Guest guest Posted July 18, 2004 Report Share Posted July 18, 2004 Thats because low K with primary aldo blocke the effects of ADH on the kidney-you cant concentrate your urine. Once this is corrected either with spiro or surgey the poly urian and noctura goes away. I once had patinet who never told me of the problem she had until after curative surgery I asked her how she was better she said she did not have to get up at night to urinate 14 times a night!. May your pressure be low! Clarence E. Grim, BS, MS, MD, FACP, FACC Professor of Medicine and Epidemiology Board Certified in Internal Medicine, Geriatrics and Hypertension Focusing on difficult to control high blood pressure and high cholesterol especially in the African Diaspora “Of all the forms of injustice, inequality in health is the most shocking and inhumanâ€: Dr. Luther King, Jr. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2004 Report Share Posted July 18, 2004 Tell your Dr to read up on the new conepts of aldo and HTN that have only been around for 30 years. Spiro does lower BP AND increases K and the level of sodium in the bood has nothing to do with it. It is how much aldo there is and how much salt you eat. Toprol works poorly in PA as the renin is low. So do ACEs adn ARBs and even CCBs may not work as well. This is the reason that many with drug resistant HTN have PA as they have failed to be controlled on these drugs which do not lower BP in PA. You probably overdosed on salt on your trip. Good reason to watch it. PA is the most salt sensitive form of HTN. May your pressure be low! Clarence E. Grim, BS, MS, MD, FACP, FACC Professor of Medicine and Epidemiology Board Certified in Internal Medicine, Geriatrics and Hypertension Focusing on difficult to control high blood pressure and high cholesterol especially in the African Diaspora “Of all the forms of injustice, inequality in health is the most shocking and inhumanâ€: Dr. Luther King, Jr. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2004 Report Share Posted July 19, 2004 Recommend you see if there is a Seattel Sutton Healthy Eating in your area. Good way to lose weight it seems to me. Am now using it myself andhave lost 30lbs in about 6 weeks. Food is excellent,, fresh and filling. It provides all you need to eat for about $15 per day. I will keep you all posted on how I am doing. May your pressure be low! Clarence E. Grim, BS, MS, MD, FACP, FACC Professor of Medicine and Epidemiology Board Certified in Internal Medicine, Geriatrics and Hypertension Focusing on difficult to control high blood pressure and high cholesterol especially in the African Diaspora “Of all the forms of injustice, inequality in health is the most shocking and inhumanâ€: Dr. Luther King, Jr. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2004 Report Share Posted July 19, 2004  I also noticed a decrease in the amount of times I have to get up at night. In addition, I no longer suffered from restless legs syndrome on the Spiro, but that was sometimes relieved by emptying my bladder so that might be related to the less frequent need to urinate as well. Re: BP spiked again Thats because low K with primary aldo blocke the effects of ADH on the kidney-you cant concentrate your urine. Once this is corrected either with spiro or surgey the poly urian and noctura goes away. I once had patinet who never told me of the problem she had until after curative surgery I asked her how she was better she said she did not have to get up at night to urinate 14 times a night!. May your pressure be low!Clarence E. Grim, BS, MS, MD, FACP, FACCProfessor of Medicine and EpidemiologyBoard Certified in Internal Medicine, Geriatrics and HypertensionFocusing on difficult to control high blood pressure and high cholesterol especially in the African Diaspora “Of all the forms of injustice, inequality in health is the most shocking and inhumanâ€:Dr. Luther King, Jr. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2004 Report Share Posted July 19, 2004  Great job! Yes, they have it in Menomonee Falls and Oconomowoc... I've considered it in the past. My issue has always been my travel schedule, but I suppose just doing it the weeks I am home would be a good start. It always helps to talk to someone else with a success story. Re: BP spiked again Recommend you see if there is a Seattel Sutton Healthy Eating in your area. Good way to lose weight it seems to me. Am now using it myself andhave lost 30lbs in about 6 weeks.Food is excellent,, fresh and filling. It provides all you need to eat for about $15 per day. I will keep you all posted on how I am doing.May your pressure be low!Clarence E. Grim, BS, MS, MD, FACP, FACCProfessor of Medicine and EpidemiologyBoard Certified in Internal Medicine, Geriatrics and HypertensionFocusing on difficult to control high blood pressure and high cholesterol especially in the African Diaspora “Of all the forms of injustice, inequality in health is the most shocking and inhumanâ€:Dr. Luther King, Jr. