Re: Re: HA suspected and testing

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Let your Dr know you are DASHing as you may see a fast fall in BP and need to back of other Rx.CE Grim MDOn Nov 27, 2009, at 8:34 AM, dbonogofsky wrote:Thank you. Sounds as if I'm fighting at least 2 situations--PA and possibly metabolic syndrome. Will be DASHing starting today. Will corresponding BP results be noticeable quickly or will they manifest itself over time ? I'm back onto the Spirno, Norvasc and Chlorthalidone and average BP is running 135/77 for the past 4 days. > > > > > > > > >> > > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 > > days> > > > > > ago now> > > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking > > this> > > > > > may be> > > > > > > > due> > > > > > > > > > to discontinuation of Spiro recently in prep for > > tomorrows> > > > > > saline> > > > > > > > > > suppression test, although its only been 5 days > > since such> > > > > > > > > > discontinuance. Not sure if K level would drop that> > > > quickly in> > > > > > > > this> > > > > > > > > > short of a time frame. Received prescription for K> > > > supplement> > > > > > > > 20MEQ> > > > > > > > > > ER twice a day. ENDO is reasonably confident that test> > > > will> > > > > > > > confirm> > > > > > > > > > PA and surgery will likely be highly beneficial in> > > > reducing> > > > > > BP to> > > > > > > > > > near normal levels, with at most a minimum of> > > > medications. I> > > > > > > > suspect> > > > > > > > > > that shortly after testing I will again go back on > > spiro> > > > at> > > > > > prior> > > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until > > decision> > > > on> > > > > > > > surgery> > > > > > > > > > is made. I'll start working on DASHing to see if it > > will> > > > lower> > > > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > > > >> > > > > > > > > > Side note that creatinine results are also changing---> > > > > > dropped from> > > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to> > > > 1.88 in> > > > > > > > Oct.> > > > > > > > > > and now 1.58. ENDO believes these changes are directly> > > > tied to> > > > > > > > blood> > > > > > > > > > pressure fluctuations. Increase being caused by drop > > in> > > > > > pressure> > > > > > > > > > when kidneys were used to years of the high > > pressure. And> > > > > > current> > > > > > > > > > decrease due to stabilization at lower pressure. > > Hopefully> > > > > > this is> > > > > > > > > > the case as ther was concern from PCP that we were> > > > seeing some> > > > > > > > signs> > > > > > > > > > of renal failure.> > > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > >> > > > > > >> > > > > >> > > > > >> > > > > >> > > > >> > > >> > > >> > > >> > >> >> >> >>

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Let your Dr know you are DASHing as you may see a fast fall in BP and need to back of other Rx.CE Grim MDOn Nov 27, 2009, at 8:34 AM, dbonogofsky wrote:Thank you. Sounds as if I'm fighting at least 2 situations--PA and possibly metabolic syndrome. Will be DASHing starting today. Will corresponding BP results be noticeable quickly or will they manifest itself over time ? I'm back onto the Spirno, Norvasc and Chlorthalidone and average BP is running 135/77 for the past 4 days. > > > > > > > > >> > > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 > > days> > > > > > ago now> > > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking > > this> > > > > > may be> > > > > > > > due> > > > > > > > > > to discontinuation of Spiro recently in prep for > > tomorrows> > > > > > saline> > > > > > > > > > suppression test, although its only been 5 days > > since such> > > > > > > > > > discontinuance. Not sure if K level would drop that> > > > quickly in> > > > > > > > this> > > > > > > > > > short of a time frame. Received prescription for K> > > > supplement> > > > > > > > 20MEQ> > > > > > > > > > ER twice a day. ENDO is reasonably confident that test> > > > will> > > > > > > > confirm> > > > > > > > > > PA and surgery will likely be highly beneficial in> > > > reducing> > > > > > BP to> > > > > > > > > > near normal levels, with at most a minimum of> > > > medications. I> > > > > > > > suspect> > > > > > > > > > that shortly after testing I will again go back on > > spiro> > > > at> > > > > > prior> > > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until > > decision> > > > on> > > > > > > > surgery> > > > > > > > > > is made. I'll start working on DASHing to see if it > > will> > > > lower> > > > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > > > >> > > > > > > > > > Side note that creatinine results are also changing---> > > > > > dropped from> > > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to> > > > 1.88 in> > > > > > > > Oct.> > > > > > > > > > and now 1.58. ENDO believes these changes are directly> > > > tied to> > > > > > > > blood> > > > > > > > > > pressure fluctuations. Increase being caused by drop > > in> > > > > > pressure> > > > > > > > > > when kidneys were used to years of the high > > pressure. And> > > > > > current> > > > > > > > > > decrease due to stabilization at lower pressure. > > Hopefully> > > > > > this is> > > > > > > > > > the case as ther was concern from PCP that we were> > > > seeing some> > > > > > > > signs> > > > > > > > > > of renal failure.> > > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > >> > > > > > >> > > > > >> > > > > >> > > > > >> > > > >> > > >> > > >> > > >> > >> >> >> >>

