bleed, I self diagnosed this time and went to the doctor for confirmation.

I was 280lbs when I went in for the second time in November (2001). Now I am 90% sure there is a tumor up there I do not know I do not want to have a M I R to see. My husband and I will not have any more kids.

I still have a fear that it will come back on its on or if I suffer a body troma that causes the pituitary to enlarge that it will cause the tumor to grow and I will have to go through this again. I am still struggling to lose this weight. I am now 230

 

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In Memory: Kandace Bankston ‘Kandy’ Kline, September 9, 2007

Leave a comment

in-memory

Kandy’s Story…

Hi, I am a 39 year old woman. I have a putitory tumor for the last fourteen years. the tumor has kiilled my putitory gland. I no longer produce any hormones. I have been on steroids for over fourteeen years and now my organs are getting damage from the steroids. The doctor say I will die if I take them I will die without them. Everytime they try to lower my steroids I catch a severe infection. I usually hospitalized every three or four months because my body won’t fight the infection so They put me in give me iv steroids and antibiotics.

I have gone down hill so bad in the last two years I can no longer work or even clean my house the doctor wants me to limit my walking to two hundred feet that is impossiable to do with children. this disease is so frustrating as no one understand what you or going though. My husband has done a lot of research on it and he a wonderful support system. I had a very hard time finding a doctor that can help me. I was hoping I could find someone to talk too that is going though the same thing.

I live in constant pain and now the depression is so bad. I try so hard to be upbeat for my family but it is a efffort to get out of bed. I am thinking about going to Nashville clinc or maybe the mayo clinc. If anyone knows about these clincs please email me K-K_Kline@hotmail.com I would very thankful for any suggestions.

Kandy passed away September 9, 2007

Kandy Klein long-time member of the message boards passed away September 9, 2007.

Information about services and donation information.

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