Guest guest Posted November 23, 2004 Report Share Posted November 23, 2004 How old were you when you were first Dxed with high blood pressure? How was it diagnosed? What problems were you having then? What was used to treat it first? What happened? When did you first get a low K? What was done? For how long were you getting up at night to pee and how many times. This start slow and work up. Any FH of low K or HTN How was the DX of PA first suspected? Detail all the drugs that were tired to get BP down. When was Sprio started This should be at least a few ribs. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHS Clinical Professor of Medicine and Epidemiology Director, Hypertension Diagnosis and Treatment Center Board Certified in Internal Medicine, Geriatrics and Hypertension Published over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes. Listed in Best Doctors in America Specializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2004 Report Share Posted November 23, 2004 Excellent,keep this stored. It seems to me it is important to have your son checked for PA as you father also had HTN onset at age 25. The first family I saw with GRA was because 2 boys age 8 and 10 were rioud to have enlarged hearts and HTN. They K was alwasy normal. The oldest son stopped his BP meds and had a bad stroke at 19 y/o. Please have your son tested. If you are taking your own BP then take his as well and sent it to us. Some more questions 1. Do you eat licorice every day? 2. Do you use any licorice flavored foods or gum or tobacco ecvery day. 3. Do you use any European meds for stomach problems. 4. Have you been botrhered with a "metallic taste" in your mouth. 5. How did they think you got the Hepatitis? 6. Has an Dr ever said you have eye damage from high blood pressure? 7. What happened when you were given diuretics? 8. Did anyone think you were abusing diuretics or vomiting on purpose to lose weight? 9. When you got cramps in your hands and legs exactly what would happen-describe in more detail. What would bring these on? 10. Was your BP high during all pregnancies? 11. Did you ever have migraines? 12. When you got weak from the low K what did you do to overcome it. 13. Did you ever crave salt or potassium? Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHS Clinical Professor of Medicine and Epidemiology Director, Hypertension Diagnosis and Treatment Center Board Certified in Internal Medicine, Geriatrics and Hypertension Published over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes. Listed in Best Doctors in America Specializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2004 Report Share Posted November 23, 2004 Hi Pam, Dr. Grim and others; I look forward to Pam's History (Her story) to be politically correct. I will be watching how you format this and may do the same, actually I wish more of us would do the same, I learn a lot that way. I know there are a lot of interesting stories out there. I really enjoy this forum, you all really help me. My only advice is, don't be afraid to be long winded. God Bless you all, I am and will be very thankful for you all, this Thanksgiving Day. ><> May we all be DASHing <>< Randy How old were you when you were first Dxed with high blood pressure? How was it diagnosed? What problems were you having then? What was used to treat it first? What happened? When did you first get a low K? What was done? For how long were you getting up at night to pee and how many times. This start slow and work up. Any FH of low K or HTN How was the DX of PA first suspected? Detail all the drugs that were tired to get BP down. When was Sprio started This should be at least a few ribs. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 24, 2004 Report Share Posted November 24, 2004 Hi, Dr. Grim Here are a few of the blood pressure medications I have taken, with the side effects. Many of them did not cause adverse reactions, but simply did not help with the blood pressure, so they were discontinued. I think ACE inhibitors make me cough, but I can't remember which ones I took. Avapro--high blood pressure. Did not help, I guess. Doctor changed to a different medication. Nadolol--It brought my heart rate down to under 50 beats per minute. It also made me depressed. The doctor cut my dose to 1/4 of the smallest tablet, but I still felt it contributed to significant depression. Labetalol--made me suicidal within two hours of taking it. It brings down the blood pressure, but it's not worth it. It won't extend my life. Atenolol--This one made me sleep sixteen hours a day and I soon became suicidally depressed from taking it. I was started at 100 mg qd and had to taper off it slowly. I felt like I was in a coma until it was out of my system. I will never take it or other Beta blockers again. Nifedepine--I took this for two years and my gums became badly swollen and sore. My legs also swelled (pitting edema). I could not care for my teeth properly; my gums were so sore I could only eat liquids