What to ask someone with adrenal insufficiency when you have bad news:


1.  Are you sitting down?

2.  Do you have your steroids on hand?

Seriously.  Maybe not even in that order.

I haven’t had any major illnesses since I’ve been diagnosed, so I have no comparison.  But I do know that, so far, what’s been most detrimental to my health since I’ve known I had adrenal insufficiency, has been that initial burst of fight-or-flight adrenaline when I encounter very bad news or an extremely stressful situation (including one where vigilance is necessary and adaptive).  Every time I’ve had that burst, it’s been accompanied by symptoms.  In fact, many times the symptoms were the first sign I was under extra stress.

The symptoms are actually much more obvious now.  Because now that I’m on dexamethasone, I have much fewer actual everyday symptoms of adrenal insufficiency.  It’s really doing wonders for me.  So when I do have more symptoms, they show up more readily against that background.  Like before, it was relatively routine for me to get so tired that breathing became difficult.  Now, it’s a sign something’s going very wrong.  

I expected my frequent medical problems to be the main thing that would set off symptoms.  Maybe they will be, once I start having more of them.  But so far, the biggest thing has been emotional stress.  My friend says that emotional stress is usually the reasons for big bursts of cortisol to be exhausted by the body anyway.  I don’t know enough to know if she’s right or wrong.  But from experience, it’s certainly been the fastest thing to cause me serious symptoms since starting steroids.  Like I can be fine one minute, find out my mom just spent two days in the ICU and that a code blue was called at one point, and suddenly I’m fighting to breathe.  And not in a panicked-and-out-of-breath way, but in an I’m-too-exhausted-to-make-my-lungs-work way.  And when I had to go over and watch my friend to make sure she didn’t have another stroke, I started shaking all over even though I wasn’t actually freaking out that much, and that was followed by other symptoms that made me realize this was physical.  In both situations all the symptoms went away completely within a couple hours of taking steroids.  (Which would not be the case for anxiety-related symptoms, given that historically I’ve found steroids make my anxiety worse.)

So yeah.  If you have something startling or horrible to tell me, ask me about my steroids first.

Oh yeah and this is reason #23481 that running around startling people for fun is a crappy thing to do.