RE: Renewing Conn's journey

May 12, 2009

Thank you Clarence. Good reminder to me re Hans Selye's book. My BP is stable, and K only being tested because I am off Spiro.

On Wed, May 13, 2009 at 4:06 AM, lowerbp2 <lowerbp2@...> wrote:

Yes but stress does its damage by biochemical mechanisms.You might want to read Hans Selye's book old but still good. Clarence E. Grim, BS, MS, MD

On Tuesday, May 12, 2009, at 06:46AM, " Helen Drewe " <hdrewe@...> wrote:>Am due for k blood test again Friday. Will keep a chart re brain fog and low

>K. Still think stress changes all my biochemistry. 2 deaths in my family in>last 2 months.>>On Tue, May 12, 2009 at 11:22 AM, Clarence Grim <lowerbp2@...> wrote:

>>>>>>> Can you correlate with your K? CE Grim MD>>>> On May 11, 2009, at 4:47 PM, Helen Drew wrote:>>>>>>>> I agree Carol. I was working in Case Management 9 years ago when first

>> diagnosed, and had to resign that position, because the brain fog was so>> severe. I had been working in Dementia care, and thought I was getting>> dementia. I have had episodes of brain fog over the years. I also times when

>> I am very clear. Its an up and down thing. At present it is down.>>>> On Tue, May 12, 2009 at 9:22 AM, Carol Christie <carolch@...>

>> wrote:>>>>>>>>>>> I have been taking clonazepam for only a few months. The mental>>> fogginess/confusion has been with me for about 5 years. My assessment is

>>> that there is some correlation with the PA condition itself.>>> Carol>>>>>>>>> Clarence Grim wrote:>>> >>>> >>>> > I would discuss this with your sleep Dr and try being off clonazepam

>>> > to assess its role in this. Were you on it before the problems emerged>>> > or after?>>> >>>> >>>> > CE Grim MD>>> > On May 10, 2009, at 10:03 PM, Carol Christie wrote:

>>> >>>> >>>>> >>>>> >> Hello again Dr Grim. My current medications are>>> >> verapamil 240mg/day>>> >> spiro 50mg/day

>>> >> clonazepam .5mg(as required)>>> >> vitamin D 2000iu/day>>> >> Carol>>> >>>>> >>>>> >> Clarence Grim wrote:

>>> >> >>>> >> >>>> >> > Tell us all meds u>>> >> > Are taking.>>> >> >>>> >> > Tiped sad Send form mi

>>> >> > iPhone ;-)>>> >> >>>> >> > May your pressure be low!>>> >> >>>> >> > CE Grim MD>>> >> > Specializing in Difficult

>>> >> > Hypertension>>> >> >>>> >> > On May 10, 2009, at 10:48 PM, Carol Christie <carolch@...<carolch%40gil.com.au>

>>>>>> >> <mailto:carolch%40gil.com.au <carolch%2540gil.com.au>>

>>> >> > <mailto:carolch%40gil.com.au <carolch%2540gil.com.au>>> wrote:

>>> >> >>>> >> > > I, too identify strongly with dealing with mental changes.>>> >> > > I thought my personal papers filing was only a few months behind. I

>>> >> > > started sorting yesterday and found it had been a year since I had>>> >> > > filed/sorted things out.>>> >> > > I used to be meticulous in recording payments due/made etc. My

>>> >> > > organisational skills have deteriorated badly.>>> >> > > Carol>>> >> > >>>> >> > >>>> >> > > Isa Hackett wrote:

>>> >> > >>>>> >> > >>>>> >> > >> ->>> >> > >>>>> >> > >> I can identify with your challenges RE mental sharpness. It seems,

>>> >> > >> especially within the past six or so months, that my language>>> >> > >> (vocabulary) is suffering. I also find myself making silly>>> mistakes.

>>> >> > >> It makes things very hard with work. I often have to be " on " - and>>> I>>> >> > >> am very aware that I am not.>>> >> > >>

>>> >> > >> I've also recently been diagnosed - actually, I still have the>>> >> > >> salt-loading test yet to confirm. I believe my father had PA and>>> will

>>> >> > >> likely be tested for GRA. From what I have read, there is an>>> >> > >> increased>>> >> > >> risk of early stroke. My father began having small strokes in his

>>> >> > >> 40's>>> >> > >> and died of a massive stroke in his early 5o's.>>> >> > >>>>> >> > >> Anyway, I encourage you to read as much as possible about GRA.

>>> >> > >>>>> >> > >> DR Grim -are you aware of any differences in symptoms or treatment>>> ->>> >> > >> or>>> >> > >> follow-up for those with GRA?

>>> >> > >>>>> >> > >> , you should know that there are lots of understanding, helpf>>> ul>>> >> > >> and experienced people on this board -welcome.