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Better to DASH with HTN and Type 2. Tell your dietician. Did she mention DASH? If not tell her about it. Get the book as well.And read it!CE Grim MDOn Nov 27, 2009, at 9:20 AM, Bindner wrote:Do you count milk as a carb serving? 12 is an awful lot, since carbs make cholesterol in your body.If you can keep to DASH, than do that. If it becomes impossible, however, try a low carb diet. Bindner From: dbonogofsky <dbonogofsky >Subject: Re: HA suspected and testinghyperaldosteronism Date: Friday, November 27, 2009, 9:44 AM Thanks . My diet is not the best, although I have minimized most sweets/sugars and tried to keep carbs down on a daily basis to no more than 12 carb servings. This was the amount the dietician recommended when I first saw her after the Type 2 diagnosis. I could definitely stand to lose somewhere between 10-15 pounds. I have begun to increase fresh fruits/vegetables in my eating plan. And will be starting to DASH now based on Dr. Grim's suggestion. I think my balance of food is OK, but need some more effort at portion control and exercise. A1C reading when first diagnosed was 6.9. Readings since then have been between 6.1 and 6.4. No drinking of any consequence. Occasional glass of wine on holidays. Perhaps once every couple of months, if that much. By the way, congrats on your testing and surgery. Hoping everything turns out great for you and this gets you back to a much more normal state of health. > > > > > > > >> > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > > ago now> > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this> > > > > may be> > > > > > > due> > > > > > > > > to discontinuation of Spiro recently in prep for tomorrows> > > > > saline> > > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > > discontinuance. Not sure if K level would drop that > > > quickly in> > > > > > > this> > > > > > > > > short of a time frame. Received prescription for K > > > supplement> > > > > > > 20MEQ> > > > > > > > > ER twice a day. ENDO is reasonably confident that test > > > will> > > > > > > confirm> > > > > > > > > PA and surgery will likely be highly beneficial in > > > reducing> > > > > BP to> > > > > > > > > near normal levels, with at most a minimum of > > > medications. I> > > > > > > suspect> > > > > > > > > that shortly after testing I will again go back on spiro > > > at> > > > > prior> > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > > on> > > > > > > surgery> > > > > > > > > is made. I'll start working on DASHing to see if it will > > > lower> > > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > > >> > > > > > > > > Side note that creatinine results are also changing---> > > > > dropped from> > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to > > > 1.88 in> > > > > > > Oct.> > > > > > > > > and now 1.58. ENDO believes these changes are directly > > > tied to> > > > > > > blood> > > > > > > > > pressure fluctuations. Increase being caused by drop in> > > > > pressure> > > > > > > > > when kidneys were used to years of the high pressure. And> > > > > current> > > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > > this is> > > > > > > > > the case as ther was concern from PCP that we were > > > seeing some> > > > > > > signs> > > > > > > > > of renal failure.> > > > > > > >> > > > > > >> > > > > > >> > > > > > >> > > > > >> > > > >> > > > >> > > > >> > > >> > >> > >> > >> >>

