Crazy Moodswings, Irrational Behaviour Of Addisonian Partner, Any Help, Advice?

LouLou

I have a cold too, most of my family have it so I'm up also.

He often tells me his body can't produce adrenaline, and I know that his adrenals aren't functioning properly, but, again, not being that well-versed on medical details it's very confusing for me. I will ask him about this, too, at least I'm learning a bit more about his conditions!

From http://www.lef.org/protocols/metabolic_health/adrenal_disorders_02.htm

Each adrenal gland has an outer region, called the cortex, and an inner region, called the medulla. Each of these regions contains highly specialized cells that secrete distinct hormones to carry out different physiologic functions (PubMed Health 2011a).

• The adrenal cortex secretes 3 types of hormones: glucocorticoids, mineralocorticoids, and androgens.
  • Glucocorticoids (eg, cortisol) control inflammation and regulate the body’s response to infections and stress. They also play a role in maintaining blood pressure, blood sugar, and cardiovascular function (Charmandari 2010).
  • Mineralocorticoids (eg, aldosterone) regulate sodium and potassium levels in the body and thereby help maintain blood pressure and water balance, mainly via the kidneys (Farman 2001).
  • Adrenal androgens (eg, dehydroepiandrosterone [DHEA]) are precursors of the sex hormones testosterone and estrogen (Gurnell 2008). In addition, the adrenal glands also produce a small amount of testosterone (PubMed Health 2011a).

• The adrenal medulla produces the catecholamine hormones, which compriseepinephrine (also known as adrenaline), norepinephrine (noradrenaline), and dopamine (PubMed Health 2011a). Norepinephrine and epinephrine are primarily responsible for the “fight or flight” response to stress or fear (Arun 2004).
  The “fight or flight” response manifests as increased heart rate and blood pressure, rapid breathing, and greater blood flow to muscles (Head 2009; Molina 2005). These physiologic responses arise via activation of the sympathetic nervous system. The sympathetic nervous system is a part of the involuntary nervous system, which controls processes such as breathing, heart rate, and metabolism (PubMed Health 2012; Molina 2005).

Though, further down, it does suggest that it is only the Cortex affected with Addisonians:

Addison’s disease is an uncommon, debilitating disease that is rarely identified in its early stages. In Addison’s disease, the function of the adrenal cortex progressively declines over time, resulting in glucocorticoid and mineralocorticoid deficiency, as well as reduced levels of DHEA and androgens (Nieman 2006; Ten 2001; Gebre-Medhin 2000; Luken 1999). The typical early symptoms of Addison’s disease are weakness, low blood pressure upon standing, and fatigue. People with Addison’s disease gradually develop an often heavy pigmentation of the skin (especially around bony prominences, skin folds, and on the back of arms and legs) and a bluish discoloration of the mucous membrane lining the mouth (Ten 2001). Cortisol and aldosterone deficiency together cause changes in blood levels of sodium and potassium and a decrease in plasma volume, which can lead to extreme dehydration and shock (Padidela 2010). Trauma, surgery, and infections in people with reduced adrenal function may result in adrenal crisis, a life-threatening condition that can lead to extreme weakness, severe body pain, low blood pressure, and fever.

His mother has impaired Adrenal function in some way (I don't know the exact details) which could suggest it's genetic. She has told me he can't produce adrenaline.

Humphrey10

LouLou wrote: »

I have a cold too, most of my family have it so I'm up also.

Lying down makes it worse, it makes my face feel horrible and all bunged up :mad:
at least I currently appear to be able to hear out of both ears, I couldn't earlier, and I had a cold a while ago when I wasn't able to hear out of either properly. Something to be "happy" about I guess.

LouLou wrote: »

He often tells me his body can't produce adrenaline, and I know that his adrenals aren't functioning properly, but, again, not being that well-versed on medical details it's very confusing for me. I will ask him about this, too, at least I'm learning a bit more about his conditions!

I think, if you can't sleep, then learn about things - either you will remember interesting things - or you will be bored and go to sleep.

LouLou wrote: »

Though, further down, it does suggest that it is only the Cortex affected with Addisonians:

Something I read said it's only the cortex if it's auto-immune Addison's , which maybe mean that there are other types that affect the medulla too?

LouLou

Humphrey10 wrote: »

Something I read said it's only the cortex if it's auto-immune Addison's , which maybe mean that there are other types that affect the medulla too?

I can see (although it's about dogs!!) http://www.addisondogs.com/addisons/

The medulla, part of the sympathetic nervous system, secretes epinephrine (adrenaline), which is generally not affected by Addison's.(though I can see it mentioned about Auto-Immune Addison's, as you said).

As boyf and his mum both say it so categorically, perhaps it's came up in further tests or there's additional damage to his adrenals somehow, I really don't know.

PS: The last cold I had, a few months back, was a doozy. I couldn't taste or smell for weeks and I was a green snot machine, haha. As long as I don't get that bad, I can live with it.

