Posts tagged ‘Glucose tolerance test’

Back from H (Hospital, Holidays)

(I’ll edit this post with the right hormone values later this weekend, so for a more accurate and probably colourful post, please come back!) Done!

I went for my three day check-up exactly three months after my surgery and things didn’t go as well as I thought they would.

Day one:

Little Magpie arrives early in the morning, fasting (i.e. hungry) and tired after a 1.5 hour drive from home. Magpie goes right to the VIP wing of the hospital because they didn’t have a bed for her in the “normal” area (where I stayed for 16 days for my surgery). That kinda upset me because I loved the staff and I wanted to see them again. On the other hand, I was excited to see what the VIP wing was like.

Unfortunately, they were not as friendly and loving and caring as in the old wing, but I was thinking positive and I thought I didn’t need as much care as I needed after surgery and I had a bigger room (although shared), a huge designer bathroom and a TV just for me.

Anyway, let’s go back to the interesting things. My first blood test was an ACTH stress test. Result: ACTH normal, GH 15 ng/ml. What??????!!!!! So I’m like on panic and no doctor is around to whom I can address my worries.

Later that day I had MRI and eye check-up. My eyes are great, my hypophysis also, doctors say. I don’t like the fact that noone showed me the images, and no one explained me what each new feature is (like how can they distinguish between the tissue-like thingy they placed to fill the hole left by the tumor and the tumor itself). But they said there was no tumor left. Ok. No chickpea left, magpie happy.

Day two:

Still thinking positive, I say to myself I’ll find the right time and the right person to ask my questions.

GTT test with 75 g glucose. ((Remember: I’ll post the exacts results later)), but it showed a 1.5 ng/ml basal amount of GH, then up to 5 ng/ml after 30 minutes and then down again to ~1.

Even though I am trying to be optimistic (what I always am) the stress of the previous day, the lack of information, the lack of interest from the staff (I totally have to beg for them to print me the results), the worries… give me such a headache they have to give me drugs and they realise I even got fever.

Day three

I am kinda upset because noone is really paying much attention to me. Not that I have to be the centre of attention, but the main doctor doesn’t even let me finish the sentences whenever I try to ask a question!. I go for a second GTT test, this time with 100 g glucose.

((Exact results to be included later))

Again, more than 1 ng/ml before sugar, goes up 30 minutes after intake, then down again.

Finally I manage to talk to a VIP-wing doctor (fortunately not the main one, whom I had begun to hate), a very nice girl, about my age, who kindly answers me all my questions.

15 ng/ml of GH the first day

No need to worry. This is due to the ACTH stress test itself. It’s an stress test, and GH levels rise with stress. It’s a 100% normal answer of my body.

Rising of GH after sugar. GH not being as low as in my 1.5 month checkup.

No need to worry. GH rises probably because I don’t like the drink (it’s true, folks, I really don’t like drinking it whatsoever and I have to concentrate myself strongly not to throw up). Important is that GH drops below 1 (or below 2, she didn’t quite remember, but she insisted my levels and my “drop” was 100% normal)

What’s with distinguishing between tissue-like filling and tumor?

Different level of grey in the MRI. And she says she saw my pictures and it was 100% normal. And, besides, in case you were wondering, the tumor is white and the hypophysis, yellowish.

My period is extremely short. Do I need to worry?

No, I don’t. PRL is also in the normal range. All female hormones are in the normal range. Instructions are: wait another three months and then ask the gynecologist.

My feeling of “breathing water” when I am training.

Nothing wrong is to be seen in the MRI scan, so as long as it doesnt leak, it’s fine. I don’t even have to stop training.

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So… how do I feel? Relieved because everything is over and because results are good, the chickpea is gone…

… but I still have a bit of a sad feeling. The reason they asked me to go back to the hospital after three months was not for me or for my health. I went back just for them to do this two studies:

a) about what is better, if 75g glucose or 100g.
b) about the feelings of acromegaly patients.

Being a scientist myself, I agreed I would take part in both studies (for the sake of science) but, honestly, I didn’t really have the choice. Had I said “no” to any of them I would have been sent straight home. Or perhaps not… I’ll never know.

The second study I found it really stupid, may be it’s a bit of a prejudice, but I don’t think psychological studies are very scientific. I found myself filling in a 20 page form, font size 8, with questions like (and I swear I am not making this up) “I find myself ugly in the mirror”, “I feel depressed because I think I look like a monster”, “I think people reject me”, “I don’t have friends because of my acromegaly”, “nobody likes me”… this is just so wrong. It looked like a suicidal test.

The worst feeling comes from the fact that the main doctor said I don’t have to come back ever again to the hospital for my next check-up. Which translated means “we used you for our studies and we don’t need you anymore, so go out and find yourself an endocrinologist, we don’t care anymore”.

