Cushing's with Moxie: Fighting The Worst Disease You've Never Heard Of: service dog

Showing posts with label service dog. Show all posts

Tuesday, April 24, 2018

TEAM TUX UPDATE: Service Dog for Cortisol Detection

APRIL IS CUSHING's AWARENESS MONTH
As you may know, I have a service dog to detect low cortisol.

Tux alerted me that I needed meds on Saturday. I got my emergency kit. While I held it and unzipped it, he nosed his way into it and grabbed the bottle of hydrocortisone with his front teeth!! We have never trained for this: never used saliva samples and never played any scent games. He couldn't pull the bottle out because it was packed tightly among three boxes of Solu-Cortef. I'll reconfigure so he can do what he needs to do!! Another VICTORY for Team Tux.

Off and on, when I remembered, I would put him into SIT position, let him smell my breath before taking any stress dose hydrocortisone or my daily prednisolone doses, let him smell the medicine in the bottle while I repeated the name to him and why I use it, then I would place the HC under my tongue and let him smell again. I always ask him to "Let me know when I need this hydrocortisone. You are so smart, and I know you can help me." 🐾 🐶

Angela Boswell, our trainer with Service Dogs Express, told me to name the meds as I take them. So I did, again, as I remembered, and here we are. Monica, a fellow Cushie/BLAer/ service dog handler, describes a game they played: "We play "find the hydro," which is based on what we learned in nose work class. I hide my bottle of hydrocortisone in different places around the room and give the command "find the hydro! Then Dubly goes off to find it. When he brings it to me, he gets a treat. This will ensure that I can send him to get the medication no matter where it is."

—Team Tux was founded on March 19, 2017. Tux accompanied me to the Adrenal Insufficiency United conference one year later, an absolute dream dog with excellent public training. We have never used scent samples. We didn't buy a pedigreed pup from a breeder. Tux was a rescue found on the streets. After one year, I bet we have only spent $3,000 including adoption fee of $300 and weekly training visits. Tux began alerting three months after we got him. Getting a service dog to detect low cortisol and associated symptoms (low blood sugar, rapid heart rate) is possible. Go for it. 🐾

PS Tux has two handlers. He also alerts to my husband, a type 1 diabetic for 30 years).

PS2 We have been delighted with our trainers Angela Boswell and Mark Palmer and the program with www.ServiceDogExpress.com. They train handlers over Skype, FaceTime, and Facebook Messenger video. I have a FAQ post percolating that will outline how we got started, what we did, and how we work with the trainers, which i hope to finish soon.

Wednesday, January 10, 2018

TEAM TUX UPDATE: Service Dog Alerts

Hey Cushies. I haven't shared much about my training with Tux, my service dog. I hope to do more in 2018.

I had to stop to tell you about what happened today.

I woke at 8 am but stayed in bed until 9:15. After I took Tux out to potty, he never left me alone. He wasn't just by my side. He was constantly trying to get my attention.

Smelling my breath.
Whining.
Barking.
Licking my face.
Sitting and staring.
Pawing me.
Climbing in my lap.
Biting my forearm.
Nibbling my chin.
Walking all over my lap.

Tux was getting my attention. What was he trying to tell me? I don't know.

I thanked him. Praised and petted him. I told him he is such a smart doggie and one day soon I'll learn what he is telling me. He'd be content with the loving for al of two minutes, then he would start it all up again.

Smelling my breath.
Whining.
Barking.
Licking my face.
Sitting and staring.
Pawing me.
Climbing in my lap.
Biting my forearm.
Nibbling my chin.
Walking all over the bruises from the past times. It hurts and sometimes I get mad. I'm trying to be more understanding, knowing he is telling me something. He is extremely well behaved as we have worked on his public access training over the past nine months.

Over and over, Tux was telling me something but I didn't know what.

Gratitude. Praise. Pet. Repeat.

Tux's aggressive alerts lasted from 10:50 am to 2:50 pm. I didn't feel that well. Back was hurting. A little nauseous and headache was ramping up.

I went to lie down for a few minutes at 2:50 pm. Out of the corner of my eye, I saw my orange medicine container on my side table.

