Well, I returned from my appointment at MDA last night worn to a frizzle. The day brought good news and not so good news. My day started at 7 am and I walked out of the last appointment at 5:15. I was pricked, prodded, poked and dilated all day long. I was able to slip in a banana for a snack during one of my many walks to an appointment and finally eat a meal at the airport on the way home during the evening.
Good news is the prolactin level is down from 338 to 144. So, the cabergoline is working. The level has to get down to 25 or below to be normal. Not so good news is all my other thyroid, hormone, and testosterone levels are exactly the same as last time which is just about zilch. So, they are doubling the dose of my medications for six weeks......even the drug which causes the side effects......yippee ay aye. My first larger dose will be tonight and I already have a headache before I even take the medicine. The mri has been postponed until the levels are medicated back to normal, possibly as much as six months out.
My biggest mistake was not taking someone with me on this trip. I thought since I was just going for lab work and vision testing that it would be a piece of cake. WRONG. I should have taken Alma with me. My vision testing began at 9:30 of which they promptly dilated my eyes. They dilated my eyes 3 times during the entire day as they continued the testing and sending me from various departments. If you have had your eyes dilated, you know it is difficult to see. Now try walking through a large medical complex trying to read signs on the wall telling you how to get to different places. It was not fun. I needed Alma there to take me by the hand and lead me; just like I have asked the Lord to take my hand and lead me through this journey.
The vision tests all seem to be good. No indication of the tumor causing problems with the optic nerve. Praise God.
As I start this new dosage, please pray the side effects will be minimal and will be tolerable. I've been able to manage the effects of the past dosage. Hopefully, I can do the same with this new dosage. I also ask for prayers in getting rid of a headcold I have had since Monday after Thanksgiving; and that my immune system would improve. My whole family has been sick and it seems as we just keep passing it back and forth, so I pray for all of our health.
But, Hey! Things are going well and we are going to be fine. Life will bring you pain all by itself. It is our responsibility to create joy. If we live, we are living for the Lord, and if we die, we are dying for the Lord. Romans 14:8
Until next time, Blessings.
Wednesday, December 10, 2008
Thursday, December 4, 2008
CONTINUING THE JOURNEY
Thanksgiving has come and gone but leftovers are still in the fridge. Only a few more days left--thank goodness. I had four real good days (Thurs - Sunday) of feeling great and then Monday I started up with a head cold. I have been fighting that all week. I guess this medicine really has shot my immune system as it seems everything that passes my way jumps on me. I go to MD next week for lab tests and vision test. Pray that the lab tests show the medicine is working as that means the tumor may be shrinking.
Wednesday, November 26, 2008
HAPPY THANKSGIVING
Tomorrow is Thanksgiving yet everyday is a day of thanksgiving for me. After being in bed for 5 days (probably should have been 7 or 8) I am back among the living. Although I am not 100%, I am functioning and have been able to return to work (and I did get my Whataburger). I tried to revive the morning workout routine but I am not there yet. Have had a couple of episodes where I get really faint and dizzy and have to just stay horizontal for about 20 minutes so guess I will continue to keep the heart rate down. (Alma will have to stay fully clothed as she walks through the house-ha)
The main side effect of the medication, other than depleting my immune system, has been increasing the severity of the headaches. Sometimes it feels like I have a ball pin hammer beating on my head which of course just makes life difficult. Nevertheless, we will persevere through this giving thanks for everyday I make it through.
MDA has moved my appointments up to December 9th, which I am happy about. I hated having to wait until end of December to see how this medicine is working.
I have to make mention here of some unsolicited support I have received from some very special people. First, to the board, staff, children, and parents at Mid Valley Christian School for their prayers and extreme acts of kindness. Second to M Jones, K Jones, their children, M McCaleb, M Hesson, C Selman for the skeet shoot held in my behalf. It was unbelievably fun and well organized. There were some EXCELLENT skeet shooters and it was such a blast to watch. Scott came out and shot (first time he ever shot a shotgun---I know, I know--I deprived him as a child--actually, dad just wasn't fun to hang around with when Scott was a teenager) and he did very well. It must be all that hand/eye coordination from video games.
I pray that everyone has a wonderful Thanksgiving holiday. Reflect on Life--everyday is a gift from God. Be thankful for it. Reflect on your family--Be thankful for each of them and the time you have to spend with them. Be thankful for your health--in sickness and in health, be thankful for God's healing power. Be thankful for Jesus and His supreme sacrifice, His love, and His grace. Happy Thanksgiving.
The main side effect of the medication, other than depleting my immune system, has been increasing the severity of the headaches. Sometimes it feels like I have a ball pin hammer beating on my head which of course just makes life difficult. Nevertheless, we will persevere through this giving thanks for everyday I make it through.
MDA has moved my appointments up to December 9th, which I am happy about. I hated having to wait until end of December to see how this medicine is working.
I have to make mention here of some unsolicited support I have received from some very special people. First, to the board, staff, children, and parents at Mid Valley Christian School for their prayers and extreme acts of kindness. Second to M Jones, K Jones, their children, M McCaleb, M Hesson, C Selman for the skeet shoot held in my behalf. It was unbelievably fun and well organized. There were some EXCELLENT skeet shooters and it was such a blast to watch. Scott came out and shot (first time he ever shot a shotgun---I know, I know--I deprived him as a child--actually, dad just wasn't fun to hang around with when Scott was a teenager) and he did very well. It must be all that hand/eye coordination from video games.
I pray that everyone has a wonderful Thanksgiving holiday. Reflect on Life--everyday is a gift from God. Be thankful for it. Reflect on your family--Be thankful for each of them and the time you have to spend with them. Be thankful for your health--in sickness and in health, be thankful for God's healing power. Be thankful for Jesus and His supreme sacrifice, His love, and His grace. Happy Thanksgiving.
Tuesday, November 18, 2008
FLU!
Well, they said that the medication I was on would weaken my immune system and it did. I woke up Sunday morning with the flu and here it is Tuesday and I am just beginning to be able to get vertical. It has been so long since I have had even a cold and this hit me really hard. Terrible sore throat, a cough that would take the life out of me, and headaches. The flu has made the headaches so much worse. I received the ok to start on zithromax antibiotics and after two doses am starting to feel better. I know I will be on the road to recovery when I am hungry for a Whataburger. As of now, though, I will stick with chicken noodle soup, baked potatoes, and warm liquids. I am not a good patient, but my wonderful "nurse" Alma has been taking great care of me as well as my boys. Pray for God's healing power and that this flu is broken and rid from me....and that I can enjoy a Whataburger real soon.
Thursday, November 13, 2008
AMAZING GRACE
Just wanted to share a link to a beautiful song sung by a fabulous quartet.
http://www.youtube.com/watch?v=YtrnB4FZ-yc
Be Blessed everyone.
http://www.youtube.com/watch?v=YtrnB4FZ-yc
Be Blessed everyone.
Tuesday, November 11, 2008
SURGERY POSTPONED
I apologize for getting this great news on the blog a day late but I was relaxing for one night and now am in a hotel room in San Antonio, TX. God has indeed heard our prayers and surgery has been delayed and possibly taken off the agenda. Dr. McCutcheon confirmed what the endocronologist has said. I feel it is best to just post the email from Dr McCutcheon which explains things much better.
Dear Mr. Summers,
What we had said during the visit was this: the likelihood was highest that the prolactin would be normal, in which case surgery would be done….BUT, if prolactin was elevated (as yours turned out to be), then we would use the medication as the first line of defense. It is never risk-free to have an operation, and treatment of a prolactin-producing pituitary tumor with medication has a long history of success with little risk attached. True, it doesn't always work, but it usually (90% of the time) does. You are not delaying the inevitable--cabergoline has a high chance of success. Thus, I agree with Dr. Devin that you should cancel the operation for now. I do not know what exact followup schedule she has proposed for you, but it would be typical to repeat the prolactin level after taking the cabergoline for a month or two, to allow for dose adjustment, and to repeat the MRI no later than 6 months after starting treatment. In this way, a decision can be taken as to the success of the cabergoline. It does not prevent or hinder the doing of an operation, should it become evident that the cabergoline is imperfectly effective. However, the drug may save you from having to have an operation, which is a very great benefit. Should there be a partial success, with (say) reduction of the prolactin level but not to normal, and/or partial shrinkage of the tumor, then the concept of surgery can certainly be revisited. A smaller tumor doesn't really make surgery easier, so the reason to take the cabergoline would not be to "prepare" the tumor for an operation, but to try to prevent an operation from being needed.
For all these reasons, I have asked Paula to cancel the surgery--Dr. Devin will take the primary role in managing the medication, but she will send you back to me should there be any reason to reconsider the surgical option.
