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Five-Year Search for Answers Ends

At just 29 years of age, Amanda (Mandy) Mrzena began a five-year journey to learn why her weight was spiraling out of control. Her search ended last fall at The Iowa Clinic when she was diagnosed with a one-in-a-million brain tumor.


Your Local Health | Written by BJ Towe

5 Year Search for Answers

Mandy's Story

In 2009, toward the end of Mandy Mrzena's first pregnancy, she began having difficulty with her legs and had to use a wheelchair or walker to get around. “But that was just the beginning of my health problems,” she recalls. Her weight began climbing, though she was careful to exercise and eat right.

She began searching for an explanation.

Over the next five years, Mrzena would go to doctor after doctor while she watched the number on the scale steadily inch upward. She learned she had developed severe osteoporosis (brittle bone disease) – practically unheard of in someone so young.

Some doctors advised her to lose weight. Since she already ate a sensible diet, she began exercising relentlessly. It didn't help.

Other doctors blamed allergies. When one doctor diagnosed her with celiac disease, she ridded her home of all gluten-containing products, stopped eating out, and completely revamped her family's diet. Still, her weight continued to increase and her overall health continued to decline.

“I gained 70 pounds. Swelling increased in my stomach, face, and neck – and eventually in all parts of my body. My ankles and knuckles didn't exist anymore. My blood pressure started to shoot sky high, and I kept switching medications,” she says.

But as a young mother, Mrzena was driven to keep looking for answers. In total, she saw more than 20 different doctors —internists, allergists, and other specialists – in Iowa, Minnesota, and Wisconsin. “These were really good doctors who came highly recommended,” she says.

Still, answers eluded them all.

Fueled By Hope, She Goes to The Iowa Clinic

“You never know when that miracle is just around the corner, so I just kept seeing one more doctor. You just can't give up,” she says.

By August 2014, “My face had gotten so big that I thought I was going to explode through my skin. A hump began growing on the back of my neck. I thought I'd try just one more group of doctors,” she says.

She saw Tamra Richardson Colby, D.O., a Family Medicine physician at The Iowa Clinic in Ankeny, not far from Mrzena's Bondurant home. “The Iowa Clinic was in my backyard and I didn't even know it,” she says.

Richardson Colby ordered diagnostic tests but didn't wait for the results. She immediately arranged for Mrzena to walk across the hall to see Internist William Wortman, M.D.

Dr. Wortman says, “By the time Mandy came to The Iowa Clinic, her disease had progressed so far that she looked like a textbook picture of Cushing's disease.” Cushing's disease is caused by a tumor of the pituitary gland, or by another tumor located elsewhere, that releases too much ACT Hormone. This triggers a series of physical reactions that ultimately cause the body to produce too much cortisol, which regulates how the body uses carbohydrates, fats, and proteins. The result is a host of negative effects, including uncontrolled weight gain, inappropriate osteoporosis, and elevated blood pressure.

“When I first saw Mandy, I immediately knew her neck was infiltrated with fat and not swelling due to allergies. She was puffing up everywhere – hands, arms, legs, even her knuckles. It was swallowing her up. She had a fat pad over the back of her neck, which is quite characteristic of Cushing's disease,” Wortman says.

In fact, all of Mrzena's symptoms pointed to Cushing's disease.

The Diagnosis: A Rare Brain Tumor

The results of tests ordered by Richardson Colby confirmed that Mrzena had too much cortisol in her blood. “Mandy's ACT Hormone level was 10 times the upper limit of normal,” says Wortman, who then arranged for Mrzena to be further evaluated by both a neurosurgeon and an endocrinologist. They confirmed that she had a brain tumor and Cushing's disease.

Most people would shudder at the diagnosis of a brain tumor. Not Mrzena. “I was thankful they found what was wrong. The best thing I heard was, 'It's not your fault; your body was taking over,'” she says.

On January 7, 2015, Mrzena's tumor was surgically removed, and her life began returning to normal.

Wortman says she's expected to lose much, or all, of the excess weight over the next two or three years. Her bones are likely to get stronger. And, says Mrzena, she improves a little every day.

“Words cannot express the gratitude I have to The Iowa Clinic. They're local. All of the tests are performed in one building. I really feel like patients are their number-one priority. To find a place where doctors really listened and cared, that was great,” she says.

Wortman adds, “That's why I'm at The Iowa Clinic. I appreciate their culture of doing the right thing for the patient every time. We are diggers; we get to the bottom of things – or we get you to the center that can.”

About Cushing's Disease

Cushing's disease is a condition in which a tumor or excess growth of the pituitary gland (located at the base of the brain) causes it to release too much of the ACT Hormone (ACTH). In turn, this causes the adrenal glands to release too much cortisol into the blood. Cortisol controls how the body uses carbohydrates, fats, and proteins. Symptoms of Cushing's disease include:

  • Upper body obesity and thin arms and legs
  • Round, red, full face
  • Slow growth rate in children
  • Skin changes, such as acne, skin infections, and purple marks on the abdomen, thighs, and breasts
  • Thin skin with easy bruising, most often on the arms and hands
  • Backache, bone pain or tenderness
  • Osteoporosis
  • Weak muscles
  • Fatigue
  • Headache
  • Increased thirst and urination
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