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03/23/2010 10:06 PM

crisis?

kgo
kgo  
Posts: 603
Member

What are the symptoms that a crisis is starting?

If she has secondary AI will she have a similar crisis to that of addisons?

Her muscles are constantly aching and her back is really hurting for a few days. Not sure what to make of this.

She has been a tad more active so I have to wonder if it is her atrophied muscles coming back to life??

We are having another family crisis with my son and the school and she is some what involved, can this kind of stress send her to crisis if she in fact can have a crisis?

Any info on crisis is greatly appriciated

Thanks

Kim

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03/24/2010 02:51 AM
LittleMissMerrySunshine
LittleMissMerrySunshine  
Posts: 1811
Group Leader

Based on recent experience, it can definitely vary. It can come on fast, or it can come on VERY slowly (apparently that's when the docs get confused...)

I am told now that I am "an interesting mix of primary and secondary". I believe the symptoms are the same for each. But after this experience, I am a FIRM believer in calling the doctor if there is ANY question whatsoever. Who knows what can really cause it? We have discussed on here whether emotional stress can do it. I am convinced emotional stress CAN cause a need for a stress dose. I've had to do it once.

Do you have this website/pdf? It has been my Bible.

http://www.addisons.org.uk/info/manual/adshgguidelines.pdf

I wonder if you suggest to the doc that she stress dose for a few days, because of what is going on with your family situation, and see if she improves?

Keep us posted. I wish I could offer more, but my one experience with crisis was so bizarre, the docs don't even know what to think!


03/24/2010 06:01 AM
teri72193
teri72193  
Posts: 1264
Senior Member

My symptoms are extreme fatigue and mine usually comes on fast, then there is the nausea. Definitely abdominal and back pain have accompanied mine, especially when it is coming on slow. They need to do a cortisol test on her.

03/24/2010 08:40 AM
ITeach91
ITeach91  
Posts: 1872
VIP Member

Kim,

Don't know if this helps but my gp told me (I'm going to double check it with endo on Friday) that secondary ai does not tend to go into the full crisis. Like I said, I'm going to double check this info so don't take it for true yet. Regardless, I have had a lot of the same symptoms - muscle achiness, increased fatigue, blurry vision, etc., which are all signs of cortisol low, but if you stress treat it in time should not go into fullblown crisis at any rate. If she is having those symptoms I personally would stress dose - I usually start with +50% and if that does not work double. But do check with your doc, remember we're not docs here so can only share our own experience.

Deb


03/24/2010 10:37 AM
kgo
kgo  
Posts: 603
Member

Thank you guys.

I got her to school at 11:45. We have her on half days but she doesn't make it everyday. We have these other stressers going on with the school so I wonder how much is that she is effected by what is happening with her brother. I know i could certainly use a stress dose myself haha! Or maybe something a little stronger Smile

I wish I could for a minute feel what she feels so I can better understand her. Her ankles hurt almost every morning but it tends to ease as she moves around. This sounds like arthritis to me. Her low back hurts almost everyday and then there are the daily headaches. It never seems to go away. Her oncology says she should no longer be experiencing headaches so I was wondering if it is part of this too.

Anyway, thakns as always for the advice and thoughts! keep them coming!!! Smile

Kim


03/24/2010 11:36 AM
bob3bob3
bob3bob3Posts: 4213
Senior Member

Hi Kim

There are lots of possible symptoms and even depends on how much you can put up with! Primary is more of a problem than secondary because there is a faster change in blood pressure, potassium, sodium and water. Primary crisis can be fatal in maybe half to 2 days if left untreated. (High potassium affecting cardiac and low BP from volume loss) Secondary might take a week but within 48 hours (often far less) you would be so brain stupid as to not know what was going on. Lack of water would probably be the defining event. It all depends on how much nearby support you have. A close by family would be able to react positively.

Probably the most common symptom is brain/logic failure and all over fatigue and pain. Nausea can also be common. Even though I have secondary I experienced primary type dehydration symptoms prior to diagnosis. I "sweated out" a lot of blood volume over maybe half an hour. I havent been able to work out the reasons why this happened except that my hypothalamus got a bad case of the stupids!

Back and muscle pain are common. Also consider that cortisol is a resource that has to be replenished and that usage rates vary. Some days you need more than others and even simple muscle repair from a day of exercise will draw down levels over the next day or so. I might consider an extra 10mg HC on the day of unusual exercise and an extra 5mg for the day or two after. This simple logic is what really irritates me about fixed dosage size regimes.

I am in two minds as to whether emotional stress NEEDS extra cortisol. A normal body produces more as the flight or fight response but its highly unlikely you'd have to physically duel with family/school. I dont stress dose for emotional events (in fact I can reduce dose - that's another story) but others on this forum do. The trick I think is to develop knowledge and adjust dose accordingly. Try to separate contrived from real symptoms though. I mean its normal to have good and bad days!

I'd disagree with Teri about cortisol testing. (Sorry Teri!) You can have zero blood cortisol and NOT be in crisis because it hangs out in the cells. Additionally the levels change so quickly and over such a wide range that any accuracy is kind of lost. My view is that since it has already been diagnosed you use other testing and symptoms to make judgments. (Like dehydration and BMP results)

Bob


03/24/2010 12:44 PM
lorajoy
lorajoy  
Posts: 338
Member

Kim,

When Landon went into crisis he was extremely fatigued (almost lathargic), vomiting and further into the crisis he was out of his head (did not know who people were, where he was, what day it was or who the president was). Blood work showed elecrolytes all out of wack! at that time they thought he was Secondary, but 6 months later at the NIH- it was confirmed that he was PAI/Addisons

Lora-Joy


03/24/2010 12:47 PM
lorajoy
lorajoy  
Posts: 338
Member

Also,We stress dose for extreme physical activity (soccer tournaments, swim meets) and severe emotional stress (such as a death in the family and a shooting at his school). We also stress dose when traveling. And of course, we stress dose in sickness. IT took us over a year to figure all this out and to determine when we needed to - we still 2nd guess ourselves sometimes.

Lora-Joy


03/24/2010 03:52 PM
LittleMissMerrySunshine
LittleMissMerrySunshine  
Posts: 1811
Group Leader

Just about the cortisol - mine tested "normal" at the hospital, but I was halfway or so into crisis. I don't understand that at all, so I'm just passing along my recent newfound knowledge.

Bob and I aren't going to agree on the emotional stress dosing! Emotional stress can cause physical manifestations...


03/25/2010 09:49 PM
kgo
kgo  
Posts: 603
Member

Thanks again....

Bob, Is it possible her extreme moods are symptoms? She is such a crab lately! Not very rational.

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