The First Diagnosis

It seems bizarre looking back, that on the eve of Alex’s Birthday on the 6th February this year, I stayed awake praying that the neurologist would confirm a 3cm body tumour in the right artery in my neck. I don’t suppose many people pray for a diagnosis of a tumour, least of all those like me whose family is horribly familiar with the count and measurement of the myriad of cancerous tumours that my sister lives with and so far have successfully been treated every 2 weeks. But in my case, if it were to be a body tumour than it would almost certainly be benign, and the surgery to remove it, whilst sounding crude (incision from collar bone to chin), would be pretty much risk free and without urgency. The alternative diagnosis or an inconclusive diagnosis at 5 months pregnant didn’t seem to bear thinking about.

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If not desperation, than a daily longing for a brother or sister for Barnaby propelled me to see the GP that day in August, together with increasingly frequent migraines that were becoming intolerable.

12 months earlier, I had said to a friend that whatever would be, with be. We were so content with Barnaby, that I would be reluctant to go down the medical intervention route (IVF) if we found it difficult to conceive again. I’d rather focus on the half full glass, rather than the gap of the brother or sister we’d always presume would come along. But weeks turned into months, and then a year to 18 months passed by of unsuccessful ‘ trying’. I don’t know about Alex, but I got to the point where the desire for another child became burning, and on the days when my period finally came I felt empty and desolate.

It was the first time I had seen Dr Helm – she was not my regular GP and was just filling in at the practise that day, luckily for me. My medical parents would later marvel that she made a connection with my migraines and irregular cycle and sent me off for a blood test to measure the hormone ‘prolactin . It was inspired pattern recognition and she would later be vindicated in her assertion that I might have a small tumour in my pituitary gland next to my brain – potentially causing the head aches, and certainly causing a hormone imbalance which had led to the irregular periods, decreasing our chances to conceive. Dr Helm referred me to an ‘Endocrinologist’ who I saw privately in Wimbledon. Endocrinologists are a funny breed of doctor, focusing entirely on the endocrine and all the biochemical cues that glands react to, in order to fire off different doses of hormones in the body. Endo Doctors provide rational explanations to some of those women who blame mood swings, or weight gain, or fatigue on ‘hormones’. It turns out that sometimes those women are right. In my case, an over production of prolactin was mimicking the effect of breast feeding, and at the same time suppressing my oestrogen production and disrupting my cycle. It turns out that I could have turned on the milk tap at any time, months and years after stopping breast feeding Barnaby. Interestingly, my body would have been sniffing out any fat in my diet and storing it up for a rich bit of milk, leading to an un naturally high body fat content. So when this diagnosis came, it was with some relief, as I had found it so difficult to fully lose the podgy weight I’d been carrying since Barnaby’s birth.

The Doctor wanted me to have an MRI to study the pituitary gland, and if it were a ‘prolactinoma’ then there would be a good chance that its size and affect could be reduced with tablets, failing that radiotherapy, and failing that surgery.
In the mean-time he suggested I lose some weight to give the oestrogen a better chance of winning the battle against the prolactin. I can’t say that I wasn’t offended in my female defensive way, by his suggestion that I needed to lose weight – and damn it - I’d just been vindicated in my challenge with weight loss, but he was suggesting that if I wanted to conceive I needed to try harder. I had always found dieting had never worked for me, and had taken the increased exercise route each time, but with the motivation of increasing our chances of having no. 2 – I invested in a ‘G.I’ diet book on the good Doc’s advice, and would spend the next month craving carbs.

Within 2 weeks, my late period came, and after a month I was still battling with the daily sense of starvation and lack of energy. In parallel I had been in continual correspondence and phone ranting with my medical insurers who had refused to sanction the MRI on the grounds that the GP had mentioned the word ‘fertility’ which is the first excuse a medical insurer can latch onto as exempt from cover. With help from both the GP and the Endocrinologist and my refusal to accept their conclusion based on my parents assurance that the insurers were wrong - I finally got the concession I needed to go ahead with the MRI.

But 5 weeks had passed since the intended MRI, and when I came to fill out the paperwork in the X ray department I realised that I couldn’t confirm with 100% certainty that I wasn’t pregnant – as I determined that there was the improbable chance of conception 2 days earlier.

I put my valuables in a locker, entered the room with the flat bed in the centre, the metallic chamber around it and the window panel to the radiology team in front. The radiologist came in and I admitted the minute possibility of pregnancy. She said that if it were her, than she wouldn’t go ahead and risk it – yes, even if the foetus was just 2 days in creation. She told me to come back when I was absolutely sure I wasn’t pregnant, or if I was, it would be safer in my second trimester.

I was so frustrated, as I just wanted to go ahead with the MRI. Now I might have to wait for up to another 3 months for my period if it were irregular again. I reasoned that I couldn’t trust a negative pregnancy test, as it had been wrong several times with Barnaby.

A few weeks later I would feel the surging emotions of relief and exhilarated happiness when I came running down the stairs to breakfast holding up the plastic pen to Alex above my head saying “it’s positive, it’s positive, it’s positive, we’re having another baby, it was also not lost on me that I could stop the GI diet right there and then. Barnaby had mimicked me, saying “yey- we’re having a baby, it’s positive”. Alex kissed me on the cheek, lifted me up in the kitchen and we then checked ourselves hoping that Barnaby wouldn’t repeat his new dance and line to anyone else.

Happiness coursed through my body for the next few weeks and months like an impenetrable shield to stress at work, the migraines (which eased off in the first trimester) and morning sickness. I felt driven, happy, complete. Every day for the first month of our knowing and not sharing it with others, I would punch the air and say ‘yes’ to myself and to the sky on my morning walk to the station. We couldn’t have felt more contented as a family. I had of course no idea of what would lay ahead in January, when the first MRI not only confirmed the presence of the pituitary tumour, but would point to a much more concerning shadow in my brain’s vascular supply.