Re: New here, not yet diagnosed, being tested

[Guest guest]

My bro goes to the VA AND a private dr. Gets advice from both worlds.

He gets in easier at the VA and prescripts are timely and 7$.

One bro-in-law wouldn't get caught dead there but got free hearing aids (not

cheap). He has free retirement-provided health insurance, not counting

Medicare. Problem is, there are long lines at the local hospital.

Other bro-in-law likes the VA - no hassle, low cost meds, never had a

problem - he is also very healthy at 82 yo.

A friend had a stroke at 58 yo - VA provided full care until the could walk

with a cane. They are experimenting with a new brainal technique to

reconnect his right arm. Something you might not see in a regulated by a

legally controlled world.

Regards

RE: Re: New here, not yet diagnosed, being

tested

I've heard your opinion many times.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Francis Bill

It doesn't take much searching to find just how bad the VA is. At first I

thought it was a lot of bull. Now I am not so sure. My own experiences with

them haven't been the best.

>

> To not recommend DASH in a VA HTN Pt is medico negligence in MHO and u

> should complain to them medical director.

[Guest guest]

My guess is it is experiment and therefore very tightly regulated in the VA. Indeed much better in VA than in outside.They do not do treatments that have not been proven to be of benefit and have lead the way in trial research. The first good high blood pressure trial was done thru the VA. In my slide set as I recall. May your pressure be low!Clarence E. Grim, BS, MS, MDSpecializing in Primary Aldosteronism the most common cause of "Difficult/Drug Resistant High Blood Pressure". Other research interests focus on the interactions of recent evolutionary forces on the body's ability to handle salt and the effect of dietary salt on blood pressure in populations today.Listed in Best Doctors of America 2009. On Oct 11, 2009, at 1:53 PM, jwwright wrote: My bro goes to the VA AND a private dr. Gets advice from both worlds. He gets in easier at the VA and prescripts are timely and 7$. One bro-in-law wouldn't get caught dead there but got free hearing aids (not cheap). He has free retirement-provided health insurance, not counting Medicare. Problem is, there are long lines at the local hospital. Other bro-in-law likes the VA - no hassle, low cost meds, never had a problem - he is also very healthy at 82 yo. A friend had a stroke at 58 yo - VA provided full care until the could walk with a cane. They are experimenting with a new brainal technique to reconnect his right arm. Something you might not see in a regulated by a legally controlled world. Regards RE: Re: New here, not yet diagnosed, being tested I've heard your opinion many times. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill It doesn't take much searching to find just how bad the VA is. At first I thought it was a lot of bull. Now I am not so sure. My own experiences with them haven't been the best. > > To not recommend DASH in a VA HTN Pt is medico negligence in MHO and u > should complain to them medical director.

[Guest guest]

