Saturday, August 12, 2017

ICYMI, AFAA: Surviving Heat with Adrenal Insufficiency

In case you missed it, I released a video on how to best manage the heat while living with Adrenal Insufficiency. I cover three main things: water, salt, and fludrocortisone.


Surviving the Heat with Adrenal Insufficiency

Many people with Adrenal Insufficiency inaccurate believe that they cannot live in the heat. I have proven them wrong. I have survived summers in Arizona, Iowa, Florida, Georgia, Texas, and even Malaysia. Before I was diagnosed, summers in Georgia and Texas were especially brutal. I have many memories of playing outside as a young child and then suddenly needing to vomit. We did not understand what was happening.

I survived summers in Arizona as well. I had been diagnosed with Adrenal Insufficiency, however my first endocrinologist never put me on fludrocortisone. That was also miserable. I suffered the most painful muscle cramps imaginable. Through later medical testing, we discovered that I am an extreme salt waster and am slightly resistant to fludrocortisone. This means that I need to take a larger dose of fludrocortisone than most.

I point these out to highlight that without proper treatment, heat does not play nice with adrenal insufficiency. However, there are three simple tips to remember that will make the heat much kinder. You need not fear it.

1. Water

I carry a water bottle everywhere I go. I prefer my water either cold or room temperature, with no ice. By constantly carrying it with me, I am able to sip water throughout the day. If you do not have a water bottle, go out and purchase one that you like.

All of my water bottles must pass the drop test, which means I need to be able to drop it and have it not break. These water bottles have all passed my drop test:
Do you have a favorite water bottle brand? Let me know, and I'll add it to the list!

2. Salt

During the hotter months of the year, you will need to increase your salt intake. I accomplish this by overly salting my food. I carry with me a small Tupperware salt shaker in my purse constantly. But sometimes, merely salting my food is not enough. In the summer months, I supplement more heavily with salt tabs. SaltStick Caps, Electrolyte Replacement Capsules are by far my absolute favorite salt tabs. My body responds better to the buffered electrolytes over just pure salt tabs. I take one of these in the morning, one of them at night, and then I will take two of them at a time for every 30-60 minutes of activity in which I am sweating heavily. You can take up to ten tablets a day, and some days I do get close to that limit.

Salty snacks are also incredibly helpful. I'm a black olive girl, but I know many others who would rather go for pickles. I have found that a can of olive brine is one of the most effective energy drinks out there. If you ever find yourself getting extremely brain foggy during the summer months, reach for a super salty liquid. It is not uncommon for me in the hotter months to consume an entire can of black olives, and then drink the olive brine. That's about 2000 mg of sodium, and I find it very helpful for bringing me out of the dreaded brain fog. Find the salty snack that works for you, and keep it constantly stocked.

Recently, I have discovered cheese crisps. These magical, high protein, high salt, gluten free snacks are amazing! Most snack bars are so incredibly sweet and thus these are a welcomed alternative. I also enjoy Moon Cheese, with my favorite flavor being the Gouda.

Do you have a favorite go to salty snack? Let me know, and I'll add it to the list!

3. Fludrocortisone

I find it necessary to have two different doses of fludrocortisone throughout the year: a summer dose and a winter dose. This will vary depending on where you live. For example, when I lived in Nevada or Washington state, I just needed one dose of fludrocortisone year round. But in Texas, in Florida, in Malaysia, in Iowa, and especially in Arizona, I require two different doses of fludrocortisone with a higher dose in the summer and a lower dose in the winter. I know it is time to bump up my dose of fludrocortisone when I can no longer sleep through the night and must wake up ridiculously early to use the restroom.

My body salt wastes. Increasing the salt alone is not enough. Other symptoms (besides frequent nightly bathroom trips) that you might need an increased dose of fludrocortisone include an increased swelling of the hands or ankles, and an increase in your fatigue levels.

If you live in a location with more extreme summers, discuss an increased summer dose with your doctor. I personally need it. That extra half tab in the summer months allow my blood pressure to remain stable, it keeps my electrolytes in range on blood tests, and it lets me sleep through the night without having to wake up every three to four hours to pee.

