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  • Friend Diagnosed with addisons...blood pressure is sky rocketing!!

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    Old 04-22-2005, 06:30 PM   #1
    concernedfrnd
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    Exclamation Friend Diagnosed with addisons...blood pressure is sky rocketing!!

    Hi all,

    I'm very concerned about my friend...she has been in the hospital since tuesday night...they have diagnosed her with addisons disease....but another problem is that her blood pressure has been very high! especially when she stands or sits up.....they said this is weird because people with addisons sometimes have low blood pressure when they stand up but not high...so now they are saying that she may have Pheochromocytoma also....and they believe that the addison had come about from taking megestrol a pill she has to take to keep away uterine cancer.....im just so frustrated shes sitting in the hospital and they are trying to lower her blood pressure but its just not responding to the meds....they have started her on cortisol also.....but she seems to be feeling worse....i would love to hear anyones input on this and would love to hear from anyone....im really trying to stay all together here....and not to break down...she is my best friend and i hate to see her this way....
    Thanks ahead of time for any comments or advice...
    Kelley

     
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    Old 04-25-2005, 05:23 PM   #2
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    Re: Friend Diagnosed with addisons...blood pressure is sky rocketing!!

    Hi Kelley,
    I'm sorry to hear about your friend. How is she doing currently?

    I would think that they are considering both a pheochromocytoma (overproduction of catecholamines) and elevated aldosterone levels as possible causes of her high blood pressure. They could be each caused by different types of tumors on her adrenal gland. Has she had any imaging t confirm the presence of a mass on an adrenal? I would imagine the aldosterone levels could be measured with a blood test, while the pheos are confirmed with urine tests (another test is called the plasma free metanephrine test). Usually young people with sudden onset of such uncontrollable high blood pressure do have some underlying reason for it.

    I hope they have found out lots of information since she arrived at the hospital. If they haven't already, make sure they involve an endocrinologist in her care to help find the culprit.

    Good Luck and best wishes to you both,
    Sadie

     
    Old 04-25-2005, 09:08 PM   #3
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    Re: Friend Diagnosed with addisons...blood pressure is sky rocketing!!

    Hi Sadie,
    They have told her she has adrenal insufficiency and think she may have other problems (endocrine)....they are not really sure....one doctor says one thing and the another says something else....they got her blood pressure somewhat controlled its 165/80 but when she sits it gets higher , and when she stands it gets even higher....but they have her on three bp medicines to try and control it....

    They did alot of blood work her cortisol level was 1.5 which they said normal was 5, her white blood count is high, hgb is high, hct is high, plt is high, mpv is low, magnesium is high, pottasium is low, glucose is somewhat high, free t4 is high....

    they also did the 24 hour urine analysis and it came back normal except for having the white blood count at 1+, positive nitrate in urine, epithelial 2+...

    She also had a ct of the abdomen and they said from what they can see (she is a heavy girl at 432) they dont see any tumor...but im not sure its accurate because of her weight?

    the dr's are all confused....they have released her yesterday and she is still feeling really bad....the reason they released her is because they dont have an endo on staff at their hospital and told her they couldnt do anything else for her....she can barely walk to the bathroom with out feeling worse....but she has an appointment wed with her gp so she can get a referal to an endo....

    they put her on 8 different meds when she left the hospital including the three bp meds , prednisone, glucophage, something for tremors, etc...shes also on megace (megestrol) its a medicine for her endometrial hyperplasia that she has to take so she doesnt get uterine cancer...and they told her this might be one of the reasons she has low cortisol...but they said they are not sure she needs to see the endo....
    So i guess we wait till the appointment....im just very worried that she will get worse ....she started having heart palpatations in the hospital and the dr's and nurses looked at her like she was nuts for everything....

    Thank you for your caring words and advice....
    Kelley

     
    Old 04-25-2005, 10:54 PM   #4
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    Re: Friend Diagnosed with addisons...blood pressure is sky rocketing!!

