It happened slowly and almost imperceptibly .
The first signs were in in sixth form. I was struggling with my A levels. Although my twin Lottie and I had sailed through our GCSEs, getting top grades in every subject, my marks and attendance started to slide. I just felt too tired and unmotivated to go to school.
Lottie continued to excel, got straight A's, and went to Oxford. I didn’t do as well, and missed out on my provisional place at Pembroke College, Cambridge. My grades were enough to get me to the University of St Andrews so I started there that Autumn studying Biology.
Of course, I was upset. I felt I could have done better in my exams. I came up with excuses. I love naps and lie-ins, I said. I just get tired easily, that’s all. I’m late because I have to be clean and made-up. I can’t just roll out of bed like you scruffs!
Life at St Andrews was an improvement – I clicked with the teachers, the material, the exams. I lived a short distance from the science campus and getting around the little flat town was easy on my bike. No more waiting for a school bus! I even got my own room, after 18 years of sharing with Lottie. I could have uninterrupted naps!
By my third year, there were more insidious symptoms. I continued to explain them away. I love crisps (US: chips) but 2 big bags of Doritos a day? I must be an addict, then! I have a funny turn if I’m in the shower for too long, maybe it’s just too hot, I do like hot showers. I can’t use my bike, I think the gears are sticking. Tired after dance rehearsals? I’m just unfit, that’s all! I’m fine! Honestly!
I often heard, “you’re so skinny...” but I’ve always been skinny. I was a UK size 6 and never weighed more than 6 ½ stone. I’d padded my bra with chicken fillets ever since I was 18. (Lottie, being non-identical, was always a size 10 and pretty sure she’s never needed a chicken fillet.)
People commented on my appearance, and not in a complimentary way.
Then came the nausea, loss of appetite, and the retching. I retched whenever I was near food that wasn’t laden with salt. I ate crisps and crackers, and teaspoonfuls of capers straight from the jar. I could only eat an apple if I dipped it in pickle.
There were more comments every day. Do you have an eating disorder? Promise me you’ll get help. We can hear you being sick at night...
When exam season finished, I knew I hadn’t done as well as in my previous two years. I’d been too tired and foggy, but I’d struggled through them anyway.
When my Mum drove up from England to pick me up from school, we ordered an Indian takeaway. I remember not being able to stand up while waiting in the car park for the delivery. I sat down, out of breath but insisting I was OK. I barely ate any of the food, although it was my favourite.
Maybe I'm pregnant, I thought. That would explain the sickness, the tiredness, the weird cravings...yes, that was it! Except I wasn’t.
Back home in Derbyshire, my Mum worried when I’d stopped having showers and took baths instead, despite having previously been highly vocal about how much I disliked baths. Post bath, I sat there in a dressing gown without my make up on, unable to get up.
“You look a funny colour.” said my Mum.
“Yes, but I always look pale-“
And I was. My face was bronzed, especially my forehead. That’s weird – I lived in Scotland! Under a layer of makeup! Nevertheless, I was so tired I just went back to bed.
I continued to lie in bed for the week. I complained of chest pains. I told my Mum I wanted to die. She took me to my general practitioner who was worried I had a pulmonary embolus (clot on my lung) and sent me straight to hospital.
The nurse who took my blood pressure had to physically hold me upright while she did it. The dial counted lower and lower until it got to 38/31, which you may recognise as "not a normal blood pressure for a human being." I got put on a drip.
“Hi, I’m the doctor." She was a junior doctor on the foundation training program, as I am now.
“About time” I said under my breath; it was past midnight.
“Have you eaten too many bananas?” she continued
“What? No? How many is too many, anyway?”
My potassium levels were high, she explained.
“No, I don’t like bananas. What’s wrong with me?”
“You could have a brain tumour, but we’ll do more tests in the morning.” And then she left.
Now that I’m a doctor too, thinking back to this moment always galls me. If she’d have taken a full history and examined me, she would have known straight away what is was, since I was a textbook case, but she didn’t. And then she wouldn’t have scared me with the words "brain tumour."
They shouldn’t have left me for hours, either, as I must have been "scoring" on my basic observations -- tachycardic, short of breath and hypotensive, I would have "scored" at least a 6 or 7 on the early warning scale; a three gets you seen quickly in most hospitals.
The consultant practically bounced through the door. She seemed excited (Aha! We’ve got one!). She started me on steroids and I perked up straight away.
She explained my adrenal glands had stopped working and that I mostly likely had the autoimmune form as I’d developed it after childhood. I learnt that the lack of aldosterone made me crave salty food and the lack of cortisol made me tired.
Being unable to stand was caused by low blood pressure, and the funny tan was a byproduct of my pituitary gland trying to wake up my adrenals.
My whole family visited every day while I recouped, even Lottie who was just about to sit her finals. I felt lucky I wasn’t at Cambridge as I would have had to take exams later in the summer. I think I would have tried to power through them and not sought medical attention.
Since the diagnosis, almost every aspect of my life has changed. I know I could take a turn for the worst if I got ill, even with something like the flu. I have to take tablets every day, and without them, I would die. Addison’s is fatal without treatment. I’m also at risk of more autoimmune conditions like type one diabetes and thyroid conditions
Knowing all this, I’ve become a lot more "YOLO" (I hate the term but that’s a good approximation). I broke up with my long-term boyfriend, who’s reaction to my diagnosis was that I was a "bad girlfriend" for not replying to every banal message he sent. Wow, I thought, I almost died, and you’re angry I didn’t text you 24/7?
I applied to medical school and was accepted. I went through various boyfriends and flings, I had fun, broke some hearts, got mine broken a few times. I got on a plane for the first time – my first flight was Heathrow to Manila! I went wild around St Andrews with my best friend Laura. I bought a sewing machine and made a medieval dress. I got a pixie cut.
My appetite isn’t the best and I’m tired a lot. The tan has mostly gone.
I put on weight (enough to ditch the chicken fillets in my bras!), but I’ve lost a lot in the past year. Being a busy trainee does that to every doctor. I try to educate other doctors about Addison’s including my class at medical school. They got me a beautiful medicAlert necklace in return.
To this day, I get comments and compliments about my appearance. I want to say, would you want a potentially deadly medical condition just to get thin? But mostly, I’m grateful there was a doctor out there who could help me. I have Addison's, but I'm okay.