The morning slot was full.
I forgot to take my morning meds.

😳🤭😱

Among my daily pain and psych meds, I also missed my fludrocortisone dose. Fludrocortisone replaces the adrenal hormone aldosterone.

Does it really matter, taking this medication just 10 hours late? Well, yeah!

Without adrenal glands, I don't make cortisol or aldosterone. This life-sustaining hormone helps regulate sodium and potassium levels in the body. It helps control blood pressure and the balance of fluids and electrolytes in the blood. Without it, I was slipping into adrenal insufficiency which can move quickly into adrenal crisis, which is lethal without cortisol and aldosterone replacement.

When Tux was alerting me, my blood pressure was low but pulse was high.

I'm so amazed by my dog. Thank goodness for Tux.
He takes care of me.

Be well, fellow Cushies.

PS My trainer Angela at Service Dogs Express told me Sunday that Tux is actually taking DNA samples when he nibbles on my chin. The term for that action is called "scraping." WOW, right?!

Sunday, March 19, 2017

Canines and Cortisol

These Dogs Save Lives By Smelling People's Breath

MAY 08, 2014

"The fact that dogs can sniff out cancer is pretty miraculous, but that’s not the only disease canines know how to catch with their incredible olfactory abilities. Medical detection dogs -- who have been trained to sense the symptoms of a range of illnesses -- perform a unique service unlike the typical assistance dog, alerting their owners to physical problems that might otherwise go unnoticed. Thanks to the work of Claire Guest, a doctor who founded the UK-based charity Medical Detection Dogs, dozens of lives have been saved (and improved) because of disease-sniffing dogs."

Continue reading the article at this link:
https://www.thedodo.com/community/jennykutner/these-dogs-save-lives-by-smell-542022566.html

Tuxie and Moxie train with Service Dog Express. www.servicedogexpress.com

keywords: service dog, Team Tux, medical alert, cortisol detection

New Service Dog!!

Hey everyone. I have some very exciting news!

Today my family got a service dog, Tux. He will be trained to detect cortisol for me and blood sugar for my husband who is a type 1 diabetic.

Follow along this new journey. Go like our Facebook page, called Fight Cushing's with Moxie.

And stay tuned, because April is Cushing's Awareness Month, and my 10th anniversary with Cushing's. Lots of new stories coming up.

-Moxie

key words: service dog, Team Tux, medical alert, cortisol detection

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Disclaimer: I Am Not a Doctor

I am not a medical professional. I am not a doctor nor have I gone to med school. I am not a physician assistant, a nurse, or a lab technician. I do not currently work in the medical field.

Perhaps what I can provide is actually better and more useful: a tale of odd symptoms, mild physical deformities, and emotional/mental experiences that match your own. It's not just you! I can share my experience in the diagnosis and treatment of my Cushing's disease. Due to this disease's 'rarity,' I relied on my Cushie friends to guide me as we fight this terrible disease. We all quickly learned the basics and the jargon: the body parts, hormone loops, testing protocals, surgical stats, surgeon bios and pedigrees, and paths to recovery. We have seen patients have successful surgeries, and we have seen patients continue to suffer after multiple surgeries. We watch the story of Cushing's unfold for our friends in real time. Our friends are case studies that are unimpressed by whether something meets the standard of 'statistically significant' to be included in the medical literature. We Cushies see and hear it all. We encourage you to grow the same eyes and ears.

We urge you to take an active role in your health care and work closely with medical professionals. If you find a doctor dismissive, find a new one. Use my blog to supplement your knowledge base but never substitute my judgment or decisions for your own.

And please, don't sue me. I have no money left over after medical expenses. One day, I swear, I'm gonna take a nice vacation.

WHERE TO START IF YOU ARE NEW?

This side bar is intended to be a mini Cushings 101. You will find much of what you need to know here. Click through these links and watch these videos. They are my favorites after researching for Cushing's for six full years now. I started this blog in 2008, so the broad view posts about me can be found there. Click around previous blog posts and read, read, read. You will get scared and overwhelmed, but with information, you will start to take charge of your health and you will arm yourself with what you need to win this war. Because you will, you know. You will win this war.