He has obviously not seem many PAs. Well he may have seen many but has not recognized them! A bump on the adrenal itself is enough to do renin and aldo in MHO. One problem with Dx HTN in the VA is the terrible way they do BP most times. But tell how BPs were done whne you went there.Someone who used to have a BP of 100/60 before PA and who now has PA that has increased BP by 40/30 to 140/90 would not be counted as having "HTN" but this guys definition I would guess. With a low K EVER it would seem to be medical negligence to not do this with an adrenal but and Pre hypertension.Send him and the VA ombudsman the Endo guidelines and my paper to get him up to speed. May your pressure be low!Clarence E. Grim, BS, MS, MDSpecializing in Primary Aldosteronism the most common cause of "Difficult/Drug Resistant High Blood Pressure". Other research interests focus on the interactions of recent evolutionary forces on the body's ability to handle salt and the effect of dietary salt on blood pressure in populations today.Listed in Best Doctors of America 2009. On Oct 11, 2009, at 9:54 AM, Francis Bill wrote: It was my intent to add the VA Endocrinologist report but somehow it didn't copy to here. so here it is. pt w/ 18 mm mass in left adrenal no Sx's of HA, no spells, no nervousness or tremolous episodes no DM Hx aunt w/ DM HTN treated for 3 yrs but ?elevated in past nl K A & P Pt w/ incidental small adrenal adenomas found on CT. Neg cortisol w/u and nl glu and K. No ~x's of pheo. Given the small size and lack of labs or Sx's, I would not proceed to any other testing at this time. ANDREW J BAUMAN Assistant Chief Medicine Signed: 04/28/2008 13:50 At the time I him I had 4 blood tests that my K was less then 3.5. and many B/P readings over 140/80. > > > > > > > > > > Hi I'm new here. I just completed a 24 hour cortisol urine test this > > > > > morning, I also had lab work yesterday to check for indicators of > > > > Conn's, > > > > > 's and Cushing's, however when I was at the Endo she and I > > > > agreed > > > > > that my symptoms most indicated conn's. I have been going through > > > > this for > > > > > 10 years. I was diagnosed with Hashimoto's thyroid 8 years ago and > > > > premature > > > > > ovarian failure. My symptoms of heart palps at night, muscle > > > > twitching, > > > > > fatigue, inability to exercise without getting wiped out have been > > > > > attributed to those 2 diseases, yet when I tried to take even the > > > > smallest > > > > > amount of thyroid or female hormones I ended up with adrenaline > > > > rushes and > > > > > spiking blood pressure. I have gone to the hospital 3 times in the > > > > last 8 > > > > > years with heart palaps that ended up being from low postassium, > > > > the last > > > > > trip was in February of this year and my postassium was 2.9, there > > > > are > > > > > plenty of other times that I know I should have gone but didn't. > > > > My bp has > > > > > gone up and down, it was always very low and my moms is very low, > > > > mine used > > > > > to run 90's over 70's. I'm very small. My 2 questions are 1. is it > > > > common > > > > > for the blood pressure and potassium to go up and down with Conn's > > > > or do > > > > > they usually stay high and low consistantly? I can have bp of > > > > 140/89 one day > > > > > and 101/68 the next for no apparent reason and most times my > > > > potassium is > > > > > normal. 2. Is it common in Conn's for people to have a bad > > > > reaction to > > > > > thyroid medicine? I can't take even the smallest dose without > > > > racing heart > > > > > and what I call night time adreanline rushes. I've been dealing > > > > with this > > > > > for so long that I am hoping to come to a diagnosis. > > > > > > > > > > Thanks! > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Classic case of evolving PA IMHO. Big bumps come from small bumps.Use Excel or Google files Plot your BP, K and Na over time. List Rx below. May your pressure be low!Clarence E. Grim, BS, MS, MDSpecializing in Primary Aldosteronism the most common cause of "Difficult/Drug Resistant High Blood Pressure". Other research interests focus on the interactions of recent evolutionary forces on the body's ability to handle salt and the effect of dietary salt on blood pressure in populations today.Listed in Best Doctors of America 2009. On Oct 11, 2009, at 9:22 AM, Francis Bill wrote: You ask good qustions. I don't mind repeting what I have already posted. I find it hard to go back and read even what I have posted. never mind trying to find out others have posted. I am still working on B/P readings. But have some readings around 125/80 to 200/100. Here is some of my blood work and Meds. PLASMA GLUCOSE BUN CREAT NA K CL Ref range low 65 7 .5 135 3.5 100 Ref range high 100 25 1.5 145 5 110 mg/dL mg/dL mg/dl mmol/L mmol/L mrnol/ date time 02/22/2009 12:15 99 11 1.0 142 3.7 105 01/02/2009 18:48 101 H 9 0.9 141 3.6 104 12/15/2008 06:00 98 6 L 0.9 140 3.5 109 12/13/2008 20:25 113 H 8 0.9 141 3.4 L 105 11/01/2008 12:05 92 9 1.0 140 3.7 104 FUROSEMIDE 3 20MG TAB 10/16/2008 10/16/2008 11:37 93 9 1.0 140 3.7 103 08/19/2008 11:33 99 7 1.0 140 3.8 106 07/18/2008 14:35 111 H 8 0.9 140 3.7 108 03/28/2008 14:46 96 12 1.1 142 3.6 108 01/08/2008 12:37 102 H 12 1.1 142 4.0 107 FUROSEMIDE 20MG TAB 12/04/2007 for a few days 10/24/2007 14:41 105 H 11 1.0 142 4.1 105 09/16/2007 12:10 97 10 1.1 140 4.1 108 08/03/2007 15:05 108 H 9 1.1 142 3.7 109 06/23/2007 12:45 97 11 1.0 140 4.1 110 POTASSIUM CHLORIDE 2 10MEQ SA TAB 06/07/2007 HYDROCHLOROTHIAZIDE STOPED FUROSEMIDE 40MG TAB 06/07/2007 05/01/2007 08:37 99 12 1.0 141 3.2 L 104 TRIAMTERENE 50MG CAP 03/27/2007 03/20/2007 10:10 139 3.4 L 102 03/13/2007 06:00 98 12 1.1 138 3.3 L 108 03/12/2007 06:00 114 H 11 1.1 135 3.2 L 106 03/11/2007 12:00 126 H 14 1.1 136 3.6 103 02/16/2007 15:33 105 H 10 1.1 140 3.9 101 HYDROCHLOROTHIAZIDE 25MG TAB 02/01/2007 06/06/2006 14:02 95 9 1.0 138 4.0 105 04/22/2006 14:20 94 7 0.9 138 3.9 105 11/16/2005 14:00 97 11 1.0 138 4.3 105 08/01/2005 11: 06 92 9 0.9 138 4.1 105 > > > > > > > > If you have PA, is is imperative that you block aldosterone and eat very > > > low > > > > salt. Do you have a choice other than VA? > > > > > > > > Val > > > > > >

[Guest guest]

