The first of August I went to OSU to complete my pre-op testing, including another MRI and visit with surgeons. During my appointment with my neurosurgeon I was shocked and disappointed when he said he really wanted me to have an additional procedure done prior to pituitary surgery. The procedure is called IPSS (inferior petrosal sinus sampling) and is done to pinpoint the location of the tumor. Though as my father said “if my surgeon needed a more specific roadmap than I’d be happy to cooperate” and so it was. Thankfully the neurosurgeon who performs this procedures was able to work me in and I didn’t have to reschedule my pituitary surgery.
IPSS is an outpatient procedure, a variation of a cerebral angiogram. I opted to be placed under general anesthesia as it is a lengthy procedure and crucial that the patient lie completely still, flat on your back, on a narrow ‘table’ with a thin mat. The surgeon threads a catheter up each side from the groin, through the vessels that are near the pituitary gland (located on the underside of the brain, behind the sinuses). After the catheters are in place a hormone called CRH (corticotropin-releasing hormone) is given to stimulate the tumor to do its thing. The timed samplings begin and blood samples are taken at specific timed intervals, and then the catheters are moved to other sites and more samples are taken.
I had the afternoon recovering on the floor in the hospital, and stayed a little longer as not only was I not feeling well but I had a slight rash on my neck. By the early evening I was released to go home, a much longer day than my mother signed up for when she agreed to take me!
I had read on the Cushings-help message board that IPSS can throw a Cushie into a ‘low’ cycle. Since a Cushie’s body has become dependent on high levels of cortisol, when a low cycle hits it’s quite miserable. But what I did not expect was to wake up and find my face red and swollen. I had been given Benadryl at the hospital for my slight rash and took one at bedtime and again in the wee hours of the morning. But when I really got up at 9 a.m. and caught a glimpse of myself in the mirror I was shaken! Right away I called into neurosurgery, and it was determined that I was having an allergic reaction to the contrast media used in the IPSS. I was given a prescription for prednisone to ward of the reaction; however that is not a great medication for a Cushie. I did a quick course of prednisone and Benadryl and within a couple days I wasn’t swollen anymore and within a couple more days I was feeling like I was recovering from the whole ordeal.
Results from IPSS took just over a week and it confirmed the suspicion of a left-side tumor.