Re: Hyperaldo Review for Dr. Grim - Urgent

October 18, 2009

Only reason to do saline is if team has failed to control BP and K using meds/DASH and surgery would be done if it is +. But of course one would need AVS first not without risk and may cost $12,000 or more just for EVS. 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 18, 2009, at 2:01 PM, jwwright wrote: That's sorta the thing in the PSA test. When I talked to the Dr, I said: I believe if you do enough biopsies you will find a carcinoma cell. Then that requires a chain of things I don't want to think about. The alternative is to wait and recheck PSA - a simple test. I could wait another 30 yrs before removing the prostate. I think we're over testing and over surgering. When we get to the point where tests are reasonable cost, different story, BUT the outcomes may be the same - wait a while. The aldosterone suppression test is another example. The dr will say "with and aldo of 10?". What do we do if it's high? Follow that line of thought and you get to wait and see every time except for symptoms. This morning I walked 1.3 miles for the fun of it. It was cold - I ran a little just to show the world I'm OK - maybe P/O the sick neighbors - get em out of the house and walk. Here's an example of confusing info to me: http://hyperaldosteronism.blogspot.com/2008/12/saline-suppression-test.html FIRST and foremost: What's the cost? I see other problems that I won't go into, but clearly that test is not cheap. Plus the fact I have no intention what so ever ingesting/infusing that much sodium. Does anyone ever stroke there? Don't bother answering - I might be the first. My greatest fear is dying for doing something stupid. Regards PS. Medicare is disallowing routine catheterizations now. Good choice - it wouldn't have saved Jim Fixx. Re: Hyperaldo Review for Dr. Grim - Urgent> hyperaldosteronism > Date: Sunday, October 18, 2009, 10:58 AM> If you feel OK then for you there> probably no need to do any more tests. What they can learn> from CT and MRI is if the tumor is big enough to see they> can make a good guess as to if it is cancerous or not. Can't> be ruled out 100% If a tumor is seen and is below 4 CM and> doesn't look like cancer they will want to do A CT or MRI 6> months later to see how fast in is growing. If it size is> still about the same they will want to do A CT or MIR a year> later. IF still the same size They may want to do a CT or> MRI after a few years. > > If tumer is over 4 CM thay may what to do a biopsy and if> it 6 cm they should do one. If CT or MRI show growth They> will also want to do a biopsy. > > Since others are saying your sceerning test shows PA then> your next test should be a aldosterone suppression test. If> this shows you have PA then medicare should pay for A CT or> MRI. > > > > > > > Just doing a review of my PAC results> obtained from blood drawn at a Lab in> > > Jamaica. The test was in fact sent to a> Lab in the US. The blood was taken> > > with me sitting down for 5 mins after> driving to the Lab. The results showed> > > Aldostorone serum was 18.6 ng/dL. This> result from the LAB in the US was> > > shown as Abnormal (high) but the wrong> reference range was used. They used> > > the Adult supine(lying) reference range of> 1 - 16 ng/dL.> > > > > But my blood was taken when I was sitting> so they should have used the Adult> > > upright reference range of 4 - 31 ng/dL.> > > > > This would have meant that my PAC was> normal. Does this mean that I don't> > > have PA.> > > > > I also got a Renin Activity of 0.45> ng/mL/hr> > > > > From my calculations My ARR = 18.6/0.45 => 41.33> > > > > Just a recap. My BP was about 245/145> before taking 3 meds that dropped it> > > to 145/95. I have since removed one of> those meds in favor of Aldactone> > > (25mg twice daily) which lowers it to> 130/88.> > > > > > > > > > > > > > > __________ NOD32 4389 (20090902)> Information __________> > > > > This message was checked by NOD32> antivirus system.> > > http://www.eset. com> > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902)> Information __________> > > > This message was checked by NOD32> antivirus system.> > http://www.eset.com> >> > > > > ------------------------------------> >

October 18, 2009

You'll know when it's time...

2 months ago I was jogging regularly and training for my 10KM sept. run.

I couldn't ignore the fact that something was changing..

I always had the odd daily episode of weakness/bloat/fatigue but generally ate

really well/organic and tried to stay fit.

Now, I'm in the process of getting tested and on 5 k-dur/ day to maintain my

potassium.

I'm no longer running but I walk daily.

So, it's time for me to test. No doubt in my mind.

I'll have the necessary tests done until they hopefully figure out what is going

on such that I can return to my " normal " routine of being a mom, a wife and

maybe actually work again as a pharmacist.

I'm not keen on being medicated until they can solve the mystery.

> > >

> > Just doing a review of my PAC results

> > obtained from blood drawn at a Lab in

> > >

> > Jamaica. The test was in fact sent to a

> > Lab in the US. The blood was taken

> > >

> > with me sitting down for 5 mins after

> > driving to the Lab. The results showed

> > >

> > Aldostorone serum was 18.6 ng/dL. This

> > result from the LAB in the US was

> > >

> > shown as Abnormal (high) but the wrong

> > reference range was used. They used

> > >

> > the Adult supine(lying) reference range of

> > 1 - 16 ng/dL.

> > >

> > But my blood was taken when I was sitting

> > so they should have used the Adult

> > >

> > upright reference range of 4 - 31 ng/dL.

> > >

> > This would have meant that my PAC was

> > normal. Does this mean that I don't

> > >

> > have PA.

> > >

> > I also got a Renin Activity of 0.45

> > ng/mL/hr

> > >

> > From my calculations My ARR = 18.6/0.45 =

> > 41.33

> > >

> > Just a recap. My BP was about 245/145

> > before taking 3 meds that dropped it

> > >

> > to 145/95. I have since removed one of

> > those meds in favor of Aldactone

> > >

> > (25mg twice daily) which lowers it to

> > 130/88.

> > >

> > __________ NOD32 4389 (20090902)

> > Information __________

> > >

> > This message was checked by NOD32

> > antivirus system.

> > >

> > http://www.eset. com

> > >

> > > __________ NOD32 4389 (20090902)

> > Information __________

> > >

> > > This message was checked by NOD32

> > antivirus system.

> > > http://www.eset.com

> > >

> >

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

> >

October 18, 2009

That's sorta the thing in the PSA test. When I talked to the Dr, I said: I believe if you do enough biopsies you will find a carcinoma cell.

Then that requires a chain of things I don't want to think about.

The alternative is to wait and recheck PSA - a simple test.

I could wait another 30 yrs before removing the prostate.

I think we're over testing and over surgering.

When we get to the point where tests are reasonable cost, different story, BUT the outcomes may be the same - wait a while.

The aldosterone suppression test is another example. The dr will say "with and aldo of 10?". What do we do if it's high?

Follow that line of thought and you get to wait and see every time except for symptoms.

This morning I walked 1.3 miles for the fun of it. It was cold - I ran a little just to show the world I'm OK - maybe P/O the sick neighbors - get em out of the house and walk.

Here's an example of confusing info to me:

http://hyperaldosteronism.blogspot.com/2008/12/saline-suppression-test.html

FIRST and foremost:

What's the cost?

I see other problems that I won't go into, but clearly that test is not cheap.

Plus the fact I have no intention what so ever ingesting/infusing that much sodium.

Does anyone ever stroke there? Don't bother answering - I might be the first.

My greatest fear is dying for doing something stupid.

Regards

PS. Medicare is disallowing routine catheterizations now. Good choice - it wouldn't have saved Jim Fixx.

Re: Hyperaldo Review for Dr. Grim - Urgent> hyperaldosteronism > Date: Sunday, October 18, 2009, 10:58 AM> If you feel OK then for you there> probably no need to do any more tests. What they can learn> from CT and MRI is if the tumor is big enough to see they> can make a good guess as to if it is cancerous or not. Can't> be ruled out 100% If a tumor is seen and is below 4 CM and> doesn't look like cancer they will want to do A CT or MRI 6> months later to see how fast in is growing. If it size is> still about the same they will want to do A CT or MIR a year> later. IF still the same size They may want to do a CT or> MRI after a few years. > > If tumer is over 4 CM thay may what to do a biopsy and if> it 6 cm they should do one. If CT or MRI show growth They> will also want to do a biopsy. > > Since others are saying your sceerning test shows PA then> your next test should be a aldosterone suppression test. If> this shows you have PA then medicare should pay for A CT or> MRI. > > > > > > > Just doing a review of my PAC results> obtained from blood drawn at a Lab in> > > Jamaica. The test was in fact sent to a> Lab in the US. The blood was taken> > > with me sitting down for 5 mins after> driving to the Lab. The results showed> > > Aldostorone serum was 18.6 ng/dL. This> result from the LAB in the US was> > > shown as Abnormal (high) but the wrong> reference range was used. They used> > > the Adult supine(lying) reference range of> 1 - 16 ng/dL.> > > > > But my blood was taken when I was sitting> so they should have used the Adult> > > upright reference range of 4 - 31 ng/dL.> > > > > This would have meant that my PAC was> normal. Does this mean that I don't> > > have PA.> > > > > I also got a Renin Activity of 0.45> ng/mL/hr> > > > > From my calculations My ARR = 18.6/0.45 => 41.33> > > > > Just a recap. My BP was about 245/145> before taking 3 meds that dropped it> > > to 145/95. I have since removed one of> those meds in favor of Aldactone> > > (25mg twice daily) which lowers it to> 130/88.> > > > > > > > > > > > > > > __________ NOD32 4389 (20090902)> Information __________> > > > > This message was checked by NOD32> antivirus system.> > > http://www.eset. com> > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902)> Information __________> > > > This message was checked by NOD32> antivirus system.> > http://www.eset.com> >> > > > > ------------------------------------> >

October 18, 2009

Have any of your doctors say your problem is that you are deconditioned

> > > >

> > > Just doing a review of my PAC results

> > > obtained from blood drawn at a Lab in

> > > >

> > > Jamaica. The test was in fact sent to a

> > > Lab in the US. The blood was taken

> > > >

> > > with me sitting down for 5 mins after

> > > driving to the Lab. The results showed

> > > >

> > > Aldostorone serum was 18.6 ng/dL. This

> > > result from the LAB in the US was

> > > >

> > > shown as Abnormal (high) but the wrong

> > > reference range was used. They used

> > > >

> > > the Adult supine(lying) reference range of

> > > 1 - 16 ng/dL.

