Second visit with the Professor

I went to the endocrine department to meet with the Professor. It was great to see familiar faces again, the nurses (Ma. & Fi.) and the doctors who made me feel so welcome last time. It was especially good to meet up with the two doctors (Vi. & St.) who had endured many hours of what must have seemed as interrogation during my two overnight stays as part of a research program I had volunteered for.

Anyhow, my wife came with me today, and the appointment today was a “catch-up” to see where I was up to and how I was getting on after my first month on Sandostatin LAR (that’s the injection that’s injected one per month). He summarised some of my results and answered a whole heap of questions I had. He still had his bright red socks on to match his personality. At the end of my barrage of questions, he smiled and asked me “Have you thought of your next question yet?”. I could have talked to him all day, so I just thanked him for answering my questions so well. He was very patient with me, and has an excellent manner and so incredibly gifted in his work.

The results of my 24-hour blood pressure monitor showed that my blood pressure was being poorly controlled.

It turns out that my blood pressure looks like “common-all-garden” blood pressure. The Doctor S. now has the quest of finding a better combination of treatment for that for me and finding one that is compatible with my pilot’s licence.

The results of my echocardiogram shows that my heart is fine. There is a slight thickening of the left ventricle, but that’s consistent with prolonged blood pressure.

Other test that were carried out on me in the last few moths were to rule out other conditions that could have contributed to the acromegaly. Thankfully I have “bog standard” acromegaly and not something more complex like “MEN-1”.

One thing that is pretty strange is the anomaly between my Growth Hormone (GH) and my Insulin-like Growth Hormone (IGF-1). Mine is 9.8 / 1244 (GH/IGF-1). So my GH is higher than it should be (it should be less than 1) but my IGF-1 is incredibly high at 1244 (I’m probably easily in the very “top” section of people with that level). For such a high IGF-1 value, my GH is suprisingly low. Very strange.

IGF-1 is produced mainly in the liver as a response to GH being produced by the pituitary gland (and of course, by the tumour that is beavering away). IGF-1 is also produced (or perhaps just stored) in muscle mass too.

Anyhow the disparity of my GH/IGF-1 could either work for me or against me. I’ve not worked it out. In a way there is a large “leverage” (ratio) between my GH/IGF-1 so a small drop in GH would result in a large drop in IGF-1 I’d imagine. On the other hand, I’d imagine that, after my eventual operation if there was still some residual tumour left producing only a small excess of GH, it would still result in an appreciably high IGF-1 level.

It’s worth remembering that it’s not Growth Hormone (GH) that causes growth as such, but rather it’s the “Insulin-like Growth Factor 1” (IGF-1).

They emphasised again that compared with a number of patients they have, my pituitary adenoma isn’t really all that big. Yes, of course it is a “macro”adenoma (macro meaning big), but many patients when diagnosed have much bigger macroadenomas. So I have in a way got a “smallish big” tumour!

Anyhow, my wife and I left feeling up-beat and happy about the whole thing, with the rays of the sun beaming down on us for the rest of the day.