Miss Diagnosis: MRI Results

Saturday, January 9, 2010

MRI Results

The results are in from the MRI last month, and the comments are less than interesting.

Dr. K's office called and said "He says there is no obvious tumor or disease". That was it. I had requested the MRI on disk and written copies of the radiology report and surgeon's report. I explained to the person on the phone that I hadn't received these things, and when pressured she agreed to fax me the two written items. The fax came through and sure enough that was the entirety of Dr. K's comments. The radiology report basically said the same thing, with a nice note saying that they had forgotten to use the dynamic protocol and would suggest they do use it next time. For the record? They "forgot" last year as well and made the same recommendation then. Jeez.

Oh, well, I think we are just not going to worry about it. Obviously there is no target worth going after at this point as far as Dr. K is concerned. Once I get the disk I'm sure Dr. McC would read it for me, but I don't think there's much point. Until next year this is going on the back burner.

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Transphenoidal Pituitary Surgery- From the UCSF web site

What happens during surgery?
The surgical removal of the pituitary adenoma is performed by a technique called a transsphenoidal operation. The word 'transsphenoidal' describes the path the surgeon follows to reach the pituitary gland. The word comes from 'trans', meaning 'to cross or pass through', and 'sphenoid', the name of the cavity (the sphenoid sinus) that is passed through to reach the pituitary gland. Newer techniques and improvements in technology now allow removal of these tumors without the need for an incision under the lip or within the nostril. The surgeon begins the approach by entering through the nostril on one side. The surgeon uses a brilliant fiber optic light to illuminate the internal anatomy, a microscope to magnify the area of surgery to 12 times the actual size, and very tiny microsurgical instruments especially designed for this particular operation. The surgeon guides the surgical instrument into the nasal cavity and an opening is made in the sphenoid bone. The sphenoid sinus is entered, and then an opening is made in the wall of the sella turcica to expose the pituitary gland. The adenoma can be readily distinguished from the normal pituitary gland tissue and is removed without removing the normal gland. After the surgeon removes all the tumor tissue, the small cavity that is left is treated with alcohol to destroy any tumor cells that may remain. This cavity is then sealed, sometimes with a piece of fat that the surgeon removes from the patient's abdomen. The surgeon then applies a biological 'glue' that helps seal the pituitary area from the nose and promotes natural healing. No nasal packs are used with this approach.