I tought them well! May your pressure be low!Clarence E. Grim, BS, MS, MDSpecializing in Primary Aldosteronism the most common cause of "Difficult/Drug Resistant High Blood Pressure". Other research interests focus on the interactions of recent evolutionary forces on the body's ability to handle salt and the effect of dietary salt on blood pressure in populations today.Listed in Best Doctors of America 2009. On Oct 11, 2009, at 8:49 AM, Francis Bill wrote: Here is the link to the the video in our files Resistant Hypertension.wmv. This will download the video to your computer. While some of this video is meant for others with a better education then I have. I find there is enough for me to understand. Much of what is on this is the same as what Dr Grim says. You can put the utube link in your e-mails. My pharmacist is the VA. I think that many times when someone has a hard to diagnose or treat problem there should be a team approach used. > > > > > > > > If you have PA, is is imperative that you block aldosterone and eat very low > > > > salt. Do you have a choice other than VA? > > > > > > > > Val > > > > > > > > From: hyperaldosteronism > > > > [mailto:hyperaldosteronism ] On Behalf Of Francis Bill > > > > > > > > > > > > Went to my VA doctor today. It is quite clear that he knows nothing about > > > > Conn's and doesn't want any part of Dr Gimm's information on it. I tried to > > > > get him to retest me off the meds. He said that there is no point to it, > > > > even if new tests showed Conn's the only way to treat it is to control B/P > > > > and K nothing about blocking the aldosterone. He says he is already doing > > > > this. He said the risk for surgery isn't worth it. He is sorry that I feel > > > > bad but he has done all that he knows how to do. > > > > > > > > As I am writing this I received a call from my Dr about the PRA ratio test > > > > that they did. Says when they do a PAR ratio tests there is no reason to > > > > stop meds as it doesn't make any difference in the PRA ratio. This is not > > > > what it says on the Quest Lab site this is who the VA uses. > > > > > > > > From quest lab site > > > > Aldosterone (LC/MS/MS)/Plasma Renin Activity Ratio > > > > CPT Code(s): 82088, 84244 > > > > Preferred Specimen(s) > > > > 4 mL (1 mL minimum) plasma from EDTA (lavender-top) tube transferred into > > > > plastic vial. Submit frozen. Avoid refrigerated temperatures. Patient should > > > > refrain from taking medications, preferably 3 weeks prior to draw. Patient > > > > should be ambulatory for 30 minutes prior to draw. Patient should be on a > > > > moderate sodium diet during collection. This test was developed and its > > > > performance characteristics determined by Quest Diagnostics Nichols > > > > Institute. It has not been cleared or approved by the U.S. Food and Drug > > > > Administration. The FDA has determined that such clearance or approval is > > > > not necessary. Performance characteristics refer to the analytical > > > > performance of the test. > > > > > > > > My doctor also told me since I had already see the VA Endocrinologist and he > > > > found nothing wrong. There Endocrinologist is a five minute wonder. He sees > > > > you for five minutes and you wonder why. Here is his report and my k > > > > readings up to the time I saw him. > > > > > > > > > >

[Guest guest]

I have been looking at b/p readings many were over 175/80 before this vist. One

thing about the VA coumper system it all the B/P readings are on a line graph.

So all he needed to do is look at this graph.

I have had my B/P checked many ways. Sometimes over my shirt.

If you will note this doctor is also there Assistant Chief Medicine.

> > > > > > >

> > > > > > > Hi I'm new here. I just completed a 24 hour cortisol

> > urine test this

> > > > > > > morning, I also had lab work yesterday to check for

> > indicators of

> > > > > > Conn's,

> > > > > > > 's and Cushing's, however when I was at the Endo

> > she and I

> > > > > > agreed

> > > > > > > that my symptoms most indicated conn's. I have been going

> > through

> > > > > > this for

> > > > > > > 10 years. I was diagnosed with Hashimoto's thyroid 8

> > years ago and

> > > > > > premature

> > > > > > > ovarian failure. My symptoms of heart palps at night, muscle

> > > > > > twitching,

> > > > > > > fatigue, inability to exercise without getting wiped out

> > have been

> > > > > > > attributed to those 2 diseases, yet when I tried to take

> > even the

> > > > > > smallest

> > > > > > > amount of thyroid or female hormones I ended up with

> > adrenaline

> > > > > > rushes and

> > > > > > > spiking blood pressure. I have gone to the hospital 3

> > times in the

> > > > > > last 8

> > > > > > > years with heart palaps that ended up being from low

> > postassium,

> > > > > > the last

> > > > > > > trip was in February of this year and my postassium was

> > 2.9, there

> > > > > > are

> > > > > > > plenty of other times that I know I should have gone but

> > didn't.

