Adrenal Insufficiency Emergency Situations

Today I wanted to talk about living with Adrenal Insufficiency and dealing with Emergency Situations. I’ll begin by saying that I have Secondary Adrenal Insufficiency which means my body cannot produce Cortisol which is known as the “stress hormone”. As a result I need to take replacement medication for life to prevent my body from getting too low in Cortisol and going into an adrenal crisis which when left untreated would result in death.

Managing Adrenal Insufficiency is not an easy task. It has taken me almost 5 years to get to understand my own cortisol needs, which fluctuate depending on life situations, illness, periods and much more. I have a daily dose of hydrocortisone, however at times I will need to increase my dose of Hydrocortisone to deal with added stresses on the body. During times of infection and (most certainly for me when I have a period) I have to double my medication and stress dose for Adrenal Insufficiency. This helps me to get through and reduces the symptoms of low-cortisol which I may suffer from.

When I am low in Cortisol, I will get weak, I will suffer pain in my body, stabbing pains in my legs. I get a headache. I struggle to think straight and clear. I will feel confused and feel sick. I will feel dizzy and my blood pressure will drop. As symptoms worsen and leading up to an adrenal crisis I will suffer from sudden diarrhoea. For some they will experience Diarrhoea and vomiting but for me it is most usually only diarrhoea.

It’s not a nice thing to talk about but it’s the reality of having too much stress on the body and not being able to cope with it. Another symptom I get which is not one I’ve really talked about before is the inability to control my bladder. When I get low in cortisol, I have less control and when I am very low in cortisol, I may find myself having an accident without even expecting it.

Different people I have spoken to with Adrenal Insufficiency may have different symptoms which present, but for me there is a general order which helps me to recognise I am low in Cortisol and in need of extra medication.

Adrenal Insufficiency Accidents and Emergencies

So what happens to a patient with Adrenal Insufficiency when they have an accident? How do we deal with it? I’ll begin by giving an example. If your in a car crash and you suffer from Adrenal Insufficiency you may need a sudden emergency injection to prevent an Adrenal Crisis. There are plenty of accident’s or emergency situations that could occur which are sudden, which may suddenly drain the cortisol out of you.

Examples might include but are not limited to a car crash, a sudden shock, an allergic reaction, finding out a member of your family has passed away, seeing someone get injured, breaking a bone or falling over and seriously hurting yourself.

Today I wanted to share 5 examples of experiences I have faced which have resulted in a sudden loss of Cortisol and made is necessary to have emergency medication. I’m sharing for educational purposes and this should hopefully help others with the condition or those wanting to understand more.

Cutting My Finger With A Knife While Cooking

So a year ago,  I was cutting onion when the knife slipped. I cut into my finger and began to bleed quite bad. The initial shock made me scream in pain and then within a few seconds I felt my body go weak. I literally felt as if my cortisol had been drained. I was ready to collapse and my head began swaying from side to side and my eyes began to roll. I had to put pressure on the bleed and lay down whilst my husband got my medication. Without emergency Hydrocortisone I would most certainly have headed towards and Adrenal Episode but the extra medication helped me to manage the situation. I simply had to rest for the rest of the day and recover.

When Someone Crashed Their Supermarket Trolley Into My Body

I was in the Supermarket with my husband when someone crashed their Supermarket trolley into my body. It was a sudden shock which would have surprised anyone, however for me my body was shocked to the point I passed out. The staff had to call an ambulance and I was given an emergency dose of Hydrocortisone and taken to the A and E. Luckily I was seen to pretty quickly and I did not need to stay in hospital for more than 24 hours.

When My Child Stood On A Nail

About 18 months ago my daughter stood on a nail and we needed to take her to the emergency room. At the time of the incident everything was fine. I stayed calm and collected and all was well. However during the car ride to the hospital my daughter passed out. She was suffering from shock and although I could cope with this mentally, my body was stressed and when we got to the Accident and Emergency Department I completely collapsed. The staff ended up dealing with my daughter and me. I was given a cannula and an emergency dose of Hydrocortisone to help me recover.

Getting Impaled With A Sharp Object

On Monday I was helping my daughter move a piece of furniture in her room. The bottom of the drawers accidentally pushed a sharp object into my foot and I began bleeding pretty bad. The pain was incredible. My daughter quickly got clothes to compress the bleeding whilst I got my Adrenal Pump and gave myself an emergency bolus of hydrocortisone. I took an extra 10mg and would have taken more if required but this was enough to manage the extra pain and help my body to get through. I did initially feel weak and felt like passing out but the medication kept me at the level I needed to be at and I had to rest for the rest of the day.

Finding Out A Close Friend Had Died

Last year I found out that a close friend had died through Facebook. It was unexpected. The friend was in their early 20’s and it was the last thing I would have ever expected to happen. As a result I suddenly felt upset. I felt my body going funny and decided to take an extra 10mg of hydrocortisone. This was needed and helped me to get through the initial shock. It helped me to cope with a sudden unexpected stress to the body and as a result I was able to manage my Adrenal Insufficiency.

Conclusions

These are not the only experiences I have had, however they are experiences which have taught me how to deal with sudden unexpected stresses which make me extra unwell as a patient with Adrenal Insufficiency. I think everyone is different. I do not know if my body produces some of the Cortisol I need in emergency situations and I suspect some is made as I do not go into an immediate crisis but simply head towards one when I am in an emergency situation.

What I do know is that for my body 10-20mg of Hydrocortisone halts my Adrenal Symptoms and with plenty of rest afterwards I am able to recover within a day or so, usually without the need to visit the Accident and Emergency. So I hope this is of interest to others and it can help you to better understand how Adrenal Insufficiency and Emergency situations work. It is not going to be the exact same for everyone with this condition and others may experience symptoms in a different order but this is how it is for me and I’m glad after 5 years of diagnosis I am better able to manage my condition in an emergency situation.

Angela x

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