ACTH/CAH Test

Thank goodness that’s over! And it was very easy, too.

Sorry about missing last week’s update. I got hit with another flu and had to spend the week in bed. But I’m doing better now, and with the ACTH test over I am nothing but happy.

The main reason I was frightened was the idea of the clinic being in the hospital--which it really isn’t, but you know how irrational fears can be. And I knew they’d need to draw blood three times and inject me once, so I was imagining all sorts of needles and tubes. But really, the only reason I had to go to the hospital was because the IV couldn’t be done at a normal clinic--and they only make one hole for the catheter, and everything goes in and out of there. It was really just a long blood test.

When I found the right area and the right desk to check in for my appointment early this morning, they fitted me with a bracelet. No sooner did I sit down then the nurse called me into the room. She was so pleasant and patient with my nerves. I was put right at ease. She explained the test once more, and then I signed a waiver which really had little to do with my particular test; it seemed to be more of a formality. She then checked my blood pressure, which reflected my anxiety, and settled me back in the reclining chair with my left arm on a heating pad to start the catheter.

She took my blood once, then flushed the tube with a bit of saline solution. I’ve never had an IV before, so the slightly cold sensation passing through my arm for a moment was a little unnerving at first, but easy to ignore each subsequent time she did it. Once the catheter was clean of blood, she injected the cortrosyn slowly over two minutes--you don’t want it to hit too fast. The bottle is tiny, about the height of half your pinky, and much of that is the lid. About a minute into the injection, I could feel a slight pressure in my chest under my ribs, rather like heartburn. Apparently some people describe it as butterflies or even nausea, and is common when doing this test. It wasn’t bad at all and eased off quite quickly.

Cortrosyn is, to my understanding, a synthetic form of a naturally occurring chemical produced by the pituitary gland when it’s communicating with the adrenal glands. So the next two times she took my blood over the following hour will help show if there’s any blockage in the chain of production of the hormones. And that, in turn, will indicate if congenital adrenal hyperplasia is the cause of the excess male hormones in my body. (That’s why they also called it a CAH test, for “congenital adrenal hyperplasia.”)

In between her taking my blood, she turned off the light and let me doze--nerves kept me from sleeping well last night and I even dreamed about the test. But I ended up spending the whole time talking to my mother, who sat in the neighboring chair. The whole thing took about an hour in a half, and I was up immediately and almost giddy with relief.

It can take a couple of weeks for the results to come back, and when they do, the endocrinologist is going to give me a call. I spoke to her office already today just to make sure she wanted me to go back on the Spiro.

And now, I’m off on vacation. See you in two weeks!