Question:
Cushing's Disease (hypercortisolism) prior to surgery?
I have a dear friend who is fighting for her life in the hospital as I write this. She was diagnosed with diabetes and thyroid problems (both of which are indicators of Cushing's Disease), however she was not tested for Cushing's prior to gastric bypass in November. Cushing's causes a weakening of tissues in addition to a myriad of other life-threatening problems. She is now on a respirator and may not survive. Please talk to your surgeons if you have these same symptoms prior to surgery. If they are aware of it before surgery, they can treat the Cushing's and make sure the cortisol in your system is at a normal level, which may decrease your chances of endangering your life with WLS. Does anyone know if it is common to test for Cushing's pre-op? — Christie S. (posted on March 13, 2002)
March 13, 2002
Usually a Dr can tell if you have cushing's by looking at you. It has a
very distinctive body type, very large stomach and very spindly (NOT normal
thin, but thin thin) arms and legs. I believe there is also usually a fat
hump in the back, though pcos can also cause a buffalo hump. I don't
believe the test for cushing's is common. One problem though, is even with
wls it's very difficult to lose weight with cushing's or prader willis. I
hope your friend gets better.
— Becky K.
March 13, 2002
here is a site about cushings
http://neurosun.medsch.ucla.edu/Diagnoses/Pituitary/PituitaryDis_8.html
so sorry to hear of your friend being so down... I will keep her in my
prayers!
Barb
— Barbara W.
March 13, 2002
Hi! I am SOOO glad you posted this! I am undergoing testing at this time to
have WLS. My DR ordered a Cat scan of my adrenal glands as my cortisol
levels are abnormal. (high) How they detected this in me was due to my
blood sugar being low. One of the causes of this is an elevated cortisol
level. The DR thinks I may have tumors on my adrenal glands, but has not
mentioned anything about Cushings Disease or Syndrome. Due to the research
I have done on this, I have been concerned! I do know the DR told me this
has to be taken care of before WLS. Looks like I have some questions to
ask. Had my Cat scan a few days ago...Waiting on the results.
— ScatCat
March 13, 2002
I'm sorry to hear of your friend's condition. There is a blood test to
determine the amount of cortisol in the blood which will alert the
physician to a variety of diseases/disorders depending on increased or
decreased levels. It is a test to measure the serum cortisol which is
performed on patients who are suspected to have hyper- or hypofunctioning
adrenal glands. For this test, blood is usually collected at 8 a.m. and
again at around 4 p.m. The 4 p.m. value is anticipated to be one-third to
two-thirds of the 8 a.m. value. There are, however, drugs that can
increase or decrease levels, and physical and emotional stress can elevate
cortisol levels.
I switched surgeons and procedures before I actually had my surgery. My
first surgeon did not require an endocrine evaluation. The second one did.
This was one of the tests performed to rule out any problems with my
endocrine system which was cause my weight gain. I think all surgeon's
should require this.
— gracie30269
March 14, 2002
My endocrinologist tested me for Cushings before he would refer me to the
surgeon. He said there are two ways to test for it: taking a cortisol pill
and having blood drawn exactly 8 hours later or collecting all of your
urine for a 24 hour period and taking that in to the lab. I am so sorry
your friend wasn't tested first and I really wish her the best for a speedy
recovery.
— Susan B.
March 14, 2002
I am so sad to say Leigh lost her battle last night around 11:00 p.m.
I felt it was important to post this question so that others will research
this condition. Although it is not common, the chances of surviving WLS
with this disease seem slim. Please spread the word to others with
multiple symptoms including but not limited to thyroid problems, high blood
sugar/diabetes, excess hair growth on face, neck chest abdomen and thighs,
buffalo hump above the collar bone, weight gain in face (moon face), and/or
easy bruising and purplish stretch marks.
Leigh had an amazing lifeforce and she will be terribly missed. She is in
God's hands now.
— Christie S.
March 14, 2002
I am so sorry to hear about the death of your friend. You may have saved my
life with this post. I can't thank you and your friend enough. I am so
sorry for your loss.
— ScatCat
March 14, 2002
I'm sorry to hear about your friend. In answer to your question, when I
had my blood gasses done, the endocrinologist also ordered a test for
Cushing's for me. He ordered it because I have a tendency to bruise
extremelly easily, and he just wanted to rule Cushing's out as a cause. If
I hadn't had the bruising issue, the Cushing's test would not have been a
normal part of the pre-op testing.
— Kathy J.
March 14, 2002
I just wanted to say that testing for this is rare. After viewing another
post where the symptoms were mentioned, I spoke with my doctor about this
disease. My daughter is having tests done this week to rule out Cushings.
If I had not seen the posts, I would not have been aware of this disease.
Good Luck everyone.
— Beffy W.
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