Rosella C
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* Seema Marwaha

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/194/19/E683/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/194/19/E683/F1)

(Left) Rosella C. before she had any symptoms of Cushing disease. (Right) Rosella C. 2 months before surgery.

Photos by Frank C. (left) and Rosella C. (right)

My health deteriorated over a period of 6 years. My symptoms escalated from easy bruising, hair loss, high blood pressure, skin thinning and flushed skin to rapid weight gain in my midsection, a puffy face, fatigue and severe joint pain. I had become unrecognizable. I was diagnosed with resistant hypertension and started medications for the first time. I was referred to several specialists by my family doctor — a cardiologist for my blood pressure, a dermatologist for the bruising and thin skin, even an allergist.

One day, I tripped over some shoes, fractured a bone in my foot and ended up at the hospital. I followed the recommended directions, but I think the fracture never fully healed. I told both my orthopedic surgeon and family doctor that I thought there was a greater problem, but my concerns were quickly dismissed.

I scheduled another appointment with my family doctor soon after for a blood test. I walked in with crutches and extensive bruising that had become impossible to hide. I left with only a higher dose of medication for my blood pressure.

Growing frustrated, I paid out of pocket for a naturopathic doctor who listened to my whole story, not just small parts of it. She conducted several blood tests and high cortisol levels were identified, but she didn’t tell me what my diagnosis was or how to treat it.

It wasn’t until after my 50th birthday, when we had a small outdoor pandemic gathering, that a friend called to ask if I had Cushing disease. His sister had it, and he thought my face and body had changed dramatically, similar to hers. This was the first time I, or my family, was made aware of Cushing disease as a diagnosis.

I immediately asked my family doctor for an urgent referral to endocrinology, but she didn’t want to refer me without conducting her own tests. It then took several months to see a specialist. During this period, my symptoms worsened. When I finally saw an endocrinologist, he diagnosed Cushing disease almost immediately.

My adrenal surgery was delayed for months because of COVID-19 restrictions. I finally had an operation 6 months ago. Some symptoms are much better now. I’m off all blood pressure medication. My complexion, skin and hair are returning to normal. But I still have profound fatigue and joint pain. I don’t look or feel like my old self, but I understand this will take time.

If I had been diagnosed earlier, I might not have such severe osteoporosis or joint pain. My symptoms were not taken seriously but were blamed on my gender, age and weight. No doctor took a step back and evaluated my situation holistically.

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