Advice needed from those with adrenal issues...

Hi all, hope everyone is well and having a good festive period. Firstly, I am NOT looking for a diagnosis here, just a bit of advice from those in the know. I was admitted to hospital on the 20th Dec with spontaneous pneumothorax (new for me!) and I was kept in until xmas eve, when I begged to be released! During my stay, I seemed to pick up some sort of virus - woke up at 3am with a temp of nearly 40 degrees, had vomiting and diarrhoea (sorry), and a massive headache.

Now, I was told at the time that it probably was just ""some sort of virus"", since my bloods weren't showing infection although my inflammatory markers were up (docs put this down to the chest drain). I was discharged from hospital on the understanding that if my symptoms grew worse, I would go to A&E.

I was told a while back that I had ""modest adrenal suppression"" (not sure what ""modest"" exactly means!) though I have not been tested/treated for it. I still have the headache, though sometimes it is not so much pain, it's a bit like a woozy/fuzzy/heavy feeling. Appetite still not there - I am eating, and don't feel nauseated, but never feel hungry (not like me at all). And the tiredness - wow - normally I get my 8 hours at night and manage perfectly well on that, but now I am sleeping 13 hours a night and still feel exhausted.

Well done, and THANK YOU, if you are still reading this! My question is this - is this a virus, or does it seem more like the adrenal suppression symptoms? Again, I am not looking for a diagnosis, just advice/opinions. It is beginning to worry me since I start back at university next Monday and wonder how I am going to cope! Is this something I should be seeing the GP about? I am sick of feeling this rubbish!! Grrr.

Again, thank you all for any advice you can give me...

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Hi, well havent you been having fun... not!

To be honest your symptoms sound just as likely to be viral than anything else, and viruses can take a good while to recover from (potentially weeks). It also wouldn't be unusual to pick something up in hospital since its full of folk with illnesses!

Telling you that you have modest adrenal suppression without any testing, or explanation of what that means isn't entirely helpful - how did that come about, have you had long term symptoms which are unexplained? Do you use steroids regularly?

Lynda

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Hi Lynda,

Fun is definitely the word for it lol! The adrenal suppression comes from the fact that I have been on pred for over 18 months and am unable to get below 10mg daily...

Many thanks for replying

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Hi Chukkin, if you're still on 10mg of pred daily then you shouldn't have the risk of going into adrenal crisis that some of us have had - as your 10mg of pred is more than a replacement dose of steroids. (Twice what most people would need). Any Seretide etc that you take on top would also add to the amount of cortisol available.

However, when you're very unwell you might need more steroid to help your body fight infection. I think the reason this isn't talked about so much in people with asthma is that for most of us a serious infection - even when it's not directly breathing related - causes us to up our asthma-steroids anyway.

Vomiting in particular needs adrenally insufficient people to respond with 50-100mg of hydrocortisone, and continue that every 4-6 hours until they're recovering. The equivalent cover with pred is 40-50mg/day (not a direct numerical 1-to-4 ratio because studies show you can get away with less hydro if it's being delivered by syringe driver at a steady rate, which the pred provides a closer match to).

In the end it does sound like a grim D&V bug you had - adrenal crisis wouldn't give you a temperature. It seems that you can't be in total adrenal failure or you would have gone into shock - people with untreated and undiagnosed adrenal failure often end up in HDU or ITU with organ failure due to shock, so either you were on enough steroid to cover your needs or your adrenals can still respond when needed.

Do you carry a steroid card? This should say on it that during acute illness you may need an increased dose of steroids - if they didn't up your steroids for D&V in hospital then they messed up. You should talk about sick-day rules for D&V / infection (infected cuts and grazes need a lot of cortisol) with either your GP or your specialist so that you're clear on what to do - it's a simple thing that for some reason often gets overlooked.

If you're in any doubt, up your pred for 2 - 3 days when you're ill (flu, D&V, high temp, infected wound) - better to take too much for a couple of days than to not have enough.

Good luck - I hope you feel better soon - remember to stay hydrated!

Cx

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Thanks Curiouser,

Yes, I am pretty certain that I am not having an adrenal crisis or adrenal failure, but was concerned that the recent illness had put strain on my adrenals and was causing the showing of symptoms (tiredness/headache/lack of appetite etc) that I don't normally get.

My basic question is - do you think it is a virus, or does it sound more like an adrenal-associated thing? I have had many infections and viruses in the past but none have persisted this long without improvement, and I have never had fatigue like this before...