The postoperative evaluation and management of patients with hypercortisolism

Dr. Lewis Blevins’ discussion on the postoperative evaluation and management of patients with hypercortisolism is technical and directed to physicians, but we encourage everyone to listen to it.

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  1. Coming off of high cortisol, whether it’s endogenous or exogenous is like coming off of crack. Not that I’ve ever used crack, but based on documentaries, I’d say it’s close. It’s miserable, difficult physically and emotionally. To say that a Cushings patient should be weaned to physiological doses by 6 weeks seems like madness and a recipe for a crisis. Maybe there are some patients who manage this maniac wean, but it would have been pure torture. And I wasn’t even on much over a physiological dose to begin with post op.

  2. I told one of my specialists how it felt tapering off high levels of cortisol and was treated as if I were threatening his ability to treat me and my inflammation. He instructed me to only comment on his area of expertise as a cardiologist while in his office. He was not interested in discussing Cushings disease or it’s complications even as a Staff member of the university medical center.


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