IGF-1 Climbing?

Since my surgery I have had (low) normal IGF-1 labs; because of this, it has been assumed that I am in remission from acromegaly. It seems the surgery was successful in removing most (if not all) of the tumor. However, my most recent MRI mentioned there was possibly residual tumor in the left cavernous sinus as well a developing mass on the right side of the cavernous sinus. My most recent IGF-1 was up a bit from 129 to 202.

Even though my Somatomedin-C (IGF-1) is considered normal, the result is higher from my previous reading 5 months ago. I asked my doctor if the fluctuation of my IGF-1 is normal or if this was an indication that residual tumor exists. He said it's hard to know for sure, and requested the glucose suppression test to be sure.

Growth hormone is supposed to supress below 1.0 ng/mL after my body is loaded with 75g of a glucose drink. Here are my results:

Baseline GH is 1.55 ng/mL
30 min 0.55
60 min 0.23
90 min 0.20
120 min 0.25

As you can see, my GH is completely normal. If there is residual tumor in the cavernous sinus, it is not producing excess hormone - this is great news!

Preparing for Another Surgery

Well, the surgery date is set. June 15th I'll be back in the operating room at UCLA to have the titanium mesh removed. I heard from my neurosurgeon. He's not sure there is residual tumor or new mass - he's going to compare my MRI's and get back to me on that. I will have blood work done because if there is a tumor, it will likely show up in the labs, so that will give me some insight into what (if anything) to prepare for. The most recent blood work (6 months ago) was completely normal, so I would be surprised if it weren't normal. As far as the surgery goes, if I have a CSF leak again, it will be repaired with a fat graft, and the titanium will not be placed back in my head.

This surgery is not as significant as the last time I went in - they won't have to cut through the dura of my brain but will be working below it. However, I'm still wrestling with having to go back under. This is an inconvenience - but life is full of inconveniences. The world seems to have no place for suffering - even though it is always present and around us. I know I don't have time for it! Comments such as, "Get-well soon..." are expressed even when someone will never get well. When a person has been handed a life of suffering - what do we say then? Naturally, we hope for the best, but words are difficult to find in these moments.

My grandfather was diagnosed with a rare form of cancer several years ago. He struggled with the disease for the remainder of his life; his last couple years revolved around weekly hospital visits and blood transfusions. He fought to get well until the very end. Death inevitably came. He died the day after I had my brain tumor removed. However, he used the final days of his life wisely. Instead of continually wallowing in self-pity (not that he never did - I'm sure he had his moments), he took the time to reflect on his life's happenings. He wrote a book recalling his life's personal highs and lows, ultimately defining who he was. He accepted his fate with dignity, and he found good even in suffering.

A source of encouragement for me has always been the life of Job in the Bible. He was given tremendous suffering - NOT that my life parallels that. When prayers are not answered in a way we desire, some people may think the suffering automatically must be some punishment from God. Perhaps it is not quite an issue in other countries. Still, in America the Gospel is often incorrectly promoted as a means to health, wealth, and happiness - this does not face the reality that Christians suffer as non-Christians do. Job's friends came around telling him he needed to repent because God had laid the problems in his life because of some unseen sin, but we read that God is sovereign even over Job's trials. As cruel as it may seem to some people that God would allow suffering - he has promised there is always good that can come out of it (Romans 5:1-5). We cannot escape disease or sickness - the world is full of it.

Last time I went through surgery, I thought my struggles were over for the most part - or at least for a while. I'm mindful that I may not remain infection-free or stay in remission forever. Either way, I believe the outcome is ultimately in God's hands. My prayer is to be content with whatever lies ahead, even if the prayers are not answered the way I hope they would be.