Deanna "Toby" Sharpe: Addison's Disease

(Medical records will be under ‘Deanna Sharpe’ but she prefers to be known as ‘Toby’.)

If Toby is unresponsive, she may be having an adrenal crisis.

DIAL 999 FOR AN AMBULANCE

Remove anything from around her neck.
Make her safe (recovery position, if possible).
If you’re trained to do so, mix and inject the solution.

Injection Instructions:

  1. Remove packaging from needles, syringe, and ampules.
  2. Gently hold water ampule (smallest bottle) upright.
  3. Tap the tip so all solution drops into the base.
  4. Snap the tip off (long safety breaker available).
  5. Fix green needle to tip of syringe like a bayonet.
  6. Insert needle into sterile solution. Draw fluid up fully.
  7. Take yellow cap off powder bottle.
  8. Insert needle through cork and deliver fluid into powder.
  9. Withdraw needle.
  10. Mix powder and fluid with circular ‘rotating’ motion.
  11. Take long ‘green’ needle off the syringe.
  12. Uncover Deanna’s thigh.
  13. Attach shorter, ‘blue’ needle to syringe.
  14. Insert shorter needle into mixed solution. Draw up fully.
  15. Check for air bubbles: focus on the tip.
  16. Hold syringe with needle pointing straight up.
  17. Gently push plunger until tiny bead of solution appears.
  18. Flick barrel twice to burst any remaining bubbles.
  19. As straight as possible, fully insert needle through bare skin into muscle.
  20. Push the plunger slowly and steadily until all solution is     fully injected into  the muscle.
  21. Carefully withdraw.
  22. Note time of injection.
  23. Make sure Deanna is safe and warm.
  24. Check that someone has called 999.
  25. Make used sharps safe in protective plastic covers.

Thank you for any help you can offer.

If Toby is unresponsive, she needs that injection.
Please do that before reading any further.
If she had a seizure, note the time and how long it lasted.

Tell the 999 operator that the NHS is aware of Deanna’s condition.

Her medical history is linked to her NHS number: 701 075 3547
and her North Hampshire Hospital number: 1077787

Name: Deanna Sharpe (prefers to be known as ‘Toby’)
Date of  Birth: 21st September 2008
Medical  Condition: Addison’s Disease
Diagnosed on 9th September 2020.
(Auto-immune condition. Adrenal glands can’t produce Cortisol. Without regular medication, her kidneys will fail and shut down.)

Contact: 
Nadia Sharpe: 07788 418683 (Mother)
Calvin Sharpe: 07787 556380 (Father)
Stephen Sharpe: 07974 974489 (Grandad)
Gary Sharpe: 07896 259452 (Uncle)

Further Information
Blood Group: B Positive
Food or drug allergies: None known

Current medication (as of Nov 2023)
Fexofenadine: 180mg OD @ 18:00
Fludrocortisone: 0.1mg  BD @ 08:00 + 18:00
Hydrocortisone: 10mg @ 08:00
Hydrocortisone: 7.5mg @ 12:00
Hydrocortisone: 5.0mg @ 16:00
Hydrocortisone: 2.5mg @ 20:00
Levetiracetam (anti-seizure medication) 500mg BD
Multivitamins: OD @ 18:00

Sick day doses
Hydrocortisone 10mg: 08:00, 12:00, 16:00, 20:00
Ferrous Fumerate 210mg OD

Emergency injections
Hydrocortisone Sodium Succinate 100mg/ml IM
or:
Hydrocortisone Sodium Phosphate 100mg/ml IM
also:
Buccal Midazolam 10mg if seizure lasts more than 5 min.

Consultant Paediatrician
Dr. Edward Hind c/o North Hampshire Hospital (01256) 314715 or (01256) 473202

GP: Dr. Vital Sijbers c/o Crown Heights Medical Centre, Basingstoke (01256) 329021

North Hampshire Hospital liaison service: PCLS@hhft.nhs.uk
Patient Medicine Helpline: (01256) 313601

Paediatrics:
(01256) 3124760 Mon-Fri
opd.child@hhft.nhs.uk

Seizures History

November 2022
1st seizure occurred on a Saturday, mid-November, between 10 and 11 pm. Quite severe, lasted at least 3-5 minutes. Emergency Hydrocortisone injection administered. Visit to A&E. Discharged early hours of Sunday.

November 2022
2nd seizure occurred same day, one week later, about the same time. Not so severe and didn’t last as long. Hydrocortisone injection again, followed by A&E. (Copy of Discharge Summary on this page came from this visit.)

November 2023
Very close to one year later, one seizure on the 6th and again on the 24th. About 3-5 min each. First one treated with injection and visit to A&E. Second with increased dosage but no A&E visit.

December 2023
1st Dec: Felt a ‘presence’ ,similar to how she felt previously, just before a seizure.
4th Dec: Around midnight, injection and A&E. Not discharged until late afternoon next day.
23rd Dec: 18:10 for 6 min. No A&E visit, but short-term increase in medication.

January 2024
1st Jan: 21:50 for 10 min. Most severe yet. Seen by Dr. Julia Shaw (Paediatric Consultant).
New anti-seizure medication prescribed: Levetiracetam. Also prescribed with Buccal Midazolam for emergency administration, if a seizure lasts longer than 5 min.

No further occurrences since January 2024. Noted June 2024.

Discharge Summary 27th November 2022:

 

End of page.