> > > >

> > > But my blood was taken when I was sitting

> > > so they should have used the Adult

> > > >

> > > upright reference range of 4 - 31 ng/dL.

> > > >

> > > This would have meant that my PAC was

> > > normal. Does this mean that I don't

> > > >

> > > have PA.

> > > >

> > > I also got a Renin Activity of 0.45

> > > ng/mL/hr

> > > >

> > > From my calculations My ARR = 18.6/0.45 =

> > > 41.33

> > > >

> > > Just a recap. My BP was about 245/145

> > > before taking 3 meds that dropped it

> > > >

> > > to 145/95. I have since removed one of

> > > those meds in favor of Aldactone

> > > >

> > > (25mg twice daily) which lowers it to

> > > 130/88.

> > > >

> > > __________ NOD32 4389 (20090902)

> > > Information __________

> > > >

> > > This message was checked by NOD32

> > > antivirus system.

> > > >

> > > http://www.eset. com

> > > >

> > > > __________ NOD32 4389 (20090902)

> > > Information __________

> > > >

> > > > This message was checked by NOD32

> > > antivirus system.

> > > > http://www.eset.com

> > > >

> > >

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

> > >

October 18, 2009

More likely low KTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Oct 18, 2009, at 6:52 PM, Francis Bill <georgewbill@...> wrote:

Have any of your doctors say your problem is that you are deconditioned

> > > >

> > > From: jwwright <jwwright@>

> > > >

> > > Subject: Re: Re:

> > > Hyperaldo Review for Dr. Grim - Urgent

> > > >

> > > hyperaldosteronism

> > > >

> > > Date: Saturday, October 17, 2009, 5:43 PM

> > > >

> > >

> > > >

> > > Aldo 10, renin 0.2. Only measured once -

> > > my internist at the time was sure I didn't have PA. The only

> > > thing I have is occasionally my BP goes low and makes my

> > > back hurt. I tracked that to an arthritic joint maybe a

> > > pinched nerve.

> > > >

> > > Take a ketoprofen - goes away.

> > > >

> > > > I

> > > resisted doing a lot of exercise for a long time, like 9

> > > yrs.

> > > > I

> > > now think, eventually, if you live and can do it, you will

> > > be better off if you do some kind of weights, and some

> > > aerobic. I like the rbike because it's safe, it's

> > > strengthens the legs and I hear it does away with osteo, and

> > > I regard osteo as very important if you intend to live to

> > > 100.

> > > >

> > > The ONE problem thing the CRers have is

> > > osteo, even at young like 42 age.

> > > >

> > > I've had no report the running prevents it

> > > or cures it, and that by fitness "gurus".

> > > >

> > > > I

> > > do a complete set of weights as I see it, and I add more as

> > > I find one little muscle that's not challenged, here and

> > > there.

> > > >

> > > Shoulder muscles are complex, many little

> > > guys pulling every which way.

> > > >

> > > > I

> > > know others have their preferences like yoga, but I like

> > > being able to lift my 190 # son off the ground. I have the

> > > same build just shorter, so my BMI looks larger. It's not

> > > I'm just too short.

> > > >

> > > When I started I could lift 260# in the

> > > rower. Now I can lift 300# at bench, not to chest, just off

> > > the bench.

> > > >

> > > Back, abdominal, leg lift, leg press, arm

> > > press, leg curl, straddle in and out are 150# exercise

> > > levels. That's 9 1/2 months. I don't look like a bodybuilder

> > > yet, just well formed muscles. I'm working on the

> > > scwartznegger part (ha).

> > > >

> > > > I

> > > believe the muscle building raises growth hormone and IGF-1

> > > similar to that in a younger person.

> > > >

> > > Get with it and you can start an exercise

> > > studio which, IMO, is a lot better than selling a "health

> > > spa" based on diet. Shouldn't take near as much money to

> > > start and you can hire PhD trainers for sports therapy.

> > > >

> > > There are MANY that need physical therapy,

> > > including almost everyone riding a Wal-mart ecart.

> > > >

> > > I've seen recovering cri

October 18, 2009

I researched the definition such that I could fully comprehend the question-I

wanted to make sure I didn't miss something after reading the question the first

time around...

" misuse/overuse of certain muscles... "

No, I started training in an attempt to correct my symptoms of fatique and

improve my energy levels. It has been documented that aerobic exercise tends to

improve well-being (increase serotonin) and health(blood pressure, weight) I've

exercised consistently over the years but have never gone beyond the 10km... Not

into marathons etc. Loved to bike, play soccer with the kids, swim...

My blood pressure/fatigue/salt-sent/polyuria/polydipsai etc. symptoms were

present prior to all this. (stage 1) I've seen at least one documented,

researched case of exercise precipitating PA (evolution-it was brewing)

resulting in diagnosis. I think I was stage 2-3 then the exercise (state of

potassium loss on top of an already low potassium that I wasn't informed

about-Dr. Grim's article discusses extra potassium in PA, part of the

evolution...

*From his article:

Aldosterone production would no longer suppress into the " normal "

range, and hypokalemia might be precipitated by a

low potassium intake, diuretic use, or extrarenal loss of

potassium in sweat, vomit, or stool.*

The exercise really tipped the balance and the symptoms were unmasked further.

*Again, from the ultimate of all PA articles-Dr. Grim's article:

Ultimately, the practitioner is presented with the

myriad physiologic effects of profound hypokalemia:

nocturia and polyuria from antidiuretic hormone (ADH)

resistance; cramps in the hands, feet, and legs, especially

with exercise; increasing fatigue; profound weakness and

periodic paralysis; cardiac arrhythmias; and even cardiac

arrest *

So, no, I'm no longer jogging etc. Exercise/stress can increase aldosterone

so I'm taking it easy on my system. I think my body has enough to handle so I'm

presently " not conditioned " being I'm not exercising but I doubt being

deconditioned.

I can't fathom 5 K-dur/day being necessary on top of a high K diet (for at

least 2 months now , blood pressure meds.) for a deconditioned individual.

Did you find this " deconditioned " in a medical journal/article and did it

really discuss the " deconditioned " state as very likely mimicking PA in it's

entity- if so, I would enjoy reading it..

I'll be waiting for the appropriate link

Chantal

> > > > >

> > > > Just doing a review of my PAC results

> > > > obtained from blood drawn at a Lab in

> > > > >

> > > > Jamaica. The test was in fact sent to a

> > > > Lab in the US. The blood was taken

> > > > >

> > > > with me sitting down for 5 mins after

> > > > driving to the Lab. The results showed

> > > > >

> > > > Aldostorone serum was 18.6 ng/dL. This

> > > > result from the LAB in the US was

> > > > >

> > > > shown as Abnormal (high) but the wrong

> > > > reference range was used. They used

> > > > >

> > > > the Adult supine(lying) reference range of

> > > > 1 - 16 ng/dL.

> > > > >

> > > > But my blood was taken when I was sitting

> > > > so they should have used the Adult

> > > > >

> > > > upright reference range of 4 - 31 ng/dL.

> > > > >

> > > > This would have meant that my PAC was

> > > > normal. Does this mean that I don't

> > > > >

> > > > have PA.

> > > > >

> > > > I also got a Renin Activity of 0.45

> > > > ng/mL/hr

> > > > >

> > > > From my calculations My ARR = 18.6/0.45 =

> > > > 41.33

> > > > >

> > > > Just a recap. My BP was about 245/145

> > > > before taking 3 meds that dropped it

> > > > >

> > > > to 145/95. I have since removed one of

> > > > those meds in favor of Aldactone

> > > > >

> > > > (25mg twice daily) which lowers it to

> > > > 130/88.

> > > > >

> > > > __________ NOD32 4389 (20090902)

> > > > Information __________

> > > > >

> > > > This message was checked by NOD32

> > > > antivirus system.

> > > > >

> > > > http://www.eset. com

> > > > >

> > > > > __________ NOD32 4389 (20090902)

> > > > Information __________

> > > > >

> > > > > This message was checked by NOD32

> > > > antivirus system.

> > > > > http://www.eset.com

> > > > >

> > > >

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

> > > >

October 18, 2009

I actually had BP/polyuria/polydipsia/fatigue/extreme salt sensitivity etc. over

the years and in the spring reported to my physician that I wasn't feeling well

at all. (she was aware of the above symptoms because I discussed thyroid with

her, my thirst/polyuria issues, blood pressure concerns, my extreme salt

sensitivity-puffy eyelids.) I couldn't get another app. with her until the

summer and they would not provide me with my blood work over the phone. (my

potassium was borderline low then.)

So imagine, in an attempt to feel better, I attempted to eat even better over

the course of the summer and start training for a fall 10km (done over the

years) because my jog was refreshing and I felt I was improving my health.

Little did I know my potassium was borderline.

In July, I had slightly blurred vision and by the time I saw her in August, I

was no longer jogging, I had eliminated salt/ was juicing (for 2-3 weeks) & I

had vertigo/dizziness with a potassium of 3.5 (normal 3.6-5.5) They placed me

on a diuretic for 3 days (I had disagreed but I needed something, my pressure

was 200/100) and it dropped my potassium further. (3.2)

Again, on 4-5 kdur/day, awaiting my PA results.

Thanks

Chantal

Renal artery stenosis ruled out with renal ultrasound....

> > > > > >

> > > > > From: jwwright <jwwright@>

> > > > > >

> > > > > Subject: Re: Re:

> > > > > Hyperaldo Review for Dr. Grim - Urgent

> > > > > >

> > > > > hyperaldosteronism

> > > > > >

> > > > > Date: Saturday, October 17, 2009, 5:43 PM

> > > > > >

> > > > >

> > > > > >

> > > > > Aldo 10, renin 0.2. Only measured once -

> > > > > my internist at the time was sure I didn't have PA. The only

> > > > > thing I have is occasionally my BP goes low and makes my

> > > > > back hurt. I tracked that to an arthritic joint maybe a

> > > > > pinched nerve.

