Re: DR.GRIM AVS & SPIRO QUESTION

[Guest guest]

Hi Carl:

Welcome to the group. Your doctor should have had you off spiro for

6-9 weeks(and some other medications if any) before doing any AVS.

The numbers dont look right. The radiologist should have taken

samples of the Infereior Vena Cava(IVC) and the glands after giving

you ACTH 3o minutes prior to performing the AVS. They need to test

for Aldosterone and cortisol. The cortisol in each gland should be

20 to 3o times higher than the cortisol in the IVC(that is how they

can tell if the sampling was done from the actual gland or not. Its

a tough procedure and many of the radiologists miss going to the

actual gland.

You need to find out if they plan to do another AVS and discuss with

your doctor that you have to stay off of Sprio. If he disagrees, its

a good indication he doesn't know what he is talking about. I am

sure Dr. Grim will tell you all about it but it helps him if you

post your history and medications you are taking so he can help you.

Meanwhile you can follow the DASH(Dietary Approaches to Stop

Hypertension) diet to keep you BP controlled.

By the way the presence of an adenoma is not necessarily an

indication of the gland producing too much aldosterone unless it is

well documented.

Best Wishes to you and your health.

Farah

>

> DR.GRIM,I HAD MY AVS SIX WEEKS AGO, SHOULD I HAVE BEEN ON SPIRO

WHEN I

> HAD MY AVS DONE. I WAS TOLD NOT TO TAKE IT THE MORNING OF MY AVS.

FROM

> READING ON THIS VERY INFORMATIVE BOARD, IT LOOKS LIKES I SHOULD

HAVE

> BEEN OFF IT AT LEAST THREE WEEKS. THE FIGURES MY DR. SHOWED ME

WERE=

> ALDESTRONE READINGS LEFT 55 AND RIGHT 24. I HAD A CT AND SHOWED A

CYST

> 1.5 CM ON LEFT SIDE. SHE SENT ME TO A SURGEON WHO QUESTION THE

FIGURES

> SHE PRESENTED HIM. HE SAID THE AVS DID NOT SHOW THE NUMBERS THAT

HE

> WOULD PERFORM SURGERY. HE DID MORE BLOOD WORK, 24 HR URINE AND

A

> MRI. HE QUESTION THE AVS BECAUSE THE AVS DR. DID NOT PERFORM SOME

> INJECTION THAT HE SHOULD HAVE. HE SAID HE PROBABLY IS GOING TO

THROW

> OUT THE AVS NUMBERS AND TO GET ANOTHER ONE DONE. I AM WAITING ON

MY

> RECENT TESTS. THE SPIRO WITH GUANABENZ WORKS GREAT WITH MY HBP AND

LOW

> POT. MY QUESTION TO YOU IS SHOULD I POLITELY SUGGEST TO GET OFF

THE

> SPIRO TO GET CORRECT FIGURES ON THE NEW AVS IF THATS THE DIRECTION

> THEY ARE TAKING ME. SORRY THIS IS KIND OF LONG BUT THIS IS GETTING

> FRUSTRATING. THANKS....CARL

>

[Guest guest]

MY SURGEON JUST CALLED AND HE WANTS ME TO GET ANOTHER AVS IN FIVE

WEEKS MINUS THE SPIRO. THE AVS DR. TOOK THE BLOOD SAMPLE FROM THE

WRONG SPOT AND HE DID NOT DO SOME KIND OF INJECTION TEST THAT THEY

WANTED. I GUESS THAT ANSWERS MY SPIRO QUESTION. HERE WE GO

AGAIN...CARL

-- In hyperaldosteronism , " farahrahbar "

<farahbar@...> wrote:

>

> Hi Carl:

> Welcome to the group. Your doctor should have had you off spiro

for

> 6-9 weeks(and some other medications if any) before doing any AVS.

> The numbers dont look right. The radiologist should have taken

> samples of the Infereior Vena Cava(IVC) and the glands after

giving

> you ACTH 3o minutes prior to performing the AVS. They need to test

> for Aldosterone and cortisol. The cortisol in each gland should be

> 20 to 3o times higher than the cortisol in the IVC(that is how

they

> can tell if the sampling was done from the actual gland or not.

Its

> a tough procedure and many of the radiologists miss going to the

> actual gland.

> You need to find out if they plan to do another AVS and discuss

with

> your doctor that you have to stay off of Sprio. If he disagrees,

its

> a good indication he doesn't know what he is talking about. I am

> sure Dr. Grim will tell you all about it but it helps him if you

> post your history and medications you are taking so he can help

you.