    Hi Kelley,
    Wow! You have kept a close eye on your friend and her blood work. I didn't know anything about the drug she was on, so I looked it up. The list below is from an NIH website for Megestrol. And Good Lord-she is FAR from nuts-she has some big issues going on here. I am glad she is hopefully going to be able to see an endo soon-she needs a professional opinion about all of this from someone in the know.


    Side effects
    Although side effects from megestrol are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

    increased appetite and weight gain
    swelling of the hands, feet, or lower legs
    increased sugar level in the blood
    headache
    breast tenderness
    impotence
    decreased sexual desire
    increase in blood pressure
    If you experience any of the following symptoms, call your doctor immediately:

    nausea or vomiting
    dizziness
    weakness
    leg pain
    breathing discomfort
    unusual bleeding or bruising
    rapid heartbeat
    chest pain
    cough
    sore throat
    weakness or numbness of an arm or leg
    sharp, crushing chest pain or heaviness in chest
    sudden shortness of breath
    severe mental depression
    unusual bruising or bleeding

    I see quite a few of her issues on these lists. I hope they are able to offer her another medication option besides this one for her EH. I don't know much about the disease but with her weight, I would worry about increased risks associated with this medication.

    I would have her ask her GP to switch her from the prednisone to cortef (natural hydrocortisone). It has a much shorter half life and is easier to titrate to the right dose in most and has fewer side effects. She will have an easier time weaning from it and testing current adrenal function while on cortef--hopefully it is temporary Addison's.

    Have they placed her on an antibiotic for her likely bladder infection? I would imagine that her immune system is poor with Addison's and diabetes issues (sugar in the urine makes bacteria very happy). The last thing she needs is a kidney issue on top of everything else. I'm glad they addressed the blood sugar issues. Her T4 is high? Could she have hyperthyroidism? That (as well as this drug) can cause palpitations. In fact, low potassium and Addison's, as well as blood pressure issues can all cause them.

    I'm so sorry. Please tell your friend to be brave-hopefully answers are on their way. I really hope a doctor can help get her off the megestrol-it certainly isn't worth all these health risks and illness. Thank you for taking such careful and loving care of your friend, she is lucky to have someone so special to help her thru this nightmare.

    Keep us posted.

    Sadie

    Last edited by sadie-mae; 04-25-2005 at 10:54 PM.

     
    Old 04-26-2005, 06:03 AM   #5
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    Re: Friend Diagnosed with addisons...blood pressure is sky rocketing!!

    I would persue the thyroid thing more actively too - high FT4 can signal hyperthyroidism which can be very dangerous.

    Hyperthyroidism side effects:
    Palpitations
    heat intolerance
    nervousness
    insomnia
    breathlessness
    increased bowel movements
    light/absent menstural periods
    fatigue
    fast heart rate
    trembling hands
    weight loss
    muscle weakness
    warm moist skin
    hair loss
    staring gaze

    Not all have to be present, so eventhough she is heavy, it could still be a possibility.

    Good luck..

    Last edited by irys; 04-26-2005 at 06:04 AM.

     
    Old 04-26-2005, 09:59 AM   #6
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    Re: Friend Diagnosed with addisons...blood pressure is sky rocketing!!

    Thank you again for your caring posts,
    She has an appointment tomorrow with her gp and im going to take the results of the tests they did with us....and hopefully she can get an endo appointment really soon....im really worried about her....she looked at the list of the side affects from the megestrol and has quite a few of them....and the list for the hyperthyroidism...she has all but two on there..so i think we are looking at several different issues....i will let you two know whats going on after the dr's appointment tomorrow....
    Again thank you so much....it helps to talk to people about everything....
    Kelley

     
    Old 04-26-2005, 08:36 PM   #7
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    Re: Friend Diagnosed with addisons...blood pressure is sky rocketing!!

    Good Luck to you both and keep us updated. I hope she finds relief soon,

    sadie

     
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