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They really do exist. Whites with angioedema even dying from it. Said to be many times more comN in AAs. But so is BTN in general.They are often reached for to treat HTN in blacks despite this and despite the fact that the recommendations are to start with a diuretic if DASH fails. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 17, 2012, at 21:40, Phyllis <phylisrn@...> wrote:

Lisinopril gave me angioedema. In fact, I see a lot of

African-Americans coming into the ER with their tongues sticking out

of their mouths because of Lisinopril.

I have never seen a Caucasian react to Lisinopril. I mean get

angioedema where their tongue, lips and throat swell.

Phyllis

On 6/17/2012 8:44 PM, Cybil wrote:

The meds I was on before my anaphylaxis were as follows

Lisinopril 10 qd

Metoprolol 25 bid

Hctz 25

Ibuprofen 800 prn for back pain

After hospitalization

Hydrolazine 25 tid

Hctz 25

Zyrtec 10 qd

Clatiron 10 qd

Allegra 220 qd

Flonase

Advair

Sent from my Verizon Wireless Phone

Clarence Grim <lowerbp2@...>

wrote:

>With a negative CT assuming it was read correctly and

I have picked up missed one's by looking at the CT. Then I

recommend a trial of Spiro and DASH. READ my evolution

article now. Please give use names of all drugs. The

anaphylaxis most like due to an ACE. BUT we and your

family need the exact names. It is a matter of life and

death.

>

>

>

>May your pressure be low!

>

>CE Grim MS, MD

>Specializing in Difficult

>Hypertension

>

>On Jun 17, 2012, at 16:32, Cybil <cybil.baker@...>

wrote:

>

>> I have had a ct scan without contrast that was

negative. I have also had an ultrasound /doppler of the

kidneys. Nothing significant found there also. My story is

that after 2 years of high BP on hctz my pcp added an ACE.

I had an episode 1 week after starting that in which I got

really dizzy and light-headed and felt like I was going to

die. In the ambulance my BP was 188/116. After nitro my BP

did not drop at all. In the hospital I had several iv BB

and more nitro. The lowest my BP got was 150/90. I was

realeased on more BB's. Then I had an anaphylaxis reaction

to one of those medications so found myself back in the

ccu of the hospital. NEVER could they get my BP lower than

150/110. But I was realeased and referred to a nephro.

That was 2 months ago and here I stand. She has not said

anything about any further testing. Should I ask her about

it?

>> Cybil 36 y.o. female

>> Dashing

>> Low k,Mg,ca

>> Just dx with hyperaldo (she will not call it PA)

>>

>> Sent from my Verizon Wireless Phone

>>

>> <jclark24p@...>

wrote:

>>

>> >I was wondering this too. Have they done a

scan to see if you have a tumor? If not they should

because there is possibility (abet low) that it could be

malginant. They should also recheck it if you have one to

ensure it is not growing. Also, your doctor should give

you all the options so you can decide what is best for

you, "wait and see" is not the best option if you are

going to consider it later because the chance of sucess is

better the sooner you remove it.

>> >

>> >

>> >> >

>> >> > I got my drug free test results

back. Serum aldo 24 (0-30) Renin 0.11. Urine aldo 47

(0-12). Nephro ordered spiro and says no more testing. Is

that ok?

>> >> >

>> >> > Cybil. 5'11 208 lbs

>> >> > 36 y.o. female

>> >> > FINALLY dx with hyperaldosteronism

(although dr. wouldn't go near PA)

>> >> > Low K+,CA, MG

>> >> > Dashing with all my heart and still

losing wt!

>> >> > BP down to 140/90 consistently

>> >> >

>> >> > Sent from my Verizon Wireless Phone

>> >> >

>> >>

>> >

>> >

>>

[Guest guest]

Will be driving to Tahoe this week on I80 and suspect we may be able to see/smell the smoke. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 17, 2012, at 22:09, 11981198 <val@...> wrote:

The fires are about 45 miles away but we're keeping a careful watch on my son's house.That endo might have killed me had I not had Dr. Grim's wonderful advice about sodium. When I got to Mayo (an awful experience), my urinary sodium was "too low to quantitate." Dr. Young said he'd never seen sodium that low. I would think an expert would have seen someone who controlled dietary sodium.Val----- Original Message -----From: hyperaldosteronism

