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Some just weights just don’t balance…

November 9, 2007

It was a fruitful morning for simple answers still fraught with thoughtful considerations ahead.

I saw the doctor at 9:30 and he took several vials of blood. This was not my own doctor, but one seeing his patients today. He was confident and instilled me with confidence, and I was as comfortable with him as I am with my own doctor. Swedish really is a fantastic group.

Nevertheless, I was still very anxious, as I had been all night. My blood pressure, normally reading a respectable Addisonian 100/60, was 140/86. They have an onsite lab and he ran my samples stat, assuring me he’d call me with the results within a couple of hours. He assured me that I was not having a heart attack, and that I did not have congestive heart failure. The night thrumming had convinced me of either, both, or worse.

The heart thrumming and ankle swelling and anxiety all are typical side effects of hydrocortisone and we’re going to try halving my morning dose. That will provide ample protection from Addisonian crisis and shock, but will likely leave me with more symptoms, especially the fatigue. And I might still experience side effects on the reduced dose; I might even develop a luna facies. No promises. A lower dose is no guarantee of protection from facial change or huge ankles. I can only ask for the grace to bear what I’m given, and that can’t come from medical science.

Going off the medication entirely was not an option this doctor would or could address; this would be for my regular endocrinologist. The side effects would reverse, but the disease would progress, and shock would always be possible. Some people with Addison’s take hydrocortisone only when they’re crashing, but no one considers this medically responsible. Unmanaged, the disease is debilitating and terminal.

I was home when the doctor called back at noon with the results that all blood values are perfect. Carry on at reduced dose. My prayer is that this will allay the side effects, deter worse ones, and manage my symptoms well.

It’s good to have answers, even if they might leave hard decisions yet ahead. The subtle synergies of autoimmune disease and the medications that treat them don’t always achieve a satisfying balance. This isn’t simple; it’s very disruptive, even of the processes I need for thoughtful consideration.

The endocrine system is a manifestation of God’s sovereignty and power and magnificence and infinitude to as vast an extent as the heavens. If you happen to be assigned a relationship with a lifelong disease in this venue, I can say with confidence that it will keep you very thoughtful.

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