Hello again!
As I write this the first big
rain from Subtropical Storm Beryl is beating against my bedroom window. Since the storm is near hurricane strength it
promises to get worse as the night wears on.
And the predictions are that I’m stuck with it for a few days. I live on the coast of Georgia.
But as the storm gets going
another one is winding down for me.
Since this is a personal blog about my personal journey with Cushing’s
as well I’m going to tell the story. The
story in some ways is something most Cushies can relate to, as those who
followed me on Facebook during this ordeal reminded me as they were there for
me. This isn’t a bitching session; some
of my Cushie friends kindly let me get that out of the way, like any good herd
of zebras. This is for your information
and insight on what those of us with chronic diseases go through if you don’t
have one.
This one started when I found
a tumor. Cushing’s is caused by tumors, mostly
tumors which run deep and require special imaging to find. However, in rare cases, often the really rare
familial Cushing’s they can occur in a place where it is possible to find them
on your own if they’re not micro tumors.
So when I found a tumor on a routine self-examination of that personal
area, oh well, my scrotum and testicles, I thought maybe I found the tumor.
Now the first thing to
understand is that anytime one
finds a lump in a man’s jewels it needs
to go to a doctor and most times will likely be removed. So the next step was one I would’ve taken
without Cushing’s being a factor. However Cushing’s did make for a
complication. I would be examined three
times before the tumor was removed.
Each time about two days after the examination I went in to a cortisol
crash. I know what those are like
because I go into them every time some doctor orders up what is known as a Dex
suppression test. So I mention this to
the surgeon who was to remove the tumor and
to head off any problems he gives
me an injection of hydrocotisef while
I’m under in the operating room and gives me instruction for taking some prednisone for the next three
days which were reasonable.
The day of the surgery, and
the day after I’m fine. But everything
starts to go downhill after that and by Sunday (the surgery was on Wednesday) I
had to go to the emergency room with acute respiratory problems. While the ER doctor is examining me I go into
extreme cramping all over my body. It
was one of the worse days of my
life. Needless to say I was in a
critical situation. After a ton of
morphine and other medications were given me I was sent home instead of
admitted with instructions to take massive doses of prednisone until I see my
surgeon at my scheduled follow-up.
That follow up was the next
Friday. That day my morning blood sugar
was 490. Since I was to see the doctor I
decided to keep the appointment as scheduled and let him send me down to the
ER, the likely course of action since his office is in the hospital I also took
more of the medication I use to control my diabetes to hopefully bring the
sugar down. Just before I leave to see
him I check my blood sugar again and the machine reads “Hi.” Blood glucose testing devices generally won’t
go above 500, which are considered lethal.
By the time I get to the ER
and they finally pull blood to check my blood sugar I was going into a diabetic
coma with a blood sugar of 632. The culprit was the massive doses of prednisone
which had been prescribed me. Once again
at the ER I’m pumped full of insulin until my blood sugar went down to 302 and
then sent home for my family to deal with.
When I call my surgeon Monday and tell him the details the first words
out his mouth were “and they admitted you?”
As you know, they didn’t. He
couldn’t believe that and the doctor he sent me to begin to wean me off the
prednisone wasn’t too pleased with it either.
Now I’m being weaned off the
prednisone slowly being given medication to prevent cramping and insulin to
control my blood sugar during the weaning process. I think the doctor wanted to have me admitted to do it under more
controlled conditions, but considering the
reluctance of the hospital to admit me when I was in critical condition
not just once, but twice in a week he opted to go the route we’re taking now. What is the matter with my local hospital
that they seem to be acting in a way which invites a lawsuit is beyond me,
but this situation isn’t by any
means all that strange to those of us
who suffer from Cushing’s and its affects.
Everyday Cushing’s patients
who have had their adrenal glands removed will develop the symptoms of Adrenal
insufficiency (AI) and have a hard time
at the ER. Many now carry letters from
their endocrinologists for emergency room staff when they go. So it would seem my experience is by no means
unique. Medical zebras aren’t so easily
seen as their wild namesakes. Our
diseases often look like other things.
So we don’t get the care we rally need in more than just the ER
setting. It still boils down to that old
saying about hoof beats.
Oh,
ReplyDeleteDuring my disasterous visit with my PCP I found out why I wasn't admitted when I had the hig blood sugar. Insurance companies don't want to pay for admissions related to high blood sugars. so the hospital won't admit those patients. Although mine was caused by the treament prescribed by a physician working for the hospital, and I really needed to be treated for that, that is weaned off the medicine under controlled conditions, it didn't matter. I was still lumped in with the diabetic who doesn't bother to try to control their situation. Unfortunately so did my PCP. Hence the end of that relationship which I blogged on in another post.
that is DISGUSTING. you can die from blood sugar readings that high!!!!!!!!!!!!!!! your doctor gave you heavy doses of prednisone. Why did you take it ? did you tell him you are a cyclical Zebra ??
ReplyDeleteThe prednisone was supposed to be short-term, just a few days with the surgeon weaning me off. That was an act of desparation by an ER doctor not willing to try what I asked for, cortisef, for the cramping I was suffering from right there in the ER. The visit to my surgeon ended up being set back two days and that was all it took for my blood sugar to go lethal.
ReplyDeleteLesson learned, I will push harder for the doctor trying the cortisef first if or when I go in with the same set of symptoms. My endocrinologist couldn't understand why the ER doctor wouldn't try that first. According to him it wouldn't hurt a thing and might work. so it was worth it with a patient with known adrenal problems.
There were more than one thing to be learned from the experience, hence my sharing it with my audience.