AcroTales

Episode 24 - Cas

Dan Jeffries Season 1 Episode 24

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0:00 | 31:44

In Episode 24 of AcroTales we meet Cas from Nevada in the USA.  

Cas's story really demonstrates the challenges faced when undergoing the 'diagnostic odyssey' in a search for answers. After experiencing a range of symptoms, Cas was finally diagnosed in 2019 - just before the COVID pandemic swept the globe. Yet Cas's resilience, positivity and humble nature means she has not let this condition define her.

SPEAKER_01

Hello and welcome to AcroTales, a podcast that explores the fascinating world of Acromegaly. My name's Dan Jeffries, and I was diagnosed with Acromegaly in 2007. And in each episode of AcroTales, I'll be talking to fellow Acromegalics from around the world about their journey with this unique condition. It's episode 24, and I am really pleased to welcome Kaz from Nevada in the USA. Kaz is 40 and was diagnosed in 2019. Kaz, welcome to AcroTales.

SPEAKER_00

Hi, thanks for having me.

SPEAKER_01

So 2019, that's a few years ago. What's that? Six years ago. So it I guess it's still quite fresh and recent. But maybe uh if you could tell us um how your life was before 2019 and what happened leading up to you getting that diagnosis.

SPEAKER_00

It got pretty miserable. Um at one point I was falling asleep mid-sentence.

SPEAKER_02

Really?

SPEAKER_00

Because I was just so exhausted. Um, we were actually contemplating having me tested for narcolepsy.

SPEAKER_01

Okay. Okay. So that was obviously a sign. Um you didn't associate that with Acromakaly at the time, I'm assuming.

SPEAKER_00

No. No, um, it was uh at least a five-year journey to get diagnosed. Okay. And even with that, it was just it wasn't a I went in and they said, Oh, okay, well, let's test you. It was a random finding.

SPEAKER_01

Um so often random. It's really strange. This happens so often.

SPEAKER_00

Yeah, um, I was noticing that I was gaining weight and I was having low energy problems. Um they'd said that I had hypothyroidism, and that was why I was tired and gaining weight. So I was on a pill every morning for that. Um one doctor even said that I was tired because I had kids. She diagnosed me with kids.

SPEAKER_01

Right. That's I was diagnosed with kids. Yeah, I I think every parent in the world is diagnosed with kids, so that's not very helpful, is it?

SPEAKER_00

Well, on and off, I've been raising kids since I was six.

SPEAKER_01

Okay.

SPEAKER_00

So I knew tired, and that was not it. Um after the PCOS diagnosis, um, they put me on metformin. So now I'm on two different pills, but I'm still gaining weight. They put me on a 20 uh 20 carbs per day, or 50 50 grams of carbs per day diet, which is nothing. That's nothing.

SPEAKER_01

That is minimal.

SPEAKER_00

Um, I did start losing weight, but like I wasn't eating, so um, as soon as I decided to stop that crash diet, the gate the weight just came right back on. It was 60 pounds in a year and a half.

SPEAKER_01

Wow, okay.

SPEAKER_00

And that was still trying to watch what I was eating and exercising. Um when I went to the next doctor, I was like, I feel like I'm crazy. I'm doing all these things. Everyone keeps telling me I'm fine, but I'm clearly not okay. And that time I walked out of the doctor's office with the diagnosis of fall apart itis. He said those words to me. Are you serious? Yes. You have fall apart itis. I don't know what's going on with you. And that was it. There were no referrals.

SPEAKER_01

No referral, not even what? That's no referrals.

SPEAKER_00

Yeah. I it was it was a military doctor, so I'll leave that at that. But it was, yeah.

SPEAKER_01

Um so you must have felt very lost and confused and oh yeah. Like, what the hell do I do?

SPEAKER_00

When things got worse, I ignored it. I'd already brought it up. Nobody cared. There were no extra testing. There was no, it was just you, your your body's sucks. Have a great day.

SPEAKER_01

Wow, that's horrendous. Okay.

SPEAKER_00

Um I was having um fluctuations in in my this is this might be a lot, in my bra size on a daily basis.

unknown

Okay.

SPEAKER_00

And it was one to two cup sizes, not just it didn't fit that one.

SPEAKER_02

Wow.

