To mark Addison’s Disease Day 2021, we speak with Professor John Wass, Professor of Endocrinology at Oxford University, chair of the Addison's Clinical Advisory Panel and Head of the Department of Endocrinology at the Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), Churchill Hospital Oxford until 2012.

John is long-time collaborator and good friend of the ADSHG. He has received awards internationally in recognition of his hard work, dedication and research into the field of endocrinology. Among his charitable activities includes Chairing our Addison's Clinical Advisory Panel (CAP) and narrating our Adrenal Crisis YouTube videos. John is also recognised from his acclaimed documentary ‘The Fantastical World of Hormones’ on BBC4, where he was introduced as "one the country's leading experts on hormones."

As chair of the Addison's Clinical Advisory Panel (CAP), John has reviewed our medical guidance throughout the pandemic, co-authoring the ADSHG "Coronavirus Vulnerable Adult Advice" statement and supporting our international response through the Adrenal Causes Together (ACT) panel co-authoring the open letter for Brazil enabling emergency injection kits to be provided. In his spare time John stepped forward as an NHS volunteer, delivering the vaccination in the UK.

John has a vital role in Getting It Right First Time (GIRFT), a national programme designed to improve medical care within the NHS by reducing unwarranted variations. This sees John visiting endocrine units around the UK, sharing best practice between trusts to ensure endocrine departments are providing emergency hydrocortisone injection kits and sick day rule education.

So let’s find out more and about this incredible man and his role in Endocrinology. Welcome Professor John Wass!

What Addison’s means to me

Dr Thomas Addison (1793-1860) was a physician at Guy's Hospital, London, where I trained in medicine. He was the first person to put it altogether, that hyperpigmentation and the skin going dark was related to the adrenals not working properly. This was all before the hormone adrenocorticotropic hormone (ACTH) was discovered. His pioneering work showed that the adrenal glands were essential for life. He also discovered a number of other diseases and was a fine and well-respected physician. He unfortunately died by suicide in 1860 aged 67 in Brighton, just a few months after he retired.

I have been interested in Addison's disease for years. Some years ago I was asked to chair the Addison's Disease Self-Help Group’s Clinical Advisory Panel (CAP) and it's a job I've hugely enjoyed over some years, forming and helping patients with Addison's Disease up and down the country. We have written surgical guidelines and a whole load of other things which hopefully help, not only patients in this country, but in other countries as well.

My career in Endocrinology 

I undertook my endocrinology training in Barts in the seventies and early eighties. Endocrinology generally is one of the great specialties. As most people with Addison’s know, often within a few hours or days of starting hydrocortisone, you feel better and as endocrinologists we have the ability to help people feel better very quickly. We have a huge effect on their quality of life. I went to Oxford in 1995 but had an interest in Addison's disease research since before then. 

I now see a wide variety of patients and I feel that I can help them often balance their hormone requirements including their steroid, fludrocortisone and DHEA. I have even had patients referred to me from Uruguay! The other aspect which is often not quite well understood is pregnancy and Addison's and how to manage labour with extra steroids. 

Unfortunately the path to be diagnosed with Addison's disease is often long and painful. I work hard to combat this and it's a very good thing to see ADSHG research grants awarded to progress this area. The ADSHG always awards the 'Professor John Wass Emergency Medical Research Award' focusing on stimulating innovations and best practice in emergency medicine concerning adrenal insufficiency and adrenal crisis.

 

John speaking at various ADSHG events - from previous AGM presentations to "Medic-in-a-Pub" sessions.

Working with the ADSHG

The Addison's Disease Self-Help Group has made an enormous improvement on the quality of care for patients with Addison's disease. I have spoken and led many events with the ADSHG over the years as chair of the Addison's Clinical Advisory Panel (CAP) and it's been a delight to meet many of you. Currently Dr Helen Simpson is doing a huge amount of work for the ADSHG and introducing the new NHS steroid alert card which I think is a very good thing and connects straight to the Society for Endocrinology website for details as to how to treat adrenal crisis. Being part of the Adrenal Crisis YouTube videos has also helped improved awareness and patient education.

It is important for endocrinologists to see and take an interest in Addison's disease. Sometimes some don't quite understand it or see enough of it. Every patient with Addison's should at least have an annual review. 

Hear John Wass speak at our AGM@Home 2021

Current Work

Before the pandemic when I was going to all the endocrine departments in the country (as part of Getting It Right First Time - GIRFT) I made sure, as far as it's possible, that every single department should provide an emergency injection kit including hydrocortisone and a syringe and needle. The results of GIRFT will be published shortly and I hope and think that Addison's care will improve as a result of this.

We can be proud that in this country we have good advocacy for patients with Addison's disease and wonderful support from people who work in the charity. 

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