Re: Symptoms and Thanks

January 11, 2012

That ER report below.....was your K low at that ER visit? (IF they even drew it right as I garauntee they slapped a tourniquet on you and probably drew blood with an IV....MAYBE??)

From: Valarie <val@...>Subject: RE: Re: Symptoms and Thankshyperaldosteronism Date: Wednesday, January 11, 2012, 2:56 PM

I have Lyme + PA, the PA likely caused by Lyme deregulating my endocrine system. There are groups who will help or even pay for your testing but it will take a Lyme-literate physician to order the correct testing. I spent thousands and thousands of dollars getting the wrong testing. If you're interested in more information about available help, write back.

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PA

The though that I could have Lyme is in the back of my mind. The Dr Young in the video is about 3/4 hours from me. Where they have support group is 1 1/2 hours from me. With limited income I would have a hard time paying out of pocket for testing and treatment. So would have to be sure it is Lyme and not PA that I have. > >> > What u want is a trial of Spiro to see if it helps BP K AND you. Most> important you. Only u can tell them u are not feeling well. No one else can> measure that. So give

us a review of how you do not feel well zoned can help> get it organized.

January 11, 2012

You are right about the IV nures note IV inserted .

Location : LEFT ARM

Size : 20

I am a hard stick most of the time it takes at least three trys before they and

in the ane in the right spot. Never had blood drawn with out having tourniquet

on.

POTASSIUM : 3.7

ED Dr read

EKG : SR, no acute St or T wave changes

Cardiology Fellow/MOD read

EKG with LVH and nonspecific ST/T changes

What it on the EKG report

Normal sinus rhythm

Leftward axis

Incomplete right bundle branch block

Left ventricular hypertrophy

Nonspecific ST and T wave abnormalty

This is the only EKG that has all this listed both before and after. Am told all

EKGS and stress test since this one have been normal.

: pt

> > >

> > > What u want is a trial of Spiro to see if it helps BP K AND you. Most

> > important you. Only u can tell them u are not feeling well. No one else can

> > measure that. So give us a review of how you do not feel well zoned can help

> > get it organized.

>

January 11, 2012

You are right about the IV nures note IV inserted .

Location : LEFT ARM

Size : 20

I am a hard stick most of the time it takes at least three trys before they and

in the ane in the right spot. Never had blood drawn with out having tourniquet

on.

POTASSIUM : 3.7

ED Dr read

EKG : SR, no acute St or T wave changes

Cardiology Fellow/MOD read

EKG with LVH and nonspecific ST/T changes

What it on the EKG report

Normal sinus rhythm

Leftward axis

Incomplete right bundle branch block

Left ventricular hypertrophy

Nonspecific ST and T wave abnormalty

This is the only EKG that has all this listed both before and after. Am told all

EKGS and stress test since this one have been normal.

: pt

> > >

> > > What u want is a trial of Spiro to see if it helps BP K AND you. Most

> > important you. Only u can tell them u are not feeling well. No one else can

> > measure that. So give us a review of how you do not feel well zoned can help

> > get it organized.

>

January 11, 2012

Hard to remember your SX and meds w/o a thumbnail but I seem to remember

something about gout. Probably can rule out the second SX but you will have to

asses 1 & 3. Suggest you go to uptodate.com and check out some of the

referenced studies to see what might apply. I think I saw items you have

talked about and it may give you specifics to discuss with your doctors.

The major conditions associated with symptomatic hypophosphatemia are chronic

alcoholism, intravenous hyperalimentation without phosphate, and the chronic

ingestion of antacids. The alcoholic patient is prone to severe

hypophosphatemia, particularly when admitted to the hospital. (See " Causes of

hypophosphatemia " and " Hypophosphatemia in the alcoholic patient " .)

Source:

http://www.uptodate.com/contents/signs-and-symptoms-of-hypophosphatemia?source=s\

ee_link

HYPOPHOSPHATEMIA

Prolonged, high-dose antacid therapy can markedly reduce phosphate absorption in

normal subjects, potentially leading to severe and symptomatic hypophosphatemia

[5]. This problem is currently infrequent, because of the preferential use of

H2-blockers to treat acid peptic disease.

Source:

http://www.uptodate.com/contents/electrolyte-complications-of-antacid-therapy?so\

urce=search_result & search=phosphate & selectedTitle=104%7E150

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C

Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > > > > > > > > > > > >> > >> > According to your analyses and

symptoms, it

> > > > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > > > >> have the same Conn's that most of us

have. Start to

> > > > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and

if you are not

> > > > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small

dosage. If your BP

> > > > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > > > >> with this medication, that's it!

