Crisis Prevention

It is with sadness that I am choosing to address this subject due to the recent passing of three Addisonians. I do not wish to intrude on the privacy of these family members, so, I will not go into details of their respective situations. We must all realize that this disease is one that can be fatal if underestimated. There is this potential with any Addison's patient. But this is not a time for panic, but to learn to care for our disease properly and to recognize and treat a crisis promptly.


It is better to err on the side of caution. Always keep a ready supply of steroid with you or nearby at all times and try to have someone to call if you need assistance...being alone when you are going into crisis can be very risky. It is possible to become so incapacitate that you can not care for yourself...at times like these you need , if possible, someone trained to inject your emergency dose of steroid. This is crucial that you have this injection available and used immediately even before you reach the ER. Any injury, or illness must be diagnosed and treated after the Addison's is addressed. Do not ignore the signs of illness and always keep adequate amounts of steroid in your system...this is important: you can not miss doses or fail to take your steroids as this in and of itself can bring about crisis.


The signs of crisis:


http://www.addisons.org.uk/info/emergency/page2.html


There may also be severe flank pain.


You must not ignore symptoms or signs of crisis. A crisis may progress rapidly. Have anti-nausea medicines to prevent vomiting as this can rapidly send us into crisis. Below are links describing Adrenal Disease and treatment procedures for a crisis. Read them and be aware of what happens when a crisis occurs and procedures for treating a crisis by the ER physician. Learn these procedures and have someone else who knows how to mediate for you.


http://emedicine.medscape.com/article/765753-overview


http://emedicine.medscape.com/article/765753-treatment

Do not ignore your disease. Do not underestimate it's potential for rapid decline and be proactive in learning to avoid or treat a crisis aggressively.

This is not meant to cause panic but to urge you to learn about your disease, which will enable you to live and cope well. Education is your best protection.

Please be prepared...

As any of us with a chronic illness can attest, we many times take several different medicines. And we are often asked to list these medicines when we go to a new doctor or the ER. We are not usually our most alert at these times or we might be unable to answer for ourselves and it is necessary to be certain someone close to us will be able to communicate for us. To make this easier for either yourself or another make and keep a current list of all medications and a copy of the Emergency Letter provided by the NADF in or near your emergency kit. I am providing a link where you can download and print a copy of this letter.

http://z12.invisionfree.com/apeoplevillage/index.php?showtopic=391

Also, it is a good idea to keep a current list of all known allergies.

Keep healthy...

Taking it one day at a time

Most patients with Addison's Disease have a limited level of energy. This varies from patient to patient, with some having only minimal limitations and others who struggle daily just to accomplish the ordinary, every day tasks. The key is to not over-reach your strength or energy level. You can do this by deciding the most needed tasks or the less stressful, or demanding ones, if you are feeling your limitations that day. Never hesitate to rest when needed or take extra steroid if you have over-reached or say you absolutely have to do something very demanding, such as traveling or caring for a spouse or child who is ill or injured. Life goes on even though we have Addison's or another chronic illness, so we need to learn our limits, and live with those in mind.

Don't feel guilty if you can't come up to the standards set by others for you! You set your standards! Only you know how you feel! Learn to say no when it's necessary, and do not let anyone make you feel guilty for doing so!

It is also essential that you care for your Addison's with adequate steroid cover, sufficient salt and fluids for the day...sometimes this requires lots of planning and invention! But you can do it! My water bottle and I are rarely separated for long! I carry extra steroid and medicines that just might be necessary to prevent a crisis...and never be without your emergency injection.

Remember you are a useful human being who just happens to have Addison's Disease.

Another article showing hyperpigmentation seen in Addison's Disease

http://patients.uptodate.com/topic.asp?file=endocrin/3060


This is an article from the Up to Date website describing and explaining Adrenal Insufficiency. There are pictures in this article also showing the hyperpigmentation of Addison's Disease.

Surgical Guidelines/ADSHG

There are going to be times when the Addisonian will need to undergo surgical procedures and there are guidelines which should be followed. The link I am enclosing is a set of guidelines in PDF format which may be printed out and taken to your doctor, hospital or dentist before you undergo the procedure. It can be much more reasurring to know that the technicians, etc. will know what is needed to keep an Addisonian stable and out of crisis, both during and after the surgery. Never hesitate to be certain that these guidelines are followed to your satisfaction and to the extent neccessary for your safety. It is your life...be proactive in your care. It is important that you know what is needed and insist it is carried out.

http://www.addisons.org.uk/comms/publications/surgicalguidelines-colour.pdf

If you are facing surgery soon, best wishes for your speedy recovery.

What Addison's Disease looks like...

http://www.emedicine.com/derm/topic761.htm#target1

The above article, from eMedicine, is a detailed description of the facts and symptoms of Addison's Disease. There are images of the hyperpigmentation seen with AD included. This may be of help to those who are seeking a diagnosis as well as those already being treated for adrenal disease.

Carefully considering what you read...

Being out and around the internet, I've come to appreciate the good information we are sharing with one another and how vast an amount there is available, from many varied sources. It is just this fact that must give us pause...not everything we read or are told is to be embraced as fact. We must take the information and research it, if possible, and most importantly, take it to our doctor for his opinion, before acting on it. I have seen, too often , those without a medical background offering medical advice and this is just not the purpose of forums like ours...some of it is just plain dangerous and can cause harm to the sick and frightened patient seeking help...many times already in a confused and overwhelmed state of mind. We are not here to practice medicine. Please learn from our shared experiences, but never use them to replace sound medical advise.