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Post by justaustin on Mar 2, 2009 20:10:41 GMT -5
350 is equivalent to one unit of packed red blood cells. If you had post-partum septic shock: Systemic infection with low bp, this could have also complicated pit issues. You pit enlarges with pregnancy. Dramatic postpartum drop in BP (ie due to dramatic drop in blood volume or due to infection) can result in necrosis of pit. MRI manifestation could be parially empty sella or even empty sella. SHEESH. Orthostatic hypotension is a drop in BP from lying/sittin/standing of 20 or more systolic points and with heart rate increase of 20or more points from lying/sitting/standing. This can be due to fluid/electryolyte imbalance such as with low aldosterone,low ADH, drop in circulating blood volume or infection.
Your hair loss can be due to low androgens due to low adrenal function,low pit function. Are you have scalp hair loss at all?
Laurie
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Post by crithium on Mar 3, 2009 11:17:10 GMT -5
So, let me see if I have this right. Are you saying that it's possible that the drop in blood volume/ orthostatic hypotension (which is stated in my medical records so I have proof) which was a result of the infection could (how likely do you think) be considered post-partum shock and resulted in damage to my pituitary? The partially empty sella could be proof that was the case right? I don't have my labs infront of me but they stated my blood pressure was 83 over 50 or something like that. MMMM more pieces to the puzzle. I need to get this really worked out and my info correct so that when I see the endo next I have it down and am not fumbleing for my words. As far as the hair on my head, I have been loosing that like crazy since june. My hands are covered when iwash my hair, covered again when I put in conditioner, I pick gobs of it out of my comb and then off my cltohes all day. I am surprised I have any hair left becuase I have really fine hair. I did get it cut shorter about a month ago so I notice it less in the shower cuase it doesn't get tangles in my fingers anymore but I still pull it out of the drain etc. So unfortunately I am still loosing it. Of course the doctors told me it was stress due to everything I was going through. I hate that word, stress, it should be put in the naughty word category and not used :-) Thanks!
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Post by justaustin on Mar 3, 2009 18:12:50 GMT -5
Yes, that is a strong possibility. Any idea of what your BP was running just previous to the shock? It's the enlarged pit associated with pregnancy then the drastic drop and change in BP that can result in damage. The only way you could prove it (cause you had head injury when younger) is if you had a MRI prior to post-partum shock/hypotension and didn't have empty sella then. Did you have MRI after cheerleading accident?
I would present the facts to the endo: Cheerleading injury resulting being dropped on head. Post partum infection resulting in shock..drop in BP.
Either one or both events could have resulted in/contributed the partially empty sella. Therefore, all hormones need to be tested......
Diffuse hair loss can be due to low thyroid, low iron, low sex hormones. Loss of pubic hair due to low androgens..aggravated by low thyroid,low iron. The postpartum shock likely didn't help matters. You really need ALL of your pit hormones with sex hormones, AM cortisol,thyroid labs(inaddition to the all holy TSH).... Plus Ferritin Vitamin D B12 if not already supplementing.
you are welcome, Laurie
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Post by crithium on Mar 3, 2009 22:32:56 GMT -5
I got out the dismissal summary and it looks like the following: Temp 38.2 Subpine pulse 133 blood pressure 102/56 standing pulse 145 blood pressure 82/39 Guess I was off when I remembered what it was. So pretty much what you said previously. It is listed as orthostatic hypotension. I don't remember having a CT or MRI after the cheerleading accident. I will ask my mom though, I am sure that she remembers. So the schock would be considered the infection or the sudden drop in blood pressure or both? I am a little confused. I have other notes from that day plus labwork if you think any other info would be helpful. I have already had my Ferritin and Vitamin D tested both were low. I am supplementing vitamin D already and am schedule to add a B complex to my other supplements on Friday. I am waiting to hear back from my GP on what tests the endo is going to order. I will let you know so if you think anything needs to be added I can ask. Does it take a while for your pituitatry to stop working? Would it be more likely that it was the infection vs. the cheerleading accident? Thanks again!
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Post by crithium on Mar 9, 2009 21:30:50 GMT -5
I think my post above got missed but I have another question anyways. I found out what test the endo requested and they are as follows: Vitamin D Parathyroid AM Cortisol ACTH (YEAH!!!!) Estridol FSH LH Prolactin Insulin Like Growth Hormone (What's that?)
I think that is it but I can't remeber. I was wondering if there was a day of my cycle that was best to test on and what to do avoid so that I don't falsely elevate my cortisol.
Thanks!
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Post by justaustin on Mar 9, 2009 22:04:03 GMT -5
Shock is the manifestation of low BP with high heart rate, shutting down of unessential body functions. Causes can vary. Extreme blood loss and infection are a couple causes. There are more.
It's really a tough call guessing which incident resulted in your hypopit. Not unless you had an MRI and pit testing after cheerleading accident and prior to pregnancy.
The first 6months after my head trauma was difficult. I was no longer an early morning person. I had difficulty getting up (still do), not human until late morning. Had headaches for first 6months. I was more introverted and moody. I was a pretty cheery,chipper,singing kid.
IGF-1 is a growth hormone marker. Have labs done on day 3.
Laurie
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Post by crithium on Mar 10, 2009 9:47:34 GMT -5
So when I have the appointment I can raise the argument that the infection and my low blood pressure could have caused damamge right? And that the proof that there was damage could be the partially empty sella? Next problem, my endo appointment is right at the start of my cycle, I got a cancellation appointment, she books out about two months. Is there a second choice for what day to test on? Plus, my cycle is so irregular that I never know when it is going to start. All I have is a record of when it started last time. Thanks!
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Post by justaustin on Mar 10, 2009 11:31:48 GMT -5
Or raise the argument that your head injury or postpartum hemorrhage/shock/infection could have resulted in partially empty. With this you argue to have ALL pituitary hormones tested.
If it's early in your cycle, you should be OK. (aldo/renin, LH/FSH and sex hormones). Some docs like day 21 for sex hormones and LH/FSH. The important thing is to make note of day of cycle so that proper range is used.
You can also do websearch of head injuries,whiplash injuries and pit damage. Bring articles with you if need be.
Laurie
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