the mitton family

Okay, so I wasn't very detailed about what is going on with Josh so for me to remember and for those who may have questions here is some more info...

Josh had an asthma check-up on Wednesday, February 8 and mentioned a few things he was noticing to the Doctor. She sent him in for some blood work and ordered an MRI. I was going to get my glucose screening test done that same day so we went together. We scheduled his MRI for the the following Wednesday, February 15th. Josh is quite claustrophobic so he was a little nervous about the MRI, but we scheduled his in an open MRI and he was given some meds to help keep him calm and I think that helped a little. The MRI people said the results would be sent to our Doctor in a couple hours. Thursday morning Josh got a message from a Dr. William White's office asking about his upcoming appointment. We don't know a Dr. White! So I looked him up on the internet--as I do with everything. Either this was the craziest coincidence in the history of mankind or something was wrong with Josh's results (which we hadn't heard about yet). Dr. William White works with the Barrow Neurological Associates out of St. Joseph's Hospital and is the Chief of Surgical Endocrinology. Okay, so we "knew" this wasn't just some random coincidence that he got the call, but it still wasn't confirmed that he had what we thought he had--a pituitary tumor. Not too long after we got that message our family doctor called and asked us to come in that afternoon to go over the results. So at this point we knew something was found, but waiting for a couple hours to talk to the doctor seemed like years! Finally, our appointment at 1 came and she told us what we were excepting. Josh has a pituitary macroadenoma that is affecting the production of his hormones.

The pituitary gland is a pea-sized endocrine gland located at the base of the brain. The pituitary helps control the release of hormones from other endocrine glands, such as the thyroid and adrenal glands. The pituitary also releases hormones that directly affect body tissues, such as bones and the breast's milk glands. These hormones include:

• Adrenocorticotropic hormone (ACTH)
• Growth hormone (GH)
• Prolactin
• Thyroid-stimulating hormone (TSH)

Here is a little information on pituitary tumors.

Most pituitary tumors are noncancerous (benign). Up to 20% of people have pituitary tumors. However, many of these tumors do not cause symptoms and are never diagnosed during the person's lifetime. They are classified into two groups: microadenomas (less than 1 cm) and macroadenomas (greater than 1 cm).

Josh's tumor is on the smaller side of macroadenomasrecieve more information in the mail and a few days later we got our welcome packet to the Barrow Neurosurgical Institute.

Then we had to wait some more. 18 days to be exact. Those were definitely the longest 18 days of my life!

Monday, March 5th finally rolled around and we were on our way to meet with Dr. White and Dr. Knecht (an endocrinologist). We were asked to arrive 15 minutes early to our 4pm appointment. We got there at 3:35 and got all checked in. We waited. And waited. And waited. Finally, at 5pm we were called back to our room. The nurse took Josh's blood pressure and stuff and said Dr. Knecht would be with us shortly. So we waited. 20 minutes later she came in. She explained everything to us from her perspective as an endocrinologist and examined Josh a little. Then Dr. White came and talked to us about our treatment options and that he recommended surgery. He examined Josh and showed us Josh's MRI and how big the tumor was compared to the pituitary gland. We agreed to surgery and he said his scheduler would call us the next day. I asked how quickly most people get in and he said generally its 6-8 weeks, but since we were having a baby they would try to fit us in sooner if they could. We left about 6:15--over two hours after our appointment time.

Here is some info on the surgery.

Transsphenoidal literally means “through the sphenoid sinus.” It is a surgical procedure performed through the nose and sphenoid sinus to remove pituituary tumors. Transsphenoidal surgery can be performed with a microscope, endoscope, or both. The procedure is often a team effort between neurosurgeons and ear, nose, and throat (ENT) surgeons. A traditional microscopic technique uses a skin incision under the lip and removal of a large portion of the nasal septum so that the surgeon can directly see the area. Another approach is called endoscopic endonasal surgery, which uses a small incision at the back of the nasal cavity and causes little disruption of the nasal tissues. The ENT surgeon works through the nostrils with a tiny camera and light called an endoscope. In both techniques, bony openings are made in the nasal septum, sphenoid sinus, and sella to reach the pituitary. Once the pituitary is exposed, the neurosurgeon removes the tumor.