Best regards,
Ian McCutcheon
As you can read in the email, 90% odds are pretty good and ones which I will gamble on. This has been an emotional roller coaster for my family and I since finding out about this tumor on September 17th. I am so grateful to be on a level ride right now as we go through this treatment via medicine. I am so grateful for the literally thousands of friends and friends of friends who have lifted me up in prayer. Our Great God has heard those prayers. Praise Him! Please continue to pray that the side effects will be minimal and a tremendous reduction in the size of the tumor will be revealed in the mri to be taken January 7, 2009.
I will close with today's devo from Max Lucado who is one of my favorite author and preacher.
My help comes from the LORD, who made heaven and earth.
Psalm 121:2 (NCV)
For many people, life is—well, life is a jungle. Not a jungle of trees and beasts….Our jungles are comprised of the thicker thickets of failing health, broken hearts, and empty wallets….We don’t hear the screeching of birds or the roaring of lions, but we do hear the complaints of neighbors, and the demands of bosses.
Whether you are a lamb lost on a craggy ledge or a city slicker alone in a deep jungle, everything changes when your rescuer appears.
Your loneliness diminishes, because you have fellowship. Your despair decreases, because you have vision. Your confusion begins to lift, because you have direction.
You haven’t left the jungle. The trees still eclipse the sky, and the thorns still cut the skin….It hasn’t changed, but you have. You have changed because you have hope. And you have hope because you have met someone who can lead you out.
Amen and thank you God for showing us the way and leading us out.
Dear Mr. Summers,
What we had said during the visit was this: the likelihood was highest that the prolactin would be normal, in which case surgery would be done….BUT, if prolactin was elevated (as yours turned out to be), then we would use the medication as the first line of defense. It is never risk-free to have an operation, and treatment of a prolactin-producing pituitary tumor with medication has a long history of success with little risk attached. True, it doesn't always work, but it usually (90% of the time) does. You are not delaying the inevitable--cabergoline has a high chance of success. Thus, I agree with Dr. Devin that you should cancel the operation for now. I do not know what exact followup schedule she has proposed for you, but it would be typical to repeat the prolactin level after taking the cabergoline for a month or two, to allow for dose adjustment, and to repeat the MRI no later than 6 months after starting treatment. In this way, a decision can be taken as to the success of the cabergoline. It does not prevent or hinder the doing of an operation, should it become evident that the cabergoline is imperfectly effective. However, the drug may save you from having to have an operation, which is a very great benefit. Should there be a partial success, with (say) reduction of the prolactin level but not to normal, and/or partial shrinkage of the tumor, then the concept of surgery can certainly be revisited. A smaller tumor doesn't really make surgery easier, so the reason to take the cabergoline would not be to "prepare" the tumor for an operation, but to try to prevent an operation from being needed.
For all these reasons, I have asked Paula to cancel the surgery--Dr. Devin will take the primary role in managing the medication, but she will send you back to me should there be any reason to reconsider the surgical option.
Best regards,
Ian McCutcheon
As you can read in the email, 90% odds are pretty good and ones which I will gamble on. This has been an emotional roller coaster for my family and I since finding out about this tumor on September 17th. I am so grateful to be on a level ride right now as we go through this treatment via medicine. I am so grateful for the literally thousands of friends and friends of friends who have lifted me up in prayer. Our Great God has heard those prayers. Praise Him! Please continue to pray that the side effects will be minimal and a tremendous reduction in the size of the tumor will be revealed in the mri to be taken January 7, 2009.
I will close with today's devo from Max Lucado who is one of my favorite author and preacher.
My help comes from the LORD, who made heaven and earth.
Psalm 121:2 (NCV)
For many people, life is—well, life is a jungle. Not a jungle of trees and beasts….Our jungles are comprised of the thicker thickets of failing health, broken hearts, and empty wallets….We don’t hear the screeching of birds or the roaring of lions, but we do hear the complaints of neighbors, and the demands of bosses.
Whether you are a lamb lost on a craggy ledge or a city slicker alone in a deep jungle, everything changes when your rescuer appears.
Your loneliness diminishes, because you have fellowship. Your despair decreases, because you have vision. Your confusion begins to lift, because you have direction.
You haven’t left the jungle. The trees still eclipse the sky, and the thorns still cut the skin….It hasn’t changed, but you have. You have changed because you have hope. And you have hope because you have met someone who can lead you out.
Amen and thank you God for showing us the way and leading us out.
Saturday, November 8, 2008
GOD IS SO GOOD------NO, GOD IS GREAT!!!!!!
Surgery may NOT be in my future. Wonderful news!! I received a phone call from my endocronologist at 5 pm on Friday. It was her 4th call as I had missed the previous 3 because I was on the phone. I thank God she was persistant. I wonder if that would have happened with the local docs or is that something unique to MD Anderson.
Anyway, as mentioned in my previous blog, we were waiting on the last test to see if the tumor was a producing tumor or not. The test finally came back and my tumor is a producing tumor; producing the hormone prolactin. My prolactin levels are 12 times what they should be. What this means is it is possible to treat this type of tumor with medication first to see if the medication can shrink the tumor; if not we go to surgery. She said she was going to confer with the neurosurgeon and a final decision made on Monday 11/10. Being that surgery is currently set for 11/17, not having to have surgery would be an answer to thousands of prayers. God is hearing and answering those prayers......just in the nick of time.
The medication, of course, has some side effects, one of which is headaches--oh great!, nausea--lovely, and fatigue--yawn. But, if it works, it is better than surgery. Although, I really was looking forward to 4 weeks of rest; oh, how I was looking forward to that. Oh well.
The doctor said there is an 80% chance the medication will reduce the size of the tumor and possibly eliminate it. If it doesn't, it will at least shrink the tumor making the surgery easier when we have to do it.
Prolactinoma is a benign tumor in the area of your pituitary gland that produces prolactin, and is the most common type of pituitary tumor. This prevalant tumor can cause overproduction of prolactin, resulting in high levels of prolactin and corresponding low levels of estrogen in women and testosterone in men. (I wonder if the person who invented viagra had a pituitary tumor and didn't know it :)
Symptoms for prolactinoma, when experienced, are the same as those for hyperprolactinemia plus headaches and vision changes.
When treatment for prolactinoma is necessary, it is often effectively treated with medications to restore your prolactin hormone levels back to normal by mimicking dopamine effects.
Bromocriptine and cabergoline are drugs used to reduce prolactin levels in both men and women. Usually taken for life, most responding with lower hormone levels. Bromocriptine may cause side effects, such as:
fatigue
headache
dizziness
constipation
lightheadedness
nasal congestion
abdominal cramps
nausea & vomiting
Cabergoline causes significantly fewer side effects, is more expensive and may have a heart valve issue with high doses.
Anyway, as mentioned in my previous blog, we were waiting on the last test to see if the tumor was a producing tumor or not. The test finally came back and my tumor is a producing tumor; producing the hormone prolactin. My prolactin levels are 12 times what they should be. What this means is it is possible to treat this type of tumor with medication first to see if the medication can shrink the tumor; if not we go to surgery. She said she was going to confer with the neurosurgeon and a final decision made on Monday 11/10. Being that surgery is currently set for 11/17, not having to have surgery would be an answer to thousands of prayers. God is hearing and answering those prayers......just in the nick of time.
The medication, of course, has some side effects, one of which is headaches--oh great!, nausea--lovely, and fatigue--yawn. But, if it works, it is better than surgery. Although, I really was looking forward to 4 weeks of rest; oh, how I was looking forward to that. Oh well.
The doctor said there is an 80% chance the medication will reduce the size of the tumor and possibly eliminate it. If it doesn't, it will at least shrink the tumor making the surgery easier when we have to do it.
Prolactinoma is a benign tumor in the area of your pituitary gland that produces prolactin, and is the most common type of pituitary tumor. This prevalant tumor can cause overproduction of prolactin, resulting in high levels of prolactin and corresponding low levels of estrogen in women and testosterone in men. (I wonder if the person who invented viagra had a pituitary tumor and didn't know it :)
Symptoms for prolactinoma, when experienced, are the same as those for hyperprolactinemia plus headaches and vision changes.
When treatment for prolactinoma is necessary, it is often effectively treated with medications to restore your prolactin hormone levels back to normal by mimicking dopamine effects.
Bromocriptine and cabergoline are drugs used to reduce prolactin levels in both men and women. Usually taken for life, most responding with lower hormone levels. Bromocriptine may cause side effects, such as:
fatigue
headache
dizziness
constipation
lightheadedness
nasal congestion
abdominal cramps
nausea & vomiting
Cabergoline causes significantly fewer side effects, is more expensive and may have a heart valve issue with high doses.