SPEAKER_00

Um, but I was gaining weight. So I was like, well, maybe that's just weight gain. Yeah. Well, when my ring stopped fitting, I was gaining weight. When my shoes stopped fitting, well, you can gain weight in your feet, right?

SPEAKER_02

Yeah, yeah.

SPEAKER_00

Um I'm still falling asleep mid-sentence. I can't, I I ended up having to be a stay-at-home mom because I couldn't work. Um I finally decided to go back to school in November of 2019. And I was like, I can't, I can't go to school and have the migraines the way I'm having them. So I called the doctor and I was like, I need to see neurology. We need to change my migraine meds. Because I had had migraines since I was six.

unknown

Wow.

SPEAKER_00

So I knew the I knew the routine.

SPEAKER_01

And you need a department, I suppose.

SPEAKER_00

Yeah.

SPEAKER_01

That helps.

SPEAKER_00

So I was like, okay, well, we just need to change the medication. And the VA had decided that their policy was in order to see neurology, you had to have a CT scan.

SPEAKER_01

Okay.

SPEAKER_00

And that is how we found the tumor.

SPEAKER_01

Okay. So you got there eventually.

SPEAKER_00

Yes. I started school on a Tuesday in December 2019, and Friday I got the diagnosis.

SPEAKER_01

And was it a shock? I mean, I get that's a really stupid question. Of course it's a shock, but was it a relief? That's a better question.

SPEAKER_00

Um, not the way it was, not the way the information was given to me.

SPEAKER_01

Okay.

SPEAKER_00

Um, I actually had a nurse diagnose me over the phone, which is illegal. Wow. Um, she called me. I was in my daughter's third grade classroom volunteering, and she just told me right there over the phone, didn't ask me if it was even a good time. Just you have a pituitary adenomer, we're ordering an MRI, get that scheduled immediately.

SPEAKER_01

That's unbelievable. I really, I really hope that's a rarity that that I hope so too. I mean, I I totally feel for you, and um, you know, that's horrendous. You've had to go through it, but I really hope that's not common practice. Wow. Okay. So that must have flawed you then. And I mean, did you even know what she meant?

SPEAKER_00

So I had been in, I had some taken some medical classes. Um, so I knew where my pituitary was, and I knew what the uh suffix oma meant.

SPEAKER_01

Okay.

SPEAKER_00

And so immediately my brain says, I have a brain tumor. There's a tumor in my head.

SPEAKER_01

Yes.

SPEAKER_00

And that was all the information I was given. And I'm volunteering in my daughter's classroom, so I couldn't just stop and Google it. And then my first recourse when I did have time was to Google it, and that's always the worst thing to do when you get a diagnosis you don't understand.

SPEAKER_01

No, but but did the explanation and the symptoms, did you read them and go, yeah, okay. That sounds that sounds familiar.

SPEAKER_00

I was really freaked out and confused until I saw the endocrinologist.

SPEAKER_01

Okay, okay.

SPEAKER_00

Um, I had the most amazing endocrinologist, even with the VA. Yay.

SPEAKER_01

What's the VA? Sorry.

SPEAKER_00

The veterans' affairs?

SPEAKER_01

Uh okay, right, okay.

SPEAKER_00

Um, so the military disabil disability medical care.

SPEAKER_01

Right, I got you. Okay.

SPEAKER_00

Um, but she sat me and my husband down, and she was like, tell me the differences. And so I went through all of it, and she goes, Okay, now pull up your Facebook profiles. And she went, she told me, go all the way back to the youngest picture you have on there. And she said, Find one where you're smiling. And the first one I found, I was smiling, and I didn't have a single space between any of my teeth. And she goes, Do you see the difference? And that was when it all hit. And all of these things that I've been experiencing, it all made sense and it was just ignored or treated as something else.

SPEAKER_01

Again, this is the trouble with rare conditions. They they don't expect to see it. So as somebody said in another podcast, it's rare, so it can't be that, you know, which is always a ridiculous argument.

SPEAKER_00

I have gotten to the point where if a doctor tells me it's rare, I stop them. That word doesn't mean what you think it means. Rare means it does happen.

SPEAKER_01

Yes.

SPEAKER_00

Or it'd be non-existent.

SPEAKER_01

Yes, exactly.

