How my postpartum hypopituitarism is likely to be Lymphocytic Hypophysitis
I had an uneventful pregnancy bar a few headaches and my son arrived conveniently on his due date. Immediately following his birth, I had a very high blood pressure but did not haemorrhage. Within a week I became concerned about his feeding as his nappies were never wet and I didn’t think I was experiencing let down of milk. He was my 4th child; I knew something was wrong, but my Health Visitor was unhelpful, stating women in Africa could feed their babies so I could too. In desperation I took him to Accident & Emergency, but my concerns weren't taken seriously, I was told to bottle feed and sent on my way.
Luckily bottle feeding proved a success but I was going downhill. The exhaustion was overwhelming, and I started to experience carpel tunnel in my wrists. Both are hypothyroid symptoms, so my General Practitioner did blood tests. They came back "normal" (aren't they always). In desperation I opted to have surgery on my left wrist under local anaesthetic as I was struggling to hold my baby.
When my son was 9 weeks old, I was asked to fill out a Quality of Life questionnaire as my Health Visitor thought I had post-natal depression. My GP thought so too and put me on Prozac. One week later I started to go into adrenal crisis. My GP was called after 24 hours of diarrhoea and vomiting but he refused to visit, finally coming begrudgingly after 48 hours. He struggled to get my blood pressure and pulse, so an ambulance was called, and I was blue lighted to resus. The doctor quizzed me about my health, and I told him I had not let down milk and was unable to breast feed. He took bloods to see what was happening and I was admitted to a ward. By now I was not really aware of what was going on. My blood glucose was checked, and it was virtually non-existent, so they assumed wrongly that I was diabetic. Then the blood work taken in Accident and Emergency flagged some issues, so I was sent for a Pituitary MRI scan. I was diagnosed with Sheehan's syndrome, put on Hydrocortisone and Levothyroxine, and sent on my way with very little knowledge and no emergency injection pack. Miraculously the carpel tunnel in my other wrist resolved spontaneously following replacement with Levothyroxine!
Cortisol replacement however proved tricky, I seemed to metabolise quickly, kept failing day curves and my dose kept increasing. I got acid reflux, my digestion slowed down and I developed grade 4 oesophagitis.
After 20 years of substandard oral replacement, I found out about the cortisol pump. I booked an appointment with a private Endocrinologist and was lucky enough to get a pump fitted. The pump has proved to be a great success and my Adrenal Insufficiency is so much easier to manage. If I'm sick I just double my rate, if I'm experiencing low cortisol symptoms, I give myself a bolus and if I'm due to have a very busy day, I do a temporary increase of 20% extra for a few hours. I still have to be vigilant; I get crappy days just like everyone else, but life is easier and much more normal.
Finally, after much research I found out about Lymphocytic Hypophysitis and on questioning my pump Endocrinologist I was told it was more likely to be the cause of my Hypopituitary.