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2004 Report Share Posted July 20, 2004 > Tell your Dr to read up on the new conepts of aldo and HTN that have only > been around for 30 years. Spiro does lower BP AND increases K and the level of > sodium in the bood has nothing to do with it. It is how much aldo there is > and how much salt you eat. > Dr Grim, I am confused - I thought that Spiro/Inspra affected sodium in the blood by blocking aldo, and the less aldo you have, the less sodium you will have, because too much aldo causes you to retain sodium. But you seem to be saying that Spiro/Inspra have nothing to do with sodium in the blood? Jim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2004 Report Share Posted July 20, 2004 > Hi, > > You might try limiting your fluid intake to around 1 > liter per day until your BP stablizes and you again > gain the benefits of your low-sodium diet. This is > the amount recommended for heart failure patients, so > I imagine it should be adequate. I'm sure Dr. Grim > can correct me about all this if I'm mistaken, but the > idea is that spironolactone works because it > interrupts the body's mechanism for the retention of > salt. Sodium retention makes us more thirsty. So > with higher aldosterone and higher sodium, we drink > more fluids, causing higher blood volume, thus > resulting in hypertension--and voila! diluting the > amount of sodium in the bloodstream, causing the serum > sodium your doctor tested to appear normal. > I always thought that drinking plenty of water was a good thing, now you are saying its bad? Is it always bad when you have PA, or just when its not controlled via Spiro or Inspra? I would think that once the spiro or inspra kicks in, that you would want to be drinking plenty of water to flush out the sodium, since the kidneys are now free to do that without the interference of aldo. It also sounds like you are saying that drinking lots of water will always cause HTN, but I don't think that's the case either - its just when your body is retaining sodium because of PA that its a problem? Jim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2004 Report Share Posted July 20, 2004 Got a hold of my nephrologist and just spent 20 minutes arguing with the nurse at her insistence that I not increase my Spiro ( " 50 mg is the highest allowed dose " ????) and that I add nifedepine to the mix. I pointed out that it wasn't effective for me in the past, she argued that I'd never taken it before and listed all the meds I had taken (including adalat on the list, which is nifedipine). My endo is out of town for a week and I'm leaving the country in two weeks. Re: BP spiked again > Tell your Dr to read up on the new conepts of aldo and HTN that > have only > been around for 30 years. Spiro does lower BP AND increases K > and the level of > sodium in the bood has nothing to do with it. It is how much > aldo there is > and how much salt you eat. > > Toprol works poorly in PA as the renin is low. So do ACEs adn > ARBs and even > CCBs may not work as well. This is the reason that many with drug > resistant > HTN have PA as they have failed to be controlled on these drugs > which do not > lower BP in PA. > > You probably overdosed on salt on your trip. Good reason to > watch it. PA > is the most salt sensitive form of HTN. > > > > May your pressure be low! > > Clarence E. Grim, BS, MS, MD, FACP, FACC > Professor of Medicine and Epidemiology > Board Certified in Internal Medicine, Geriatrics and Hypertension > Focusing on difficult to control high blood pressure and high > cholesterol > especially in the African Diaspora > > > > “Of all the forms of injustice, inequality in health is the most > shocking and > inhuman”: > Dr. Luther King, Jr. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2004 Report Share Posted July 20, 2004 Hi, ! I support you in arguing with the nurse; I hope you contact your nephrologist soon so you can manage your hypertension appropriately. I definintely support you in not changing any meds on the word of someone who does not understand your condition. I think most of us here have probably collectively tried just about all the hypertension meds there are. It's important for health care professionals to know that ordinary BP meds do not control aldosterone-driven hypertension. You go, girl! Warmly, Pam --- leslie@... wrote: > Got a hold of my nephrologist and just spent 20 > minutes arguing with the nurse at her insistence > that I not increase my Spiro ( " 50 mg is the highest > allowed dose " ????) and that I add nifedepine to the > mix. I pointed out that it wasn't effective for me > in the past, she argued that I'd never taken it > before and listed all the meds I had taken > (including adalat on the list, which is nifedipine). > > My endo is out of town for a week and I'm leaving > the country in two weeks. > > > > Re: BP spiked again > > > Tell your Dr to read up on the new conepts of aldo > and HTN that > > have only > > been around for 30 years. Spiro does lower BP > AND increases K > > and the level of > > sodium in the bood has nothing to do with it. It > is how much > > aldo there is > > and how much salt you eat. > > > > Toprol works poorly in PA as the renin is low. > So do ACEs adn > > ARBs and even > > CCBs may not work as well. This is the reason that > many with drug > > resistant > > HTN have PA as they have failed to be controlled > on these drugs > > which do not > > lower BP in PA. > > > > You probably overdosed on salt on your trip. > Good reason to > > watch it. PA > > is the most salt sensitive form of HTN. > > > > > > > > May your pressure be low! > > > > Clarence E. Grim, BS, MS, MD, FACP, FACC > > Professor of Medicine and Epidemiology > > Board Certified in Internal Medicine, Geriatrics > and Hypertension > > Focusing on difficult to control high blood > pressure and high > > cholesterol > > especially in the African Diaspora > > > > > > > > “Of all the forms of injustice, inequality in > health is the most > > shocking and > > inhuman”: > > Dr. Luther King, Jr. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 21, 2004 Report Share Posted July 21, 2004 > Hi, Jim > > That's just my understanding of one of the mechanisms > of aldosterone-driven HTN. I know it's > oversimplified, but it helps me get a grasp of what is > going on. > > [snipped] Hi Pam, Thanks for the explanation, that really helped. I have noticed that I am less thirsty, so that fits what you are saying. I have always been a big water drinker, and I can see how that would get me in trouble with this. Thanks for helping to understand. Jim Quote Link to comment Share on other sites More sharing options...
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