> > > > > >

> > > > > Take a ketoprofen - goes away.

> > > > > >

> > > > > > I

> > > > > resisted doing a lot of exercise for a long time, like 9

> > > > > yrs.

> > > > > > I

> > > > > now think, eventually, if you live and can do it, you will

> > > > > be better off if you do some kind of weights, and some

> > > > > aerobic. I like the rbike because it's safe, it's

> > > > > strengthens the legs and I hear it does away with osteo, and

> > > > > I regard osteo as very important if you intend to live to

> > > > > 100.

> > > > > >

> > > > > The ONE problem thing the CRers have is

> > > > > osteo, even at young like 42 age.

> > > > > >

> > > > > I've had no report the running prevents it

> > > > > or cures it, and that by fitness " gurus " .

> > > > > >

> > > > > > I

> > > > > do a complete set of weights as I see it, and I add more as

> > > > > I find one little muscle that's not challenged, here and

> > > > > there.

> > > > > >

> > > > > Shoulder muscles are complex, many little

> > > > > guys pulling every which way.

> > > > > >

> > > > > > I

> > > > > know others have their preferences like yoga, but I like

> > > > > being able to lift my 190 # son off the ground. I have the

> > > > > same build just shorter, so my BMI looks larger. It's not

> > > > > I'm just too short.

> > > > > >

> > > > > When I started I could lift 260# in the

> > > > > rower. Now I can lift 300# at bench, not to chest, just off

> > > > > the bench.

> > > > > >

> > > > > Back, abdominal, leg lift, leg press, arm

> > > > > press, leg curl, straddle in and out are 150# exercise

> > > > > levels. That's 9 1/2 months. I don't look like a bodybuilder

> > > > > yet, just well formed muscles. I'm working on the

> > > > > scwartznegger part (ha).

> > > > > >

> > > > > > I

> > > > > believe the muscle building raises growth hormone and IGF-1

> > > > > similar to that in a younger person.

> > > > > >

> > > > > Get with it and you can start an exercise

> > > > > studio which, IMO, is a lot better than selling a " health

> > > > > spa " based on diet. Shouldn't take near as much money to

> > > > > start and you can hire PhD trainers for sports therapy.

> > > > > >

> > > > > There are MANY that need physical therapy,

> > > > > including almost everyone riding a Wal-mart ecart.

> > > > > >

> > > > > I've seen recovering cri

>

October 18, 2009

BTW, i did a google search with the fatigue, bloat and cramps and I see how

deconditioned popped up (almost typed out pooped -getting tired oops,)

Didn't get any other info. though

> > > > > >

> > > > > Just doing a review of my PAC results

> > > > > obtained from blood drawn at a Lab in

> > > > > >

> > > > > Jamaica. The test was in fact sent to a

> > > > > Lab in the US. The blood was taken

> > > > > >

> > > > > with me sitting down for 5 mins after

> > > > > driving to the Lab. The results showed

> > > > > >

> > > > > Aldostorone serum was 18.6 ng/dL. This

> > > > > result from the LAB in the US was

> > > > > >

> > > > > shown as Abnormal (high) but the wrong

> > > > > reference range was used. They used

> > > > > >

> > > > > the Adult supine(lying) reference range of

> > > > > 1 - 16 ng/dL.

> > > > > >

> > > > > But my blood was taken when I was sitting

> > > > > so they should have used the Adult

> > > > > >

> > > > > upright reference range of 4 - 31 ng/dL.

> > > > > >

> > > > > This would have meant that my PAC was

> > > > > normal. Does this mean that I don't

> > > > > >

> > > > > have PA.

> > > > > >

> > > > > I also got a Renin Activity of 0.45

> > > > > ng/mL/hr

> > > > > >

> > > > > From my calculations My ARR = 18.6/0.45 =

> > > > > 41.33

> > > > > >

> > > > > Just a recap. My BP was about 245/145

> > > > > before taking 3 meds that dropped it

> > > > > >

> > > > > to 145/95. I have since removed one of

> > > > > those meds in favor of Aldactone

> > > > > >

> > > > > (25mg twice daily) which lowers it to

> > > > > 130/88.

> > > > > >

> > > > > __________ NOD32 4389 (20090902)

> > > > > Information __________

> > > > > >

> > > > > This message was checked by NOD32

> > > > > antivirus system.

> > > > > >

> > > > > http://www.eset. com

> > > > > >

> > > > > > __________ NOD32 4389 (20090902)

> > > > > Information __________

> > > > > >

> > > > > > This message was checked by NOD32

> > > > > antivirus system.

> > > > > > http://www.eset.com

> > > > > >

> > > > >

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

> > > > >

October 18, 2009

It is my medical record Juse a few of the notes

Walking with the patient: 02 Sats between 97-100 on RA

HR 80-100

CXR: my read

no acute cardiopulmonary process

EKG: SR, no acute ST or T wave changes

IMPRESSION: This is a 61 y/o man with a history of

morbid obesity, chronic lightheadedness /dizziness, sensorineural loss,

chronic fatigue syndrome , HTN, tachycrdia, who presents to the ED today for

SOB. His Oxygen saturation at rest and when walkinq is normal. His CXR, EKG and

labs are unremarkable. His exam, his CXR and his BNP are not consistent with CHF

exacerbation.

Resident MD

Signed: 02/22/2009 13:54

/es/ NICHOLS SKIADAS

Cardiology Fellow/MOD

Cosigned: 02/22/2009 16:26

02/22/2009 ADDENDUM STATUS: COMPLETED

Patient seen and examined in the ED with Dr Thol. I agree with her assessment

and plan as deliniated. In brief patient is a 61 year old WM with PMH as noted

below who presents with a aint of shortness of breath that started in last

24 hours. He had difficultly today doing his laundary. Patient denied any CP or

pressure with activity.

PE

BP: 158/98

Studies reviewed: Normal CXR. EKG with LVH and nonspecific ST/T

This is what the EKG showed 22-FEB-2009 12:22:53

Vent. rate 78 BPM

Male Caucasian PR interval 128 ms

QRS duration 94 ms

QT/QTc 414/471 ms

P-R-T axes 37 -18 14

Normal sinus

Leftward axis

Incomplete right bundle branch block

Left ventricular hypertrophy

Nonspecific ST and T wave abnormality

A/P SOB of unclear cause (Possible deconditioning). No signs of cardiac

ischemia, infection, systolic chf. PE less likely in light of normal 02 sats and

absence of tachycardia. Current patient with uncontrolled HTN

At this point patient is stable for DC. No further workup is needed at this

point.

- At some point would repeat echo as outpatient to look for signs of diastolic

CHF, or pulmonary HTN from OSA.

- Patient will also need to follow up with PCP so better control of BP can be

achieved.

/es/ NICHOLS SKIADAS

Cardiology Fellow/MOD

Signed: 02/22/2009 16:26

Next note about it

Dizziness/fatigue - chronic issue, liekly not associated with ST that pt has had

intermittent for several years. likely tach secondary to sleep apnea as well

as morbid obesity and deconditioning. If pt has any sxs of cp, palpitations,

etc, he may benefit from holter monitor, etc.

IRUM ZIAUDDIN

Physician Assistant

Signed: 02/05/2009

next note

As a result of the above the only firm dx that has come to light has been that

of OSA,

In regards to his Iightheadedness - he does not describe vertigo has not

fallen, and no LOC. It is exacerbated by getting up quickly.

In regards to tachycardia - he describes a variable rate of 60-100 in the past

months, but has gone as high as 120.

I do think a large part of this is deconditioning

next note

We reviewed again the results of CT scan and other previous studies. He's

concerned that his heart rate increases with standing up/walking activity

etc. Given the results of previous ekg/echo/event monitor - I really think a

big part of his problem is deconditioning

> > > > > >

> > > > > Just doing a review of my PAC results

> > > > > obtained from blood drawn at a Lab in

> > > > > >

> > > > > Jamaica. The test was in fact sent to a

> > > > > Lab in the US. The blood was taken

> > > > > >

> > > > > with me sitting down for 5 mins after

> > > > > driving to the Lab. The results showed

> > > > > >

> > > > > Aldostorone serum was 18.6 ng/dL. This

> > > > > result from the LAB in the US was

> > > > > >

> > > > > shown as Abnormal (high) but the wrong

> > > > > reference range was used. They used

> > > > > >

> > > > > the Adult supine(lying) reference range of

> > > > > 1 - 16 ng/dL.

> > > > > >

> > > > > But my blood was taken when I was sitting

> > > > > so they should have used the Adult

> > > > > >

> > > > > upright reference range of 4 - 31 ng/dL.

> > > > > >

> > > > > This would have meant that my PAC was

> > > > > normal. Does this mean that I don't

> > > > > >

> > > > > have PA.

> > > > > >

> > > > > I also got a Renin Activity of 0.45

> > > > > ng/mL/hr

> > > > > >

> > > > > From my calculations My ARR = 18.6/0.45 =

> > > > > 41.33

> > > > > >

> > > > > Just a recap. My BP was about 245/145

> > > > > before taking 3 meds that dropped it

> > > > > >

> > > > > to 145/95. I have since removed one of

> > > > > those meds in favor of Aldactone

> > > > > >

> > > > > (25mg twice daily) which lowers it to

> > > > > 130/88.

> > > > > >

> > > > > __________ NOD32 4389 (20090902)

> > > > > Information __________

> > > > > >

> > > > > This message was checked by NOD32

> > > > > antivirus system.

> > > > > >

> > > > > http://www.eset. com

> > > > > >

> > > > > > __________ NOD32 4389 (20090902)

> > > > > Information __________

> > > > > >

> > > > > > This message was checked by NOD32

> > > > > antivirus system.