> > > > > > My bp has

> > > > > > > gone up and down, it was always very low and my moms is

> > very low,

> > > > > > mine used

> > > > > > > to run 90's over 70's. I'm very small. My 2 questions are

> > 1. is it

> > > > > > common

> > > > > > > for the blood pressure and potassium to go up and down

> > with Conn's

> > > > > > or do

> > > > > > > they usually stay high and low consistantly? I can have

> > bp of

> > > > > > 140/89 one day

> > > > > > > and 101/68 the next for no apparent reason and most times my

> > > > > > potassium is

> > > > > > > normal. 2. Is it common in Conn's for people to have a bad

> > > > > > reaction to

> > > > > > > thyroid medicine? I can't take even the smallest dose

> > without

> > > > > > racing heart

> > > > > > > and what I call night time adreanline rushes. I've been

> > dealing

> > > > > > with this

> > > > > > > for so long that I am hoping to come to a diagnosis.

> > > > > > >

> > > > > > > Thanks!

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

I did note that. A tiitle does not guarantee expertise as noted by his

note of ? HTN and no low K.

Keep us posted.

CE Grim MD

On Oct 11, 2009, at 7:56 PM, Francis Bill wrote:

> I have been looking at b/p readings many were over 175/80 before this

> vist. One thing about the VA coumper system it all the B/P readings

> are on a line graph. So all he needed to do is look at this graph.

> I have had my B/P checked many ways. Sometimes over my shirt.

>

> If you will note this doctor is also there Assistant Chief Medicine.

>

>

> > > > > > > >

> > > > > > > > Hi I'm new here. I just completed a 24 hour cortisol

> > > urine test this

> > > > > > > > morning, I also had lab work yesterday to check for

> > > indicators of

> > > > > > > Conn's,

> > > > > > > > 's and Cushing's, however when I was at the Endo

> > > she and I

> > > > > > > agreed

> > > > > > > > that my symptoms most indicated conn's. I have been

> going

> > > through

> > > > > > > this for

> > > > > > > > 10 years. I was diagnosed with Hashimoto's thyroid 8

> > > years ago and

> > > > > > > premature

> > > > > > > > ovarian failure. My symptoms of heart palps at night,

> muscle

> > > > > > > twitching,

> > > > > > > > fatigue, inability to exercise without getting wiped out

> > > have been

> > > > > > > > attributed to those 2 diseases, yet when I tried to take

> > > even the

> > > > > > > smallest

> > > > > > > > amount of thyroid or female hormones I ended up with

> > > adrenaline

> > > > > > > rushes and

> > > > > > > > spiking blood pressure. I have gone to the hospital 3

> > > times in the

> > > > > > > last 8

> > > > > > > > years with heart palaps that ended up being from low

> > > postassium,

> > > > > > > the last

> > > > > > > > trip was in February of this year and my postassium was

> > > 2.9, there

> > > > > > > are

> > > > > > > > plenty of other times that I know I should have gone but

> > > didn't.

> > > > > > > My bp has

> > > > > > > > gone up and down, it was always very low and my moms is

> > > very low,

> > > > > > > mine used

> > > > > > > > to run 90's over 70's. I'm very small. My 2 questions

> are

> > > 1. is it

> > > > > > > common

> > > > > > > > for the blood pressure and potassium to go up and down

> > > with Conn's

> > > > > > > or do

> > > > > > > > they usually stay high and low consistantly? I can have

> > > bp of

> > > > > > > 140/89 one day

> > > > > > > > and 101/68 the next for no apparent reason and most

> times my

> > > > > > > potassium is

> > > > > > > > normal. 2. Is it common in Conn's for people to have a

> bad

> > > > > > > reaction to

> > > > > > > > thyroid medicine? I can't take even the smallest dose

> > > without

> > > > > > > racing heart

> > > > > > > > and what I call night time adreanline rushes. I've been

> > > dealing

> > > > > > > with this

> > > > > > > > for so long that I am hoping to come to a diagnosis.

> > > > > > > >

> > > > > > > > Thanks!

> > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> > >

> >

>

>

[Guest guest]

Here is something one of there other provides had to say. She is only a

physicians assistant but she was my PCP.

This is what she says about this report The arrhythmia monitor results were

reviewed with the patient has no indication that his systoms are related to

cardiac. Maybe she is right.

LOOP RECORDER REPORT

Dates worn: 11/28 -> 12/02/05

Requested by: Amelia Sereen

Reason for request: Presyncope

Impressions by Dr. Dan O'Rourke:

Baseline: NSR @ -90 bpm with frequent asymptomatic PVC's.

Event #1: " Short of breath " Sinus tach @ -110 bpm.

Event #2: " Fast heart rate " - Sinus tach @ -110 bpm with occasional unifocal

isolated PVC's.

Event #3: " Dizziness " - NSR @ -90 with occasional unifocal isolated PVC's.

Event # 4 : " Short of breath " - Sinus tach @ -115 bpm with rare unifocal

isolated PVC's.

Event #5: light headed and short of breath - NSR @ 75 bpm.

