I have previously mentioned my two greatest fears when it comes to living with Adrenal Insufficiency. These include the following adrenal crisis scenarios:
4. The doctor and the staff Okay Clearly Alive Family, this is where the stories no longer parallel. This marks the difference between my 2013 crash and my 2019 crash. This one critical point drastically changed the outcome. And for that, I am thankful.As I went to turn in the insurance forms, I realized that I was about to crash and it was not going to be pretty. The last thing I did before I fell down was call my mom, place her on speaker phone, and throw the phone onto the counter. I knew I was about to lose my ability to speak, reason, and most importantly, advocate.To the outside world, it would appear that I was throwing a temper tantrum mixed with an anxiety attack. To those familiar with my disease, they would recognize my body systematically shutting down.My mom was already aware that I was feeling unwell, as I had been in contact with her throughout the day. She immediately began to advocate for me, as I could not speak for myself. The next moments are incredibly fuzzy in my memory. I do know that I was escorted out of the waiting room and into a back room. I was also surrounded by several staff and eventually the endodontist.
5. The doctor I am quite proud of my emergency injection kit. It has everything that a person could possibly need. This includes several vials of the act-o-vial solu-cortef, multiple intramuscular needles, ample alcohol swabs, band-aides, and even instructions on how to inject.But that kit is absolutely worthless if it is not on me.In an emergency, I need the solu-cortef injection. The act-o-vial is much easier because all there is no measuring required. In a pinch, the powder plus sterile water works. You just have to measure out the sterile water. By the Grace of God, I had my emergency cortisol pump kit. This kit contains everything necessary to perform two site changes. It has sterile water, solu-cortef powder, and several infusion kits. It does not contain intramuscular needles.The endodontist repeated how he was unfamiliar with my medicine. Initially, he did not want to inject me. But between my urging and my mom’s urging he revised his stance. He mixed up 2ml of sterile water with the powder. There was a bit of a hunt for needles. I think they ended up using one of the needles that normally numbs patients for dental procedures.He injected my life saving medicine into the muscle in my arm. Almost immediately, I felt the relief. His actions halted the spiral towards an adrenal crisis further.
6. The EMTs were The office staff still called an ambulance for me. When the EMT’s arrived, there was an unexpected surprise.“So just to let you know, I’ve actually rescued you before.”“Ha. Really? Ok, was it town home or apartment?”“Well town home. But I was also the EMT that picked you up from the tarmac. When they radioed in female, Addisonian I thought to myself, ‘That can’t be the same girl! She doesn’t live over on this side of town.’ And yet, it was you!”“Yeah… I was here for a dental appointment. I didn’t even get to the appointment part. I crashed before.”To be honest, I was embarrassed that this particular EMT has rescued me by way of ambulance now three times. But I also took comfort in she remembered me, learned more about my disease, and was willing to advocate for me once I reached the ER. It was such a different experience than six years ago.
7. The ER staff was I did have to wait about two hours after triage before being seen due to the busyness of the ER. But I did not mind the wait. I knew the emergency injection delivered by the endodontist stopped the spiral towards full crisis.Once in a room, I had the standard blood work with IV fluids shortly following. I also received a few doses of an antibiotic as a preventative measure.
- Beginning to crash towards an Adrenal Crisis in a place where no one knows me.
- Beginning to crash towards an Adrenal Crisis while flying on an airplane.
An Adrenal Crisis while Flying on an AirplaneI crashed towards an Adrenal Crisis while flying on an airplane for the first time on June 17th, 2014. I was on a flight from South Korea to Malaysia flying over open water. The event culminated in me receiving additional cortisol and IV fluids in an international airport upon landing.
I survived.The second time I crashed towards an Adrenal Crisis while flying on an airplane happened on June 25th, 2018. I was returning home from a brief layover in Chicago. This particular episode culminated in me receiving 100 mg of solu-cortef from a Good Samaritan in the terminal, an additional 125 mg of solu-medrol from the EMT in an ambulance on the tarmac, and an additional 100 mg of solu-cortef and seven liters of fluids while in the emergency room.
I survived.One of my biggest fears I have already survived, not once but twice.
An Adrenal Crisis in an Unknown LocationThe first time I crashed in an unknown location, it inspired the Nightmare blog post. For several years after this incident, my family and I struggled to come to terms with that horrible ordeal. Yes, I was alive after that episode. But it left semi-permanent scars in terms of PTSD and an increased anxiety in normal, everyday situations. Through therapy, targeted coping strategies, and time, my day to day struggles with the nightmare have reduced dramatically. For that, I am thankful.But what caused it? What made it so bad?
A Perfect StormPart of what made the original nightmare so terrifying was everything that could go wrong did seem to go wrong. It was a compounding of events.
- I was already feeling unwell that morning and knew something was “off.”
- I had already seen another doctor.
- This was the first time the new doctor and the staff met me.
- The doctor and staff refused to listen to my mom.
- The doctor did not want to take responsibility for my care.
- The EMT’s were unfamiliar with Adrenal Insufficiency and refused to take action.
- The ER staff was unfamiliar with Adrenal Insufficiency and delayed treatment.