> > > > > > http://www.eset.com

> > > > > >

> > > > >

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

> > > > >

October 18, 2009

My k was 3.7 on 02/22/2009

> > > > > > >

> > > > > > Just doing a review of my PAC results

> > > > > > obtained from blood drawn at a Lab in

> > > > > > >

> > > > > > Jamaica. The test was in fact sent to a

> > > > > > Lab in the US. The blood was taken

> > > > > > >

> > > > > > with me sitting down for 5 mins after

> > > > > > driving to the Lab. The results showed

> > > > > > >

> > > > > > Aldostorone serum was 18.6 ng/dL. This

> > > > > > result from the LAB in the US was

> > > > > > >

> > > > > > shown as Abnormal (high) but the wrong

> > > > > > reference range was used. They used

> > > > > > >

> > > > > > the Adult supine(lying) reference range of

> > > > > > 1 - 16 ng/dL.

> > > > > > >

> > > > > > But my blood was taken when I was sitting

> > > > > > so they should have used the Adult

> > > > > > >

> > > > > > upright reference range of 4 - 31 ng/dL.

> > > > > > >

> > > > > > This would have meant that my PAC was

> > > > > > normal. Does this mean that I don't

> > > > > > >

> > > > > > have PA.

> > > > > > >

> > > > > > I also got a Renin Activity of 0.45

> > > > > > ng/mL/hr

> > > > > > >

> > > > > > From my calculations My ARR = 18.6/0.45 =

> > > > > > 41.33

> > > > > > >

> > > > > > Just a recap. My BP was about 245/145

> > > > > > before taking 3 meds that dropped it

> > > > > > >

> > > > > > to 145/95. I have since removed one of

> > > > > > those meds in favor of Aldactone

> > > > > > >

> > > > > > (25mg twice daily) which lowers it to

> > > > > > 130/88.

> > > > > > >

> > > > > > __________ NOD32 4389 (20090902)

> > > > > > Information __________

> > > > > > >

> > > > > > This message was checked by NOD32

> > > > > > antivirus system.

> > > > > > >

> > > > > > http://www.eset. com

> > > > > > >

> > > > > > > __________ NOD32 4389 (20090902)

> > > > > > Information __________

> > > > > > >

> > > > > > > This message was checked by NOD32

> > > > > > antivirus system.

> > > > > > > http://www.eset.com

> > > > > > >

> > > > > >

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

> > > > > >

October 18, 2009

Good reading and interpretation of my article. We do know that aldo increase the retention of Na and excretion of K into the urine, sweat, saliva, tears and stool.So exercise should be a good way to precipitate overt low K and its problems in those with early PA.Perhaps others on our site can comment if exercise was heavy early on in their symptom evolution. On Oct 18, 2009, at 8:14 PM, Chantal wrote: I researched the definition such that I could fully comprehend the question-I wanted to make sure I didn't miss something after reading the question the first time around... "misuse/overuse of certain muscles..." No, I started training in an attempt to correct my symptoms of fatique and improve my energy levels. It has been documented that aerobic exercise tends to improve well-being (increase serotonin) and health(blood pressure, weight) I've exercised consistently over the years but have never gone beyond the 10km... Not into marathons etc. Loved to bike, play soccer with the kids, swim... My blood pressure/fatigue/salt-sent/polyuria/polydipsai etc. symptoms were present prior to all this. (stage 1) I've seen at least one documented, researched case of exercise precipitating PA (evolution-it was brewing) resulting in diagnosis. I think I was stage 2-3 then the exercise (state of potassium loss on top of an already low potassium that I wasn't informed about-Dr. Grim's article discusses extra potassium in PA, part of the evolution... *From his article: Aldosterone production would no longer suppress into the "normal" range, and hypokalemia might be precipitated by a low potassium intake, diuretic use, or extrarenal loss of potassium in sweat, vomit, or stool.* The exercise really tipped the balance and the symptoms were unmasked further. *Again, from the ultimate of all PA articles-Dr. Grim's article: Ultimately, the practitioner is presented with the myriad physiologic effects of profound hypokalemia: nocturia and polyuria from antidiuretic hormone (ADH) resistance; cramps in the hands, feet, and legs, especially with exercise; increasing fatigue; profound weakness and periodic paralysis; cardiac arrhythmias; and even cardiac arrest * So, no, I'm no longer jogging etc. Exercise/stress can increase aldosterone so I'm taking it easy on my system. I think my body has enough to handle so I'm presently "not conditioned" being I'm not exercising but I doubt being deconditioned. I can't fathom 5 K-dur/day being necessary on top of a high K diet (for at least 2 months now , blood pressure meds.) for a deconditioned individual. Did you find this "deconditioned" in a medical journal/article and did it really discuss the "deconditioned" state as very likely mimicking PA in it's entity- if so, I would enjoy reading it.. I'll be waiting for the appropriate link Chantal Chantal > > > > > > > > > > > > > > Just doing a review of my PAC results > > > > obtained from blood drawn at a Lab in > > > > > > > > > Jamaica. The test was in fact sent to a > > > > Lab in the US. The blood was taken > > > > > > > > > with me sitting down for 5 mins after > > > > driving to the Lab. The results showed > > > > > > > > > Aldostorone serum was 18.6 ng/dL. This > > > > result from the LAB in the US was > > > > > > > > > shown as Abnormal (high) but the wrong > > > > reference range was used. They used > > > > > > > > > the Adult supine(lying) reference range of > > > > 1 - 16 ng/dL. > > > > > > > > > > > > > > But my blood was taken when I was sitting > > > > so they should have used the Adult > > > > > > > > > upright reference range of 4 - 31 ng/dL. > > > > > > > > > > > > > > This would have meant that my PAC was > > > > normal. Does this mean that I don't > > > > > > > > > have PA. > > > > > > > > > > > > > > I also got a Renin Activity of 0.45 > > > > ng/mL/hr > > > > > > > > > > > > > > From my calculations My ARR = 18.6/0.45 = > > > > 41.33 > > > > > > > > > > > > > > Just a recap. My BP was about 245/145 > > > > before taking 3 meds that dropped it > > > > > > > > > to 145/95. I have since removed one of > > > > those meds in favor of Aldactone > > > > > > > > > (25mg twice daily) which lowers it to > > > > 130/88. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902) > > > > Information __________ > > > > > > > > > > > > > > This message was checked by NOD32 > > > > antivirus system. > > > > > > > > > http://www.eset. com > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902) > > > > Information __________ > > > > > > > > > > This message was checked by NOD32 > > > > antivirus system. > > > > > http://www.eset.com > > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > >

October 18, 2009

Thanks Chantal. Can you put all of this in a detailed story when you have time. You are one of the best documented cases of exercise bringing on low K that led to Dx of PA. Would like to consider writing this up when we have more details. CE Grim, MDOn Oct 18, 2009, at 8:28 PM, Chantal wrote: I actually had BP/polyuria/polydipsia/fatigue/extreme salt sensitivity etc. over the years and in the spring reported to my physician that I wasn't feeling well at all. (she was aware of the above symptoms because I discussed thyroid with her, my thirst/polyuria issues, blood pressure concerns, my extreme salt sensitivity-puffy eyelids.) I couldn't get another app. with her until the summer and they would not provide me with my blood work over the phone. (my potassium was borderline low then.) So imagine, in an attempt to feel better, I attempted to eat even better over the course of the summer and start training for a fall 10km (done over the years) because my jog was refreshing and I felt I was improving my health. Little did I know my potassium was borderline. In July, I had slightly blurred vision and by the time I saw her in August, I was no longer jogging, I had eliminated salt/ was juicing (for 2-3 weeks) & I had vertigo/dizziness with a potassium of 3.5 (normal 3.6-5.5) They placed me on a diuretic for 3 days (I had disagreed but I needed something, my pressure was 200/100) and it dropped my potassium further. (3.2) Again, on 4-5 kdur/day, awaiting my PA results. Thanks Chantal Renal artery stenosis ruled out with renal ultrasound.... > > > > > > > > > > > > > > > > > > > > > > > From: jwwright <jwwright@> > > > > > > > > > > > Subject: Re: Re: > > > > > Hyperaldo Review for Dr. Grim - Urgent > > > > > > > > > > > hyperaldosteronism > > > > > > > > > > > Date: Saturday, October 17, 2009, 5:43 PM > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Aldo 10, renin 0.2. Only measured once - > > > > > my internist at the time was sure I didn't have PA. The only > > > > > thing I have is occasionally my BP goes low and makes my > > > > > back hurt. I tracked that to an arthritic joint maybe a > > > > > pinched nerve. > > > > > > > > > > > Take a ketoprofen - goes away. > > > > > > > > > > > > I > > > > > resisted doing a lot of exercise for a long time, like 9 > > > > > yrs. > > > > > > I > > > > > now think, eventually, if you live and can do it, you will > > > > > be better off if you do some kind of weights, and some > > > > > aerobic. I like the rbike because it's safe, it's > > > > > strengthens the legs and I hear it does away with osteo, and > > > > > I regard osteo as very important if you intend to live to > > > > > 100. > > > > > > > > > > > The ONE problem thing the CRers have is > > > > > osteo, even at young like 42 age. > > > > > > > > > > > > > > > > > I've had no report the running prevents it > > > > > or cures it, and that by fitness "gurus". > > > > > > > > > > > > I > > > > > do a complete set of weights as I see it, and I add more as > > > > > I find one little muscle that's not challenged, here and > > > > > there. > > > > > > > > > > > > > > > > > Shoulder muscles are complex, many little > > > > > guys pulling every which way. > > > > > > > > > > > > I > > > > > know others have their preferences like yoga, but I like > > > > > being able to lift my 190 # son off the ground. I have the > > > > > same build just shorter, so my BMI looks larger. It's not > > > > > I'm just too short. > > > > > > > > > > > > > > > > > When I started I could lift 260# in the > > > > > rower. Now I can lift 300# at bench, not to chest, just off > > > > > the bench. > > > > > > > > > > > > > > > > > Back, abdominal, leg lift, leg press, arm > > > > > press, leg curl, straddle in and out are 150# exercise > > > > > levels. That's 9 1/2 months. I don't look like a bodybuilder > > > > > yet, just well formed muscles. I'm working on the > > > > > scwartznegger part (ha). > > > > > > > > > > > > I > > > > > believe the muscle building raises growth hormone and IGF-1 > > > > > similar to that in a younger person. > > > > > > > > > > > > > > > > > Get with it and you can start an exercise > > > > > studio which, IMO, is a lot better than selling a "health > > > > > spa" based on diet. Shouldn't take near as much money to > > > > > start and you can hire PhD trainers for sports therapy. > > > > > > > > > > > > > > > > > There are MANY that need physical therapy, > > > > > including almost everyone riding a Wal-mart ecart. > > > > > > > > > > > I've seen recovering cri >

