baffled. unilateral gyne twice....six years apart?

[faust]

There's a full story of my previous case here:
http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=2;action=display;num=1113454906

if you'd like more detailed background on this.  

For now, I'll summarize the pertinent info.  I developed a truly unilateral case of gyne (only my left side was affected, my right was totally normal) approximately six years ago, when I was around 14.  It consisted of a hard, irregular golf-ball sized lump of tissue under the nipple surrounded by a large area of "puffyness".  My memory is hazy, but I think it reached its final size after about 2 years of growth, and remained constant until I had it removed by Dr. Fielding last May.  The healing process has been more drawn out than I had expected, but I have noticed constant positive changes and at 9 months I am starting to think that it may look almost normal by summertime.  I have a pretty positive outlook on life, so until last weekend I was incredibly hopeful despite not yet being 100% happy with my results.  The end actually seemed to be within sight.

Then, on Saturday something I could not even have imagined in the worst of my nightmares happened.  I noticed what seemed to be a small lump developing under my RIGHT nipple.  For two days I passed it off as paranoia...as I'm sure is the case with many of you, I examine my chest quite a bit and can be prone to imagining things.  But between yesterday and today it has become clear that this is not just in my imagination.  The lump has gone from literally nonexistant to pea-sized and tender in four days, and the surrounding tissue has began to puff up as well.  Today for the first time it became marginally, but unmistakably, noticable in the mirror.  By which I mean that nobody except myself would likely notice a difference, but that the change is noticable enough to me that I am 100% sure that I am not just imagining this.  Since noticing this, I have also examined the left (operated side) extensively but have found no change there.

I am at an absolute loss.  I am so devastated that I am still numb to this on an emotional level; the reality of it has only registered intellectually.  I cannot understand what would cause this to happen six years after the onset of the first case.  My health habits have been more or less constant for the last two years.  My diet, my drugs and medications, my exercise patterns have not changed.  I am clearly well beyond puberty.  It simply makes no sense to me.  

I will try to get an appointment with a GP tomorrow to get a referral to an endocrinologist (I am in Ontario, gov't health insurance requires I go through a GP to see a specialist).  My hormones must somehow be messed up...perhaps if I take fast enough action there's a glimmer of hope that they can be righted while this is developing, thereby stopping, or even reversing this process.  If things don't work out that way, I suppose I'll just have to muster the strength to go under the knife and through the healing process once again.

Does anybody have any ideas as to how this could be?  Has anybody experienced anything similar to this?  Any comments would be much appreciated.

Thanks,
-f

[Hypo-is-here]

Sorry to hear of your situation

If you get a referral to an endocrinologist who has an active interest in reproductive endocrinology then hopefully nothing will be overlooked.

I found these for you that fit that bill in Ontario, hopefully you can get a referral to one of them via your gp.

Ronnie Aronson, MD, FRCP, FACE
1235 Trafalgar Road
#412
Oakville, Ontario, L6H 3P1
CANADA
Phone: (905) 337-0040
Interest Areas:
   Diabetes Mellitus
   Lipid Disorders
   Reproductive Endocrinology
   Thyroid Dysfunction
   Osteoporosis
   
Tisha Joy, MD
710-500 Proudfoot Lane
London, Ontario, N6H 5G7
CANADA
Interest Areas:
   Hypertension
   Reproductive Endocrinology
   Thyroid Dysfunction
   
Shagufta Usmari Khan, MBBS
138 Laurel Avenue
Etobicoke, Ontario, M9B 4T6
CANADA
Phone: (416) 695-3452
Interest Areas:
   Reproductive Endocrinology
   Osteoporosis

[faust]

Argh.  Doctor's office is booking 3 weeks in advance.  I'll have to go into the student clinic tomorrow to see a nurse, convince them to refer me to the doctor-on-call (there isn't one on duty today), and then convince them to refer me to an endo.  I'm worried I'll get some ignorant nurse who won't deem my situation urgent enough to require 5 minutes of the doctor's time.  I don't think there are many medical professionals out there who would understand the time sensitivity of this issue.  And even if I do succeed in getting my referral, god knows how long it will be until I can actually get an appointment with the endo.

Here's hoping that this time around I'll be on the good side of the stat that says that 90% of cases of gyne remit within a few months.  Although I seem to recall that stat being for adolescents....

Thanks for the info hypo, but unfortunately none of those endos are close to me.  I'll just have to hope that whomever I am referred to knows what they're doing.

[faust]

Went into the clinic today and spent almost 2 hrs. jumping through hoops before I eventually got to see the doctor on call.  She was a very nice lady but seemed to have a somewhat minimal knowledge of gyne (the nurse who screened me beforehand had never even heard of it, and the doctor herself misspelled it on one of the forms).  Despite my insistence that I needed to see a specialist, she refused to refer me to an endo, saying that an endo wouldn't want to see me unless a blood test already showed that something was amiss.  

So...she ordered a blood test to check thyroid function, testosterone and prolactin levels...luckily I had done some research and when I suggested that she also check my liver enzymes, estrogen, Luteinzing Hormone and Follicle Stimulating Hormone she seemed to think they were all good ideas and added them to the list.  She also ordered an ultrasound but I know enough to know that that won't really tell anybody jack.  She said the blood test results should come in within a few days.  Overall her attitude seemed to be that I need to get back in for surgery as soon as possible.  She was wholly unconvinced by my insistence that since this has arisen so rapidly and recently there is still a chance that it could remit on its own, or if there is a hormonal cause, with medication.  She also seemed to think that the fact that it is still growing will have no impact on the chances of it reoccuring if i have it surgically removed.

*sigh*  I feel like I'm going through the exact same sh*t I had to go through a year ago.

[Paa_Paw]

Don't lose faith yet, it is not a problem that wost women would be conderned about so the Nurses ignorance is not unusual. And with respect to the spelling, The root words are Greek, Their spelling is different in some texts depending upon who did the translating.

[Tim_Hortons_Coffee]

Just wondering if this poster is still around at all. I have a case almost identicle to his, and I'm even looking into surgery with Dr Fielding this summer....disturbingly similar.

[moobius]

*sigh*  I feel like I'm going through the exact same sh*t I had to go through a year ago.

doc's don't always know the best course of action for every ailment, unfortunately....

[geg100]

i know it may sound crazy but if i were u i would start a course of anti estro straight away as its still soft and tender not hard yet.