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Better to DASH with HTN and Type 2. Tell your dietician. Did she mention DASH? If not tell her about it. Get the book as well.And read it!CE Grim MDOn Nov 27, 2009, at 9:20 AM, Bindner wrote:Do you count milk as a carb serving? 12 is an awful lot, since carbs make cholesterol in your body.If you can keep to DASH, than do that. If it becomes impossible, however, try a low carb diet. Bindner From: dbonogofsky <dbonogofsky >Subject: Re: HA suspected and testinghyperaldosteronism Date: Friday, November 27, 2009, 9:44 AM Thanks . My diet is not the best, although I have minimized most sweets/sugars and tried to keep carbs down on a daily basis to no more than 12 carb servings. This was the amount the dietician recommended when I first saw her after the Type 2 diagnosis. I could definitely stand to lose somewhere between 10-15 pounds. I have begun to increase fresh fruits/vegetables in my eating plan. And will be starting to DASH now based on Dr. Grim's suggestion. I think my balance of food is OK, but need some more effort at portion control and exercise. A1C reading when first diagnosed was 6.9. Readings since then have been between 6.1 and 6.4. No drinking of any consequence. Occasional glass of wine on holidays. Perhaps once every couple of months, if that much. By the way, congrats on your testing and surgery. Hoping everything turns out great for you and this gets you back to a much more normal state of health. > > > > > > > >> > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > > ago now> > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this> > > > > may be> > > > > > > due> > > > > > > > > to discontinuation of Spiro recently in prep for tomorrows> > > > > saline> > > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > > discontinuance. Not sure if K level would drop that > > > quickly in> > > > > > > this> > > > > > > > > short of a time frame. Received prescription for K > > > supplement> > > > > > > 20MEQ> > > > > > > > > ER twice a day. ENDO is reasonably confident that test > > > will> > > > > > > confirm> > > > > > > > > PA and surgery will likely be highly beneficial in > > > reducing> > > > > BP to> > > > > > > > > near normal levels, with at most a minimum of > > > medications. I> > > > > > > suspect> > > > > > > > > that shortly after testing I will again go back on spiro > > > at> > > > > prior> > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > > on> > > > > > > surgery> > > > > > > > > is made. I'll start working on DASHing to see if it will > > > lower> > > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > > >> > > > > > > > > Side note that creatinine results are also changing---> > > > > dropped from> > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to > > > 1.88 in> > > > > > > Oct.> > > > > > > > > and now 1.58. ENDO believes these changes are directly > > > tied to> > > > > > > blood> > > > > > > > > pressure fluctuations. Increase being caused by drop in> > > > > pressure> > > > > > > > > when kidneys were used to years of the high pressure. And> > > > > current> > > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > > this is> > > > > > > > > the case as ther was concern from PCP that we were > > > seeing some> > > > > > > signs> > > > > > > > > of renal failure.> > > > > > > >> > > > > > >> > > > > > >> > > > > > >> > > > > >> > > > >> > > > >> > > > >> > > >> > >> > >> > >> >>

[Guest guest]

Dr GrimMy doctor hasn't mentioned dashing, although I have told him I am following the DASH diet. My BP is the lowest it's been - within a very healthy range, while still on 100mg spiro per day. He was quite surprised that I had the BP results on only 100mg.Does the work you are doing correlate the information between dashing and the need for Spiro in Conn's sufferers?Many thanks SueFrom: Clarence Grim <lowerbp2@...>hyperaldosteronism Sent: Sun, 29 November, 2009 10:59:46 AMSubject: Re: Re: HA suspected and testing

Let your Dr know you are DASHing as you may see a fast fall in BP and need to back of other Rx.CE Grim MDOn Nov 27, 2009, at 8:34 AM, dbonogofsky wrote:Thank you. Sounds as if I'm fighting at least 2 situations-- PA and possibly metabolic syndrome. Will be DASHing starting today. Will corresponding BP results be noticeable quickly or will they manifest itself over time ? I'm back onto the Spirno, Norvasc and Chlorthalidone and average BP is running 135/77 for the past 4 days. > > > > > > > > >> > > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 > > days> > > > > > ago now> > > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking > > this> > > > > > may be> > > > > > > > due> > > > > > > > > > to discontinuation of Spiro recently in prep for > > tomorrows> > > > > > saline> > > > > > > > > > suppression test, although

its only been 5 days > > since such> > > > > > > > > > discontinuance. Not sure if K level would drop that> > > > quickly in> > > > > > > > this> > > > > > > > > > short of a time frame. Received prescription for K> > > > supplement> > > > > > > > 20MEQ> > > > > > > > > > ER twice a day. ENDO is reasonably confident that test> > > > will> > > > > > > > confirm> > > > > > > > > > PA and surgery will likely be highly beneficial in> > > > reducing> > > > > > BP to> > > > > > > > > > near normal levels, with at most a minimum of> > > > medications.

