adrenal crisis 😢

[RT18]

Back again!

So mum diagnosed with uti yesterday - not unwell with that BUT today full on adrenal crisis - temperature, weakness, vomiting, very low BP followed by 90mins unconsciousness……all developed within 2-3 hrs and even took me by surprise as I assumed the temp was infection.

THANKS to you all I shouted hydrocortisone and on 15 mins after administering she slowly came round!

I was going to post to ask you advice of questions to ask as A&E doc clearly not up on steroid issues. But thankfully a lovely endocrinologist has just been (coincidentally on duty) and speaks the sense I have read and she will be reviewed in the morning, but they’re doubling her dose and will probably give us rescue hydrocortisone.

[SheffieldJane]

What a fright! Great response from you and then the Endo team Whew!

[PMRpro Ambassador]

Good you have a Person of Sense in the form of a with-it endocrinologist!

The emergency steroid card was introduced a few years ago because of the lack of awareness of adrenal issues amongst HCPs. I am yet to be convinced it has improved ...

[RT18]

The lack of awareness has been shocking. We have never been given advice even though I ask every time I speak to a GP. I think she must have a low threshold for problems as technically she was just on enough pred according to latest royal society of endocrinology guidelines but adrenal issues still set in - and then of course vomited up her last dose and couldn’t hold down another.

Her GP practice is generally good so I may write a nice letter but gently raising awareness and requesting some sort of alert on her notes - although I doubt the computer system will allow.

[PMRpro Ambassador in reply to RT18]

The RSE guidelines are VERY low - something like 2mg is claimed to be enough, Maybe it is for some but we know that patients coming down off high dose pred often start to feel the lack at 10mg, never mind the older recommendation of 7mg. I've been on pred for 14 years - I have just gone down to 5mg and a bit of extra stress made me feel dreadful the other day.