Hannah is passionate about raising awareness of Addison's disease since her own recent diagnosis in May 2022. Here she shares with us her diagnosis story, how she manages her Addison's while living abroad in Gibraltar with the Royal Navy and embracing her diagnosis with an Addison's tattoo.

Read on to see other awareness tattoos shared by our community and the 'The Doctor's View', on dosing for a tattoo.

My Diagnosis

My Addison’s journey is still very new to me as I was only diagnosed in May 2022. In the 6 months prior to this, I was very unwell. Initially we put this down to the stress of getting married in February 2022 and my husband being away with work. Having gotten through this stressful period, I still didn’t improve, and I visited my GP numerous times. Looking back my symptoms were feeling constantly fatigued, craving salty snacks, aching (including chest pains) and low blood pressure.

Eventually, I knew I couldn’t go on like this so I called in at the GP clinic and begged for an appointment. Luckily, I was given an emergency appointment and saw a different GP who immediately recognised something was wrong. Minutes later, I walked out of the GP clinic with a direct admission letter for the hospital as the GP thought I had something wrong with my adrenal glands.

I was taken straight through triage and sent for review by a doctor. Immediately I was being questioned about any recent holidays because of my tanned skin (we had been on a mini-moon to Cornwall and had seen far more rain than sunshine). What I now know is that I had hyperpigmentation.

I underwent a Short Synacthen Test and when my results came back the next day, my cortisol levels were so low that the Endocrine consultant said that I was very lucky to be alive (somehow I’d walked our dog, Rodney, that morning too!)

The Aftermath

Before I left hospital, I was given an injection of hydrocortisone and sent home with my new medication and a lot of leaflets about Addison’s disease. Almost overnight, I began to feel better and within weeks I felt better than I had in months.

Among this, my husband was told that he was being posted abroad to Gibraltar with the Royal Navy. I was told at my diagnosis to avoid stress, however in the period where most people find their feet with Addison’s, we were packing up our house and preparing to put it up for rent. Of course, this was the easy bit, the reality of leaving our friends, family and our lives was the hard part! Despite the inevitable period of denial, our friends, including my amazing work colleagues, got me into a routine and I continued to feel better every day.

Managing Addison's Abroad

Since diagnosis, I have always used alarms on my phone as reminders for taking medication. The move inevitably upturned our lives, but we ensured we stuck to our routine. After a 1600-mile drive through France and Spain we found ourselves arriving in Gibraltar on our first wedding anniversary. Now as we often take day trips to Spain, I always make sure to carry the adrenal crisis letter in Spanish, which I downloaded from the ADSHG website.

Now living in sunnier climes, I have had to adjust a few bits of my lifestyle to cope with the heat. I make sure I remain hydrated and use electrolyte drinks (sugar-free of course) and salty snacks to replace the salts I am losing. My consultant care has remained in the UK but I do get my medication through the military GP here (although renewing the injection kit was harder than I’d hoped!)

As my confidence has grown, I’ve felt more open about talking about Addison’s to other people and I try to promote awareness through community craft fairs. One of my closest friends is a paramedic and she’s made me a video of how to draw up my injection kit, which I have been showing to my new friends and work colleagues.

Awareness Tattoo

Finally, being brave enough I decided to have it tattooed onto my arm which I am super pleased with. I wanted to be able to feel proud to have a rare condition and not embarrassed. It is such a good talking point when people ask, and it means I no longer have to worry about losing a medical band as it's permanently on my arm. When I had the tattoo, I made sure to double my hydrocortisone dose as I knew it would be painful and take a little while to complete.

I’ve come a long way and I’ve still got lots to learn. For now, we’re enjoying our adventures in Gibraltar and I am promoting awareness of Addison’s wherever I can.

Thank you Hannah for sharing your experience with us and raising vital awareness. 

Author: Hannah

To hear more from Hannah, follow her on Instagram @nicksy04.

The Doctor's View

If you're thinking about getting a tattoo, as long as you are feeling well, there shouldn’t be a problem. There are just a few things to bear in mind before you get one. Dr Alessandro Prete, ADSHG Medical Trustee and Consultant Endocrinologist, gives his advice.

"Getting a tattoo is a thrilling and deeply meaningful experience for many. It's an art form that allows people to express themselves, commemorate significant life events, or simply wear a piece of their heart on their skin. Getting a tattoo can be a bit scary for first-timers and even for seasoned ink enthusiasts, and it can be accompanied by a dose of anxiety due to the potential pain involved.

In people living with Addison’s disease, severe pain and anxiety can precipitate symptoms of cortisol deficiency and – in rare cases – can trigger an adrenal crisis. Therefore, on the day of getting a tattoo, it is advisable to take some extra steroids.

People using hydrocortisone tablets for stress dosing can take 10-20mg of hydrocortisone one hour before the start of the tattoo session. Patients treated with prednisolone, prednisone, or modified-release hydrocortisone (Plenadren) who do not have access to hydrocortisone tablets can take extra doses of their routine medication (e.g., 2.5-5mg of prednisone/prednisolone or 10-20mg of Plenadren one hour before).

In the unlikely event that the tattoo session lasts more than 4-6 hours, patients should take another steroid dose 6 hours after the first one."

Medical Tattoos

Increasingly people are using tattoos to show that they have Addison’s disease or adrenal insufficiency and are steroid-dependent. It is recommended that these tattoos are not used in replacement of medic alert identification, but in addition to medical jewellery and your steroid alert card.

If in an emergency you are unable to communicate, medics would not be able to confirm the tattoo is in relation to yourself, as many people use tattoos to commemorate a cause which affects a loved one. This is why medic alert identification (such as the steroid alert card or jewellery) should always include your name.

Here some of our community share their tattoos, which have been inspired by their Addison's disease or adrenal insufficiency diagnosis. As Dr Prete says, tattoos are an art form that allows people to express themselves and commemorate significant life events. Thank you Hollie, Adam and Dean for sharing your tattoos with our community.

Hollie @hollie934

Adam @adamcooper_thepit

Dean @shep88d

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