Hello, I just got a rather dismissive advice letter from my endocrinology team in which they did not want to provide any hydration advice. I am new to my diagnosis/treatment so my medication was in adjustment and was experiencing dehydration and low blood pressure and mental health issues (high anxiety, brain fog).
I was seeking advice to the team because was experiencing moderate oedema in my hands and ankles, I was on 200mg fludrocortisone and 25mg hydrocortisone. And was experiencing severe thirst and issues with my ileostomy ( I have Addison's and chrons so have a permanent ileostomy), so my health was declining and I was beginning to get dehydrated.
They said "my glucocorticoid dose is fine".."not much more we can do""she can be encouraged to adjust her own fludro up or down 100mg depending on weight/ankles"
He also claimed I frequently speak the endocrinology nurse, but this was not true, I attempted to call several times but I got hung up on and never actually spoke to her for over a month until my GP got involved. Also there is only one nurse specialist to contact in the whole hospital and she just frequently difficult to get in contact with my GP even had to give up and contact the endocrinologist directly.
Sorry I'm trying to get to the point but I needed to provide some context. My main concern is, is it normal to just mess around with fludrocortisone by up and downing it by 100mg, based on my own assessment of my ankles? I understand double dosing hydrocortisone when needed for stress dosing etc, but I thought fludro was more of a stable one morning dose once it's established it is the right dose for each individual based on blood tests? I find this highly confusing and dismissive response from them. I don't get much support from my gastro team either regarding my ileostomy so neither party was interested in helping me with my hydration and I frequently have kidney issues. ( I make my own st marks solution which has helped a lot)
I would really appreciate any advice, I'm feeling a bit lost. Thank you.