OBESITY MYSTERY SOLVED: The Reversible Cause You Never Knew!

meet Leslie a woman whose life took a drastic turn in her late 20s when she gained over 100b for no apparent reason little did she know her weight gain stemmed from a hidden medical condition a reversible cause of obesity so join me on this medical mystery as Leslie regains her health and her life Leslie grew up in the United States and like the rest of her family she'd always been a bit heavier but it wasn't until her late 20s that she really noticed her weight getting out of control At first she rationalized it saying it was because of culinary school and then because of her first pregnancy but the weight just steadily piled on until she could barely recognize herself when she looked in the mirror it became pretty obvious that the weight gain was not due to either one of them and it was getting so bad and coming on so fast that I was getting to a point that I did not recognize myself I recognized my eyes um but the rest of me just just looking so strange I was starting to run into things uh door ways and countertops now I'm running into the wall now I'm knocking something off the counter uh that was very strange to to live through and to experience lesie withdrew into the home rarely going out or socializing at all she became increasingly anxious and irritable and she was exhausted but she kept waking up at 3:00 a.m. every morning and couldn't get back to sleep so she went to her family doctor he noted her weight gain found that she now had high blood pressure and a blood test confirmed new diabetes so things were really piling on at this point so he prescribed the medic medicines for the the diabetes and the blood pressure he gave me a copy of the Mediterranean diet but I could just tell he could tell that there was something else going on and he was a good partner as far as he could be um he learned a lot he was very curious you know throughout but he just didn't didn't have the skill set I guess um to to get it right it looked a lot like things he had seen you know he seen a lot of Di IES a lot of high blood pressure and a lot of obesity and so he attempted just to um treat those things that he saw one day she developed such a splitting headache that she had to go to the emergency department and she found out that her blood pressure was through the roof all of a sudden had this horrible headache one of the worst pains I had felt up to that point and I'd had two kids at this point so like my my mind went wild with what it could have been so I went to the ER in triage they they noted that my my blood pressure was extremely high I want to say it was like 180 over 110 or 120 oh well you've got hypertension well I mean this is a hypertension migraine oh it's just this well you need to lose weight just it just hurts so bad uh in my head you the pain but also to uh have the doctors just sort of it's cuz of your weight then Leslie's skin started to change she developed deep purple stretch marks all over her abdomen and severe cystic acne that she hadn't even had as a teenager it became so bad that she went to her family doctor complaining of shoulder pain only to find out that she had a severely infected skin abscess on the back of her shoulder next to Leslie's horror her hair started changing first her eyebrows became noticeably darker and bushier and then she developed some dark hairs in the top of her lip for the first time ever her hair was thinning so fast that she became terrified to even brush it like so many of us Leslie's long hair was part of her identity and one of the last things that felt like her was disappearing quickly and through all of this Leslie's mood just plummeted she became irritable paranoid and depressed so unfortunately with all these symptoms also came uh pretty intense anger more accurately categorized as rage sometimes really a difficult balance because you know you want to isolate and you just want to kind of be by yourself but at the same time you don't want to be lonely and you don't want to be left by yourself of course this was also the time that our best friend was getting married so at the height of her weight gain Leslie put on a bridesmaid's dress hid her depression behind a big smile and walked down the aisle a few months later one of Leslie's friends came to visit so she parked she got out of a car she started to walk up to me and then when we made eye contact she just sort of stopped and she was like girl what let's talk and turned out she had just had thyroid cancer surgery she still had a kind of a fresh scar and um she had a friend that had PCOS who had just recently been diagnosed she was convinced Leslie must have undiagnosed polycystic ovarian syndrome that's what got it in my head you know I need to go to the gynecologist so Leslie made an appointment with a gynecologist who ran a whole bunch of tests and told her that she did not have PCOS but that she was concerned she may have a different hormone problem my doctor called me when she got the test results and said this is not PCOS this is something pointing to the brain please immediately go and make an appointment with an endocrinologist so Leslie was referred to an endocrinologist who ran more tests and confirmed that she had high cortisol levels now cortisol is a hormone that plays a crucial role in your body's response to stress it regulates your metabolism immune response blood pressure and sleep in other words without cortisol you would die but on the other hand high levels of cortisol over years can wreak half havoc on your body and can ultimately be fatal so like so many things in our body it's a fine balance think of cortisol regulation like a thermostat for stress in your body when stress levels rise whether it's something scary like a loud noise or something more long term like pressure at work your brain releases a hormone called act and that signals your adrenal glands to release cortisol so then why is Leslie's body making too much cortisol so there's usually two main reasons this could happen either her body is making way too much act hormone and usually that's because there's a tumor summer in the body doing that or her adrenal glands are making way too much cortisol for some reason so when Leslie's endocrinologist tested her act level and found that it was really high the hunt was on to find the tumor in her body that was releasing all this act and this was the MRI of Leslie's brain which showed a tumor on her pituitary gland right at the base of her brain after some confirmatory testing Leslie finally had a diagnosis she has Cushings Disease a condition where a brain tumor causes high cortisol levels and it explains all of her symptoms one of the things I found when I was uh searching uh for information about Cushings after I got my diagnosis was the Mayo clinics page it's a a basic info page about Cushings but there was a drawing of a person's body and it looked just like me um come to find out a lot of patients come across that it's pretty popular page and they have that exact same response that's me Leslie's doctors explained that the next step was brain surgery remove the tumor remove the problem sounds straightforward right little did Leslie know that her treatment would be anything from straightforward I definitely remember what it felt like there's like the the pre-op room where you you change out of your clothes and you get into the gown and then you have to wait somebody comes in and puts the IV in your arm wait a little bit more and then the door opens and there's a hustling