Miss Diagnosis: Meds, Meds, Meds...

Thursday, April 5, 2012

Meds, Meds, Meds...

The medical techs always ask, as we sit down in the exam room, "Are you on any medications?". Alex and I give each other "the look". Yes. Lots.

We'll talk cost another day.

Hydrocortisone ~ twice daily for cortisol replacement

Fludrocortisone ~ twice daily for aldosterone replacement

DHEA 25mg ~ once daily for, well, DHEA replacement (adrenals normally make it)

Estrogen/Progesterone combo ~ to regulate periods and prevent migraines

Nexium 40 mg ~ once daily for GERD

Vyvance 50 mg ~ once daily for ADHD

Levoxyl 150 mcg ~ once daily for central hypothyroidism

Clarinex 5 mg ~ once daily for year 'round allergies

Ironsorbs ~ three times daily for severe anemia

Vitamin D-3 50,000 IU ~once weekly for very low D levels

Albuterol Inhaler ~ as needed for asthma

Nasonex ~ as needed for allergies

Tramdol ~ as needed for pain (headaches)

B-12 ~ for improved energy?

Oh, and salt, in the form of Thermotabs, to replace lost sodium

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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.