Her severe anxiety and weight gain weren’t caused by wedding jitters

But no matter what Hauser did, her weight stubbornly increased, her oval face became rounder, and the changes were obvious when compared to her identical twin sister.

Hauser wondered if her 5-pound weight gain despite all her hard work was the result of other problems.For the past two years she has been battling strings. Type of illness: first daily headaches, then severe anxiety, then insomnia, hair loss, and acne, which she could never have endured as a teenager.

“Stress was the universal explanation,” recalls Hauser, a small business auditor in Chicago. When a doctor suggested that her future marriage might be the cause of her problems, Hauser considered the theory, but later rejected it. It didn’t suit her feelings.

In early 2019, about six months after the wedding, Hauser insisted her doctor run some tests. They eventually determined that her symptoms were not due to stress or marital anxiety, but rather to a serious illness that had been smoldering for years.

After successful treatment and a long recovery, Ms. Hauser, now 34, feels much better than she did during a miserable period in her late 20s.

“I wish I had been kinder to myself and didn’t blame myself for what was going on,” she said.

survive the wedding

In 2016, Hauser began experiencing daily pain in the back of her head, which is common in tension-type headaches. When her headaches didn’t improve with dietary changes and over-the-counter painkillers, she consulted her primary care physician, who then consulted a neurologist, who told her that she had migraines. It was done.

Hauser, then 27, noticed that wearing it made her headaches worse. contact lens. “Her daily life was being affected, so she told herself that the problem might be with her contacts,” she said.she decided lasik surgery It may work, so in October 2017 I had surgery to use a laser to reshape my cornea and reduce or eliminate my dependence on contacts and glasses.

Her vision improved and the pain temporarily disappeared. A week after her eye surgery, her headaches returned. “I wasn’t too worried,” Hauser said. “I know a lot of people have headaches.”

A few months later, for no apparent reason, Hauser developed “really bad anxiety.” “She wasn’t just insecure,” she recalled. “I couldn’t function. I’m type A, so I knew what anxiety was, but I didn’t know this far.”

“I wish I had been kinder to myself and didn’t blame myself for what was going on.”

— Bridget Hauser

One weekday morning in early 2018, she felt so overwhelmed that she took sick leave and called her twin, Molly, and her mother to tell them she needed immediate help.

They managed to get same-day appointments with a psychiatrist and a therapist, whom Hauser began seeing regularly. The psychiatrist focused on her impending wedding and told Hauser that the event could cause “great anxiety.”she started taking antidepressants ativan, an anti-anxiety medication she used when things got really bad. She also stepped up her yoga practice, hoping it would calm her down.

Hauser vividly remembers riding the escalator to the office one morning. He didn’t know what the problem was, but he “kept saying in his head, ‘I’m in trouble, I’m in trouble.'”

Her changing appearance was the source of great unhappiness. Although her weight was within normal limits, Ms. Hauser cannot understand why her weight has increased even though she has significantly reduced her food intake and greatly increased her physical activity. did. Her normally thick hair had thinned noticeably, so the hairdresser gently advised her to consult her doctor.

Hauser’s psychiatrist thought her hair loss might be caused by antidepressants, so he changed her medication. That didn’t seem to help.

Hauser was particularly concerned about her chubby face. “It was like a joke in the family,” she said, adding that she was teased for being too sensitive.

Even her wedding day was colored by unhappiness regarding her appearance and an intense, amorphous anxiety that seemed to be present everywhere.

“Rather than thinking about how excited I was, I was like, ‘How am I going to get through this day?'” Hauser recalled.

After the wedding, Hauser’s mood worsened. She developed severe insomnia, night sweats, and acne. In February 2019, a primary care nurse ordered a thyroid test, which came back normal. When Hauser requested additional tests, she was referred to an endocrinologist. He told her he was stressed.

Frustrated, she saw a second endocrinologist who agreed with the first. “She said, ‘I don’t think there’s anything wrong with you,'” Metabolically Hauser recalled. A second nurse endocrinologist once reviewed questions about Hauser’s marriage in the presence of Hauser’s husband, Doug, who was accompanying her to the appointment. “She said, ‘On her honeymoon, she knew she shouldn’t get married,'” Hauser remembered her saying. She said, “‘Are you happily married?’ I couldn’t believe it.”

A few months ago, the nurse who ordered my thyroid test briefly mentioned measuring my levels of cortisol, a hormone involved in the body’s response to stress and other functions. Elevated cortisol levels may indicate: Cushing’s syndrome, a rare hormonal disorder This occurs when the body produces too many hormones over a long period of time.

“I think that was always in the back of my mind because she threw the cortisol test out there,” Hauser said.