October 18, 2009

being labeled with chronic fatiuge syndorme will minimize the likelyhood that anyone with look for other causes (low K) of not feeling well. Early CHF presents with SOB but no other signs. Were feet swelling? How many times a night did you get up to pee.Deconditiing is a Dx i have never made.CE Grim MDOn Oct 18, 2009, at 9:41 PM, Francis Bill wrote: It is my medical record Juse a few of the notes Walking with the patient: 02 Sats between 97-100 on RA HR 80-100 CXR: my read no acute cardiopulmonary process EKG: SR, no acute ST or T wave changes IMPRESSION: This is a 61 y/o man with a history of morbid obesity, chronic lightheadedness /dizziness, sensorineural loss, chronic fatigue syndrome , HTN, tachycrdia, who presents to the ED today for SOB. His Oxygen saturation at rest and when walkinq is normal. His CXR, EKG and labs are unremarkable. His exam, his CXR and his BNP are not consistent with CHF exacerbation. Resident MD Signed: 02/22/2009 13:54 /es/ NICHOLS SKIADAS Cardiology Fellow/MOD Cosigned: 02/22/2009 16:26 02/22/2009 ADDENDUM STATUS: COMPLETED Patient seen and examined in the ED with Dr Thol. I agree with her assessment and plan as deliniated. In brief patient is a 61 year old WM with PMH as noted below who presents with a aint of shortness of breath that started in last 24 hours. He had difficultly today doing his laundary. Patient denied any CP or pressure with activity. PE BP: 158/98 Studies reviewed: Normal CXR. EKG with LVH and nonspecific ST/T This is what the EKG showed 22-FEB-2009 12:22:53 Vent. rate 78 BPM Male Caucasian PR interval 128 ms QRS duration 94 ms QT/QTc 414/471 ms P-R-T axes 37 -18 14 Normal sinus Leftward axis Incomplete right bundle branch block Left ventricular hypertrophy Nonspecific ST and T wave abnormality A/P SOB of unclear cause (Possible deconditioning). No signs of cardiac ischemia, infection, systolic chf. PE less likely in light of normal 02 sats and absence of tachycardia. Current patient with uncontrolled HTN At this point patient is stable for DC. No further workup is needed at this point. - At some point would repeat echo as outpatient to look for signs of diastolic CHF, or pulmonary HTN from OSA. - Patient will also need to follow up with PCP so better control of BP can be achieved. /es/ NICHOLS SKIADAS Cardiology Fellow/MOD Signed: 02/22/2009 16:26 Next note about it Dizziness/fatigue - chronic issue, liekly not associated with ST that pt has had intermittent for several years. likely tach secondary to sleep apnea as well as morbid obesity and deconditioning. If pt has any sxs of cp, palpitations, etc, he may benefit from holter monitor, etc. IRUM ZIAUDDIN Physician Assistant Signed: 02/05/2009 next note As a result of the above the only firm dx that has come to light has been that of OSA, In regards to his Iightheadedness - he does not describe vertigo has not fallen, and no LOC. It is exacerbated by getting up quickly. In regards to tachycardia - he describes a variable rate of 60-100 in the past months, but has gone as high as 120. I do think a large part of this is deconditioning next note We reviewed again the results of CT scan and other previous studies. He's concerned that his heart rate increases with standing up/walking activity etc. Given the results of previous ekg/echo/event monitor - I really think a big part of his problem is deconditioning > > > > > > > > > > > > > > > > > Just doing a review of my PAC results > > > > > obtained from blood drawn at a Lab in > > > > > > > > > > > Jamaica. The test was in fact sent to a > > > > > Lab in the US. The blood was taken > > > > > > > > > > > with me sitting down for 5 mins after > > > > > driving to the Lab. The results showed > > > > > > > > > > > Aldostorone serum was 18.6 ng/dL. This > > > > > result from the LAB in the US was > > > > > > > > > > > shown as Abnormal (high) but the wrong > > > > > reference range was used. They used > > > > > > > > > > > the Adult supine(lying) reference range of > > > > > 1 - 16 ng/dL. > > > > > > > > > > > > > > > > > But my blood was taken when I was sitting > > > > > so they should have used the Adult > > > > > > > > > > > upright reference range of 4 - 31 ng/dL. > > > > > > > > > > > > > > > > > This would have meant that my PAC was > > > > > normal. Does this mean that I don't > > > > > > > > > > > have PA. > > > > > > > > > > > > > > > > > I also got a Renin Activity of 0.45 > > > > > ng/mL/hr > > > > > > > > > > > > > > > > > From my calculations My ARR = 18.6/0.45 = > > > > > 41.33 > > > > > > > > > > > > > > > > > Just a recap. My BP was about 245/145 > > > > > before taking 3 meds that dropped it > > > > > > > > > > > to 145/95. I have since removed one of > > > > > those meds in favor of Aldactone > > > > > > > > > > > (25mg twice daily) which lowers it to > > > > > 130/88. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902) > > > > > Information __________ > > > > > > > > > > > > > > > > > This message was checked by NOD32 > > > > > antivirus system. > > > > > > > > > > > http://www.eset. com > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902) > > > > > Information __________ > > > > > > > > > > > > This message was checked by NOD32 > > > > > antivirus system. > > > > > > http://www.eset.com > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > >

October 19, 2009

I remember when I went back to work and my doctor recommended jogging. I also added sea salt, thinking my alergy was to iodine. Both BP and weight went up.

Bindner

Web Directory (links to my sites and blogs):

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

http://mikeybdc.blogspot.com

From: Chantal <chantalrobichaud29@...>Subject: Re: Hyperaldo Review for Dr. Grim - Urgenthyperaldosteronism Date: Sunday, October 18, 2009, 9:28 PM

I actually had BP/polyuria/ polydipsia/ fatigue/extreme salt sensitivity etc. over the years and in the spring reported to my physician that I wasn't feeling well at all. (she was aware of the above symptoms because I discussed thyroid with her, my thirst/polyuria issues, blood pressure concerns, my extreme salt sensitivity- puffy eyelids.) I couldn't get another app. with her until the summer and they would not provide me with my blood work over the phone. (my potassium was borderline low then.)So imagine, in an attempt to feel better, I attempted to eat even better over the course of the summer and start training for a fall 10km (done over the years) because my jog was refreshing and I felt I was improving my health. Little did I know my potassium was borderline.In July, I had slightly blurred vision and by the time I saw her in August, I was no longer jogging, I had eliminated salt/ was juicing (for 2-3 weeks) & I had

vertigo/dizziness with a potassium of 3.5 (normal 3.6-5.5) They placed me on a diuretic for 3 days (I had disagreed but I needed something, my pressure was 200/100) and it dropped my potassium further. (3.2) Again, on 4-5 kdur/day, awaiting my PA results.Thanks ChantalRenal artery stenosis ruled out with renal ultrasound.. ..> > > > > >> > > > >

>> > > > > >> > > > > From: jwwright <jwwright@>> > > > > >> > > > > Subject: Re: [hyperaldosteronism ] Re:> > > > > Hyperaldo Review for Dr. Grim - Urgent> > > > > >> > > > > hyperaldosteronism> > > > > >> > > > > Date: Saturday, October 17, 2009, 5:43 PM> > > > > >> > > > > >> > > > > >> > > > >> > > > > >> > > > > Aldo 10, renin 0.2. Only measured once -> > > > > my internist at the time was sure I didn't have PA. The

only> > > > > thing I have is occasionally my BP goes low and makes my> > > > > back hurt. I tracked that to an arthritic joint maybe a> > > > > pinched nerve.> > > > > >> > > > > Take a ketoprofen - goes away.> > > > > >> > > > > > I> > > > > resisted doing a lot of exercise for a long time, like 9> > > > > yrs.> > > > > > I> > > > > now think, eventually, if you live and can do it, you will> > > > > be better off if you do some kind of weights, and some> > > > > aerobic. I like the rbike because it's safe, it's> > > > > strengthens the legs and I hear it does away with osteo, and> > > > > I regard osteo as very important if you intend to live to> >

> > > 100.> > > > > >> > > > > The ONE problem thing the CRers have is> > > > > osteo, even at young like 42 age.> > > > > >> > > > > >> > > > > I've had no report the running prevents it> > > > > or cures it, and that by fitness "gurus".> > > > > >> > > > > > I> > > > > do a complete set of weights as I see it, and I add more as> > > > > I find one little muscle that's not challenged, here and> > > > > there.> > > > > >> > > > > >> > > > > Shoulder muscles are complex, many little> > > > > guys pulling every which way.> > > > > >> > > > > > I> > > > > know others

have their preferences like yoga, but I like> > > > > being able to lift my 190 # son off the ground. I have the> > > > > same build just shorter, so my BMI looks larger. It's not> > > > > I'm just too short.> > > > > >> > > > > >> > > > > When I started I could lift 260# in the> > > > > rower. Now I can lift 300# at bench, not to chest, just off> > > > > the bench.> > > > > >> > > > > >> > > > > Back, abdominal, leg lift, leg press, arm> > > > > press, leg curl, straddle in and out are 150# exercise> > > > > levels. That's 9 1/2 months. I don't look like a bodybuilder> > > > > yet, just well formed muscles. I'm working on the> > > > > scwartznegger part

(ha).> > > > > >> > > > > > I> > > > > believe the muscle building raises growth hormone and IGF-1> > > > > similar to that in a younger person.> > > > > >> > > > > >> > > > > Get with it and you can start an exercise> > > > > studio which, IMO, is a lot better than selling a "health> > > > > spa" based on diet. Shouldn't take near as much money to> > > > > start and you can hire PhD trainers for sports therapy.> > > > > >> > > > > >> > > > > There are MANY that need physical therapy,> > > > > including almost everyone riding a Wal-mart ecart.> > > > > >> > > > > I've seen recovering

cri>

October 19, 2009

Night time peeing isn't a problem only daytime is. Some days more then other. I

don't think I change my fluid intake that much. I think it bulids up in my body

until my system decides to get rid of it.

