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Discussing the the Cort-Stim Test results with the weekend coverage doctor

I saw the full results of my Friday, 9/28 Cortisol-Stimulus test by Saturday morning. As the results did not look good, I called the 24/7 Melanoma Clinic hotline and spoke to (I assume) a residents who seemed very knowledgeable. He told me that:
  • Had I felt like crap the last several weeks? (YES)
  • The results indicate adrenal insufficiency, caused by a destructive autoimmune reaction in either the pituitary gland or adrenal glands.
  • The results from another test, ACTH (adrenocorticotropic hormone), had not come in yet. They would help tell them whether it's the pituitary gland or the adrenal gland.
  • Stay on prednisone for now.
  • Make a temporary medic alert "piece of paper" to put in my wallet for now. I will likely need to get a more permanent one.
  • An adrenal crisis is usually when you get sick or injured. Your body needs to produce twice the normal cortisol level or more to handle the injury/illness. A regular dose of hormone replacement, won't handle it and it becomes a dangerous condition. Especially if this happens while you are on trip or become unconscious, hence the need for medic alert.
  • An endocrinologist will likely take over next week (I hope) to move from prednisone to the appropriate hormone therapy replacements, which also will depend on whether it is a pituitary or adrenal problem. 
Finally, I asked whether i should resume treatment on Monday. He said yes, absolutely, depending on what your oncologist says.

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