Day Six, Cushing’s Awareness Challenge

People sometimes ask me how I found out I have Cushing’s.  Theoretically, it was easy.  In practice, it was very difficult.

Ladies Home Journal, 1983In 1983 I came across a little article in the Ladies Home Journal which said “If you have these symptoms…”

I found the row with my symptoms and the answer read “…ask your doctor about Cushing’s”.

After that article, I started reading everything I could on Cushing’s, I bought books that mentioned Cushing’s. I asked and asked my doctors and all of them said was rejected each time.

 

 

Due to all my reading at the library, I was sure I had Cushing’s but no one would believe me. My doctors would say that Cushing’s Disease is too rare, that I was making this up and that I couldn’t have it.

In med school, student doctors are told “When you hear hoofbeats, think horses, not zebras“.  According to Wikipedia: “Zebra is a medical slang term for a surprising diagnosis. Although rare diseases are, in general, surprising when they are encountered, other diseases can be surprising in a particular person and time, and so “zebra” is the broader concept.

The term derives from the aphorism “When you hear hoofbeats behind you, don’t expect to see a zebra”, which was coined in a slightly modified form in the late 1940s by Dr. Theodore Woodward, a former professor at the University of Maryland School of Medicine in Baltimore.  Since horses are the most commonly encountered hoofed animal and zebras are very rare, logically you could confidently guess that the animal making the hoofbeats is probably a horse. By 1960, the aphorism was widely known in medical circles.”

So doctors typically go for the easily diagnosed, common diseases.  Just because something is rare doesn’t mean that no one gets it.  We shouldn’t be dismissed because we’re too hard to diagnose.

When I was finally diagnosed in 1987, 4 years later, it was only because I started bleeding under the skin. My husband made circles around the outside perimeter each hour with a marker so my leg looked like a cut log with rings.

When I went to my Internist the next day he was shocked at the size. He now thought I had a blood disorder so he sent me to a Hematologist/Oncologist. Fortunately, he ran a twenty-four hour urine test and really looked at me and listened to me.  Both he and his partner recognized that I had Cushing’s but, of course, couldn’t do anything further with me.  They packed me off to an endo where the process started again.

My final diagnosis was in October, 1987.  Quite a long time to simply  “…ask your doctor about Cushing’s”.

Looking back, I can see Cushing’s symptoms much earlier than 1983.  But, that ‘s for a different post.

 

Without a shadow of a doubt.

Without a shadow of a doubt.

…So I will say this to anyone reading who is in the same situation that I was: Don’t give up. Stay strong. If you know in your heart that something is wrong, keep pushing until you figure out what it is. Be calm, be implacable, be willing to listen and to accept hypotheses. Take the tests you’re offered, even if you don’t agree that you need them – they might throw up something useful. Be assertive but not aggressive. And don’t ever quit…”

Great post on the difficulties of getting a diagnosis. The author is participating in the Cushing’s Awareness Challenge by request. She doesn’t have Cushing’s but is hypopituitary.

via Without a shadow of a doubt..

Have You Been Diagnosed With Cushing’s? Earn $125-$250

We invite you to help us create better information, tools, and resources for people with Cushing’s Syndrome

How: Share your opinions and give input in a one-on-one confidential interview. Your opinions will remain confidential. The overall results will help others with Cushing’s Syndrome.

When: Market research interviews can be conducted by phone or in-person, in a location near you. The interview will last approximately 45 minutes.

If you are interested in a phone interview or in-person interview, please contact Clair Carmichael Johnstone (see details below). More information (including cities and locations for in-person interviews) will be provided on the phone.

Am I Eligible? If you’ve been diagnosed with Cushing’s Syndrome and still experience symptoms of Cushing’s you are eligible to participate. Cushing’s Syndrome includes: Cushing’s Disease, ectopic Cushing’s and adrenal Cushing’s. Patients should have been diagnosed within the last 10 years.

At this time, patients who are in remission, were diagnosed more than 10 years ago, or have had a bilateral adrenalectomy are not eligible for research.