> Meanwhile you can follow the DASH(Dietary Approaches to Stop

> Hypertension) diet to keep you BP controlled.

> By the way the presence of an adenoma is not necessarily an

> indication of the gland producing too much aldosterone unless it

is

> well documented.

>

> Best Wishes to you and your health.

> Farah

>

>

> >

> > DR.GRIM,I HAD MY AVS SIX WEEKS AGO, SHOULD I HAVE BEEN ON SPIRO

> WHEN I

> > HAD MY AVS DONE. I WAS TOLD NOT TO TAKE IT THE MORNING OF MY

AVS.

> FROM

> > READING ON THIS VERY INFORMATIVE BOARD, IT LOOKS LIKES I SHOULD

> HAVE

> > BEEN OFF IT AT LEAST THREE WEEKS. THE FIGURES MY DR. SHOWED ME

> WERE=

> > ALDESTRONE READINGS LEFT 55 AND RIGHT 24. I HAD A CT AND SHOWED

A

> CYST

> > 1.5 CM ON LEFT SIDE. SHE SENT ME TO A SURGEON WHO QUESTION THE

> FIGURES

> > SHE PRESENTED HIM. HE SAID THE AVS DID NOT SHOW THE NUMBERS THAT

> HE

> > WOULD PERFORM SURGERY. HE DID MORE BLOOD WORK, 24 HR URINE

AND

> A

> > MRI. HE QUESTION THE AVS BECAUSE THE AVS DR. DID NOT PERFORM

SOME

> > INJECTION THAT HE SHOULD HAVE. HE SAID HE PROBABLY IS GOING TO

> THROW

> > OUT THE AVS NUMBERS AND TO GET ANOTHER ONE DONE. I AM WAITING ON

> MY

> > RECENT TESTS. THE SPIRO WITH GUANABENZ WORKS GREAT WITH MY HBP

AND

> LOW

> > POT. MY QUESTION TO YOU IS SHOULD I POLITELY SUGGEST TO GET OFF

> THE

> > SPIRO TO GET CORRECT FIGURES ON THE NEW AVS IF THATS THE

DIRECTION

> > THEY ARE TAKING ME. SORRY THIS IS KIND OF LONG BUT THIS IS

GETTING

> > FRUSTRATING. THANKS....CARL

> >

>

[Guest guest]

DR.GRIM,I HAD MY AVS SIX WEEKS AGO, SHOULD I HAVE BEEN ON SPIRO WHEN

I

HAD MY AVS DONE. I WAS TOLD NOT TO TAKE IT THE MORNING OF MY AVS. FROM

READING ON THIS VERY INFORMATIVE BOARD, IT LOOKS LIKES I SHOULD HAVE

BEEN OFF IT AT LEAST THREE WEEKS. THE FIGURES MY DR. SHOWED ME WERE=

ALDESTRONE READINGS LEFT 55 AND RIGHT 24.

Ask what the corticol was in each sample-they should have also done IVC

below the adrenals.

I HAD A CT AND SHOWED A CYST

1.5 CM ON LEFT SIDE. SHE SENT ME TO A SURGEON WHO QUESTION THE FIGURES

SHE PRESENTED HIM. HE SAID THE AVS DID NOT SHOW THE NUMBERS THAT HE

WOULD PERFORM SURGERY.

Cysts are not usually causing hyperaldo.

HE DID MORE BLOOD WORK, 24 HR URINE AND A

MRI. HE QUESTION THE AVS BECAUSE THE AVS DR. DID NOT PERFORM SOME

INJECTION THAT HE SHOULD HAVE.

That would have been ACTH infusion before the sampling. We have

references in our files.

HE SAID HE PROBABLY IS GOING TO THROW

OUT THE AVS NUMBERS AND TO GET ANOTHER ONE DONE. I AM WAITING ON MY

RECENT TESTS. THE SPIRO WITH GUANABENZ WORKS GREAT WITH MY HBP AND LOW

POT. MY QUESTION TO YOU IS SHOULD I POLITELY SUGGEST TO GET OFF THE

SPIRO TO GET CORRECT FIGURES ON THE NEW AVS IF THATS THE DIRECTION

THEY ARE TAKING ME. SORRY THIS IS KIND OF LONG BUT THIS IS GETTING

FRUSTRATING. THANKS....CARL

It is best to do this without Spiro for as long as possible.