Pray for a confirmation of no surgery.
Tuesday, November 4, 2008
VISIT WITH DR MCCUTCHEON
More steps of my journey have been completed as today I met with the Neurosurgeon, Dr. Ian McCutcheon, as well as had lab work done, met with many depts. of MDA and visited with the Endocronologist. God's hand was definitly there today as everything ran so smoothly. Appointments ran on time, EVERYONE was so helpful and friendly. The second person I met with this morning was a lady who took my vitals. When I finished, she said, "give me a hug Mr. Summers, I want you to know everythings going to be ok and we will take care of you." I almost cried.
Anyway, the tumor is causing problems with thyroids, hormones, and testosterone. All levels are very low and they are going to put me on medication to replace those prior to surgery. We are also waiting lab reports for levels of prolactin. If those levels are real high, then additional medicine will be prescribed to bring those levels down. Sometimes, if the tumor is producing prolactin, then medication can reduce that and often times shrink the tumor. However, due to the size of the tumor, the symptoms, and how close it is to the optical nerves, Dr. McCutcheon recommends that regardless of the level of prolactin being produced, that it be removed. I am in agreement.
Intially we had been given a "soft" date for surgery of November 11th. Once we were with the Dr., the choices given were this Friday November 7th or Monday November 17th. As much as I want this removed, I felt it best to wait till November 17th in order to get some preparations made and take care of some deals hanging at work. That is the week prior to Thanksgiving so things will begin to slow down at work and perhaps make things a little easier on everyone.
The doctor says to prepare for a 3-4 day hospital stay. Typical is 3 days but if there is a spinal fluid leak, an extra day will be required. Time out of work will be 3 - 4 weeks. He said after 2 weeks I will get really bored and want to go back to work but to hold off another week at least. Guess I can get some online Christmas shopping done.
I have more peace about my situation after visiting with Dr. McCutcheon. God delivered me to the right neurosurgeon.
The Rotary House is the place to stay if you ever have to come to MDA. It is right across the street from MDA and is connected by a skybridge. You never have to step outside and plenty of places to eat. The hotel is owned by MDA but managed my Marriott. Make your reservations early. When we tried to make reservations for the week of surgery, there were none to be had. When I was mentioning this to the driver on our way back to the airport, he told me to write down the dates I needed and he would see what he could do as he used to work there. While waiting on the plane, he called and gave me my confirmation numbers. God is definitly in control.
As I sit waiting, for the plane to head home, I thank everyone for their prayers and continued prayers. And thank you Pat B. for your comments and scripture. I will close with that. May God Bless.
In Joshua Chapter 1 vs. 9 God said to Joshua, "Remember that I commanded you to be strong and brave. Don't be afraid because the Lord your God will be with you everywhere you go".
Anyway, the tumor is causing problems with thyroids, hormones, and testosterone. All levels are very low and they are going to put me on medication to replace those prior to surgery. We are also waiting lab reports for levels of prolactin. If those levels are real high, then additional medicine will be prescribed to bring those levels down. Sometimes, if the tumor is producing prolactin, then medication can reduce that and often times shrink the tumor. However, due to the size of the tumor, the symptoms, and how close it is to the optical nerves, Dr. McCutcheon recommends that regardless of the level of prolactin being produced, that it be removed. I am in agreement.
Intially we had been given a "soft" date for surgery of November 11th. Once we were with the Dr., the choices given were this Friday November 7th or Monday November 17th. As much as I want this removed, I felt it best to wait till November 17th in order to get some preparations made and take care of some deals hanging at work. That is the week prior to Thanksgiving so things will begin to slow down at work and perhaps make things a little easier on everyone.
The doctor says to prepare for a 3-4 day hospital stay. Typical is 3 days but if there is a spinal fluid leak, an extra day will be required. Time out of work will be 3 - 4 weeks. He said after 2 weeks I will get really bored and want to go back to work but to hold off another week at least. Guess I can get some online Christmas shopping done.
I have more peace about my situation after visiting with Dr. McCutcheon. God delivered me to the right neurosurgeon.
The Rotary House is the place to stay if you ever have to come to MDA. It is right across the street from MDA and is connected by a skybridge. You never have to step outside and plenty of places to eat. The hotel is owned by MDA but managed my Marriott. Make your reservations early. When we tried to make reservations for the week of surgery, there were none to be had. When I was mentioning this to the driver on our way back to the airport, he told me to write down the dates I needed and he would see what he could do as he used to work there. While waiting on the plane, he called and gave me my confirmation numbers. God is definitly in control.
As I sit waiting, for the plane to head home, I thank everyone for their prayers and continued prayers. And thank you Pat B. for your comments and scripture. I will close with that. May God Bless.
In Joshua Chapter 1 vs. 9 God said to Joshua, "Remember that I commanded you to be strong and brave. Don't be afraid because the Lord your God will be with you everywhere you go".
Sunday, November 2, 2008
P-R-E-S-S ON
I returned home Friday evening, to celebrate my 22nd wedding anniversary with my bride Alma, after spending most of the week at the ICSC Texas Retail Roundup Convention. One of the highlights of each convention is the prayer breakfast hosted by the Retail Christian Network. It is always refreshing to meet others in the industry who call Christ their Savior, enjoy a good breakfast, hear a testimony or brief message about our Lord, and pray.
God is so amazing and He always assures me in different ways that He is in control. The message was delivered by Tarrant (last name not remembered at this time) with Panera Bread. He is a graduate of TCU and played football there. Naturally, his message had a football theme but Phillipians 3:12-14 was the verse his message centered around.
12 Not that I have already obtained all this, or have already been made perfect, but I press on to take hold of that for which Christ Jesus took hold of me. 13 Brothers, I do not consider myself yet to have taken hold of it. But one thing I do: Forgetting what is behind and straining toward what is ahead, 14 I press on toward the goal to win the prize for which God has called me heavenward in Christ Jesus.
He used the example of a football team being behind in the score and the quarterback working hard to rally his team to a last minute victory. We, too, as we go through life, have to keep our sight on the goal, the prize, the victory that our faith will bring. We will have trials and tribulations but we must press on.
P-Patience. Phillipians 4:6 - 7 Do not be anxious about anything but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.
R-Reflect. Think about what you know, about what you have been trained to do.
E-Extra Effort. Go the extra mile
S-Support. Get others to believe in the vision, the goal. Encourage others.
S-Score. Finish Strong. Battles will be lost, but don't lose the war.
Jesus was the best quarterback ever....and His best score was for you and me on the cross.
Don't worry about what you don't have control over. That is what I keep telling myself with regard to my situation. I take comfort knowing that God is in control.
Matthew 6: 25 - 34
25 "Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more important than food, and the body more important than clothes? 26 Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? 27 Who of you by worrying can add a single hour to his life?
28 "And why do you worry about clothes? See how the lilies of the field grow. They do not labor or spin. 29 Yet I tell you that not even Solomon in all his splendor was dressed like one of these. 30 If that is how God clothes the grass of the field, which is here today and tomorrow is thrown into the fire, will he not much more clothe you, O you of little faith? 31 So do not worry, saying, 'What shall we eat?' or 'What shall we drink?' or 'What shall we wear?' 32 For the pagans run after all these things, and your heavenly Father knows that you need them. 33 But seek first his kingdom and his righteousness, and all these things will be given to you as well. 34 Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.
I leave tomorrow to be able to make my appointment at 7 am on Tuesday morning. I will write an update Tuesday afternoon or evening. May God Bless.
God is so amazing and He always assures me in different ways that He is in control. The message was delivered by Tarrant (last name not remembered at this time) with Panera Bread. He is a graduate of TCU and played football there. Naturally, his message had a football theme but Phillipians 3:12-14 was the verse his message centered around.
12 Not that I have already obtained all this, or have already been made perfect, but I press on to take hold of that for which Christ Jesus took hold of me. 13 Brothers, I do not consider myself yet to have taken hold of it. But one thing I do: Forgetting what is behind and straining toward what is ahead, 14 I press on toward the goal to win the prize for which God has called me heavenward in Christ Jesus.
He used the example of a football team being behind in the score and the quarterback working hard to rally his team to a last minute victory. We, too, as we go through life, have to keep our sight on the goal, the prize, the victory that our faith will bring. We will have trials and tribulations but we must press on.
P-Patience. Phillipians 4:6 - 7 Do not be anxious about anything but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.
R-Reflect. Think about what you know, about what you have been trained to do.
E-Extra Effort. Go the extra mile
S-Support. Get others to believe in the vision, the goal. Encourage others.
S-Score. Finish Strong. Battles will be lost, but don't lose the war.
Jesus was the best quarterback ever....and His best score was for you and me on the cross.
