Had the ACTH challenge this morning. It's over. No more frenetic working out. I can take a day off and relax. Except for one day when my knee was really painful, I have exercised every. single. day. leading up to the ACTH test.
Yesterday, I walk a mile, biked 2 miles and swam 1.5 hours with the toddler. It was exhausting and I was completely wilted by low blood sugar/lack of calories, which turned around with a small piece of cake at my sibling's Bon Voyage party. (They are going Down Under to study PT for a few months.)
So today, I'm wearing my comfiest knit pants and a soft t-shirt and oh yes I will go out in public like an under-dressed hobo. I don't care. My legs ache. Both knees hurt. My lower back aches. I'm going to lay low for a day or two before getting back on the hamster wheel.
If the ACTH challenge comes back normal, then based on the wringer I put myself through, I think it's safe to say it's pretty much over. Hello, Normal, here I come.
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Diagnostic Tests to Reassure Patients
4 days ago
Hi, quick question... you're definitely much more knowledgeable about this adrenal stuff than I am, as it's all very new to me. What would you consider a normal cortisol test? After being on 20-60mg of prednisone for 2 months, I was told to go basically cold turkey and ended up in Urgent Care 4 days later. They did a urine test that came back as 4, but don't seem too worried about it...
ReplyDeleteThe only urine test I know of is the 24 hour urine collection for which anything under 10 would be low. (http://endocrinesurgery.ucla.edu/patient_education_adm_tst_urine_cortisol_test.html).
ReplyDeleteI'm not sure what testing you've had based on your comment. AM cortisols are blood tests not urine tests. Cortisol testing after 9am-ish is mostly useless anyway.
What did Urgent Care do? Put you back on steroids? Have you seen an endo or your PCP? That would be the next step.
M
Hope the ATCH levels come back normal!!!!!!!
ReplyDeleteUrgent care diagnosed Addisonian Crisis just based on symptoms (took until today for the cortisol test to come back, I went in with extremely low bp, hr 130, dehydration, etc.) and gave me IV steroids and put me back on prednisone for a 20-day taper this time. The doc said it is basically the same as the 24 hour urine test but without the 24 hour averaging bit. I haven't seen an endo yet as I'm not sure what good it would do since I am back on the pred, but was curious just where 4 fell on the range. Thanks for the insight.
ReplyDeleteUmmm a 20 day taper may be too fast. You must see an endo. They will manage the taper so you don't end up dying from a Crisis.
ReplyDeleteAlso your system may not come back online quite right. You will need monitoring and further care. Please see an endo.
You got pretty intelligent care at the Urgent Care. You were lucky. Sometimes people die instead because they are too sick to wait for doctors to figure it all out.
M
Thanks, will look up an endocrinologist in my insurance network. Got kind of a lot going on at the moment as somehow the Addisonian crisis has set off what I think is Myasthenia Gravis, I can't walk due to extreme weakness in my legs, they just buckle under me. There's always got to be something going on, right?
ReplyDeleteAgree, we definitely got lucky at Urgent Care. My regular doc who had me doing the cold turkey apparently didn't have the common sense that the Urgent Care doc did, because he pretty much called it right away.
Sorry to hear that. Hope you feel better soon.
ReplyDeleteM