Adrenal Insufficiency Community
Crisis
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Crisis

I had my first adrenal crisis 2 weeks ago brought on by gastroenteritis.  Vomiting started around midnight long with diarrhea and I was at the hospital at 1:20 and by 1:45 my veins were collapsing....they couldn't get blood out of my arms but finally gave me the 100mg of HC at 2:10 when my blood pressure was down to 72/38.  I asked the ER doc if I supposed to take my regular HC dose the next day and he said yes.  Well here it is 2 weeks later and I can barely walk again....just like I was before being diagnosed.   The tendons and ligaments in my ankles, feet, knees and hips are aching, burning, sore...blah, blah, blah, plus erratic heart rate swollen ankles and face, etc.  My AI doc was inaccessible due to moving his practice to another state and I can't talk with him for 2 more days.  What should I do?  I realize now that I should have weaned down....is it too late to take large doses and wean down over a couple of weeks?
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657231_tn?1390151580
The ER doc is not skilled in adrenal crisis. You cannot go from crisis to a normal dose. While you are ill, you need more cortef so you should have kept to a higher dose for a few days (or as needed) and then tapered down. You also need extra fluids and SALT.

It is not too late - bump up your dose a bit - also increase your sodium intake and up your fluids to feel better.

It is helpful as well to know if you need just sodium and need to avoid potassium (the norm is to spike in potassium during a crisis), or sodium and potassium (some drop in both) - and that way you can add back what you need and avoid what you don't.

Also, you need to find a local doc that can help you ASAP.
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Avatar_f_tn
I have low potassium due to the damage from Prednisone.  How much should I spike my dose....it's been 16 days since the 100 mg stress dose and my feet feel like something is eating them.  I have the same problem I had when I was improperly weaned from prednisone 4 years ago.  I have suppression of half of the normal aldosterone, no cortisol, no DHEA so other hormones are low.  Should I go up to 60mg or more per day.  There isn't a doctor is this pathetic stage who could treat me except maybe one doctor at the university hospital.  I have an appointment scheduled for May 31... I had to go out of state with initial diagnosis because the wait was 5 months then and I was dying.....literally.
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Avatar_f_tn
I take 30mg HC, 10 mg DHEA, 37.5 mg Armour and 20mg of progesterone thanks to the Prednisone HPA damage.
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657231_tn?1390151580
I would drink gatorade or tomato juice - both of those have sodium and potassium that you need. I would add extra salt to the drinks too - and add salt to anything that eat or drink - even if you cannot taste it - just add a shake.

If you have the meds, go up to to where you can function, I would double or 1.5 your daily dose (HC is short acting so you can always add as needed - so I carry meds and even take small amounts when I get off - like I need now as we have a recent death in the family, normally I avoid that but I need to now) and then slowly taper back as you can function. The most important thing is SALT and FLUIDS.

At this point, you need sodium and that will start to make you feel better - pickles, olives, chips, ramen, bouillion in a cup - just go for all the salt that you can get. I also carry salt on me. I am prepared. I think.

Can you call that doctor out of state? My doc is out of state too so I feel for you. I have a local one, but my out of state doc is my lifeline.

I take 25mg dhea daily...
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Avatar_f_tn
I talked to him today.  Dose increase to 70% more for a week and then maybe start to taper down.  ER docs need to be educated.  I haven't been able to find an endo or any other type of doc in my state who knows anything about SAI.  I got 2 injection kits today at the pharmacy in case I crisis again....that was a first!
How long have you been taking DHEA?  Have you ever taken Pregnenolone?  I haven't but have considered it....my doc mentioned it one time.
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657231_tn?1390151580
The ER docs are really good at some things - trauma, heart attacks etc - but not an adrenal crisis. I avoid going for that reason as I try to do all I can to head it off at home. I am now better at understanding what is going on and I can head off most awful stuff - and when the bucket comes out, I hit the meds really hard - fluids and salt. I have salty stuff all over so as soon as I feel cruddy, I hit the salt and it brings me back. At the crux of the issue is sodium so I can head it off and stay out of trouble unless I get surprised.

I also carry an emergency shot too.

I have not taken pregnelone.
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Avatar_f_tn
Apparently a stomach virus got me or food poisoning.....not sure but it lasted 4 days.  Do you have a carrying case for the injection?  I've tried to locate one online but can't find anything.  Is your emergency shot labeled so it could be easily found by others  in an emergency?
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