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The Curious Case of a Cushing’s Disease Diagnosis

For roughly a year, Alaina Axford-Moore struggled to rationalize a strange set of symptoms, and her medical mystery didn't end with her diagnosis.

For roughly a year, Alaina Axford-Moore struggled to rationalize a curious set of symptoms. She was gaining weight at an increased rate; her blood pressure was unusually high, and more often she found herself feeling simultaneously anxious and fatigued. At age 45 she had also stopped menstruating, a clue that led her primary-care physician to write off the problems as symptoms of early menopause.

But Alaina knew there was more to the story.

Things weren’t adding up. I wasn’t feeling well. I had talked to other women who had gone through menopause and they all agreed that my physical symptoms weren’t normal. —Alaina Axford-Moore

At the recommendation of a friend, Alaina searched and eventually found an endocrinologist in Bryn Mawr who diagnosed her with Cushing’s disease, an ailment caused by a tumor or excess growth of the pituitary gland.

While she was relieved to finally have an explanation for her symptoms, Alaina worried about what lay ahead. The pituitary gland is located at the base of the brain. If the doctor’s diagnosis was correct, Alaina would need to prepare for brain surgery.

When her physician referred her to neurosurgeon Dr. James Evans, at Jefferson’s Center for Minimally Invasive Cranial Base Surgery and Endoscopic Neurosurgery, Alaina quickly learned that her initial diagnosis may not have been as accurate as it seemed.

“I went to see Dr. Evans and he said to me, ‘You definitely have Cushing’s disease, but it’s just not adding up to me. I don’t think this has to do with your pituitary gland,’” she recalls.

Dr. Evans referred Alaina to Jefferson’s Department of Endocrinology, Diabetes and Metabolism where Dr. Jeffrey Miller began a series of in-depth testing and observation with hopes of discovering the true source of Alaina’s malaise.

After a month of CT scans, ultrasounds and MRIs, Dr. Miller discovered that Alaina’s Cushing’s was being caused by a small tumor on her lung, not her pituitary gland.  According to Dr. Miller, the tumor had been causing overproduction of cortisol in her adrenal glands, a syndrome that can be missed in testing because it mimics obesity in many ways. Dr. Miller was certain that the tiny tumor was the cause of Alaina’s physical and emotional symptoms, so he referred her to thoracic surgeon Dr. Scott Cowan to have it removed.

After the surgery, both Dr. Miller and Alaina knew the riddle had been solved. Only three days after the surgery, Dr. Miller noted that Alaina’s face was noticeably slimmer and her symptoms had begun to subside.

Having had her fears about her health problems quelled and her disease now cured, Alaina says she’s feeling better than ever and has big plans for how she’ll maximize her new lease on life.

I’ve lost 60 pounds since the tumor was removed. Dr. Evans saved me from unnecessary brain surgery and when I met Dr. Miller and told him my story, I felt relieved that he was going to try and figure this out. It was really relieving to know that they really had my best interest at heart. —Alaina

“After being ill and getting well, I feel like I have a second chance with my life,” Alaina says. “So I went back to school for medical coding and billing, something I’ve always wanted to do. When I think about my doctors and how they really worked hard to save me, I feel like I owe it to myself and to them to take care of myself and get the best out of my life.”

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