I> > > > > > > > suspect> > > > > > > > > > that shortly after testing I will again go back on > > spiro> > > > at> > > > > > prior> > > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until > > decision> > > > on> > > > > > > > surgery> > > > > > > > > > is made. I'll start working on DASHing to see if it > > will> > > > lower> > > > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > > > >> > > > > > > > > > Side note that

creatinine results are also changing---> > > > > > dropped from> > > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to> > > > 1.88 in> > > > > > > > Oct.> > > > > > > > > > and now 1.58. ENDO believes these changes are directly> > > > tied to> > > > > > > > blood> > > > > > > > > > pressure fluctuations. Increase being caused by drop > > in> > > > > > pressure> > > > > > > > > > when kidneys were used to years of the high > > pressure. And> > > > > > current> > > > > > > > > > decrease due to

stabilization at lower pressure. > > Hopefully> > > > > > this is> > > > > > > > > > the case as ther was concern from PCP that we were> > > > seeing some> > > > > > > > signs> > > > > > > > > > of renal failure.> > > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > >> > > > > > >> > > > > >> > > > > >> > > > > >> > > > >> > > >> > > >> > > >> > >> >> >> >>

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Yes that is one of the major findings from our group if u look in our files DASH SUCCESS STORIES. Remind your dr that for Aldo to have a BP or kaluretic effect there MUST be high salt intake. I wouldRecommend discussing stepping down spiro to lowestDoseNeeded to keep BP at goal and I would be happy with a BP at home of just < 135/85 Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Dec 1, 2009, at 3:53 PM, marysue hopper <marysuehopper@...> wrote:

Dr GrimMy doctor hasn't mentioned dashing, although I have told him I am following the DASH diet. My BP is the lowest it's been - within a very healthy range, while still on 100mg spiro per day. He was quite surprised that I had the BP results on only 100mg.Does the work you are doing correlate the information between dashing and the need for Spiro in Conn's sufferers?Many thanks SueFrom: Clarence Grim <lowerbp2mac>hyperaldosteronism Sent: Sun, 29 November, 2009 10:59:46 AMSubject: Re: Re: HA suspected and testing

Let your Dr know you are DASHing as you may see a fast fall in BP and need to back of other Rx.CE Grim MDOn Nov 27, 2009, at 8:34 AM, dbonogofsky wrote:Thank you. Sounds as if I'm fighting at least 2 situations-- PA and possibly metabolic syndrome. Will be DASHing starting today. Will corresponding BP results be noticeable quickly or will they manifest itself over time ? I'm back onto the Spirno, Norvasc and Chlorthalidone and average BP is running 135/77 for the past 4 days. > > > > > > > > >> > > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 > > days> > > > > > ago now> > > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking > > this> > > > > > may be> > > > > > > > due> > > > > > > > > > to discontinuation of Spiro recently in prep for > > tomorrows> > > > > > saline> > > > > > > > > > suppression test, although

its only been 5 days > > since such> > > > > > > > > > discontinuance. Not sure if K level would drop that> > > > quickly in> > > > > > > > this> > > > > > > > > > short of a time frame. Received prescription for K> > > > supplement> > > > > > > > 20MEQ> > > > > > > > > > ER twice a day. ENDO is reasonably confident that test> > > > will> > > > > > > > confirm> > > > > > > > > > PA and surgery will likely be highly beneficial in> > > > reducing> > > > > > BP to> > > > > > > > > > near normal levels, with at most a minimum of> > > > medications.

I> > > > > > > > suspect> > > > > > > > > > that shortly after testing I will again go back on > > spiro> > > > at> > > > > > prior> > > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until > > decision> > > > on> > > > > > > > surgery> > > > > > > > > > is made. I'll start working on DASHing to see if it > > will> > > > lower> > > > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > > > >> > > > > > > > > > Side note that

creatinine results are also changing---> > > > > > dropped from> > > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to> > > > 1.88 in> > > > > > > > Oct.> > > > > > > > > > and now 1.58. ENDO believes these changes are directly> > > > tied to> > > > > > > > blood> > > > > > > > > > pressure fluctuations. Increase being caused by drop > > in> > > > > > pressure> > > > > > > > > > when kidneys were used to years of the high > > pressure. And> > > > > > current> > > > > > > > > > decrease due to

stabilization at lower pressure. > > Hopefully> > > > > > this is> > > > > > > > > > the case as ther was concern from PCP that we were> > > > seeing some> > > > > > > > signs> > > > > > > > > > of renal failure.> > > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > >> > > > > > >> > > > > >> > > > > >> > > > > >> > > > >> > > >> > > >> > > >> > >> >> >> >>