> > > > > > > > >

> > > > > > > > > Hi I'm new here. I just completed a 24 hour cortisol

> > > > urine test this

> > > > > > > > > morning, I also had lab work yesterday to check for

> > > > indicators of

> > > > > > > > Conn's,

> > > > > > > > > 's and Cushing's, however when I was at the Endo

> > > > she and I

> > > > > > > > agreed

> > > > > > > > > that my symptoms most indicated conn's. I have been

> > going

> > > > through

> > > > > > > > this for

> > > > > > > > > 10 years. I was diagnosed with Hashimoto's thyroid 8

> > > > years ago and

> > > > > > > > premature

> > > > > > > > > ovarian failure. My symptoms of heart palps at night,

> > muscle

> > > > > > > > twitching,

> > > > > > > > > fatigue, inability to exercise without getting wiped out

> > > > have been

> > > > > > > > > attributed to those 2 diseases, yet when I tried to take

> > > > even the

> > > > > > > > smallest

> > > > > > > > > amount of thyroid or female hormones I ended up with

> > > > adrenaline

> > > > > > > > rushes and

> > > > > > > > > spiking blood pressure. I have gone to the hospital 3

> > > > times in the

> > > > > > > > last 8

> > > > > > > > > years with heart palaps that ended up being from low

> > > > postassium,

> > > > > > > > the last

> > > > > > > > > trip was in February of this year and my postassium was

> > > > 2.9, there

> > > > > > > > are

> > > > > > > > > plenty of other times that I know I should have gone but

> > > > didn't.

> > > > > > > > My bp has

> > > > > > > > > gone up and down, it was always very low and my moms is

> > > > very low,

> > > > > > > > mine used

> > > > > > > > > to run 90's over 70's. I'm very small. My 2 questions

> > are

> > > > 1. is it

> > > > > > > > common

> > > > > > > > > for the blood pressure and potassium to go up and down

> > > > with Conn's

> > > > > > > > or do

> > > > > > > > > they usually stay high and low consistantly? I can have

> > > > bp of

> > > > > > > > 140/89 one day

> > > > > > > > > and 101/68 the next for no apparent reason and most

> > times my

> > > > > > > > potassium is

> > > > > > > > > normal. 2. Is it common in Conn's for people to have a

> > bad

> > > > > > > > reaction to

> > > > > > > > > thyroid medicine? I can't take even the smallest dose

> > > > without

> > > > > > > > racing heart

> > > > > > > > > and what I call night time adreanline rushes. I've been

> > > > dealing

> > > > > > > > with this

> > > > > > > > > for so long that I am hoping to come to a diagnosis.

> > > > > > > > >

> > > > > > > > > Thanks!

> > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

From what I can make out if you are tested on diuretics and you don't have PA

then your renin is going to be increased. If your renin is near the low side

that PA should be suspected no matter what the ratio is.

To me this would mean that if tested on diuretics and renin is on the low side

they PA can't be ruled out and you need further testing. Now I don't know how

low this means. Is 1.8 low when on diuretics? My level frow the VA test. How

about .8? my level from the Dartmouth test. Is there any way to know what renin

should be on diuretics?

> > > > >

> > > > > If you have PA, is is imperative that you block aldosterone and

> > > eat very

> > > > low

> > > > > salt. Do you have a choice other than VA?

> > > > >

> > > > > Val

> > > >

> > >

> > >

> >

>

[Guest guest]

If this dr looks at PA the same as my PCP dr then there is no reason to test for

PA. Even if you have it it doesn't matter still will treat you the same meds to

contlol B/P and K nothing else. This is the message that my dr made clear to me.

All other SX just live with. After all I can still fuction to some extent.

> > > > > > > > >

> > > > > > > > > Hi I'm new here. I just completed a 24 hour cortisol

> > > > urine test this

> > > > > > > > > morning, I also had lab work yesterday to check for

> > > > indicators of

> > > > > > > > Conn's,

> > > > > > > > > 's and Cushing's, however when I was at the Endo

> > > > she and I

> > > > > > > > agreed

> > > > > > > > > that my symptoms most indicated conn's. I have been

> > going

> > > > through

> > > > > > > > this for

> > > > > > > > > 10 years. I was diagnosed with Hashimoto's thyroid 8

> > > > years ago and

> > > > > > > > premature

> > > > > > > > > ovarian failure. My symptoms of heart palps at night,

> > muscle

> > > > > > > > twitching,

> > > > > > > > > fatigue, inability to exercise without getting wiped out

> > > > have been

> > > > > > > > > attributed to those 2 diseases, yet when I tried to take

> > > > even the

> > > > > > > > smallest

> > > > > > > > > amount of thyroid or female hormones I ended up with

> > > > adrenaline

> > > > > > > > rushes and

> > > > > > > > > spiking blood pressure. I have gone to the hospital 3

> > > > times in the

> > > > > > > > last 8

> > > > > > > > > years with heart palaps that ended up being from low

> > > > postassium,

> > > > > > > > the last

> > > > > > > > > trip was in February of this year and my postassium was

> > > > 2.9, there

> > > > > > > > are

> > > > > > > > > plenty of other times that I know I should have gone but

> > > > didn't.

