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View Full Version : New member and, yeap, I have a story too. WG PanHypoPit



vdub
11-27-2010, 07:40 PM
This is how it started with me about 18 months ago.

May 2008 – Absolutely dead tired all spring and summer. Sleeping whenever possible – maybe as much as 16 hrs/day. Totally wiped out.....

Aug 2008 -- Grudgingly saw doctor and thyroid readings lower than should be. Referred to ENT. ENT does an ultra sound and my left thyroid is 3 times larger than normal, so they do a full body MRI looking for anything that might smack of cancer. They find 3 suspicious lymph nodes. Thyroid is to deep to biopsy so they just leave it alone.

Oct 2008 – Surgery #1 -- Lymph nodes removed and were tested as benign, but no other testing done (I wonder if they had granuloma lesions?). The surgeon however, said they looked “really weird”.
Generally felt pretty good during the winter of 08/09.

Spring 2009 – Psoriasis developed on my hands. Should have been another red flag I suppose, but instead I get my first introduction to Prednisone and discover what has to be the best legal drug you can get your hands on.

Aug 2009 – Surgery #2 -- Tired again and no energy. By just an off chance, they test my testosterone level (apparently not done often). Way low, so they start me on testosterone injections. Seems to help a little bit. Also, at the same time, I’m snoring more, so they do a sleep lab. The conclusion is that I have a deviated septum, so they do a rhinoplasty (hurt like hell). This surgery was suppossed to help my sinus issue. I think the ENT just likes to do surgeries. They also put me on a CPAP.

Nov 2009 – We are out RV’ing and on the east coast in FL. I come up with a slight cough and constantly running nose. I chaulk it up to hayfever. We fly home from Atlanta to the Pacific Northwest for xmas and I still have the “hayfever”. Just before flying back to Atlanta, I call my local doc and he gives me 10 days of antibiotics, thinking it was a sinus infection.

Feb 2010 – We’re at Memphis NAS, so I go to see the Navy docs. Same thing – sinus infection, handful of antibiotics.

Mar 2010 – We’re at New Braunfels, TX for a month. At the beginning of the month I see yet another doc – sinus infection, handful of a different antibiotic. At the end of the month, I go back to him. Still had the running nose, but also now had a severe headache whenever I coughed. He gave me a steroid shot in the butt. Ah, the steroid shot – felt great, so headed to Whitesands Missile Range in NM.

Mar 2010 – Steroid shot I had received in TX wore off after about a week and the headaches came back only worse. I put up with them for a while and then they just became unbearable, so I went to the Army docs at Whitesands. The Army docs looked at me for about a half hour, then put me in an ambulance and sent me over the hill to the LasCruces hospital. At this point, I was going in and out of consciousness. I only remember that the ambulance ride was one the roughest damn rides I’ve ever been on. I also remember being at the hospital for about 10 minutes – wife claims it was closer to 12 hrs. I also remember that morphine is really good **** – maybe as good as prednisone. Soooo, they did a CT scan at Las Cruces, told me I had a polyp in my sinus, gave me a handful of prednisone and tell me to make an appointment with my ENT and head home. I was flying pretty high on the prednisone, so got back home in record time.

Apr 2010 – Surgery #3 -- My local ENT sees me and says there is no polyp and, besides, a polyp wouldn’t cause headaches. I’m still on the prednisone, so no problems. Once I run out of the prednisone, however, the headaches come back, so I make an appointment with my local doc. He’s very good and a little more than curious, so orders an MRI on Monday, 19Apr10. Ah Ha! The MRI shows it’s not a polyp, but it’s a stink’n brain tumor or maybe a pituitary tumor (they can’t tell).

Wednesday, 21Apr10 at 1600, surgery to remove the "tumor". Four hour surgery. Stayed in ICU for 8 days and another 2 days in the regular ward. My life changed dramatically once the pit was destroyed!

Apr 2010 - The neurosurgeon sends the “tumor” to the mayo clinic and they come back and say it is a granuloma and Wegener's Granulomatosis should be considered as the type disease I have.

