Showing posts with label panhypopituitarism. Show all posts
Showing posts with label panhypopituitarism. Show all posts

Monday, April 1, 2019

Article The Guilt of Feeling Well - by Sunny Amerman


I wanted to share an article written by someone with Congenital Panhypopituitarism - the Disease I was born with. I can relate to much of what she writes about in the article, especially the unpredictability of this disease, flare-ups and feeling guilty when I have to cancel plans because of my health. So little is known about this rare disease.


ARTICLE: The Guilt of Feeling Well - by Sunny Amerman



The title of this article might seem absurd to most people, but those of us living with chronic illness won’t even do a double-take. Generally, people have good health that is consistent day-to-day, save for the occasional cold or flu, so this isn’t something most people even think to consider. It’s hard for most people to understand having energy some days, and feeling unwell on others for seemingly no reason at all.
Anyone living with the fatigue that accompanies many chronic illnesses can tell you that there is no such thing as “normal” for us. One day, we might wake up feeling like we can conquer the world, but we can not promise you that we’ll be able to get out of bed the next morning, or that we won’t have to cancel out plans for this evening thanks to a flare-up out of nowhere
That’s where a lot of this “grief” comes from; those nights when we have to cancel plans due to a sudden wave unanticipated exhaustion.
Of course, the fatigue is only one of many symptoms of chronic illnesses, but I’m focusing on it for this article as I have the most experience dealing with it due to my Panhypopituitarism and the Secondary Adrenal Insufficiency and numerous hormonal deficiencies caused by it. 
With Adrenal Insufficiency, the fatigue is brought on by complications with my adrenal glands, and it doesn’t take much to cause a flare-up. Even emotional stress has a real, physiological affect on my overall health that can be seen in lab tests. This is not a case of “mind over matter”, but a real physical symptom of a disorder that can be life-threatening. An imbalance in many of the hormones I am deficient in can cause debilitating bouts of fatigue, vertigo, and just general malaise as well. 
Every diagnosis that fits the label of chronic illness has its unique complications and some are harder to cope with than others, but fatigue is consistently one of the more debilitating symptoms, which is why I am choosing to focus on that for now.
Before I go any further, I want to clarify what exactly fatigue is. This is not tiredness or feeling sleepy. The Mighty has an excellent video explaining it. Please watch this. It’s short, and to the point:


Because the fatigue is so overwhelming, we simply can’t “tough it out”. Doing so might put us in danger of passing out, or falling over and injuring ourselves, and that’s despite the fact that it just physically feels awful. Even forcing myself to sit up during a particularly bad bout of fatigue makes me feel nauseous and shaky. Sometimes if it’s just minor fatigue spell, a cup of coffee can help get me through it, but that’s rare. Usually, I have no choice but to lay down to rest, even if I had planned to do something I was really excited for. I can’t tell you the number of times I have had to cancel outings with friends and family because of the fatigue alone. I have tried to push through it a few times, and I always wind up feeling miserable, so I’ve learned to listen to by body and rest when it demands it.

Of course, that carries some social consequences. To people who don’t understand our illnesses, it may seem like we are blowing them off if they see us going out and having fun one day, and cancelling plans with them the next. It can look like we’re making excuses not to see them, when in reality we’re sitting at home feeling like crap physically, and beating ourselves up emotionally because we had to cancel.
While that by itself is difficult, I personally find it even harder to cope with the guilt I feel when I’m having a good day. I lost by job because of the fatigue and vertigo spells that overwhelm me at unpredictable times. Because I am unable to keep a job thanks to these complications, I decided to apply for disability. The process is long, stressful, and disheartening. I have been denied twice already. My attorney and I are appealing to see a judge now. With all of this going on, it’s hard for me to appreciate those rare “good energy” days when I have them.

Despite the fact that I know that the symptoms I feel are real and do require rest at times, I can’t help but feel like a hypocrite when I cancel plans one day and go out on the town the next, and when I DO go out and have fun on those good days, I can’t help but grapple with the thought that I could easily be at work somewhere in that moment. There are some days when I feel like I COULD be at work bringing in some pay to help with bills and groceries. Unfortunately, days like that are very few and far in-between. It isn’t uncommon for me to go a couple of weeks without having a “good energy” day. Most of the time, I am so weak I can barely keep up with household chores, let alone a part-time job. I know that if I were to go out and get a job, no employer would put up with having such an unreliable employee. Having a regular schedule just does not work when you can’t predict when you will be stuck in bed.

This is a boatload of emotion for me, personally, and I have a feeling many of you can relate to it. It’s so hard to enjoy myself when I’m feeling well, because I know it must look like I’m lying about my bad days.
This may seem odd, but I have grappled with the feeling that I shouldn’t go out and enjoy those good days. I feel like if I don’t stay at home and keep with the appearance of being ill, people won’t believe that I really am unwell. I don’t do that to myself, of course. I make the most of those days when I have them, but I still have that pang of guilt, especially when I can tell someone is judging me for doing so. 
I don’t have a solution for this. As a matter of fact, I am currently seeing a therapist to help me cope with these thoughts and the depression brought on by them, as well as the depression from my hormonal imbalances courtesy of Panhypopititarism. I wish I had some advice to give those of you struggling with those thoughts as well, but as of right now, I’m at a loss just as much as you are. All I can say is, even though this is extremely rare and you are not likely to meet another person with this condition outside of the internet, you are not alone. I’m here, and I know how it feels. I’m always free to talk if you ever need to. You can reach me via any of the social media platforms listed under the “social media” menu at the top of this page. 
If you are on Facebook, check out this support group for Congenital Panhypopituitarism patients. If you do not have CPHP, but you struggle with other chronic illnesses, there are a plethora of amazing support groups on Facebook for you as well! My favorite out of all of them so far has been “MBMBaM Spoonies“, a group specifically for those of us with chronic illness who also happen to be fans of “My Brother, My Brother, and Me“. 
Even though I struggle with this guilt and shame, I always try to remember that this was not my fault. This was not my choice. These symptoms are real, and what I feel is real. My experiences are real, and my frustration is valid. Anyone who chooses not to believe this is ignorant, and I should really pity them for being unable to show compassion for someone enduring something that would likely break them.
I am physically weak as hell, but I am strongerthan they will ever be.
I just need to keep remembering that, and I hope you will as well.