Ah yes u can pay for your degree in Pakistan. Trust the fires missed u?On Jun 17, 2012, at 19:26, 11981198 <val@...> wrote:

I was referred from a GP to an endocrinologist with raging BP about 200/100. It took two months to get into see her. When I told her about PA and Dr. Grim, she muttered something under her breath about "other patients." I honestly don't think she knew anything about PA prior to my mention. She gave me spiro, as I asked. When my heartbeaty went erratic (via my husband's listening), she called in Toprol. Never did she ever listen to my heart. Then, she referred me to a shrink. I don't believe I've ever seen a doctor more incredibly incompetent. She got her MD from the University of Lahore in Pakistan.ValFrom: Study Circle <studycircle@...>

"A physician who remains silent after two months about a patient in dire need of dx must be placed among jack asses for one whole year and fed the same food as asses..."

Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use

.

[Guest guest]

I've seen many in the rainbow react to Lisinopril - the ACE Inhibitors, but they aren't recommended in AA's anyway, typically. Some research says they do not work as well in AA's and some say as good as anything else. I tend not to use them as a first line in my AA patients just to be safe.

>> >> >I was wondering this too. Have they done a scan to see if you have a tumor? If not they should because there is possibility (abet low) that it could be malginant. They should also recheck it if you have one to ensure it is not growing. Also, your doctor should give you all the options so you can decide what is

best for you, "wait and see" is not the best option if you are going to consider it later because the chance of sucess is better the sooner you remove it.>> >>> >>> >> >>> >> > I got my drug free test results back. Serum aldo 24 (0-30) Renin 0.11. Urine aldo 47 (0-12). Nephro ordered spiro and says no more testing. Is that ok?>> >> > >> >> > Cybil. 5'11 208 lbs>> >> > 36 y.o. female>> >> > FINALLY dx with hyperaldosteronism (although dr. wouldn't go near PA)>> >> > Low K+,CA, MG>> >> > Dashing with all my heart and still losing wt! >> >> > BP down to 140/90 consistently >> >> > >> >> > Sent from my Verizon

Wireless Phone>> >> >>> >>>> >>> >>>

[Guest guest]

I'd bet the chart shows they listened.

I was referred from a GP to an endocrinologist with raging BP about 200/100. It took two months to get into see her. When I told her about PA and Dr. Grim, she muttered something under her breath about "other patients." I honestly don't think she knew anything about PA prior to my mention. She gave me spiro, as I asked. When my heartbeaty went erratic (via my husband's listening), she called in Toprol. Never did she ever listen to my heart. Then, she referred me to a shrink. I don't believe I've ever seen a doctor more incredibly incompetent. She got her MD from the University of Lahore in Pakistan.Val

From: Study Circle <studycircle@...>

"A physician who remains silent after two months about a patient in dire need of dx must be placed among jack asses for one whole year and fed the same food as asses..."

Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use

..

[Guest guest]

It likely was a reaction but not true anaphylaxis if they couldn't get your BP down and it stayed high. The true hallmark of real anaphylaxis is a drop in blood pressure through a process of vascular dilation in the allergic mechanism, which, when our vascular system loses it's tension, our blood doesn't flow well. When I teach it, I use the example, albeit super simplistic of picturing the hose on on your home water spigot. When you turn it on, and have a tight hose, it squirts out great. But if you tried to put a fire hose onto the same spigot (they are 4" wide BTW) then water barely drips out at the end, even though the same amount is coming out of the spigot. And your case would have been awful delayed for anaphylaxis.

But what makes more sense is that ACEI's create the byproduct bradykinin - this is the common cause - though harmless - of the cough which the most common side effect of ACEI's, but sometimes it builds up and it causes a vasodilation, which is the swelling we get all over, especially our face, and is a more likely cause of your angioedema. Alcohol and cinnamon, of all things, can actually make it worse.

ACEI's, among alot of things, are also known to trigger hereditary angioedema (HAE), wherein the signs and symptoms are very anaphylaxis like, except it is not allergy caused. Treatment is not terrifically different, but it is a little. That's why when we work the ER it's important to try and at least figure out what we have. We'd treat the true anaphylaxis with epinepherine, but we probably wouldn't want to give someone EPI in angioedema, especially someone high stroke risk and with severe HTN.

So your likely not "allergic" to ACE inhibitors, but your body reacts to it in a bad way.