She asked a second endocrinologist to order a cortisol test. Doctors agreed, but before that, Hauser didn’t have the typical symptoms of her significant weight gain, purple stretch marks, or a knot of fat between her shoulders, so she knew she was Cushing’s. She told him she didn’t think he was sick. Hauser had “.round face” That is also a characteristic of Cushing. Hauser was not taking steroids, which is seen in people who take high doses of steroids for long periods of time to treat various illnesses. Insomnia, headaches, acne, and anxiety can occur. symptoms Cushing’s.

“When you tell your primary care doctor that this is a rare disease, it goes out of one ear and out the other.”

— James Findling, MD

There are several formats cushing syndromeIt is usually caused by a tumor (usually benign, but sometimes cancerous) in the pituitary gland or adrenal gland that excretes excess cortisol. In some cases, tumors may develop elsewhere in the body, such as the lungs or pancreas. Cushing’s disease affects about five times as many women as men, and it usually occurs between the ages of 30 and 50. If left untreated, it can lead to death.

a trio of tests Measurements of Hauser’s cortisol levels in his blood, urine and saliva showed they were significantly elevated. The amount in her urine was eight times the normal amount. Her previously skeptical endocrinologist in Chicago told Hauser that she had Cushing’s disease and referred her to her next hospital. james findlinga Milwaukee endocrinologist who is internationally recognized for his treatment of this disease.

“I was really happy to get the diagnosis,” Hauser said.

Findling Hauser asked him to bring a photo taken several years ago to his October 2018 appointment. This is a request he makes to his patients as a way to spot obvious physical symptoms. In Hauser’s case, the changes in her face were especially noticeable because she is an identical twin.

Findling noted that diagnosis is typically delayed because changes in the body and other symptoms tend to occur gradually and imperceptibly. Hauser added: A typical Cushing’s patient. She was not obese and did not have diabetes or high blood pressure. Hers was a more nuanced case than many. ”

The next step was to locate the small tumor. Tests showed nothing in Hauser’s pituitary or adrenal glands, and CT scans of his pelvis, chest and abdomen showed no abnormalities. Findling ordered: Dotate PET This is a highly sensitive CT scan that can detect tumors that cannot be detected with conventional imaging. Scans revealed a nodule in Hauser’s left lung.

Hauser sought a second opinion from a thoracic surgeon in Chicago.While Findling and the thoracic surgeon are at Milwaukee Hospital Frottart Hospital Doctors in Chicago strongly recommended that she undergo surgery to remove the tumor, but she was against it. She said he believed her lung nodules were not the cause of Cushing’s disease and encouraged Hauser to continue treating her and giving her anti-anxiety medication.

“Do you know what it’s like to wake up from surgery and not feel better?” she remembers him asking her.

After careful consideration with her husband and consultation with doctors in Milwaukee, Hauser chose to undergo surgery to remove part of her left lung on October 30th. The pathologist determined that the nodule was a rare, slow-growing neuroendocrine lung cancer. May cause bronchial carcinoid and Cushing’s disease. The stage 2 cancer had spread to nearby lymph nodes.

“Fortunately, I think we hit it early,” Findling said. “She continued her remission and her Cushing’s disease was cured.”

“Cancer didn’t rock my world,” said Hauser, who previously had melanoma skin cancer removed. (Her doctors told her they didn’t think it was related to her cancer.) “It was important that I no longer had Cushing’s disease, that was more important.”

So why didn’t Hauser’s doctors, including an endocrinologist, suspect Cushing?

Findling, who estimates he has treated 2,000 people with the disease during his 40-year career, said doctors are taught that Cushing’s disease is rare, but that’s not actually the case. . He said: 2016 surveyit was found 26/353 A patient in the endocrinology department was found to be suffering from this disease.

Textbook descriptions, including the presence of purple stretch marks and bumps, are “almost caricatures,” Findling said. “It is well known that Cushing’s disease is more subtle than that and can cause neuropsychiatric and neurocognitive problems.”

The fact that Hauser was of normal weight and did not have high blood pressure or diabetes may have misled doctors.

“I think we’ve moved the needle a little bit, especially among endocrinologists,” he continued, adding, “Screening standards have to change. , goes out in one ear and out the other. They think they’ll never see it.”

“When you make this diagnosis, there can be great outcomes,” he added, citing Hauser’s case. “That’s why I’m still doing this at this age.”

Hauser considers Findling “a literal lifesaver.” She spent the next year seeing him while gradually weaning her medication to normalize her hormone levels and restore her strength.

She is tested for Cushing’s disease every year, is cancer-free, and feels well except for some residual fatigue. She gave birth to a baby girl in October 2021. Her son was born eight weeks ago.

Hauser believes support from her family, especially her husband, who she calls “my biggest supporter,” is essential. This seems especially ironic considering that marital stress was actually blamed for symptoms caused by cancer.

“He was so helpful in calling the doctor and making necessary appointments when I didn’t have the energy to fight anymore.” His unwavering love was “a testament to the strength of our marriage.” she said.

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