Humphrey10

LouLou wrote: »

As boyf and his mum both say it so categorically, perhaps it's came up in further tests or there's additional damage to his adrenals somehow, I really don't know.

PS: The last cold I had, a few months back, was a doozy. I couldn't taste or smell for weeks and I was a green snot machine, haha. As long as I don't get that bad, I can live with it.

Maybe they have a thyroid problem too, I think that's got something to do with adrenaline somehow. It sounds like it's something they know for sure anyway.

Paracetamol is helping with the symptoms of the cold at least.

Also something I meant to put in my original reply, about helping with stress - you could suggest he leaves some of each type of medication at your house, in case he forgets to bring it with him when he comes and stays. I leave a cartridge of each type of insulin at my mum's house for the same reason, I stay there occasionally. (Also remember to leave needles too). It's one less thing to worry about.

Anyway goodnight - I must try and sleep, I hope you sleep well too!

Counting_Pennies_2

Two thoughts

If he cant detect when a hypo comes is it worth exploring one of the assistance dogs? They are specially trained to identify when a sufferer is having trouble before it gets too bad and indicates to them to take something before it gets worse

In terms of complaining about bad treatment in hospital it might be worth getting in contact with the patients association. It has changed names a lot over the last few years but there is a voluntary organisation set up to help patients with their complaints might be worth looking into it

Counting_Pennies_2

http://www.patients-association.com/

HPoirot

Has your partner ever been put in touch with a dietician, does he have a diet put in place? In cases like his, "you are what you eat" - or drink - couldn't be more apt.

It doesn't seem like he gives much thought to his intake or food and drink. In the case of dining out for example he should have gone out on a light meal at his regular time and not just rely on what will be on offer at the time the restaurant decides. From your posts I do not see your BF managing his condition through diet and that would play a major part towards his troubles.

Tygermoth

My days of ward craft are very rusty but in the old days...

Sliding scale insulin. Used when diabetics came in unwell. When unwell a diabetics regime or good practice of their own medication can be altered as well as the bodies reaction to sugars and the insulin while its fighting and infection. If the patient had for example a severe chest infection you would normally find just being unwell their sugars would be all out of whack.

So you would be set up on a pump that would give you a constant slow low dose of fast acting insulin. The blood monitoring is done regularly - every 15 mins/once a hour/every four hours (depended in the severity of the illness or the seriousness of the blood sugar readings) the insulin is tapered on a sliding scale in response to the results. This in theory would smooth out any massive highs or lows leaving the patient to just concentrate on the recovery from the chest infection.

In my day it worked just fine. Never had any issues in treatment or on the patient side. However as advised previously this was some time ago and the NHS is a different place now. Not the fault of the Nurses or the Doctors, In my very humble opinion.

A little off topic and not related to the OP but this might explain the resistance a bit in regards to patient knowledge...I spent a day volunteering on a specialist unit recently and was outraged at what stresses the staff were working under and the general publics attitude and how they spoke and treated them.

It seems like doing a bit of research on Google makes every tom,!!!!!! or harry more qualified that the very experienced staff and rather than a reasoned discussion will demand treatment in line with what they have researched. One lady was adamant that for burns you put butter on it and just wouldn't listen to reason in the treatment of her small daughters large serious burn.:mad: This was an extreme example but in most cases the information supplied was incorrect or outdated in the worst cases just dangerous.

The staff were good gentle souls hard-working people that just shrugged off the frankly mindboggling level of aggressive behaviour off as part of the job but it was an eye opener to why they become closed down and less empathetic over time. honestly, it was unremitting!

mildredalien

I'm not a health professional by any means, but symptoms of Type 1 diabetes and Addisons (from a cursory read through the NHS website) don't seem to include rudeness, short temper, irritability...? It describes things like low mood and with hypoglycaemia things like confusion and anxiety. You can't rule out that some of his behaviour is due to his personality, or perhaps difficulties coping with his health issues?

I suppose it doesn't really matter WHAT is causing his behaviour as it's one of those situations where there's no easy fix even if it is medical. However it doesn't sound like he's always doing the best things for his health e.g. drinking. Have you sat down and discussed what general lifestyle stuff might make coping with his health issues better? Could be simple things like sleeping in separate bedrooms, planning nice meals in rather than meals out if he becomes very anxious about his glucose levels etc. when out. He also has to take responsibility for treating you well though and can't use his health problems as an excuse!

please-let-me-be-lucky

Hi, I don't have any experience of Diabetes of Addisons, but my DH has had a severe brain injury and can have excessive mood swings like you are describing.

Headway have been very helpful in terms of information
https://www.headway.org.uk/Emotional-and-Behavioural.aspx.

It can be very hard living with someone who has issues like your OH, particularly if you have no history with them previously. Well done gor sticking it out and looking for ways to help Xx