Adrenal Insufficiency Community
Infection
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Infection

At what point should the doctor be informed of a possible infection in someone who has adrenal insufficiency?

My son has had a temperature, on and off, for a few days. Today he feels unwell, has chest tightness, his peak flow is down slightly but no significantly, and his temperature is up by about 1C (2F). He just feels not quite right. His blood pressure is down lightly and his heart rate is a bit irregular.

Now, I know that I should talk to the GP (Primary Care Physician?) but I don't have a great relationship with them. They only ever suggest either paracetamol or taking him to the paediatrician which means a hospital admission. We try not to use the paed if we can help it as I would prefer not to panic everytime he is slightly unwell.

So, any suggestions? Do I just write this off as a virus and not that bad a one and see how he goes or should I up his steroids or, should I swallow my dislike of the GP and give them a call?

I hate the way this problem is not quantifiable! I prefer to know for certain what is going on!
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657231_tn?1390151580
If he has a fever, his steroids should be bumped up a bit IMHO to fight it.

I have no adrenals. I know my body a bit now so when I have a slight fever, I start to bump a little and go up from there as needed. If he is AI, he will otherwise not be able to fight and go further down - his low BP is showing that he needs more.

I am not one to go to the ER either, so if you do want to fight at home, at least push fluids, add salt to his diet and add some steroids. Salt is very helpful. Remember that at its base, that AI is just not being able to hold on to sodium.

If he cannot fight off the fever or starts to vomit, then I would get to the doctor pronto.
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Avatar_f_tn
Thanks for that!

I am just feeling completely out my depth at the moment with all of this. The respiratory paed reduced his inhaled steroids last week and now this. I am not sure if this is a reaction to the reduced dose or just a virus! Nightmare! His temperature is still up and his heart rate is also markedly increased!

However, he has said he does not want to go to the hospital tonight so I will take him to the GP tomorrow if we last out that long! I increased his steroid dose tonight so I am hoping he will be okay.

I really would love to prevent him gettng unwell at all but I guess I just have to learn to deal with it all.

Thanks rumpled. I guess I just needed to vent and know I wasn't getting things totally wrong!
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657231_tn?1390151580
How is he today?

It would be nice to prevent all illness, but alas, that is not possible.

Just remember the salt when his heart rate is high - it will help lower it. I get salt - just plain salt - tablets and keep them on hand. I have to take them daily.
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Avatar_f_tn
I didn't think of the salt as a cause of his tachycardia! DOH! Idiot that I am!

He is tons better, thanks. We gave him a double dose of steroid last evening and from then he just picked up no end. His temperature and pulse rate have been absolutely normal today so he is away to a sleepover! First time away from us since diagnosis! Luckily he is only 20 minutes away from here and 15 from the hospital so if anything goes wrong it will be okay! LOL!

Thanks  for the info re salt. we have had very little support since diagnosis. We don't even know if this is permenant or not yet!
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657231_tn?1390151580
Salt is not the cause, rather lack of salt is more like it. Hence why he will need fluids and a nice pickle and some chips when he feels like crud.

Sometimes a bit of steroids, some salt and fluids will get him over the hump - that is all I need. I make sure that my script always gives me extra every month and that way if I need it, I can take it. Just be judicious - too much can be very damaging as well - I had my adrenals removed because too much was killing me.

Is he on florinef? That will help hold on to salt as well.

Adrenals are very fickle little things - they like to go on vacation and when they do, they do not like to come back...
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Avatar_f_tn
LOL @ the vacation comment!

He is not on florinef. He is due to have another synacthen test hopefully by the end of August. They have reduced his steroid inhaler for asthma and hope that his adrenals will show an improved response but none of us are holding our breath!

We will see how he is tomorrow. His temperature is up a little today and he is going to be exhausted tomorrow. He got no sleep last night at all at the sleepover and is at a laser shooting game tonight for 3 sessions. Talk about stress testing him! I will make sure he has something salty and a drink before bed.

Funny how all the advertising around food these days is not to eat salt and, having been careful all his life, I now have to add salt! Life is odd.

Thanks again.
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657231_tn?1390151580
Yeah, my husband has high BP, and mine is low, so I salt like crazy and he thinks I am nuts. I like sea salt and have tons of different kinds now. People think I am nuts - but I even carry my own salt in my purse!
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