Guest guest Posted October 5, 2005 Report Share Posted October 5, 2005 Hi Dr Grim, I called the hospital which did my brother's autopsy. In which state do you live? Would you be willing to travel to go to the hospital where the slides are? P.S. My endocrinologist says I have potassium wasting. They are trying to fiigure out if I have Liddle or Barter(?). They also said that they think I have a problem with the potassium channel in the distal tubule. They don't know if I will regain muscle streight with the K+ or if I have permanent muscle weakness damage. The internist said that there is no test to find out. He says that he wants to see me again in 2-3 months to see if I have improved. In the meantime they have schedule a test where there will trigger a paralysis attack and measure my K= at time 0, 2 mn and 5 mn. I have to stop my K+ 3 days before the testing. I wonder if I should wear my compression socks and take my Proamatine and Propronolol for the test as I don't want to faint before I paralyse. Do you have any opinion on my meds for the testing? Thank you Ernie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2005 Report Share Posted October 6, 2005 In a message dated 10/5/05 11:45:05 PM, friday@... writes: Ernie, they are looking at you for Gittelman's or Barrter's Syndrome as well? I am being evaluated for both illnesses. Barrter's is normally seen by the age of 2 and Gittelman's is an adult form of Barrter's if I understand what I've read correctly. Here is a quick overview and proper spelling so you can read up on them. I have read everything I can find. http://www.endocrinesurgeon.co.uk/adrenals/adrenals5.html I think we're on the same bus going I don't know where. We're still not sure if I have primary or secondary hyperaldosteronism. In the mean time I am miserable. The closest nephrologist appointment was made last month for 11/22. Good luck. FYI Liddle's can be cured by kidney transplantation-a form of gene therapy. May your pressure be low! 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 October 6, 2005 Report Share Posted October 6, 2005 In a message dated 10/5/05 11:45:05 PM, friday@... writes: Ernie, they are looking at you for Gittelman's or Barrter's Syndrome as well? I am being evaluated for both illnesses. Barrter's is normally seen by the age of 2 and Gittelman's is an adult form of Barrter's if I understand what I've read correctly. Here is a quick overview and proper spelling so you can read up on them. I have read everything I can find. http://www.endocrinesurgeon.co.uk/adrenals/adrenals5.html I think we're on the same bus going I don't know where. We're still not sure if I have primary or secondary hyperaldosteronism. In the mean time I am miserable. The closest nephrologist appointment was made last month for 11/22. Good luck. Thanks this looks like a very nice site but will need to study in detail. I note that it states that PA is more common in men that women but it is the other way around at least in the states. Would like others to look at this site and if OK then set up a link to it. May your pressure be low! 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 October 6, 2005 Report Share Posted October 6, 2005 Hi Dr. Grim, yes here it is. The latest urine I did was aroud the same time as the aldosterone being 100 (1-10) and renin 3495 (1-160). I was fasting for a procedure for half of this. Sodium 24 hr urine 94 (50-230MOL/G Creat) Sodium 24 hr urine 124 (52-380 MMOL/24 hrs) Creatinine 24 hr urine 1.32 (.0.63-2.50 G/24 hrs) Potassium 24 hr urine 56 (22-160 MMOL/G 24 hrs) I was told it was "unremarkable". Blood level of K was 4.1 after taking high doses 2 days before my procedure (EUS). I had taken 220 MEQ/day where normal is 120MEQ. My doc wanted to be sure I was stable for the procedure. Currently managing on 120MEQ/day to stay in the 3.5-3.8 range. My fatigue remains staggering, headaches, had one episode that had symptoms of a TIA per you (didn't go to the ER), and the orthostatic hypotension remains a major problem. (without midodrine which the side effects are awful for me) Meds are levoxyl, Genotropin .4, 1G salt, 120MEQ K, testosterone gel (compound per endo) occasional benedryl for allergies. I am panhypopit. HI all,I have been suffering a very strange combination of things and I'mhoping it may ring a bell with someone here. Since February of thisyear I have been losing potassium at an exorbitant rate. (causing 4cardiac events so far) My local hospital kept pumping me full ofpotassium and sending me home so I returned to my endocrinologistwho diagnosed my Cushing's Disease (pituitary) and he had an adrenalstim test