M o x i e_F a v o r i t e s :

* Moxie's Tips to Diagnosis

* Initial Work up for Cushing's

* Comprehensive symptoms list

* Can your cooking pots be the cause of Cushing's?

* Cushing's for the new folks

* Cushing's patients often need multiple surgeries

* What People Need to Know about Cushing's Awareness Month

* Cushing's symptom list, dates, pain scale

* PNA's Pituitary Patients' Bill of Rights

* Cushies describe Cushing's

* Listen to 3 call-in talk shows with Cushing's expert Dr. Friedman

* Listen to Dr. Friedman's 4th call-in show about medical therapies

Symptoms of Cushing's

**You can have Cushing's even if you don't have all of these symptoms**
Anxiety
Irritability
Extreme mood swings and rage, gets confused with bi-polar
Medication-resistant depression
Sensitivity to loud sounds and light
Absent sex drive
Facial redness
Rounding of the face (moon face)
Unexplained weight gain around belly
Buffalo hump, or hump on back of neck
Pink or purple stretch marks
Thicker or more visible body and facial hair
Acne
Muscle weakness
Extreme fatigue
Thin and fragile skin that bruises easily
Slow healing of cuts, insect bites and infections
Bone thinning
Recurrent infections
Sleep disturbances, night sweats, awake at midnight or 4 am
High blood pressure
Diabetes mellitus
Irregular or absent menstrual periods in females

~BEST ADVICE BASED ON MY EXPERIENCE~

This disease is an enigma - a mystery wrapped in a riddle.

Remove the guesswork and pressure off yourself to know how cortisol ravages your body as it swings from high to low to high levels. Very few Cushies when their cortisol levels are high versus low, and frankly, it is quite unfair that we should have to know. Until someone develops a cortisolometer, similar to a glucometer for testing blood sugar, a Cushing's patient may never know for sure whether the cortisol is high or low. I hope the Addison's community will take the lead on that!

I encourage you to test your cortisol testing every night in a row until you get your highs. Do not skip.
1) Do 24 hour UFCs with 17-OHS.
2) Get cortisol blood draws at midnight and again 30 minutes later.
3) Chew a salivary cortisol test swab while getting your blood drawn each time.

I got my biggest diagnostic highs doing this, after 4 years of trying to follow doctors' suggestions of tracking symptoms and only testing once a night around midnight. Take control. Your mission is to show up every night, and hang in there.

TRUST YOUR GUT. It just might save your life.

I am a cyclical Cushing's patient. I had transsphenoidal pituitary brain surgery on June 11, 2009. By going through my nose with scopes and scalpels, my neurosurgeon removed a 3 millimeter ACTH-secreting benign tumor on the left pituitary that disrupted every hormone and every body system. He says the tumor's cytology was consistent with other Cushing's tumors he has removed in the past, meaning that he removed a milky white substance that was different looking that the normal pinkish pituitary gland cells. Within 3 months of my surgery, I knew I was not cured. I still had Cushing's symptoms, and I tested again for a re-occurrence of Cushing's. In 2010 alone, F*I*V*E endocrinologists told me I don't have Cushing's and they think I never did. They said I had pituitary surgery for nothing. That includes two that I saw before my pituitary surgery. It seems doctors really don't know what to do with a Cushing's patient, much less one that comes back still sick after pituitary surgery.

In February 2011, I tested again at my local hospital, and I hit the jackpot: the highest results for midnight cortisol serums and midnight cortisol salivas that I have had in nearly 4 years. I also had nine straight days of high 17-OHS (used to measure urinary cortisol in patients with mild or cyclical Cushing's). I had diagnostic results on three types of cortisol tests: midnight salivary cortisol, midnight cortisol serum, urinary 17-OHS.

