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-   -   Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ work? (https://www.healthboards.com/boards/addisons-disease/601003-adrenal-insufficiency-severe-enough-warrant-short-term-disability-leave-work.html)

TheAntiEndo 05-06-2008 06:16 PM

Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ work?
 
Should I even try to get my Endo (who still isn't convinced I have an AI problem and wants to re-run my ACTH Stim test) to approve a request for Short-Term Disability leave at work, or would he just pat me on the head and tell me to exercise?
:confused: / :( / :confused:

Is it best to let work know about your problem, and how it is influencing my problems with coming in late in the mornings, or would that just complicate things? Sould I push for Flex-Time via the Americans with Disabilities Act, or would that just make things worse?

Cat2008 05-07-2008 05:04 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
[QUOTE=TheAntiEndo;3559637]Should I even try to get my Endo (who still isn't convinced I have an AI problem and wants to re-run my ACTH Stim test) to approve a request for Short-Term Disability leave at work, or would he just pat me on the head and tell me to exercise?
:confused: / :( / :confused:

Is it best to let work know about your problem, and how it is influencing my problems with coming in late in the mornings, or would that just complicate things? Sould I push for Flex-Time via the Americans with Disabilities Act, or would that just make things worse?[/QUOTE]

Hi, I was wondering why you have problems getting in to work late in the mornings and why do you need disability leave? is it for time off for hospital appointments? I would post a better reply to your message however I wanted to get a beeter understanding hence my two questions.

TheAntiEndo 05-07-2008 06:28 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
Ok, here is my symptom list:
[LIST][*]Difficulty handling daily or excessive stress[*]General feeling of weakness and being tired[*]Taking longer then previously to get over illness or heal[*]Rarely feel rested in the morning after 7 hours sleep, (getting out of bed in the morning is frequently a Hurculean task)[*]Panic attacks / hyperventilation / heart palpitations / feeling like someone is standing on my chest during times of great sudden stress[*]Inability to exercize or perform strenuous physical activity without it making me much weaker for a day or more (used to run Cross Country / Track in High School, but something suddenly changed where I couldn't breathe during my normal running pace and it's never been same since)[*]Symptoms frequenty get worse around 3:00p-4:00p[*]Frequent problems with mind wandering / excessive daydreaming / feeling drowsy if reading, driving, or being mentally inactive for over 20 minutes[*]Problems with focus, short-term memory, concentration, etc, (even though my IQ has been clocked in the low 150's)[*]Frequent bouts of depression and hopelessness[*]Recent labido issues and low-to-no motivation or drive[*]Don't enjoy things or activities I used to enjoy[*]Impared social skills and awareness, emotional distress in most social activities, little / no social life or friends[*]Mild psychotic episodes (usually goes along with the depression / hopelessness where I can't find a way out and it all comes caving in, but there are no physical outbursts and I still have a pretty good grip on reality)[*]Work performance has gone down the drain. Basically, I'm in "Zombie" mode most of the time where my body is there, but I'm next to useless[*]Occasional headaches, or light-headedness / dizziness (sometimes when still just sitting down)[*]Unable to finish college because of a learning disability probably related to all of the above[/LIST]
Basically, I'm dead in the mornings. My head feels like it's full of Jell-o, and my body usually overrides my need to get out of bed. We need to get my daughter off to school in the morning, but my wife has both Lyme Disease and (under treated) Hypothyroidism, so it's pretty much up to me to get the family going in the mornings. (If I don't wake up early to get my wife her pain meds, she's not able to get out of bed).

There are occasionally days where I'm clear headed and semi able to function, but I spend those days mainly wondering at what time of the day it will all come back. We have yet to find any rhyme or reason for the temporary remission or the up/downs, (and it doesn't fit Bi-Polar I, II, or Rapid-Cycling).

I have no stamina, drive, career sense, and during times of stress or challenge I "lose it" and have panic attacks instead of "stepping up". Motivation at work/home is basically gone, because it doesn't matter how much I may happen to succeed it won't change my health, so why use more of my dwindling energy stores trying?