Featured image courtesy of Pexels.com

Please read the article and view Sunny’s video on CPHP basics - an informative video on the disease

Chronic Fatigue from Panhypopituitarism


Ableism

Sunny Amerman, of Insomnia Doodles and The Mighty author, wrote a post on her Insomnia Doodles blog on why she celebrated being approved for disability support by going bowling, titled:

Why I decided to celebrate winning my disability hearing by going bowling:

"I know that headline caused some eyebrows to jump towards the ceiling, so please allow me to explain:
Disabled  Incapacitated
I repeat- Being disabled does not necessarily mean that you are physically incapacitated.
This is something I wish more people understood, and the taboo imposed on those of us with debilitating invisible conditions is so great that I honestly had to think long and hard about whether or not I was brave enough to write this article. I mulled over the idea, worrying about the potential backlash of ableism and judgement that might follow. When I realized just how afraid I was to write this, that’s when I knew I had to."
( Continue reading here.)

I think some people are going to learn a great deal from it and those like me who have Panhypopituitarism know that you might get a rare good day and most of the other are a struggle. It’s very important to socialise and to celebrate with friends, especially after a very long and drawn out process to being approved for disability support.

Like Sunny, I get ableist remarks from some people, mostly when I use my Mobility scooter. Just because I can walk short distances doesn’t mean I can do it all the time. I might look like I have fully functional feet because I wear Colorado boots every day of my life to lock my ankle so I don’t walk over my heels. I do walk for exercise but I often use my scooter for shopping trips and to carry my bags.

I have a bad neck and can’t drive due to a fall down 23 stairs and a car accident. I can’t turn my head most days and I have muscle wastage from the degenerated discs in my neck. I’ve had people make snide comments under their breath or straight to my face that I should ‘get of your fat ass and walk, you lazy bitch’. Yes, people can be very judgemental.

The last person who said so got an education in not judging a book by its cover when I explained my medical history and they apologised and gave me a hug and said it was amazing I was getting around with a smile despite Chronic pain and Chronic Illness. I usually don’t let people’s harsh words ruin my day but sometimes I decide to turn the situation into a learning experience.

I am trying to walk more, only on level ground or I twist my ankle and can’t walk at all. I signed up for Walk For Autism which starts tomorrow. 10,000 steps a day (roughly 6km) for 8 days - a mammoth task for me but I’m going to do my best - especially when it helps people with autism!

I use a mobility scooter to get around most days and whilst some people are downright rude and point fingers at me for being a 'young' woman (47 years old) riding a mobility scooter when I don't look disabled. 

I do find that if I put a smile on my face and apologise if I get too close to someone (usually their fault) and smile then most people smile back and say 'no problem'. It's all about the attitude in my experience. I put myself in their shoes. Having a moving vehicle getting close to pedestrians can be scary for the pedestrians.

I am so grateful for every kindness shown to me, which can be as small as a smile, stepping to the side so I can pass, or cars stopping so I can make it across traffic (something which can be hair-raising at times! I am very fortunate that the majority of people are nice and understanding. 


Sunday, March 31, 2019

Mobility scooter accident


This afternoon I was on my way to Raby Bay to walk a friend’s dogs after doing 7,500 steps earlier in the day. On the way, on the ‘Rainbow Serpent’ pathway from the Cleveland Library to the Raby Bay Harbour / Marina, I had a cyclist ram my scooter and cause 3cm worth of damage to the front of my mobility scooter where his wheel crashed into the plastic to the right of the left front wheel.
We collided twice and I got a small whiplash, thrown forward and then back, wrenching my back and neck and went into shock which lasted for hours.
I’m about to stress dose with some Cortisone as I feel adrenal crisis due to the physical and psychological shock I experienced. Google ‘Panhypopituitarism’ and shock and you’ll read how people with my disease can die from an adrenal crisis.
It wasn’t entirely his fault as the hedges block off the view of someone coming around the corner but he was going VERY fast and crashed his wheel in between my left wheel and the front of the scooter which has a black handle.
The plastic has shattered and you can see the usually hidden part of the front place handle through the cream plastic casing. I was severely shaken up with slight whiplash and I went into shock, hands and spine-tingling and felt nauseous.
The young man riding the bicycle seemed very remorseful and kept asking if I was ok but he was the one that was launched forward and hit the front of my scooter and almost smashed into my face 😯
I asked him to go to the hospital to get checked out. but he said he was fine.
I will take a photo of the damage to the scooter in the morning as it is already 7.23pm and my iPhone 6S Plus has a dodgy camera that has 90% of images look like my hands are shaking from side to side. Annoying because I love taking photos and it only stops when I hold a magnet near the camera lens. Weird, right? I found this solution on a google search.
But I digress, photo in the morning and I’ll be visiting the council and demanding they reduce the hight of the hedge before the next accident is fatal. The young man could have become a quadriplegic if he had fallen. Not good enough!
I’m aching from head to toe and still a little shaken. I’m about to get into the bath and then get into bed with my heated back and shoulder blanket and recover from a very eventful day. I am 1, 428 steps short of 10,000 but everyone said I should just head home and recover so I relented even though it annoyed me that I was so close. I will add it onto tomorrow’s 10,000 steps. Wish me luck!
Time to go self-care and hope I can get out of bed in the morning.
Night!
Vanessa

Thursday, March 21, 2019

What is Panhypopituitarism?


