Breathlessness when walking up slight gradients/stairs

[Flivoless]

Further to my previous post about breathlessness, I finally had an audience with the Pope, masquerading as my GP (my he's aged a lot since the last time I saw him - mind you, haven't we all. My goal was to get a Acth test arranged, as I'm convinced my problem is adrenal related and I'm concerned about reducing Pred further (now at 3.5mg) without knowing that my adrenals are at least capable of working again, GP says only my Rheumy can arrange this but I think she must have won the lottery and moved to sunnier climes. However, GP decided to do something of an MOT test, including an ECG. Temperature fine, blood pressure fine but heart was racing away at 128. Not knowing the cause and not being convinced about adrenal insufficiency, he decided to pack me off to the Ambulatory Unit at our, not so local, hospital. They did another manual bit of prodding and another ECG with exactly the same result as at the GP's. Had various blood tests but nothing dramatic there, sent for Xray, no problems found, so sent for a CT scan using injected dye (for those who have not experienced this, it gives you a warm feeling in your nether region, akin to having an accident). No blood clots found so still no nearer to finding the cause. They gave me a beta-blocker to try and reduce my heart rate which it did by a princely 3 after an hour but that could also have been my deep breathing exercise. I should pick up a prescription for a beta-blocker and blood thinner today, so we'll see how I fare with these, meanwhile it back to trying to get an Acth test I think. He-Ho.

[DorsetLady PMRGCAuk volunteer]

GP can organise a basal cortisol test at surgery -then if necessary you will be referred for ACTH test…

But good that you got some attention I guess!

[SheffieldJane]

Why is there this reluctance amongst GPs with regard to Adrenal deficiency?

When I finally got to an Endocrinologist, he took it all very seriously, especially as I initially failed the test. My GP had looked at me askance and said “ Oh I don’t think you have Addisons”. It was a bit of a battle. I must have got a more sensible GP eventually. Keep plugging away. I would welcome and have had all the tests you describe. You just need a simple morning cortisol test without Pred. Initially.

[Flivoless]

I have just been sent an appointment for Cardiac Investigations department Sept 25th. Hopefully I'm still around then.

[DorsetLady PMRGCAuk volunteer in reply to Flivoless]

Hope so -and that it 2023!

[Flivoless in reply to DorsetLady]

Oh, never thought to ask 😳

[DorsetLady PMRGCAuk volunteer in reply to Flivoless]

Was joking …. 😉

[Flivoless in reply to DorsetLady]

So was I, I already knew it was 2025

[PMRpro Ambassador]

If your HR was chugging away at 128 - no wonder you feel the way you do and I truly wouldn't be worrying about a synacthen test.

What the GP CAN do is the next time you need a blood test (or anyway) is to order a basal cortisol - which for at least half of patients will provide the same info as a synacthen test. Inbetween it would give grounds for a synacthen test in the non-pred patient but you are on enough pred to suppress the normal function still - but it would give you a baseline to work on.

I'm not convinced by the "pill in a pocket" approach to calming an arrythmia down, doesn't work for me either! But you are on their radar now and they will have a look. They were obviously not seeing anything nasty on the ECG, just it was fast. And that will cause breathlessness if you try to do anything. I speak from experience!!!!!

[Flivoless in reply to PMRpro]

Yes PMRpro, I actually meant to write basal cortisol at GP with a view to Acth later.

[Sophiestree]

No words other than 'wow'