Monday, January 4, 2010

Injury and Addison's




After reading some comments here and on FaceBook, I realized that I was so obsessed with the injury itself that I forgot to mention some really important Addison's stuff.
  • It's a hip injury, it's a stress fracture to the neck of the femur. It's in the femoral neck (see picture above)
  • My awesome ortho made me feel quite confident that this is an OVERUSE injury as opposed to a "fragility issue". By "fragility issue", I believe he meant hormonal imbalance, osteoporosis, etc. I had a DEXA (bone density) scan three years ago and showed him the results which showed good bone density. He did recommend a follow up DEXA scan. My GP tried to get me to have one this last fall but I declined...(cause I'm noncompliant!)
  • This is a common endurance athlete injury. This stress fracture of the femoral neck is most likely not from too many steroids. Many "normal" endurance runners get this injury. (free membership is needed to access this medscape.com article if you're interested in reading it)
  • I have kept my Hydrocortisone the same, 25 mg per day, despite not exercising at all for the last six weeks. The first five weeks I was wrestling with some intense pain, working despite the pain and thyroid problems and I think my steroids were being depleted. I was exhausted. The last week has been full of adjustments like walking around on crutches which is exhausting and taxing to my upper body. I'm still really tired and wanting to go to bed around 5 pm. I don't get in bed until 7 or 8 but I'm wanting to hit the hay around 5.
  • I've even upped my hydrocortisone by 5 to 10 mg when I've been nauseous and cold. Nausea and bone chilling cold are symptoms of low cortisol for me and are usually resolved with 5 or 10 mg of hydrocortisone.
  • I will lower my hydrocortisone when I start falling asleep and waking up at a normal time and when I get my appetite back.
  • I've lowered my florinef from .075 to .025 mcg and reduced my salt consumption. My blood pressure has been high 150/80 for the last month. I think the lack of exercise has reduced my need for florinef and salt. Too bad cause I like the salt and miss it.
  • For those of you who know me or feel like you do, I am really being compliant. I am staying off my leg as much as possible. Of course I'm unable and unwilling to be too sedate so I'm hobbling around on the crutches and getting really sore. My son and husband will be helping me at work. My husband has been picking up a lot of slack for me for weeks now. He's starting to cook! Yay!!
Thanks to everyone for the kind words and prayers. Thanks also to those of you who have offered to hang out with me and watch movies or play games or go to the bar. I really appreciate it!!!




4 comments:

  1. Hi Dusty. So sorry to hear about your injury! I'm very glad to hear the prognosis for a full recovery though. Wishing you all the best and a Happy New Year (even with a broken hip)!

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  2. It's good to hear your injury's unlikely to be due to steroids. With the amount of running you were doing though, I guess an overuse injury is excusable! It's just as well nearly all of your running is offroad.

    I would think that an injury like yours would be swallowing up chunks of cortisol, especially if you're in pain.

    As for me, still feeling miserable. I can't wait to get my glasses, but I'm scared they're not going to fix all my symptoms. My Endo has me on 20mg of Hydro when I wake up, then 10 and 10. 40mg feels so high! I was finding however that I was getting nauseaus during my morning shower on a 10mg morning dose, and that's a sign for me of low cortisol levels I think.

    Two other observations: without all the exercise I'm not getting up at night to use the bathroom, which suggests to me I might need to up my Fludro when I'm running a lot (electrolyte imbalance). Also, I had an unexplained ankle injury a couple of years back. Nothing showed on the scan but I suspect a stress fracture. There's really nothing for it but to rest and be patient. If it hurts to be moving round so much, then stop!!

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  3. Oh, crap, Dusty...but as you said, the very important thing is that it is a regular overuse injury and not disbalance of anything more serious. You may be off cratches sooner than you think. Heal up!

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