Now it is possible to take too much fludrocortisone. Too much fludrocortisone will lead to easier bruising, a more prolonged swelling of the ankles, and potential weight gain due to fluid retention. It is also very important to realize that fludrocortisone does not work in isolation. It does absolutely no good to just increase the medicine without simultaneously increasing both your water intake and your salt intake. All three of these things work together. All fludrocortisone does is help your body retain salt, which helps you retain the fluids, which allows your body to remain hydrated.

Closing Remarks

Surviving summer with adrenal insufficiency can be broken down into three simple tips:
  1. Always make sure you carry water with you and drink it frequently.
  2. Increase your sodium intake through salty snacks, salt tabs, and extra salt on all of your food.
  3. Chat with your doctor if you live in a hotter area and see if you could benefit from an increased dose of fludrocortisone during the summer.
And in full disclosure, there is also a very important fourth tip that I should mention. After walking over a mile to a park, filming the video, and walking over a mile back in the peak of the Texas summer heat, I was extra brain foggy and not feeling particularly well. I corrected with an additional two salt tabs and a little bump dose of HC. Three hours later, I was feeling much better!
    4. Recognize the symptoms and pro-actively follow the advice!
In a future blog post, I'll share how I used these four tips and tricks to enjoy several theme parks in the heat of the summer!

Did we forget anything? Please comment below! 
Have a suggestion for a future topic? Suggest it here!

Medical Disclaimer

All content found on this website, including: text, images, audio, or other formats were created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 

Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

By using this website, you acknowledge and agree to and accept these Terms of Service, including all policies and terms linked to or otherwise referenced herein.

Reliance on any information provided by this website is solely at your own risk.

Saturday, August 5, 2017

ICYMI, AFAA: Stress Management and Chronic Illness

In case you missed it, Action for Adrenal Awareness released our video for the month of July. In it, Heather speaks about stress management and adrenal insufficiency. It is possible to manage stress with adrenal insufficiency. Over the last ten years of Heather helping her mom manage Addison's Disease and extreme anxiety, she has learned a few things about stress management.


Stress Management

At first, it almost seems like an oxymoron to speak on stress management and adrenal insufficiency in the same sentence. From medical research, we know that stress is how the body responds when it thinks that it is in danger. It makes additional hormones that speed up heart rate, increasing breathing, and enable a burst of energy. This is the flight or fight response. However, those stress hormones are the main ones that people living with Adrenal Insufficiency do not make: DHEA, Cortisol, Aldosterone.

So, what does your body do when stressed if the body’s main stress fighting hormone is in short supply? First, if you have adrenal insufficiency, you are taking cortisol. When you experience a very stressful event, such as illness, injury, surgery, psychological, or emotional stress it is imperative that you increase your medicine. Debby has already discussed this in another video.

But if we do not manage the day to day stress, danger awaits in the form of getting sicker, catching colds, being exhausted, lost relationships, or even going into crisis. Below are Heather's two key takeaways.

1. We cannot always control what happens to us, but we can control how we choose to respond.

This is more easily done with proper cortisol coverage. If you find yourself unable to control your response (be it inappropriate anger, uncontrollable weeping, uncharacteristic rage), try taking a little bump dose of cortisol and see if that allows you to choose a different response.

With proper cortisol, you can choose to respond with anger or with peace. You can choose fear or faith. You can choose revenge or kindness. You can choose to to view yourself as a victim or as a survivor. You can look at things with despair or with hope.

2. We can rewire our brain to respond to stressors differently.

Psychologists say we have an automatic side to our brain that is a reactive response and we have a conscious brain that helps us handle things with more thought and care. We must learn to engage our conscious brain when we are feeling good so that our automatic reactive brain does not go into overdrive during times of high stress. 

Heather worked as a flight attendant. She was trained that her time sitting in the jump seat for the few minutes during take off should be used to consciously breath deeply and imagine things that could go wrong on the flight. She was to visualize every detail, from where she stood, who would be there to help, what doors to use, and what to tell the passengers.

This same theory helps Heather now as a mom and as a caregiver. She wakes up early to visualize peaceful parenting. Heather's mom uses visualizing how she might handle a stressful person. She also uses it to help her plan out how a day is going to go if a little more is planned than the normal.

