What doesn't kill you

There is an old adage that I often use which says that what doesn't kill you only makes you stronger. I wonder if the strength you gain is proportional to how close to death you come or how much you actually suffer. Because if it is, I should be as strong as an ox by now! (Or at least a very strong cow!?)

On Thursday the 1st of November, I checked in to the National Hospital for Neurology and Neurosurgery in Queen's Square, London. I showed up at 9am, having fasted from the night before and mentally ready for the Inferior Petrosal Sinus Sampling (IPSS). But I don't think I was prepared for the day ahead of me. Firstly it turns out that contrary to what was stated on my letter, I did not need to be there for 9am as I wouldn't have the procedure until 2pm. Which also means that I didn't have to start my fast until later that day. But because the nurses were unsure and as usual no doctor was around to give correct advice, they refuse to let me have anything except a small glass of water. 

Quick update

Just a quick update this time. I've not forgotten about you but I've been pretty busy actually having a life (nice change!) My doctoral course has started, I'm attending more social events and have started going to the gym 3 times a week so my days are starting to fill up which is nice.

So the update is that I have a date for my IPSS. I have a pre-admissions assessment on Tuesday the 23rd of October. This is when you undergo a series of tests that check that you are suitable for the procedure e.g. blood pressure, weight, etc... Then, provided I get the all clear, I am being admitted on the 1st of November. The procedure will take place in the afternoon and should last a couple of hours max. I am required to stay overnight so they can monitor me. 

I've had mixed reviews about this test with some people saying it's a horrible experience and others saying it wasn't so bad. Thanks to a friend of mine I'm able to think about it in a positive way and am feeling more relaxed about the idea now. She encouraged me to visualise it as a positive experience by switching my way of thinking. Kinda like going from seeing it half empty to half full. So instead of thinking: "OMG, I'll be able to feel everything" (in a panicked, nervous way) think: "Wow, how fortunate I am that I'll be able to feel everything, they won't be doing anything without my knowledge" (in a calm, optimistic way). It's easier said than done but I've been practising every day and I really feel like I've made some progress. So much so that I will not be asking for full sedation, maybe just a little something to calm my nerves. We'll see...

Where do we go from here?

So as I've already mentioned several times, I have a confirmed Cushing's recurrence. However, this time around things aren't as straightforward. You see, although all my blood tests and urine collections are showing increased cortisol, nothing is visible on the MRIs which isn't good. It's not good because if the neurosurgeon cannot see anything on the MRI he doesn't know what his "target" is and although he could just go in and identify the tumour cells visually (apparently they look different to healthy cells), I'm not sure I trust him THAT much...

So this is where I'm at right now: my endo and other doctors will be discussing my case in their multi-disciplinary meeting to decide what the next course of action should be. At that meeting there are several key doctors such as endocrinologists, neurosurgeons and radiotherapists. As I mentioned in a previous posts there are several treatment options for Cushing's disease including neurosurgery, radiotherapy, adrenalectomy and medication. Therefore they will all be discussing what they think is most suitable considering the details of my case.