Mid-2004, at age 24 and halfway through planning my wedding, I started gaining weight. Hair started growing on my chin. Unexplained bruises started appearing on my legs. The wedding dress I had ordered in January didn’t fit, and the salon had to rush-order an extra four yards of fabric, so the seamstress could insert an extra panel in the bodice.
No matter what I did, I couldn’t lose the weight. My face became round and red, and while I had never completely outgrown my teenage acne, it got 10 times worse. Even the strongest acne drug on the market, Accutane, couldn’t make it go away. I had been taking oral birth control pills to ease PMS cramps, but when I accidentally skipped a few pills in early 2006, my period never came. My gynecologist referred me to an reproductive endocrinologist who diagnosed me with Poly-Cystic Ovarian Syndrome. My blood sugar tested high; I was pre-diabetic. Unbeknownst to me, they tested my steroid levels. They were elevated, but out of the range of normal.
In September 2006, my father was watching a local NBC news (which was a bit unusual; he normally always watched the local ABC news). The health segment was on, which he normally ignores. They were profiling a woman with a rare disease called Cushing’s. The woman had the same round, red face, and distended stomach. He called for me to come see the TV. “I think that’s what you have.”
I found a general practitioner, as I didn’t have one at the time. Prior to my first appointment, I wrote out my health history. I attached pictures of myself as I used to be (prior to getting sick, I was about 130 pounds). I listed my complaints (always tired, bruising, no period, acne, high blood sugar, depression). I brought everything with me. His response? “You don’t have that; it’s too rare.” Instead he told me I had high blood pressure (another Cushing’s symptom), gave me a prescription and told me to come back in two weeks.
He bullied me into enrolling in a study on depression and anxiety through a local teaching hospital. In order to enroll, I needed to submit a urine test. The urine test showed above-normal steroid levels, but he continued to insist I did not have Cushing’s. The study weaned me off my anti-depressant and onto an anti-psychotic. I was to slowly increase my dosage, stay there for a month, then wean off. In the meantime, I was going back to the general practitioner every two weeks for a blood pressure check (paying a co-pay every time). The general practitioner continued to diagnose me with everything ELSE under the sun, even referring me to a neurologist to rule out early-onset Parkinson’s disease. The neurologist told me that my general practitioner was an “idiot” (his words) and said, “Get thyself to a endocrinologist.” I called for an appointment, but they couldn’t fit me in for two months.
In the meantime, the anxiety/depression study had me wean off the anti-psychotic, and I relapsed so deeply into depression, I contemplated but never attempted suicide.
I brought the same health history, photos and complaints to the endocrinologist in January 2007. I didn’t even finish my “presentation” when he said, “You have the most classic case of Cushing’s I’ve ever seen.” He explained what it was, and the different causes. He explained that I was most likely facing surgery, and I would need to contact an endocrinologist at one of two hospitals in the city. I went to the one that was able to give me the earlier appointment, which turned out to be the Hospital of the University of Pennsylvania.
My first appointment was very disappointing. They wanted to run their own battery of tests, the same tests I had already completed. To be honest, I broke down and cried on the exam table. But I did their tests. I got an MRI. They were concerned that my tests showed symptoms of Cushing’s, but there was no tumor visible on the MRI. They recommended I undergo a procedure called Inferior Petrosal Sinus Sampling. It happened in May 2007. I was sedated, and a catheter was inserted into the vein near my groin. Tubes were threaded up to my brain. I was given an injection of steroids, and my body’s reaction was measured. Results indicated the tumor was on the right side. Surgery was scheduled for the end of July 2007.
On July 3rd, after coming home from a meeting with a realtor where my then-husband and I put in an offer and good-faith deposit on our first home, I passed out and fell down the stairs. My family called 9-1-1, and the EMTs transported me to a local hospital’s emergency room. They tried 12 times to take blood, but were unsuccessful. They told me I was dehydrated, and to stop taking my blood pressure medication.
Two days later, I met with the ear, nose and throat doctor who would assist in the surgery. He explained his role, and the risks of the surgery, which included death. I asked how many have died from the surgery. He said that in the years he had been assisting the neurosurgeon who’d be doing my surgery, the only patient they’d ever lost on the table had undiagnosed blood clots in his lungs.
Three days later, while at work at a university in New Jersey, I collapsed again while standing at the copy machine. I was taken to a different hospital. My family arrived and explained my condition to them. They were unfamiliar with it, and asked for my endocrinologist’s phone number to consult with him. He directed them to check my lungs for clots. Sure enough, a CT scan showed massive blood clots on both lungs — they were 80% blocked. I was admitted to the ICU. I couldn’t even roll over in bed without gasping for breath. My surgery was cancelled.
I spent 5 days in the ICU while they did ultrasounds, CT scans and other tests. They wanted to give me Tissue Plasminogin Activator, a scary clot-busting drug that carries a risk of causing internal bleeding. I requested a transfer to the hospital where I was being treated for Cushing’s. I spent another five days in the hospital there, getting more ultrasounds and CT scans. They recommended a “wait and see” approach, and I was discharged on blood thinning medication.
Several months of doctor visits followed. I saw the endocrinologist, the neurosurgeon, the pulmonologist, and the hematologist. The first two argued with the second two about when surgery would be safe. I finally got word that my surgery would occur mid-December 2007.
The surgery itself was uneventful, and a suspicious mass was removed. My steroid levels plummeted (my pituitary had stopped producing steroids while the tumor made them) and I supplemented with hydrocortisone pills. At a follow-up appointment four months later, my endocrinologist was concerned that my pituitary had not “woken up” and started producing steroids on its own again. I had to wear a Medic Alert bracelet, because my body wouldn’t be able to cope with a major injury or illness.
It took almost a year for any steroids to be detected through blood tests. But in the meantime, the weight nearly melted off. My acne went away. My period returned. My blood pressure and blood sugar returned to normal. My depression eased. My hair thickened. I was able to sleep at night without a sleep aid. I stopped the blood thinners. Once my coritsol levels returned to normal, I only went back every six months, and later once a year, for follow-ups. My endocrinologist proclaimed me cured.
I am now 32 years old. My marriage did not survive Cushing’s disease, but I’m with someone new, and we have a healthy, happy baby boy. Part of the clots calcified in my lungs, and I will always be about 10% blocked (which means I’ll never run a marathon, but hey! I never planned to, haha). As the years pass, the struggle with Cushing’s feels like it happened to someone else.
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