May 2010 - They put together a team of docs with a neurosurgeon, neurologist, rheumatologist, ENT, endocrinologist, and my local doc. I start giving up gallons of blood for testing. It's also difficult to make appointments with docs because they are interfering with other appointments with docs. After a bunch of tests, they conclude its Wegener’s Granulomatosis with Pituitary Involvement and start treating me accordingly.

Jun 2010 -- Mt Sinai Research Hospital in Toronto, Canada requests DNA samples for study.

Nov 2010 -- Surgery #4 -- Sinuses are overflowing. ENT decides to do an endoscopy, basically scrape out the sinuses (3/8" Craftsman drill?). Yeah, this is the same guy that just likes the knife. Not sure if the issue is rhinitis or the WG. Given other symptoms, it's probably WG, which means the surgery will probably do very little in relieving the situation.

End of Nov 2010 -- Earlier suspecions that surgery #4 was a waste of money has come to pass. The nose is still running and the headaches are still there even when on pain meds. Another MRI is scheduled for just a couple days from now. I'm hoping they won't find anything. On the otherhand, I'm hoping they do find something so that there's is a chance of correcting it. Most likely another brain surgery is in my future. I'm certain glad we have good looking nurses around here as I seem to be destined to spending a lot time with them.

I am PanHypoPit, which is fancy doc talk for the pituitary has totally checked out. Since the pituitary controls most all of the endocrine system, all sorts of stuff is messed up. So far, my testacies, adrenal, thyroid, hypothalmus, and pituitary glands have all checked out and gone south. I’m on about 5 or 6 different hormone drugs, plus several “treatment” drugs.

The drugs I'm on have so many side effects that I feel "not normal" most all the time. Some drugs are taken to counter the adverse side effects of others. Lots and lots of drugs. The worst part? I’m just always bloody tired and have no energy…. Oh well…. Could be worse... In fact, there are many, many people worse off than me.... I count my blessings for having things as well as I do............

Sooooo, does this pretty much describe "as good as it gets"? Will I ever feel normal or should I stop whining, accepted things as they are make the most of it?

Jack
11-27-2010, 10:46 PM
With the exception of the pituitary involvement, your story sounds very familiar and the usual advice is to get to see a vasculitis specialist as soon as possible. A whole team of well meaning doctors who may lack the required experience of treating hundreds of Wegener's patients is just not going to cut it.

What medication are you receiving for the Wegener's? Cyclophosphamide and Prednisolone is the usual first shot, but you should be aware of the potential dangers of both of these so that you are in a better position to protect yourself.

Having now had a quick Google of Wegener's +Pituitary, there seems to be quite a lot of information out there about the combination.

A word of warning - don't let doctors jump to the conclusion that any problem you may have is due to an infection, it probably is not. Also, don't let them do any surgery on you unless it is a life threatening situation, it is usually unnecessary and can stir up the Wegener's.

elephant
11-28-2010, 12:04 AM
Welcome Vdub, glad you told your story here. You may want to look up" 2010 Vasculits Symposium Presentation" this is a conference with all the Vasculitis specialist including Wegeners specialist. Very informative...check out the Vasculits Foundation too! Feel free to vent, we are here for you!

Sangye
11-28-2010, 01:39 AM
Hi Vdub, welcome to the group! I agree with Jack and Elephant. Especially with your pituitary involvement you need to have a Wegs specialist at a major center overseeing your care. Here's some info that might help: http://www.wegeners-granulomatosis.com/forum/general-wg-chat/986-what-newly-diagnosed-need-know.html

Meanwhile, I suggest you never again allow a surgery unless a Wegs specialist has okayed it. Not only is it often pointless, but it can worsen Wegs or cause major tissue damage.