>> >> >I was wondering this too. Have they done a scan to see if you have a tumor? If not they should because there is possibility (abet low) that it could be malginant. They should also recheck it if you have one to ensure it is not growing. Also, your doctor should give you all the options so you can decide what is

best for you, "wait and see" is not the best option if you are going to consider it later because the chance of sucess is better the sooner you remove it.>> >>> >>> >> >>> >> > I got my drug free test results back. Serum aldo 24 (0-30) Renin 0.11. Urine aldo 47 (0-12). Nephro ordered spiro and says no more testing. Is that ok?>> >> > >> >> > Cybil. 5'11 208 lbs>> >> > 36 y.o. female>> >> > FINALLY dx with hyperaldosteronism (although dr. wouldn't go near PA)>> >> > Low K+,CA, MG>> >> > Dashing with all my heart and still losing wt! >> >> > BP down to 140/90 consistently >> >> > >> >> > Sent from my Verizon Wireless Phone>> >> >>> >>>> >>> >>>

[Guest guest]

all I know is that I was given epinephrine in the e.r. and that to this

day my chart reads: anaphylaxis general, angioedema of the lips and throat, and

hives. And they never did put on my chart an allergy to ANYTHING. But that is

exactly what must nephro said to me also. Actually her exact words were " that's

odd, in true anaphylaxis your blood pressure should have dropped " . All I know

is that I was covered from head to toe with hives,my face and hands were

swollen, my lips were swollen and I couldn't breathe well.

Sent from my Verizon Wireless Phone

Bingham <jlkbbk2003@...> wrote:

>

>

> 

>It likely was a reaction but not true anaphylaxis if they couldn't get your BP

down and it stayed high. The true hallmark of real anaphylaxis is a drop in

blood pressure through a process of vascular dilation in the allergic

mechanism, which, when our vascular system loses it's tension, our blood

doesn't flow well. When I teach it, I use the example, albeit super simplistic

of picturing the hose on on your home water spigot. When you turn it on, and

have a tight hose, it squirts out great. But if you tried to put a fire hose

onto the same spigot (they are 4 " wide BTW) then water barely drips out at the

end, even though the same amount is coming out of the spigot. And your case

would have been awful delayed for anaphylaxis.

> 

>But what makes more sense is that ACEI's create the byproduct bradykinin -

this is the common cause - though harmless - of the cough which the most common

side effect of ACEI's, but sometimes it builds up and it causes a

vasodilation, which is the swelling we get all over, especially our face, and is

a more likely cause of your angioedema. Alcohol and cinnamon, of all things, can

actually make it worse.

> 

>ACEI's, among alot of things, are also known to trigger hereditary angioedema

(HAE), wherein the signs and symptoms are very anaphylaxis like, except it is

not allergy caused. Treatment is not terrifically different, but it is a little.

That's why when we work the ER it's important to try and at least figure out

what we have. We'd treat the true anaphylaxis with epinepherine, but we probably

wouldn't want to give someone EPI in angioedema, especially someone high stroke

risk and with severe HTN.

> 

>So your likely not " allergic " to ACE inhibitors, but your body reacts to it in

a bad way.

> 

> 

>  

>>>

>>> >I was wondering this too. Have they done a scan to see if you have a tumor?

If not they should because there is possibility (abet low) that it could be

malginant. They should also recheck it if you have one to ensure it is not

growing. Also, your doctor should give you all the options so you can decide

what is best for you, " wait and see " is not the best option if you are going to

consider it later because the chance of sucess is better the sooner you remove

it.

>>> >

>>> >

>>> >> >

>>> >> > I got my drug free test results back. Serum aldo 24 (0-30) Renin 0.11.

Urine aldo 47 (0-12). Nephro ordered spiro and says no more testing. Is that ok?

>>> >> >

>>> >> > Cybil. 5'11 208 lbs

>>> >> > 36 y.o. female

>>> >> > FINALLY dx with hyperaldosteronism (although dr. wouldn't go near PA)

>>> >> > Low K+,CA, MG

>>> >> > Dashing with all my heart and still losing wt!