and was unable to sleep through the night. I lost a tooth due to an infection and told my doctor to take me off it. When I finally went off it, my heart rate went back to normal after being in the 120-150 range for a year. Verapamil--blood pressure. Did not help. Verapamil SR--blood pressure. Did not help. Hydrocortothyazide--edema. Which turned out to be caused mostly by Nifedpine. Since going off Nifedpine, I hardly ever have any edema. Atacand--blood pressure. I guess it didn't work. The doctor put me on something else. Maxzide--edema. Apparently caused by Nifedepine, but anyway it's better now. Hydralazine; gives me joint and muscle aches and pains, fever, chills, headache, dark urine Clonidine--makes me so sleepy I can't function. Prazosin--lowered my blood pressure for about half the day while I took the aldosterone:renin test, but not below 135/95. Imdur--this one did not bother me, but it did not control my blood pressure once I went off spironolactone as a test. Once the spironolactone kicked in, my blood pressure dropped too low for me to benefit from it. Cozaar--no benefit Norvasc--no benefit There were so many others I tried and forgot. I think Dr. Kant has a more complete list than I do. Warmly, Pam > Excellent,keep this stored. > > It seems to me it is important to have your son > checked for PA as you father > also had HTN onset at age 25. The first family I > saw with GRA was because 2 > boys age 8 and 10 were rioud to have enlarged hearts > and HTN. They K was > alwasy normal. > > The oldest son stopped his BP meds and had a bad > stroke at 19 y/o. > > Please have your son tested. If you are taking > your own BP then take his as > well and sent it to us. > > Some more questions > > 1. Do you eat licorice every day? > 2. Do you use any licorice flavored foods or gum > or tobacco ecvery day. > 3. Do you use any European meds for stomach > problems. > 4. Have you been botrhered with a " metallic taste " > in your mouth. > 5. How did they think you got the Hepatitis? > > 6. Has an Dr ever said you have eye damage from > high blood pressure? > > 7. What happened when you were given diuretics? > > 8. Did anyone think you were abusing diuretics or > vomiting on purpose to > lose weight? > > 9. When you got cramps in your hands and legs > exactly what would > happen-describe in more detail. What would bring > these on? > > 10. Was your BP high during all pregnancies? > > 11. Did you ever have migraines? > > 12. When you got weak from the low K what did you > do to overcome it. > > 13. Did you ever crave salt or potassium? > > > > Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, > FACP, FACC, FAHS > Clinical Professor of Medicine and Epidemiology > Director, Hypertension Diagnosis and Treatment > Center > Board Certified in Internal Medicine, Geriatrics and > Hypertension > > Published over 220 scientific papers, book chapters > and 220 abstracts in the > area of high blood pressure epidemiology, > physiology, endocrinology mea > surement, treatment and how to detect curable > causes. > Listed in Best Doctors in America > Specializing in Difficult to Control High Blood > Pressure and the History and > Physiology of High Blood pressure in the African > Diaspora > ===== " I'd rather learn from one bird how to sing, than to teach ten thousand stars how not to dance. " __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 24, 2004 Report Share Posted November 24, 2004 Dr Kant is an MD, right? The name is famous in the history of Western philosophy (Immanuel Kant), for starting the suspicion that there is some information not ascertainable by human reason. Imagine the nerve! Wow, Pam, I thought I had troubles with reactions. Less than half what you have gone through. Have you heard about the upcoming test for what meds will work and not have reactions for each individual? They should have developed that first, then the meds. I'd like to see a study on the percentages of mortality hastened by medicine experimentation--longitudinal. Thanks for sharing this, Best Thanksgiving, Dave On Nov 24, 2004, at 6:37 AM, Pamela s wrote: > > Hi, Dr. Grim > > Here are a few of the blood pressure medications I > have taken, with the side effects. Many of them did > not cause adverse reactions, but simply did not help > with the blood pressure, so they were discontinued. > > I think ACE inhibitors make me cough, but I can't > remember which ones I took. > > Avapro--high blood pressure. Did not help, I guess. > Doctor changed to a different medication. > > Nadolol--It brought my heart rate down to under 50 > beats per minute. It also made me depressed. The > doctor cut my dose to 1/4 of the smallest tablet, but > I still felt it contributed to significant depression. > > Labetalol--made me suicidal within two hours of taking > it. It brings down the blood pressure, but it's not > worth it. It won't extend my life. > > Atenolol--This one made me sleep sixteen hours a day > and I soon became suicidally depressed from taking