So this week we met with a new Pediatric Endocrinologist. We wanted to to see if a fresh pair of eyes could see if we have missed something or if we have the wrong diagnosis. He was great! He examined both C and T and went over the history, which was very lengthy! After getting a better picture he thought that the best course for the twins would be to basically start from square one. That means that when it's time to change the implants in September, we will not replace them. We will give their bodies a little time after the implants are taken out, to be free of the medicine, and then do a new Follicle Stimulation Test. We are hoping that if we start back at square one we will be able to get a new perspective on their puberty. Once we have the results from the Follicle Stimulation test we will be able to determine which course of treatment, if any, we will take. The doctor explained that some younger patients, such as the twins, can have a break-through on the longer acting medications such as the 3 month Lupron or year long implant.
He said that a colleague of his has been studying Lupron for over 20 years and what they found is the younger patients tend to brake through the medication. What that means is that using the longer acting medications such as the 3 month Lupron injection, can have a higher likely hood of not being fully suppressed for the entire 3 months. So for a young patient like T, Lupron every 28 days might have done a better job for him than the Lupron every 84 days or the implant that is suppose to last a year.
After he explained the differences in medication he expressed a need to repeat the MRI for C. He was also concerned that T had not had an MRI because there are some benign brain tumors that can be causing this issue and mimicking Precocious Puberty. He thought that the likely hood of T having a tumor was small, and reassured us that he thought it would most likely be negative for a brain tumor but we need to do the MRI just to be sure. Overall he thought that at least for now we have the correct diagnosis and that starting over will really just reassess everything.
After this appointment we left feeling hopeful that we might have an answer as to why the twins are still showing signs of puberty, even after all the treatments we have tried. I am hoping that we might finally have some peace of mind that we are doing the right thing for them.
