Wednesday, June 24, 2015

Pituitary Problems 2: Surgery OR Out Damn Spot

Since the last post, there have been some developments. After a review MRI done in April, I got back to see the neurosurgeon, just last week, for his assessment. The drug I was prescribed back in December, Dostinex (cabergoline), which I take weekly, has done wonders for suppressing the prolactin that I was over-producing. Sadly, it has not had the effect of shrinking the tumour.

If anything, it's grown marginally - they are known to be slow-growing, so this in itself is not a major problem.

So, the tumour cannot be described as a prolactinoma; it's more likely to be a non-functioning tumour. Put simply, this means that it doesn't produce excess hormones, in and of itself. The raised prolactin levels actually demonstrate that it is the pituitary stalk producing prolactin  - think of it as a protest at being squished up out of the way by this rogue growth.

After mulling a few options over in the consultation, I decided to get it out. The surgeon offered the 21st of July as the nearest date, which I was happy to take. He says that it is fairly straightforward. It's called a transsphenoidal surgery, and basically he goes in just above my front teeth in a line back to the skull/brain base, breaking a small hole in the sphenoid bone, and using endoscopic techniques he'll go in and (hopefully) take it all out. I'll only be in hospital for a few days, and willl recover at home in about 2-6 weeks. Hopefully in time to make it back to work in September.

In myself, I'm seeing a gradual improvement, week on week. I have a bit more stamina, lasting the day and only feel whacked if I've overdone it - but so often I don't realise I've overdone it, until I've overdone it! But compared to my last visit to this blog, I can really see a difference - and the good weather recently has really helped too.

Yesterday after visiting the endocrinologist, he agreed that it was probably the best course of action to have it out, but warned that it was unlikely that I would regain any lost hormonal function. So I could well remain on cortisol (steroids) and growth hormone injections for the rest of my life.

But hey, it will be nice not to have this bump in my head, and it pressing on my sinuses, giving me headaches and vision problems and all the other problems; as well as having histology and pathology done on it to ensure there's no nasty surprises.

So roll on July 21st!

Tuesday, May 05, 2015

Pituitary Problems - or, how I learned to chillax about stuff

About last October 2014, I began to experience really debilitating fatigue. I couldn't understand it, I wasn't ill, or so I thought, just a long-standing sinus problem that wouldn't go away.

I had been feeling that same fatigue previously, in February 2014 – but I was doing a year-long post-graduate course in Education, working 19 hours a week in teaching and doing the usual mother stuff, so I put it down to that. I remember going to see a herbalist in Meath, who prescribed me a tonic, reckoning that my adrenal system needed some support. That tonic did seem to perk me up and I hobbled through the rest of the academic year, having some time off in August and picking myself up a bit.

At the same time, I noticed that I just couldn't stomach alcohol any more – I mean even a pint seemed to make me feel more than woozy, so I basically avoided drinking. I also seemed to start avoiding most social situations – Christmas, anything with friends: I just couldn't cope with anything beyond a working day.

Then finally my menstrual cycle ground to a halt in October. I waited until the end of November to see if it’d restart and when it didn't, I visited the doctor.

She sent me for blood tests to see what was lacking, with the mild warning that it could well be the onset of menopause. However, the tests revealed that I had a high prolactin level. She then requested an MRI scan to check out my pituitary, as she suspected I might have a pituitary adenoma.

She was right.

Just before Christmas, I was then referred on to a neuro-surgeon to see what he thought. He walked me through the MRI images: a 2cm tumour, and prescribed cabergoline, a dopamine agonist, to help suppress the prolactin, and possibly shrink the tumour. But he advised me to see an endocrinologist to see what hormones the pituitary was not making, as it is common for pituitary tumours to suppress normal pituitary function. He wasn't going in there, until the endocrinologist had established what function the pituitary did still have.

I now know more than is healthy to know about this tiny pea-sized master-gland located just beneath the brain, about 2 inches directly back from the bridge of the nose. It governs the release of ACTH, which tells your kidneys to make cortisol (and other hormones), as well as human growth hormone, which maintains normal cell function and has implications for the liver (hence the aversion to alcohol), as well as TSH, which stimulates the thyroid gland in the neck, not to mention all other hormones to do with sexual function and reproduction.

When these are governed normally by the pituitary, you don’t notice. You just have a normal quality of life. When these are suppressed, well, let’s say your quality of life ebbs away, drip by drip. It’s insidious and you really don’t notice it, except as a gradual withdrawal of living: fatigue, disinterest and just paring back to basic life functions. I hadn't been writing for a while, but at this stage I wasn't even interested. I had no interest in books either. I seemed to have a complete sense of humour failure too.