What is more of a problem is gas this will wake me up and sometimes I have to

get up for a while until I get rid of it.

You are right about being labeled with chronic fatigue syndorme It never was

really Diagnosed That is I don't have any of the SX any where in my record. Yes

I am fatigued a lot so one could say it is chronic but this isn't the same as

chronic fatigue syndorme. What you don't see listed as a problem is the adrenal

adenoma.

I do have swelling in my feet but having two ECGs and some kind of blood test

they have ruled out CHF.

If it truly was deconditioning I got deconditioned in less then a month. I also

don't belive deconditioning makes one lightheaded / dizzy all the time It should

go away when resting.

> > > > > > > >

> > > > > > > Just doing a review of my PAC results

> > > > > > > obtained from blood drawn at a Lab in

> > > > > > > >

> > > > > > > Jamaica. The test was in fact sent to a

> > > > > > > Lab in the US. The blood was taken

> > > > > > > >

> > > > > > > with me sitting down for 5 mins after

> > > > > > > driving to the Lab. The results showed

> > > > > > > >

> > > > > > > Aldostorone serum was 18.6 ng/dL. This

> > > > > > > result from the LAB in the US was

> > > > > > > >

> > > > > > > shown as Abnormal (high) but the wrong

> > > > > > > reference range was used. They used

> > > > > > > >

> > > > > > > the Adult supine(lying) reference range of

> > > > > > > 1 - 16 ng/dL.

> > > > > > > >

> > > > > > > But my blood was taken when I was sitting

> > > > > > > so they should have used the Adult

> > > > > > > >

> > > > > > > upright reference range of 4 - 31 ng/dL.

> > > > > > > >

> > > > > > > This would have meant that my PAC was

> > > > > > > normal. Does this mean that I don't

> > > > > > > >

> > > > > > > have PA.

> > > > > > > >

> > > > > > > I also got a Renin Activity of 0.45

> > > > > > > ng/mL/hr

> > > > > > > >

> > > > > > > From my calculations My ARR = 18.6/0.45 =

> > > > > > > 41.33

> > > > > > > >

> > > > > > > Just a recap. My BP was about 245/145

> > > > > > > before taking 3 meds that dropped it

> > > > > > > >

> > > > > > > to 145/95. I have since removed one of

> > > > > > > those meds in favor of Aldactone

> > > > > > > >

> > > > > > > (25mg twice daily) which lowers it to

> > > > > > > 130/88.

> > > > > > > >

> > > > > > > __________ NOD32 4389 (20090902)

> > > > > > > Information __________

> > > > > > > >

> > > > > > > This message was checked by NOD32

> > > > > > > antivirus system.

> > > > > > > >

> > > > > > > http://www.eset. com

> > > > > > > >

> > > > > > > > __________ NOD32 4389 (20090902)

> > > > > > > Information __________

> > > > > > > >

> > > > > > > > This message was checked by NOD32

> > > > > > > antivirus system.

> > > > > > > > http://www.eset.com

> > > > > > > >

> > > > > > >

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

> > > > > > >

October 19, 2009

Good to add to your "Story".I encourage you all to update your story as more is recalled or new data becomes available. 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 19, 2009, at 4:20 AM, Bindner wrote: I remember when I went back to work and my doctor recommended jogging. I also added sea salt, thinking my alergy was to iodine. Both BP and weight went up. Bindner Web Directory (links to my sites and blogs): http://www.geocities.com/mikeybdc/index.html http://mikeybdc.blogspot.com From: Chantal <chantalrobichaud29 (DOT) ca>Subject: Re: Hyperaldo Review for Dr. Grim - Urgenthyperaldosteronism Date: Sunday, October 18, 2009, 9:28 PM I actually had BP/polyuria/ polydipsia/ fatigue/extreme salt sensitivity etc. over the years and in the spring reported to my physician that I wasn't feeling well at all. (she was aware of the above symptoms because I discussed thyroid with her, my thirst/polyuria issues, blood pressure concerns, my extreme salt sensitivity- puffy eyelids.) I couldn't get another app. with her until the summer and they would not provide me with my blood work over the phone. (my potassium was borderline low then.)So imagine, in an attempt to feel better, I attempted to eat even better over the course of the summer and start training for a fall 10km (done over the years) because my jog was refreshing and I felt I was improving my health. Little did I know my potassium was borderline.In July, I had slightly blurred vision and by the time I saw her in August, I was no longer jogging, I had eliminated salt/ was juicing (for 2-3 weeks) & I had vertigo/dizziness with a potassium of 3.5 (normal 3.6-5.5) They placed me on a diuretic for 3 days (I had disagreed but I needed something, my pressure was 200/100) and it dropped my potassium further. (3.2) Again, on 4-5 kdur/day, awaiting my PA results.Thanks ChantalRenal artery stenosis ruled out with renal ultrasound.. ..> > > > > >> > > > > >> > > > > >> > > > > From: jwwright <jwwright@>> > > > > >> > > > > Subject: Re: [hyperaldosteronism ] Re:> > > > > Hyperaldo Review for Dr. Grim - Urgent> > > > > >> > > > > hyperaldosteronism> > > > > >> > > > > Date: Saturday, October 17, 2009, 5:43 PM> > > > > >> > > > > >> > > > > >> > > > >> > > > > >> > > > > Aldo 10, renin 0.2. Only measured once -> > > > > my internist at the time was sure I didn't have PA. The only> > > > > thing I have is occasionally my BP goes low and makes my> > > > > back hurt. I tracked that to an arthritic joint maybe a> > > > > pinched nerve.> > > > > >> > > > > Take a ketoprofen - goes away.> > > > > >> > > > > > I> > > > > resisted doing a lot of exercise for a long time, like 9> > > > > yrs.> > > > > > I> > > > > now think, eventually, if you live and can do it, you will> > > > > be better off if you do some kind of weights, and some> > > > > aerobic. I like the rbike because it's safe, it's> > > > > strengthens the legs and I hear it does away with osteo, and> > > > > I regard osteo as very important if you intend to live to> > > > > 100.> > > > > >> > > > > The ONE problem thing the CRers have is> > > > > osteo, even at young like 42 age.> > > > > >> > > > > >> > > > > I've had no report the running prevents it> > > > > or cures it, and that by fitness "gurus".> > > > > >> > > > > > I> > > > > do a complete set of weights as I see it, and I add more as> > > > > I find one little muscle that's not challenged, here and> > > > > there.> > > > > >> > > > > >> > > > > Shoulder muscles are complex, many little> > > > > guys pulling every which way.> > > > > >> > > > > > I> > > > > know others have their preferences like yoga, but I like> > > > > being able to lift my 190 # son off the ground. I have the> > > > > same build just shorter, so my BMI looks larger. It's not> > > > > I'm just too short.> > > > > >> > > > > >> > > > > When I started I could lift 260# in the> > > > > rower. Now I can lift 300# at bench, not to chest, just off> > > > > the bench.> > > > > >> > > > > >> > > > > Back, abdominal, leg lift, leg press, arm> > > > > press, leg curl, straddle in and out are 150# exercise> > > > > levels. That's 9 1/2 months. I don't look like a bodybuilder> > > > > yet, just well formed muscles. I'm working on the> > > > > scwartznegger part (ha).> > > > > >> > > > > > I> > > > > believe the muscle building raises growth hormone and IGF-1> > > > > similar to that in a younger person.> > > > > >> > > > > >> > > > > Get with it and you can start an exercise> > > > > studio which, IMO, is a lot better than selling a "health> > > > > spa" based on diet. Shouldn't take near as much money to> > > > > start and you can hire PhD trainers for sports therapy.> > > > > >> > > > > >> > > > > There are MANY that need physical therapy,> > > > > including almost everyone riding a Wal-mart ecart.> > > > > >> > > > > I've seen recovering cri>

October 19, 2009

Deconditioning- I interpreted deconditioned last evening as essentially not

conditioned , ie. not fit.. Not use to that activity...or as the definition

states, overuse/misuse...

So, to date no discussion of deconditioning from my doctors...I'm a little over

my BMI (I was attempting to get healthier this summer) but I can't exercise too

much so my diet will go sodium reduced today (ie. healthy ) being I had my

ARR today. Yay!!

I await these results, I just notice my endo added T4 (normal TSH)

free- so I guess we are rechecking thyroid/pituitary.

Thanks

Chantal

Hooray...

> > > > > > >

> > > > > > Just doing a review of my PAC results

> > > > > > obtained from blood drawn at a Lab in

> > > > > > >

> > > > > > Jamaica. The test was in fact sent to a

> > > > > > Lab in the US. The blood was taken

> > > > > > >

> > > > > > with me sitting down for 5 mins after

> > > > > > driving to the Lab. The results showed

> > > > > > >

> > > > > > Aldostorone serum was 18.6 ng/dL. This

> > > > > > result from the LAB in the US was

> > > > > > >

> > > > > > shown as Abnormal (high) but the wrong

> > > > > > reference range was used. They used

> > > > > > >

> > > > > > the Adult supine(lying) reference range of

> > > > > > 1 - 16 ng/dL.