SPEAKER_00

So don't tell me it's rare, like that's a good thing. I generally fall into that category.

SPEAKER_01

Okay. So did so you obviously you were in better hands. Having a good endocrinologist is really essential, and a good nursing team around you as well. Did they how long between diagnosis and surgery? Assuming you went down surgery.

SPEAKER_00

I did. Um, my tumor was the size of a marble, it was 11 by 10.

SPEAKER_01

Okay.

SPEAKER_00

Um they sent me immediately to the neurosurgeon. The problem that I ran into was I was diagnosed in 2019, and in January of 2020 is when the shutdown happened.

SPEAKER_02

God, of course.

SPEAKER_00

My original surgery was scheduled in February. I actually had the surgery in July of 2020.

SPEAKER_01

Okay. So not a pleasant wait, I guess, because you get the buildup for it, but you know, you you can't do much about a pandemic, can you?

SPEAKER_00

And they cancelled my surgery three days prior. So there was there was not a lot of yeah.

SPEAKER_01

You have to, I think it's frustrating, but you have to just be understanding.

SPEAKER_00

I I I I always wasn't actively dying.

SPEAKER_01

Exactly. That that is my point. And you know, I have had uh seen quite a few people in the Facebook groups that understandably complain that they may have been bumped or pushed back because another priority came in. And I always think just be glad you're not that priority.

SPEAKER_00

You're not that priority, yep, exactly.

SPEAKER_01

So, you know, we can live with this, and a few more months will not make a huge amount of difference.

SPEAKER_00

Not when you've waited years to be diagnosed.

SPEAKER_01

Precisely, precisely. Okay, so surgery happened and it went well.

SPEAKER_00

It was successful.

SPEAKER_01

There's a difference.

SPEAKER_00

Um, because I was on metformin for the PCOS, the nursing staff tried giving me insulin right out of surgery in the ICU.

SPEAKER_01

Right.

SPEAKER_00

Um, but I have hypoglycemia.

SPEAKER_01

Okay.

SPEAKER_00

So the entire time I was in the hospital, they had to check my blood sugar and and immediately give me orange juice because it was always so low.

SPEAKER_01

Right.

SPEAKER_00

So she could have killed me.

SPEAKER_01

Right.

unknown

God.

SPEAKER_00

Um, and this was not at the VA hospital, this was a civilian hospital.

SPEAKER_01

Okay, okay.

SPEAKER_00

Um, I ended up with diabetes insipidus.

SPEAKER_01

Yep.

SPEAKER_00

Um, so I was in the hospital for six days.

SPEAKER_01

Mm-hmm. Okay.

SPEAKER_00

Um, I went home, I want to say on Friday. And I I think it was the change in elevation because my surgery was about two hours away from my house. Um, I ended up with a CSF leak.

SPEAKER_01

Yep. Okay. When I went to leaking, was it leaking when you left? No. So it started leaking when you got home.

SPEAKER_00

Mm-hmm.

SPEAKER_01

Okay.

SPEAKER_00

There's about a 500-foot elevation difference between the hospital and the house.

SPEAKER_01

The pressure, obviously, the change in pressure caused. I think so to happen. Okay.

SPEAKER_00

Um, I went to the ER and they said, oh no, no, no. You have to be where your doctor is. We're not, we're not dealing with this. What? So they ambulanced me the almost two hours to the hospital.

SPEAKER_01

Okay.

SPEAKER_00

And then the on-call doctor took my sterile CSF sample that I was collecting and poured it into an EDTA tube.

SPEAKER_01

I don't what's an EDTA tube, sorry?

SPEAKER_00

So EDTA tube is an anticoagulant tube for blood collection.

SPEAKER_01

Right.

SPEAKER_00

And you can no longer test for CSF if you you had just the worst luck.

SPEAKER_01

Or the the or incompetence, I'm not sure which.

SPEAKER_00

I'm telling you, rare means nothing to me.

SPEAKER_01

No. Wow. Okay.

SPEAKER_00

So the lab wasn't even able to confirm that it was CSF.

SPEAKER_01

Right.

SPEAKER_00

And because my doctor wasn't on call, I spent the weekend in the hospital anyways. He came in and said, well, if it was CSF, it resolved, so you can go home now.