It's been like this as long as I can remember, but recently with both my Daughter and Son starting to show signs of the same social / emotional / mental markers I did when I was a kid. I now have to deal with the stress of knowing they'll probably end up the same way when they hit adulthood, on top of dealing with my health and my wife's disability, (and the strain our relationship takes from all the stress).

No smoking / no alcohol / no drugs / no coffee or caffinated drinks / no credit-card debt / no console video games / no unhealthy obsessions, and we try to eat healthy home cooked meals with very few fast-food trips, (and even then we only order small portions - no combos or Happy Meals). I am probably too inactive, but anytime I try to exercise I just end up almost fainting from anything over a gentle pace, and I feel weak for the next day or two, (and my GP still insists the answer is that I need to exercise more). :(

I have an abnormal ACTH Stim test (more then doubled but still under 20), flattened Cortisol daily rhythm, and elevated ACTH vs. Cortisol, as well as Low T, Low FSH, Low LH, and Thyroid results that look like something is blocking my T3 from being absorbed, (but still in the normal range, and not HypoT or HyperT). I also have abnormal Pregnenolone, DHEA-s, and IGF-1, so my Endo is confused and convinced that my labs are flukes and probably thinks it's all in my head. (I frequently see a Shrink w/ the wife, and he's yet to tell me I'm crazy, so I doubt it's all cognative based especially since my kids, Father, and some siblings show similar mental traits).

So, does that sound like something that would need some leave to seek treatment and keep it all from crashing down?

Cat2008 05-07-2008 06:52 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
Hi,
The reason I ask is because I have APECED which is a collection of endocrine disorders and so I have Addison's Disease, Hypothyroidism, Hypoparathyroidism, thin bones, Diabetes - low blood sugar, enamel dysplasia, candidiasis, and nail dystrophy.

I am 33yrs old and got Addison's Disease when I was 11years old. I live by myself, with my two children aged 11yrs and 4years and work full time in a very stressful job. I can't do much sports however I find swimming is very benficial and stress relieveing.

What medication/dosage are you on because this would impact upon how you feel - palpatations and lethargy. Addison's Disease is not curable however with the correct medication you can lead a relatively normal and healthy life. I have a positive outlook as a result because what is the point in dwelling on things that won't go away. I don't smoke either, I drink socially, eat healthily and I too have credit card bills and a hefty mortgage however it is this that motivates me to go to work and do things because they won't go away.

I have had about 10 Adrenal Crisis and have ended up in the emergency department however I have always recovered.

I do think it is to do with the doses and medication yoou are on. If you got this sorted I'm sure you would feel alot better. I'm not a medical person however can speak from my own experience.

TheAntiEndo 05-07-2008 07:21 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
At this point, I'm basically on nothing, and want to stay that way until we figure things out. I had previously been on anti-depressants and ADHD stims, but after years of having my brain/body locked in a constant tug-of-war, I finally decided to go off everything "cold turkey" style about this time last year.

I don't want to muddy up the waters with supplements, since my Endo already suspects I'm taking / doing something to get strange results that don't perfectly fit Primary Adrenal Insufficiency but do point to some problem with Cortisol production, (yet high DHEAs - still trying to figure out that one out).

I did just recently start taking some Iron (Feosol x 2) since I have low Ferritin from donating blood too often and all the blood tests from the last few months.

Cat2008 05-07-2008 07:40 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
Hi,

There is a cortisol test which is very thorough. I had it done last year as I was on too high a dose of hydrocortisone. I basically went into hospital for the day, they take a blood test to measure the level of cortisol in your body first thing in the morning. They then take blood at regular intervals thoughout the day to measure the levels over 8 hours.

When my adrenal gland was on its way out I was still producing cortisol and so the results were confusing as they did not indicate Addison's Disease. I was at school at the time and felt very tired all the time and just walking up a flight of stairs made me out of breath and tired. I felt drained all the time, I could not get out of bed in the morning and felt very down.

