Sunday, July 19, 2009

Silver Lining?

If you had told me back in that first week of March that my crash would have a silver lining I would have been highly skeptical. It was hard to imagine anything good coming from the broken bones, abrasions, aches and pains. Even now as I write this, knowing all I’m about to share, I’m not sure silver is the color I would choose to describe the ‘treasure’ that March 1st cloud concealed.

The first hint that there would be more to this story came in the initial radiology report: patient appears to have an enlarged pituitary gland, follow up testing should be pursued to evaluate further (or something like that). I asked my doctor about it and he said it was a common condition which for most people didn’t cause problems and we should focus on the issues at hand. That same week a second CT scan confirmed the enlarged sella but again I was told it was probably nothing to worry about. While I didn’t worry too much I did enough research to be aware of the issues and it remained in the back of my mind.

In May, after I was moderately healed and Egan had arrived, I pursued that ‘follow up testing’. I still wasn’t concerned. I wasn’t feeling any symptoms and expected the tests to show a condition that I might have to watch in the years to come. Unfortunately, my concern took a quantum step up midway through my MRI when the radiologist asked me 'Do you get a lot of headaches?'

Tumor is not a word you ever really want to hear your doctor say. At least until they discover the ‘male sexual enhancement tumor’ or the ‘detachable fat burning tumor’. ‘Benign tumor’ is obviously a better combination of words than ‘malignant tumor or cancer’ but benign tumor inside your head is not a happy combination. So, needless to say, I was less than thrilled when I heard my doctor say I had a Macro Pituitary Adenoma (tumor).

A quick geography/physiology lesson for those of you unfamiliar with the pituitary gland. It resides in your head, almost the geometric center of your head. While it isn’t technically part of your brain this may be one of those cases that can be added to ‘horse shoes’ and ‘hand grenades’ on the list of situations where close counts. Zooming in, the pituitary gland resides at the base of your brain as a protrusion off the hypothalamus. It sits on a small bone called the sella, just below the optic chiasm and between the left and right carotid arteries. At first glance, not the easiest place to swing a scalpel. The pituitary gland is the link between the nervous system and the endocrine system and is responsible for regulating hormone production, a relatively important task in the functioning of the human body.

As it turns out, pituitary tumors are fairly common. Studies have found that as many as one in five adults have a pituitary tumor. Fortunately, most don’t cause any problems and go unnoticed. The tumors that do get noticed usually cause problems in several ways. They can interfere with hormone production which may or may not be severe enough to warrant treatment. They can put pressure on or displace the optic chiasm, causing vision loss. They can also put pressure on the carotid arteries and possibly cause a rupture and hemorrhaging in your skull (should be avoided if possible).

So, getting back to my situation, my Macro Pituitary Adenoma is about the size of a large cherry tomato. The tumor has displaced my pituitary gland and probably inhibited some hormone production. Luckily, I have not noticed any symptoms. My vision has tested fine. My hormone levels are almost normal and my carotid arteries are still intact. But the tumor has already displaced my optic nerves and is very close to the carotid artery on the left. So, if it hadn’t been for my bike accident I may not have discovered this tumor until it was much more difficult to remove. This early discovery probably warrants the designation ‘silver lining’. However, they still need to go in and get this thing out so at the moment the silver looks a bit tarnished.

Monday morning Dr. K is going to polish it up for me. Sometime around 7 I will undergo transsphenoidal surgery to resect my adenoma. Luckily for me Dr. K performs these surgeries 3 or 4 times a week with very few complications.

Stay tuned, we’ll keep you posted.


PAB(a.k.a.CID) said...

my personal physician assures me that you will be fine.

believe me, she is good, she knows her stuff.

heal well, heal quickly my friend.

X Bunny said...

thanks for sharing this

we'll be sending good healing vibes your way

L said...

hi, i just read your 'silver lining' post and wanted to ask you a few questions!!
I have just been diagnosed with the same thing today infact! I didnt have any symptoms either and wanted to ask you about your experience of surgery and post operative pain!?!
I would appreciate if you could email me! I know its an experience you probably dont want to think about, but I would be interested to hear about your experience seeing as though i'm going to be going through the same thing!
my email adress is
I hope you are well!
Thanks for reading this and hope to hear from you,