SPEAKER_01

But you just okay. And that was it.

SPEAKER_00

Yeah.

SPEAKER_01

And so you went home and I went home and I recovered. Oh, thank God for that. It didn't start again.

SPEAKER_00

No. That was it.

SPEAKER_01

I thought you were gonna tell me you caught meningitis or something like that. Oh my gosh. Because I went through that. I I Oh I'm so sorry. No, that's okay. I had CSF leak and when I got home, but I they I left the hospital with the leak. Oh. Which they really shouldn't have done. And I don't think they would do that anymore. But yeah, it was it was it was pretty horrible. Anyway, this isn't about me. So you you got home and it healed.

SPEAKER_00

It did.

SPEAKER_01

And did life start to get better after that?

SPEAKER_00

Um, well, I lucked out and COVID made everyone go to school online, so I was able to continue schooling just like everyone else.

SPEAKER_01

Okay, okay.

SPEAKER_00

Um, I graduated in August of 2021. When I started working, I started noticing that things weren't adding up again.

SPEAKER_01

Right.

SPEAKER_00

Um, we started checking my levels every three months. And um, I went I graduated as a medical laboratory technician, so lab values is literally my job.

SPEAKER_01

Okay, right. I understand why you know so much now. Okay.

SPEAKER_00

So um I started watching my IGF one trend upward.

SPEAKER_01

Right.

SPEAKER_00

And they kept telling me, well, it's in normal levels. And I was like, but I have I'm symptomatic. And it's trending up, it's not staying the same, it's not variating, it's it's trending up. And so every three months I would just message my doctor and say, Okay, my symptoms are getting worse, let's check again. And then I finally breached the threshold of high. Okay, and they were like, okay, well, let's put you on medication. So they put me on cabergaline, right? Which doesn't directly affect IGF 1. When my prolactin went down, the IGF went down.

SPEAKER_01

Okay.

SPEAKER_00

Um throughout this whole time they kept telling me that my imaging was stable. And then in 2022, I started losing peripheral vision.

SPEAKER_01

Okay.

SPEAKER_00

I went to everyone because my imaging said the tumor wasn't there. There was no tumor.

SPEAKER_01

Right.

SPEAKER_00

So the tumor isn't causing the peripheral vision loss. Right. And the eye doctor I went to says, I can't find anything wrong. But if you're losing your vision, limb life or eyesight is ER.

SPEAKER_01

Yes.

SPEAKER_00

So he sent me to the emergency room, and the emergency room doctor says, the ERs can only order CT scans, and that's not going to show us what we need to see.

SPEAKER_01

Right.

SPEAKER_00

So I'm going to admit you because inpatient can have MRIs.

SPEAKER_02

Okay.

SPEAKER_00

So I'm at the civilian hospital. I get my MRI, and they say, Oh, yeah, there's definitely post-surgical changes. I can't guarantee it's a tumor. But there's something there that wasn't there in our last imaging. So I called my endocrinologist the next day, and she says, Well, I got the images, but it looks like it's just scar tissue.

SPEAKER_01

Right.

SPEAKER_00

So you're telling me scar tissue showed up two years later? Because it wasn't in previous imaging. And so she was like, Okay, well, I'll send you to see the neurosurgeon. And he said, I can't guarantee it's tumor or scar tissue, because it's imaging. Generally, with what I'm seeing, I would say, let's go in and get it. But you got DI last time, and you were lucky that it went away.

SPEAKER_01

Right.

SPEAKER_00

If we do it again, it may not.

SPEAKER_01

Okay.

SPEAKER_00

So at this point, we're just waiting for it to be big enough again to go back in. After seeing the neurosurgeon, the endocrinologist finally admitted that my IGF-1 was going up again. So that meant that there was tumor cells.

SPEAKER_01

Right. Okay.

SPEAKER_00

And I said, well, if there's tumor cells, then that means tumor. The tumor's there. It's just not visible on imaging. We don't have to draw these little technical lines.

SPEAKER_01

No, I know it's there. I can yeah, I'm getting the the the uh you know the side effects from it.

SPEAKER_00

Yeah. And now so with the with the VA, when you see the specialist, sometimes when you see your primary care, they will send in a fellow. So someone learning that specialty.

unknown

Okay.