But if Spiro is controlling your BP and K without side effects I would

not even do the AVS now. As far as we know controlling the BP with

drugs in PA is as good as surgery. There has never been a proper

trial done on this. But it is time to start one now that we have a good

drug (we think) with Inspra. So the trial would be (in those with +

AVS) 1/3 get surgery, 1/3 Inspra, 1/3 Spiro and then follow for 5-20

years and see who does the best. Of course all should be on DASH

during this time as well. Would prob need 2000 patients so not an easy

or cheap study to do.

If spiro fails then would try Inspra. If that fails then AVS but after

being off for 6 weeks if your BP can stand it.

[Guest guest]

>

>

>

>

>

> DR.GRIM,I HAD MY AVS SIX WEEKS AGO, SHOULD I HAVE BEEN ON

SPIRO WHEN

> I

> HAD MY AVS DONE. I WAS TOLD NOT TO TAKE IT THE MORNING OF MY AVS.

FROM

> READING ON THIS VERY INFORMATIVE BOARD, IT LOOKS LIKES I SHOULD

HAVE

> BEEN OFF IT AT LEAST THREE WEEKS. THE FIGURES MY DR. SHOWED ME

WERE=

>

>

> ALDESTRONE READINGS LEFT 55 AND RIGHT 24.

>

> Ask what the corticol was in each sample-they should have also

done IVC

> below the adrenals.

>

> I HAD A CT AND SHOWED A CYST

> 1.5 CM ON LEFT SIDE. SHE SENT ME TO A SURGEON WHO QUESTION THE

FIGURES

> SHE PRESENTED HIM. HE SAID THE AVS DID NOT SHOW THE NUMBERS THAT HE

> WOULD PERFORM SURGERY.

>

> Cysts are not usually causing hyperaldo.

>

> HE DID MORE BLOOD WORK, 24 HR URINE AND A

> MRI. HE QUESTION THE AVS BECAUSE THE AVS DR. DID NOT PERFORM SOME

> INJECTION THAT HE SHOULD HAVE.

>

> That would have been ACTH infusion before the sampling. We have

> references in our files.

>

> HE SAID HE PROBABLY IS GOING TO THROW

> OUT THE AVS NUMBERS AND TO GET ANOTHER ONE DONE. I AM WAITING ON MY

> RECENT TESTS. THE SPIRO WITH GUANABENZ WORKS GREAT WITH MY HBP AND

LOW

> POT. MY QUESTION TO YOU IS SHOULD I POLITELY SUGGEST TO GET OFF THE

> SPIRO TO GET CORRECT FIGURES ON THE NEW AVS IF THATS THE DIRECTION

> THEY ARE TAKING ME. SORRY THIS IS KIND OF LONG BUT THIS IS GETTING

> FRUSTRATING. THANKS....CARL

>

> It is best to do this without Spiro for as long as possible.

>

> But if Spiro is controlling your BP and K without side effects I

would

> not even do the AVS now. As far as we know controlling the BP

with

> drugs in PA is as good as surgery. There has never been a proper

> trial done on this. But it is time to start one now that we have a

good

> drug (we think) with Inspra. So the trial would be (in those with

+

> AVS) 1/3 get surgery, 1/3 Inspra, 1/3 Spiro and then follow for 5-

20

> years and see who does the best. Of course all should be on DASH

> during this time as well. Would prob need 2000 patients so not an

easy

> or cheap study to do.

>

> If spiro fails then would try Inspra. If that fails then AVS but

after

> being off for 6 weeks if your BP can stand it.

>

>

>

>

>

>

>

[Guest guest]

>DR. GRIM, IT WASNT A CYST BUT AN ADENOMA ON MY ADRENAL GLAND. MY DR

DID NOT MENTION ACTH BUT I WILL KNOW WHEN I SEE HER NEXT

TIME..THANKS...CARL

>

>

>

>

>

>

> DR.GRIM,I HAD MY AVS SIX WEEKS AGO, SHOULD I HAVE BEEN ON

SPIRO WHEN

> I

> HAD MY AVS DONE. I WAS TOLD NOT TO TAKE IT THE MORNING OF MY AVS.

FROM

> READING ON THIS VERY INFORMATIVE BOARD, IT LOOKS LIKES I SHOULD

HAVE

> BEEN OFF IT AT LEAST THREE WEEKS. THE FIGURES MY DR. SHOWED ME

WERE=

>

>

> ALDESTRONE READINGS LEFT 55 AND RIGHT 24.

>

> Ask what the corticol was in each sample-they should have also

done IVC

> below the adrenals.

