Cortisol Pump Info

PumpAware

In the United States, there is very little awareness on infusion pump therapy for the treatment of adrenal insufficiency.  This is the reason Adrenal Alternatives Foundation was created. 

This foundation was named Adrenal Alternatives because when Founder, Winslow E. Dixon sought to better her quality of life, she was repeatedly told “no.” She asked multiple endocrinologists to put her on the cortisol pump and was told “We don’t do alternative treatments.” Her quest to find quality of life again led her to discover the cortisol pump method and establish Adrenal Alternatives.

Though we are not a replacement for medical care or advice, our foundation team is a combination of licensed medical professionals and adrenal patients who are veteran pumpers. We can help guide you to the right information to manage your care with the infusion pump. It is our objective to ensure this treatment option is available to any adrenal patient who would benefit from it.

We are leading patients to all adrenal alternatives!

 

What is a Cortisol Pump?


Cortisol pumping is a concept documented and researched by Professor Peter Hindmarsh, the founder of CAHISUS , a research organization dedicated to treating adrenal diseases.

In his research, he found that adrenal patients were able to find better quality of life by the use of an infusion pump that distributed cortisol in a more consistent, bio-identical way that mimicked the body’s natural circadian rhythm.

With the pump, patients can bypass the gastric pathway and absorb their life-sustaining medication better. This treatment is revolutionary for hypermetabolizers and for those with gastro-intestinal problems and malabsorption issues.

 

Access to and awareness about cortisol pumping is limited in the United States. This foundation works to connect patients to the resources that can help them achieve better quality of life. We work extensively to help sufferers of adrenal insufficiency obtain this life changing treatment.

 

Finding an endocrinologist willing to work with this relatively unknown treatment option and obtaining insurance approval for a pump, supplies and solu-cortef is a tough battle. Adrenal Alternatives was founded to help adrenal patients every step of the way in their fight for quality of life.

 

How do I get on a pump?


1- Assess your life, health and disease management.

The cortisol pump is not a cure for adrenal insufficiency and is not a treatment that is right for everyone. If you are well managed on the steroid replacement pills, the adrenal pump is excess money and effort you may not need. The pump is not an easy thing to acquire and the fight to get one takes a great deal of trouble, mental stamina and resources.

 

2- Research, learn and educate for yourself.

Information you need to know:

What is your diagnosis?

What form of adrenal insufficiency do you have? What is your quality of life?

Are you able to work, drive, do housework or function normally?

What have you tried to manage your adrenal disease?

What is your current daily dose of replacement steroid?

How much are you stress dosing?

What other medical issues do you have?

Are you able to afford the supplies and medication needed for the pump?

 

Insurance may or may not cover your pump, supplies or solu-cortef.

 

3- Find a Pump Friendly Endocrinologist

Prepare the best case possible. Send your research, your health information, everything you can to the endocrinologist before your appointment so they are aware of your intentions before hand. Write a letter to the endocrinologist explaining your diagnosis, failed treatments and desire to be on the pump. They may or may not be receptive to your request and alerting them of your intentions beforehand may save you time, money and effort.

 

4- Battling the Insurance Company

Adrenal Insufficiency is documented to be treated by oral steroids and not by the insulin pump but there are options to attempt insurance coverage for the use of infusion pumps in adrenal disease.  Our team has successfully battled countless insurance companies across the nation and can assist you in your fight for coverage.

We have aligned with the organization CR3 to help adrenal patients acquire pumps in a safe and legal manner.

PumpPartnership (2)

Founders Winslow E. Dixon and Charles Ray III have created a program which combines the resources of both organizations in order to supply pumps to adrenal disease patients in a safe and legal manner.

To apply click the highlighted text.

Starting the Pump  


1– Finding the right pump system.

There are multiple different pump systems available in the United States. Determining what company works best for you will depend on your personal cortisol needs, what your insurance will cover and your lifestyle. Though the concept of all pumps are the same, some have different features such as being waterproof or tubeless.

 

2– Choosing a Solu-Cortef ratio.

Solu-Cortef comes in two forms, Acto-Vials and powder vials. The acto-vials are Solu-Cortef powder that is attached with 2ML of saline solution at the top of the canister. The powder vials are only Solu-Cortef.

With Acto-vials, the ratio is 2:1. This means that 2ml of solution is equal to 2mg of cortisol because 100mg of solu-cortef was mixed with the 2ml of saline contained in the canister and reconstituted before adding it into the pump reservoir. Pump distribution rates will be calculated according to this.

Example-If a patient takes 20 mg daily their basal rate will be 40units.

2units= 2mg at the 2:1 ratio.

With the powder solu-cortef vials, patients can run a 1:1 ratio by mixing the 100mg of Solu-Cortef powder with 1ML of saline or bacteriostatic water and reconstituting it with a syringe before adding it into the pump reservoir.

Example-If a patient takes 35 mg daily, their basal rate will be 35units.

1unit= 1mg at the 1:1 ratio.

 

3– Finding the right basal dose and rate distribution.

Cortisol replacement therapy needs to be a personalized, calculated process where many things are considered.

A– Your personal absorption. Clearance testing labs can be done to determine how quickly your body metabolizes cortisol.

B– Your daily basal dose needs. Every adrenal patient is different. Your dose will depend on your specific body’s needs according to your health status, comorbidities, pain levels, weight, and cortisol clearance.

C– Your distribution rates.  Cortisol replacement needs to be done as closely to the circadian rhythm as possible. 24 hour profiles can be done to try and match your body’s natural process of cortisol production.

 

4– Managing “artificial adrenals”

The pump truly puts adrenal patients in control of their cortisol distribution in a way that steroid pills cannot. In situations of physical or emotional stress where “updosing” is needed, the pump can immediately administer a BOLUS, which is extra cortisol administered through the pump canula at the amount you select. Instead of having to wait 30 minutes for pills to metabolize, the cortisol can be absorbed faster and can help prevent adrenal crisis.

 

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There is very little research on infusion pump therapy for the treatment of adrenal insufficiency.  However, this foundation has tirelessly worked to gather as much research and information as possible to change lives with this revolutionary concept.

Though we are not a replacement for medical care or advice, our foundation team is a combination of licensed medical professionals and adrenal patients who are veteran pumpers. We can help guide you to the right information to manage your care with the infusion pump.  It is our objective to ensure this treatment option is available to any adrenal patient who would benefit from it.

Please fill out the contact form if you need assistance with cortisol pump advocacy.

 

 

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