Don't wait 6

> > > > > > > > > > > > months

> > > > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > > > >> appointment and some more years until

you are going

> > > > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including

myself, are still

> > > > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F

with 2 cm left

> > > > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg

Micardis,

> > > > > > > > > > > > 2000

> > > > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam;

Dashing; still

> > > > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na

when over-

> > > > > > > > > > > > salt

> > > > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

________________________________

> > > > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012

1:45 PM

> > > > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all

that responded.

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

> > > > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for

new sudden

> > > > > > > > > > > > onset

> > > > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat

intolerance, weakness,

> > > > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional

swings. I am a

> > > > > > > > > > > > 58 yo

> > > > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is

small Pineal

> > > > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with

synthesis for

> > > > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 11, 2012

I have posted about gout but never had it. My Sx are listed in this posting.

Have read all this about hypophosphatemia. And I do not drink nor use antacids.

BST in the VA was doing it job here Thay should at least be asking me this

information. They just don't say any thing about this. When I ask am told it

doesn't mean much. Maybe there are right.

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

> > > > > > > > > > > > > > > > > > > > > >> > >> > According to your analyses

and symptoms, it

> > > > > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > > > > >> have the same Conn's that most of

us have. Start to

> > > > > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and

if you are not

> > > > > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small

dosage. If your BP

> > > > > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > > > > >> with this medication, that's it!

Don't wait 6

> > > > > > > > > > > > > months

> > > > > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > > > > >> appointment and some more years

until you are going

> > > > > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including

myself, are still

> > > > > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > > > > >> after several years and many

doctors.

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

> > > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F

with 2 cm left

> > > > > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80

mg Micardis,

> > > > > > > > > > > > > 2000

> > > > > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam;

Dashing; still

> > > > > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > > > > >> occasional problems with BP, K and

Na when over-

> > > > > > > > > > > > > salt

> > > > > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > > > > >> on private consultation with Dr

Grim.

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

________________________________

> > > > > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2,

2012 1:45 PM

> > > > > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all

that responded.

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

> > > > > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo

for new sudden

> > > > > > > > > > > > > onset

> > > > > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat

intolerance, weakness,

> > > > > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional

swings. I am a

> > > > > > > > > > > > > 58 yo

> > > > > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx

is small Pineal

> > > > > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled

with synthesis for

> > > > > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 11, 2012

From information in files related to false K value. The hemolysis rate is

inversely proportional to the diameter of the needle or catheter, with the

highest hemolysis rates in 24- to 20-gauge catheters.

> > > >

> > > > What u want is a trial of Spiro to see if it helps BP K AND you. Most

> > > important you. Only u can tell them u are not feeling well. No one else

can

> > > measure that. So give us a review of how you do not feel well zoned can

help

> > > get it organized.

> >

>

January 11, 2012

Is renal artery the same as kidney artery? They checked my kidney artery. I don't have stenosis of it, at least.I also suspect that I have both Primary and secondary, since my cortisol originally was high and since Micardis works for me, what is unusual for Primary.Dr. Grim, what do you think?Many thanks, NataliaFrom: Francis Bill SUSPECTED PA

<georgewbill@...> hyperaldosteronism Sent: Monday, January 9, 2012 8:11 AM Subject: Re: Symptoms and Thanks

Isn't renin of 74.16 very high? If someone is diabetic and has somewhat high cholesterol at more as risk of having renal artery stenosis? With Renin this high isn't it more likely that DX would be secondary hyperaldosteronism? I do know she could have both Primary and secondary as she says she has adrenal tumor.

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

> > > >> > > > > > > > > > >> Did I answer your question, ?

> > > >> > > > > > > > > > >> In the time when I had this visit to my

> > PCP I already subscribed

> > > >> > > > > > > > > > >> to this group and learned about spiro and

> > eplerenone, but I didn't

> > > >> > > > > > > > > > >> communicate either with group or with Dr.

> > Grim yet. I started

> > > >> > > > > > > > > > >> eplerenone without any proof and hope,

> > just out of desperation,

> > > >> > > > > > > > > > >> since my BP and my condition were killing

> > me and EVERY BB, Calcium

> > > >> > > > > > > > > > >> channel, and other made me feel terrible.

> > No mention that clonidine

> > > >> > > > > > > > > > >> almost killed me.

> > > >> > > > > > > > > > >> After the first day on eplerenone, my BP

> > was 130/80 - I do not

> > > >> > > > > > > > > > >> remember that I ever had this BP in my life.

