Pituitary Team Changes Life of Patient with Growth Hormone Deficiency

Patricia Buckley has a small tattoo on her wrist. It says one word: “rare.”

In late 2017, Patricia learned she had a tumor at the base of her brain that had compressed her pituitary gland and affected the organ’s ability to produce growth hormone. Growth hormone deficiency is a rare condition, especially in adults.

But for Patricia, the diagnosis came as somewhat of a relief. She finally had an answer—and a solution.

Pituitary Tumor: ‘Not Your Everyday Diagnosis’

Patricia first realized something was wrong when she couldn’t get out of bed one day in April 2016. The extreme fatigue lasted about two to three weeks and recurred that August. By the second episode, she felt indifferent about waking up ever again.

“That was my ‘ah ha’ moment because … that’s not me and that’s not who I am,” she said.

After seeing her primary care physician and an ear, nose, and throat (ENT) doctor, Patricia underwent brain imaging and received a referral for a neurosurgeon. She researched different providers in the Phoenix area and ultimately called Dr. Andrew Little’s office at Barrow Neurological Institute in the fall of 2017. He could see her in just a few business days.

“How did I get to the head of the line?” she thought, feeling a little worried about what her imaging tests had revealed.

Dr. Little told Patricia she had a tumor on her pituitary, a pea-sized gland that produces hormones needed to regulate many important bodily functions.

He could remove it through a minimally invasive procedure known as transsphenoidal surgery, which involves accessing the pituitary gland through the nasal passage and sphenoid sinus. Because her tumor appeared to be benign, like most pituitary tumors, her other option was a “wait-and-see” approach.

“It’s not your everyday diagnosis,” Patricia said. Although she can recount the experience with some lightheartedness, she explains it was frightening at the time.

“You’re thinking to yourself: Am I facing my own mortality?” she recalled.

Patricia decided living with the tumor wasn’t an option, so she scheduled the surgery. In the meantime, Dr. Little suggested she visit the new neuro-endocrinologist at the Barrow Pituitary Center, Dr. Kevin Yuen, to evaluate how the tumor might be affecting the function of her pituitary gland.

‘One Heck of a Visit’ with Dr. Kevin Yuen

Neuro-endocrinologists specialize in the interactions between the brain and the system of glands that regulate the body’s hormones, known as the endocrine system. Dr. Yuen mainly treats disorders of the pituitary gland, including adult growth hormone deficiency.

“Because the hormones of the pituitary gland impact the whole body, patients like Patricia need a team of providers from multiple specialties to help individualize treatment to fit their needs,” Dr. Little said.

“I was Dr. Yuen’s first patient when he came to Barrow, so I’m affectionately known as Patient No. 1,” she said with a laugh.

To Patricia’s surprise, Dr. Yuen spent about two hours with her during her first visit. He took a detailed medical history, answered all of her questions, and provided a thorough explanation of pituitary tumors and what to expect throughout the treatment process.

“I remember walking out of that meeting, and I got in the car and cried, because it was the first time that I actually knew what was wrong with me,” Patricia said.

She went home to her husband and confidently explained her diagnosis, showing him pictures that Dr. Yuen had drawn for her in the clinic.

“He was like, ‘Wow, that must have been one heck of a visit,’” Patricia recalled.

Pituitary Surgery: ‘I Could Have Danced Around the Hospital Floor’

Patricia underwent pituitary surgery with Dr. Little on Friday, Dec. 1 of 2017 and woke up in the Neuro-ICU on Saturday morning feeling “phenomenal.”

“I felt so great I could have danced around the hospital floor,” she remembered.

After walking eight laps around the unit with her husband, Patricia was discharged home. She took it easy the rest of the weekend and felt well enough to return to her telecommuting job as an executive recruiter that Monday.

But the walnut-sized tumor had done irreversible damage to her pituitary gland. Dr. Yuen ordered a variety of tests, which revealed that her pituitary wasn’t producing enough growth hormone.

Adult growth hormone deficiency can reduce energy levels, alter body composition, weaken bones and muscles, cause insulin resistance, and even impair heart function.

“I look back at pictures of myself … and it wasn’t like I was heavy; it was like I was swollen,” Patricia said, framing her face with her had. “You’re swollen through the middle (of your body) too.”

Thriving with Growth Hormone Deficiency Treatment

Patricia began injecting growth hormone daily and gradually noticed changes, both physically and mentally. She lost weight, slept better, felt energized, and her mood improved.

Walking her dogs and cooking dinner didn’t feel like chores. Finishing a work project wasn’t so draining. She no longer worried that hiking and vacationing would be too taxing to enjoy.

“Dr. Yuen was able to quickly assess the situation and, over time, has literally given me my life back,” she said. “He gave me back things that I hadn’t even realized that I was missing out on.”

Dr. Yuen estimated that Patricia’s tumor had developed at least a decade before her diagnosis, impacting her life in ways she hadn’t recognized until she started feeling better.

“Her life has turned around 180 degrees,” Dr. Yuen said. “Not only has her employment capacity improved but also her ability to form new relationships with people and strengthen existing relationships.”

Because Patricia’s MRIs have shown no tumor recurrence, she now only needs imaging every 18 months.

“I am so gratified that Patricia is living the life she has hoped for and has thrived after surgery,” Dr. Little said.

With her growth hormone deficiency well managed, she has also “graduated” to seeing Dr. Yuen every six months instead of every three.

Although it has taken time to get to this point, Patricia feels better than she has in the last 10 to 15 years. She remained patient and confident that Dr. Yuen would get her where she needed to be.

“Dr. Yuen has been a tremendous partner in this health journey,” Patricia said, “I tell him all the time, ‘It’s not the average doctor that knows what this is.’”

It’s true. If there’s one word to describe neuro-endocrinologists like Dr. Yuen, it’s rare.