Dr. White uses the endoscope procedure. He has performed almost 1500 pituitary tumor surgeries and is one of the best in the world. We are very lucky to be so close.

So back to our timeline....The following day Josh got a call from the surgery scheduler, Storm. He was at work so we called her back when he got home around 2pm. She said he was penciled in for March 14th and asked if that would work. March 14th? So soon? She said it was Dr White's only opening in the next month or so and figured we needed it because of our upcoming baby so she put him down. We, of course, agreed. After getting off the phone we were both in shock. We just laughed (Josh I'm sure liked that response much better than my usual crying response to everything...I can't help it...I'm pregnant).

So I think that covers mostly everything. We are once again in the waiting phase. We should be getting a packet in the mail (hopefully today) with more detailed information about where and when we need to be at the hospital. All we know is he has pre-op stuff on Tuesday and surgery on Wednesday.

Oh, recovery...here is what we know about recovery.

Surgery is usually performed in the morning. He will be in a recovery room for a couple hours until the anesthesia wears off and then moved to the ICU for the rest of the night. The following day he will be moved to a normal room and monitered for another night. If there are no complications he will get to come home on Friday. He will need to take about two weeks off to recover and then be on light duty at work for a couple months. He cannot bend over, sip through a straw, or blow his nose for the first few months. He will never be able to scuba dive.

Well, I think that about covers everything. 4 more days...





Well, first let me give you an update on baby boy...and me. We are surviving. Haha. I have been pretty stressed and anxious about stuff (coming below) so I think it has made me start to have quite a few more contractions than before. Some are super strong and painful and some are not. Last night was the worst so far, but with a little rest, relaxation and large amounts of water I usually can get them to calm down. I probably could have gone to the ER because they were so bad, but I had my normal Dr appointment today so I just held out. They eventually subsided and things were pretty normal this morning. I mentioned it to my OB just to be safe and she hooked me up to be monitored for a bit. Nothing too abnormal. She is sending me in for an ultrasound in a couple weeks just to be sure everything is all good. Baby boy's heart rate was a little low today as well when she checked so being hooked to the monitor thingy was comforting to see that it was just how he was positioned or something. He is super strong when he moves around and jabs my ribs ALL the time. It is quite painful. I really think I may end up with a broken rib before he is born.

Avery is up next. She had her well child check up the other day and she is doing great! We switched Dr's and for the first time she didn't cry when the Dr tried to examine her. She doesn't like strangers. But, she was such a good girl! The Dr was impressed with how smart she was. She is in the 75th percentile for her height and weight. Next step...potty training.

And last, but not least, Josh. This is where all my stress and anxiety comes from. A few weeks ago Josh had some blood work done and an MRI. The Dr said she would call us if anything abnormal came back...we got a call the next day. We went in to meet with her and she told us that he has a rare pituitary macroadenoma (large tumor). We were set up to see a neurosurgeon and met with him on Monday. He said surgery was the best treatment option and explained the surgery, risks, recovery, and everything in between. Since I am having a baby within the next 10 weeks they said they would try to fit us in before then. We figured it would be the end of March or beginning of April. The surgery scheduler called us and said she had him down for next Wednesday. NEXT WEDNESDAY! We definitely were totally shocked. I am still shocked that this is all happening so fast. But, more than that I am glad it is happening next week. I can't imagine waiting for weeks, even months, to get this taken care of. I can barely get to sleep at night because I just keep thinking about it all (on top of being super uncomfortable and in pain at times).

I am sure its hard for other people to handle this type of thing, but adding pregnancy to the mix has not been easy. I think we are doing pretty good with it all. Josh more so than me. So once again I ask for your prayers. For Josh, for me, and for his surgeon (who we hear is one of THE best in the world).