Acromegaly

With snow on the ground, my thoughts often turn toward skiing-one of my extra-curricular passions. This week, a wonderful medical story, one that comes from my ski travels, popped into my head.

It was 8 or 9 years ago when our pastor and his wife asked my wife and me if we wanted to go skiing with them to Squaw Valley where the pastor’s brother from San Francisco had a condo. Always willing to consider a quick skiing jaunt, my wife and I left our 1-year-old daughter in the capable hands of the grandparents and set off for Reno the weekend before Christmas. I had never been to Lake Tahoe skiing and was looking forward to it. Unfortunately, the skiing was terrible since California was in the middle of a drought; but the medical diagnosis I made for my pastor’s brother still to this day makes me quite proud.

To be a family physician, one has to have a huge breadth of knowledge that oftentimes is impossible to achieve. Sometimes though, the family physician is the first doctor to see the patient for a particular problem, and the first to make the diagnosis of a disease.

The pastor’s brother met us at the Reno Airport and it was during our introduction and handshakes that I immediately recognized features of a rare condition called acromegaly, which I remembered from medical school studies. Even though he was a short man, he had a large beefy hand and coarse facial features, including prominent forehead ridges over his eyes. I didn’t know anything about this man, but he appeared healthy and had no problem skiing. Over the next few days, I kept replaying the signs of acromegaly over and over again, trying to decide what to do or say. I reminded myself not to say anything to our gracious host, fearing that I must be mistaken in my diagnosis.

Finally on the plane ride home, as I sat next to our pastor, and relived the wonderful time we had, I gently raised the issue of his brother’s physical characteristics. He agreed that there had been some changes in his brother and so I further explained my reasoning. To make a long story short, the ending is happy. Upon arriving home, our pastor immediately telephoned his brother, who ended up having microsurgery on his pituitary gland to remove the tumor causing his acromegaly. In gratitude, he sent my daughter a beautiful, framed poster of a Santa Cruz boardwalk carousel horse which still hangs in her room as a continual reminder of our encounter.

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