Saturday, March 30, 2013

Alternative Medicine for Adrenal Insufficiency/HPA Axis Suppression

I got this comment on an old post the other day:

"My husband is a physician suffering from all sorts of complications after a year on Prednisone including two taper attempts--the first nearly killed him with an adrenal crisis. You definitely need an endocrinologist working with you and insist on being monitored closely with blood work done frequently. Does anyone have any thoughts or suggestions on home to go the alternative route in conjunction with conventional medicine? "

Having done a lot of alternative or integrative medicine stuff to try and support my recovery, I feel I can say, the short answer to your question is, no, there isn't really an alternative route for steroid induced adrenal insufficiency.

The best 'natural' treatments for HPA Axis Suppressoin are things like taking lots of B vitamins as well as C. You should also monitor your blood pressure and salt food for low blood pressure. It's also important to keep sugar on hand for low blood sugar.

Don't ever leave home without some form of salt and sugar. If you can keep blood sugar and blood pressure stable you can avoid a lot of bad adrenal ju-ju.(Ju-ju being not digging yourself into a pit where conditions are ripe for an adrenal crisis.)

Plus, you should sleep as much as possible. And don't try to exercise until you can handle regular activities of daily living (i.e. work, cleaning house, running errands all the usual stuff you couldn't do while in the depths of adrenal insufficiency). You might not be able to tolerate exercise for up to a year or longer, depending on how resilient your system is (or isn't as the case may be).

I think some people are just really sensitive to adrenal suppression and don't come back like the text books say they should. And it sucks. All you can do is ride it out.

If you go the alternative route, be careful. Likely the first thing they'll want to do is hook you up with a Meyer's Cocktail via IV. Every alternative doctor has a different recipe and some of them add steroids to the mix, which might not be such a good idea for those of us trying to recover adrenal function.

Alternative medicine likes to 'rest' the adrenals by giving patients steroids and using a diagnosis of Adrenal Fatigue. Sometimes the doses are as high as 40mg which will not stimulate your HPA axis to function. In fact, it will further suppress it! Some alternative patients have found my blog because the steroids they were given left them suppressed. They weren't necessarily insufficient to begin with, but all the 'resting' of their adrenal system ensured they ended up that way.

The most effective treatment alternative medicine has to offer adrenal suppression patients is bio-identical hormone replacement...if blood work shows you need it. In my case, I had low progesterone and replacing that has made the biggest difference out of anything I've tried (ostensibly because it is one of two precursors to cortisol production). However, not everyone will have low levels of hormones.


Regarding the difficulties with tapering...Any time tapering steroids is a disaster that means you're not going low or slow enough.   Too few physicians understand this 'law of tapering steroids'. It's not an area of medicine they know. They still think adrenal stuff is rare or that steroid induced adrenal stuff follows all the 'rules' of their medical textbooks.

Based on my experience and that of other patients, the ideal taper is to drop the dose by only 1 or 1/2 mg every taper. You don't taper again until you feel okay at the new dose.

Also, try to switch to hydrocortisone with its shorter half-life. Take all your doses before noon and then nothing after (you might have to work up to this). Once you adjust to it, the shorter half-life will support recovery whereas prednisone's 24 hours+ half life impedes it. (Note: Don't try to taper until you've fully adjusted to the switch from prednisone to hydrocortisone. Be advised, switching steroids can be rough...some level of misery is unavoidable, but shouldn't last more than ten days.I ended up alternating between prednisone and hydrocortisone for a while until my body could handle the change in half-life.)

If you are struggling with a steroid taper, please check out the forums links that show up when you go to leave a comment on my blog posts. Those patients know what they are talking about and are an invaluable resource.

Tuesday, March 26, 2013

Surprise!

It's been an interesting few days. I did not travel well either going or coming. Adrenal whatsit does indeed seem to be active.

Right after I posted my last post I got the "stomach flu."  You know, the stomach flu no one else in the house gets but me. The intense burning stomach pain was a match for what I felt during the supposed adrenal crisis in 2011.

Of course, it could be anything. Food poisoning, stomach flu for one etc... But it felt very adrenal.

How strange. I am flabbergasted that it would happen like this.

I did not stress dose because I didn't actually vomit, just felt like it all the damn time. I just tried to ride it out and crossed fingers, toes and curls that it would be mild. So far, so good. It took about 5 days for the burning pain and nausea to subside. My energy is still kind of yuck but I did go for a walk today.

I know Addison's patients say they have issues with travel, but I don't have Addison's and thought I was pretty much over the hump. Huh. Guess not.

Well, at least I didn't have to fall back on steroids.

I'm very tired right now. The weather is not helping. The time zone change isn't helping. I so want to Rip Van Winkle.

And the real stomach flu is coming for us. We arrived home to a shut down preschool, cancelled dance classes and dehydrated kids in the hospital. Everyone's puking around here. I've stocked up on Sprite and Jello and am engaging in lots of magical thinking which goes something like...

