Sick day rules after having IV cortisol?

[Supertech]

On holiday in Majorca with family and had been fine although probably not pacing so much with increased activity compared to home in the UK.

During the night developed severe d & v and did not realise it was an adrenal crisis, just thought I had a bug.

Luckily I had told husband and daughter about adrenal insufficiency, they called a doctor and sent to hospital.

I have been here all day and will be overnight. I have just had my second infusion of 50mg cortisol with another scheduled for the morning.

I have had IV antibiotics as they found raised infection levels as well as a saline drip. They are repeating bloods tomorrow.

At the minute I am on 9.5mg from 10mg which was by DL slow taper.

Just put me on oxygen as my oxygen levels are low at 92. Normal is 99.

My question is whether sick day rules apply when I get back to hotel or just to up the pred by 5mg until I get back to the UK on Tuesday?

Thank you for any suggestions.

[PMRpro Ambassador]

I think the medical team caring for you will be the best to advise there and in my experience, Spanish medics won't let you go until they are happy!! Not like the NHS where they are desperate for the bed!

92% O2 isn't too bad - mine is mostly 93-95% and that is the bottom end of normal.

Kudos to you for having told the family, kudos to them for calling a doctor - and well done the hospital for getting it right!

Get well soon - and let us know how you get on.

[Supertech in reply to PMRpro]

Thank you for your reply, not only for replying yesterday but for your great advice on this site.

Thursday update. They have just given me more IV antibiotics and saline but think the next Pred will be pills. O2 is @97 this morning but still want me to keep on the oxygen.

[PMRpro Ambassador in reply to Supertech]

97 on oxygen or air? I'd expect better on O2,

[123-go]

No suggestions except to say take it easy when you are discharged. Applause from me too for your husband and daughter taking in your lesson on adrenal insufficiency 👏👏👏.

[Supertech in reply to 123-go]

Thank you. Learnt it all on this site, it’s been such a help. X

[Sophiestree]

This is really interesting as in my head I would not have thought of adrenals on that kind of dose. Hence why reading posts is invaluable. Sats are also interesting as mine can drop as low as 83% but recover reasonably quickly, although I then get horrible palpitations. You sound like you were in the best place. I hope you're recovery doesn't take too long and you get some holiday.

[RT18]

my mum had adrenal crisis at 10mg pred with uti - I think they suggest anything under 15mg can cause crisis if sick day rules not followed. It’s again thanks to here I realised what was happening and hydrocortisone administered by paramedics.