it. > I was started at 100 mg qd and had to taper off it > slowly. I felt like I was in a coma until it was out > of my system. I will never take it or other Beta > blockers again. > > Nifedepine--I took this for two years and my gums > became badly swollen and sore. My legs also swelled > (pitting edema). I could not care for my teeth > properly; my gums were so sore I could only eat > liquids and was unable to sleep through the night. > I lost a tooth due to an infection and told my doctor > to take me off it. When I finally went off it, my > heart rate went back to normal after being in the > 120-150 range for a year. > > Verapamil--blood pressure. Did not help. > > Verapamil SR--blood pressure. Did not help. > > Hydrocortothyazide--edema. Which turned out to be > caused mostly by Nifedpine. Since going off > Nifedpine, I hardly ever have any edema. > > Atacand--blood pressure. I guess it didn't work. The > doctor put me on something else. > > Maxzide--edema. Apparently caused by Nifedepine, but > anyway it's better now. > > Hydralazine; gives me joint and muscle aches and > pains, fever, chills, headache, dark urine > > Clonidine--makes me so sleepy I can't function. > > Prazosin--lowered my blood pressure for about half the > day while I took the aldosterone:renin test, but not > below 135/95. > > Imdur--this one did not bother me, but it did not > control my blood pressure once I went off > spironolactone as a test. Once the spironolactone > kicked in, my blood pressure dropped too low for me to > benefit from it. > > Cozaar--no benefit > > Norvasc--no benefit > > There were so many others I tried and forgot. I think > Dr. Kant has a more complete list than I do. > > Warmly, > > Pam > >> Excellent,keep this stored. >> >> It seems to me it is important to have your son >> checked for PA as you father >> also had HTN onset at age 25. The first family I >> saw with GRA was because 2 >> boys age 8 and 10 were rioud to have enlarged hearts >> and HTN. They K was >> alwasy normal. >> >> The oldest son stopped his BP meds and had a bad >> stroke at 19 y/o. >> >> Please have your son tested. If you are taking >> your own BP then take his as >> well and sent it to us. >> >> Some more questions >> >> 1. Do you eat licorice every day? >> 2. Do you use any licorice flavored foods or gum >> or tobacco ecvery day. >> 3. Do you use any European meds for stomach >> problems. >> 4. Have you been botrhered with a " metallic taste " >> in your mouth. >> 5. How did they think you got the Hepatitis? >> >> 6. Has an Dr ever said you have eye damage from >> high blood pressure? >> >> 7. What happened when you were given diuretics? >> >> 8. Did anyone think you were abusing diuretics or >> vomiting on purpose to >> lose weight? >> >> 9. When you got cramps in your hands and legs >> exactly what would >> happen-describe in more detail. What would bring >> these on? >> >> 10. Was your BP high during all pregnancies? >> >> 11. Did you ever have migraines? >> >> 12. When you got weak from the low K what did you >> do to overcome it. >> >> 13. Did you ever crave salt or potassium? >> >> >> >> Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, >> FACP, FACC, FAHS >> Clinical Professor of Medicine and Epidemiology >> Director, Hypertension Diagnosis and Treatment >> Center >> Board Certified in Internal Medicine, Geriatrics and >> Hypertension >> >> Published over 220 scientific papers, book chapters >> and 220 abstracts in the >> area of high blood pressure epidemiology, >> physiology, endocrinology mea >> surement, treatment and how to detect curable >> causes. >> Listed in Best Doctors in America >> Specializing in Difficult to Control High Blood >> Pressure and the History and >> Physiology of High Blood pressure in the African >> Diaspora >> > > > ===== > " I'd rather learn from one bird how to sing, than to teach ten > thousand stars how not to dance. " > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 25, 2004 Report Share Posted November 25, 2004 Hi, Dave Yes, I am aware of the philosopher you are referring to. I guess we are a few years too late for him, and we probably wouldn't see him about aldosteronism anyway. . . smile. I assure you this is a different Dr. Kant! Dr. Shashi Kant is an excellent nephrologist, though. My case file was about four inces thick when he first got me as a patient, and when I sat down to speak to him, he had obviously read every last word. In several instances, he could quote my test results by date, without looking. It's reassuring to be treated by someone who cares. I would like to know more about those tests. . . boy, I want to be first in line! One of my gripes about modern medicine is that the approach to treatment is so heavily guinea-pig inspired. When I was wandering from one cardiologist to another for second opinions about the malignant hypertension, I was always so discouraged when I explained all the medications I had tried and the doctors would say, " Oh, you just haven't found the right combination yet " . I felt like screaming. My pharmacists have a record of most of my severe reactions and they know when a new presceription comes in for the same family of drugs that it's not going to work for me. They do me the service of warning me when this happens. But it sounds like the tests are superior. I hope things are going better for you now. Hang in there! Warmly, Pam --- Mr Pearson <dp@...