Ask Dr. Gott: Persistent patient gets treatment

From http://www.montereyherald.com/health/ci_12177391?nclick_check=1

Peter Gott

Updated: 04/19/2009 01:42:53 AM PDT

Dear Dr. Gott: You have responded to several letters about the pituitary and adrenal glands, and I thought I should write to share my story. I am 75 years old, but this started when I was in my late teens. I started to have health problems but never gave them much thought.

Every doctor I saw gave me a diet sheet, treated my blood pressure and told me to lose weight. They didn't seem to care about the other symptoms and didn't understand I couldn't lose weight. Later, another doctor ordered tests. He told me that my adrenal glands were putting out too much hormone. The level should have been 17, but mine was 37. He gave me the diagnosis of Cushing's disease.

I became a research patient at The University of California Hospital in San Francisco. I had my adrenal glands removed in 1964. I was told I didn't have Cushing's anymore because the glands were gone, but now I had Addison's disease.

I now take two pills to replace hormones my adrenal glands produced. I have to be careful to limit my stress, but I am happy to be alive. I was told that if I went untreated, I would have only lived five years at most.

My primary reason for writing is to share my story and tell everyone not to be afraid to be a guinea pig. It was hard, but it was worth it. I have my life back.

Dear Reader: Cushing's disease, now known as Cushing's syndrome, is a condition in which the body is exposed to too much cortisol. This can occur because of abnormalities of the adrenal or pituitary glands, tumors that release the hormone adrenocorticotropin, and more.

Symptoms include high blood pressure, upper-body obesity, severe muscle weakness and fatigue, easy bruising, backaches and high blood sugar. In women, it may be accompanied by excess facial and body-hair growth and irregular and absent menstrual periods.

Treatment depends on the cause. In the late 1950s and early 1960s, not much was known about the disorder. You were lucky to have been diagnosed. Your surgery to remove the adrenal glands saved your life but made you rely on medication to do what your body is unable to do. Today, removing adrenal glands is a last resort used for persistent cases or those that are the result of tumors.

Addison's disease is the result of too little cortisol. Like its antithesis, it can be caused by abnormalities of the adrenal or pituitary glands, certain disorders, chronic infection, cancer and removal of the adrenal glands.

Symptoms include chronic and worsening fatigue, weight loss, muscle weakness, loss of appetite, nausea, vomiting, low blood pressure and more.

Treatment is replacing or substituting the hormones that are not being produced.

In both conditions, if there is an underlying cause, it must be treated. Both require monitoring by an endocrinologist.

To provide related information, I am sending you a copy of my Health Report "Medical Specialists." Other readers who would like a copy should send a self-addressed stamped envelope and a check or money order for $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Write to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, N.Y. 10016.

Wondering about the past

Technically, I didn't start to think about Cushing's until about 1983 when I was gaining weight uncontrollably even though I was staying faithful to my Weight Watcher's diet AND working out at the gym nearly every day.

I was always a chubby kid. Now I have to wonder if there was something lurking way back then. In 5th grade my parents were concerned about my weight and mentioned that my mom would have to get me a girdle. A few weeks later, when a new one arrived at home, I was worried but it turned out to be for my mom, not for me. Talk about a low blow to the self-esteem, though!

Later on, still chubby, my father went every now and again (maybe once a month?) to an endo in Providence. In those days, that was a big trip. I never knew what was going on - my parents didn't confide much in me, but later I wondered what kind of endocrine issue he might have had.

As a young adult, I know he had had awful, huge, acne. The kind where he stood on a stage in front of medical students. Maybe that was related to HIS secret endo issues.

Later, when I was a young adult, married only a few years, I had that awful, huge acne, too. Kids in the street would point and laugh at me. From people's expressions in the store, I gather that they were repulsed by this stuff on my face.

I couldn't take it anymore and got to a doctor. I was expecting the usual tetracycline I had taken throughout college. The doctor said that this acne was too bad for that. He injected antibiotics directly into each individual eruption. Then, I got the tetracycline.

I had trouble getting pregnant. I had a miscarriage early on. I finally took fertility drugs but they made me nuts. I was blessed to have one child. I am also an only child, as is my father.

I think that there are several generations of endo issues here. When my son was a teenager with awful acne, I had him tested for Cushing's before I took him to the dermatologist.