Don't worry about what you don't have control over. That is what I keep telling myself with regard to my situation. I take comfort knowing that God is in control.
Matthew 6: 25 - 34
25 "Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more important than food, and the body more important than clothes? 26 Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? 27 Who of you by worrying can add a single hour to his life?
28 "And why do you worry about clothes? See how the lilies of the field grow. They do not labor or spin. 29 Yet I tell you that not even Solomon in all his splendor was dressed like one of these. 30 If that is how God clothes the grass of the field, which is here today and tomorrow is thrown into the fire, will he not much more clothe you, O you of little faith? 31 So do not worry, saying, 'What shall we eat?' or 'What shall we drink?' or 'What shall we wear?' 32 For the pagans run after all these things, and your heavenly Father knows that you need them. 33 But seek first his kingdom and his righteousness, and all these things will be given to you as well. 34 Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.
I leave tomorrow to be able to make my appointment at 7 am on Tuesday morning. I will write an update Tuesday afternoon or evening. May God Bless.
Tuesday, October 28, 2008
Praise
Although my post today doesn't have much to do with my journey, I wanted to give praise to God for two events which happened today. First, my oldest son (20) obtained a job today which we have been praying for. Second, my youngest (17) was named Student of the Week at his high school.
I also want to thank everyone for your continued prayers. November 4 will be my appt with the neurosurgeon and surgery is tentativley scheduled for November 11th. Keep the surgeon in your prayers as well that he will have a stable hand.
I also want to thank everyone for your continued prayers. November 4 will be my appt with the neurosurgeon and surgery is tentativley scheduled for November 11th. Keep the surgeon in your prayers as well that he will have a stable hand.
Saturday, October 25, 2008
Insurance Update
Sorry for the length in time from the last update. Since I posted so much information last time I thought I would give everyone a chance to read and watch the surgery video. The video is not for weak stomachs but it does make you give thanks to God that the doctors are out there that can perform such delicate surgeries and the technology has been developed to make the surgery perhaps a little less delicate than what it used to be.
Late this week, I was notified that the surgery would not be taken care of by insurance, even with the local neurosurgeon stating in his referral comments that this particular type of delicate neurosurgery could not be performed in the Valley (add another nerve of fright). However, Alma did some internal research and found out that MDA is a provider for another health plan that VB Health Systems has a working relationship with and that relationship allows the insurance to cover on an 80/20 basis. Praise God! We are awaiting formal written authorization. Even still, I am not sure that formal written authorization will guarantee payment as back in January, Scott had some medical needs while at college. We called and received written authorization. Last week, the provider of the services called and said VB Health Sytems had called them asking them to return the funds provided them for services. When asked why, VBHS said since VBHS was a self insured group, they could change their mind. Now isn't that something!? We have not been notifed personally by VBHS that they are requesting funds back.
I continue to be touched and humbled and brought to tears at the support that has been offered via prayer, comments, love and even fundraising to help with medical expenses. As I have told several, I have never accepted charity and thank God, have never needed it. I prayed to God several years ago that He would bless me in order that I could bless others. Although I may not have been able to provide monetary blessings to some, God has blessed me in ways I never imagined which allowed me to bless others in many different ways. God answered my prayer, not necessarily in the manner I was expecting, but in His own way. That reminds me of that beautiful song, Have Thine own way Lord.... and indeed He does.
It's just 10 days until my appt at MDA and although very nervous about what will be discussed, I take comfort in knowing that God is in control. I'm taking Alma and my wonderful mother with me as I figure 3 minds can come up with all the questions better than just my feeble mind.
Psalms 77:11-14
I will remember the deeds of the LORD; yes, I will remember your miracles of long ago.
I will meditate on all your works and consider all your mighty deeds.
Your ways, O God, are holy. What god is so great as our God?
You are the God who performs miracles; you display your power among the peoples.
Late this week, I was notified that the surgery would not be taken care of by insurance, even with the local neurosurgeon stating in his referral comments that this particular type of delicate neurosurgery could not be performed in the Valley (add another nerve of fright). However, Alma did some internal research and found out that MDA is a provider for another health plan that VB Health Systems has a working relationship with and that relationship allows the insurance to cover on an 80/20 basis. Praise God! We are awaiting formal written authorization. Even still, I am not sure that formal written authorization will guarantee payment as back in January, Scott had some medical needs while at college. We called and received written authorization. Last week, the provider of the services called and said VB Health Sytems had called them asking them to return the funds provided them for services. When asked why, VBHS said since VBHS was a self insured group, they could change their mind. Now isn't that something!? We have not been notifed personally by VBHS that they are requesting funds back.
I continue to be touched and humbled and brought to tears at the support that has been offered via prayer, comments, love and even fundraising to help with medical expenses. As I have told several, I have never accepted charity and thank God, have never needed it. I prayed to God several years ago that He would bless me in order that I could bless others. Although I may not have been able to provide monetary blessings to some, God has blessed me in ways I never imagined which allowed me to bless others in many different ways. God answered my prayer, not necessarily in the manner I was expecting, but in His own way. That reminds me of that beautiful song, Have Thine own way Lord.... and indeed He does.
It's just 10 days until my appt at MDA and although very nervous about what will be discussed, I take comfort in knowing that God is in control. I'm taking Alma and my wonderful mother with me as I figure 3 minds can come up with all the questions better than just my feeble mind.
Psalms 77:11-14
I will remember the deeds of the LORD; yes, I will remember your miracles of long ago.
I will meditate on all your works and consider all your mighty deeds.
Your ways, O God, are holy. What god is so great as our God?
You are the God who performs miracles; you display your power among the peoples.
Sunday, October 19, 2008
Interview with a Neurosurgeon
Here is a link to an interview with neurosurgeon with regard to pituitary tumors and surgery. The interviewer asks some good questions.
http://www.youtube.com/watch?v=XzvrlBOiOfc&feature=related
http://www.youtube.com/watch?v=XzvrlBOiOfc&feature=related
Video of Actual Pituitary Tumor Surgery
Ok, friends and family, this is not for the faint at heart. I found a video of an actual surgery. It is 8 minutes long and can be viewed at this link.
http://www.youtube.com/watch?v=-O0Jy4g0IEk&NR=1
http://www.youtube.com/watch?v=-O0Jy4g0IEk&NR=1
What Happens During Surgery
I found this information about the surgery. I sure look forward to my actual visit with the neurosurgeon so I can confirm or dispell everything I have been reading. This information says I should plan on taking 2 - 4 weeks off of work. That sounds great, but unfortunately, I can't be gone that long. I need to be making real estate deals.......and, it sounds like I am going to not be able to work out for some time and I may be taking daily doses of stool softners...I'm so excited!!!
What Happens During Surgery?
The pituitary gland is often reached through one of the nostrils. If this cannot be done, an incision may be made in the upper gum, under the top lip. The surgeon then would use x-ray and an endoscope to guide his way to the tumor.
A small piece of bone is removed to expose the pituitary gland and the tumor. Using a microscope to guide his way, the surgeon removes the tumor. If it is too large or stuck to important structures, the entire tumor may not be removed.
Fat from the lower abdomen is sometimes used to close and seal the open area. (I've got plenty there for them to use) This will leave a small incision where the fat was removed.
Samples of the tumor are sent to the pathology lab to decide the tumor type. These tumors are almost always non-cancerous and very slow growing. A final report will be ready in five working days, and you will be told when your doctor will share this with you.
After the Surgery
You will remain in the recovery room one to two hours until fully awake, at which time you will be taken to either NSICU. Most often, your stay will be about 2 days. During this time, nurses and doctors will be checking your arm and leg strength, pupil size, and level of alertness. They will be keeping track of the amount of fluid your drink and you excrete. You can expect to have a catheter draining the bladder the first day, an IV in an arm vein until able to take enough fluid by mouth, and leg wraps to prevent clots forming in the legs.
A cerebral spinal fluid (CSF) leak may occur as a result of this surgery. In this case, a small tube (lumbar drain) is inserted into the lower back to drain the fluid into a bag. This drain will decrease the spinal fluid pressure and allow the area to heal.
Pain
You may feel more pressure in the head or have a headache. Pain medicine will be ordered and ready if this occurs.
Nasal Spray
There may be nose stuffiness for a few weeks. It may be helpful to do gentle nasal washing with sterile saline to clear out blood and mucus. Sterile saline may be purchased at your local drugstore.
Activity
You will be asked to get out of bed the same day or the day after, and to slowly increase your activity in order to be walking in the halls before discharge. Walking is the best exercise.
You should avoid bending from the waist or straining to lift for 3-4 weeks. Bending and straining could cause a CSF leak.