The title of an eBook I am working on. I will share it soon. 

A group of people living with PHP are sharing their stories to raise awareness of this rare condition which can be life-threatening.

What is Panhypopituitarism?

"Panhypopituitarism is a condition of inadequate or absent production of the anterior pituitary hormones. It is frequently the result of other problems that affect the pituitary gland and either reduce or destroy its function or interfere with hypothalamic secretion of the varying pituitary-releasing hormones."
"The pituitary gland is called the master endocrine gland of the body because it controls the function of other endocrine organs. The anterior pituitary produces the hormones thyrotropin (thyroid-stimulating hormone [TSH]), corticotropin (adrenocorticotropic hormone [ACTH]), luteinizing hormone (LH), follicle-stimulating hormone (FSH), growth hormone (GH), and prolactin (PRL). The anterior pituitary is controlled by specific hypothalamic-releasing hormones. The posterior pituitary produces vasopressin (antidiuretic hormone [ADH]) and oxytocin."

Wednesday, March 20, 2019

Panhypopituitarsm 101: The Basics of Panhypopituitarism by Amerman





My favourite advocate for Panhypopituitarism is Sunny Ammerman. Her videos and blog articles are insightful, educational and very easy to read. Please visit the links below to learn more about her journey with Panhypopituitarism

Watch videos by Sunny on YouTube

Read articles by Sunny on her blog, Insomnia Doodles

Wednesday, March 6, 2019

Diabetes scare


Recently I was admitted to hospital as my Blood Sugar Level (BSL) was over 30 mmol (576 mg/DL). I've had high levels (over 18-25) recently due to bad food habits. Now I'm on Bydureon injections once a week to lower my BSL. It's now down to 14-18. I often forget to test myself before a meal OR I snack too much and it gives a high reading. I need to get it down to 6-9 mmol (109-152 mg/DL)
Does anyone with Panhypopituitarism have diabetes? Do you have a problem regulating your BSL? Anyone have any advice? Other than to cut out foods that spike BSL. I'm already working on that

Friday, March 1, 2019

Overview of the Pituitary by the Australian Pituitary Foundation







(Source: Australian Pituitary Foundation )


Dr. Saima Amer, Endocrinologist Department of Diabetes & Endocrinology, Gold Coast Hospital

CONTENTS:
Feed Back Loops
Pituitary Hormones
Anterior Pituitary Hormones
Posterior Pituitary Hormones
Are there other Endocrine glands in the body?
How would I know if my pituitary gland was not functioning correctly?

The pituitary gland is the “master gland” of the body. It controls the functioning of most of the other endocrine organs of the body called “glands”. Glands are organs that produce hormones.

Hormones are chemical messengers that travel in the blood stream to reach their specific target organs, which are affected by the action of the hormone.This sounds funny. How is it that the hormones only act on certain organs/tissues when in fact, through the blood stream, they can reach every tissue of the body? To understand this, consider the analogy of a lock and key.The key would open only the lock it has been designed for. Hormones work on their target tissues or cells in the same way. They attach to receptors on the surface of the cells, and bring about a series of changes in the target cell.



The pituitary gland sits very securely in a bony pocket of the skull called the “sella turcica”. The gland is about the size of a pea. It is actually comprised of two parts. The anterior pituitary is the front part, and the posterior pituitary is the hind part of the pituitary gland. The posterior pituitary is an actual extension of neurons from the under-surface of the brain called the hypothalamus.

The function of the pituitary gland is controlled by two types of influences; mainly by the lower part of the brain called the “hypothalamus”, and via a “feed-back loop” by the hormones made by other glands of the body.




Feed Back Loops:

A feedback loop is also an interesting and important concept to understand in order to facilitate the understanding of endocrine systems. This can be best demonstrated by the example of thyroid hormones (T3 and T4) and their relationship with the pituitary hormone (TSH) which stimulates the production of thyroid hormones.

The hypothalamus, which is the lower part of the brain, produces a hormonecalled TRH (Thyrotrophin Releasing Hormone). TRH stimulates the pituitarygland to make TSH (Thyroid Stimulating Hormone) which, as its name suggests, stimulates the thyroid gland to make Thyroxine (T4). When the levels of T4 and also T3 (an active form of T4) exceed a certain limit, T4 and T3 have an inhibitory (negative) effect on both the hypothalamus as well as the pituitary gland, so that they reduce the production of TRH and TSH. This is in turn results in reduced production of T4 and T3 by the thyroid gland. When the levels of T4 and T3 drop below a certain limit, the negative effect on the hypothalamus and the pituitary goes away, resulting in increased production of both of these hormones, which then increase T4 and T3 production. This loop is orchestrated to maintain normal levels of thyroid hormones in normal individuals. Any increases or decreases are designed to meet the demands of the body at certain times. Most of us would be glad to know we don’t have to consciously think about it on a day-to- day, and hour-to- hour basis.
Pituitary Hormones:

The hormones secreted by the pituitary are generally studied best by dividing them up between those secreted by the anterior pituitary and the posterior pituitary.