> wrote: > > Dr Kant is an MD, right? The name is famous in the > history of Western > philosophy (Immanuel Kant), for starting the > suspicion that there is > some information not ascertainable by human reason. > Imagine the nerve! > > Wow, Pam, I thought I had troubles with reactions. > Less than half what > you have gone through. Have you heard about the > upcoming test for what > meds will work and not have reactions for each > individual? They should > have developed that first, then the meds. I'd like > to see a study on > the percentages of mortality hastened by medicine > experimentation--longitudinal. > > Thanks for sharing this, > > Best Thanksgiving, > > Dave > > > ===== " I'd rather learn from one bird how to sing, than to teach ten thousand stars how not to dance. " __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 26, 2004 Report Share Posted November 26, 2004 A very good list of the side effects of each drug: As I just wrote in my review article the following popular drugs that work in many with HTN done work in PA or other causes of the lower renin don't work in PA as renin is already so low. ACES ARBS BB Also CCBS dont work as well. Diruetics worsen low K. Soooooo... Many who are " resistant " to todays leading drugs are not resisitant they are just the wrond meds for those with low renin levels. Here is where the aldo blockers excell and indeed are specific treatments for the cause of the HTN-too much aldo. Please keep all these (your and mine)notes and we will assemble them into the report. Did many folks try to use combinations of drugs. Most of my difficult pts (before they got to me) require small doses of up to 5 or 6 different drugs. -- May your pressure be low! CE Grim MD Clinical Professor of Internal Medicine Professor of Epidemiology Board Certified in Internal Medicine, Geriatrics and Hypertension Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 26, 2004 Report Share Posted November 26, 2004 > > Diruetics worsen low K. > > CE Grim MD > Clinical Professor of Internal Medicine Dear Dr. Grim: One small bone to pick with your list. Potassium sparing diuetics might be considered. Amiloride in particular. This is one of the questions my interist has struggled with. Inspra gets me down to 135/90, but I seem to need a little extra help. He considered amiloride, but went with 20 mg. accupril. There is some other benefit to accupril that he thought might make it a better choice. I have to say, based on past experience with HTN that a diuretic does the most with the least side effects (assuming low potassium is not a problem.) Wayne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 26, 2004 Report Share Posted November 26, 2004 Hi, Wayne Amerliorde is one my doctors never tried (I don't know why not!). I didn't have much success with the usual diuretics, however. If they had any effect, it was temporary and slight. They kept switching diuretics on me because they said I became resistant to them. Dr. Grim, perhaps you can offer an explanation of why one person with PA is able to benefit from diuretics, and another may not? Clearly, those with potassium loss are worse off with the standard diuretics, but would the K loss factor prevent the diuretic's effective action in controlling hypertension with PA? Warmly, Pam --- wbongianni <wbongianni@...> wrote: > > > > > > Diruetics worsen low K. > > > > CE Grim MD > > Clinical Professor of Internal Medicine > > Dear Dr. Grim: > One small bone to pick with your list. > Potassium sparing > diuetics might be considered. Amiloride in > particular. > This is one of the questions my interist has > struggled with. > Inspra gets me down to 135/90, but I seem to need a > little extra > help. He considered amiloride, but went with 20 mg. > accupril. There > is some other benefit to accupril that he thought > might make it a > better choice. I have to say, based on past > experience with HTN that > a diuretic does the most with the least side effects > (assuming low > potassium is not a problem.) Wayne > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2004 Report Share Posted November 28, 2004 In PA ACEs and ARBs usually have a minor effect.