For 3-4 weeks, you should avoid coughing, blowing the nose, sneezing, drinking with a straw, and straining while having a bowel movement. These things increase pressure in the head and may lead to an opening at the site (causing a CSF leak). If there is a need to sneeze, you should keep your mouth open to avoid pressure. To prevent the need to strain at stool, you should eat foods with fiber, drink at least 8 8-ounce glasses of fluid each day, and use stool softeners as needed.
Diet
You will be offered clear liquids first, returning slowly to a normal diet as you are able to take solid food. If there is an oral incision, soft foods may be best. Rinsing the mouth gently after eating will keep the incision clean. You should not brush over this area with a toothbrush.
Going Home
Depending on how you are feeling and the level of fatigue, plan to take 2-4 weeks off work and have someone help with housework for a few days. The amount of time needed for recovery depends on the person.
Follow-up
A clinic visit with the surgeon about one week after discharge will be scheduled before you leave the hospital. This doctor will decide how often you need an MRI.
On the day of the clinic visit, a blood test will be done before seeing the doctor. Because this surgery may disturb your hormone levels, you may need to take hormones for some time. You may also need to be followed by an eye doctor and an endocrine doctor as well as the surgeon.
When to Call the Doctor
Increased amount of nasal drainage
Fever greater than 100.5°F
Foul taste in the mouth
Signs of a CSF leak (often made worse with movement)
Constant drainage down the back of the throat
Cear fluid draining from the nose
Headache
Nausea or vomiting
Signs of sinus infection (in a few weeks or months)
Green nasal drainage
Headache
Fatigue
Increased nasal stuffiness
Signs of a low blood sodium level
Nausea
General weakness
Headache
What Happens During Surgery?
The pituitary gland is often reached through one of the nostrils. If this cannot be done, an incision may be made in the upper gum, under the top lip. The surgeon then would use x-ray and an endoscope to guide his way to the tumor.
A small piece of bone is removed to expose the pituitary gland and the tumor. Using a microscope to guide his way, the surgeon removes the tumor. If it is too large or stuck to important structures, the entire tumor may not be removed.
Fat from the lower abdomen is sometimes used to close and seal the open area. (I've got plenty there for them to use) This will leave a small incision where the fat was removed.
Samples of the tumor are sent to the pathology lab to decide the tumor type. These tumors are almost always non-cancerous and very slow growing. A final report will be ready in five working days, and you will be told when your doctor will share this with you.
After the Surgery
You will remain in the recovery room one to two hours until fully awake, at which time you will be taken to either NSICU. Most often, your stay will be about 2 days. During this time, nurses and doctors will be checking your arm and leg strength, pupil size, and level of alertness. They will be keeping track of the amount of fluid your drink and you excrete. You can expect to have a catheter draining the bladder the first day, an IV in an arm vein until able to take enough fluid by mouth, and leg wraps to prevent clots forming in the legs.
A cerebral spinal fluid (CSF) leak may occur as a result of this surgery. In this case, a small tube (lumbar drain) is inserted into the lower back to drain the fluid into a bag. This drain will decrease the spinal fluid pressure and allow the area to heal.
Pain
You may feel more pressure in the head or have a headache. Pain medicine will be ordered and ready if this occurs.
Nasal Spray
There may be nose stuffiness for a few weeks. It may be helpful to do gentle nasal washing with sterile saline to clear out blood and mucus. Sterile saline may be purchased at your local drugstore.
Activity
You will be asked to get out of bed the same day or the day after, and to slowly increase your activity in order to be walking in the halls before discharge. Walking is the best exercise.
You should avoid bending from the waist or straining to lift for 3-4 weeks. Bending and straining could cause a CSF leak.
For 3-4 weeks, you should avoid coughing, blowing the nose, sneezing, drinking with a straw, and straining while having a bowel movement. These things increase pressure in the head and may lead to an opening at the site (causing a CSF leak). If there is a need to sneeze, you should keep your mouth open to avoid pressure. To prevent the need to strain at stool, you should eat foods with fiber, drink at least 8 8-ounce glasses of fluid each day, and use stool softeners as needed.
Diet
You will be offered clear liquids first, returning slowly to a normal diet as you are able to take solid food. If there is an oral incision, soft foods may be best. Rinsing the mouth gently after eating will keep the incision clean. You should not brush over this area with a toothbrush.
Going Home
Depending on how you are feeling and the level of fatigue, plan to take 2-4 weeks off work and have someone help with housework for a few days. The amount of time needed for recovery depends on the person.
Follow-up
A clinic visit with the surgeon about one week after discharge will be scheduled before you leave the hospital. This doctor will decide how often you need an MRI.
On the day of the clinic visit, a blood test will be done before seeing the doctor. Because this surgery may disturb your hormone levels, you may need to take hormones for some time. You may also need to be followed by an eye doctor and an endocrine doctor as well as the surgeon.
When to Call the Doctor
Increased amount of nasal drainage
Fever greater than 100.5°F
Foul taste in the mouth
Signs of a CSF leak (often made worse with movement)
Constant drainage down the back of the throat
Cear fluid draining from the nose
Headache
Nausea or vomiting
Signs of sinus infection (in a few weeks or months)
Green nasal drainage
Headache
Fatigue
Increased nasal stuffiness
Signs of a low blood sodium level
Nausea
General weakness
Headache
Pituitary Tumor Article
I found the following article that was interesting. I know it is long and may not be of any interest to anyone but I wanted to allow those following an opportunity to read. I hope everyone had a great day and Alma and I would like to take this time to wish our former neighbor Pat Beard HAPPY BIRTHDAY! We miss you.
Pituitary Tumors by John R. Mangiardi, M.D. and Howard Kane, Wm.
The pituitary gland is a half-breed in many ways. It is not really a part of the brain, but rather hangs beneath it. Half of the gland comes down from the brain (the posterior lobe which controls the body's water levels and secretes the hormone ADH -- anti-diuretic hormone). The other half comes from tissues originating from the roof of the embryonic mouth, the anterior lobe which controls sex hormone levels, lactation, growth hormone, body steroids, and the thyroid gland).
The pituitary is responsible for almost all of the body's hormonal systems, taking all of its cues from the hypothalmus, the hidden and very deeply located Grand Wizard of the brain. The hypothalmus also controls such activities as body temperature, sexual drive, appetite, blood glucose levels, and sleep/arousal behavior patterns.
As elsewhere in the brain, tumors of the pituitary gland behave according to their cell of origin. Most of these tumor are truly benign, although on occasion they may prove to be malignant (pituitary carcinomas). The list of cells of the pituitary determines the tumor types, as well as the clinical syndromes related to each. Almost all have the good prognosis which calls for total removal. On the other hand, almost all can eventually become "malignant by position."
This is especially true when the tumors grow off to either side, involving the jam packed structures behind both eyeballs, called the "cavernous sinuses." The pituitary gland is located exactly between these two structures, which contain the nerves that control eye movement and the major arteries that feed the brain (carotid arteries, the veins that drain the eyes and other nerve related structures). Therefore, these tumors may occasionally present the patient with double vision, or even something called "Pituitary Apoplexy" (severe sudden headache, loss of and/or double vision, protruding eyeball).
Each tumor, because of its extraordinarily high hormonal output, creates a characteristic clinical syndrome that brings attention to the tumor. Because the pituitary gland is located directly beneath the place where the nerves cross, coming from the eyes to the brain (the optic chiasm), many tumors also present -- along with the hormonal problems listed below -- loss of peripheral vision.
Hormonal Problems Gigantism: This syndrome is caused by pituitary tumors on the growth hormone secreting cells of the pituitary gland. Remember Lurch from the James Bond movie -- large hands, protruding jaw, severe arthritis, huge size, protruding eyebrows, plus other systemic problems -- a classic example of gigantism.
Cushings Disease: This syndrome is caused by tumors on the ACTH (Adrenal Corticotrophin Hormone) secreting cells of the pituitary gland. Patients with this problem develop fat deposits in strange places (Moon face, Buffalo hump on the back of the neck), spontaneous scarring of the skin along the belly that look striated, pimples in adults, high blood pressure and elevated body temperature. These tumors are usually so small that the surgeon might have a difficult time finding the little "bad pearl" in the gland during surgery. This is the one time when small can be bad, especially if the surgeon is unable to locate and remove the tumor! ACTH secreting tumors, although small and troublesome, are readily cured by surgery alone.
Prolactin Syndrome: This syndrome is caused by tumors on the prolactin secreting cells of the pituitary gland. The tumors are the most common of all the pituitary tumors. Production of breast milk in women who are not pregnant, loss of menstrual cycle, and loss of bone calcium are all hallmarks of this tumor. When small, it may be cured; when large, it may cause visual problems and require other (e.g. radiation) therapy. Many women with this tumor visit their gynecologist thinking that they might be pregnant.