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

> > > >> > > > > > > > > > >> Natalia

> > > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@>

> > > >> > > > > > > > > > >> "hyperaldosteronism " <hyperaldosteronism

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

> > > >

> > >

> >

>

January 11, 2012

>She he low renins before.True. My original renin was 0.1. >I recall this was when she was adItted when dehydrated. False. The blood test was done in October 5, 2011, when I was home, Dashing and on 100 eplerenone, feeling more or less okay, no dehydration and nothing special. NataliaFrom: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Monday, January 9, 2012 9:18 AM Subject: Re: Re: Symptoms and Thanks

She he low renins before. I recall this was when she was adItted when dehydrated. This can cause high renin as both tKicks adrenal to make more aldo to hold onto salt to repair dehydreationMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 9, 2012, at 6:11, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

Isn't renin of 74.16 very high? If someone is diabetic and has somewhat high cholesterol at more as risk of having renal artery stenosis? With Renin this high isn't it more likely that DX would be secondary hyperaldosteronism? I do know she could have both Primary and secondary as she says she has adrenal tumor.

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

> > > >> > > > > > > > > > >> Did I answer your question, ?

> > > >> > > > > > > > > > >> In the time when I had this visit to my

> > PCP I already subscribed

> > > >> > > > > > > > > > >> to this group and learned about spiro and

> > eplerenone, but I didn't

> > > >> > > > > > > > > > >> communicate either with group or with Dr.

> > Grim yet. I started

> > > >> > > > > > > > > > >> eplerenone without any proof and hope,

> > just out of desperation,

> > > >> > > > > > > > > > >> since my BP and my condition were killing

> > me and EVERY BB, Calcium

> > > >> > > > > > > > > > >> channel, and other made me feel terrible.

> > No mention that clonidine

> > > >> > > > > > > > > > >> almost killed me.

> > > >> > > > > > > > > > >> After the first day on eplerenone, my BP

> > was 130/80 - I do not

> > > >> > > > > > > > > > >> remember that I ever had this BP in my life.

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

> > > >> > > > > > > > > > >> Natalia

> > > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@>

> > > >> > > > > > > > > > >> "hyperaldosteronism " <hyperaldosteronism

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

> > > >

> > >

> >

>

January 11, 2012

How did they check kidney artery? I believe they are both the the same

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

> > > > >> > > > > > > > > > >> Did I answer your question, ?

> > > > >> > > > > > > > > > >> In the time when I had this visit to my

> > > PCP I already subscribed

> > > > >> > > > > > > > > > >> to this group and learned about spiro and

> > > eplerenone, but I didn't

> > > > >> > > > > > > > > > >> communicate either with group or with Dr.

> > > Grim yet. I started

> > > > >> > > > > > > > > > >> eplerenone without any proof and hope,

> > > just out of desperation,

> > > > >> > > > > > > > > > >> since my BP and my condition were killing

> > > me and EVERY BB, Calcium

> > > > >> > > > > > > > > > >> channel, and other made me feel terrible.

> > > No mention that clonidine

> > > > >> > > > > > > > > > >> almost killed me.

> > > > >> > > > > > > > > > >> After the first day on eplerenone, my BP

> > > was 130/80 - I do not

> > > > >> > > > > > > > > > >> remember that I ever had this BP in my life.

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

> > > > >> > > > > > > > > > >> Natalia

> > > > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@>

> > > > >> > > > > > > > > > >> " hyperaldosteronism "

<hyperaldosteronism

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

> > > > >

> > > >

> > >

> >

>

January 11, 2012

Guess that is what I get for going on a " wild goose chase " and won't attempt it

again! I appear to have you confused with someone else.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C

Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > > > > > > > > > > > > > >> > >> > According to your analyses

and symptoms, it

> > > > > > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > > > > > >> have the same Conn's that most of

us have. Start to

> > > > > > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better

and if you are not

> > > > > > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small

dosage. If your BP

> > > > > > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > > > > > >> with this medication, that's it!

Don't wait 6

> > > > > > > > > > > > > > months

> > > > > > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > > > > > >> appointment and some more years

until you are going

> > > > > > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including

myself, are still

> > > > > > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > > > > > >> after several years and many

doctors.

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

> > > > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian

F with 2 cm left

> > > > > > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone,

80 mg Micardis,

> > > > > > > > > > > > > > 2000

> > > > > > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg

Lorazepam; Dashing; still

> > > > > > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > > > > > >> occasional problems with BP, K

and Na when over-

> > > > > > > > > > > > > > salt

> > > > > > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > > > > > >> on private consultation with Dr

Grim.

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

________________________________

> > > > > > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2,

2012 1:45 PM

> > > > > > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to

all that responded.

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

> > > > > > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo

for new sudden

> > > > > > > > > > > > > > onset

> > > > > > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat

intolerance, weakness,

> > > > > > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional

swings. I am a

> > > > > > > > > > > > > > 58 yo

> > > > > > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > > > > > >> firefighter. Only other medical

Hx is small Pineal

> > > > > > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled

with synthesis for

> > > > > > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 11, 2012

Bet that 3.7 was clearly a false high because many of your symptoms sound like low K. Even moderately low they would likely ingore it.