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Depends on where they sent it and if the numbers were too high or too low they would then need to test the blood again. And last week was holidays.When you get results be sure to get their normal values and send to us.CE GrimMDOn Dec 3, 2009, at 7:28 PM, dbonogofsky wrote:Amazing. It wil be exactly 2 weeks tomorrow since I had the 4 hour infusion saline suppression test and doctor's office claims they don't have results yet ? Something seems wrong here. How long should it take to have results of such a test ? I would have thought 3-4 days to be reasonable. > >> > > > > > > > > >> >> > > > > > > > > > > Thank you. Appreciate your advice. Blood work > >> from 2> >> > > days> >> > > > > > > ago now> >> > > > > > > > > > > shows K at 4.0; down from 5.7. However, I'm > >> thinking> >> > > this> >> > > > > > > may be> >> > > > > > > > > due> >> > > > > > > > > > > to discontinuation of Spiro recently in prep for> >> > > tomorrows> >> > > > > > > saline> >> > > > > > > > > > > suppression test, although its only been 5 days> >> > > since such> >> > > > > > > > > > > discontinuance. Not sure if K level would drop > >> that> >> > > > > quickly in> >> > > > > > > > > this> >> > > > > > > > > > > short of a time frame. Received prescription > >> for K> >> > > > > supplement> >> > > > > > > > > 20MEQ> >> > > > > > > > > > > ER twice a day. ENDO is reasonably confident > >> that test> >> > > > > will> >> > > > > > > > > confirm> >> > > > > > > > > > > PA and surgery will likely be highly beneficial > >> in> >> > > > > reducing> >> > > > > > > BP to> >> > > > > > > > > > > near normal levels, with at most a minimum of> >> > > > > medications. I> >> > > > > > > > > suspect> >> > > > > > > > > > > that shortly after testing I will again go back > >> on> >> > > spiro> >> > > > > at> >> > > > > > > prior> >> > > > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until> >> > > decision> >> > > > > on> >> > > > > > > > > surgery> >> > > > > > > > > > > is made. I'll start working on DASHing to see > >> if it> >> > > will> >> > > > > lower> >> > > > > > > > > > > needed doseage of the spiro as you suggest.> >> > > > > > > > > > >> >> > > > > > > > > > > Side note that creatinine results are also > >> changing---> >> > > > > > > dropped from> >> > > > > > > > > > > high of 2.22 in Sept. (after BP decreased on > >> spiro) to> >> > > > > 1.88 in> >> > > > > > > > > Oct.> >> > > > > > > > > > > and now 1.58. ENDO believes these changes are > >> directly> >> > > > > tied to> >> > > > > > > > > blood> >> > > > > > > > > > > pressure fluctuations. Increase being caused by > >> drop> >> > > in> >> > > > > > > pressure> >> > > > > > > > > > > when kidneys were used to years of the high> >> > > pressure. And> >> > > > > > > current> >> > > > > > > > > > > decrease due to stabilization at lower pressure.> >> > > Hopefully> >> > > > > > > this is> >> > > > > > > > > > > the case as ther was concern from PCP that we > >> were> >> > > > > seeing some> >> > > > > > > > > signs> >> > > > > > > > > > > of renal failure.> >> > > > > > > > > >> >> > > > > > > > >> >> > > > > > > > >> >> > > > > > > > >> >> > > > > > > >> >> > > > > > >> >> > > > > > >> >> > > > > > >> >> > > > > >> >> > > > >> >> > > > >> >> > > > >> >> > > >> >> > >> >> > >> >> > >> >> >> >>> >>> >> >> > Need mail bonding? Bring all your contacts to Xtra with > > TrueSwitch> >>

[Guest guest]

Probably depends on where you

are.

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of dbonogofsky

Amazing. It wil be exactly 2 weeks tomorrow since I had the

4 hour infusion saline suppression test and doctor's office claims they don't

have results yet ? Something seems wrong here. How long should it take to have

results of such a test ? I would have thought 3-4 days to be reasonable.