Your story also demonstrates why it's so important to question a doc who diagnoses anything (not just Wegs). For example, when they found you had sleep apnea and chalked it up to a deviated septum, it would be important to ask why it would suddenly cause sleep apnea-- surely it's been there for many years, if not your entire life. It's very common for doctors to find some abnormality and link it to your symptoms without really thinking it through. More common than you might want to know.... This happens less at major research institutions like Mayo and Johns Hopkins. Those docs are taught to think.

vdub
11-28-2010, 05:22 AM
I'm afraid I've already allowed myself to be damaged further by one well-intentioned ENT who likes to cut. I have splints in my nose right now from surgery that happened last Monday. An endoscopy.... Supposedly, the endoscopy would open the passages into my sinuses, allow more air, and stop the constant drip. Of course, that hasn't happened.

Can't recall if the question as to wha drugs I was on was in this thread or the other.... I'm only on methotrexate for the WG -- 15mg once a week. Then, of course, there is the folic acid to counter some of the damage the mtx does.

My largest batch of pills comes from being panhypopit. The pituitary is the master gland in the endocrine system and controls most all the other glands. I could really get into the physiology of it because it is quite interesting, but I won't because it's also quite complex. Suffice to say, I now have to provide the hormones for what would otherwise be provided by one of the endocrine glands; hydrocortisone (adrenal), levothyroxine (thyroid), testosterone (gonads), desmopressin and B-12 (hypothalmus).

What's really super interesting is that there isn't a bloody darn thing wrong with each of my individual glands. The only thing wrong is that the pit isn't there to tell them what to do. Big bummer.

Jack
11-28-2010, 05:47 AM
I am a bit concerned that you are only being treated with Methotrexate. This would normally indicate that your Wegener's symptoms were well under control which is obviously not the case from the description of your continuing sinus problems. I would suggest that you seek a consultation with a specialist as soon as possible.

vdub
11-28-2010, 06:06 AM
I saw where the University of Utah was mentioned as a WG research center. I may head that way.....

elephant
11-28-2010, 06:52 AM
I agree with Jack and Sangye. Your headaches and sinuses still dripping concerns me...need to see a Rheumatololgist that see's 100's of Wegeners patients. I see Dr Langford at the Cleveland Clinic in Ohio. Mayo in Minnesota is a good one too. I don't know anything about University of Utah, but if there is a good Weg specialist...go ahead and check it out.

I had four Maxillary sinus surgeries and the last one helped but the other four did no good. This disease is very sneaky...My suspicion is that the docs think you have limited and they are treating you very very conservative and not enough meds to keep the WG quiet. Let me tell you my "limited....is not limited it snuck in my lungs and other organs....

vdub
11-28-2010, 08:08 AM
I totally agree with you... I think that's probably why I was doing more and more research on the wegener's. Previously, my research had been pretty much limited to the panhypopit situation and wegener's was more of an after-thought.

I've also been wheezing/coughing quite a bit, which sort of sounds wg-like....

Sangye
11-28-2010, 10:14 AM
Please start calling to get into a Wegs center asap.... It might take longer with the holidays, but if they know you have CNS involvement they would likely get you in sooner.

Wheezing and coughing can be a common allergic reaction to methotrexate (mtx) called "pneumonitis." It causes pulmonary infiltrates and looks like typical pneumonia on x-ray. Very easy to misdiagnose it. If the mtx is causing that, you'd have to stop it immediately and you couldn't take it again. Wegs involvement in the lungs or trachea can also cause those symptoms and can become serious quite quickly. Please get to your doc on Monday to have it checked out. I would think that a chest x-ray is in order. I'm also wondering if that lousy ENT has used a scope to look at your trachea. I cringed when I saw that he did further surgery....

marta
11-28-2010, 06:48 PM
Welcome vdub. Sounds like you've had quite the ride. I am always amazed at the strength and fortitude of the people on this site and you're no exception. This is a very good place to be if you're dealing with the $#!^ that comes with Wegener's. The knowledge base here far surpasses that of any ER room when it comes to this particular disease. Listen to what Jack, and Sangye and elephant are saying. One thing that I've learned in my very short time of being a Weggie is that you HAVE to take control of your recovery and health care. Although intentions are good out there in medical world, there is sometimes waffling in the decision making process and if it's at your expense and long term health and welfare, it's no good. Be your own best advocate and forge on forward and demand answers, ask questions and get better.