OpenHealth Q&A

Navigating MRI Delays and Battling Persistent Symptoms

Recently, my prolactin levels were found to be elevated, showing increases in two consecutive blood tests taken a week apart: the first test revealed 74 ug/L, while the second measured 101.7 ug/L, with the monomeric prolactin at 77 ug/L. Following that, I consulted with an endocrinologist who informed me that I’d be placed on a waiting list for an MRI. Regrettably, she mentioned it could take over three months to get an appointment. She proposed treating me with cabergoline, which could potentially reduce the size of any tumor present, but that would complicate the MRI results since it might not be detectable afterward. After considerable thought, I decided against the medication because I've been dealing with a multitude of unpredictable hormonal symptoms classified under PCOS, even though I do not meet all the usual criteria for it. I am keen on identifying the true cause of my issues. Historically, I had regular menstrual cycles until very recently when I stopped menstruating entirely. My ovarian follicles have always appeared healthy, and my previously noted PCOS indicators included hair thinning on my scalp while experiencing growth in other areas, along with insulin resistance that has progressed to prediabetes. I suspect this could be linked to a prolactinoma, rather than PCOS, owing to the overlapping symptoms. At present, I am plagued by relentless nausea. I wake up feeling as if I’m going to vomit, and these waves of nausea are continuous, leaving me on the verge of being sick throughout the day. I’m taking the maximum allowed dose of gravol, but it doesn’t alleviate the discomfort. Ginger chews offer little relief, and my appetite has vanished, making it extremely challenging to keep any food down. I find myself vomiting at least once daily. Additionally, I’m battling profound fatigue that never seems to lift. Headaches and migraines accompany these symptoms almost daily, and coincidentally, my endocrinologist recorded a change in my vision, necessitating two new prescriptions for glasses in less than a year—an unprecedented occurrence for me, as I typically only need an update once every two years. I am a 24-year-old graduate student on the brink of beginning a practicum soon as an intern therapist, which raises my anxiety about managing my academics, thesis work, and practical training while struggling to get out of bed due to nausea. The prospect of dealing with all of this when I feel so unwell is overwhelming, especially knowing I have to wait months for an MRI. I'm reaching out for advice on how to expedite the MRI process or any suggestions for additional steps I can take. My daily existence has become a struggle with constant discomfort, leaving me utterly drained. This situation is deeply affecting my relationships and overall well-being, and I feel like I’m spiraling away from everything I’ve worked hard to achieve. I am a 24-year-old female, suspected to have a prolactinoma or some form of pituitary adenoma. I have been informally diagnosed with PCOS by my endocrinologist, and my primary care physician suspects Hidradentitis Suppurativa (currently on a waitlist for a dermatologist). My medications include 1000mg of metformin, Tylenol, Advil, and gravol as required (typically at full dosage daily), alongside topical treatments like Arazlo and azelaic acid for acne. My symptoms, prioritized by impact, include: - Chronic nausea and daily vomiting - Frequent headaches and migraines almost every day - Persistent fatigue occurring constantly - Mood fluctuations primarily manifesting as anxiety and depression - Recent onset of painful vaginal boils (potentially HS), an issue I’ve never encountered before - Absence of menstruation for six months - Lactation persisting for four months - Markedly diminished sex drive for the past six months - Ongoing vaginal dryness for over six months - Notable changes in vision (0.5 diopter shift from December to June) - Tenderness in breasts and swollen feeling in the chest area - Severe acne on my back - Experiencing phantom smells, such as gasoline.

Answers (1)

8/30/2025, 7:06:35 AM

OpenHealth AI

I'm sorry to hear about the difficult situation you're facing. Your symptoms are significant, and it’s understandable to feel overwhelmed by them, especially with your academic commitments. Here’s a concise plan to help address your concerns:

Main Points

1. Significant symptoms like nausea, vomiting, headaches, and vision changes need closer monitoring and possible intervention.
2. There are strategies to manage your health while waiting for an MRI.
3. It’s essential to prioritize symptom management and advocate for your healthcare needs to expedite the diagnosis process.

Explanation

Your elevated prolactin levels and related symptoms suggest a potential issue with your pituitary gland, like a prolactinoma. Some of your symptoms, such as nausea, vomiting, headaches, and mood changes, could be connected to hormonal imbalances. Given your current situation and the waiting time for an MRI, managing these symptoms effectively is crucial for your quality of life.

Next Steps

1. Symptom Management:

   • Nausea/Vomiting Relief: Since gravol hasn't been effective, speak to your healthcare provider about prescribing medications more tailored for nausea (like ondansetron or metoclopramide). Sometimes dietary changes can help; consider small, bland meals if you can tolerate them, and stay hydrated with clear fluids.
   • Headaches/Migraines: Consider tracking your headaches to identify any potential triggers. Discuss the possibility of switching to triptans or other preventive migraine medications with your doctor.
   • Fatigue & Mood Fluctuations: Ensure you're getting enough rest. Regular light exercises and mindfulness or relaxation techniques such as yoga or meditation can help improve your mood and energy levels.

2. Expediting the MRI Process:

   • Ask for Follow-Up: Follow up with your endocrinologist's office periodically. Express the urgency of your symptoms and ask if there are any cancellations or the possibility of being put on a priority list.
   • Seek Alternatives: If the MRI wait is extensive, consider asking if there are private facilities that could conduct the MRI sooner or if any urgent care facilities can evaluate your case.
   • Engage Your Primary Care Physician: They can sometimes assist in faster referrals or emphasize the urgency of your case, especially with your additional symptoms.

3. Maintain Communication:

   • Stay in close contact with your healthcare providers. Be open about how your symptoms are affecting your daily life and studies. You may also want to consider speaking with a counselor or therapist who can help manage stress during this challenging time.

4. Document Changes:

   • Keep a log of your symptoms, medications, food intake, and any changes, especially with your headaches and vision. This information is valuable for your medical team.

Supportive Tips

• Managing Anxiety: Consider speaking to your endocrinologist about psychological support options, particularly since you're experiencing significant anxiety and depression.
• Nutritional Support: Since your appetite is low, consider supplements if you struggle to eat enough. Speak with a dietitian for tailored advice.

Take one step at a time, and remember you're not alone in this journey. Your health is a priority, and seeking help is a strong step in advocating for yourself. If you have any more questions or need further support, feel free to reach out.