What is Addisonian Crisis and How Can You Prepare for It?

People who suffer from Addison's Disease are in danger of experiencing something called Addisonian Crisis. Addisonian crisis or adrenal crisis is a life threatening condition and those who have Addison's Disease should prepare for the possibility of this occurrence.

What is Addison's Disease?

Addison's Disease is an endocrine disorder where the adrenal glands do not produce enough of the following key hormones: cortisol, aldosterone, and androgen. Without these hormones, the body cannot physiologically respond to stress. As a result, people with Addison's disease cannot retain proper sodium and glucose levels so their blood pressure decreases and they begin to experience syncope. Additional manifestations include dizziness, confusion, and neuromuscular dysfunction due to low sodium and weakness, loss of appetite, and lethargy due to low sugar.

What is Addisonian crisis?

Addisonian crisis is a life threatening condition that occurs in about 25% of everyone who has Addison's Disease. Addisonian crisis is usually precipitated by stressful events like surgery, trauma, or abrupt withdrawal of longterm cortisol therapy. Signs of someone in Addisonian crisis are similar to the manifestations of Addison's Disease in addition to a high fever and severe vomiting. Addisonian crisis is treated with a rapid replacement of fluids and steroids.

How can you prepare for an Addisonian crisis?

With a one in four chance of experiencing Addisonian crisis, people diagnosed with Addison's disease should always be prepared for an emergency.

Take your medications-People who have Addison's Disease will most likely need to take medications for the rest of their lives. A sudden and abrupt end to taking medications can result in Addisonian crisis. So follow your medication regiment diligently.

Tell your doctors-All your health care providers should know you have Addison's Disease. Since Addisonian crisis is usually precipitated by conditions like surgery or trauma, your doctors need to know ahead of time what to do in case a procedure they perform or an injury you encounter sends your body into adrenal crisis. Many of the manifestations of Addison's Disease and Addisonian crisis are non-specific and vague, so keeping your doctors informed of your condition could save your life.

Wear a medical alert bracelet- Medical alert bracelets and cards will be your voice if you cannot tell EMT workers or other emergency personal what to do if you experience Addisonian crisis. You can purchase a medical alert bracelet or other medical ID jewelry here and have it inscribed with adrenal insufficiency: takes hydrocortisone.

Carry an emergency kit-If you have Addison's Disease, you should always carry hydrocortisone and be prepared to self administer an injection to yourself in times of crisis. Your kit should include syringes, cortisone, and directions for administration. If you do not know how to self administer injections, speak with your doctor for teaching and return demonstrate.

Sources:

Medline Plus website, Acute adrenal crisis, retrieved on December 22, 2010

LeMone, Priscilla & Burke, Karen (2008). Medical-Surgical Nursing-Critical Thinking In Client Care (4th ed.). Upper Saddle River NJ: Pearson Prentice Hall pp 553-556