Also, to understand these hormones better, we need to understand what the target glands do in response to pituitary hormones. Generally there is a cascade of hormones that is secreted. Hormones secreted by the hypothalamus control the pituitary hormones, and the pituitary hormones in turn control hormones secreted by other glands of the body. Those hormones in turn go and act on different cells and tissues of the body and cause a stream of reactions or actions that lead to some changes in the body function, be it growth, heart rate, glucose levels in blood, secretion of milk for the baby, or contraction of the uterus during labour.

The anterior pituitary makes the following hormones:
GH (Growth Hormone)
TSH (Thyroid Stimulating Hormone)
ACTH (Adrenocorticotrophic Hormone)
FSH (Follicle Stimulating Hormone)
LH (Luteinizing Hormone)
Prolactin

The posterior pituitary makes the following hormones:
Anti-Diuretic hormone (ADH, also called Vasopressin)
Oxytocin
Anterior Pituitary Hormones:
Growth Hormone

Growth hormone is secreted by pituitary cells called Somatotrophs. It is a peptide hormone. The secretion of growth hormone, like a few others is pulsatile and follows a circadian or day-night rhythm. GH levels are highest at night-time when we are asleep, and relatively lower during the day. GH secretion varies at different stages of life. Adolescents have the highest levels, followed by children,and then adults. As we age the GH levels fall off and there has been much interest in GH as an anti-aging hormone, but so far there has been no proof that it can reverse or stop the clock. GH is ketogenic, i.e. it stimulates the formation of free fatty acids, which can be used by the body as a fuel when it is deprived of glucose as a source of energy.
As the name indicates, the main function of growth hormone in children and adolescents is regulation of growth. GH does this by recruiting other hormones;mainly IGF-1 (Insulin-like Growth Factor-1) which is secreted by the liver inresponse to GH. There are many others in the family, but IGF-1 is by far the most important.
Thyroid Stimulating Hormone





Human TSH is a glycoprotein. It stimulates the thyroid gland to produce thyroxine, which is a hormone that has wide spread implications for metabolism in the body. Absence of thyroxine is incompatible with life. Patients with pituitary problems, who lose the function of TSH, have to have thyroxine replacement life-long. Thyroid hormone or thyroxine increases mental alertness,heart rate, motion of the gastrointestinal tract, breathing drive, as well as brain development and skeletal maturation in the foetus.




ACTH (Adreno Corticotrophic Hormone)

ACTH is secreted by pituitary cells called corticotrophs. The hormone stimulates the adrenal glands to make cortisol, which is the natural steroid our bodies make. The adrenal glands are two small glands, one on top of each of our kidneys. They make other hormones in addition to cortisol, but for the purposes of this article we will not discuss those hormones as they are not under the control of the pituitary gland. Cortisol is essential for survival; absence of cortisol is incompatible with life.


One of the interesting, as well as very important aspects of steroid secretion is that steroids are secreted by theadrenal glands in the form of pulses, in a circadian rhythm. The maximum secretion of steroids happens around the early hours of the morning and reachesa peak generally when we wake up.Afterwards the levels of steroids slowly come down during the day as the sun goes down. Changes in ACTH secretion through the day govern this day-night cycle of steroid secretion.

Note that patients who take steroids due to pituitary or other diseases have theirmaximum dose first thing in the morning, and progressively lesser doses during the day. This is because we are trying to mimic the natural cycle.

Steroids maintain normal blood pressure, increase protein and fat metabolism,and increase blood glucose levels. Externally administered steroids can make diabetes worse. They generally suppress the immune system. They can stop the bone-building cells, resulting in osteoporosis, a condition resulting in weak bones and susceptibility to fractures due to a low level of trauma. Steroids have effects on mood, and play important roles in growth and development. Different factors can have an impact on the amount of steroids the body needs or secretes.Stress, both physical and emotional, results in increased steroid levels. Infection,inflammation and low blood glucose levels can all increase the steroid production by the body, provided all the feedback circuits are working normally. In patients with a deficiency of ACTH, the ability to increase steroid production is absent,therefore patients are asked to increase the dose of their steroids when they are ill or have elective surgery etc.




FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone)

These two hormones are best described together as they have actions very closely related. These are stimulated by a hypothalamic hormone called GnRH(Gonadotrophin Releasing Hormone). These control the ovarian function,formation of follicles and hence eggs (ova), and maintenance of the female reproductive cycle in females. They stimulate formation of testosterone and sperm production in males. In females FSH stimulates the development of the follicles in a cyclical manner. The follicle then produces oestrogen. In men FSH stimulates the production of sperm. LH is responsible for causing ovulation in females, and in men production of testosterone.
Prolactin

It is secreted by the pituitary cells called lactotrophs, and causes milk secretion from the breast after oestrogen and progesterone priming during pregnancy. Prolactin also inhibits the secretion of gonadotrophins (the hormone responsible for pituitary secretion of FSH and LH). Therefore some patients with prolactin-secreting tumours can present with irregular cycles, or infertility, or low testosterone levels. Its secretion is increased by exercise, surgical and psychological stresses, and stimulation of the nipple. Secretion is increased during pregnancy, reaching a peak at the time of child birth. Interestingly prolactin is under an inhibitory control, i.e. dopamine. This factor secreted by the hypothalamus inhibits the secretion of prolactin. Hence, if due to a tumour the pituitary stalk is compressed, prolactin levels rise as thinhibitory signal is removed.
Posterior Pituitary Hormones:
Vasopressin (Anti-Diuretic Hormone, ADH)

ADH is secreted in response to high serum osmolality (Na) or low bloodpressure. It works on the kidneys to conserve water, hence restoring osmolality.It also works on the blood vessels to increase blood pressure.
Oxytocin

It is released during labour and increases uterine contractions at the time ofdelivery. It also causes the ejection of milk from the breast by causing contraction of the myo-epithelial cells. It is the hormone that is used in the form of a drip to induce labour in women who do not enter into labour naturally, and is commonly known as a “Syntocinon” drip.