[Guest guest]

It is disappointing when we think we have an answer to our problem thinking there is a light at the end of the tunnel of less or no more meds. I thought I would be tested further for PA because of my test results but cardiologist doesn't think so. We just have to hang in there and keep positive. In my book faith and prayer has blessed me a lot. I hope they send you to someone that can help you further. DanaSent from my Verizon Wireless BlackBerryFrom: "dbonogofsky" <dbonogofsky@...>Date: Sun, 06 Dec 2009 02:20:59 -0000<hyperaldosteronism >Subject: Re: HA suspected and testing Disappointing results. ENDO says only 2 of the 3 blood tests during saline suppression test came out. And if that wasn't enough, those 2 don't definitively indicate PA. He still thinks I have an " active " tumor on the adrenal based on the past CTs, low K and good drop in BP while on the spiro. But he can't recommend surgery based on these test results. Mentioned possibility of going to a university hospital in the Chicago area but didn't say where or for what purpose. I assume he is starting to feel overwhelmed, for lack of a better term. Wonderful doctor, but wonder how often he has seen and treated PA. We are supposed to talk again at he beginning of the week. I suppose I should be happy that the blood pressure is down after 20 years, but was thinking that maybe I was on track to potentially eliminating or reducing it permanently with little or no medication. Wonder what the next steps will be>> Probably depends on where you are.> > Val> > From: hyperaldosteronism > [mailto:hyperaldosteronism ] On Behalf Of dbonogofsky> > > Amazing. It wil be exactly 2 weeks tomorrow since I had the 4 hour infusion> saline suppression test and doctor's office claims they don't have results> yet ? Something seems wrong here. How long should it take to have results of> such a test ? I would have thought 3-4 days to be reasonable.>

[Guest guest]

Next test is adrenal venous sampling.

Bindner

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From: dbonogofsky <dbonogofsky@...>Subject: Re: HA suspected and testinghyperaldosteronism Date: Saturday, December 5, 2009, 9:20 PM

Disappointing results. ENDO says only 2 of the 3 blood tests during saline suppression test came out. And if that wasn't enough, those 2 don't definitively indicate PA. He still thinks I have an "active" tumor on the adrenal based on the past CTs, low K and good drop in BP while on the spiro. But he can't recommend surgery based on these test results. Mentioned possibility of going to a university hospital in the Chicago area but didn't say where or for what purpose. I assume he is starting to feel overwhelmed, for lack of a better term. Wonderful doctor, but wonder how often he has seen and treated PA. We are supposed to talk again at he beginning of the week. I suppose I should be happy that the blood pressure is down after 20 years, but was thinking that maybe I was on track to potentially eliminating or reducing it permanently with little or no medication. Wonder what the next steps will be>> Probably depends on where you are.> > Val> > From: hyperaldosteronism> [mailto:hyperaldosteronism] On Behalf Of dbonogofsky> > > Amazing. It wil be exactly 2 weeks tomorrow since I had the 4 hour infusion> saline suppression test and doctor's

office claims they don't have results> yet ? Something seems wrong here. How long should it take to have results of> such a test ? I would have thought 3-4 days to be reasonable.>

[Guest guest]

Find yourself an endocrinologist. PA is not something most cardios know about.

Bindner

Web Directory (links to my sites and blogs):

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

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From: cowdoc@... <cowdoc@...>Subject: Re: Re: HA suspected and testinghyperaldosteronism Date: Saturday, December 5, 2009, 9:46 PM

It is disappointing when we think we have an answer to our problem thinking there is a light at the end of the tunnel of less or no more meds. I thought I would be tested further for PA because of my test results but cardiologist doesn't think so. We just have to hang in there and keep positive.. In my book faith and prayer has blessed me a lot. I hope they send you to someone that can help you further. Dana

Sent from my Verizon Wireless BlackBerry

From: "dbonogofsky" <dbonogofsky>

Date: Sun, 06 Dec 2009 02:20:59 -0000

<hyperaldosteronism>

Subject: [hyperaldosteronism ] Re: HA suspected and testing

Disappointing results. ENDO says only 2 of the 3 blood tests during saline suppression test came out. And if that wasn't enough, those 2 don't definitively indicate PA. He still thinks I have an "active" tumor on the adrenal based on the past CTs, low K and good drop in BP while on the spiro. But he can't recommend surgery based on these test results. Mentioned possibility of going to a university hospital in the Chicago area but didn't say where or for what purpose. I assume he is starting to feel overwhelmed, for lack of a better term. Wonderful doctor, but wonder how often he has seen and treated PA. We are supposed to talk again at he beginning of the week. I suppose I should be happy that the blood pressure is down after 20 years, but was thinking that maybe I was on track to potentially eliminating or reducing it permanently with little or no medication. Wonder what the next steps will be>> Probably depends on where you are.> > Val> > From: hyperaldosteronism> [mailto:hyperaldosteronism] On Behalf Of dbonogofsky> > > Amazing. It wil be exactly 2 weeks tomorrow since I had the 4 hour infusion> saline suppression test and doctor's

office claims they don't have results> yet ? Something seems wrong here. How long should it take to have results of> such a test ? I would have thought 3-4 days to be reasonable.>

