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New Message on Pituitary Chat

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From: Willard1H
Message 5 in Discussion

Hi, LK,   We're eager to hear how your medical trip went. I hope we got you our 
messages in time to be of use to you. Since you'd already decided to have an 
MRI or CT-scan, I felt it was crucial to mention the importance of 
comprehensive blood testing. Marcia and Anita certainly agreed with me.   In my 
case, the MRI was done weeks before at a moderately sized hospital. But not 
until I met with an endo and a neurosurgeon a few weeks later, did we know what 
the huge mass was inside my skull. At the big regional clinic, the hormone work 
showed high Prolactin, along with levels of all the other important hormones. 
The bloodwork was crucial.   But don't believe all the hearsay and get the 
impression of MRI imaging being less important. The Pituitary Network 
Association (PNA) emphasizes its importance, pointing out:   "Most 
prolactinomas can be visualized on both MRI and CT scans of the pituitary 
gland. Such scans should be performed without and following contrast 
administration." It's premature for us to suggest that you have the most common 
kind of pit tumor, a micro or macro prolactinoma -- at this point, we dunno if 
you even have a tumor at all!. But PNA's point is true in varying degrees, in 
maybe a dozen varieties of pituitary tumors.    But suppose a woman has a 3 mm 
tumor that the technician misses on the MRI images. My 50 mm tumor was obvious, 
even to my untrained eye. Yet we can't ignore what the MRI also tells the 
medical team -- what is NOT there. They want to get a good look at the whole 
brain, to be sure there is no tumor there, or a Rathke's cleft cyst. They also 
feel relieved if there is no visible damage to surrounding tissue.    Another 
reason we can't minimize the importance of the initial MRI is "time." Magnetic 
Resonance Imaging is not known to leave any ill effects. A tumor patient might 
be subjected to a dozen of them over a few decades of treatment and follow-up 
testing. That first imaging session would always be the benchmark in a 
patient's 20 or more years of checkups. (By contrast, CT-scans use radiation 
and are less sensitive, but also are considered vital.)   The same is true with 
the hormone assays from comprehensive bloodwork.If the lab techs stringently 
follow standard procedures, they can detect high or low growth hormone, FSH- 
and LH-secreting tumors, Cushings, etc. But a non-secreting tumor is more 
difficult to detect.   I'd suggested studying MinnieChat's Association Links 
and other resources on the blue sidebars of the page. PNA is one of the many on 
that list. The National and the American brain tumor associations are also 
valuable sources of information, and are much more autoritative than opinions 
or old wives' tales we members share here.     As one PitChat member advised 
recently, "Beware of some advice in forums: some people are extremist and do 
more harm then good." Sometimes a member might indeed have more recent or more 
scholarly research than the nat'l groups'.We'll be quick to provide links if 
that is the case.   Let us know as soon as you learn the outcome of your tests. 
If you haven't gotten a better endocrinologist, it's very likely we could 
recommend one near your geographical area.   Bless you, Willard

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