run which turned out normal. I am 33.During that test I started my 4th cardiac event...while in thehospital we learned that my aldosterone was 100 (normal 1-10) andrenin was 3495 (normal 1-160). I just had new levels drawn onFriday but I have no results yet. I have consulted with 2 highlyrespected endocrinologists, a wonderful nephrologist and acardiologist. At the time of my 4th cardiac issue my potassium was2.2 and the cardiologist has never had to pump so much potassium ina patient (me) to bring them back up to a 3.5 (Bottom of normal). Ibelieve it took 320MEQ in a 24 hr period.I have done 24 hour urines for Na, K and Creatnine (which is prettyhigh but not high enough for dialysis), CT and MRI of my abdomen,endoscopic ultrasound to biopsy abnormalities (huge lymph nodes bymy right kidney). I take a gram of salt a day, drink salt richdrinks (per the endos and nephrologist) and it is still unclear ifthis is primary or secondary hyperaldosteronism. The kicker is myBP is low to normal which seems to throw a big monkey wrench intothe puzzle.My symptoms are major fatigue, limited urine output despite what Idrink, extreme hypokalemia, severe orthostatic hypotension and lotsof headaches. I pass out frequently if I am up too long. My heartis ok after all it's been through.Does this sound remotely familiar to anyone? The doctors arepuzzled.The next steps recommended are VSS in my kidneys for renin,exploratory surgery for a neuroendocrine tumor. I have beenreferred to a new nephrologist as well. We have ruled out allmedication conflicts or causes by taking me off almost everythingthat wasn't critical.Thanks and my apologies for the biography.Ohio -- Re: Dr Grim In a message dated 10/5/05 11:45:05 PM, friday@... writes: Ernie, they are looking at you for Gittelman's or Barrter's Syndrome as well? I am being evaluated for both illnesses. Barrter's is normally seen by the age of 2 and Gittelman's is an adult form of Barrter's if I understand what I've read correctly. Here is a quick overview and proper spelling so you can read up on them. I have read everything I can find. http://www.endocrinesurgeon.co.uk/adrenals/adrenals5.html I think we're on the same bus going I don't know where. We're still not sure if I have primary or secondary hyperaldosteronism. In the mean time I am miserable. The closest nephrologist appointment was made last month for 11/22. Good luck. Have yoiu given us "'s story" so we can try to help more? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2005 Report Share Posted October 6, 2005 Hi Thanks for the links. I think they are testing me for Barter or Liddle. I am seeing my endocrinologist at the begining of December. I feel too that we are on the same bus. I got a referral for a nephrologist today but I am keeping it until I see my endo. I am not sure if I will get referred by me endocrinologist or my PCP. I just can't wait to get my diagnosis. Keep me posted on your nephrologist appointment. Take care Ernie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2005 Report Share Posted October 11, 2005 In a message dated 10/11/05 1:01:42 AM, farahbar@... writes: Though I've read of various studies that show high incidence of PA in > Japan, so maybe it's just coincidence (or Japanese diet?) Dont think the prevalence is any higher there that other places that look for it carefully. May your pressure be low! 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 October 11, 2005 Report Share Posted October 11, 2005 How about Friday this week at the Milwaukee Enterprise Center at 4th and Locust 2821 N 4th to be exact. May your pressure be low! 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 October 11, 2005 Report Share Posted October 11, 2005 Sounds great. What time? lowerbp2@... wrote: > How about Friday this week at the Milwaukee Enterprise Center at 4th > and Locust 2821 N 4th to be exact. > > > > May your pressure be low! > > 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 October 13, 2005 Report Share Posted October 13, 2005 Lets say 2 pm at 2821 N 4th street, the Milwaukee Enterprsie center. Call me at 414-374-2733 when you arrive and I will come down and we can use a conference room on the 1st floor. May your pressure be low! 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 October 13, 2005 Report Share Posted October 13, 2005 Are we still on? If so, what time? Thanks, lowerbp2@... wrote: > How about Friday this week at the Milwaukee Enterprise Center at 4th > and Locust 2821 N 4th to be exact. > > > > May your pressure be low! > > 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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