Are there other Endocrine glands in the body?

Yes. Other glands in the body include the four parathyroid glands for calcium production, the pancreas gland for insulin production, and the central parts of the adrenal glands which produce adrenalin and nor adrenaline. These glands do not need the pituitary gland to give them messages to make their hormones, they are dependant on other chemical or neurological control, but they are partof the endocrine system.
How would I know if my pituitary gland was not functioning correctly?

Pituitary gland hormones, through their target glands and hormones secreted from the target glands, control a wide range of body functions. Most of these are essential for normal growth, metabolism and reproduction. Deficiency or excess of these hormones can therefore lead to a wide range of problems.

There are a variety of things which may happen. Usually more than one physical sign or sympton (feeling) may be found.In children and adolescents, linear growth and puberty are dependant on hormal signals from the hypothalamus and pituitary gland, and therefore problems in this hormal axis may become manifest as problems in linear growth and acquisition of puberty.

In women of reproductive age, problems with monthly cycles, and fertility can be the first sign of pituitary problems. A wide variety of symptoms including but not limited to weight and appetite changes, and changes in skin, vision, mood, general well being can be due to pituitary problems. These signs and symptoms may occur because of the target organs not working effectively and not be the fault of the pituitary gland itself.

The expression “we are slaves to our hormones” is one that people with an imbalance of the endocrine system can relate to very well. Your GP would generally look at more common problems first before considering any pituitary problem as the underlying reason. Your endocrinologist (hormone specialist), after careful questioning of your symptoms, and a check for subtle body changes, may request special tests to diagnose if you have a problem with any part of your endocrine system.

Illustrations © Kathryn Skelsey (HealthArt Illustration)
Reviewed: March 2013

Rare Disease Day #panhypopituitarism


I have a rare disease. It is called CPHP (Congenital Panhypopituitarism ) and in my case was caused by an underdeveloped Pituitary Gland and PSIS (Pituitary Stalk Interruption Syndrome) due to low levels of Growth Hormone in the womb.
I take Cortisone/ Prednisone plus Throxine since I was diagnosed age 13. It has a huge impact on my health as my pituitary doesn’t work properly so I don’t produce Cortisone , male and female hormones or growth hormone. I reached 154cm after three (3) years on Growth Hormone injections- aged 16-19 years
. I didn’t develop naturally and went on HRT (Hormone replacement therapy ) aged 20 when I stopped growing. Until then I had a pre-pubescent body. I was told it was very unlikely that I would fall pregnant and carry a child to term. I went off HRT aged 24 when on my honeymoon since the Endocrinologist said my body might kick in and start producing male and female hormones. It didn’t and I went through change of life / menopause - which was devastating.
Cortisone is an immunosuppressive which means I have to be vigilant when it comes to staving off colds and flu plus I heal slower than most people plus infections last longer. I have to be careful not to become dehydrated or lower electrolyte levels or I can fall in a heap.
When I was first diagnosed at age 13 the words Addison’s Disease (secondary) were added next to my name and I knew my life would never be the same. My Endocrinologist Dr Ray Slobodnuik (deceased) told me to research Endocrinology and arm myself with knowledge on how to keep myself well and know when to stress dose or go to hospital.
Before I was diagnosed I had severe pain I the abdomen and was scheduled for an appendectomy as we thought I had appendicitis. The put me on the drip (saline infusion) and after a while, the pain went away. They were insistent that I was just afraid of the operation but thankfully mum believed me and the operation was called off. I was in adrenal crisis and I could have died if operated on.
When I was diagnosed aged 13 they did a bone age scan which showed my bone age was 3 years below my chronological age. This explains why I was always 2-3 years shorter than my peers.
It’s been an interesting 47 years and I wouldn’t be alive today if not for my mothers fierce material instinct and taking me to many doctors before someone referred me to an Endocrinologist in 1984.

Wednesday, January 2, 2019

Self care




I’ve decided that my #1 New Years resolution is to self care more. If 2018 taught me anything it’s that there is only one me and I can’t keep burning the candle at both ends and expecting a different result. I get exhausted easily because of my congenital disease, Panhypopituitarism, and I need a good six hours sleep and low levels of stress. I’m going to meditate more, have long bubble baths, get out of the house and enjoy nature more. And spend quality time with my husband Philip Russell who is very patient as I worked 12-18 hour days in 2018. Time for a change!

Tuesday, December 11, 2018

The Difference Between Brain Fog and Forgetfulness by S.E. Carson


Many people who live with invisible illnesses such as (Panhypopituitarism, FIbromyalgia, MS) or chronic pain often experience Brain Fog.
It's not that a person is being forgetful but they are dealing with physical symptoms which makes life harder to function. Amazing, intelligent people who are doing the best they can.
Remember how impossibly exhausting it was to run your meeting the last time you went to work sick? Brain fog is a lot like that, except it persists. A fog can linger for several days, sometimes even weeks.
Please read the article below. It may help raise awareness for people who don't often speak up for themselves and identify as having health issues. Sometimes it may take them longer to reply but please be patient and not dismiss them, show empathy instead of disdain.
One day it could be you.

