We got the call from Dr. Friedman this evening. He has no doubt that Alex still has Cushing's and has given her his approval for surgery. He gave us the choice between a repeat of the pituitary surgery or bilateral adrenalectomy- henceforth known as BLA. After much thought and internal debate we are opting for the BLA. It will mean a life time of steroid replacement but the chance that it will be a cure for Cushing's is 99% vs, at best, 50% with another pituitary surgery. Alex's pituitary surgery, while unsuccessful, at least left her pituitary function intact. We feel that alone is enough reason to avoid going in again; considering the neurosurgeon would plan on removing half of the pituitary itself instead of just tumor the second time around.
We are being referred to Dr. Duh at UCSF, he is one of the few surgeons in the country skilled at bilateral adrenalectomy using a laprascopic approach. Hopefully he will be "on board" with the idea and diagnosis. For now we wait for the referral process.