bustling movement while everyone's ready to go you know they've got the the the bed and they've got everything and you just stand up and you walk towards them and then you sit on the bed and you sit back and you start crying and you look at your husband and then you're both crying and it was just awful it's cold it's it's just there there's nothing you can do it's almost like you're trapped I hope I wake up please give me something right now to knock me out you know I was just like please give me something I I don't want to feel this and then you know before you know you're waking up because of the position of the pituitary right between the eyes and behind the bridge of the nose surgeons actually do this surgery by going through the nostril drilling a hole at the back of the nose to get at the base of the skull and that's actually how they remove a pituitary tumor the surgeon hadn't made his rounds yet so I hadn't talked to anybody that worked there but my husband was like good news they got it you got it all now I've heard it can take up to 6 weeks to recover and I'm going to you know feel better I'm going to lose this weight and then uh not too long after that the the resident came through to talk about next steps because somehow my husband had misunderstood and I had not been cured um in fact I was still had really high cortisol and cruel trick um I know he didn't mean to do that I mean there we were I I had not had a successful surgery and we had to talk about what to do next so Leslie went back into surgery and this time the surgeon ended up removing her entire pituitary now keep in mind your pituitary gland doesn't just control your cortisol levels it also controls many other hormones that Leslie now has to replace with medications it seemed like a reasonable trade-off if she was going to get better but even after surgery when her entire pituitary was removed Leslie's cortisol levels kept Rising Leslie's doctor were stumped maybe they didn't get the whole tumor during surgery in the end they decided to let Leslie heal monitor her cortisol levels and then decide on the next step so she went home and waited I'll just say those were some really some really dark days just not knowing what to do it didn't make much sense that my cortisol continued to go up even without a pituitary gland we kind of talked about some of the options but I was just in kind of bad shape I just had two significant surgeries and they just wanted me to kind of cool off a little bit before we figur fig out what to do next Leslie had been warned that she'd probably feel congested and maybe have a runny nose I mean they had just cut a hole in the back of her nose but she found that her nose was running a lot to the point that she couldn't lie down flat without fluid pouring down the back of her throat then she developed a headache and a stiff neck so she went to the emergency department and waited all night to be seen maybe 4: or 5 in the morning one of the neurosurgeons um came through to check on me he told me to sit up so he could listen to my lungs and when I sat up bunch of the fluid sored out of my nose and it was the middle of the night I'm sure he was tired but I just remember like the look on his face like just you just don't expect to see that and he knew exactly what was going on and so I was back in surgery within about an hour to close that leak Leslie had a CSF leak she was literally leaking spinal fluid out of her nose and on top of that she had menitis bacteria had crawled up through that hole in her skull and infected her spinal fluid that's why she had such a bad headache and a stiff neck I mean poor Leslie she just can't seem to catch a break 3 months later after she'd been treated with antibiotics for the infection there was finally a glimmer of hope one morning I woke up and I had slept all night and I wasn't hot and I didn't hear my heart trying to beat out of my body and a lot of these physical things that I've been feeling every single day for well over a year um just seemed quiet do she called up her doctor and they checked her cortisol level and to everyone's surprise it was normal so I kind of stayed in this kind of pseudo remission feeling mostly better but not all the way for about 2 2 and 1/2 years 2 and 1/2 years went by and it all started happening again Leslie gained 30 lb in 1 month her hair started falling out in clumps and her mental health took a dive she went to such a dark place and she knew her Cushings was back her doctors did another MRI and this time they found a shadow where the pituitary had been removed maybe there were some tumer cells left but after two failed attempts surgery was off the table instead Leslie went for radiation therapy 10 minutes of a beam aimed at her head every day for 6 weeks plus she was also put on a medication that blocked cortisol so the type of radiation I chose uh I go in and have a mask uh fitted um especially to my face and every day that I would go in for the radiation it would uh I would lay down on the table and they would put the mask over my face and then latch it behind my head and that just ensured that my head stayed very very still because they were aiming a very small beam of radiation at my pituitary area and it worked it took another 18 months but Leslie's cortisol levels were finally normal her symptoms melted away and after 10 years she was finally completely free of Cushings Disease now Leslie's become a strong advocate for those suffering with Cushings she's the president of the Cushing support and Research Foundation and she's on a mission to create community and peer support something she wish she'd had when she was first diagnosed um I don't know why I didn't find csrf you I looked online I looked at lots of things um on the internet but I just I never found it um and so I wish for something like that um just to have had that connection immediately sometimes we'll get a call from someone that just got the diagnosis or or they're pretty sure they had it they're in the testing and I'm like wow like what if I could have what if I had found it then you know and I could have made that phone call and just been supported through all the rest of it and had somebody to give me the good advice to know what really happens afterwards you know to what really to be prepared for and I probably would have just tried to be even more gentle with my myself to not push myself to try to you know make up for what felt like a huge failure you know I couldn't be a mom I couldn't be what I needed you know what I had the roles that I had always played for my family just couldn't be that anymore and it felt really terrible it felt like a loss of identity but I just I just wish I hadn't carried all that burden at the time I wish I could have had more of just a free communication with the people I loved and lived with so I want to give a huge thank you to Leslie for sharing her story with us and for the terrific work she's doing so if you like this video you might want to check out this one next Chris had hiccups for 3 years before doctors figured out the trigger be sure to subscribe and that way I'll see you in the next video so bye for now

Channel: Violin MD

Views: 286,396

Keywords: violinmd, violin md, life as a doctor, day in the life of a doctor, doctor vlog, junior doctor, life as a resident, life as a medical student, internal medicine, vlogging in the hospital, cushing's disease, cushing disease, cushing, cushing's, obesity

Id: 8U8ciNyH6pk

Length: 14min 51sec (891 seconds)

Published: Sat May 11 2024