I had an adrenal crisis yesterday. It came on suddenly with no obvious cause, though I did push myself a little harder than I probably should have in order to have a long social visit with friends. We played Dungeons and Dragons for eight hours straight. Probably not the smartest idea, but we had fun.
Aside from being very tired near the end of our game, I was feeling pretty good, and I had been drinking plenty of water and tea throughout the night. I went to bed some time around 4am, according to my fitbit. I woke up around 6am feeling like I had to puke. I got up, went to the toilet, and vomited twice- dinner, not straight bile. I felt better afterwards, so I took the stress dose of steroids as instructed by my doctor, drank some water, and went back to bed. I couldn’t get to sleep, and felt like I was about to have bad diarrhea, so I went back to the restroom. I had a loose bowel movement, and suddenly felt lightheaded. I lost consciousness suddenly while sitting on the toilet, but I caught myself on the sink before I could fall. I sat on the toilet fading in and out of consciousness for a while. Something was obviously VERY wrong. I “came to” just enough to realize I might be having an adrenal crisis. I fumbled with the toilet paper so that I could wipe, and wound up losing one roll and had to find another one. My arms were not responding like they should. This was a VERY difficult task. I managed to wipe and make my way back to the bedroom despite that.
I woke Justin up and told him I was having a crisis and I needed him to find my injection kit. I laid down on the bed in a daze. I could not remember where I had put my purse that has my kit in it, but he hurried and searched for it and brought it to me. I watched an injection training video for the solu-cortef because I could not for the life of me (maybe literally haha) remember how to do it. I was able to give myself the injection and we left immediately afterwards to go to the ER where I have been successfully treated for a crisis twice before. I bought a couple plastic shopping bags with me because I was feeling extremely nauseated. On the way to Rushville, I vomited three times, all bile, and it was a surprising amount, filling about half the plastic shopping bag. I felt better when it was all out.
When we got to the ER, I checked in and they had me in a room right away even though the sign-in nurse had never even heard of adrenal insufficiency before. The RN assigned to me asked me to explain what was going on. I was still really scatterbrained, but I did my best. I told her I thought I was having an adrenal crisis and explained what had happened that morning. She took my vitals and left to get the doctor. The doctor assigned to me asked me what was going on. I told him I thought I was having an adrenal crisis, and he cut me off and told me to list my symptoms and tell him what happened. Again- scatterbrained, but I did my best to explain everything. After I told him all I could, I tried to explain that I have had adrenal crises twice in the past and it’s a very distinct feeling, and this definitely felt like one. He seemed to just ignore that comment entirely. He did order the IV and steroids, though. They took good care of me, and I went through two bags of IV fluids before they discharged me. He said that my blood pressure was fine, but my potassium was low, so he ordered some potassium for me, which I took before I left. I want to take a moment to note that abnormal electrolyte levels are a strong indicator of an adrenal crisis and was exactly what a different ER I had gone to in the past had used to determine whether or not a patient is in crisis (even though only 56% of adrenal crisis patients show abnormal test results). The differing opinions between ERs makes my head spin sometimes.
The discharge paperwork I was given did not state Adrenal Crisis specifically, but every symptom he had listed as my diagnosis was a textbook indicator of an adrenal crisis. I’m not sure if the doctor was just clueless, or if he simply did not want to admit a patient was correct about their “self-diagnosis”. Buddy, I’m not trying to be better than you at your job. I was just trying not to die.
Snippet from my discharge paperwork:
He neglected to mention my extreme weakness, dizziness, shakiness, and trouble concentrating as well.
Whether he was willing to properly document it or not, that was an adrenal crisis. I am glad I was able to get treatment in time. Giving myself the emergency injection was scary, but I must admit I actually did a kick-ass job administering it despite my shaking hands. There’s barely a dot now where the needle went in, and it only hurt after I took the needle out. Patting myself on the back for that one!
Of course, the real MVP here is Justin. He’s awesome. ❤ I literally could not have properly cared for myself if he hadn’t been there.
I am feeling much better today, but I’m still pretty weak and tired. I’m sure I’ll be back to “normal” in no time after I get some more rest.