>>> >> > >>>>> >> > >> Wishing you better health!>>> >> > >>>>> >> > >> >>> >> > >>

>>> >> > >> Sent via BlackBerry from T-Mobile>>> >> > >>>>> >> > >> --->>> >> > >> ----------------------------------------------------------

>>> >> > >> *From*: Echols>>> >> > >> *Date*: Sun, 10 May 2009 19:17:24 -0700 (PDT)>>> >> > >> *To*: <hyperaldosteronism <hyperaldosteronism%40>

>>>>>> >> <mailto:hyperaldosteronism%40<hyperaldosteronism%2540>

>>> >>>> >> > <mailto:hyperaldosteronism%40<hyperaldosteronism%2540> >>> >>>>> >> > >> *Subject*: Re: Renewing Conn's journey>>> >> > >> I plan to check my history and talk with my dad (it may take me a

>>> >> > >> little time though). I think I posted my story but I'll check my>>> past>>> >> > >> posts.>>> >> > >>>>> >> > >> ---

>>> >> > >> ---------------------------------------------------------->>> >> > >> *From:* Clarence Grim <lowerbp2@... <lowerbp2%40mac.com>

>>> >> <mailto:lowerbp2%40mac.com <lowerbp2%2540mac.com>> <mailto:>>> lowerbp2%40mac.com <lowerbp2%2540mac.com>>>

>>>>>> >> > >> *To:* hyperaldosteronism <hyperaldosteronism%40>

>>>>>> >> <mailto:hyperaldosteronism%40<hyperaldosteronism%2540>

>>> >>>> >> > <mailto:hyperaldosteronism%40<hyperaldosteronism%2540>

>>> >>>> >> > >> *Sent:* Sunday, May 10, 2009 1:34:25 AM>>> >> > >> *Subject:* Re: Renewing Conn's journey

>>> >> > >>>>> >> > >> If you father had PA can you give us his story as well (check with>>> >> > >> him>>> >> > >> first of course).

>>> >> > >>>>> >> > >>>>> >> > >> If he has clearly been diagnosed then it is likely that you and he>>> >> > >> have the same thing (assuming your have a Dx of PA that is clear

>>> as>>> >> > >> well). You likely have GRA which is an autosomal dominate genetic>>> >> > >> cause of PA in which 1/2 of all your first degree relatives will

>>> have>>> >> > >> it as well (on the average).>>> >> > >>>>> >> > >> Recommend you find out as much as you can about your FH of HTN,

>>> low>>> >> > >> K,>>> >> > >> causes and age of death as far back as you can go.>>> >> > >>>>> >> > >> I am looking for the Dr. in ville and should get back with

>>> you>>> >> > >> soon.>>> >> > >>>>> >> > >> Have you given us you complete story yet. I may have missed it as>>> >> > >> have been at the Am Soc of HTN meeting for last week. Lots of

>>> things>>> >> > >> to report to the group.>>> >> > >>>>> >> > >>>>> >> > >> On May 9, 2009, at 10:18 PM, Echols wrote:

>>> >> > >>>>> >> > >>>>>> >> > >>>>>> >> > >>>>>> >> > >>> D oc, I am closer to than I am Birmingham. To answer the

>>> >> > >>> family history question, my father was diagnosed with PA in 2007>>> but>>> >> > >>> he stated that no CT was ran. It appears that the spiro is

>>> lowering>>> >> > >>> my bp.>>> >> > >>> As far as my CT scan, would a scan of my renal arteries and>>> kidneys>>> >> > >>> reveal a bump? I am still suffering extreme fatigue and muscle

>>> >> > >>> weakness and tingling in my extremities, headaches, mental>>> confusion>>> >> > >>> and cloudiness (harde to concentrate) , memory loss, language

>>> >> > >>> difficulty. I also have intermittent pain in the region of my>>> coccyx>>> >> > >>> bone. Further, when I am surprised, or see something that causes

>>> me>>> >> > >>> to cringe, I feel a tingling sensation in my lower back that>>> flows>>> >> > >>> down toward my rear pelvic region.

>>> >> > >>> Doc, I agree with your comment as to other physicians do not>>> appear>>> >> > >>> to want to work with others to assist in the care of their

>>> patients.>>> >> > >>> I don't know if it is pride or the fact that the concern of>>> >> > >>> keeping a>>> >> > >>> patient overrides the overall health of the & nbsp;patient. I have

>>> >> > >>> the>>> >> > >>> same concerns in the legal profession. I have heard attorneys say>>> >> > >>> that " you can't help people " . The statement broke my heart. Last

>>> I>>> >> > >>> checked, there were three (3) noble professions: Doctors, lawyers>>> >> > >>> and>>> >> > >>> ministers. We provide a service. Don't misunderstand me, doc,

>>> this>>> >> > >>> is my livelihood and I am not apologizing for the salaries in our>>> >> > >>> respective professions. I pprovide a service and plan to receive

>>> >> > >>> compensation for those services. My concerned is that we need to>>> >> > >>> keep>>> >> > >>> in my that we are providing " people " with those services.