>>> >> > BP down to 140/90 consistently

>>> >> >

>>> >> > Sent from my Verizon Wireless Phone

>>> >> >

>>> >>

>>> >

>>> >

>>>

>

>

>

>

>

[Guest guest]

You had a classic ACE reaction and your chart should be labeled so. If you were also on BB the BP may have gone up do to the BB effect. CE GrimMDOn Jun 18, 2012, at 9:13 AM, Cybil wrote: all I know is that I was given epinephrine in the e.r. and that to this day my chart reads: anaphylaxis general, angioedema of the lips and throat, and hives. And they never did put on my chart an allergy to ANYTHING. But that is exactly what must nephro said to me also. Actually her exact words were "that's odd, in true anaphylaxis your blood pressure should have dropped". All I know is that I was covered from head to toe with hives,my face and hands were swollen, my lips were swollen and I couldn't breathe well. Sent from my Verizon Wireless Phone Bingham <jlkbbk2003@...> wrote: > > > >It likely was a reaction but not true anaphylaxis if they couldn't get your BP down and it stayed high. The true hallmark of real anaphylaxis is a drop in blood pressure through a process of vascular dilation in the allergic mechanism, which, when our vascular system loses it's tension, our blood doesn't flow well. When I teach it, I use the example, albeit super simplistic of picturing the hose on on your home water spigot. When you turn it on, and have a tight hose, it squirts out great. But if you tried to put a fire hose onto the same spigot (they are 4" wide BTW) then water barely drips out at the end, even though the same amount is coming out of the spigot. And your case would have been awful delayed for anaphylaxis. > >But what makes more sense is that ACEI's create the byproduct bradykinin - this is the common cause - though harmless - of the cough which the most common side effect of ACEI's, but sometimes it builds up and it causes a vasodilation, which is the swelling we get all over, especially our face, and is a more likely cause of your angioedema. Alcohol and cinnamon, of all things, can actually make it worse. > >ACEI's, among alot of things, are also known to trigger hereditary angioedema (HAE), wherein the signs and symptoms are very anaphylaxis like, except it is not allergy caused. Treatment is not terrifically different, but it is a little. That's why when we work the ER it's important to try and at least figure out what we have. We'd treat the true anaphylaxis with epinepherine, but we probably wouldn't want to give someone EPI in angioedema, especially someone high stroke risk and with severe HTN. > >So your likely not "allergic" to ACE inhibitors, but your body reacts to it in a bad way. > > > >>> >>> >I was wondering this too. Have they done a scan to see if you have a tumor? If not they should because there is possibility (abet low) that it could be malginant. They should also recheck it if you have one to ensure it is not growing. Also, your doctor should give you all the options so you can decide what is best for you, "wait and see" is not the best option if you are going to consider it later because the chance of sucess is better the sooner you remove it. >>> > >>> > >>> >> > >>> >> > I got my drug free test results back. Serum aldo 24 (0-30) Renin 0.11. Urine aldo 47 (0-12). Nephro ordered spiro and says no more testing. Is that ok? >>> >> > >>> >> > Cybil. 5'11 208 lbs >>> >> > 36 y.o. female >>> >> > FINALLY dx with hyperaldosteronism (although dr. wouldn't go near PA) >>> >> > Low K+,CA, MG >>> >> > Dashing with all my heart and still losing wt! >>> >> > BP down to 140/90 consistently >>> >> > >>> >> > Sent from my Verizon Wireless Phone >>> >> > >>> >> >>> > >>> > >>> > > > > >

[Guest guest]

