Association for Multiple Endocrine Neoplasia Disorders

AMEND Medical Advisory Team Member Interview (From Q1 2012 Newsletter)

Who are you and where do you work?

I am Dr Caroline Brain & I am a Paediatric Endocrinologist.  I work at two hospitals in central London; Great Ormond Street Hospital for Sick Children and UCLH.

Why Paediatric  Endocrinology?

I think Paediatric Endocrinology found me rather than the other way around! My very first SHO job after house jobs was a year working at the Central Middlesex and Middlesex hospitals.  One of the Consultants was Charles Brook, a very well known & respected Paediatric Endocrinologist who inspired in me a deep interest in his specialty.  I went on to be his Registrar and later research fellow.  The area just fascinates me so I am still here!

What are the challenges and rewards of working in this area?

The challenges are making the right diagnosis especially in the complex adrenal disorders, and getting replacement optimized for each patient.  Rewards are endless but the great thing about endocrinology is that you can usually make things better.  Endocrinology is a specialty relevant to almost every other paediatric subspecialty so there is the opportunity to interact with colleagues from all areas, from medicine through to neurosurgery!

What future do you see for your paediatric MEN patients?

I am very fortunate in that I work with a fantastic Endocrine surgeon, Tom Kurzawinski in running a monthly clinic where we see children who have usually been referred because of a Family history of MEN and who have been screened as positive for the mutation.

The future is looking good for the children who are being proactively screened and referred early for prophylactic thyroidectomy.  We are seeing C-Cell hyperplasia in children a young as 3 years of age and so will undertake surgery as soon as the calcitonin starts to rise and recommend surgery at around 5yrs of age as a routine otherwise. Screening for phaeochromocytoma is also a routine part of the surveillance for this group so we are hoping that we can prevent problems in most of the patients referred to us as long as they come early enough!

How can / does AMEND help you?

AMEND has been brilliant so for in just keeping us on our toes and up to date with our patients needs.  The patient booklets and just general publications/web site etc mean that the patients & professionals are much more aware of the issues facing this group of patients so that screening is actively being carried out followed by prompt referral if positive. Just keep up the good work and it is up to all of us to spread the word!

How do you chill out after a long day at the hospital?

After a day at the hospital it is great to just go home & chill with my family although my kids are growing up fast and one has already gone to study Medicine at Bristol University. For pure relaxation I love to swim…anywhere and no matter what the water temperature!  We deliberately moved out of London for secondary schools and so when I do get home I am in a different world immediately.