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Steve Washko: Cushing's Disease

He stands on the beach. He wears a black and green t-shirt. He has gray hair and a gray moustache.

The Challenge

When Steve Washko started gaining weight, his doctor encouraged him to work out and eat healthier foods to drop the extra pounds. But Steve’s weight continued to increase until he eventually developed uncontrolled diabetes.

"I'm in the best health I've been in years." — Steve

Steve also began to experience dizziness, headaches, fluctuating blood pressure, and double vision.

“I would look up at the night sky, and see two of everything. It was very odd,” Steve says.

When the pain and dizziness became unmanageable, Steve went to his local emergency room. He was diagnosed with vertigo and prescribed medication. Unfortunately, the medication did not help. For years, Steve suffered through these symptoms with no relief — and no answers.

Convinced his symptoms were related to something more serious than vertigo, Steve’s family physician scheduled an MRI. The scans showed a lesion on Steve’s brain that was resting on his pituitary gland, a small organ at the base of the brain that controls hormones. Steve met with an endocrinologist who diagnosed him with Cushing’s.

“I had never heard the word Cushing’s before. I had no idea it even existed,” Steve says.

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The Path to UPMC

Cushing’s is a rare condition caused by elevated levels of cortisol, a hormone that is essential for regulating many of the body’s basic functions. Symptoms of Cushing’s are weight gain, high blood pressure, fatigue, and memory impairment.

“My endocrinologist told me that this was beyond what she could help me with, so she sent me to UPMC,” Steve says.

Steve was referred to neurosurgeon Paul Gardner, MD, director of the UPMC Center for Skull Base Surgery. Working with UPMC endocrinologist Sue Challinor, MD, Dr. Gardner’s first step was figuring out whether Steve had Cushing’s syndrome or Cushing’s disease.

When a pituitary tumor is causing the high cortisol, the condition is called Cushing’s disease. The disorder is referred to as Cushing’s syndrome when the excess hormones occur for any other reason. It’s important to confirm the specific type because treatment options vary based on the condition.

Dr. Challinor confirmed that Steve had Cushing’s disease caused by a tumor on his pituitary gland. To alleviate the irritating symptoms that had plagued him for years, Steve would need surgery to remove the tumor.

“After years of different diagnoses and inconclusive bloodwork, it was a great relief to finally figure out what was causing my symptoms,” Steve says.

The Solution

Dr. Gardner removed the tumor using the endoscopic endonasal approach (EEA), an innovative technique to remove tumors through the nose and sinuses. UPMC neurosurgeons are internationally recognized leaders in performing EEA procedures. EEA allows surgeons to reach tumors without trauma to the brain, face, or scalp.

“After my surgery, the first thing I remember is opening my eyes and the double vision was gone,” says Steve.

Steve was released from the hospital in just a few days and had no scars, bruising, or facial deformities that would show he had undergone major surgery.

The Results

As a result of his Cushing’s disease and previous thyroid surgery, Steve now takes a regimen of hormones to regulate his residual hormonal imbalance.

The 66-year-old says he has never felt better. Within months, his blood pressure normalized and he lost more than 60 pounds. Today, Steve is no longer diabetic.

“I have nothing but praise and respect for UPMC. Dr. Gardner was a great guy and he has an amazing staff,” Steve says.

Now retired, Steve and his wife enjoy traveling, photography, and hiking. On a recent European river cruise, Steve and his wife hiked the famous Matterhorn Trail in Switzerland. He’s looking forward to more adventures in his future.

“I’m hiking at 10,000 feet and traveling across the world. I couldn’t do that before. I’m in the best health I’ve been in years,” Steve says.

Our patient stories profile a number of patients who have had brain surgery at UPMC. Although everyone's care experience is unique, we hope that sharing these stories will help other prospective patients and their families better understand these procedures and their potential benefits.

Steve's treatment and results may not be representative of all similar cases.

Read More Pituitary Stories