Here are some thumbnail sketches. Endocrinologist/Consultant Physician
• Is a major influence on how well the patient copes with the condition.
• Makes or confirms the initial diagnosis, possibly the first physician from whom the patient first hears about the pituitary gland.
• Arranges initial treatment.
• Provides ongoing treatment; monitors and modifies as appropriate. Neurosurgeon
• Operates inside the patient's head close to the brain and optic nerves.
• Is a critical factor in subsequent recovery.
• Interprets the MRI scans but probably won't meet the patient. Radiotherapists
• Meets the patient for consultations and preparation, then again during treatment.
• Should be aware that radiotherapy is another very scary time for the patient.
"The prospect of radiotherapy was daunting and I was especially concerned about my eyesight."
• The technician who makes the mask should be prepared for a patient who may find it an unpleasant and frightening experience.
• A pituitary patient will be a fairly rare visitor to their clinic.
"Having met the radiographer and learnt more about what was in store, I was quickly in the system. Having the facemask made is a strange experience, but I tried to tell myself to imagine I was having a facemask in an expensive beauty salon and tried to enjoy it."
"The technician was brilliant, describing what he was doing all the time, constantly telling me what part of the room he was in, which was so reassuring when you can't see anything and are lying flat on a bench with cotton wool in your mouth and nose and pink gunge over your face. He said some people find fitting the mask the worst part of their radiotherapy."
Endocrine Specialist Nurses
• Build relationships with patients by spending time with them for tests and treatment.
• Viewed by patients as an important source of information— and of reassurance.
• May be the recipients of key information from patients about their condition, things that the doctors may not be told.
• Are met when the patient has treatments such as ultrasound, colonoscopy, bone density scans, gallbladder scans—depending on their condition.
• They need to be able to explain to the patient why they are having the treatment; the patient may not know.
The General Practitioner in the UK or Family Doctor /Primary Care
Physician in North America
• May have a poor relationship with the patient as a result of experiences leading up to a diagnosis, often a lengthy process, sometimes traumatic.
• May not have as up-to-date information about treatment as the patient does.
• May not be regularly updated with details of treatment and test results. (This needs to be managed by the hospital.)
• May not see the patient often.
• May have to authorize the use of expensive drugs and meet the cost from his budget for treatment he knows little about.
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