The special test that I needed came up towards the end of February. I underwent an Insulin Tolerance Test. In this, I came fasting to the hospital. They inserted a cannula to withdraw blood at regular intervals and then injected me with insulin. This is what is called a provocative test: basically the equivalent of inducing hypoglycaemia in a diabetic patient.

You don’t feel much discomfort, you just feel a little sweaty like you’re going to faint. The nice part is the Lucozade and biscuits you eat once you've achieved a low enough blood sugar count. The test also provokes the pituitary gland to release ACTH and growth hormone, a normal bodily response to an invoked stress. About a month later, in March 2015, I headed back to receive the results. I was still feeling very much under the weather, in fact, I was even worse than I had been before Christmas, but I now found out why.

My body wasn't releasing enough ACTH to stimulate normal cortisol production: basically I was only producing about a 1/3 of what I needed for normal daily function. So the endocrinologist said I needed to replace this with hydrocortisone. In other words, steroids. I have to take these every day, in the morning and early afternoon, to mimic the body’s normal pulses of these. If I am ill or vomiting, I have to double the dose. If I can’t keep them down, I would have to go to hospital to get an injection.

That was a shock in and of itself, but the next shock was to find out that I wasn't producing enough growth hormone. My numbers showed to be only 10% of what I should be producing. This hormone regulates cell function, liver function and without it, your cholesterol levels rise (something I hadn't got checked in yonks anyway), and your body fat rises. I had noticed my upper arms and tummy getting extra flab, but I had just put this down to getting older. It also effects your stamina and ability to exercise. Both of which had lately just had me flummoxed – I couldn't walk up the hill in Carlingford (a steep one, but a great one to get your heart going) any more, and just found it so hard to get from A-B in class – I’d come home wiped out from teaching most days, but lately I was wiped out after just driving the hour it took to get to work, never mind trying to get through a 5 hour class.

My eyesight doesn't seem to be as good as it used to be either. Sitting looking at a laptop or on my iPhone has a tendency to make my eyes feel sore after a while. This could be down to the tumour too, as where they develop they can press on the optic chasm: where the nerves from the eyeballs go back into the brain. As a tumour develops it can press on the nerves causing vision problems. I probably need to be assessed for this too.

The stage I am at now, is waiting to see. I am on growth hormone therapy and steroids – and could possibly remain on them for the rest of my life. The tumour itself has been scanned since, just last week, late April. And it doesn’t seem to be responding to the cabergoline, which I take every week – it’s more or less the same size. Whether it will need to be removed is something I’ll find out down the line: I've to wait and see how I stabilise on the additional drugs. Since beginning the extra drug therapy I am seeing minor improvements in stamina, but it doesn't take much to tire me out. I can manage a morning, but I get tired in the afternoon easily. Needless to say, I'm not at work – I haven’t been able to go, since the March visit to the endocrinologist.

I found that once I started the steroids I was all over the place, as I was when I started the growth hormone therapy. Four weeks in, things are starting to level off, but the advice I've been given is that it will take a long time to get back to normal – possibly six months to a year. I have a lovely app to help remind me to take everything, as there’s so much to take at different times I’d forget, if it was left up to me!

To be honest, this is the first time in a long while I've managed to type anything of substance. But it is a sign that something is coming back and at the very least the tumour I have is unlikely to be malignant. Reasons to be cheerful – 1, 2, 3.

Thursday, July 25, 2013

Reviews of The Angels's Share

Slow, slow, slow!

A year later--okay over a year later--I have discovered some reviews of The Angels' Share online. I am quite excited by this, as these are some more than the first collection got: showing that it takes a terribly long time to get going in poetry-- as well as showing that I must be terribly idle to even be looking!

First, I found one in Australia: Tintean, a journal for the Australian Irish Heritage Network. They used to be a hard-copy journal but have gone over to an online version. The reviewer is quite kind, overall, but isn't keen on Pair Bond-- one of the poems that goes down a storm at readings--nor some of the Mallory poems--where I would have 'recycled' some of Mallory's quotes from his letters and journals, which I suppose might have made the poems seem stilted, as the language of the early 20th C is more formal than our 21st C brogues. Can't win 'em all, I guess.

Then there's a very warm one from Dublin Duchess --on an aside, her reading list is quite exhaustive and worth checking out. She loves Pair Bond, but thems the breaks, as they say.

