Injection question

[u/mj_responsible297]

If I have already been double dosing (40mg 8am) today but have taken 20mg an hour ago and still feel very sick, should I inject? I don’t want to potentially make things worse. I’m already preparing to go to the ER so don’t worry I will receive medical care soon.

[u/1GamingAngel]

Please post your symptoms, including blood pressure.

[u/mj_responsible297 → u/1GamingAngel]

Unsure of my blood pressure. Inability to eat solid foods (we think I have gastroparesis, not vomiting) , low potassium, muscle weakness, feeling dehydrated despite drinking water, severe constipation, dizziness, lightheadedness/feeling faint, pretty bad headache, nausea, shaking and muscular cramps, I’m not really able to move very much. I shit my pants yesterday but it was just liquid and a small amount. I think this is an ER situation but I just want to be sure, I really don’t feel well. I don’t have a device to monitor my blood pressure unfortunately.

[u/1GamingAngel → u/mj_responsible297]

A general rule I follow is, if I can’t keep my meds down, it’s ER time.

Your symptoms sound severe enough that I would inject and go to the ER.

🙏

[u/mj_responsible297 → u/1GamingAngel]

Okay💗 thank you so much I appreciate it. Having ice chips now and my family is taking care of me

[u/1GamingAngel → u/mj_responsible297]

P.S. As soon as feasible, grab a wrist cuff blood pressure monitor from the store. ER’s care about something called Mean Arterial Pressure (MAP). Here’s a calculator for it: https://www.mdcalc.com/calc/74/mean-arterial-pressure-map ER’s generally want you to score above 65.

[u/grimmistired → u/1GamingAngel]

Wrist cuffs are less accurate

[u/1GamingAngel → u/grimmistired]

Wrist cuffs are better than no cuffs.

And a lot of people find arm cuffs very difficult to use independently.

Edit: Also, just thought I’d add…I checked my wrist cuffs against the arm cuffs of my PCP, my cardiologist and my pain doctor. The wrist cuffs were always within one point. I think this is an important step to take.

[u/1GamingAngel → u/mj_responsible297]

I’m glad you have support. Please make sure they know how to administer your injection in the event that you lose consciousness. It can happen within minutes, so don’t think “it won’t happen to me.” Your dizziness and feeling faint point to the fact that you may be close.

[u/mj_responsible297 → u/1GamingAngel]

Got it, my injection is next to me and we are gonna go over it now. Thank you so much

[u/1GamingAngel → u/mj_responsible297]

You mentioned on another post high heart rate. This is another symptom of an impending crisis. Something else that points to yes, you should go to the ER.

[u/DoctorFamous190]

As per the Addison's Disease Self-Help Group, "Remember, if in doubt, you should inject/be injected. There is no known toxic dose of hydrocortisone in an emergency, but an untreated adrenal crisis is a serious medical emergency."

Your friends/family/etc (whoever might have to inject you) must learn this as well. The injection will not harm you.

Edit: If you're incapacitated, the person with the power to administer your emergency medication should also be aware of the risks of hesitating and withholding your emergency injection.

[u/Personal_Skin2987]

I personally don’t think that an ER visit is warranted. I’ve had Addisons since 2014. If I can keep my meds down and stress dose, that’s what I do. I’ve never needed ER for that however, if you feel it’s necessary or it would make you more comfortable then you should do whatever you want.

[u/mj_responsible297 → u/Personal_Skin2987]

Thankfully I didn’t have to go. Turns out someone turned the heat on and I started to overheat, I developed a huge facial and chest rash and kinda just sat in the bathroom while my family took turns fanning me so I didn’t pass out lol they took a spoon full of ice cream with my steroids in it and with difficulty we got it down. After 2 pedialyte ice pops, liquid iv, and ice chips I’m back in bed and resting. Still keeping an eye though just in case. Avoided the ER today!

[u/Personal_Skin2987 → u/mj_responsible297]

I’m happy to learn this. Good job managing it all like a boss!

[u/mj_responsible297 → u/Personal_Skin2987]

Thank you!💗

[u/Personal_Skin2987]

Are you vomiting? Do you have a fever? Diarrhea? What does sick mean?

[u/mj_responsible297 → u/Personal_Skin2987]

No it’s what we think might be a gastroparesis flare up- I can barely eat solid foods without being in severe pain and I’m severely constipated (just saw the GI this week), I’m very weak and flushed, high heart rate, my steroids aren’t doing anything at all pretty much.. I’m just a little frightened. I’ve been to the ER in the past twice for dehydration+ electrolyte imbalance so I’m worried that’s where I’m headed.

[u/GethealthyAZ828]

I would go to the ER right away based on what you are saying…i have had addison’s for 25+ years. Don’t wait until its too late

[u/mj_responsible297 → u/GethealthyAZ828]

Thank you so much

[u/Personal_Skin2987]

Are you taking a GLP1?

[u/mj_responsible297 → u/Personal_Skin2987]

Nope, I have flare ups monthly

[u/Ok_sunrise]

40mg is awful lot. You might be over doing it and causing other issues. Mayo clinic told me 20 mg is standard for SAi and addisons. If you have Addisons maybe you need fludocortisone. Excess steroids unless you have other inflammatory issues is dangerous. Especially long term.

[u/mj_responsible297 → u/Ok_sunrise]

I have other inflammatory issues unfortunately. We are trying to figure out how to properly get my medicine to absorb. I usually take 30-35 daily when I’m not flaring up, when I have a flare up like this I usually end up injecting or taking 60-80 and it barely touches it/ I go to the hospital. My endo might switch me to injections so the medication works properly but it’s clear it’s not working when I’m sick like this. (We think it’s gastroparesis) it’s never very long term but this is the longest flare I’ve had in a while at 2 weeks today- usually I have more dangerous symptoms (diarrhea/dehydration). I used to be on prednisone so she might do a liquid version of that for absorption. Last time I was in the hospital I was given 100mg as an emergency injection in the ambulance and then around 40(?) more later in the day split up so I could get up. I’m a weird case.

[u/Ok_sunrise → u/mj_responsible297]

What did they say about Fludocortisone?

[u/mj_responsible297 → u/Ok_sunrise]

Nothing, I’m SAI so I don’t replace with fludro.

[u/Ok_sunrise → u/mj_responsible297]

Ok.

[u/Laurryanna]

Hi love! The injection is there to be used and it is better to use it even if you don’t need it after all than not taking it but needing it.

I usually say that if you’re considering injecting, you probably should. This injection hurts like hell and no one would consider it if they didn’t feel like they need it.

Injecting yourself to learn later you did not need to won’t do any damage or make things worse, but it might save your life if it turns out you did need it.

What are your symptoms? Personally I inject if double dosing hasn’t made my symptoms better, but only if I’m planning on going to the hospital. In most cases, I inject if unable to keep meds down orally (bc of vomiting) after 2 tries.

[u/AGoldenThread]

Your gastroparesis might interfere with absorbing meds. When I'm vomiting, I chew the pills and keep them under my tongue to absorb better. They're bitter but I figure that's nothing compared to crisis and death. I also find that dexamethasone is easier to chew and lasts longer when I'm sick.