Monday, December 3, 2018

Growth Hormone approved on PBS!


Yay!!!! Growth Hormone Replacement therapy for people with Growth Hormone Insufficiency!


Great news for people with growth hormone insufficiency in Australia. Growth Hormone is now on the Pharmaceutical Benefits Scheme which means free Growth Hormone!
I’ve waited for this day since I was 19 and cut off Growth Hormone after three years on it. I grew to 154cm and noticed a difference in my metabolism and quality of life. I have Panhypopituitarism, a disease of the pituitary caused by an underdeveloped pituitary gland and absent pituitary stalk. It affects my health on a daily basis and means that I have no growth hormones in my system.
I’m so happy that the government has listened.
I’m seeing my Endocrinologist this month and I will definitely be bringing it up with her.
I can’t wait!!!!! 😀🎉👍🤩

Monday, October 8, 2018

My post to a Talipes equinovarus Facebook Group


I am 45 years of age and have Clubfeet. I was also born with Panhypopituitarism due to the fact that I received an insufficiency of growth hormone in the womb and my pituitary gland didn't develop.
I had several operations on my tendons and at age 9 I had invasive surgery where the orthopaedic surgeons broke my bones, chiselled them, re-set them and placed a surgical staple in my calcanae. Looking at X-Rays you can see where they fused two of my toes together at the base and the surgical staple.
Due to Panhypopituitarism, I was born 2 1/2 years shorter than my peers so I went on growth hormone when I was 16-19 and when I stopped using the growth hormone injections I was supposed to have an operation on my heels. I was at University and didn't want to interrupt my studies so put off the operation.
Now I'm 45 and I still walk over my heel, have week ankles and can't stand for long periods. I wear Colorado boots to lock the heel, which is restrictive and heavy. It is my dream to have an operation on my feet and finally be able to wear something other than Colorado shoes and still be supported and not jar my ankles when walking or standing.
I am very nervous about the surgeries and have only just started researching Orthopaedic surgeons in Brisbane, Australia, however, I did move into a house that is disability friendly.
If you or someone you know has had reconstructive heel surgery as an adult I'd love to hear from you. This operation is way overdue but at the time the only doctors near me where considered 'butchers' by the patients and I wasn't willing to make things worse.

Tuesday, September 19, 2017




Something I am working on.
A group of people living with PHP are sharing their stories to raise awareness of this rare condition which can be life-threatening.
What is Panhypopituitarism?
"Panhypopituitarism is a condition of inadequate or absent production of the anterior pituitary hormones. It is frequently the result of other problems that affect the pituitary gland and either reduce or destroy its function or interfere with hypothalamic secretion of the varying pituitary-releasing hormones."
"The pituitary gland is called the master endocrine gland of the body because it controls the function of other endocrine organs. The anterior pituitary produces the hormones thyrotropin (thyroid-stimulating hormone [TSH]), corticotropin (adrenocorticotropic hormone [ACTH]), luteinizing hormone (LH), follicle-stimulating hormone (FSH), growth hormone (GH), and prolactin (PRL). The anterior pituitary is controlled by specific hypothalamic-releasing hormones. The posterior pituitary produces vasopressin (antidiuretic hormone [ADH]) and oxytocin."

Friday, September 15, 2017

My article for The Mighty on my conditions related to Panhypopituitarism


Hello. My name is Vanessa and ​I'm a 45 year old woman with chronic illness and disability.

I was born with a very rare pituitary disease called Panhypopituitarism (PHP),​ which​ is a clinical syndrome of deficiency in pituitary hormone production.​ ​In my case it was caused in utero due to Growth Hormone (GH) Insufficiency​ and other health issues.

My pituitary gland is only 60% in size compared to normal and I have an absent pituitary stalk, also known as Pituitary Stalk Interruption Syndrome (PSIS). What this means is that I do not produce Cortisol and have low levels of Thyroid function, no male and female hormones which means that I am in the pre-menarche / post menopausal range when my blood is tested. I have been on Hormone Replacement Therapy in the past and I have just started again.

A major factor ​of panhypopituitarism and PSIS is that in 1971 there were no warnings about smoking and drinking affecting the development of the foetus due to reduced growth hormone insufficiency and other hormones such as cortisol.

Below is an excerpt from a medical article which helped to explain what happened:

"During pregnancy, the hormonal systems of the mother and fetus are intricately interconnected
to ensure normal fetal development.​ ​Accordingly, maternal alcohol consumption during pregnancy can interfere with fetal development, not only directly, through adverse effects exerted by alcohol that crosses the placenta and enters the fetal bloodstream, but also indirectly, by disturbing the functions and interactions of maternal and fetal hormones.

In both the mother and the fetus, alcohol​ ​​exposure can impair the functioning of the hypothalamic-pituitary-adrenal axis, which regulates the body’s response to stress; the hypothalamic-pituitary-gonadal axis, which controls reproductive functions; and the hypothalamic-pituitary-thyroid axis, which regulates the metabolism of almost​ ​all tissues.