Maybe we won't catch it because we've been out of town. La-la-la-la I can't hear you puking.

Then I take my pointer fingers and make a cross like I'm averting the Evil Eye.

On the work front...some exciting stuff. Although it's been difficult to find time to write. We're just so busy, going here, there and everywhere and bringing people home with us. (Also, ZOMG the preschool homework. Pages of it! WTF?) I'm kind of in hostess mode for the next few weeks as we have a house guest who needs hosting as opposed to the more typical 'person who lives with us' guest. So my time is not my own.

However, the last story sold pretty well. The sequel is in final edits (if I can find time to work on it) and I'm branching out into some cross marketing by sponsoring some stuff. The sponsor thing is what I'm most excited about. I have no idea if it will be effective or not, but it should be hella fun...I get free tickets.

 PS: I believe comments have been enabled once again.

Wednesday, March 20, 2013

Reentry

It's past midnight and I can't sleep because we've traveled backwards in time. My body thinks it's 10pm. The kiddo is still up even. I can hear her playing in her room.

FYI if you're going to hop, skip and jump time zones, don't do it the same time as 'spring forward' daylight savings time. That just makes it worse.

So we are back home for a few days and will be leaving again shortly. Then a house guest followed by another. Never a dull moment!

The trip went well, but there were some surprises. Getting out of town was so stressful I almost didn't want to leave. The kiddo did indeed have strep and that had us running around like crazy headless chickens to get her to the doctor, fill her prescription, talk to TSA about how to transport it and pack. The dogs were looking pretty frail and we wondered if they would survive. Then the furnace died the night before we were supposed to leave.

Luckily my husband is very handy and has lots of industrial contacts. Between his skills and a few furnace people on speed dial, he was able to sort it out. But it was touch and go there for several hours...late at night. That's just when you want to be fixing your furnace right? In the dead of winter with all the stores closed? It's so awesome, you should put it on your bucket list.

Changing time zones and climates hit me like a ton of bricks. My lungs were riled up for almost a week--a huge weather swing from 80F to 30F didn't help--and...I had some adrenal symptoms. To the point of considering a stress dose, mostly because I couldn't wake up a few times. (And I don't mean, lazy ass lolling on a bed, I mean I want to wake up, I am trying to wake up but I can't, the fatigue is that thick.)

I haven't had much adrenal anything for a while. I think the flu was the last time I had any symptoms. It was disappointing and unexpected. Although I guess I'm not quite a year out from my last high dose of steroids so maybe two months actually matter when it comes to these things. Thankfully, after the first week my body mostly got over itself.

Overall, we had a fabulous time. Even better, our elderly dogs are still alive and looking pretty good at the moment. Huzzah!

Now to somehow navigate the coming adventures along with some writing deadlines that I cannot miss. That should be interesting. Oh and I have to get the kiddo in for a vaccine shot before the neighbor kid infects her with some new unholy terror of a germ.

Until my body says otherwise, I'm chalking up the adrenal stuff to the stress of travel and possibly maybe a bug as I had a sore throat for several days but never really became all that sick. I am assuming it won't hit me now that I'm on home turf. I don't know.

And comments are still off because I forgot what I did to turn them off. I'll get to it when we're finally home for more than twenty four hours. Gosh, while we had a great time, I'm kind of looking forward to having nowhere to go for a while!

Sunday, March 3, 2013

Quick Update:Comments Off

I believe I've turned off comments...assuming I hit all the right buttons on blogger. If not, I'll keep playing with the settings until I do or take the blog private for the next few weeks.

(Edited to Add: Comments are off. You won't be able to post anything, it will be blocked.)

Someone had a bad day as a medical professional and is hate reading the blog, leaving angry comments as they go. Since I'm about to go out of town, I'm shutting it all off so I don't have to deal with some asshat's temper tantrum.

Secondly, the neighbor kid appears to have given mine strep. She's got the fever and the rosy cheeks with glassy eyes just like her little friend. Of course this all hits the day before we fly out. Naturally! I'm getting her into the doctor for antibiotics asap and am crossing fingers the bug doesn't hop to me for a joy ride.

I wasn't going to bring the nebulizer with me, but I guess I'll be packing it now.

I'm trying not to hate the neighbor kid's parents right now because any kid could've passed on the bug, but they are just so...negligent, so not caring if they're kid is sick. This is what? The third time they've sent their obviously ill child over to my house now? WTF? I really want to say something because I am not without risk here, but I'm so ticked I don't think I can be nice.

So I'll bitch about it here instead. Yes, it's impossible to stop all the germs, but we shouldn't have to welcome them with open arms either.

Wish us luck with our vacation for four, the three of us and strep. Whee! At least sick 5-year-olds bounce...I doubt my kiddo will notice she's sick once the fever breaks.