>>> >> > >>> I am not a complainer. I have been told that I am kind of stoic>>> in>>> >> > >>> nature. However, in my profession, I cannot afford to lose my

>>> mental>>> >> > >>> edge or acuity. My job depends on it and I am on a quest to feel>>> >> > >>> better. Thanks for responding.>>> >> > >>> If the best doctors are in Birmingham, I will go there but if you

>>> >> > >>> know someone in , that is closer. Thanks, Doc.>>> >> > >>>>>> >> > >>> --->>> >> > >>> ---

>>> >> > >>> ---------------------------------------------------------->>> >> > >>> *From:* Clarence Grim <lowerbp2mac (DOT) com>>>> >> > >>> *To:* hyperaldosteronism

>>> >> > >>> *Sent:* Friday, May 8, 2009 10:39:57 AM>>> >> > >>> *Subject:* Re: [hyperaldosteronism ] Renewing Conn's journey>>> >> > >>>

>>> >> > >>> As you can see from our group's stories we need to increase the>>> >> > >>> knowledge base or every one who sees pts with high blood>>> pressure.

>>> >> > >>> HTN + low K = PA.>>> >> > >>>>>> >> > >>> At some point we would like to have your complete story as well>>> if

>>> >> > >>> you have time.>>> >> > >>>>>> >> > >>>>>> >> > >>>>>> >> > >>> Your aldo and renin confirm this Dx.

>>> >> > >>>>>> >> > >>> If you have not read my article on the evolution of PA please do>>> >> > >>> so-and take to your Dr. I would be happy to work with him in your

>>> >> > >>> care but most Drs don't seem to be interested. Which blows my>>> mind.>>> >> > >>>>>> >> > >>> Any family Hx of HTN and/or low K?

>>> >> > >>>>>> >> > >>> If spiro works for BP and K and your are DASHing to the max that>>> >> > >>> essentially confirms the Dx.

>>> >> > >>> If the first CT did not show a bump on the adrenal then others>>> will>>> >> > >>> not likely show anything.>>> >> > >>>

>>> >> > >>>>>> >> > >>> Our basic approach here(based on 45 years of experience) is to>>> treat>>> >> > >>> with medications and DASH and if BP and K are controlled and

>>> other>>> >> > >>> Sx>>> >> > >>> go away not to do any further D x tests at this stage.>>> >> > >>> If there is a single bump and Rx fails to get to feeling normal

>>> >> > >>> then>>> >> > >>> would do AVS to see if the problem is unilateral or bilateral.>>> >> > >>>>>> >> > >>> I know folks in MS, in New Orleans and in Birmingham who

>>> are>>> >> > >>> experts in PA. I would recommend you go to someone who has a lot>>> >> > >>> of>>> >> > >>> experience in this and has been doing it for some time.

>>> >> > >>>>>> >> > >>>>>> >> > >>>>>> >> > >>>>>> >> > >>> Clarence Grim BS, MS, MD

>>> >> > >>>>>> >> > >>> Clinical Professor of Medicine>>> >> > >>> Medical College of Wisconsin>>> >> > >>> Senior Consultant to Shared Care Research and Education

>>> >> > >>> Consulting, Inc.>>> >> > >>>>>> >> > >>> Specializing in Difficult to control high blood pre ssure.>>> >> > >>>

>>> >> > >>>>>> >> > >>>>>> >> > >>>>>> >> > >>>>>> >> > >>> On May 7, 2009, at 1:49 PM, Echols wrote:

>>> >> > >>>>>> >> > >>>>>>> >> > >>>>>>> >> > >>>>>>> >> > >>>> Dr. Grim, I am an attorney in Mississippi and have just recently

>>> >> > >>>> been diagnosed with PA. My family physician was attempting to>>> treat>>> >> > >>>> my extremely high bp to no avail and after nearly 3 years fina

>>> lly>>> >> > >>>> told me that he did not have a clue as to what was going on and>>> >> > >>>> referred me to an internist. The internist specializes in

>>> >> > >>>> hypertension. I really don't know how much the internist>>> >> > >>>> understands>>> >> > >>>> about PA but I am glad that he has at least heard of it after

>>> I've>>> >> > >>>> suffered for about 15 or more years with nearly all the symptoms>>> >> > >>>> listed by others here. The internist ordered a blood workup and

