update Day 10 postop

Today is day 10 in the hospital. It has been a lonely experience, since COVID19 restrictions do not allow friends or family to visit. I have had to advocate for myself, which can be quite challenging while you’re in so much pain and on multiple medications. I am grateful for my nurses who have come along side me and helped me talk to the doctors about my pain/anxiety.

Part of the reason I am still admitted is because I’ve had some major set backs and my pain is still high. However, the bigger problem is my heart rate is uncontrolled. We’re talking really uncontrolled. Most of the day I am tachycardic, with a heart rate of 110-135. The worst experience was when I passed out due to my high heart rate and landed directly on my butt (which if you don’t remember is my surgical site.) To say it was excruciating would be an understatement. In another episode, I was at complete rest and my heart rate jumped up to 180.

This prompted my nurse to call the “Rapid Response Team”, which is a group of nurses and doctors who run codes in the hospital or assist in acute crises. It was very overwhelming to have eight nurses and two doctors run in and immediately start barking orders. Everyone had a specific job during the event, so I knew everyone was necessary to be in my room, but it was extremely nerve-wracking as the patient. Multiple people screamed “calm down” at me, which is literally the WORST way to get someone to calm down.

Thankfully, after a dose of adenosine and lots of fluids, my heart rate came down to the high 90s. Although my heart rate improved, there were still a lot of questions to be answered. Most importantly being “why is my heart rate so high at rest?”

In response, my doctors ran new blood work, performed an echocardiogram, and got a CT scan to rule out a pulmonary embolism. Luckily, the imaging was all normal. But the blood work showed that I am in adrenal failure again.

My attending physician was extremely worried when he received my blood work results; he explained that normal range for this cortisol level test is between 6-10… mine was 1. This means it is nearly undetected in my blood stream.

The adrenal glands are located just above the kidneys and consists of two parts. The outer portion, called the cortex, produces cortisol. This is an important hormone for controlling blood pressure. The inner portion, called the medulla, produces the hormone adrenaline (also called epinephrine). Both cortisol and adrenaline are released in response to stress. Because my adrenal glands are not working properly, the stress from the surgery ultimately caused me to have an acute adrenal crisis.

Other symptoms that occur because of it are severe tachycardia (check), chronic weakness/lethargy (check), severe pain throughout the body (check), vomiting/diarrhea (check), inability to regulate body temperature (check), irritability/depression (check), and worsening anxiety (check)!

Earlier in this post I stated I was in adrenal failure “again”, which means this is not the first time I’ve been treated with steroids for this problem. I was on steroids daily for almost a year, then was given the all-clear by my endocrinologist this April. I stopped taking the steroids as recommended by my doctor, but unfortunately, this was not good advice. Based on comparison to the lab work from April through now, it is apparent my adrenal insufficiency never improved.

As for now, I will stay in the hospital and receive steroids/fluids until I am healthy enough to go home. I am still recovering from surgery, too, so I will be resting a lot.

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