u/Equal-Ad-4463

Managing post-surgery - call endo?

Had total hip replacement 2 weeks ago. 49F.

Was only just diagnosed with secondary adrenal Insufficiency in March, so this is new. I believe it's opioid induced, as I don't have any other risk factors or signs for other causes, and I've been on pain management awhile (for the hip).

My endo did give the surgery team recommendations for extra IV steroids in pre-op, and they kept me overnight for monitoring. I seemed to do fine. But the past few days I feel stalled out in my recovery from surgery. I'm having a lot of pain, which could be from the opioid use/dependency or from previous surgeries I've had there that left scar 8tissue. Or both.

Should I call my endo today to ask for more recommendations? Right now I'm prescribed 10mg hydrocortisone in a.m. and 5 mg mid-day. I suspect that needs to go higher though, as my last blood test showed my cortisol hadn't budged since initial diagnosis. So, it's possible my baseline was already low. Since surgery I've updosed to 10mg/10mg for the stress.

I'm not sleeping much at night (2 hrs at most, then up awhile due to pain and dozing til morning, naps during day). I'm still very swollen and sore. Is there value in calling my endo to see what he'd recommend? They didn't seem too concerned when I called before my surgery, but I'm tired of feeling so tired and sluggish. And the pain. Blah. Hard to tell how much is from pain and how much may be due to the SAI.

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u/Equal-Ad-4463 — 20 hours ago

Opioid induced secondary adrenal insufficiency

Curious if anyone's SAI is due to opioids. I have been in pain management for many years due to an orthopedic issue (have tried to get it fixed several times, all failed, so in daily pain from it). I was recently diagnosed with SAI and can't find anything else to explain why, so I'm thinking maybe it's the long-term use of narcotics. I actually find myself hoping it IS opioid induced, because that is one of the only fixable causes of SAI.

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I can try again to get this joint fixed and see if it resolves my pain or at least improves it so I get off the pain meds. From what I've read, then it would be several more months before my adrenals hopefully kick back in. Anyone know if this is a realistic expectation? Want to share your experience with the same?

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u/Equal-Ad-4463 — 2 months ago