[Guest guest]

please send us all results(and normal values for lab) so we can help him and you. You may want to go to the NIH site for free testing and treatment. M Binder has done this.On Dec 5, 2009, at 8:20 PM, dbonogofsky wrote:Disappointing results. ENDO says only 2 of the 3 blood tests during saline suppression test came out. And if that wasn't enough, those 2 don't definitively indicate PA. He still thinks I have an "active" tumor on the adrenal based on the past CTs, low K and good drop in BP while on the spiro. But he can't recommend surgery based on these test results. Mentioned possibility of going to a university hospital in the Chicago area but didn't say where or for what purpose. I assume he is starting to feel overwhelmed, for lack of a better term. Wonderful doctor, but wonder how often he has seen and treated PA. We are supposed to talk again at he beginning of the week. I suppose I should be happy that the blood pressure is down after 20 years, but was thinking that maybe I was on track to potentially eliminating or reducing it permanently with little or no medication. Wonder what the next steps will be>> Probably depends on where you are.> > Val> > From: hyperaldosteronism > [mailto:hyperaldosteronism ] On Behalf Of dbonogofsky> > > Amazing. It wil be exactly 2 weeks tomorrow since I had the 4 hour infusion> saline suppression test and doctor's office claims they don't have results> yet ? Something seems wrong here. How long should it take to have results of> such a test ? I would have thought 3-4 days to be reasonable.>

[Guest guest]

If doing OK I would stay on Spiro and DASH.CE Grim mdOn Dec 6, 2009, at 6:47 AM, Bindner wrote:Next test is adrenal venous sampling. Bindner Web Directory (links to my sites and blogs):http://www.geocities.com/mikeybdc/index.htmlhttp://mikeybdc.blogspot.com --- On Sat, 12/5/09, dbonogofsky <dbonogofsky > wrote:From: dbonogofsky <dbonogofsky >Subject: Re: HA suspected and testinghyperaldosteronism Date: Saturday, December 5, 2009, 9:20 PM Disappointing results. ENDO says only 2 of the 3 blood tests during saline suppression test came out. And if that wasn't enough, those 2 don't definitively indicate PA. He still thinks I have an "active" tumor on the adrenal based on the past CTs, low K and good drop in BP while on the spiro. But he can't recommend surgery based on these test results. Mentioned possibility of going to a university hospital in the Chicago area but didn't say where or for what purpose. I assume he is starting to feel overwhelmed, for lack of a better term. Wonderful doctor, but wonder how often he has seen and treated PA. We are supposed to talk again at he beginning of the week. I suppose I should be happy that the blood pressure is down after 20 years, but was thinking that maybe I was on track to potentially eliminating or reducing it permanently with little or no medication. Wonder what the next steps will be>> Probably depends on where you are.> > Val> > From: hyperaldosteronism> [mailto:hyperaldosteronism] On Behalf Of dbonogofsky> > > Amazing. It wil be exactly 2 weeks tomorrow since I had the 4 hour infusion> saline suppression test and doctor's office claims they don't have results> yet ? Something seems wrong here. How long should it take to have results of> such a test ? I would have thought 3-4 days to be reasonable.>

[Guest guest]