Growth hormone secreting tumors may very occasionally be treated with drugs, but most often must be removed surgically.
Non-Secreting Tumors: Can be treated by surgery and/or radiation. These patients almost always have problems with vision, as the hormonally quiet tumor grows to oversized proportions, actually growing to the point of lifting up and stretching the optic nerves (especially where the nerves from both eyes cross as they travel to the brain). The treatment of these tumors is variable. Prolactinomas are most often treated non-surgically with drugs that inhibit prolactin production (parlodil). Microprolactinomas sometimes never really grow over long periods of time, and do not require surgery.
All pituitary tumors can be treated by radiation, especially with the improvements brought on by focused beam radiation (liner accelerator and proton beam). The idea of radiosurgery originated in this venue. One serious problem with radiation has been loss of function in the remainder of the pituitary gland, requiring patients to depend on hormone supplements for the continuation of their lives. Another has been the inability to quickly reverse visual loss in large tumors using radiation. On the other hand, radiation has been used as a very successful adjunct in larger tumors that pose a threat to long term survival.
Surgery on Pituitary Tumors The wonderful surgical achievement of the modern age is the combination of improved lighting, the surgical microscope, and computer assisted navigational instrumentation now used in the O.R. The pituitary gland lies just above the air spaces in the nose (if you'd stick a pencil through your nose hard enough, you'd end up in your pituitary gland). In fact, the word "pituita" (like the word "ptuey!") refers to the not so delicate production of "snot." In medieval times in Europe, and in China today, it is thought that "pituita" was something good to get rid of, serving as a relief valve for bad humors of the brain. In other words, spitting was good for the soul as well as one's health.
Thus, by traversing the structures just beneath the skull through the nasal cavities, brain surgery can be avoided and the risk of approaching the pituitary gland can be enormously reduced.
Decision Making for Pituitary Tumor Surgery
It's an Emergency: Patients who have a large pituitary tumor (and often don't even know about it) will occasionally develop a kind of pituitary "stroke," called pituitary apoplexy. This occurs after the tumor outgrows its blood supply and suddenly enlarges (due to swelling) after it infarcts (a type of local stroke), or begins bleeding within the tumor. The enlargement causes severe headache and/or double vision, because the nerves that control the eye located next to the gland are pressed upon. It can also cause loss of vision (because the gland swells upward, pressing from beneath the optic nerves above). Surgical decompression is an emergency procedure because permanent blindness may result if left untreated.
Surgery Is the Best Way to GoCushing's Disease: Because the tumor is so small, a cure is possible when removed. Thus, surgery is the best way to go. Moreover, the remainder of the gland is left intact, and will function normally thereafter.
Large tumors with liquified (necrotic) centers: In these cases, the surgery is easy, and the improvement is immediate. Any remaining tumor beyond the confines of the surgical field can be safely treated by other standard therapies (e.g. radiation therapy).
Medium sized tumors: Still within the confines of the pituitary gland. As with the Cushing's tumors, the tumor can be completely removed and the gland saved for normal function.
A 'Hold' on the SurgeryProlactinomas: Should always be treated initially with medication (anti-DOPA agents such as Parlodil, Bromocriptin, etc.). Even large tumors that most need to be treated by either surgey or radiosurgery should be pretreated with these drugs to shrink the tumor away from vital brain structures before surgery should be contemplated.
Microprolactinomas: Surgically, nothing need be done for as long as possible. Some of these tumors appear to just sit there for years, even decades.
Extremely large tumors that cause little visual or other brain problems: In treating these tumors, particularly in older people, the physician should consider radiation therapy to stop the progression of these tumors. A surgical cure is usually not an option, for the substantial surgical risk entailed.
Pituitary Tumors by John R. Mangiardi, M.D. and Howard Kane, Wm.
The pituitary gland is a half-breed in many ways. It is not really a part of the brain, but rather hangs beneath it. Half of the gland comes down from the brain (the posterior lobe which controls the body's water levels and secretes the hormone ADH -- anti-diuretic hormone). The other half comes from tissues originating from the roof of the embryonic mouth, the anterior lobe which controls sex hormone levels, lactation, growth hormone, body steroids, and the thyroid gland).
The pituitary is responsible for almost all of the body's hormonal systems, taking all of its cues from the hypothalmus, the hidden and very deeply located Grand Wizard of the brain. The hypothalmus also controls such activities as body temperature, sexual drive, appetite, blood glucose levels, and sleep/arousal behavior patterns.
As elsewhere in the brain, tumors of the pituitary gland behave according to their cell of origin. Most of these tumor are truly benign, although on occasion they may prove to be malignant (pituitary carcinomas). The list of cells of the pituitary determines the tumor types, as well as the clinical syndromes related to each. Almost all have the good prognosis which calls for total removal. On the other hand, almost all can eventually become "malignant by position."
This is especially true when the tumors grow off to either side, involving the jam packed structures behind both eyeballs, called the "cavernous sinuses." The pituitary gland is located exactly between these two structures, which contain the nerves that control eye movement and the major arteries that feed the brain (carotid arteries, the veins that drain the eyes and other nerve related structures). Therefore, these tumors may occasionally present the patient with double vision, or even something called "Pituitary Apoplexy" (severe sudden headache, loss of and/or double vision, protruding eyeball).
Each tumor, because of its extraordinarily high hormonal output, creates a characteristic clinical syndrome that brings attention to the tumor. Because the pituitary gland is located directly beneath the place where the nerves cross, coming from the eyes to the brain (the optic chiasm), many tumors also present -- along with the hormonal problems listed below -- loss of peripheral vision.
Hormonal Problems Gigantism: This syndrome is caused by pituitary tumors on the growth hormone secreting cells of the pituitary gland. Remember Lurch from the James Bond movie -- large hands, protruding jaw, severe arthritis, huge size, protruding eyebrows, plus other systemic problems -- a classic example of gigantism.
Cushings Disease: This syndrome is caused by tumors on the ACTH (Adrenal Corticotrophin Hormone) secreting cells of the pituitary gland. Patients with this problem develop fat deposits in strange places (Moon face, Buffalo hump on the back of the neck), spontaneous scarring of the skin along the belly that look striated, pimples in adults, high blood pressure and elevated body temperature. These tumors are usually so small that the surgeon might have a difficult time finding the little "bad pearl" in the gland during surgery. This is the one time when small can be bad, especially if the surgeon is unable to locate and remove the tumor! ACTH secreting tumors, although small and troublesome, are readily cured by surgery alone.
Prolactin Syndrome: This syndrome is caused by tumors on the prolactin secreting cells of the pituitary gland. The tumors are the most common of all the pituitary tumors. Production of breast milk in women who are not pregnant, loss of menstrual cycle, and loss of bone calcium are all hallmarks of this tumor. When small, it may be cured; when large, it may cause visual problems and require other (e.g. radiation) therapy. Many women with this tumor visit their gynecologist thinking that they might be pregnant.
Growth hormone secreting tumors may very occasionally be treated with drugs, but most often must be removed surgically.
Non-Secreting Tumors: Can be treated by surgery and/or radiation. These patients almost always have problems with vision, as the hormonally quiet tumor grows to oversized proportions, actually growing to the point of lifting up and stretching the optic nerves (especially where the nerves from both eyes cross as they travel to the brain). The treatment of these tumors is variable. Prolactinomas are most often treated non-surgically with drugs that inhibit prolactin production (parlodil). Microprolactinomas sometimes never really grow over long periods of time, and do not require surgery.
All pituitary tumors can be treated by radiation, especially with the improvements brought on by focused beam radiation (liner accelerator and proton beam). The idea of radiosurgery originated in this venue. One serious problem with radiation has been loss of function in the remainder of the pituitary gland, requiring patients to depend on hormone supplements for the continuation of their lives. Another has been the inability to quickly reverse visual loss in large tumors using radiation. On the other hand, radiation has been used as a very successful adjunct in larger tumors that pose a threat to long term survival.
Surgery on Pituitary Tumors The wonderful surgical achievement of the modern age is the combination of improved lighting, the surgical microscope, and computer assisted navigational instrumentation now used in the O.R. The pituitary gland lies just above the air spaces in the nose (if you'd stick a pencil through your nose hard enough, you'd end up in your pituitary gland). In fact, the word "pituita" (like the word "ptuey!") refers to the not so delicate production of "snot." In medieval times in Europe, and in China today, it is thought that "pituita" was something good to get rid of, serving as a relief valve for bad humors of the brain. In other words, spitting was good for the soul as well as one's health.
Thus, by traversing the structures just beneath the skull through the nasal cavities, brain surgery can be avoided and the risk of approaching the pituitary gland can be enormously reduced.