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To get rid of this feeling, the third day, after leaving the VIP area, I flew upstairs to the wing where I was when I had the surgery. The usual staff was there, all remembered me, all were friendly and truly very happy to see me healed. That was a bit of a relief and reconciliation with the human race.Or the magpie race. :)Now I am back to normal life, back from holidays, back to work, and back in the nest, and when I think of this (horrible) mini-hospital stay I just focus on the words “you don’t have acromegaly anymore“.
Nevertheless, this just made me think. I was very lucky, during the surgery nurses and doctors were caring and loving, so much I regretted going back to Munich, I just didn’t want to leave the hospital! I think this helped a lot in my recovery. I’m glad I didn’t stay in the VIP area then.

August 13, 2008 at 12:20 pm 1 comment

All’s well that ends well

I’ve tried to post an online graph, but not successfully so I’ll post my GH values instead:

2002 my very first hormone blood test shows

PRL 26.6 ng/ml

This raises the fear of a prolactinoma, they MRI the chickpea for the very first time. Further blood work underwent in the following months.

2002

GH 20 ng/ml suppressed to 14 ng/ml after glucose tolerance test
IGF-1 118 ng/ml normal.
PRL 27 ng/ml high.

2002 – 2006 (several times, similar values)

2006

PRL 34 ng/ml high (max is 20)
GH and IGF-1 high (but doesn’t say how much).

This is the first time IGF-1 is not in the normal range.

2007

PRL 62.79 ng/ml very high.

2007-12

GH 10 ng/ml
IGF-1 566 ng/ml
PRL 34.70 ng/ml

2008-01 Glucose tolerance test (GTT)

IGF-1 624 ng/ml (max 492)
t=0 GH 11.40 ng/ml
t=15 min GH 10.40 ng/ml
t=30 min GH 10.30 ng/ml

2008-04 At the hospital, one day before surgery

PRL 890 uU/ml (different units, max is 500)
IGF-1 612 ng/ml
t=0 GH 17.6 ng/ml
t=60 min
GH 14.9 ng/ml

2008-05 At the hospital, one week after surgery

PRL 43 uU/ml (20 times less than the previous week!)
IGF-1 273 ng/ml normal!
t=0 GH 5.25 ng/ml still high, but better than ever!
t=60 min
GH 4.83 ng/ml

2008-06 One and a half months after surgery

PRL 9.83 ng/ml normal! (max: 20)
IGF-1 283 ng/ml normal! (max: 492)
t=0 GH 0.31 ng/ml normal!
t=30 min GH 0.23 ng/ml
t=60 min GH 0.22 ng/ml
t=120 min
GH 0.23 ng/ml

Happy ending!

July 7, 2008 at 10:10 am 3 comments

hospital, day 0

I went to the hospital on April 27th in the evening. It was a Sunday. Surgery was planned for Tuesday early in the morning but I needed to be at the hospital the whole Monday to get some things checked. So, I arrived there on sunday evening and hit my first milestone: I met my roommate.

She had had surgery, the same as I needed, one week earlier. She looked fine. Her voice was a little bit weird, apparently because of the breathing-tube during the surgery. She explained me plenty of interesting things such as how does the bed bend and where is the light, how does the tv work, what time do we wake up, etc. Our room is great (that was another milestone), very big, very big bathroom, huge window from where a forest could be seen… and very quiet.

Seeing my roommate so well helped me a lot. There is nothing to fear! And besides, she was such a nice person she’d always answer my questions and helped the worries stay away from me.

The following day, Monday, I had
– an oral glucose-tolerance test,
– a sight field (whatever you call it) because the adenoma is close to the optic chiasma and there is a risk it is damaged during the surgery,
– a chat with the anesthesia team and
– a chat with the neurosurgeon.

Everything was fine but for the chat with the neurosurgeon. He was a little bit too straightforward (in my oppinion). I was kind of afraid of him…I didn’t want him to think I was asking too much so I didn’t ask for all the details of the surgery such as how, what instrument are used, will they use X-Rays, what about the bone structures on the way…. Now I regret. A couple of things remain still unclear for me, minor details, but I would love to know the answer. This was the only thing I can complain about. My family is with me, they agree he could have been a somewhat nicer, closer, but I am not there to be his friend, I am there to be his patient, and he is the best neurosurgeon in Europe, which is what I want him to be.

Instructions from the anesthesia-team for monday night and early tuesday (day D) are two little pills. One for monday night, so that I can sleep through the night in case I feel I am too nervous (which I am) and a mild sedative for tuesday morning (my surgery is scheduled at 7 am) which I must take in order to remain calm and because less amount of anesthesia is needed if I take it.

So, it’s monday evening, I took the sleeping pill and I felt tired and relaxed… good night!

June 9, 2008 at 7:36 am Leave a comment


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