> > > > > > > > My bp has

> > > > > > > > > gone up and down, it was always very low and my moms is

> > > > very low,

> > > > > > > > mine used

> > > > > > > > > to run 90's over 70's. I'm very small. My 2 questions

> > are

> > > > 1. is it

> > > > > > > > common

> > > > > > > > > for the blood pressure and potassium to go up and down

> > > > with Conn's

> > > > > > > > or do

> > > > > > > > > they usually stay high and low consistantly? I can have

> > > > bp of

> > > > > > > > 140/89 one day

> > > > > > > > > and 101/68 the next for no apparent reason and most

> > times my

> > > > > > > > potassium is

> > > > > > > > > normal. 2. Is it common in Conn's for people to have a

> > bad

> > > > > > > > reaction to

> > > > > > > > > thyroid medicine? I can't take even the smallest dose

> > > > without

> > > > > > > > racing heart

> > > > > > > > > and what I call night time adreanline rushes. I've been

> > > > dealing

> > > > > > > > with this

> > > > > > > > > for so long that I am hoping to come to a diagnosis.

> > > > > > > > >

> > > > > > > > > Thanks!

> > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Francis has had aldo/renin as I recall. His ARR is about 8 or so. I wish he'd write his story and put it

in the files so we could remember.

Francis, I will help you do that if you need it.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Clarence Grim

He has obviously not seem many PAs. Well he may have seen many but

has not recognized them! A bump on the adrenal itself is enough to do

renin and aldo in MHO. One problem with Dx HTN in the VA is the terrible

way they do BP most times. But tell how BPs were done whne you went

there.

Someone

who used to have a BP of 100/60 before PA and who now has PA that has increased

BP by 40/30 to 140/90 would not be counted as having " HTN " but this

guys definition I would guess. With a low K EVER it would seem to be

medical negligence to not do this with an adrenal but and Pre hypertension.

Send

him and the VA ombudsman the Endo guidelines and my paper to get him up to

speed.

On

Oct 11, 2009, at 9:54 AM, Francis Bill wrote:

It was my intent to add the VA Endocrinologist

report but somehow it didn't copy to here. so here it is.

pt w/ 18 mm mass in left adrenal

no Sx's of HA, no spells, no nervousness or tremolous episodes

no DM Hx aunt w/ DM

HTN treated for 3 yrs but ?elevated in past

nl K

A & P

Pt w/ incidental small adrenal adenomas found on CT.

Neg cortisol w/u and nl glu and K. No ~x's of pheo.

Given the small size and lack of labs or Sx's, I would not proceed to any

other testing at this time.

ANDREW J BAUMAN

Assistant Chief Medicine

Signed: 04/28/2008 13:50

At the time I him I had 4 blood tests that my K was less then 3.5. and many B/P

readings over 140/80.

>

> Went to my VA doctor today. It is quite clear that he knows nothing about

Conn's and doesn't want any part of Dr Gimm's information on it. I tried to get

him to retest me off the meds. He said that there is no point to it, even if

new tests showed Conn's the only way to treat it is to control B/P and K

nothing about blocking the aldosterone. He says he is already doing this. He

said the risk for surgery isn't worth it. He is sorry tha t I feel bad but he

has done all that he knows how to do.

..

[Guest guest]

Do you take your BP at home, daily? If not, you should.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Francis Bill

I have been looking at b/p readings many were over 175/80

before this vist. One thing about the VA coumper system it all the B/P readings

are on a line graph. So all he needed to do is look at this graph.

I have had my B/P checked many ways. Sometimes over my shirt.

If you will note this doctor is also there Assistant Chief Medicine.

[Guest guest]

You are right about the ratio. VA test done by Quest labs RENIN 1.8 ALDOS 16

also note in report Treatment with medications such as diuretics or ACE

inhibitors increase PRA levels. Since I was tested on diuretics and beta blocker

I guess this would pretain to me. So ratio is mostly higher.

Test done at Dartmouth I belive by mayo lab renin .8 aldos 5.5. again tested on

diuretics and beta blocker.

I am trying to get my story on here. Have some where around 500 pages of

information to look at.

> >

> > Went to my VA doctor today. It is quite clear that he knows nothing about

> Conn's and doesn't want any part of Dr Gimm's information on it. I tried to

> get him to retest me off the meds. He said that there is no point to it,

> even if new tests showed Conn's the only way to treat it is to control B/P

> and K nothing about blocking the aldosterone. He says he is already doing

> this. He said the risk for surgery isn't worth it. He is sorry tha t I feel

> bad but he has done all that he knows how to do.

>

>

> .

> Web Bug from

> http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=

> 16495/stime=1255304745/nc1=1/nc2=2/nc3=3

> <http://www.mailscanner.info/images/1x1spacer.gif>

>

[Guest guest]

I have an automatic B/p device. I don't trust hearing good enough to it

manually. I don't check daily. When I do check readins change a lot as dose my

heart rate.

>

> Do you take your BP at home, daily? If not, you should.