And the medication of the bad way is immuniologic in part because ACE blocks one of the systems that couteracts an allergic reaction.Again if you BB one loses the normal BB effect of vasodilation when needed to modulate BP responses. But when there is an need for an SNS discharge the only effect may be a alpha effect which increases BP esp if one got NE.Wonder if you have gotten the Hypertension Primer yet?Can strongly recommend it for bedside reading. Each chapter is only 2 pages or so an if you do it every week night you will have gotten thru it in about a year. Some parts are great snoozers except of course fo the BP chapter which we wrote.CE Grim MDOn Jun 17, 2012, at 11:43 PM, Bingham wrote: It likely was a reaction but not true anaphylaxis if they couldn't get your BP down and it stayed high. The true hallmark of real anaphylaxis is a drop in blood pressure through a process of vascular dilation in the allergic mechanism, which, when our vascular system loses it's tension, our blood doesn't flow well. When I teach it, I use the example, albeit super simplistic of picturing the hose on on your home water spigot. When you turn it on, and have a tight hose, it squirts out great. But if you tried to put a fire hose onto the same spigot (they are 4" wide BTW) then water barely drips out at the end, even though the same amount is coming out of the spigot. And your case would have been awful delayed for anaphylaxis. But what makes more sense is that ACEI's create the byproduct bradykinin - this is the common cause - though harmless - of the cough which the most common side effect of ACEI's, but sometimes it builds up and it causes a vasodilation, which is the swelling we get all over, especially our face, and is a more likely cause of your angioedema. Alcohol and cinnamon, of all things, can actually make it worse. ACEI's, among alot of things, are also known to trigger hereditary angioedema (HAE), wherein the signs and symptoms are very anaphylaxis like, except it is not allergy caused. Treatment is not terrifically different, but it is a little. That's why when we work the ER it's important to try and at least figure out what we have. We'd treat the true anaphylaxis with epinepherine, but we probably wouldn't want to give someone EPI in angioedema, especially someone high stroke risk and with severe HTN. So your likely not "allergic" to ACE inhibitors, but your body reacts to it in a bad way. >> >> >I was wondering this too. Have they done a scan to see if you have a tumor? If not they should because there is possibility (abet low) that it could be malginant. They should also recheck it if you have one to ensure it is not growing. Also, your doctor should give you all the options so you can decide what is best for you, "wait and see" is not the best option if you are going to consider it later because the chance of sucess is better the sooner you remove it.>> >>> >>> >> >>> >> > I got my drug free test results back. Serum aldo 24 (0-30) Renin 0.11. Urine aldo 47 (0-12). Nephro ordered spiro and says no more testing. Is that ok?>> >> > >> >> > Cybil. 5'11 208 lbs>> >> > 36 y.o. female>> >> > FINALLY dx with hyperaldosteronism (although dr. wouldn't go near PA)>> >> > Low K+,CA, MG>> >> > Dashing with all my heart and still losing wt! >> >> > BP down to 140/90 consistently >> >> > >> >> > Sent from my Verizon Wireless Phone>> >> >>> >>>> >>> >>>

[Guest guest]

Oh I agree Cybil and it sounds like they took good care of you and I know I would never touch it again. I had a bad reaction to nifedipine in the ER once - made my heart rate over 200 - and I wouldn't chance it again. Just sayin how the ACE reaction is a little different and as Dr G says below the ACEI's are known to have that type of reaction which is too common in medical terms. While it's just a little different than true anaphylaxis though the end result could be......well, we don't want to talk about.

>>> >>> >I was wondering this too. Have they done a scan to see if you have a tumor? If not they should because there is possibility (abet low) that it could be malginant. They should also recheck it if you have one to ensure it is not growing. Also, your doctor should give you all the options so you can decide what is best for you, "wait and see" is not the best option if you are

going to consider it later because the chance of sucess is better the sooner you remove it.>>> >>>> >>>> >> >>>> >> > I got my drug free test results back. Serum aldo 24 (0-30) Renin 0.11. Urine aldo 47 (0-12). Nephro ordered spiro and says no more testing. Is that ok?>>> >> > >>> >> > Cybil. 5'11 208 lbs>>> >> > 36 y.o. female>>> >> > FINALLY dx with hyperaldosteronism (although dr. wouldn't go near PA)>>> >> > Low K+,CA, MG>>> >> > Dashing with all my heart and still losing wt! >>> >> > BP down to 140/90 consistently >>> >> > >>> >> > Sent from my Verizon Wireless Phone>>> >> >>>> >>>>> >>>> >>>>

>>>>>

[Guest guest]

I can also highly recommend it! I got mine online for $10 - $12, a student had

it and it looked brand new! (It's a lot more tattered now!)

> > >> >> >

> > >> >> > I got my drug free test results back. Serum aldo 24 (0-30)

> > Renin 0.11. Urine aldo 47 (0-12). Nephro ordered spiro and says no

> > more testing. Is that ok?

> > >> >> >

> > >> >> > Cybil. 5'11 208 lbs

> > >> >> > 36 y.o. female

> > >> >> > FINALLY dx with hyperaldosteronism (although dr. wouldn't go

> > near PA)

> > >> >> > Low K+,CA, MG

> > >> >> > Dashing with all my heart and still losing wt!

> > >> >> > BP down to 140/90 consistently

> > >> >> >

> > >> >> > Sent from my Verizon Wireless Phone

> > >> >> >

> > >> >>

> > >> >

> > >> >

> > >>

> >

> >

>