Or let us teach your CARDS and you.CE Grim MDOn Dec 6, 2009, at 6:48 AM, Bindner wrote:Find yourself an endocrinologist. PA is not something most cardios know about. Bindner Web Directory (links to my sites and blogs):http://www.geocities.com/mikeybdc/index.htmlhttp://mikeybdc.blogspot.com --- On Sat, 12/5/09, cowdocsbcglobal (DOT) net <cowdocsbcglobal (DOT) net> wrote:From: cowdocsbcglobal (DOT) net <cowdocsbcglobal (DOT) net>Subject: Re: Re: HA suspected and testinghyperaldosteronism Date: Saturday, December 5, 2009, 9:46 PM It is disappointing when we think we have an answer to our problem thinking there is a light at the end of the tunnel of less or no more meds. I thought I would be tested further for PA because of my test results but cardiologist doesn't think so. We just have to hang in there and keep positive.. In my book faith and prayer has blessed me a lot. I hope they send you to someone that can help you further. DanaSent from my Verizon Wireless BlackBerryFrom: "dbonogofsky" <dbonogofsky>Date: Sun, 06 Dec 2009 02:20:59 -0000<hyperaldosteronism>Subject: [hyperaldosteronism ] Re: HA suspected and testing Disappointing results. ENDO says only 2 of the 3 blood tests during saline suppression test came out. And if that wasn't enough, those 2 don't definitively indicate PA. He still thinks I have an "active" tumor on the adrenal based on the past CTs, low K and good drop in BP while on the spiro. But he can't recommend surgery based on these test results. Mentioned possibility of going to a university hospital in the Chicago area but didn't say where or for what purpose. I assume he is starting to feel overwhelmed, for lack of a better term. Wonderful doctor, but wonder how often he has seen and treated PA. We are supposed to talk again at he beginning of the week. I suppose I should be happy that the blood pressure is down after 20 years, but was thinking that maybe I was on track to potentially eliminating or reducing it permanently with little or no medication. Wonder what the next steps will be>> Probably depends on where you are.> > Val> > From: hyperaldosteronism> [mailto:hyperaldosteronism] On Behalf Of dbonogofsky> > > Amazing. It wil be exactly 2 weeks tomorrow since I had the 4 hour infusion> saline suppression test and doctor's office claims they don't have results> yet ? Something seems wrong here. How long should it take to have results of> such a test ? I would have thought 3-4 days to be reasonable.>

[Guest guest]

What you first want to do is to find out how low you can go on Spiro to see if breast tenderness stops or to ask Endo to change to Inspra (eplerenone) usually at twice the dose of spiro.Don't forget that the best way to minimize the need for BP drug (and side effects) is to do the Low Sodium DASH to the max. CE Grim MDOn Dec 6, 2009, at 1:45 PM, dbonogofsky wrote:Thanks everyone for the responses and words of encouragement. Yes, I'm disappointed that the test results were not definitive and I don't yet have a diagnosis, but I remain hopeful nonetheless. Really don't have much of an option. The 125 mg of spiro with the chlorthalidone and norvasc have made a big improvement in my BP. Averaging about 128/74. Only bothersome side effect is tenderness and enlargment of breasts. I will be discussing the matter further with the ENDO tomorrow and will ask for the test results and lab normal values so I can post them. Will also discuss the possibility of AVS, although I suspect the ENDO will be hesitant to go that route based on the saline suppression results. I suppose as a last resort I can try the NIH also. Thanks much for the link ! > >> > Probably depends on where you are.> > > > Val> > > > From: hyperaldosteronism > > [mailto:hyperaldosteronism ] On Behalf Of dbonogofsky> > > > > > Amazing. It wil be exactly 2 weeks tomorrow since I had the 4 hour infusion> > saline suppression test and doctor's office claims they don't have results> > yet ? Something seems wrong here. How long should it take to have results of> > such a test ? I would have thought 3-4 days to be reasonable.> >>

[Guest guest]

They have been told it is so rare you may never see one so dont look.CE Grim MDOn Dec 7, 2009, at 11:55 AM, Francis Bill wrote:All doctors can read There is a lot of information about how to do the tests for PA. If I can find it with very limited knowledge then why can't doctors find it. I am sure cardiologist get a lot of training about PA as in causes heart related problems. Endocrinologist should be well trained as well but many of them don't understant PA. Nephrology should have training in PA as well. I have seen that Urology should know about PA.The question is why do they all miss the PA training? > > >> > > Probably depends on where you are.> > >> > > Val> > >> > > From: hyperaldosteronism> > > [mailto:hyperaldosteronism] On Behalf Of > > dbonogofsky> > >> > >> > > Amazing. It wil be exactly 2 weeks tomorrow since I had the 4 hour > > infusion> > > saline suppression test and doctor's office claims they don't have > > results> > > yet ? Something seems wrong here. How long should it take to have > > results of> > > such a test ? I would have thought 3-4 days to be reasonable.> > >> >> >> >>