If you can shift your body’s physiology out of emergency mode with these mindful exercises, you can help your brain remember what it is you really need, and how to get it. You can learn to respond with your conscious brain.

Ten Additional Tips

Below are Heather's top ten additional tips. 

1. Breath


When someone or something upsets you, before you react stop and breathe. Take three deep breaths in and out slowly, and then count down from ten. Rhythmic breathing is also extremely effective. Lie down in a dark and quiet room and close your eyes. Inhale through your nose for ten seconds. Hold that for three seconds. Exhale for ten seconds. As you do this, feel each muscle loosening from the top of your head down to the tips of your toes. Do this exercise for ten minutes and then rest.

2. Write


Keep a stress journal. Write down when things make you feel stressed, and how you reacted. Keep a daily gratitude journal. Write down three things you are grateful for everyday. Keep a log of medicine and food to help. This can help you understand if a medicine or food might be contributing to a stressful feeling. Keep a bucket list. Try to live each of your good days to the fullest.

3. Look into Apps


There are many apps available on both Google Play and the iPhone App store that can lead you through self mediation. Additionally, giving yourself a ten minute time out to enjoy some relaxing nature sounds can be incredibly beneficial.

4. Laugh


Grab a jar of pickles (or olives) and watch your favorite funny movie. Read your favorite funny book. Call or visit a friend that always makes you giggle. Spend time dancing and laughing with children. Watch funny pets on YouTube.

5. Unplug and Say No Thank You


You will have good days and bad days. It is okay to ask for a rain check if you are having a bad day. Good people should understand. If they don’t, they will eventually. And if they never understand, surround yourself with different people. Remove toxic people from your life. Also, turn off the phone, the computer, or the TV every now and then. Allow yourself to rest.

6. Lean on Others


Cultivate your support system. Reach out to friends, family, or support groups. These can be either in-person or online. Seek counseling. You do not have to walk this journey alone.

7. Have a Basic Routine

Photo taken from here.

Sometimes, thinking about all that we need to do can add to the stress. Having a basic routine can help avoid this. For example, Heather's family follows Fly Lady and schedules Wednesday as Desk Day. This day is set aside for tasks that her family has been avoiding, such as prescription refills, scheduling doctor appointments, ordering medical records, paying bills. 

A basic morning and evening routine is also beneficial. Heather's mom has to take her morning cortef with a cup of tea, and then lie back down for a good half hour before she begins her day. She must allow her medicine to kick in before she starts running. She watches the news, sips her tea, and allows the cortisol to work. She also places everything out the night before in order to reduce the stress of the mornings.


8. Be Kind


Find someone to hug. It can be a family member, a pet, a neighbor, or a friend. Hugs help reduce stress. If no one is around, find someone this week to do something nice for. Being kind releases magic inside that helps you get through your next stressful moment.

9. Exercise


This doesn't have to be some big or scary thing. It could be as simple as going on a walk for a few minutes each night. Other things to consider are yoga, swim, Pilates, dance, Zumba, bowling, rollerskating, yard work, house work, shopping. Look on YouTube for exercise programs for beginners.


10. Be Gentle with Yourself.


Aim for at least one day a week to purposefully treat yourself. Some of Heather's favorite treats include a hot lavender and Epsom salt bath, watching a movie, walking through a national park, reading a good book, a visit to the library, enjoying a treat at the favorite coffee or ice cream shop, dancing to loud music, calling a friend, creating something, or learning something new.

Closing Remarks

While this list of things will help with stress management, it is very important to note that thinking positively and going for a nice walk will never replace missing cortisol. If the stress has gone on for too long, increase your medicine and seek emergency medical attention immediately.

Be kind and gentle to yourself always. This is the best form of stress management there is. 

Did we forget anything? Please comment below! 
Have a suggestion for a future topic? Suggest it here!

Medical Disclaimer

All content found on this website, including: text, images, audio, or other formats were created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 

Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

By using this website, you acknowledge and agree to and accept these Terms of Service, including all policies and terms linked to or otherwise referenced herein.

Reliance on any information provided by this website is solely at your own risk.