>

> Val

>

> From: hyperaldosteronism

> [mailto:hyperaldosteronism ] On Behalf Of Francis Bill

>

>

> I have been looking at b/p readings many were over 175/80 before this vist.

> One thing about the VA coumper system it all the B/P readings are on a line

> graph. So all he needed to do is look at this graph.

> I have had my B/P checked many ways. Sometimes over my shirt.

>

> If you will note this doctor is also there Assistant Chief Medicine.

>

[Guest guest]

Beta Blockers may kill Renin artificially, so this is also a concern.

Bindner

Web Directory (links to my sites and blogs):

http://www.geocities.com/mikeybdc/index.html

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From: Francis Bill <georgewbill@...>Subject: Re: New here, not yet diagnosed, being testedhyperaldosteronism Date: Monday, October 12, 2009, 10:42 AM

From what I can make out if you are tested on diuretics and you don't have PA then your renin is going to be increased. If your renin is near the low side that PA should be suspected no matter what the ratio is. To me this would mean that if tested on diuretics and renin is on the low side they PA can't be ruled out and you need further testing. Now I don't know how low this means. Is 1.8 low when on diuretics? My level frow the VA test. How about .8? my level from the Dartmouth test. Is there any way to know what renin should be on diuretics? > > > > >> > > > > If you have PA, is is imperative that you block aldosterone and > > > eat very> > > > low> > > > > salt. Do you have a choice other than VA?> > > > >> > > > > Val> > > >> > >> > >> >>

[Guest guest]

From what I read beta blockers tend to give false positive resultes but can give

fales negative as well. Diuretics tend give false negative resultes. Haven't yet

seem where Diuretics give false positive resultes.

> > > > > >

> > > > > > If you have PA, is is imperative that you block aldosterone and

> > > > eat very

> > > > > low

> > > > > > salt. Do you have a choice other than VA?

> > > > > >

> > > > > > Val

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

Actually, I thought verapamil (the only CCB listed) was one of the few drugs

that wouldn't affect the ARR (endo guidelines)

That's what they have me on in prep. for the test ARR

Chantal

>

>

> From: Francis Bill <georgewbill@...>

> Subject: Re: New here, not yet diagnosed, being tested

> hyperaldosteronism

> Date: Monday, October 12, 2009, 10:42 AM

>

>

>

> From what I can make out if you are tested on diuretics and you don't have

> PA then your renin is going to be increased. If your renin is near the low

> side that PA should be suspected no matter what the ratio is.

>

> To me this would mean that if tested on diuretics and renin is on the low

> side they PA can't be ruled out and you need further testing. Now I don't

> know how low this means. Is 1.8 low when on diuretics? My level frow the VA

> test. How about .8? my level from the Dartmouth test. Is there any way to

> know what renin should be on diuretics?

>

[Guest guest]

Most CCB's effect, but Verapamil does not

Bindner

Web Directory (links to my sites and blogs):

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From: Francis Bill <georgewbill>Subject: [hyperaldosteronism ] Re: New here, not yet diagnosed, being testedhyperaldosteronismDate: Monday, October 12, 2009, 10:42 AMFrom what I can make out if you are tested on diuretics and you don't havePA then your renin is going to be increased. If your renin is near the lowside that PA should be suspected no matter what the ratio

is.To me this would mean that if tested on diuretics and renin is on the lowside they PA can't be ruled out and you need further testing. Now I don'tknow how low this means. Is 1.8 low when on diuretics? My level frow the VAtest. How about .8? my level from the Dartmouth test. Is there any way toknow what renin should be on diuretics?

[Guest guest]

I had a lot of arrhythmia until I got on spiro and got my K up.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Francis Bill

Here is something one of there other provides had to say.

She is only a physicians assistant but she was my PCP.

This is what she says about this report The arrhythmia monitor results were

reviewed with the patient has no indication that his systoms are related to

cardiac. Maybe she is right.

LOOP RECORDER REPORT

Dates worn: 11/28 -> 12/02/05

Requested by: Amelia Sereen

Reason for request: Presyncope

Impressions by Dr. Dan O'Rourke:

Baseline: NSR @ -90 bpm with frequent asymptomatic PVC's.

Event #1: " Short of breath " Sinus tach @ -110 bpm.

Event #2: " Fast heart rate " - Sinus tach @ -110 bpm with occasional

unifocal isolated PVC's.

Event #3: " Dizziness " - NSR @ -90 with occasional unifocal isolated

PVC's.

Event # 4 : " Short of breath " - Sinus tach @ -115 bpm with rare

unifocal isolated PVC's.

Event #5: light headed and short of breath - NSR @ 75 bpm.

__

[Guest guest]

You should check it every day at about the same time. Keeping a seven-day moving average so

daily blips are smoothed out over time.

You can't possibly be on top of your condition without keeping a record.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Francis Bill

I have an automatic B/p device. I don't trust

hearing good enough to it manually. I don't check daily. When I do check

readins change a lot as dose my heart rate.

>

> Do you take your BP at home, daily? If not, you should.