-but dont know what happens when they are added to Inspra. CE Grim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2004 Report Share Posted November 28, 2004 In a message dated 11/26/04 4:46:37 PM, spirlhelix@... writes: Dr. Grim, perhaps you can offer an explanation of why one person with PA is able to benefit from diuretics, and another may not? Clearly, those with potassium loss are worse off with the standard diuretics, but would the K loss factor prevent the diuretic's effective action in controlling hypertension with PA? it likely depends on how much aldo they are making-if a lot them the K will drop very low and they will get low K problems. CE Grim MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 In a message dated 11/26/04 13:56:22, spirlhelix@... writes: I was starting to get much lower readings at home with the spionolactone, so I had requested the increased dose. The lower readings did not show up in the doctors' offices for a few more months. AGain assuming they were doing the BP right in the office and not just writing down the previous one. Be on the watch for hits. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHS Clinical Professor of Medicine and Epidemiology Director, Hypertension Diagnosis and Treatment Center Board Certified in Internal Medicine, Geriatrics and Hypertension Published over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes. Listed in Best Doctors in America Specializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 Classic story! Thanks. Are you keeping all this together to weave it into a timeline with symptoms etc. Please do that. You might even want tho make it into chapters. Chap 1 before Hepatitis Chap 2 hep and GN Chap 3 the struggle with HTN and Low K. Etc. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHS Clinical Professor of Medicine and Epidemiology Director, Hypertension Diagnosis and Treatment Center Board Certified in Internal Medicine, Geriatrics and Hypertension Published over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes. Listed in Best Doctors in America Specializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2004 Report Share Posted December 10, 2004 In a message dated 11/26/04 13:56:22, spirlhelix@... writes: Blood pressure: 182/118 * * * * * * * * * * 10/10/03 Diovan 160 bid Blood pressure: 182/118 Please note the two blood pressure readings above are identical, despite the combination of medications used for the earlier visit. Evidently all those medications were not doing much. Or they are faking the BP and just writing donw the last one. Would be VERY unusual to have two BP exaclty the same on tw visits. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHS Clinical Professor of Medicine and Epidemiology Director, Hypertension Diagnosis and Treatment Center Board Certified in Internal Medicine, Geriatrics and Hypertension Published over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes. Listed in Best Doctors in America Specializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2004 Report Share Posted December 11, 2004 In a message dated 12/10/04 19:49:12, spirlhelix@... writes: Hi, Dr. Grim These visits were more than a year apart and from different doctors. I found it interesting that the BPs were identical, but that is exactly what they read as recorded in the doctors' notes. Perhaps having two identical readings reflects the frequency of doctor visits more than anything else, but I still think it also demonstrates that all that medicine was not doing very much. Warmly, Pam If they were different Drs and diff people taking the BP and they did not ask you what your old BP was or had old records it could be that they were both exactly the same. But the changes are very low but no zero they wrer the same. Anyway I am just suspcicious I guess. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHS Clinical Professor of Medicine and Epidemiology Director, Hypertension Diagnosis and Treatment Center Board Certified in Internal Medicine, Geriatrics and Hypertension Published over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes. Listed in Best Doctors in America Specializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2004 Report Share Posted December 12, 2004 In a message dated 12/11/04 22:11:18, spirlhelix@... writes: Hi, Dr. Grim I'm sure you have reason to be suspicous; you probably see blood pressures taken incorrectly or assumed from previous readings quite often. There were many intervening visits to various doctors between these readings, with different blood pressures read by different individuals at each visit. The two doctors consulted when these readings were made did not have access to one another's records; and I would not have remembered the precise numbers of each reading, even if I were asked what my previous blood pressure(s) had been. Warmly, Pam rare things happen rarely Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHS Clinical Professor of Medicine and Epidemiology Director, Hypertension Diagnosis and Treatment Center Board Certified in Internal Medicine, Geriatrics and Hypertension Published over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes. Listed in Best Doctors in America Specializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora Quote Link to comment Share on other sites More sharing options...
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