MsH's Journal

So I'm in the middle of a little "health scare" and I'm trying to keep my emotions in check while balancing the amount of medical stuff I read with just trying to bury my head in the sand... Here's the scoop....

Before my DD was conceived/born, I would have bad headaches, migraine like, fairly often. I never really thought much about it, since I had a fairly stressful job (a RN in a busy cardiology step-down unit) and I am not the kind of girl to medicate, I never sought treatment for them. One time I mentioned them to my internist, in passing when she was rounding at my job, and she wanted to MRI my head. I deffered, and also refused the script for muscle relaxants. (As I said, I'm not the kind to medicate). Everyone gets headaches, right? Usually 1000 mg Tylenol, 800 mg Ibuprofen and caffeine make them tolerable. Besides my obvious fertility issues and the headaches, I've never had much to complain about health-wise.  After I got pregnant I had monthly scripts for massages, and my headaches diminished and greatly spaced out. Hunky dory! After Madigan's birth I refused b/c pills, because obviously they're a waste for us. We were careful and used other methods of b/c until her first birthday. We stopped using protection all together then, with (obviously) no luck or conception since then. We aren't too worried, since it took us a while with Madigan, and obviously have our hands full with a 16 month old. Another pregnancy would be icing, you know? But not vital at this point in our lives. Anyway in the last 16 months my headaches have returned. Bad. Vomiting bad, lazy-mommy bad. I hate it, and before I could just take OTC meds and sleep, but now I feel like I'm missing my daughters life! So I have been trying to find my "trigger" for them, since I changed jobs I have no real stress to speak of. They seem almost hormone related, occuring during when my "ovulation" should be, except I don't ovulate. I was just working through all my symptoms and putting the clues together when I had "the symptom" that caused me to realize this needs addressed medically: I began to lactate again. 

Truly, one night I was sitting in my PJ's without a bra and noticed that I was leaking. I can express it too, both sides. I have that "full" feeling as well. I called my OB's office the next morning, where they told me that it could take "months" for my lactating to go away, and it's normal. The nurse told me "if you really feel like seeing your doctor you can...." and "worked me in" two weeks later.  I felt it needed addressed before then, so I made an appt with my Internist. She was as alarmed as I was. It is NOT normal to lactate like that.  She sat me down, drew a slew of labs, and asked me about every symptom under the sun. Weird stuff, like how much licorice I eat, how often I have periods, etc. etc.  We covered all the bases, and the symptoms that she felt "most" alarmed about are: the headaches, infrequent/irregular periods, night sweats, ear pain, and lactation. She explained lactation is due to an increase in prolactin, and although I nursed my daughter for 12 months, I should not be lactating 4 months after this. We also covered thyroid dysfunction. Most of our discussion was centered around prolactin, hyperprolactinemia (elevated prolactin) more specifically. She said once we have the levels back, we can know how alarmed to be, but higher levels increase the probablilty of a pituitary tumor. 

My labs were back the next day: HCG negative (not pregnant).  CBC was normal. Metabolic panel was normal. Thyroid function was normal. Prolactin was normal.  She called me and said "You baffle me. Who lactates and has normal prolactin?" She said the things they question are Pituitary tumor, thyroid dysfunction,  PCOS, diabetes insipidus, and then a wide assortment of endocrine dysfunctions. The blood tests ruled out thyroid, Diabetes insipidus, and probably PCOS. (My fasting glucose is 86 and I have no other signs of this). She said the "top 3" on her list are 1. Pituitary tumor 2. Endocrine Dysfunction 3. I'm just a milker. (lol) 

My MRI is scheduled for Monday Nov 9th. My OB appointment is Friday the 13th. My internist said she would call my OB and ask what other labs (hormonal wise) need to be drawn in the mean time. Right now, she says she expects Pituitary tumor until proven otherwise. My research shows she is probably right- 70% of people who are unintentionally lactating (with or without increased prolactin) have microadenomas of the pituitary gland. To be producing milk shows that I've had a prolactin surge at some point prior to this, who knows why the level has gone down and I'm STILL lactating.  Eek. (Note we have ruled out the other causes for lactation like certain Rx meds and frequent stimulation). Trying to make "light" of this, my husband and I joke that I'm "TUPO" (tumor until proven otherwise) in a little play off of the "PUPO" (pregnant until proven otherwise) of the Infertility era. Sigh. 

So...  I'm struggling with staying positive right now. Terrified of an MRI of my brain. I have a feeling that it's NOT a tumor- because- that would be the "obvious" answer, and nothing for me is ever what it seems. 

I do have a feeling that this- the h/a, lactating, hot flashes, and infertility are all related. Somehow. We have discussed premature menopause, but since I can't be exact with the first day of my last period, I also cannot be exact about my cycle day. Which means we can't exactly draw my estrogen, FSH, etc without knowing. And I vaguely remember when we first started down the IF path, some doctor telling me my labs looked great and I'm "definitely nowhere near menopause..." Hmm... I knew I should have paid attention when the doctors were talking way back then....

So there you have it. My stress for the week/month. I'm open to any suggestions. Tomorrow is the MRI, and the chance to rule out a pituitary tumor. Nothing more, nothing less. One step closer to knowing what's wrong with me. Maybe putting all the pieces together, and figuring out my infertility and my lactation... I guess I'll just keeping reminding myself it's a "TUPO", because the other options... well, they're not so exciting either.