Decision Making for Pituitary Tumor Surgery
It's an Emergency: Patients who have a large pituitary tumor (and often don't even know about it) will occasionally develop a kind of pituitary "stroke," called pituitary apoplexy. This occurs after the tumor outgrows its blood supply and suddenly enlarges (due to swelling) after it infarcts (a type of local stroke), or begins bleeding within the tumor. The enlargement causes severe headache and/or double vision, because the nerves that control the eye located next to the gland are pressed upon. It can also cause loss of vision (because the gland swells upward, pressing from beneath the optic nerves above). Surgical decompression is an emergency procedure because permanent blindness may result if left untreated.
Surgery Is the Best Way to GoCushing's Disease: Because the tumor is so small, a cure is possible when removed. Thus, surgery is the best way to go. Moreover, the remainder of the gland is left intact, and will function normally thereafter.
Large tumors with liquified (necrotic) centers: In these cases, the surgery is easy, and the improvement is immediate. Any remaining tumor beyond the confines of the surgical field can be safely treated by other standard therapies (e.g. radiation therapy).
Medium sized tumors: Still within the confines of the pituitary gland. As with the Cushing's tumors, the tumor can be completely removed and the gland saved for normal function.
A 'Hold' on the SurgeryProlactinomas: Should always be treated initially with medication (anti-DOPA agents such as Parlodil, Bromocriptin, etc.). Even large tumors that most need to be treated by either surgey or radiosurgery should be pretreated with these drugs to shrink the tumor away from vital brain structures before surgery should be contemplated.
Microprolactinomas: Surgically, nothing need be done for as long as possible. Some of these tumors appear to just sit there for years, even decades.
Extremely large tumors that cause little visual or other brain problems: In treating these tumors, particularly in older people, the physician should consider radiation therapy to stop the progression of these tumors. A surgical cure is usually not an option, for the substantial surgical risk entailed.
Thursday, October 16, 2008
Thursday, October 16, 2007
New prayer request. We are attempting to get insurance to cover surgery at MDA. Our current health insurance pays 90/10 in-network but only 50/50 out of network. MDA was considered in-network as recently as a year ago but for some reason they were dropped. My medical records are being sent to Valley Health Plans for "consideration" along with the Dr's referral to see if the appointments, lab work, and surgery can be covered "in-network". Please pray that my case would be seriously reviewed and accepted as in-network.
Romans 8:28 And we know that in all things God works for the good of those who love him, who have been called according to his purpose.
Romans 8:28 And we know that in all things God works for the good of those who love him, who have been called according to his purpose.
Monday, October 13, 2008
Visit with Valley Neurosugeon
Well, today's update is an interesting one. First of all, those who I had sent the other blogspot link have now been directed to this site. www.randysummers.com should be easier to remember how to get to. Thank you to Joel Wilson and Pat Beard for getting this set up. Unfortunately, the comments posted on the other blog site did not move to this new site. If you had posted a comment on the other blog site, please go to that site and to your comment--then copy it--then come back to www.randysummers.com --click on post comment--paste your comment.
Second, I was able to visit the local neurosurgeon today. Since the diagnosis of the pituitary tumor (PT) by the radiologist, I have not been able to sit down personally and talk to a neurosurgeon while viewing the many photos from my mri. My information has come from reading as much as I could on PT's, looking at numerous pictures of PT's and talking to different people. I am very thankful that I had the chance to do this as I learned a tremendous amount.
My tumor is considered a macroadenoma which means it is considered a large tumor. The neurologist said by looking at the mri, he is almost positive that it is benign. Praise God.
However, due to its size, it is wrapped around the pituitary stem which sends alot of important information back and forth to the brain, and it is protruding upwards through the small opening of the pituitary gland and lying very close to the optic nerve. Only a small membrane separates the tumor from the optic nerve.
The tumor also is pressing against a carotid vessel. The doctor said this would be a difficult surgery but was not afraid to do it.
Prior to it being done, I will need to visit with the endocronologist to establish "base lines". In other words, the pituitary, in men my age, sometimes still produces hormones. If so, it needs to be established which hormones, if any, are being produced so that after the surgery, it can be determined if they are still being produced after messing around so close to the pituitary gland. The same with thyroids.
A vision test also needs to performed to determine if my vision field is still 100% and to make sure it is the same after the surgery. Your vision field is your periphial vision limits to the left and right as well as up and down.
I know the neurosurgeon I saw today is very capable. However, after learning of the increased risks I am grateful that I have an appointment at M.D. Anderson for a second review. With the increased risks, being in a medical center that performs these kind of surgeries on a daily basis adds a greater degree of comfort in the decision to go to MDA.
II Samuel 22:2-4
And he said: "The Lord is my rock and my fortress and my deliverer;
The God of my strength, in whom I will trust;
My shield and the horn of my salvation,
My Stronghold and my refuge;
My Savior, You save me from violence.
I will call upon the Lord, who is worthy to be praised;
So shall I be saved from my enemies.
Second, I was able to visit the local neurosurgeon today. Since the diagnosis of the pituitary tumor (PT) by the radiologist, I have not been able to sit down personally and talk to a neurosurgeon while viewing the many photos from my mri. My information has come from reading as much as I could on PT's, looking at numerous pictures of PT's and talking to different people. I am very thankful that I had the chance to do this as I learned a tremendous amount.
My tumor is considered a macroadenoma which means it is considered a large tumor. The neurologist said by looking at the mri, he is almost positive that it is benign. Praise God.
However, due to its size, it is wrapped around the pituitary stem which sends alot of important information back and forth to the brain, and it is protruding upwards through the small opening of the pituitary gland and lying very close to the optic nerve. Only a small membrane separates the tumor from the optic nerve.
The tumor also is pressing against a carotid vessel. The doctor said this would be a difficult surgery but was not afraid to do it.
Prior to it being done, I will need to visit with the endocronologist to establish "base lines". In other words, the pituitary, in men my age, sometimes still produces hormones. If so, it needs to be established which hormones, if any, are being produced so that after the surgery, it can be determined if they are still being produced after messing around so close to the pituitary gland. The same with thyroids.
A vision test also needs to performed to determine if my vision field is still 100% and to make sure it is the same after the surgery. Your vision field is your periphial vision limits to the left and right as well as up and down.
I know the neurosurgeon I saw today is very capable. However, after learning of the increased risks I am grateful that I have an appointment at M.D. Anderson for a second review. With the increased risks, being in a medical center that performs these kind of surgeries on a daily basis adds a greater degree of comfort in the decision to go to MDA.
II Samuel 22:2-4
And he said: "The Lord is my rock and my fortress and my deliverer;
The God of my strength, in whom I will trust;
My shield and the horn of my salvation,
My Stronghold and my refuge;
My Savior, You save me from violence.
I will call upon the Lord, who is worthy to be praised;
So shall I be saved from my enemies.
Monday, October 6, 2008
THE DISCOVERY-THE JOURNEY'S BEGINNING
Well, here I am. I guess I am catching up with newer technology and actually creating my own blog. This has all come about due to the overwhelming support of emails, calls, and prayers since I have been diagnosed with a pituitary brain tumor.
In order to keep those who are interested up-to-date, I decided to create this blog where everyone can check progress as we go along. Perhaps I will like this blogging so much I will keep it up from now on.
Many have asked how I discovered the tumor. About a year ago in September 2007, I had my annual physical done. At that time I mentioned to my doctor that I was having occassional discomfort behind my right ear. He asked what I did for the pain and I told him I took tylenol and that seemed to ease the pain. He said to monitor it and if there was any significant change to let him know. As the months went along, the discomfort was there but nothing overbearing. Gradually, I began to notice a slight pressure in my right ear feeling like my ear needed to be popped or perhaps there was water in my ear. Discomfort behind my ear became constant and a feeling like pins were sticking me there also began. I noticed that I was having some short term memory loss. I tried to blame that on age and stress but guess that wasn't the case.
When I went in for my annual in September 2008, I mentioned what was going on and asked that we be proactive about this as my uncle and grandfather had both had brain tumors. My uncle's had wrapped around his ear canal and caused him to lose his hearing in that ear. I am not sure what type my grandfather had but praise God that both of their tumors were benign.
The doctor scheduled an mri on my 50th birthday. That was the first mri I ever remember having. It is difficult to lay still for so long. The preliminary results showed a possible pituitary tumor and a more extensive mri was ordered. The results from the second mri showed a definite tumor attached to the pituitary and it is just a little bit smaller than the size of a quarter. The best way to describe the location of the pituitary is to draw a line from ear to ear and from nose to the back of skull. Where those lines intersect is the pituitary.
