When I got home from that most devastating Endocrinologist appointment in St. Louis I put my research cap on. There were two doctor's in the Cushing's community that were considered to be the experts in the country. I decided Dr. Friedman was by far the one that would fit me the most in terms of his testing methods. I was sure that when I had highs they were at night and that I was bottoming out during the day. I needed someone who believed in Cyclical Cushing's and knew how to test for it. Dr. Friedman has tests set up perfectly for someone like myself. Most Endo's only collect a 24 hour urine cortisol, where as Dr. Friedman does a 10 hour that is from 10 at night until 8 in the morning. This is an excellent way for someone like myself to catch the highs. Also he does other tests that most Endocrinologists don't do that check to see if recently your body had been high with cortisol. This was one of the tests the I scored high on, even when my pee tests would come back normal.
Once we got our tax refund back I decided it was time to take action. I booked the appointment and got everything set to go to Los Angeles on June 6th, 2011. It never would have been possible if it weren't for the help from my family. I am forever grateful to them. I spent days working on getting all my past medical records together in a huge binder, collecting photos to show Dr. Friedman and just getting myself ready to go to L.A. I was scared to death, yet I was hopeful. What if he told me I didn't have this? Was this my fault somehow? All these questions running through my mind. I was having a hard time just leaving my children behind for five days to head out there. I had never been away from my babies before, but I knew if I didn't do this they may not have a mom around anymore. I had to put on my big girl panties and do this.
I remember the feeling as we were starting to land in Los Angeles. I was so overwhelmed with raw emotion. I teared up and thought to myself, this is it. Everything I have been through has led me to this city. Would it live up to it's name as the city of Angels? Everything went perfectly once we arrived. Very odd things happened that I cannot explain, but I felt surrounded by Angels. A song came on the radio that I associate with my Grandma who passed away. I was very, very close to her. This song was very old and there was no way it would just randomly come on without it being a sign from above. I felt immediately at peace and knew that I was in the right place. On June 7th, we arrived at Dr. Friedman's office. My hubby took a pic of me in front of the sign with Dr. Friedman's name on it. Cheesy, I know but this was hopefully going to be my life changing experience. We arrived way too early so we just hung out until it was time to go in. I felt complete panic walking into his office. I was greeted by Dr. Z who immediately almost put me in tears. He said, "Let me guess, you have been sick for at least 5 years, have seen multiple specialists and they have all told you it was in your head?" I nodded as the tears began to well in my eyes. He said "I can tell just by looking at you that you have this disease and that you will finally be taken care of." As I write this I am still overcome with emotion from those words he spoke to me. Someone finally could see what I had been trying to say for years.
He took all my vitals and wrote that my pulse was high. Another symptom of Cushing's. I rarely have a pulse below 100. I then returned to the waiting area until Dr. Friedman was ready to see me. He called me back into his office and immediately turned into this nervous mess. How could I feel calm when my life was on the line and "The Wizard" was right in front of me asking me questions. He asked me about my story. I told him. He looked through my files and of all the sheets in my file he took all my high results and my IPSS results. He then wanted to see my MRI cd that I brought with. I watched him load it on to his laptop and then he said to me...."And they read this as normal?" I instantly felt a lump in my throat. He turned around his laptop and pointed to me on the screen two areas he believed were tumors. Then a minute later he decided there was a third. At this point my brain was racing. I could hardly speak. I was so overcome with emotions of anger, fear and validation. He feared that the type of tumors I had may be aggressive because of the way they were showing up on film. He also examined me and said that he believed I did have Cushing's and he also believed I was growth hormone deficient. He gave me a battery of tests to do once I returned back to Illinois and a plan of attack for testing. Someone BELIEVED in me! The following day I was set to have another brain MRI at Cedars Sinai on a 3 Tesla MRI machine. It's considered to be the best imaging source for MRI that is out there right now. He also put me on some Vitamin D drops because mine is low and also wanted me to start taking L Glutamine twice daily to try and build up some of the muscle I had been losing from being sick with Cushing's. After meeting with Dr. Friedman they drew some blood and I was free to go. I walked outside and just started crying. After I regained my composure I phoned my parents to let them know what had just taken place. My mom, bless her heart was a mess. No one wants to hear their child has brain tumors, but to me I was overjoyed. I know that sounds absolutely crazy to a normal person, but to someone who has been sick and knew it was just a matter of time before it reared it's ugly head, it was a target. A target to evict and hopefully give me my life back.
I did the MRI the next day and spent a few more days in Los Angeles before heading back home to Illinois to begin my testing. The testing included multiple 24 hour urine free cortisol tests, multiple salivary tests to do at 11 at night or later, 10 hour Urine Free Cortisol tests and he would also check for hydroxycorticosteroids aka 17OHCS which is what would show if I had recently had a surge of cortisol in my system.
It took roughly a month of testing to complete all the tests he wanted me to do. I would do tests basically 4-5 days out of the week. I was tethered to the house for the majority of my testing, because collecting urine for 24 hours is not fun to do anywhere else. Who am I kidding? It's not fun EVER at any place!!
So in the meantime I waited for all my test results to come back in, got my MRI results which showed several areas where the contrast did not go through, but they couldn't say for sure there were tumors. Dr. Friedman wanted me to send my MRI off to Dr. McCutcheon in Houston. He is considered to be one of the best Neurosurgeons in this field and amazing at seeing what most miss on the MRI's. So I shipped off my MRI's and began the waiting game.
I received an email from Dr. Friedman's office stating he would like to have a phone appointment to discuss my results and a plan. I figured this meant how we were going to proceed with testing. I had a sheet of paper with questions to ask. Could I do midnight blood draws so that I could have those highs as well? I know that I needed highs in at least three different testing areas for him to confirm I had Cushing's. As far as I knew I had only one test come back high so far, but had not seen all the results yet. I set up the appointment and waited for the call with my questions in hand. I was prepared to do as much testing as it took to prove I had Cushing's. I was not prepared for what took place during that phone conversation.