>>> my>>> >> > >>>> aldosterone levels were 3 times the normal amount and my renin>>> was>>> >> > >>>> undetected. No other tests were run. He did not order a CT scan

>>> of>>> >> > >>>> my adrenals. After being hospitalized, my family physician>>> >> > >>>> (after I>>> >> > >>>> pushed for it) ordered a CT scan of my kidneys and renal

>>> arteries>>> >> > >>>> and stated that they looked fine. That was prior to seeing the>>> >> > >>>> internist. After reading postings in this group, I requested on

>>> May>>> >> > >>>> 5th to have a CT scan performed to look at my adrenal glands. He>>> >> > >>>> stated that he was not going to do it now, but might in about 2

>>> >> > >>>> months.>>> >> > >>>> I told the internist that I am still extremely fatigued, that I>>> >> > >>>> have>>> >> > >>>> headaches, my mind is cloudy, having a problem with

>>> concentration>>> >> > >>>> and memory and that I am concerned because it was affecting my>>> work>>> >> > >>>> (I have been off work for about a month). Internist told me that

>>> he>>> >> > >>>> believed that I was just depressed and prescribed lexapro. He>>> >> > >>>> stated>>> >> > >>>> that I should be excited because my blood pressure was coming

>>> down.>>> >> > >>>> I told him that I was excited but that I did not think that I>>> was>>> >> > >>>> depressed to the point of needing medication. I am thinking of

>>> >> > >>>> either going to the University of Birmingham to see a>>> nephrologist>>> >> > >>>> and/or endo. Is this a good idea? Is UAB a good place to go for

>>> >> > >>>> hyperaldosterinism? If not, can you refer a place near MS? I>>> need>>> >> > >>>> to>>> >> > >>>> make sure that I have this condition ( I have all the symptoms

>>> and>>> >> > >>>> the spiro-75mg- is helping my bp) and if so, how I can cure or>>> best>>> >> > >>>> treat it. The internist stated that he did not know what caused

>>> it>>> >> > >>>> and that he did not believe that I had a tumor. I am grateful>>> that>>> >> > >>>> he looked into hyperaldosteronism but I think the internist is

>>> more>>> >> > >>>> concentrated on the bp, since that is his specialty. I am>>> concerned>>> >> > >>>> not only about the bp, but also the mental aspects of this

>>> >> > >>>> condition>>> >> > >>>> because it emy livelihood. Please respond.>>> >> > >>>>>>> >> > >>>> ---

>>> >> > >>>> --->>> >> > >>>> ---------------------------------------------------------->>> >> > >>>> *From:* Clarence Grim <lowerbp2mac (DOT) com>

>>> >> > >>>> *To:* hyperaldosteronism>>> >> > >>>> *Sent:* Thursday, May 7, 2009 1:32:35 AM>>> >> > >>>> *Subject:* Re: [hyperaldosteronism ] Renewing Conn's journey

>>> >> > >>>>>>> >> > >>>> Dont recall your previous story. Do we need to update your>>> story?>>> >> > >>>>

>>> >> > >>>>>>> >> > >>>> CE Grim MD>>> >> > >>>> On May 6, 2009, at 6:05 PM, hdrewe wrote:>>> >> > >>>>

>>> >> > >>>>> I have not been in contact with this site for a few weeks,>>> >> > >>>>> however,>>> >> > >>>>> am now back on track. I visited Dr Nikwan at Greenslopes

>>> Hospital,>>> >> > >>>>> and am going ahead with the workups prior to maybe having>>> surgery.>>> >> > >>>>> He was certainly surprised to see me after 9 years.

>>> >> > >>>>>>>> >> > >>>>> My Aldosterone/ Renin assays wer e:->>> >> > >>>>> Aldosterone (upright) 1923 (pmol/L) (100 - 950)

>>> >> > >>>>> Renin (upright) 14 (mU/L) (3.3 - 41)>>> >> > >>>>> Aldosterone/ Renin Ratio 137>>> >> > >>>>>>>> >> > >>>>> These results were while on 25mg Spironolactone.

>>> >> > >>>>>>>> >> > >>>>> I have been taken off Spiro and put on Verapamil SR 240mg/day,>>> >> > >>>>> which I began this morning.

>>> >> > >>>>> I am to have CT scan of adrenal gland to see what has happened>>> >> > >>>>> after all this time.>>> >> > >>>>> Will revisit Dr Nikwan in 8 weeks.

>>> >> > >>>>> Helen D>>> >> > >>>>>>> >> > >>>>>>> >> > >>>>>>> >> > >>>

>>> >> > >>>>>> >> > >>>>>> >> > >>>>> >> > >>>>> >> > >>>>> >> > >

>>> >> > >>>> >> > >>>> >> > > ------------------------------------>>> >> > >>>> >> > >

May 12, 2009