 Mike Begnal's review on Todd Swift's Eyewear blog is very generous, I got the impression he really liked the book and his favourite towards the end, Modern Fantasia is one of my favourites too. 

And lastly there's one on Magma poetry's blog but alas, I don't know what it says yet, as there seems to a problem with the website--maybe it's just me!

By the way, if you're wondering what Pair Bond is all about, click on the link for a very short video of me and some Poetry Divas giving it what for (thanks to you-know-who for putting it together for me).

Thursday, May 23, 2013

Awfully Brrr for May

Coldy, coldy coldy. Out weather here in Ireland is giving us much pause for thought, what with these unseasonable northerly winds. The garden outside was given its annual shearing about three weeks ago and has been behaving immaculately ever since.

My pinky clematis looks lovely, spread all over our neighbour's wall and all the other plants I put into a small raised bed are thriving - bar the bean plants. Is it the cold? Is it the rain? I don't know.

What I do know is that the peas I put beside them are thriving; already climbing up the string and bamboo wigwam I set up for them. But the beans are withering and looking decidedly peaky. I should have just stuck with the peas overall, perhaps.

In writing news, all is very quiet since the end of the Dundalk Book Festival back at the end of April - almost a month ago. I believe most events were well attended and we Poetry Divas helped to rock the Panama Cafe on the Square (hai). We had an interesting afternoon, with many readers and even a musical interlude. More on Michael Farry's blog.

A highlight for me was Noel McGee, doing an excerpt from a one-man play, I, Kavanagh. This is a brightly woven piece with excerpts from Kavanagh's work and work about his work. The audience loved it - what with Patrick Kavanagh being from out the road a bit - and I saw many audience members mumming the words of his poems along with the actor.

There were parts in it I remembered from Antoinette Quinn's Biography of Kavanagh, which by the way if you've never read it is a fantastic read and full of inspiration too. One to buy rather than borrow. "O he was a quare one..." Kavanagh's poetry is something I return to time and again, probably because of the local connection but also because of his way of talking about the land. When you're a country girl, like me, it's nice sometimes to be grounded by what you've come from.

Wednesday, January 30, 2013

Underground Competition

Ever spent any time on the tube?

Submissions are now open for the first Fire Hazard anthology, "Underground".

To mark the 150th anniversary of the opening of the world's first underground railway in London in 1863, Fire Hazard is compiling a print anthology of poetry dealing with experiences of underground railways and their impact (for better and worse) on the communities they serve around the world.

Themes could include (but are by no means limited to):

Construction of underground railways
History of the lines and the stations
The above-ground communities the underground serves
The experience of commuting / travelling underground
The art of the underground
People experienced on the underground
Subterranean geographies / cities
Mapping the underground

If you would like your work to be considered for this anthology, please send up to four poems and a brief biographical note to us at with the word "underground" in the subject title. The deadline for submissions is March 31st, 2013. All included poets will receive an electronic copy of the anthology, hardcopies of which will be available for purchase in early summer.

Turbulence Magazine subscription rates: single issue £2; annual subscription (four issues): £6 (UK rates - please email for international rates). Please send cheques / postal orders (payable to "A Fisher") to: A Fisher, 29 Finchley Close, Hull. HU8 0NU. 

Visit their website at

Saturday, November 24, 2012

More Divas? And a Divo..!

Oh boy it's a busy season for the Divas! At 6.30pm, Wednesday 28th November, the Divas read in DkIT in Dundalk, in the Tomas Mac Anna theatre, emceed by the new Writer in Residence, Ferdia Mac Anna. Us Divas will be Kate Dempsey and Triona Walsh, and meself.

This time we are featured readers with a guest: Michael Farry. I wonder does that make him a Divo - even just an honorary one!

Thursday, November 15, 2012

Poetry Divas are go

Us Poetry Divas are getting around a bit these days! On Wednesday 21st November we're reading at The Grand Social in Dublin along with many other poets in support of Pussy Riot.

This event is just one of many organised across the UK and Ireland to coincide on that date, through the auspices of English PEN and our own counterpart Irish PEN.

We have a Facebook event page set up: if you're in Dublin on the night do come along from 6pm onwards, it's FREE and it promises to be a great night. Poets who have agreed to read include: Kimberly Campanello, Sophie Collins, Sue Cosgrave, Anatoly Kudryavitsky, Christodoulos Makris, Máighréad Medbh, Paula Meehan, Alan Jude Moore, Christine Murray, The Poetry Divas, Sam Riviere.