My operation in France: Pituitary adenoma

The inside story of readers who have had operations in France – and how they found the health service, by Gillian Harvey 

21 November 2018
By Gillian Harvey

Former engineer Alexander Prette, 71, moved to Mesnil Mauger in Seine-Maritime in April 2005 with his wife Toni, 71, a former lecturer and exam moderator. They chose Haute-Normandie to retire to as it is close to their former home in Kent.

They had worked abroad – in Europe and beyond – for 25 years and both had a reasonable knowledge of French.

 

Initial symptoms

In 2016, I began to feel very unwell. I lost my appetite and experienced weight loss, fatigue, dizziness and nausea. My doctor sent me for various blood tests, which proved inconclusive and medications to alleviate the symptoms, including antibiotics and anti-nausea tablets, did not help.

The GP continued to support me with my symptoms over the months that followed, but the cause remained a mystery.

However, six months after my initial visit, I began to experience double-vision and alarm bells rang. The GP sent me for an immediate brain scan, which revealed I had a macro adénome hypophysaire (a tumour on the pituitary gland). This had grown rapidly and it was affecting major arteries and pressing on my optic nerve.

 

At the hospital

My scan took place just before Christmas 2016 so there was an initial delay in treatment starting. In early January, my doctor arranged an appointment with a neurosurgeon at Charles-Nicolle hospital in Rouen.

After tests, the neurosurgeon set another appointment for the end of January but almost as I arrived home, the hospital called asking me to return within a few days to see the neurosurgery professor

In the next two weeks, I made several visits to the endocrinology clinic affiliated with the hospital at Bois-Guillaume CHU plus full examinations with another MRI. I was put on medication to alleviate my symptoms, but told I needed an operation to stop the growth of the tumour, as it could eventually destroy my optic nerve.

 

The operation

The operation was carried out in February 2017, under general anaesthetic. The tumour was accessed via my nostril using micro-surgery. On the same day, I was on the phone to my wife by 2pm, but stayed in Intensive Care for 24 hours.

There, I was required to lie flat on my back and was monitored constantly.

I remained in hospital for six days and cannot fault the wonderful care I received. In fact, I became quite famous – on one occasion a nurse came in, spoke to me and, when I replied, she said with a big smile: “Ah, vous êtes l’homme avec le bel accent!

 

Aftercare

After discharge, I continued to experience a little bleeding from my nose, but no other ill-effects. However, at my follow-up appointment four months after surgery in July 2017, the neurosurgeon explained that although the operation had been a success, he hadn’t been able to remove the whole tumour because of its vulnerable position.

So, every six-months, I go for a check at the endocrinology clinic, see the professor in charge once a year and see my neurosurgeon twice a year. I also have MRIs to check the tumour isn’t causing problems.

So far, he is satisfied with my progress, and it’s a relief each time he tells my wife and I “all is good; see you in a year!”

Because both my pituitary gland and thyroid are now not working, I am on medication for the rest of my life. However, I feel better than I have for years – with so much more energy. My wife tells me I’m a new man!

I do not have the words to express my gratitude to our GP, neurosurgery at Charles-Nicolle, endocrinology at Bois-Guillaume for not only the speed with which I was treated, but the care and efficiency of everyone involved.

If my doctor had not diagnosed my condition so quickly, I may have eventually developed blindness.

 

FACTS ON PITUITARY TUMOURS by The Pituitary Foundation. Further information can be found in Surgery & Radiotherapy booklet

Alexander Prette praises health service

The operation

The majority of pituitary gland operations are carried out through the nose, known as “transsphenoidal” surgery. 

The aim is to remove as much of the tumour as safely as possible, without damaging delicate nerves and blood vessels in the area. Surgery can, in some cases, remove all of small tumours but complete removal of large tumours can be difficult. The operation is carried out under general anaesthetic and takes several hours – although this will depend on the size and accessibility of the tumour. Patients are usually kept in hospital for about a week.

 

Aftercare

Regular blood tests will be carried out to ensure hormone levels haven’t been adversely affected; if they have, medication may be required. Some patients may develop diabetes insipidus, but this can be temporary. After the operation, you are likely to have a painful nose, perhaps a headache or bruising of your face. You will be asked routine questions by the nurse, such as what day it is and where you are. They will also test your eyesight.

 

Outlook

Radiotherapy is sometimes used as part of the overall treatment for pituitary tumours (also called pituitary adenomas). The aim is to control the growth of the tumour and prevent it enlarging. In some cases, radiotherapy also results in shrinkage of the tumour, but this can take months or years.

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