SPEAKER_00

And then you have an appointment with them, and then they go get the resident, and then you have the appointment again with the resident. And with the fellows, uh specifically this one, um I can tell she doesn't understand acromagaly because the thing she's saying doesn't make sense.

SPEAKER_01

Okay.

SPEAKER_00

I told her I was symptomatic, I'm gaining weight, I'm eating too much, but there's days, generally after my medication, where I don't eat anything. I have zero appetite, and my IGF 1 is trending up again. And then she says, Well, your IGF 1 isn't being treated by the kabergaline, because that's not what it's for. But it's within normal range, so it's probably a problem with your thyroid.

SPEAKER_01

Right.

SPEAKER_00

And I said, Well, if I'm not hungry, that's hyperthyroid.

SPEAKER_01

Yeah.

SPEAKER_00

But if I'm eating too much, that's hypothyroid. And if you're telling me I have both, that means I have a functioning thyroid. Because it either is working too much or not enough. And if it's working in the middle, it's normal.

SPEAKER_01

Yeah.

SPEAKER_00

And I'm not going on thyroid medication again. When I didn't need it the first time, I had a tumor in my head. We know the tumor cells are there, so let's not pretend it's anything else. So I'm actively in that battle at the moment. I see the message.

SPEAKER_01

Right. Wow. What journey.

SPEAKER_00

Uh uh. And I have to go to Colorado to see my endocrinologist because that's where I met them. And my team is one of the best in the country.

SPEAKER_01

Okay. How far is that from where you are?

SPEAKER_00

It is a two-hour flight.

SPEAKER_01

Okay. Wow. So you gotta pay, you gotta Yeah.

SPEAKER_00

I'm not the only one that travels for a good team, though, so I don't feel that.

SPEAKER_01

Uh I I I can totally understand that. And when you've got people that you trust and know, and they know you and they know your story, you don't want to just relocate to someone else because it's a bit more convenient.

SPEAKER_00

When we were discussing moving to Nevada, I started the research because I know. I know it's hard to find a good team that specializes in a rare condition. I called almost every endocrinologist in town. Not one of them had a necromagaly patient.

SPEAKER_01

Okay.

SPEAKER_00

So I was like, I'm just I just have to fly.

SPEAKER_01

Can I ask how this has um uh uh impacted on your family?

SPEAKER_00

Well, I mean, I'm gone at the moment for at least three days every five weeks, so that's a huge impact. Um because I think that I had the tumor for much longer than we realize, um, I think that a lot of my other medical conditions were caused by that. But that actually softened the blow for my family because they were already used to me having so many medical problems.

SPEAKER_01

Okay. So when it comes out of the blue, suddenly, you know, you've led a healthy life for 30 years, and then bang, you're diagnosed with the purity tumor. That's quite a shock. So you're saying, yes, because you've lived with some rare conditions, it wasn't having to go to hospital wasn't such a unique thing, it wasn't so scary. Going for scans wasn't so scary. And you obviously live in the medical world as well, which helps.

SPEAKER_00

My brain tumor was actually surgery number 13. Wow. And I've had seven since then.

SPEAKER_01

So my god.

SPEAKER_00

Uh the the surgery life is is not something abnormal in my family.

SPEAKER_01

Okay, okay. I don't want to say that helps, but obviously it it it's it's a adds a dimension.

SPEAKER_00

It makes the one issue a little bit less intense.

SPEAKER_01

Yeah. I mean, Kaz, I'm I'm really, you know, regardless of whether you've had 13, 13. I'm at 20 now. 20? Bloody hell. I thought I had a few. But if you're at 20 surgeries, you know, it seems to me that your optimism and your outlook uh is is really positive. And I I sense that you know you've been dealt a difficult hand, but you're just trying to play those cards as best as you can. And I assume you enjoy life and aim to enjoy life as much as possible?

SPEAKER_00

I I try to do as much as I can. Um the the tumor and the subsequent medical issues have given me an outlook of I don't know when it will be the last time I can do this. So I'm gonna do what I can while I have the ability.

SPEAKER_01

Okay. Okay. And how how your vision is that is that is that improved, or has you still got some loss of peripheral vision?

SPEAKER_00

Um, I still have some loss, but it has not gotten worse.