>

[Guest guest]

Also, I think my renin is very low because of verapamil (CCB).

Regards

Re: New here, not yet diagnosed, being tested

hyperaldosteronism

Date: Monday, October 12, 2009, 10:42 AM

From what I can make out if you are tested on diuretics and you don't have

PA then your renin is going to be increased. If your renin is near the low

side that PA should be suspected no matter what the ratio is.

To me this would mean that if tested on diuretics and renin is on the low

side they PA can't be ruled out and you need further testing. Now I don't

know how low this means. Is 1.8 low when on diuretics? My level frow the VA

test. How about .8? my level from the Dartmouth test. Is there any way to

know what renin should be on diuretics?

[Guest guest]

Your ratio is 50. You have PA

Bindner

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From: jwwright <jwwright@...>Subject: Re: Re: New here, not yet diagnosed, being testedhyperaldosteronism Date: Monday, October 12, 2009, 7:02 PM

Actually, my renin is 0.2 and I don't have PA, yet.

Aldo 10.

I can only think it's there because of the CCB.

Regards

[hyperaldosteronism ] Re: New here, not yet diagnosed, being tested> hyperaldosteronism> Date: Monday, October 12, 2009, 10:42 AM> > > > From what I can make out if you are tested on diuretics and you don't have> PA then your renin is going to be increased. If your renin is near the low> side that PA should be suspected no matter what the ratio is.> > To me this would mean that if tested on diuretics and renin is on the low> side they PA can't be ruled out and you need further testing. Now I don't> know how low this means. Is 1.8 low when on diuretics? My level frow the VA> test. How about .8? my level from the Dartmouth test. Is there any way to> know what renin should be on diuretics?>__________ NOD32 4389 (20090902) Information __________This message was checked by NOD32 antivirus system.http://www.eset. com

[Guest guest]

Actually, my renin is 0.2 and I don't have PA, yet.

Aldo 10.

I can only think it's there because of the CCB.

Regards

Re: New here, not yet diagnosed, being tested> hyperaldosteronism > Date: Monday, October 12, 2009, 10:42 AM> > > > From what I can make out if you are tested on diuretics and you don't have> PA then your renin is going to be increased. If your renin is near the low> side that PA should be suspected no matter what the ratio is.> > To me this would mean that if tested on diuretics and renin is on the low> side they PA can't be ruled out and you need further testing. Now I don't> know how low this means. Is 1.8 low when on diuretics? My level frow the VA> test. How about .8? my level from the Dartmouth test. Is there any way to> know what renin should be on diuretics?>__________ NOD32 4389 (20090902) Information __________This message was checked by NOD32 antivirus system.http://www.eset.com

[Guest guest]

Might be an individual thing. Could never take diuretics.

Regards

[hyperaldosteronism ] Re: New here, not yet diagnosed, being testedhyperaldosteronismDate: Monday, October 12, 2009, 10:42 AMFrom what I can make out if you are tested on diuretics and you don't havePA then your renin is going to be increased. If your renin is near the lowside that PA should be suspected no matter what the ratio is.To me this would mean that if tested on diuretics and renin is on the lowside they PA can't be ruled out and you need further testing. Now I don'tknow how low this means. Is 1.8 low when on diuretics? My level frow the VAtest. How about .8? my level from the Dartmouth test. Is there any way toknow what renin should be on diuretics?__________ NOD32 4389 (20090902) Information __________This message was checked by NOD32 antivirus system.http://www.eset.com

[Guest guest]

Well IMHO if the AR is not high and one was on drugs the best course is to stop all for 2 weeks (spiro for 6 wks) and then retest. Or try a trial of spiro. No BP or K response to spiro in high enough doses (up to 400/d) means no PA. May your pressure be low!Clarence E. Grim, BS, MS, MDSpecializing in Primary Aldosteronism the most common cause of "Difficult/Drug Resistant High Blood Pressure". Other research interests focus on the interactions of recent evolutionary forces on the body's ability to handle salt and the effect of dietary salt on blood pressure in populations today.Listed in Best Doctors of America 2009. On Oct 12, 2009, at 12:23 PM, Chantal wrote: Actually, I thought verapamil (the only CCB listed) was one of the few drugs that wouldn't affect the ARR (endo guidelines) That's what they have me on in prep. for the test ARR Chantal > > > From: Francis Bill <georgewbill@...> > Subject: Re: New here, not yet diagnosed, being tested > hyperaldosteronism > Date: Monday, October 12, 2009, 10:42 AM > > > > From what I can make out if you are tested on diuretics and you don't have > PA then your renin is going to be increased. If your renin is near the low > side that PA should be suspected no matter what the ratio is. > > To me this would mean that if tested on diuretics and renin is on the low > side they PA can't be ruled out and you need further testing. Now I don't > know how low this means. Is 1.8 low when on diuretics? My level frow the VA > test. How about .8? my level from the Dartmouth test. Is there any way to > know what renin should be on diuretics? >