Hi Kris,

Getting Misty's ACTH into the normal range should be a priority right now. That uncontrolled PPID could be the driving force behind all the issues she is having. Uncontrolled PPID will cause tendon issues and a host of other problems as well. Jaini has given you a great guide for getting your perglide dose higher to work toward getting that ACTH under control.

Have you considered botox injections for the contracted tendons? Also, a lot of muscle work to facilitate her ability to lower her heels. The demineralization of the coffin bone is likely due to the excessive pressure being placed upon it from the heels being too high.

If she is in a chronic state of pain then it shouldn't really skew ACTH results. Insulin/glucose may be a bit affected but you still need to know where they are so you can make management decisions based on facts rather than guesswork.

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team