If there is one thing we have learned in the last 9 months it is that where Adrenal Insufficiency (Addison’s) is concerned, One Size Does NOT Fit All.
We have met other addisonian’s on line, from NZ and other countries. They are all different in how they manage their condition, how much Hydrocortisone they take, or which other corticosteroids they take to replace their Cortisol. It also varies on when they take it, when they “stress dose”, why they “stress dose” etc.
Derek is slowly learning what works for him. We ask others with more experience what they do, and then work out if it could be of benefit, either by trialing, or by “assessing the benefits”.
One thing we have found out is that “Stress” is different for everyone. Derek finds it stressful getting to work in the morning. Since he has had a Taxi to work, he is feeling a lot better.
He also finds meetings where he is not the person with the knowledge and experience, can be extremely stressful. When he is in a meeting at work, or with a client discussing their needs for individualised versions of his Security software, he is in control, he knows what he is talking about, so he does not get as stressed and can normally manage such meetings without “stress dosing”.
When he is in a meeting with someone where they “have the upper hand”, or they are controlling the meeting, it is a lot more stressful. A Job interview, a phone call to make a complaint as a consumer etc, are all stress triggers for him and he needs to Stress Dose. Others find just dealing with their Dr causes high stress levels.
We have also found that the standard “You are this height, take this dose” also doesn’t fit everyone. In fact, it’s a shame the Dr’s don’t realise it doesn’t fit anyone. There is no consideration for what you do for a living, what your home life is like, what other medical conditions you may have that your body is working hard to control.
And then, just for the heck of it. Something happens (like you get older) and you have to change the amount you take because your circumstances have changed. You no longer have to get yourself to work, your have moved into a house with no garden work to do, you get a pay rise so can get a house keeper, your kids leave home (one day please). Any thing can change your routine to a point where you need to take extra, or, if you are lucky, can reduce what you take routinely.
Addison’s, like many, is a hidden condition. You don’t know someone has got it unless they tell you, or they collapse in front of you. On a good day, they look “Normal”, on a rough day, they look tired, on a bad day you don’t see them because they haven’t got out of bed.
The only time you would notice it is if they are in a stressful situation or they have overdone things and they start to “crash” in front of you as their cortisol levels drop, their blood pressure drops, their ability to “function” drops.
I have watched this happen with Derek recently. He was fine, talking, thinking, interacting, with life and zeal. I turned to look at him and I could see him going down in front of me. His speech had slowed, his eyes were a little sunken, he looked like he had been through the mill. He decided to get up from his seat to get some more HC and found it hard to stand. His blood pressure had dropped.
It can happen quickly. The good news with this event is that when it happened, he took the extra HC and an hour later he was feeling better. He woke up the next morning feeling well enough to go to work.
The speed an Addisonian recovers from stress is proportionate with how they are feeling pre-stress. If they are unwell, it will take a lot longer to recover than if they were feeling good before hand.