SPEAKER_01

Okay. That's that's a good thing. Okay, okay. And if someone's listening back to this podcast and they've just been diagnosed, what's your advice to them?

SPEAKER_00

We have a great community. Reach out for support. I can't say it's gonna get better, but you can emotionally feel better about it. It it doesn't have to be that diagnosis.

SPEAKER_01

No. No, it's a shock. And uh uh and you know, it has an impact on your life. I mean, I I sense that early diagnosis, even with you know the complex journey that you had to get on to get there, uh, diagnosis seems to be a lot earlier than it maybe was 10, 15, 20 years ago, which is which is a great thing.

SPEAKER_00

And uh I've said this before, I think social media definitely has played a part in that to raise awareness and and um uh for people to reach out if they think that they might be going through it, which is which is I am also working on a tour through different medical campuses to give speeches while they're in their endocrinology classes. Um because of my case, my husband has been able to get four different patients diagnosed with acromagly.

SPEAKER_01

Wow.

SPEAKER_00

Because he knew the signs.

SPEAKER_01

Wow, that's that's phenomenal. And I have to say, Kaz, you're a really good speaker. Thank you. You're very confident, you're very eloquent, uh, and you, you know, you're very considered in in what you say. And um I think that probably uh comes from having a bit of a medical background because obviously you think maybe logically about these things, uh, and maybe try not to let emotion interfere too much. But obviously, but obviously that's gonna happen. But I think you know, I I I can imagine you giving these talks will be really inspirational and and and helpful. So really well done. And and I'm assuming I'm assuming you're on things like the Facebook groups and the Acromegaly community. And have you been to any get-togethers or meetups or regional events? Have you met other people with Acromegaly? Okay.

SPEAKER_00

Yes. Um, I went to the Denver one. I don't remember what year.

unknown

Okay.

SPEAKER_00

All the years just kind of blend together in my life. Um, I went to the one in Phoenix.

SPEAKER_01

Did I go to that one? Did I go to the Phoenix one?

SPEAKER_00

Was I there? Um, I want to say you were, but I don't know that we met because I had another different medical issue going on then that I was kind of staying in the background to deal with.

SPEAKER_01

I'm pretty sure I was I should really know that. I am 99. Yeah, I definitely was in Phoenix.

SPEAKER_00

Um the Barrow Institute.

SPEAKER_01

Yes. I was I was what God, my memory. I was 100% there. Oh, it's a shame we didn't get to meet.

SPEAKER_00

I was blonde then too, so.

SPEAKER_01

Oh, okay. Maybe we did, and then I don't remember. But I'm hoping, you know, if there's going to be another international one at some point soon, which I'm sure there will be. Um it would be great to to to to go back and and meet you and and new people as well. And I and I just think getting together and and sharing stories is so important. We've got a UK uh get together in September. And uh it's the first one we've been able to do for three, four years just because of logistics. Um and we were running these during COVID as well, which you know, or trying to, which which didn't help. So yeah, I think the power of getting together and sharing and telling your story, and that's exactly what you've done today, is just so Powerful.

SPEAKER_00

I'm also publishing a calendar in which I have gotten together a group of brain tumor patients. Um and we did a pin-up cocktail party photo shoot for May.

SPEAKER_01

Oh, amazing.

SPEAKER_00

For Go Gray and May.

SPEAKER_01

Oh, that's fantastic. Look, you've completely embraced what life has dealt you, and you're just trying to do the best of it, and and and I love it. And um, Kaz, it's been absolutely fascinating talking to you and um really honestly inspirational um listening to you tell your story in in such an eloquent way.

SPEAKER_00

Well, thank you. I've enjoyed being able to help other people. So if this helps anyone, I would do it a million times over.

SPEAKER_01

I know I I can truly sense that. And uh I have I have no doubt that this is gonna help a lot of people. So, Kaz, once again, thank you so much. Uh, if you found Kaz's story interesting, and my god, how could you not? And you want to hear other AcroTales, head over to Acrotales.com where you can find the ever-expanding library of interviews. And of course, you can subscribe to the podcast to receive the latest updates. You can do that on iTunes, Spotify, or wherever you get your podcast from. Once again, Kaz, thank you so much. Thank you for listening, and we'll see you next time for another AcroTale.