As you can imagine, my mind ran wild. Any problems in the head is never good and just the word "tumor" stirs up all kinds of bad thoughts. Immediately we began doing research on a pituitary tumor and found out that 99% of them are benign and many people have them and don't even know it. It seems as if they can remain very small and one never knows unless they are pressing against a nerve or something. That is the case with mine as it is extending to the right and pressing on the nerves that extend to my ear and the back of my head.
According to what I've read, some pituitary tumors, depending on size, can be treated with medication. Others radiation and still others surgery. The diagnosis so far is that surgery will be needed.
I had so many dear and wonderful friends step up and offer assistance in getting into the top hospitals that deal with pituitary tumors. Many calls were made on my behalf to several medical centers and I so appreciated that. After a lot of prayer and research I decided on MD Anderson and Dr. Ian McCutcheon. He is the chief surgeon for pituitary brain tumors at the Brain and Spine Institute at MD Anderson. There are numerous neurosurgeons out there but selecting one who does this day in and day out was very important to me. I will be traveling to MD Anderson on November 4th for appointments with the doctor and endocronologist and surgery will be approximately one week later.
Once I was diagnosed with the tumor, many prayer requests went out on my behalf. I have been so humbled by all of them and I know God has heard every prayer and He will answer every one of them. I know that God will use this inconvenience in my life for His glory and everything will be just fine.
Well, that describes the beginning of this journey and a journey it will be. I will keep this updated as I learn new things. I will post some links that maybe helpful in understanding. I've uploaded a picture of the actual mri so you can see where the tumor is and the size. Scary, egh?

Psalm 111:1-9Praise the Lord! I will praise the LORD with my whole heart, in the assembly of the upright and in the congregation. The works of the LORD are great, studied by all who have pleasure in them. His work is honorable and glorious, and His righteousness endures forever. He has made His wonderful works to be remembered; the LORD is gracious and full of compassion. He has given food to those who fear Him; He will ever be mindful of His covenant. He has declared to His people the power of His works, in giving them the heritage of the nations. The works of His hands are verity and justice; all His precepts are sure. They stand fast forever and ever, and are done in truth and uprightness. He has sent redemption to His people; He has commanded His covenant forever: Holy and awesome is His name.
Our faith is in the LORD! The creator of the universe and all that is within it. Praise, honor, power, and glory be unto Him. For He is greatly to be praised.
Here is a link to the biography of Dr. Ian McCutcheon:
http://www.mdanderson.org/Care_Centers/BrainSpinal/display.cfm?id=E7DC266B-803E-11D4-AEC800508BDCCE3A&method=displayFull&pn=E7DC2468-803E-11D4-AEC800508BDCCE3A
The pituitary is a tiny pea-sized gland at the base of the brain. It serves as the body's "command center," producing hormones that regulate growth and metabolism, as well as the actions of other glands, including the thyroid, adrenals and gonads (ovaries in women and testes in men).Tumors arising from the cells of the pituitary gland are also known as pituitary adenomas. They are almost always benign, but can have significant side effects when they produce excessive amounts of hormones or grow large enough to affect normal pituitary function or interfere with surrounding structures, particularly the optic nerves, which are responsible for sight.There are few known risk factors for pituitary adenomas. The only confirmed risk factor is multiple endocrine neoplasia type 1 (MEN 1), a hereditary condition that increases the chance of developing certain pituitary tumors.
Types of Pituitary Tumors
Diagnosing Pituitary Tumors
Treating Pituitary Tumors
Symptoms of Pituitary Tumors:
Specific symptoms depend on the type of hormone secreted by a pituitary tumor. Symptoms that may result from the size of the tumor can include headaches, double vision and loss of vision due to impingment of the optic nerves.
In order to keep those who are interested up-to-date, I decided to create this blog where everyone can check progress as we go along. Perhaps I will like this blogging so much I will keep it up from now on.
Many have asked how I discovered the tumor. About a year ago in September 2007, I had my annual physical done. At that time I mentioned to my doctor that I was having occassional discomfort behind my right ear. He asked what I did for the pain and I told him I took tylenol and that seemed to ease the pain. He said to monitor it and if there was any significant change to let him know. As the months went along, the discomfort was there but nothing overbearing. Gradually, I began to notice a slight pressure in my right ear feeling like my ear needed to be popped or perhaps there was water in my ear. Discomfort behind my ear became constant and a feeling like pins were sticking me there also began. I noticed that I was having some short term memory loss. I tried to blame that on age and stress but guess that wasn't the case.
When I went in for my annual in September 2008, I mentioned what was going on and asked that we be proactive about this as my uncle and grandfather had both had brain tumors. My uncle's had wrapped around his ear canal and caused him to lose his hearing in that ear. I am not sure what type my grandfather had but praise God that both of their tumors were benign.
The doctor scheduled an mri on my 50th birthday. That was the first mri I ever remember having. It is difficult to lay still for so long. The preliminary results showed a possible pituitary tumor and a more extensive mri was ordered. The results from the second mri showed a definite tumor attached to the pituitary and it is just a little bit smaller than the size of a quarter. The best way to describe the location of the pituitary is to draw a line from ear to ear and from nose to the back of skull. Where those lines intersect is the pituitary.
As you can imagine, my mind ran wild. Any problems in the head is never good and just the word "tumor" stirs up all kinds of bad thoughts. Immediately we began doing research on a pituitary tumor and found out that 99% of them are benign and many people have them and don't even know it. It seems as if they can remain very small and one never knows unless they are pressing against a nerve or something. That is the case with mine as it is extending to the right and pressing on the nerves that extend to my ear and the back of my head.
According to what I've read, some pituitary tumors, depending on size, can be treated with medication. Others radiation and still others surgery. The diagnosis so far is that surgery will be needed.
I had so many dear and wonderful friends step up and offer assistance in getting into the top hospitals that deal with pituitary tumors. Many calls were made on my behalf to several medical centers and I so appreciated that. After a lot of prayer and research I decided on MD Anderson and Dr. Ian McCutcheon. He is the chief surgeon for pituitary brain tumors at the Brain and Spine Institute at MD Anderson. There are numerous neurosurgeons out there but selecting one who does this day in and day out was very important to me. I will be traveling to MD Anderson on November 4th for appointments with the doctor and endocronologist and surgery will be approximately one week later.
Once I was diagnosed with the tumor, many prayer requests went out on my behalf. I have been so humbled by all of them and I know God has heard every prayer and He will answer every one of them. I know that God will use this inconvenience in my life for His glory and everything will be just fine.
Well, that describes the beginning of this journey and a journey it will be. I will keep this updated as I learn new things. I will post some links that maybe helpful in understanding. I've uploaded a picture of the actual mri so you can see where the tumor is and the size. Scary, egh?

Psalm 111:1-9Praise the Lord! I will praise the LORD with my whole heart, in the assembly of the upright and in the congregation. The works of the LORD are great, studied by all who have pleasure in them. His work is honorable and glorious, and His righteousness endures forever. He has made His wonderful works to be remembered; the LORD is gracious and full of compassion. He has given food to those who fear Him; He will ever be mindful of His covenant. He has declared to His people the power of His works, in giving them the heritage of the nations. The works of His hands are verity and justice; all His precepts are sure. They stand fast forever and ever, and are done in truth and uprightness. He has sent redemption to His people; He has commanded His covenant forever: Holy and awesome is His name.
Our faith is in the LORD! The creator of the universe and all that is within it. Praise, honor, power, and glory be unto Him. For He is greatly to be praised.
Here is a link to the biography of Dr. Ian McCutcheon:
http://www.mdanderson.org/Care_Centers/BrainSpinal/display.cfm?id=E7DC266B-803E-11D4-AEC800508BDCCE3A&method=displayFull&pn=E7DC2468-803E-11D4-AEC800508BDCCE3A
The pituitary is a tiny pea-sized gland at the base of the brain. It serves as the body's "command center," producing hormones that regulate growth and metabolism, as well as the actions of other glands, including the thyroid, adrenals and gonads (ovaries in women and testes in men).Tumors arising from the cells of the pituitary gland are also known as pituitary adenomas. They are almost always benign, but can have significant side effects when they produce excessive amounts of hormones or grow large enough to affect normal pituitary function or interfere with surrounding structures, particularly the optic nerves, which are responsible for sight.There are few known risk factors for pituitary adenomas. The only confirmed risk factor is multiple endocrine neoplasia type 1 (MEN 1), a hereditary condition that increases the chance of developing certain pituitary tumors.
Types of Pituitary Tumors
Diagnosing Pituitary Tumors
Treating Pituitary Tumors
Symptoms of Pituitary Tumors:
Specific symptoms depend on the type of hormone secreted by a pituitary tumor. Symptoms that may result from the size of the tumor can include headaches, double vision and loss of vision due to impingment of the optic nerves.
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