Sunday, July 15, 2018

Pre and Post Surgery Update


Where to begin? First of all I do apologize to those who were reading my blog that I have not kept up with it. Shortly after my last February entry I went to see the doctor and they advised me that I was diagnosed with Cushing's Disease. Since then I've been working hard to make sure I have enough funds for my leave of absence from work and doing a lot of research and now recovering from surgery.

To begin it starts out as Cushing's syndrome and in this link if you go further you'll find the description of where a pituitary gland tumour, benign can cause Cushing's disease. This is what I was finally diagnosed with after two MRI tests and other blood work.

The basics of this to put it simply are that my pituitary had a growth on it which then in turn caused my gland to over produce cortisol and other hormones over the course of who knows how long, we estimate about 6-7 years and therefore caused my diabetes mellitus type 2 (the diabetes we know to be common regarding blood sugar), not to be confused with diabetes insipidus (which I will mention later) among other things such as my weight gain, migraines, floaters in my vision, etc.


What I was told , admittedly frightened me, is that I would undergo surgery for this in order to cure it. It's the one cure that is known to work aside from in some cases pills or chemo as last resorts especially if the patient decides not to go for surgery. 99% of surgeries however go well.

I've been on medication for Diabetes type 2 for over a year now, since December of 2016. I've gone down part time at my job because of the stress etc. The cause of the tumour or growth is unknown and there are actually many people out there who have them who don't show any symptoms and have a regular normal life with no issue. However in my case I did when I suspect it got to be big enough to cause pressure on the gland itself to start secreting extra hormone levels.

So months have gone by in preparation of this possible surgery. It was inevitable. And so came June 25th whereby I was admitted to hospital for the surgery at 6 am. To start they did an MRI and by 7:50 I was in the operating room and holding onto the doctor's hand as they put me under and assured me that everything was going to be OK. I didn't really want to go under and it was more nerve wracking once I got there and it was in the works than it was in the months or weeks prior. I was told of course about one to two weeks prior all the risks that may happen, including death and where the tumour was etc that might happen.

The tumour was on the right side and I was told that the pituitary gland, for those that don't know, sits right under your brain really and kind of in the middle of your carotid arteries and in front of and just under your optic nerves. Therefore if one of those arteries were cut and the tumour had been attatched I could have been dead, on the other hand if it had been putting pressure on my optic nerves and they had cut there I could be blind. I could also get a Cerebral Spinal Leak from the surgery where if there was any little pin prick of a hole then I'd get leakage of brain fluid and could also get Meningitis and also could die. So far, I'm still here.

To got through what I have has been frustrating. I'm now going to go through the details from waking up and onward. So I woke up in observation, I recall them saying my name and talking to me and telling me things were ok and going through a series of being asked my name, where we were, why we were there and to hold my hands up, read off and eye chart, lift my feet and tell the date. I was woken every two hours to do these tests and to take blood. I recall the first waking of being disoriented from the anesthetic and everything being a blur and people talking to me and saying my name and to open my eyes and my parents being there. I remember asking for my owl to cuddle and that I wanted to sleep. I remember also throwing up at least once at that point.

Day two. Still disoriented, still going through tests. I could drink at that point. That however did not go well. I threw up a second time, my stomach had been filled with blood and I literally spewed it everywhere. The nurses however were right on it and three of them were to my aid to clean me up and make sure I was ok. I had a sling around my nose to keep in all the mucus and stuff from the surgery. I was plugged into a catheter still also and they were monitoring my urine. Why you ask? Imagine this, they go into your brain, poke around, remove a growth that's been sitting there for years, imagine it kind of like a parasite that's been telling your brain to make x amount of hormones all this time. So now it's been removed and now your gland is like where did it go and what do I do? Now there are two parts of your pituitary. A front and back. The front is where the growth was and none of the gland was luckily sliced off apparently and that's where the cortisol etc is made. However there is a hormone called ADH that controls urine output through your kidneys. If this is not working your kidneys suck up all water and drain it out no matter what not just the bad stuff and the sodium etc, everything. Though that part was not actually touched it was kind of, how shall we say, tasered or zapped.

Day 3. I was able to eat. I was able to sit up and do stuff a bit but I did throw up a third time in the morning the remainder of whatever blood was in there. I also had the sling (the padding or gauze wrapped around my head and under my nose ) semi removed from my nose and the balloon that was put up there holding it all open was deflated. I still had some mucus and blood but it was healing. I was then moved also to another room as I was not in intensive care as much. While I was in main observation I was unable to sleep well. The two hour testing turned to every four hours but I of course had the complaints of other patients, their families as well. It was not pleasant. I had visitors but was still groggy and sleepy earlier in the day and later in the day they nurses gave me a wipe down and had me get up to walk as I also had these special cuffs on my legs to keep me from losing circulation. I was able to take a nice little walk around the ward.

Day 4. I was able to be wide awake, stand up and walk around. I had a visitor and was able to do some stuff. I was definitely able to eat by this point though small amounts I actually got used to hospital food which was not bad at all. They still had me doing tests and they still had me hooked up to the catheter. I was able to take a shower finally.

Day 5. I was able to dress in pjs of my own, have the catheter out and a full proper shower again. It seems that my urine at the time was doing ok as was my sugars. They were monitoring my medications etc as well to regulate it. Now I was on certain meds which I am continuing called Cortef. I will speak more on that in a moment.

I had the doctors see me every day to check in with me and by Saturday I was able to go home. It was a very hot day and one day before Canada day. I am not allowed to lift anything more than 20 lbs, I am not allowed to bend over. I have to watch what I eat, take my meds and I still wake up a lot. I was prescribed my diabetes meds as usual but Cortef is to replace gradually and make my body make up for the cortisol that is now missing as they made it go down from 400 to 40 in like the first two days due to the surgery. The complication with this is that originally the pharmacy read the prescription wrong and I was on only two a day where I should have been on four a day, so I was exhausted. I was dizzy and tired and the heat on top of that. It was horrible. Now after my parents left, I was seemingly ok, they left on the Monday morning and the temperature started going down. However another complication became apparent on Thursday. Diabetes insipidus which as I said earlier has nothing to do with the sugar in your blood but your urine output. Peeing every 30 minutes what would seem like a small bucket and ending up filling a 24hr urine jug in under 8 hours with diluted and near clear like water urine is not a good thing. Now this is week three of being out of hospital and I'm now doing more blood tests and on special ADH pills to combat that. The weather has also been trying as it's been very hot here where I am and I do not have an AC unit. I also had the concern of being alone and having to do certain things to avoid a CSF leak which I now have determined that it might actually be a cold or allergies for what seems to be a bit of a runny nose , likely cold or just simply due to the crusting and the plastic in my nose still and stitching that I'm sneezing 40 times a day literally. To determine a leak I would have to taste salt or metallic, and have puddles running down my throat or through my nostrils. Neither of that is happening. Concentration would have been an issue and vision and balance. As well as pain, such as headache or in the neck. None of that is happening either with the exception of sitting too long.

So there you have it thus far. I will be off at least until end of August and at most end of September. It's still trying and there will be more tests and things to come. July 26th I get the plastic and stitches out hopefully and then as instructed further rest. I feel all I've been doing is napping and trying to catch up on sleep and though others said I would be wanting to go back to work sooner , I find that doubtful with all the things going on and things I have to do and take care of. Keeping myself occupied has not been an issue but I must say, though I don't mind the quiet sometimes, I do miss actually talking to people about things.

More to come later. I will try to keep this as updated as possible, when I can and at times that I am well enough to do so.

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