It was not until I was nearly at death's door that they reaised it was my Adrenal gland and so gave me hydrocortisone and fludrocortisone and I was so much better. Hydrocorisone is a replacement for cortisol which the body produces and so it would not do you any harm if your Endo prescribed this. It does sound like your adrenal gland is on its way out however is still producing some cortisol.

TheAntiEndo 05-07-2008 07:53 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
How was you DHEA(s), Cortisol, and Aldosterone while you were "on the way out"?

DHEA(s) - 461 (110-370) - 135% of range
Aldosterone - 7.4 (4.0-31.0) - 13% of range
Costisol - 8.8 (4.0-22) - 25% of range
ACTH - 69 (7-50) - 144% of range

I would think that if everything is going ka-put, that my DHEA(s) wouldn't be so high, (or is that diagnostic of another problem)?

Cat2008 05-07-2008 08:07 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
Hi,

I would have to look back in my notes because I was only 11 at the time but I do know that my cortisol level was the lower range of normal.

They did countless tests on me because they could not understand what was wrong with me when the tests came back within the normal range.

DHEA is not a big thing over here, I know you can buy it in the States and New Zealand where I have a friend who has the same condition as me. It is not available to buy here however you can get it on the Internet.

I know that your levels of DHEA should decrease with age and so they did do some trials on giving it to people with Addisons Disease to see if it was of any benefit. I don't take it because I felt no different being on it.

It's worth going on *********** and typing in something like +endocrine +increased levels of DHEA, I did alot of research into my condition on the web as it is very rare and not mentioned in many medical books.

TheAntiEndo 05-07-2008 08:15 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
Does your condition have a genetic or congenital component, or is it completely random? Based on my family on my Dad's side, it looks like we are looking for something genetic or something that carries a pre-disposition for certain problems.

Also, what are some of the other markers they used to verify your condition? Anything to keep an eye on from a CBC, CMP, Minerals, Cholesterol, Vitamins, Calcium, etc?

(BTW - DHEA does come in supplement form, but it is also a precursor to the Androgens in the Steroid synthesis pathways; it is what the body converts to make Testosterone and Estrogens)

TheAntiEndo 05-07-2008 08:21 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
But, back to my original question - is Adrenal Insuffiency generally considered a condition that could qualify for Short-Term Disability leave?

Cat2008 05-07-2008 08:31 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
Hi,

My condition is genetic (autosomal recessive) which means that both parents have to have the same defective gene in order to pass it on and this is extremely rare. If they have children usually one child will get the condition full-blown and the other children will just be carriers and be perfectly healthy. The condition cannot be passed on unless they meet someone with the same defective gene which as mentioned is very very rare!

I was born health and did not show any signs of my first endocrine disorder until I was 3years old. I suffered from mal-aborption and could not tolerate milk or fatty foods and so I was on a strict diet. I lost alot of weight and it was not until nerous repeated tests that they discovered I was not producing calcium and so I was diagnosed with Hypoparathyroidism.

I then went on to get Addison's disease when I was 11yrs old and when I was 21years old after having my daughter my thyroid packed up although it does partially work and so I don't take a high dose of thyroxin.

I have always had bad nails....bumpy with slight ridges and they never grow really long because they break. Also, when I was younger and still now from time to time I get candidiasis in my mouth on the inside of my lips and roof of my mouth. Also, when I was younger the corners of my mouth would split.

It was not until I was 19years of age that I was referred to a professor of tropical disease because of my mouth and she was fascinated and sook photographs of my nails etc. she researched this and discovered some Finnish Literature and told me the name of my condition. Most cases are in Finland and so it was originally thought to be linked to the Finnish Gene however there are cases in the US, New Zealand and Iran as far as I know from my research.

The initial symptoms are the candidiasis and the nails, also 4 of my back teeth have malformed enamel and this is also linked to the condition. Its actually called Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy and it is genetic as mentioned. There are up to 7 endocrine illnesses which you can get if you have this condition however most people usually just get 2 illnesses. I on the other hand have a few more.

