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A Moment of Adrenal Insufficiency

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Lethargy Struck Yesterday

It happened a little differently yesterday. After breakfast, I started feeling extremely lethargic. Instead of doing anything, I just sat on the couch staring at the wall … at the television which was off … at my feet. At one point, when Martine came into the room, I told her I was suffering another adrenal episode, meaning that I was not getting any adrenaline.

Usually when that happens, my digestive system goes out of whack with explosive vomiting and diarrhea. Followed by blacking out. Not this time. Fortunately.

I knew what to do. I was able to stand up and walk to the kitchen, where my 10 mg Hydrocortisone HCL pills were stored. I took three tabs with cold water and returned to the living room couch.

After several hours of s-l-o-w-l-y diminishing lethargy, I got all better. But I took it slowly. There’s no way of rushing the cure.

Because I have no pituitary gland, there are times when my body is just not getting the adreno-cortico-tropic hormone (ACTH) it needs. In the past, I was usually admitted to the emergency room when this happened, and I had to hang out there for several days while the cardiologists who usually run the ER tried to puzzle out what I had and how it affected their specialty. (It doesn’t really.)

This morning I felt good so I went downtown and attended the Thursday Mindful Meditation session at the Central Library. After, I went across the street and had a big bowl of pho at the Downtown LA Pho Restaurant. I was back to normal.

In the Hospital Again

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UCLA Santa Monica Medical Center

Ye gods, not again! On Sunday during the hour of the wolf (around 4 AM), my digestive system spewed waste with great force. While still in bed, I projectile vomited with such velocity that nothing within an eight foot radius was left unmarred by my effluvia. This was followed up what the doctors at UCLA Santa Monica Medical Center referred to in my discharge papers as “acute weakness.” It was more than weakness: I was too lethargic to get out of bed.

Unaffected was my brain function. Martine wanted to call an ambulance to take me to the hospital. I demurred. Then she called my brother in Palm Desert and got him into the act. At that point, I finally agreed. Martine cleaned me up as best she could. In no time at all, the Los Angeles Fire Department was there hoisting me up and strapping me in a device that took me down the apartment steps to the waiting ambulance that stood there with its lights flashing.

I asked to go to the UCLA Ronald Reagan Medical Center. Apparently, their emergency room was filled to capacity with the usual weekend accidents. Fortunately, there was an opening at the UCLA-owned Santa Monica Medical Center. If I were to go to a non-UCLA-affiliated emergency room, I would be poked, prodded, and tested for days for the simple reason that few if any hospitals could afford to keep an endocrinologist on hand at all hours. Probably not even Bellevue in New York or the Mayo Clinic in Rochester, Minnesota!

So, what happened? I am no longer possessed of a working pituitary gland in the center of my head (due to a benign tumor I had roughly between 1956 and 1966). No pituitary gland means no signal to my glands to produce hormones. So, no hormones at all—zilch. That means no thyroid, no testosterone, and—most important—no adrenaline.

Sometime in the early morning hours of Sunday, my body made a request for adrenaline due to something I ate. When it did not respond to that request, my body basically shut down. Fortunately, I was conscious the times I wasn’t snoozing.

And so what did they do at the hospital to make me better? Not a damned thing. Before the paramedics came, I asked Martine for a glass of water and five 10mg tabs of Hydrocortisone, which I was able to ingest. I was still weak for several hours, but that’s what made me feel able to get up and walk.

What the hospital staff did do was X-Ray me, start an IV, and take my vital signs. Fortunately, the hospital had access to previous hospital admissions which gave my medical history. When they finished poking and prodding me, they discharged me. Scram, Buddy, we need your space for other patients. So they called Martine, who was having back pains from having to clean the mess I made; and she grabbed my car keys and picked me up.

In the end, I wonder whether I should have gone to the hospital at all. I decided to mainly because Martine and my brother were bummed out by my condition. I’ll have to talk to my doctor about this when I see her.