> > > > > > >

> > > > > > But my blood was taken when I was sitting

> > > > > > so they should have used the Adult

> > > > > > >

> > > > > > upright reference range of 4 - 31 ng/dL.

> > > > > > >

> > > > > > This would have meant that my PAC was

> > > > > > normal. Does this mean that I don't

> > > > > > >

> > > > > > have PA.

> > > > > > >

> > > > > > I also got a Renin Activity of 0.45

> > > > > > ng/mL/hr

> > > > > > >

> > > > > > From my calculations My ARR = 18.6/0.45 =

> > > > > > 41.33

> > > > > > >

> > > > > > Just a recap. My BP was about 245/145

> > > > > > before taking 3 meds that dropped it

> > > > > > >

> > > > > > to 145/95. I have since removed one of

> > > > > > those meds in favor of Aldactone

> > > > > > >

> > > > > > (25mg twice daily) which lowers it to

> > > > > > 130/88.

> > > > > > >

> > > > > > __________ NOD32 4389 (20090902)

> > > > > > Information __________

> > > > > > >

> > > > > > This message was checked by NOD32

> > > > > > antivirus system.

> > > > > > >

> > > > > > http://www.eset. com

> > > > > > >

> > > > > > > __________ NOD32 4389 (20090902)

> > > > > > Information __________

> > > > > > >

> > > > > > > This message was checked by NOD32

> > > > > > antivirus system.

> > > > > > > http://www.eset.com

> > > > > > >

> > > > > >

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

> > > > > >

October 19, 2009

I can understand what normal Deconditioning is. What I don't think it is when

your go into a store and within 5 min. you are looking for a place to sit down.

Something is wrong. What I can't seem to make them understand is for me I went

to doing labor inteniseve work to being Deconditioned within less then a month

in fact more like overnight.

> > > > > > > >

> > > > > > > Just doing a review of my PAC results

> > > > > > > obtained from blood drawn at a Lab in

> > > > > > > >

> > > > > > > Jamaica. The test was in fact sent to a

> > > > > > > Lab in the US. The blood was taken

> > > > > > > >

> > > > > > > with me sitting down for 5 mins after

> > > > > > > driving to the Lab. The results showed

> > > > > > > >

> > > > > > > Aldostorone serum was 18.6 ng/dL. This

> > > > > > > result from the LAB in the US was

> > > > > > > >

> > > > > > > shown as Abnormal (high) but the wrong

> > > > > > > reference range was used. They used

> > > > > > > >

> > > > > > > the Adult supine(lying) reference range of

> > > > > > > 1 - 16 ng/dL.

> > > > > > > >

> > > > > > > But my blood was taken when I was sitting

> > > > > > > so they should have used the Adult

> > > > > > > >

> > > > > > > upright reference range of 4 - 31 ng/dL.

> > > > > > > >

> > > > > > > This would have meant that my PAC was

> > > > > > > normal. Does this mean that I don't

> > > > > > > >

> > > > > > > have PA.

> > > > > > > >

> > > > > > > I also got a Renin Activity of 0.45

> > > > > > > ng/mL/hr

> > > > > > > >

> > > > > > > From my calculations My ARR = 18.6/0.45 =

> > > > > > > 41.33

> > > > > > > >

> > > > > > > Just a recap. My BP was about 245/145

> > > > > > > before taking 3 meds that dropped it

> > > > > > > >

> > > > > > > to 145/95. I have since removed one of

> > > > > > > those meds in favor of Aldactone

> > > > > > > >

> > > > > > > (25mg twice daily) which lowers it to

> > > > > > > 130/88.

> > > > > > > >

> > > > > > > __________ NOD32 4389 (20090902)

> > > > > > > Information __________

> > > > > > > >

> > > > > > > This message was checked by NOD32

> > > > > > > antivirus system.

> > > > > > > >

> > > > > > > http://www.eset. com

> > > > > > > >

> > > > > > > > __________ NOD32 4389 (20090902)

> > > > > > > Information __________

> > > > > > > >

> > > > > > > > This message was checked by NOD32

> > > > > > > antivirus system.

> > > > > > > > http://www.eset.com

> > > > > > > >

> > > > > > >

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

> > > > > > >

October 19, 2009

Same here, I hear you.

Standing sometimes is an effort, my muscles start to shake.

Now when we go for even a small walk, I sit down when we stop for a break.

I find it hard to maintain any activity for extended periods.

It is a work-out to vacuum the house.

I get exhausted so easily and it comes on quickly. Just like potassium helping

me one minute and poof, here it comes, weakness!

I take my k-dur and it lasts me 2 to 3 hours if I'm lucky. Then it's like I get

faint, lightheaded and need to take another....

I don't seem to be storing my potassium at all, it gets flushed out rather

quickly.... I may change my dosing to every 2 hours (1/2) instead of 1 4-5 /day

(7,11,3,7,11) to see if I can control the breakthrough symptoms. In other

words, maintain a steady-state of potassium to get me through the day.

keep you posted

> > > > > > > > >

> > > > > > > > Just doing a review of my PAC results

> > > > > > > > obtained from blood drawn at a Lab in

> > > > > > > > >

> > > > > > > > Jamaica. The test was in fact sent to a

> > > > > > > > Lab in the US. The blood was taken

> > > > > > > > >

> > > > > > > > with me sitting down for 5 mins after

> > > > > > > > driving to the Lab. The results showed

> > > > > > > > >

> > > > > > > > Aldostorone serum was 18.6 ng/dL. This

> > > > > > > > result from the LAB in the US was

> > > > > > > > >

> > > > > > > > shown as Abnormal (high) but the wrong

> > > > > > > > reference range was used. They used

> > > > > > > > >

> > > > > > > > the Adult supine(lying) reference range of

> > > > > > > > 1 - 16 ng/dL.

> > > > > > > > >

> > > > > > > > But my blood was taken when I was sitting

> > > > > > > > so they should have used the Adult

> > > > > > > > >

> > > > > > > > upright reference range of 4 - 31 ng/dL.

> > > > > > > > >

> > > > > > > > This would have meant that my PAC was

> > > > > > > > normal. Does this mean that I don't

> > > > > > > > >

> > > > > > > > have PA.

> > > > > > > > >

> > > > > > > > I also got a Renin Activity of 0.45

> > > > > > > > ng/mL/hr

> > > > > > > > >

> > > > > > > > From my calculations My ARR = 18.6/0.45 =

> > > > > > > > 41.33

> > > > > > > > >

> > > > > > > > Just a recap. My BP was about 245/145

> > > > > > > > before taking 3 meds that dropped it

> > > > > > > > >

> > > > > > > > to 145/95. I have since removed one of

> > > > > > > > those meds in favor of Aldactone

> > > > > > > > >

> > > > > > > > (25mg twice daily) which lowers it to

> > > > > > > > 130/88.

> > > > > > > > >

> > > > > > > > __________ NOD32 4389 (20090902)

> > > > > > > > Information __________

> > > > > > > > >

> > > > > > > > This message was checked by NOD32

> > > > > > > > antivirus system.

> > > > > > > > >

> > > > > > > > http://www.eset. com

> > > > > > > > >

> > > > > > > > > __________ NOD32 4389 (20090902)

> > > > > > > > Information __________

> > > > > > > > >

> > > > > > > > > This message was checked by NOD32

> > > > > > > > antivirus system.

> > > > > > > > > http://www.eset.com

> > > > > > > > >

> > > > > > > >

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

> > > > > > > >

October 19, 2009

Hypothyroid can look like PA. Except aldo is low not high as I recall.So looks like AME.Am J Hypertens. 2007 Jan;20(1):104-7; discussion 108.Related Articles, Links Apparent mineralocorticoid excess manifested in an elderly patient with hypothyroidism.Inagaki K, Otsuka F, Otani H, Sato C, Miyoshi T, Ogura T, Makino H.Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama City 700-8558, Japan.The syndrome of apparent mineralocorticoid excess (AME) is characterized by persistent hypertension and hypokalemia, which is caused by impaired inactivation of cortisol (F) to cortisone (E). The thyroid hormone has been known to influence the F to E conversion leading to efficacious inactivation of F into E. However, there have been no reports regarding the clinical manifestation of secondary AME due to hypothyroidism. Here we report an elderly patient who manifested AME, showing persistent hypertension with hypokalemia induced by primary hypothyroidism. Maintenance of euthyroid conditions ameliorated the concurrent AME and restored adrenal secretion of aldosterone after the recovery of the F to E shuttle. This case report would broaden our clinical recognition regarding acquired AME in relation to thyroid dysfunction.On Oct 19, 2009, at 9:09 AM, Chantal wrote: Deconditioning- I interpreted deconditioned last evening as essentially not conditioned , ie. not fit.. Not use to that activity...or as the definition states, overuse/misuse... So, to date no discussion of deconditioning from my doctors...I'm a little over my BMI (I was attempting to get healthier this summer) but I can't exercise too much so my diet will go sodium reduced today (ie. healthy ) being I had my ARR today. Yay!! I await these results, I just notice my endo added T4 (normal TSH) free- so I guess we are rechecking thyroid/pituitary. Thanks Chantal Hooray... > > > > > > > > > > > > > > > > > > > > Just doing a review of my PAC results > > > > > > obtained from blood drawn at a Lab in > > > > > > > > > > > > > Jamaica. The test was in fact sent to a > > > > > > Lab in the US. The blood was taken > > > > > > > > > > > > > with me sitting down for 5 mins after > > > > > > driving to the Lab. The results showed > > > > > > > > > > > > > Aldostorone serum was 18.6 ng/dL. This > > > > > > result from the LAB in the US was > > > > > > > > > > > > > shown as Abnormal (high) but the wrong > > > > > > reference range was used. They used > > > > > > > > > > > > > the Adult supine(lying) reference range of > > > > > > 1 - 16 ng/dL. > > > > > > > > > > > > > > > > > > > > But my blood was taken when I was sitting > > > > > > so they should have used the Adult > > > > > > > > > > > > > upright reference range of 4 - 31 ng/dL. > > > > > > > > > > > > > > > > > > > > This would have meant that my PAC was > > > > > > normal. Does this mean that I don't > > > > > > > > > > > > > have PA. > > > > > > > > > > > > > > > > > > > > I also got a Renin Activity of 0.45 > > > > > > ng/mL/hr > > > > > > > > > > > > > > > > > > > > From my calculations My ARR = 18.6/0.45 = > > > > > > 41.33 > > > > > > > > > > > > > > > > > > > > Just a recap. My BP was about 245/145 > > > > > > before taking 3 meds that dropped it > > > > > > > > > > > > > to 145/95. I have since removed one of > > > > > > those meds in favor of Aldactone > > > > > > > > > > > > > (25mg twice daily) which lowers it to > > > > > > 130/88. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902) > > > > > > Information __________ > > > > > > > > > > > > > > > > > > > > This message was checked by NOD32 > > > > > > antivirus system. > > > > > > > > > > > > > http://www.eset. com > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902) > > > > > > Information __________ > > > > > > > > > > > > > > This message was checked by NOD32 > > > > > > antivirus system. > > > > > > > http://www.eset.com > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > > >

October 19, 2009

Remind me of the meds you are on. Edema is common with CCBs.On Oct 19, 2009, at 7:10 AM, Francis Bill wrote:I do have swelling in my feet but having two ECGs and some kind of blood test they have ruled out CHF.

October 19, 2009

Hope you get on Spiro soon.Please add these details to your "story". Thanks.On Oct 19, 2009, at 9:58 AM, Chantal wrote: Same here, I hear you. Standing sometimes is an effort, my muscles start to shake. Now when we go for even a small walk, I sit down when we stop for a break. I find it hard to maintain any activity for extended periods. It is a work-out to vacuum the house. I get exhausted so easily and it comes on quickly. Just like potassium helping me one minute and poof, here it comes, weakness! I take my k-dur and it lasts me 2 to 3 hours if I'm lucky. Then it's like I get faint, lightheaded and need to take another.... I don't seem to be storing my potassium at all, it gets flushed out rather quickly.... I may change my dosing to every 2 hours (1/2) instead of 1 4-5 /day (7,11,3,7,11) to see if I can control the breakthrough symptoms. In other words, maintain a steady-state of potassium to get me through the day. keep you posted > > > > > > > > > > > > > > > > > > > > > > > > > > Just doing a review of my PAC results > > > > > > > > obtained from blood drawn at a Lab in > > > > > > > > > > > > > > > > > Jamaica. The test was in fact sent to a > > > > > > > > Lab in the US. The blood was taken > > > > > > > > > > > > > > > > > with me sitting down for 5 mins after > > > > > > > > driving to the Lab. The results showed > > > > > > > > > > > > > > > > > Aldostorone serum was 18.6 ng/dL. This > > > > > > > > result from the LAB in the US was > > > > > > > > > > > > > > > > > shown as Abnormal (high) but the wrong > > > > > > > > reference range was used. They used > > > > > > > > > > > > > > > > > the Adult supine(lying) reference range of > > > > > > > > 1 - 16 ng/dL. > > > > > > > > > > > > > > > > > > > > > > > > > > But my blood was taken when I was sitting > > > > > > > > so they should have used the Adult > > > > > > > > > > > > > > > > > upright reference range of 4 - 31 ng/dL. > > > > > > > > > > > > > > > > > > > > > > > > > > This would have meant that my PAC was > > > > > > > > normal. Does this mean that I don't > > > > > > > > > > > > > > > > > have PA. > > > > > > > > > > > > > > > > > > > > > > > > > > I also got a Renin Activity of 0.45 > > > > > > > > ng/mL/hr > > > > > > > > > > > > > > > > > > > > > > > > > > From my calculations My ARR = 18.6/0.45 = > > > > > > > > 41.33 > > > > > > > > > > > > > > > > > > > > > > > > > > Just a recap. My BP was about 245/145 > > > > > > > > before taking 3 meds that dropped it > > > > > > > > > > > > > > > > > to 145/95. I have since removed one of > > > > > > > > those meds in favor of Aldactone > > > > > > > > > > > > > > > > > (25mg twice daily) which lowers it to > > > > > > > > 130/88. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902) > > > > > > > > Information __________ > > > > > > > > > > > > > > > > > > > > > > > > > > This message was checked by NOD32 > > > > > > > > antivirus system. > > > > > > > > > > > > > > > > > http://www.eset. com > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902) > > > > > > > > Information __________ > > > > > > > > > > > > > > > > > > This message was checked by NOD32 > > > > > > > > antivirus system. > > > > > > > > > http://www.eset.com > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > > > > > > >

October 19, 2009

I eat potatoes, 2 bananas and get enough protein and take OTC K. My symptoms aren't as bad. Make sure you eat high K foods! Not all foods on DASH are the same, so you must make a conscious effort.

Bindner

Web Directory (links to my sites and blogs):

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

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From: Chantal <chantalrobichaud29@...>Subject: Re: Hyperaldo Review for Dr. Grim - Urgenthyperaldosteronism Date: Monday, October 19, 2009, 10:58 AM

Same here, I hear you.Standing sometimes is an effort, my muscles start to shake.Now when we go for even a small walk, I sit down when we stop for a break.I find it hard to maintain any activity for extended periods. It is a work-out to vacuum the house. I get exhausted so easily and it comes on quickly. Just like potassium helping me one minute and poof, here it comes, weakness!I take my k-dur and it lasts me 2 to 3 hours if I'm lucky. Then it's like I get faint, lightheaded and need to take another....I don't seem to be storing my potassium at all, it gets flushed out rather quickly.... I may change my dosing to every 2 hours (1/2) instead of 1 4-5 /day (7,11,3,7,11) to see if I can control the breakthrough symptoms. In other words, maintain a steady-state of potassium to get me through the day.keep you posted> > > > > > > > > > > > > > > > > > > > > > > > > > Just doing a review of my PAC results> > > > > > > > obtained from blood drawn at a Lab in> > > > > > > > > > > > > > > > > Jamaica. The test was in fact sent to a> > > > > > > > Lab in the US. The blood was taken> > > > > > > > > > > > > > > >

> with me sitting down for 5 mins after> > > > > > > > driving to the Lab. The results showed> > > > > > > > > > > > > > > > > Aldostorone serum was 18.6 ng/dL. This> > > > > > > > result from the LAB in the US was> > > > > > > > > > > > > > > > > shown as Abnormal (high) but the wrong> > > > > > > > reference range was used. They used> > > > > > > > > > > > > > > > > the Adult supine(lying) reference range of> > > > > > > > 1 - 16 ng/dL.> > > > > > > > > > > > > > > > > > > > > > > > > > But my blood was taken when I was sitting> > > > > > > > so

they should have used the Adult> > > > > > > > > > > > > > > > > upright reference range of 4 - 31 ng/dL.> > > > > > > > > > > > > > > > > > > > > > > > > > This would have meant that my PAC was> > > > > > > > normal. Does this mean that I don't> > > > > > > > > > > > > > > > > have PA.> > > > > > > > > > > > > > > > > > > > > > > > > > I also got a Renin Activity of 0.45> > > > > > > > ng/mL/hr> > > > > > > > > > > > > > > > > > > > > > > > > > From my calculations My ARR = 18.6/0.45 => > > > >

> > > 41.33> > > > > > > > > > > > > > > > > > > > > > > > > > Just a recap. My BP was about 245/145> > > > > > > > before taking 3 meds that dropped it> > > > > > > > > > > > > > > > > to 145/95. I have since removed one of> > > > > > > > those meds in favor of Aldactone> > > > > > > > > > > > > > > > > (25mg twice daily) which lowers it to> > > > > > > > 130/88.> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902)> > > > > > > > Information __________> > > > > > > > > > > > > > > > > > > > > > > > > > This message was checked by NOD32> > > > > > > > antivirus system.> > > > > > > > > > > > > > > > > http://www.eset. com> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > > > > > > __________ NOD32 4389 (20090902)> > > > > > > > Information __________> > > > > > > > > > > > > > > > > > This message was checked by NOD32> > > > > > > > antivirus system.> > > > > > > > > http://www.eset. com> > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ------------ --------- --------- ------> > > > > > > > > > > > > > > >

October 19, 2009

I also think BB as well. For Meds I take 25 mg Atenolol 60 mg Fufosemide 50 mg Triamterene and 20 meq Potassium Chloride a day.

I am now on 180 MG of Diltiazem I was on it before. At the time had my appendex removed had an UTI. Some thing during this time made me end up in the ED I woke up with shaking and heart rate of arould 120 the EMT thought I should be seen. The ED couldn't find the cause.. I stoped the diltiazem as I read this could be side effect of it.Last Dr visit he wanted me to restart it. So will see what happens.

I do have swelling in my feet but having two ECGs and some kind of blood test they have ruled out CHF.

October 19, 2009

Try not to give BB and DILT. LATTER likely causing edema. Furos shops be taken bid if for BP. CHECK WITH UR TEAM. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Oct 19, 2009, at 10:55 AM, Bill <georgewbill@...> wrote:

I also think BB as well. For Meds I take 25 mg Atenolol 60 mg Fufosemide 50 mg Triamterene and 20 meq Potassium Chloride a day.

I am now on 180 MG of Diltiazem I was on it before. At the time had my appendex removed had an UTI. Some thing during this time made me end up in the ED I woke up with shaking and heart rate of arould 120 the EMT thought I should be seen. The ED couldn't find the cause.. I stoped the diltiazem as I read this could be side effect of it.Last Dr visit he wanted me to restart it. So will see what happens.

I do have swelling in my feet but having two ECGs and some kind of blood test they have ruled out CHF.

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Re: Hyperaldo Review for Dr. Grim - Urgent

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