Cushing's Disease Part I

Cushing's Disease.
The devastating news that came since Feb this year.

Simba was suspected of Cushing's since Jan' 2013, diagnosed with it in Feb and had a CT scan in Mar which confirmed the suspicions of the tumour in his right adrenal gland in Mar.

Typical symptoms of Cushing's are the following:

- Weight gain and fatty tissue deposits, especially around the midsection and upper back, in the face (moon face) and between the shoulders (buffalo hump)
- Pink or purple stretch marks on the skin of the abdomen, thighs and arms
- Thinning, fragile skin that bruises easily
- Slow healing of cuts, insect bites and infections
- Acne
- Muscle weakness
- Brittle bones that can result in osteoporosis
- Diabetes
- High cholesterol
- High blood pressure
- Low potassium
- Balding

Like many others, I dismissed the mere thought of him getting any serious illness and concluded that his weight gain was either due to aging or his desk bound job that prevented him from chances to walk often.

The first indication came when he took studio photos for his graduation in Aug 2011; his face was slightly fatter but overall he looks better, fatter. Then came his IPPT in Sep and he failed Standing Broad Jump, Pull Up and Shuttle Run. (It was quite a surprise since he is usually a gold, and he trains on his own almost everyday.) He told me he experienced muscle weakness and found it hard to run and keep up with his usual exercises. I have never seen him so burned out until the days he went for his Remedial Training (something the Singaporean men have to go for if they fail their IPPT). I remembered he said he really couldn't meet me after these trainings as his muscles really ache so much. I laughed and teased him for aging so quickly as his strength was deteriorating at an exaggerating speed.

The most definitive change I saw in him was the thickening of the area just below chest during CNY last year. As much as he wants to deny, Simba is a very vain person; he does workouts regularly to make sure that his tummy is flat (yes, even slim people have bulging tummies if they don't exercise). At that time I couldn't figure out why he reached a mutual agreement with his mind to let go of his strict exercise routine (but little did I know that he was exercising all the same but still getting fat).

Then he began to lose hair. But his age was the age where men is progressing toward middle age, so I perceived it as normal.

The gradual progression of gaining weight is not worrying any of us, but i told him to go on a diet to lose some tummy fats. Lol! He ate only healthy food since then and went to the gym during lunch breaks. But all these didn't help. Tiny red bruises formed on his arms and legs few hours after he lift weights. And that was when his parents asked him to consult a doctor.

He took a blood test and it indicated low potassium and high cholesterol levels. His blood pressure measured at different times of the days vary from 150 to 180. He had to collect urine for 2 consecutive days; the occasional trips to the washroom at his workplace with the urine collection container started to intrigue his colleagues. It was difficult for him to voice it out to them initially but their acceptance and concern made him feel more comforted later. He also began taking potassium pills and eating bananas daily to keep his potassium level in the healthy range.

The urine test showed elevated levels of cortisol, a stress hormone controlled by the pituitary gland. They were so high that they were out of the detection limit. That was the day I blinked my tears away when the doctor told him that he was diagnosed with Cushing's.


70% of Cushing's was due to the tumour in the pituitary gland, a gland situated at the base of the brain. Although the tumour
is usually benign, the surgery to remove it is of high complexity. Some surgeons removed part of it and it grew back; some removed the whole gland with the tumour altogether. As the tumour grows bigger, it disrupts neighbouring nerves and causes diabetes and heart disease in some patients.

I was crestfallen after gathering these information from google. Most of the times I asked God why He was being so cruel and how could He do this to us. I was never genuinely happy until I met Simba; if anything unfortunate happens to him, my primary source of happiness will be cut off and I will never be able to get on with life anymore. However, as upset as I was, I tried not to display that kind of negativity in front of Simba.

I recently read a book about a man blinded by some intruders at his house. He didn't inform his girlfriend at the initial stage of recovery as he was feeling the worst and didn't want to comfort someone else in spite of his feelings. So yup, didn't want Simba to feel this way too.

I had emotional outbursts as and when, especially whenever I saw the fat deposits on the back of his neck, or the thinning of his skin, or his inability to feel strength.

One of these days, his plan to jog in discreet foiled when his mum found it out. I broke down. It was definitely not being paranoid this time. He could break his bones if he falls from running, but he was never taking the doctor's advice seriously. I chided him harshly, and said I would never talk to him again if he jogs before recovery.

It was later assessed that the tumour was located in his adrenal gland and most likely benign. The uneasiness eased for me since then, as the adrenal tumour is less risky to be removed and hence the high success rate. The surgeon performed a keyhole surgery; 4 incisions followed by cutting off the tumour's blood vessels and flipping the liver to allow space for the machine to eradicate the tumour.

The surgery was scheduled on the 26th April, so this year's birthday was one special day since I spent it teaching tuition and staying in the hospital with Simba.

Do you still remember how pint-sized Simba used to be?



This was taken in feb 2011. He had a really small face.




Jan 2012, Langkawi.

A rounder face, but it wasn't noticeable until u take a closer look.





Feb 2012. Valentines Day.





CNY 2012.






Met up with Carine and Bi Han after so long for Kevin's choir performance and they commented that he put on weight.





Apr 2012.
Bangkok.




May 2012. 4th year anniversary.




Sep 2012. His birthday.








Oct 2012. Legoland.










Nov 2012. 





Dec 2012. Christmas.





Jan 2013. Ling's birthday.





Feb 2013.






Apr 2013. Last month. TWG & Gardens by the Bay.










Looking through the photos taken last month at Gardens by the Bay and realising how much he has changed due to the disease made me really emotional. He looked so pale, his arms and legs especially. He used to sit or stand beside me to make me look real fat (see pic below). 




(June 2008. My cute boyfriend and I)


Thank you friends for showing concern for us throughout this difficult period. His surgery was a success, and he is recuperating well at home now. His recovery was so rapid; it's like he never had surgery. :)


To be continued.