Friday, July 21, 2006

She's Pregnant!

Today, I found out I got a girl pregnant.
And instead of balls-shrinking, nauseating fear, I was ecstatic. Beyond myself. It just made my day.
She was a 32 year old woman who had trouble conceiving for many years. Had bad acne, overweight and looked like a man. So they thought polycystic ovary syndrome. Her docs did some blood tests which were negative, and then decided to scan her head and found a pituitary adenoma on magnetic resonance imaging, high IGF-1 levels.
Acromegaly. They sent her to me. Pretty classical features, what with the ring size, coarsening features, space between her lower teeth. So classical that I had the medical center photographer take her pictures for teaching slides.
Her prolactin and other pituitary hormones aside from the GH and IGF-1 were normal. So I sent her for a transphenoidal resection of the adenoma, and she was dismissed a day after brain surgery.
Although her prolactin levels when we checked it were normal, the tumor stained for growth hormone and prolactin, so it was likely a co-secretor.
Saw her back for follow up today, 4 months afer I last saw her. I gave her my share of good news; the IGF-1, growth hormone and prolactin were normal. And then she sprung her good news: after 8 years of unsuccessful conceiving, she just found out 3 days ago she's pregnant!
Although the PRL wasn't too high, it likely was high enough to suppress normal reproductive function. So while I can't say for sure that we fixed her, I'm pretty certain we did.
I don't usually show too much emotion with my patients these days, but the 3 of us; patient, her mom and I shared a warm embrace. And I left work with my feet feeling a little bit lighter, my strides bouncier.
I bet I scared the crap out of Kris though, when she asked me how my day was. I replied, "I got a girl pregnant!".
On most days this is something most guys fear more than "Honey, I had a little accident driving your car..." but this I shall make an exception.