Medical Shenanigans.

So... I am back from my time off, and back from a wonderful NESAT. The health stuff has been taken care of at the start of May, and it was definitely an experience.

I could have gone on living very well without being medically interesting, but in things like that, well, you don't always get a choice. I was very, very lucky overall, however.

What I had goes by the lovely name of Cushing's Disease - and if a condition has "disease" in its name, usually that is not a good thing to have. My diagnosis happened more or less by a chance discovery of abnormally high DHEA-S levels, so I did not have any real, noticeable symptoms yet. Cushing's Disease is a rather rare condition; most people, however, have heard of Cushing's Syndrome, which has similar symptoms and is much more common. 

Both conditions are characterised by an excess of cortisone in the system. Cortisone is a good thing to have, in general (you need it for the flight reflex, for instance, or to handle other stressful situations both physical and psychological), but too much of it for too long is very much not-so-good. In Cushing's Syndrome, the excess cortisone can come from anywhere, for instance from a therapy with cortisone. In C's Disease,  it's all home-made stuff. In my case (which is the most common variety of CD), it was a little adenoma (a benign tumour) on the pituitary gland. That tiny booger had nothing better to do than sit there and secrete ACTH, which is the signal stuff telling the adrenal glands to get going on making some more cortisone. Because, well, the booger thinks it's a good idea. (If it thinks. Anyways.)

There's only one good way to fix this, and that's to cut out the adenoma. How this is done is fairly straightforward, literally - you go in through the nose, then make your way through the sphenoid bone, open up the bottom of the sella turcica where the pituitary gland sits in, cut out the adenoma, and that's it. (Well, you place the insides of the nose back where they belong on your way out, of course. The septum gets temporarily pushed to the side, which means two small incisions inside the nose, but they can't really be seen from outside.) Going for the brain through the nose is not a new idea either, as the old Egyptians did that already. (They may not have been so specific and precise with what they took out, though. I was quite determined to only do this kind of reenactment in a very much modernised and very watered-down version.)

So. First bit of real good luck: Diagnosis before the onset of any noticeable symptoms. Second bit of real good luck: One of the best clinics in Germany for this kind of surgery is in Erlangen. Third bit of real good luck: Everything went very well, without complications, and I had the best team, best nursing staff, and best roommates imaginable in the clinic for my recovery.

Now I have a lot of high-res images of my brain, with and without the booger in. There will be another check in about three months where I get to lie down on the really expensive wellness lounger again. (Pro tip: If you have to go for an MRI, bring a blanket or ask for one. I almost turned into an icicle my first time; the bed itself is heated, so you're warm from the bottom, but there's a cold air flow inside the machine, and that does mean business. I was afraid that I'd start shivering and would ruin the images! Second time I asked for a blanket and it was really nice and comfy.) 

I will also get the questionable treat of a lot more visits to the doctor in the future than I was used to, as hormone levels of all kinds need to be checked regularly for now. Time will tell whether my pituitary gland will take up its job again to produce ACTH - as it has been on pause for a good while, it might be a little miffed and not willing to do the work just now. (The surgeon said that for them, it's nicest if the gland never starts up again, as that means the tumour is gone and has not come back. Once production starts again, checks have to be made to see if it's legit and done by the gland, or if something has grown back.) So for a while, I'm now depending on meds to keep me going. That is a little scary, actually... but I'll get used to it for a bit, and I do hope I will be able to wean myself off the pills at some point. I can report that there was no problem at all with my dosage even hopping through Warsaw for the NESAT conference, which I was able to attend without problems. The only thing that happened was that I got very tired rather quickly in the evening, and a bit earlier than usual, but then, everyone was tired after the very intense days of the conference.

(Side note: It was a very good thing that I prefer the train to the plane and had arranged for a night train trip to Warsaw and back - you're not allowed to fly for three months after a surgery that goes inside your skull. So I was very, very pleased to have travel plans compatible with after-surgery guidelines!)