Is it AI or just electrolytes? Or thyroid? Or an infection?

Well, durn-it-all, I had to take an extra 5 mg of hydrocortisone again tonight. That's twice this week, and actually three times if I count last Sunday when I was flying across the country coming home. I'm trying so hard to wean off of the hydro but my body just won't let me. I don't know if it's because my pituitary still isn't making enough ACTH after my surgery 18 months ago or if it's cantankerous sometimes. Or is it my adrenal glands? Have they given up the ghost?

Between the nausea, being freezing cold in a 76 degree room, the fatigue, and the headache that comes with it, there was no way around my need for the drug I both love and hate. I fought for years to get rid of the bugger that was causing my body to be overrun with the steroid only now to be dependent on it. But I never want a repeat of a couple of episodes I've had with AI. No way, no how.

So, are my electrolytes off, or do I need more cortisol? And if I do, why? Do I have an infection? That's usually my first indication of an infection, but that's not the only reason I get AI. In fact, I'm still fighting that sinus infection and see my ENT on Wednesday. The last few times other than with sinuses, it's been UTI's. I didn't even know I had them until they got so bad and became Pyelonephritis. You know, it's all relevant and we "Cushies" tend to ignore signs others don't just because we've tolerated so much for so long. It's hard to know when one is sick outside of the endocrine disease itself.

I know, I know...time to go get some blood work done. I've been putting it off for too long. I spent the week with my daughters this past week, so really need to get on the ball and go. But, I can't go in the morning. Since I have to have the serum cortisol and ACTH done at 8 a.m. and I'm supposed to withhold my hydrocortisone for 24 hours prior...well....I blew that.

I know that my pituitary has quit making a lot of things, but the tumor did that. Surely it will make ACTH again. I hope it will, but yet, I'm afraid it will, too. The chance of a recurrence within 5 years is high, and since my tumor went into my cavernous sinus and had to be scraped off the wall there, just one cell can cause it to regrow. Most of the time I don't think about that, but every now and again....like tonight....I do.

Why would my pituitary start making ACTH and not the GH or TSH I need? Oh, I've read all the research and supposition that goes with a pituitary tumor and the hormones it affects. But think about it. The pituitary has a posterior and anterior section. It also leads into the hypothalamus. The anterior section is responsible for the majority of the hormones, and those are the hormones I'm missing. All of them. TSH, GH, FSH, LH, etc. So, why would I not produce them but still produce ACTH? Yeah, you see why I'd worry if I did produce enough ACTH? Why won't I produce all the other ones?

Oh, I know, as we get older there are a lot of other things that happen in our bodies that cause the GH and estrogen to fall. And I know there are feedback mechanisms that fail, too. In fact, the hypothalamus directs a lot of the action with the anterior pituitary, including GH production.

The hypothalamus is a very small portion of the brain, but wow, is it ever busy! I'll have to do a piece on it sometime. In fact, there is some new research involving the hypothalamus and obesity. It's very interesting. If the hypothalums is damaged, a lot of the hormone production of the body goes haywire or stops. You can read more about it in Testing 101: An introduction. So, is my hypothalamus damaged? Ok, y'all....I know some of you are saying "she's dain bramaged for sure!" ;) Yeah, yeah.... I'm just curious!

So, I'm still cold, my nausea has abated to a tolerable level, and my headache is tolerable, too. Maybe I can sleep again. At least my polar fleece blanket will feel good tonight!