In addition, alcohol can interfere with the activities of growth hormone and insulin-like
growth factors, which promote body growth and activity. Some of the effects of maternal alcohol
consumption on fetal hormone systems may contribute to the adverse effects observed in children with fetal alcohol syndrome and related disorders. "​ (​Tze, W J, H G Friesen, and P M MacLeod​, 1976)​

This lack of Growth Hormone meant that the bones in my feet didn't develop in utero and I developed severe Congenita​l​ Talipes equinovarus aka Clubfoot​. My mother was told that I wouldn't be able to walk until I was at least 3 years of age. She was determined to prove them wrong, propping me up against a wall and helping me strengthen my legs and calf muscles so that later I would stand by the age of 2. She also fed my mind and taught me to read and write by that age, which helped me with the pain and discomfort of manipulations, allowing me to escape with the joy of books and stories that helped a great deal.

​I have had several operations on my feet including ​the cutting and manipulation of tendons, ​breaking of bones, chiselling ​of ​some, and setting them with a surgical staple​​ in my Calcanae.​  I then had both my legs in plaster from my toes to my hips. I was in a wheelchair for several months. After the casts came off, I had to learn to walk again.  ​My physical limitations meant that my mother had me focus on learning, creating and finding positive outlets which meant that I had a higher quality of life and through reading so many books, ​a curious ​and open ​mind. ​

​The under-developed pituitary gland led to a lack of Growth Hormone and short stature throughout my life. My bone age was 2 1/2 years behind my chronological age when I was tested at age 13. When I was 5 I looked 3. When I was 8 I looked 6. When I was 16 I looked 13 etc. When I was 16 I went onto Growth Hormone (GH) and reached the height of 5ft 1 1/2 inches (152cm). It wasn't until I reached my mid 30s that I was asked to provide ID to show that I was over 18. I have a youthful face and when I was a primary school teacher I was often mistaken as a student aged 12. Seriously.


​Due to lack of male and female hormones, ​I have never had a natural period and I cannot conceive without a lot of intervention and even then with a lot of serious health concerns if I tried.​ Fortunately, I married a wonderful man 23 years my senior who has two adult children in their 30s and I have a grandson from the eldest son. I love my stepsons and my grandson and feel blessed that I have them in my life, despite the fact they live in Tasmania and myself in Brisbane, QLD Australia. ​I have a habit of adopting other people's children as members of my soul family and love handing them back afterwards  

I am now retired as a primary school teacher due to the fact that the schools were not disability friendly and I was made to stand on uneven ground for extended periods during recess, lunch and sports duties. When I asked to be given a different task, I was told that it was part of the duties of a substitute teacher and just get on with it. This meant that later that evening and the next day I could barely walk without screaming in agony.

When my father-in-law passed away in 2000 we moved states to Tasmania, Australia from Wollongong (Sydney), Australia and I retired and after some training became a website developer and Digital Media publisher, which I continue to do today.  I work for my own business where I work around my health problems, working my own hours and loving what I do.

At age 19 I attended the University of Wollongong and started a double degree in Mathematics and Computing Science. I loved some subjects but the Theory of Mathematics and Electronics I struggled with. I began having migraines from stress and after a year switched to a 4 Year Bachelor of Education degree which i studied part time for eight years. When I wasn't in class or doing assignments I was studying my condition and psychology. I was like a sponge soaking up all the knowledge. I loved the majority of my Primary Education courses and graduated in 2000. Within my degree I specialised in Information Technology and Communication which is where I developed my love of creating multimedia resources and websites.

I have often said that without my health issues and disabilities, I would not have the drive and determination. I would not be the person I am today. Thanks to having to sit in one place as a baby and toddler, and not as active as my peers growing  due to chronic fatigue, I focused on reading and learning, enriching the mind and was tested as an IQ of 154 via the mensa website at age 22.


I am working with a local charity that supports adults with disabilities, The Spirit of the Dragonfly, as their website developer and social media marketing consultant. They do amazing work with people who have a wide range of disabilities. They fundraise to support their dreams towards independence, travel and other experiences. One of their projects is to send members that qualify on a cruise and as a group bond and grow through their experiences. Some of the members live at home or in group homes and this gives them a sense of independence.

 I love my life and am thankful for everything I have experienced.

​Article Source​s​:

Tze, W J, H G Friesen, and P M MacLeod.
“Growth Hormone Response in Fetal Alcohol Syndrome.”
Archives of Disease in Childhood 51.9 (1976): 703–706
https://pubs.niaaa.nih.gov/publications/arh22-3/170.pdf

​Orpha.net. "Pituitary Stalk Interruption Syndrome"
​http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=EN&Expert=95496​P​
--
Regards,
Vanessa Pike-Russell


Thursday, September 14, 2017

Talipes resulting from Panhypoptiuitarism

I was born with Talipes Equinovarus, also known as Club Feet. This is a condition that stemmed from my primary condition of Panhypopituitarism  and Growth Hormone Insufficiency.  

So what is Talipes?

"In clubfoot, the tendons on the inside of the leg are shortened, the bones have an unusual shape, and the Achilles tendon is tightened." (1) 

A good image showing before and after treatment can be seen below:




Recently I was on Instagram and saw the image by @_kursti of a child wearing a 'boots and bar' apparatus similar to the one I had to straighten the toddler's feet into the correct position.  It didn't work so I underwent invasive surgery. 






I remember feeling frustrated that I had to sit in the one position and it made it difficult to move around. My mum helped me by teaching me how to read by the age of 2 and I always had a book handy to take my mind off things. I am now sitting in one position for up to 18 hrs a day with my website and social media marketing company.

When the boots and bar and manipulations obviously were not working, the Orthopaedic Surgeon cut my tendons, lengthened the inside of the foot tendon and shortened the outside of the foot, in both feet. It didn't work very well and I kept tripping over as my toes would turn inwards. 

