You will have to take your diagnosis and your lab tests that prove Cushings and discuss with the pituitary neurosurgeons in Canada. I don't know if they will accept the findings or not from Dr. Friedman, or for any doctor in the U.S. for that matter. Dr. Friedman uses some testing protocols that are considered newer testing protocols and many endocrinologists, even in the U.S. do not recognize the testing or the results. You may find yourself either finding a compassionate endocrinologist in Canada that will work with Dr. Friedman, or you may have to open your pocketbook and get surgery in the U.S. You won't know unless you start door knocking. If I were you, I'd consider a NIH protocol for Cushings and get treatment for free. ![]() . I tried that myself, but I was such a weirdo, they wouldn't have me... they don't open a protocol for Minnie (they need more than 1) They wanted Minnie s... and lordie...there is only ONE of me! lol. In general, regarding Cushings, I have been flabbergasted that the testing for Cushings, as even described and published in the JECM, has been flat out phoo phooed by top endocrinologists and I have found that many patients are forced to back up their own test results with published literature. The problem is that Cushings is considered a rare disorder. Personally, I don't think it as rare as what physicians believe. I think the 'cushing's phenotype' is rare - the physical phenotype - as only 20% or so of Cushings patients actually look like the textbook cases. It is an eye opening experience to get 30 or so of us in a room and let us give each other the eye up and down... let me tell you... and I am one that definitely didn't look Cushings! I guess my point is... get ready for a battle, or get out your checkbook to pay for a U.S. neurosurgeon out of pocket that will take Dr. Friedman's patients, or see if you can be referred to the NIH. If you do opt to pay out of pocket for surgery in the U.S. and have an ACTH tumor removed and successfuly stained, you might be successful at reimbursement in Canada, but get ready for a long lenghtly battle. Do know that ACTH secreting tumors are difficult critters re: path... and the clinical dx up front is critical. Pathology often misses the tumors because they are so small. They also get 'sucked up' in the suction, or path messes them up in the prep. Good luck! Minnie | 