Actually, stick with OHSU for the pituitary hypersecretion issue. I think that the neuroendo there is actually very good with Cushings. He is conservative regarding moving towards surgery with light evidence, but if he firmly believes you have a hypersecreting tumor, he will keep with you until he figures it out. The thing with cyclical cushings disease is that the doctor must prove that the tumor turns on and off and that the disease has to be proven to the satisfaction of the institution before the patients can be referred to surgery. It is not uncommon with Cushings that the disease must be proven under three seperate parameters. If the physician proves the disease with 2 parameters, and the patient is a long time patient, the physician can argue the diagnosis based on clinical disease progression. I know alot of patients don't like having to do so many urine collections too, but when working with a tumor that turns on and off, the doctor has to get creative. Most doctors would have you do 3 urine collections, and if they came back normal, would tell you to get with Jenny Craig or Weight Watchers. But... it may be worth investigating other potential endocrine issues that could be underlying... and for that, it might be worth seeking a second opinion... but... talk with your managing neuroendo first and see what he says. He may know someone in your area that will work with him. Minnie | 