I am grateful for the lessons of tolerance and patience that it taught me. I had some amazing people in my life that went out of their way to increase my quality of life and extend upon my skills and talents. Today I wear Colorado boots which help to lock my weak ankles and allow me to walk up to 3km on level ground. I still experience pain and discomfort on a daily basis with poor circulation after my first operation where they cut my tendons and tried to make my feet turn outwards.

When I was 9 I had another operation, this time they broke some bones in my feet and chiseled bones then added a surgical staple in my calcanae which is still in operation today. It caused juvenile arthritis and cold weather made it worse. 

I know it was hard for my mother but she persisted with my physical therapy and despite doctors advice that I wouldn't walk until the age of three, she would strengthen my leg muscles and hold me up against the wall and build up my muscle until I not only walked developed calf muscles which was again contrary to doctor's opinion. 

My mum was determined that I would walk and I can never thank her enough for the fierce determination she showed as a mother of a baby with talipes equinovarus. I am grateful for that her every day.

Below is a photo of my feet, taken when I was at the Podiatrist's. 











In the photos you can see that I walk over my heel as it is malformed. I was supposed to have a heel operation in my late teens but since I was studying my degree I didn't want to take time off. I'm now 45 and suffer from weak ankles and jarring when I walk over my heel when not wearing Colorado boots done up tightly to lock the heel. They are very constrictive but I am so thankful for them. Most people don't notice my talipes. Some notice that one hip is higher than the other, though and my gait is a little lopsided. I am able to walk up to 3km on a good health day, which is amazing. I can't jump or run or hop or enjoy a trampolene but compared to what I was like when I was born and a toddler I am so thankful to my Orthopaedic Surgeons for what they did for me.

Friday, September 8, 2017

My Talipes Equinovarus (Club feet) Journey


@_kursti posted a photo of #bootsandbar apparatus similar to the one I used to wear on my #feet which helps to correct #talipes or #clubfeet
As I was a toddler and there was no photos taken of me in them, I can only go on how they were described to me.
"The #orthosis is two open-toed leather boots connected by a metal bar. The Boots and Bar orthosis is also called a #footabductionbrace orthosis or a #DenisBrownesplint The brace holds the child’s feet turned outwards and in the corrected position. "
I remember feeling #frustrated that I had to sit in the one position and it made it difficult to move around. My mum helped me by teaching me how to read by the age of 2 and I always had a #book handy to take my mind off things. I am now sitting in one position for up to 18 hrs a day with my #website and #socialmedia #marketing company.
I am #grateful for the lessons of tolerance and patience that it taught me. I had some amazing people in my life that went out of their way to increase my quality of life and extend upon my skills and talents.
I know it was hard for my mother but she persisted with my #physicaltherapy and despite doctors advice that I wouldn't walk until the age of three, she would strengthen my leg muscles.
She would hold me up against the wall and build up the #muscle strength in my feet and legs until I not only walked developed #calfmuscles which was again contrary to doctor's opinion.
My mum was determined that I would walk and I can never thank her enough for the #fierce #determination she showed as a #mother of a #babywith #talipesequinovarus
I still experience #pain and #discomfort on a daily basis with poor circulation after my first #operation where they cut my #tendons and tried to make my feet turn outwards. It didn't work and means that I get #pinsandneedles on a regular basis.
I feel blessed that the #orthopaedic doctors and #orthapedicsurgeryspecialists met for a convention when I was 9. My mum and I had travelled up from #wollongong to the #sydneychildrenshospital and I was presented to a group of surgeons who specialised in talipes correction. After examining me they said that there was a new operation which I would be a good candidate for.
In this ground breaking surgery they broke some bones in my feet, chiseled bones and then re-set them and added a surgical staple in my #calcanae which is still in operation today.
The breaking and chiseling of bones caused #juvenilearthritis and cold #weather made it worse. I remember that I did a lot of crying through the night with pain that was crippling and my heart goes out to people like my husband who lives with the pain and aches of arthritis on a daily basis.
Today I wear #colorado #boots which help to lock my #weakankles and allow me to walk up to 3km on level ground. I wear them almost every day and they provide support but are heavy and very constrictive and make my feet ache. I prefer aching, constricted feet to the alternate of walking over my malformed heel and twisting my ankle and not being able to walk at all.
Thanks to my mothers determination that I would have a good education I #graduated from university of wollongong with a degree in #Education with a specialisation in #informationtechnology and #communication which I am forever #thankful for.
I was a casual/ substitute teacher in primary school ( Years K-6 ) until I moved to Tasmania with the death of my father in law. It was mandatory that casual teachers must supervise yard duty at recess and lunch time plus sport where I stood on uneven ground which caused great pain and sometimes I couldn't walk without yelping in pain.
In my degree ( B.Ed) I had excelled at Website Design and Development and whilst living in Tasmania 2000-2002 I focused on creating a collaborative group work project called The Crab Street Journal, a web based magazine for Land Hermit Crab owners. There were over 2000 people in the Land Hermit Crab Owners Society and a group of us published the magazine which is still in operation today.
It made me feel productive and fulfilled and I decided that since I could work around my Panhypopituitarism ( PHP) which in simple terms is Pituitary Disease. I could work my own hours and live a creative, fulfilling life.
I love my job as Website Developer and Social Media Specialist. I still use my Education degree when I train my adult clients and whilst I miss teaching children I am glad that I made the decision to chose to retire from teaching in primary schools that were not sensitive to my physical issues due to talipes and health issues with PHP.
I love my life and feel that my adversity had made me the strong, resilient and compassionate person that I am today