People usually get Addisons Disease and Hypoparathyroidism and so it is good to have your adjusted calcium levels checked. The ideal level should be about 2.2. I have mine checkedd when I

Cat2008 05-07-2008 08:32 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
Hi,

My condition is genetic (autosomal recessive) which means that both parents have to have the same defective gene in order to pass it on and this is extremely rare. If they have children usually one child will get the condition full-blown and the other children will just be carriers and be perfectly healthy. The condition cannot be passed on unless they meet someone with the same defective gene which as mentioned is very very rare!

I was born health and did not show any signs of my first endocrine disorder until I was 3years old. I suffered from mal-aborption and could not tolerate milk or fatty foods and so I was on a strict diet. I lost alot of weight and it was not until nerous repeated tests that they discovered I was not producing calcium and so I was diagnosed with Hypoparathyroidism.

I then went on to get Addison's disease when I was 11yrs old and when I was 21years old after having my daughter my thyroid packed up although it does partially work and so I don't take a high dose of thyroxin.

I have always had bad nails....bumpy with slight ridges and they never grow really long because they break. Also, when I was younger and still now from time to time I get candidiasis in my mouth on the inside of my lips and roof of my mouth. Also, when I was younger the corners of my mouth would split.

It was not until I was 19years of age that I was referred to a professor of tropical disease because of my mouth and she was fascinated and sook photographs of my nails etc. she researched this and discovered some Finnish Literature and told me the name of my condition. Most cases are in Finland and so it was originally thought to be linked to the Finnish Gene however there are cases in the US, New Zealand and Iran as far as I know from my research.

The initial symptoms are the candidiasis and the nails, also 4 of my back teeth have malformed enamel and this is also linked to the condition. Its actually called Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy and it is genetic as mentioned. There are up to 7 endocrine illnesses which you can get if you have this condition however most people usually just get 2 illnesses. I on the other hand have a few more.

People usually get Addisons Disease and Hypoparathyroidism and so it is good to have your adjusted calcium levels checked. The ideal level should be about 2.2. I have mine checked when I feel it is too high or too low so I know whether to take more or less calcitriol. I'm used to the symtoms and so no what to expect.

rumpled 05-07-2008 09:03 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
I have long term disability based on it. But my adrenals were removed and I have other hormonal issues (panyhypopituitary). I know of some people that have disability based on addison's. Some people are very stable - some are not.

Cat2008 05-07-2008 09:14 AM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
[QUOTE=TheAntiEndo;3560277]But, back to my original question - is Adrenal Insuffiency generally considered a condition that could qualify for Short-Term Disability leave?[/QUOTE]

It could qualify. When I get ill - like the flu for example if you have Addison's Disease you tend to have it for longer than a healthy person and you have to take extra steroids and then gradually get back to your normal dose once you are recovered.

As mentioned I only have time off from work now for appointments or if I am ill, I do not have time off for having Addison's Disease however your employment law might be different in the States.

My Addison's Disease was not stable for a long time until I was referred to this new specialist and he monitored my cortisol levels throughout the day and as a result cut my hydrocortisone down from 30mg a day to just 15mg per day and I have never felt better.

Once you find the right dose (if you were on steroids) and maintain this you can lead a normal life which is what I have managed to do after all this time.

I have had adrenal crisis and needed the IV injection but I have recovered every time and gone back to normal.

anna1970 05-07-2008 08:53 PM

Re: Is Adrenal Insufficiency severe enough to warrant Short-Term Disability leave @ w
 
[QUOTE=TheAntiEndo;3560277]But, back to my original question - is Adrenal Insuffiency generally considered a condition that could qualify for Short-Term Disability leave?[/QUOTE]
I was off for two weeks for short-term disability after I was diagnosed because I had missed so much work in the mornings before the diagnosis. It depends on your employer. It qualified me based on what my doctor submitted to my supervisor. I'm feeling better on my meds now so I was able to go back to work full-time. But, my employer knows that if I have trouble, I may have to take some more time off. But I'm fine for now. I would talk with your employer. What is your doctor saying?


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