I had a 2nd pituitary surgery on April 20, 2011. The neurosurgeon removed a 5-millimeter benign tumor from the right side of my pituitary. I still suffer from high cortisol and high ACTH, with the latter pinpointing the source as pituitary. No tumor shows on my MRI so in August 2012 I started a medical therapy by taking a well-established medication called ketoconazole. This has helped me reverse some but not all of the Cushing's symptoms. Keto can cause liver damage so I must have liver function tests every three months. I hope I can continue to tolerate this medication until a tumor shows. Next MRI scheduled for June 2013.

WHAT DID I LEARN?
Rather than test once in a while, I tested every day. My results clearly showed I had an abnormal cortisol production pattern. I was right. Those doctors were wrong. ALL OF THEM WERE WRONG. Trust your gut. You know your body.

What Doctors Will Claim You Have Instead of Cushing's:

Obesity (lose weight, lose symptoms)
Polycystic ovarian syndrome (PCOS)
Fibromyalgia (no lab tests can prove this; diagnosis given when they don't know what else is wrong with you)
Back and muscle pain
Diabetes
Blurred vision, visual field loss, double vision
Chronic fatigue syndrome
Dry, oily, or sweaty skin
Impotence or infertility
Joint pain, joint/bone abnormalities
Migraines
Muscle weakness, carpal tunnel syndrome
Temporomandibular joint/TMJ/jaw joint pain
Thyroid imbalance or "slow metabolism"

Is it possible you have many conditions damaging your body simultaneously? Sure. Is it more likely that you have ONE condition that explains all that ails you? Yes. That could be Cushing's.

In medical school, doctors are trained that it is better to find one diagnosis to fit all symptoms. Go ahead and ask your doctor about that when s/he tells you that you have multiple overlapping illnesses.

Once you get abnormally high biochemical evidence (ACTH and cortisol) in the form of urine, saliva, and/or blood tests, it is highly probable you have Cushing's. Trust your instincts. Don't let the doctors tell you differently.

Different Doctors Treat Symptoms of Cushing's: A List of Professionals You May Have Seen

The pituitary controls the production of every hormone in the body. We Cushies go undiagnosed as we bounce around from medical subfield to subfield. Each doc treats the symptoms they know best, while piling on the medication.
We Cushies later find that our constellation of symptoms are punctuated with abnormal test results hidden away in our patient charts. No one told us. Since our medical history stays with the office not the patient, one change in doctor leaves these clues to diagnosis behind.
This is why I suggest you take a list of symptoms to every appointment. You won't be boxed in by narrowly-focused questions based on one field of medicine, but you can instead partner with your doctors and discuss your symptoms list so you can get the care you deserve.
DON'T GET STUCK SEEING A SPECIALIST WHO TREATS ONLY ONE BODY SYSTEM. CUSHING'S AFFECTS THEM ALL.
Endocrine:: Thyroid problems and diabetes (many have this, caused by Cushing's)
Orthopedics :: joint pain, joint/bone abnormalities, Plain ol' back and muscle pain (caused by Cushing's)
Dermatology :: dry, oily, diaphoretic skin
Ophthalmology :: blurred vision, visual field loss, diplopia
Neurology :: headache, proximal muscle weakness, carpal tunnel syndrome
Urology :: impotence, hypogonadism
Obstetrics and Gynecology :: galactorrhea, menstrual irregularities, infertility, hirsutism, polycystic ovarian syndrome (PCOS)
Fibromyalgia (no lab tests can prove this, given when they don't know what else is wrong with you)
Don't bounce around. See an endocrinologist. Show them you are an informed patient. Don't let them turn you away to suffer.Get yourself help. Demand it, if you must. Don't give up.

DISCLAIMER: ME AND MY CORCEPT

I want to disclose my relationship with Corcept Therapeutics. I participated in their market research study in Philadelphia, CA in February 2012. I gave feedback on marketing material and told my story on camera for internal educational use. Corcept paid for my travel expenses. In July 2012, I met the Cushing's advocate and nurse at the MAGIC Convention in Chicago. We shared a meal as a group, and she kindly paid for our dinner. In addition, I hold stock in Corcept Therapeutics; not because I am rich, but because I have Cushing's.

Please rest assured that this affiliation will never compromise my intent to bring patients all information I can get my hands on to help them on their road to diagnosis and recovery. You have my word.