Details: Participants eligible for market research will be asked to participate in the 45-minute interview. Patients participate also receive an honorarium (payment) for your time. Those who participate in an in-person interview will be compensated $250 and those who choose a phone interview will receive $125 for their time.

Why? Corcept Therapeutics is interested in hearing from people who suffer from Cushing’s Syndrome in order to improve treatment and information available. This can lead to improved education and resources for those with Cushing’s and physicians treating Cushing’s.

How do I find out more?
If you have questions or would like to participate, please contact Clair Carmichael Johnstone at:
Toll-free number: (800) 856-6706, or
E-mail: cushing@compasshc.com

Please provide your name, phone number, and the best times to reach you so we can follow up promptly.

Cushing’s and Cancer – the Reality of it all

This post is by Judy, a long-time message board member who is in the middle of Cushing’s patients.  Both children and her ex-husband have dealt with Cushing’s.  Judy is a Cushie-Blogger.

She posted this on her blog at http://judcol.blogspot.com/2011/06/okay-im-probably-ready-to-get.html

Okay, I’m probably ready to get politically incorrect here. Oh well.
It seems that at least once a day, sometimes many times a day,I see a post on Facebook that in its short version says a cancer patient has just one wish, that is to live. Repost…….

I have no doubt that is true. I have known several cancer patients & it is a real struggle and sometimes the outcome isn’t good (understatement).

Now here is the *but* & my own little personal rant.

A Cushing’s patient has many wishes.
1. Finding a doctor that believes they can actually be sick, not just fat & depressed (which happen to be symptoms).
2. Having friends & family that thought they were truly sick not just lazy.
3. Having enough energy to make it through the day and not being totally exhausted whether they did or didn’t accomplish something that day.
4.Being able to find an understanding doctor that isn’t halfway across (or clear across) the country. The same can be said of finding surgeons.
5. Wanting their mind to be clear enough that they can keep up with their job & their peers.
6. Wishing their body was physically able to do just some of the simple tasks set before it.
7. Wishing that they didn’t feel like they could throw up most of the day.
8. Praying they can get a nights sleep so they can make it through work the next day. And that they didn’t have so much muscle & bone pain.
9. Wanting their mood swings to go away so they can keep up with their emotions.
10. Praying (literally) that they live long enough to get a diagnosis.

This list could go on & on. The really sad part is that there were times I wished my family had cancer. Getting a dx would of (usually) been so much easier. Cancer doesn’t usually affect every system in the body. If you get a cure from cancer you aren’t usually left with permanent damage to random body systems.

Statistics say that Cushing’s is rare. I know it’s not. As the Cushie community says – it’s just rarely diagnosed. Most people think they don’t know anyone with Cushing’s. Most people would be wrong. They just don’t know a diagnosed Cushing’s patient.

That overweight woman in front of you in the checkout line? The one that has terrible mood swings? She might have Cushing’s. The coworker that suddenly can barely do her job because she is so exhausted and has terrible brain fog? She might also have Cushing’s. You know that girl at school that now has arms so hairy it looks like fur? You know, the one that also smells funky sometimes? Yeah, she probably has Cushing’s. You laugh at her but you know what? This disease doesn’t discriminate. It might be you someday wondering why the weight keeps piling on when you barely have an appetite and work out every day.
As with the list of *wishes* I could go on & on because Cushing’s truly is the disease that keeps on giving & giving & giving. Even after a cure (relative term) it still keeps on giving.

As a wonderful neurosurgeon has said “Cushing’s kills.” It just does it at a very slow, painful pace.

MaryO’Note:

This is fantastic, Judy. Thanks for saying it!

I’ve often seen that stupid FB post and haven’t reposted it.

I am both a Cushing’s and a cancer survivor. For me, the cancer was easier to deal with.

I have been dealing with Cushing’s and the after-effects since the early 1980’s.

All I’m left with after my cancer is a scar and some bad memories.

I think Sarah’s death got lots of us thinking. We’ve seen so many unnecessary Cushing’s deaths and it just breaks my heart.

Judy, may I use this as a guest post on my Cushing’s and Cancer blog? It’s perfect!

