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I had Cushing's Syndrome due to non-pituitary-dependent bilateral adrenal hyperplasia. Rather than immediately recommend a bilateral adrenalectomy, my doctor put me on ketoconazole, a drug that inhibits steroid synthesis. I did very well on ketoconazole, and all of my Cushing's symptoms dramatically improved. Unfortunately, we had to keep increasing the dose during the year, so eventually surgery was recommended.
My endocrinologist at UCSF recommended that the bilateral adrenalectomy be done by laparoscopy and referred me to a surgeon at UCSF who had experience with the technique. Laparoscopy involves the use of multiple, 1 cm. incisions through which the surgeon inserts small surgical tools, including a camera, and views the procedure on a video screen. This approach is much less invasive than conventional approaches and was developed by Dr. Michel Gagner, at Hotel Dieu de Montreal. In the spring of 1994, this procedure was not yet in extremely wide spread use in the US.
We also learned that Dr. Andre Lacroix, Chief of Endocrinology, at Hotel Dieu was doing research on adrenal hyperplasia. Thus, I elected to travel to Montreal for testing and surgery. Once there, I underwent extensive testing to better understand the causes of the abnormal growth and function of my adrenals. After Dr. Lacroix had eliminated all other possible forms of treatment, Dr. Ganger removed both of my adrenal glands. I was very impressed with the speed of my recovery. I was walking within 24 hours, and was discharged from the hospital within 48 hours. I was off all oral pain medication in about 1 week, and mostly back to all of my normal activities within 6 weeks. If anyone is facing an adrenalectomy, I think it would be well worth the time to find a surgeon skilled in the laparoscopy procedure. |
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