Monday, July 16, 2012

Adrenal Insufficiency

Hello again:

I’ve got my computer back and the programs I wanted on it for the most part.  So now I’m back to where I can start doing things again.  That being the case, sit back and let me tell you a little story, a true one.

It was February the eighteenth 2008.  I woke up about four in the morning feeling sick, very sick.  I ran to the bathroom and vomited, and then I had to take a dump which turned out to be so watery it was unbelievable.  Before I knew it I was sitting on the toilet defecating so hard my bladder was running and viciously vomiting at the same time.  My wife woke up to me gasping for help between the retching and rushed me to the hospital.

The triage nurse took me right on back into a treatment room where an IV was started and some medicine to calm the overwhelming nausea and pain I was experiencing.  I have the lab report from the ER that morning and know I was suffering from Adrenal Insufficiency, or AI and was undergoing an Adrenal Crisis.

Adrenal Insufficiency, or AI as it’s often called, occurs when the adrenal glands shut down production the hormones they produce.  When this happens it throws the electrolytes out of balance and the sodium drops and the potassium rises.  When this happens suddenly the symptoms often seen are:

·        Nausea and vomiting
·        Diarrhea
·        Acute stomach pain and cramps
·        Generalized cramping
·        Dizziness which increases upon standing  (due to low blood pressure which drops further on standing)
·        Disorientation leading to unconsciousness and coma

An adrenal crisis is a serious problem and can lead to death if untreated.  Although it is often considered a slow starter, I know of one post surgical Cushing’s sufferer whose boyfriend went out to run errands for a couple of hours and found her dead on his return.  So it’s serious business.  Unfortunately ER doctors don’t consider it so and won’t even test Cortisol levels even with the electrolyte results staring them in the face.  That was what happened to me that night.

Fortunately the treatment includes giving the patient fluids by IV, which was what the doctors did that night and patients in adrenal crises which are recognized are given Hydrocortisef, or cortisol, by injection.  Fortunately the treatment for dehydration along with the anti-nausea drugs were enough to stabilize the symptoms and I was sent home with a prescription for more anti-nausea medicine and an order to take in as much fluids as I could handle.

For many Cushies, AI and the possibility of an adrenal crisis is a very real danger.  The majority face it because of surgery.  Removing a tumor causing Cushing’s syndrome can cause the adrenals to temporarily shut down and precipitate a crisis.  Those who have to go on Hormone Replacement Therapy (HRT) because both adrenals have been removed live with the reality as well.  But a rare set of Cushies, cyclical Cushies with cycles which swing extremely low, may also face both.  So be aware of the possibilities my friends if you fall into any of those categories and make sure both you and those close to you know the symptoms.

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