NIH Cushing’s Clinical Trials

Rank Status Study
1 Recruiting Safety and Efficacy of LCI699 in Cushing’s Disease Patients

Condition: Cushing Disease
Intervention: Drug: LCI699
2 Recruiting Preoperative Bexarotene Treatment for Cushing’s Disease

Condition: Cushing’s Disease
Intervention: Drug: Bexarotene
3 Recruiting Rosiglitazone in Treating Patients With Newly Diagnosed ACTH-Secreting Pituitary Tumor (Cushing Disease)

Condition: Brain and Central Nervous System Tumors
Interventions: Drug: rosiglitazone maleate;   Other: laboratory biomarker analysis
4 Unknown  Study of Depression, Peptides, and Steroids in Cushing’s Syndrome

Condition: Cushing’s Syndrome
Intervention:
5 Recruiting Examination of Brain Serotonin Receptors in Patients With Mood Disorders

Conditions: Mood Disorder;   Bipolar Disorder;   Depression
Intervention:
6 Recruiting An Investigation of Pituitary Tumors and Related Hypothalmic Disorders

Conditions: Abnormalities;   Craniopharyngioma;   Cushing’s Syndrome;   Endocrine Disease;   Pituitary Neoplasm
Intervention:
7 Recruiting Prospective, Open-Label, Multicenter, International Study of Mifepristone for Symptomatic Treatment of Cushing’s Syndrome Caused by Ectopic Adrenal Corticotrophin Hormone (ACTH) Secretion

Condition: Cushing’s Syndrome
Intervention: Drug: Mifepristone
8 Recruiting Anesthesia Management of Retroperitoneal Adrenalectomies

Condition: Adrenal Tumors
Intervention:
9 Recruiting Defining the Genetic Basis for the Development of Primary Pigmented Nodular Adrenocortical Disease (PPNAD) and the Carney Complex

Conditions: Cushing’s Syndrome;   Hereditary Neoplastic Syndrome;   Lentigo;   Neoplasm;   Testicular Neoplasm
Intervention:
10 Recruiting New Imaging Techniques in the Evaluation of Patients With Ectopic Cushing Syndrome

Condition: Cushing Syndrome
Intervention:
11 Recruiting Adolescence, Puberty, and Emotion Regulation

Conditions: Mood Disorder;   Neurobehavioral Manifestation;   Healthy
Intervention:
12 Recruiting Insulin Sensitivity and Substrate Metabolism in Patients With Cushing’s Syndrome

Conditions: Cushing’s Syndrome;   Insulin Resistance
Intervention: Procedure: Surgery
13 Recruiting Study of Adrenal Gland Tumors

Condition: Adrenal Gland Neoplasm
Intervention:
14 Not yet recruiting Adrenalectomy Versus Follow-up in Patients With Subclinical Cushings Syndrome

Condition: Adrenal Tumour With Mild Hypercortisolism
Intervention: Procedure: Adrenalectomy
15 Recruiting Assessing Fertility Potential in Female Cancer Survivors

Condition: History of Cancer
Intervention:
16 Recruiting Study of Pasireotide in Patients With Rare Tumors of Neuroendocrine Origin

Conditions: Pancreatic Neoplasm;   Pituitary Neoplasm;   Nelson Syndrome;   Ectopic ACTH Syndrome
Intervention: Drug: Pasireotide LAR
17 Recruiting Adrenal Tumors – Pathogenesis and Therapy

Conditions: Adrenal Tumors;   Adrenocortical Carcinoma;   Cushing Syndrome;   Conn Syndrome;   Pheochromocytoma
Intervention:
18 Recruiting Prevalence of Pituitary Incidentaloma in Relatives of Patients With Pituitary Adenoma

Condition: Pituitary Tumor
Intervention:
19 Recruiting Safety and Effectiveness of Granulocyte Transfusions in Resolving Infection in People With Neutropenia (The RING Study)

Conditions: Neutropenia;   Infection
Interventions: Drug: Standard antimicrobial therapy;   Biological: Granulocyte transfusions;   Drug: G-CFS/dexamethasone;   Device: Apheresis machine