>

> I HAD A CT AND SHOWED A CYST

> 1.5 CM ON LEFT SIDE. SHE SENT ME TO A SURGEON WHO QUESTION THE

FIGURES

> SHE PRESENTED HIM. HE SAID THE AVS DID NOT SHOW THE NUMBERS THAT HE

> WOULD PERFORM SURGERY.

>

> Cysts are not usually causing hyperaldo.

>

> HE DID MORE BLOOD WORK, 24 HR URINE AND A

> MRI. HE QUESTION THE AVS BECAUSE THE AVS DR. DID NOT PERFORM SOME

> INJECTION THAT HE SHOULD HAVE.

>

> That would have been ACTH infusion before the sampling. We have

> references in our files.

>

> HE SAID HE PROBABLY IS GOING TO THROW

> OUT THE AVS NUMBERS AND TO GET ANOTHER ONE DONE. I AM WAITING ON MY

> RECENT TESTS. THE SPIRO WITH GUANABENZ WORKS GREAT WITH MY HBP AND

LOW

> POT. MY QUESTION TO YOU IS SHOULD I POLITELY SUGGEST TO GET OFF THE

> SPIRO TO GET CORRECT FIGURES ON THE NEW AVS IF THATS THE DIRECTION

> THEY ARE TAKING ME. SORRY THIS IS KIND OF LONG BUT THIS IS GETTING

> FRUSTRATING. THANKS....CARL

>

> It is best to do this without Spiro for as long as possible.

>

> But if Spiro is controlling your BP and K without side effects I

would

> not even do the AVS now. As far as we know controlling the BP

with

> drugs in PA is as good as surgery. There has never been a proper

> trial done on this. But it is time to start one now that we have a

good

> drug (we think) with Inspra. So the trial would be (in those with

+

> AVS) 1/3 get surgery, 1/3 Inspra, 1/3 Spiro and then follow for 5-

20

> years and see who does the best. Of course all should be on DASH

> during this time as well. Would prob need 2000 patients so not an

easy

> or cheap study to do.

>

> If spiro fails then would try Inspra. If that fails then AVS but

after

> being off for 6 weeks if your BP can stand it.

>

>

>

>

>

>

>

[Guest guest]

In a message dated 4/20/06 8:17:39 PM, cjcmaddog@... writes:

>DR. GRIM, IT WASNT A CYST BUT AN ADENOMA ON MY ADRENAL GLAND. MY DR

DID NOT MENTION ACTH BUT I WILL KNOW WHEN I SEE HER NEXT

TIME..THANKS...CARL

Be certain the person doing the AVS knows as well.

May your pressure be low!

CE Grim, BS(Chem/Math), MS(Biochem), MD.

Board Certified in Internal Medicine, Geriatrics and Hypertension

Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC

Specializing in Difficult to Manage High Blood Pressure

Clinical Professor of Medicine, Medical College of Wisconsin

[Guest guest]

In a message dated 4/20/06 8:17:39 PM, cjcmaddog@... writes:

>DR. GRIM, IT WASNT A CYST BUT AN ADENOMA ON MY ADRENAL GLAND. MY DR

DID NOT MENTION ACTH BUT I WILL KNOW WHEN I SEE HER NEXT

TIME..THANKS...CARL

Hopefully they also did cortisol on the samples see what they were. Maybe they did not give them to you thinking you would not know what to do with them.

May your pressure be low!

CE Grim, BS(Chem/Math), MS(Biochem), MD.

Board Certified in Internal Medicine, Geriatrics and Hypertension

Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC

Specializing in Difficult to Manage High Blood Pressure

Clinical Professor of Medicine, Medical College of Wisconsin

[Guest guest]

In a message dated 4/20/06 7:59:32 PM, cjcmaddog@... writes:

PGH

is this Pitsburgh?

May your pressure be low!

CE Grim, BS(Chem/Math), MS(Biochem), MD.

Board Certified in Internal Medicine, Geriatrics and Hypertension

Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC

Specializing in Difficult to Manage High Blood Pressure

Clinical Professor of Medicine, Medical College of Wisconsin

[Guest guest]

DR. GRIM, YES IT IS PITTSBURGH...CARL>

> In a message dated 4/20/06 7:59:32 PM, cjcmaddog@... writes:

>

>

> > PGH

> >

> is this Pitsburgh?

>

>

>

> May your pressure be low!

>

> CE Grim, BS(Chem/Math), MS(Biochem), MD.

> Board Certified in Internal Medicine, Geriatrics and Hypertension

> Former Epidemiologic Intelligence Services Officer (Lt. Comdr.),

CDC

> Specializing in Difficult to Manage High Blood Pressure

> Clinical Professor of Medicine, Medical College of Wisconsin

>