From: Francis Bill SUSPECTED PA <georgewbill@...>Subject: Re: Symptoms and Thankshyperaldosteronism Date: Wednesday, January 11, 2012, 7:28 PM

From information in files related to false K value. The hemolysis rate is inversely proportional to the diameter of the needle or catheter, with the highest hemolysis rates in 24- to 20-gauge catheters. > > > >> > > > What u want is a trial of Spiro to see if it helps BP K AND you.

Most> > > important you. Only u can tell them u are not feeling well. No one else can> > > measure that. So give us a review of how you do not feel well zoned can help> > > get it organized.> >>

January 11, 2012

I believe that it was X-ray. It was done in a hospital in September 2010. It was the first thing that they were suspected, because my BP was stable around 220/140. They told me to be prepared to a stent installed. Next day they said, it's okay, look instead for a good hypertension specialist. I don't think that I have stenosis, Francis. I think in this case eplerenone would be useless. Don't you think so? When I don't oversalt eplerenone, I feel mostly okay. NataliaFrom: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Wednesday, January 11, 2012 7:36 PM Subject: Re: Symptoms and Thanks

How did they check kidney artery? I believe they are both the the same

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

> > > > >> > > > > > > > > > >> Did I answer your question, ?

> > > > >> > > > > > > > > > >> In the time when I had this visit to my

> > > PCP I already subscribed

> > > > >> > > > > > > > > > >> to this group and learned about spiro and

> > > eplerenone, but I didn't

> > > > >> > > > > > > > > > >> communicate either with group or with Dr.

> > > Grim yet. I started

> > > > >> > > > > > > > > > >> eplerenone without any proof and hope,

> > > just out of desperation,

> > > > >> > > > > > > > > > >> since my BP and my condition were killing

> > > me and EVERY BB, Calcium

> > > > >> > > > > > > > > > >> channel, and other made me feel terrible.

> > > No mention that clonidine

> > > > >> > > > > > > > > > >> almost killed me.

> > > > >> > > > > > > > > > >> After the first day on eplerenone, my BP

> > > was 130/80 - I do not

> > > > >> > > > > > > > > > >> remember that I ever had this BP in my life.

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

> > > > >> > > > > > > > > > >> Natalia

> > > > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@>

> > > > >> > > > > > > > > > >> "hyperaldosteronism " <hyperaldosteronism

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

> > > > >

> > > >

> > >

> >

>

January 11, 2012

Have also read that if EKG shows ST and T wave abnormalty It can be from low K

> > > > >

> > > > > What u want is a trial of Spiro to see if it helps BP K AND you. Most

> > > > important you. Only u can tell them u are not feeling well. No one else

can

> > > > measure that. So give us a review of how you do not feel well zoned can

help

> > > > get it organized.

> > >

> >

>

January 11, 2012

They must have used a dye if they thought they might put a stent in. Due you

have a copy of that report.

Eplerenone will work if you have stenosis. Stenosis causes you to have high

Aldo.

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

> > > > > >> > > > > > > > > > >> Did I answer your question, ?

> > > > > >> > > > > > > > > > >> In the time when I had this visit to my

> > > > PCP I already subscribed

> > > > > >> > > > > > > > > > >> to this group and learned about spiro and

> > > > eplerenone, but I didn't

> > > > > >> > > > > > > > > > >> communicate either with group or with Dr.

> > > > Grim yet. I started

> > > > > >> > > > > > > > > > >> eplerenone without any proof and hope,

> > > > just out of desperation,

> > > > > >> > > > > > > > > > >> since my BP and my condition were killing

> > > > me and EVERY BB, Calcium

> > > > > >> > > > > > > > > > >> channel, and other made me feel terrible.

> > > > No mention that clonidine

> > > > > >> > > > > > > > > > >> almost killed me.

> > > > > >> > > > > > > > > > >> After the first day on eplerenone, my BP

> > > > was 130/80 - I do not

> > > > > >> > > > > > > > > > >> remember that I ever had this BP in my life.

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

> > > > > >> > > > > > > > > > >> Natalia

> > > > > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@>

> > > > > >> > > > > > > > > > >> " hyperaldosteronism "

<hyperaldosteronism

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

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 11, 2012

Sorry DASHing and eplere will kick the renin and aldo up. We dont have normal values to make judgements tho. When we used to give Lasix and a low sodium diet for one day even PAs had an increase in renin and aldo but it was not normal. See my CV for some references. CE Grim MDOn Jan 11, 2012, at 5:35 PM, Natalia Kamneva wrote: >She he low renins before.True. My original renin was 0.1. >I recall this was when she was adItted when dehydrated. False. The blood test was done in October 5, 2011, when I was home, Dashing and on 100 eplerenone, feeling more or less okay, no dehydration and nothing special. NataliaFrom: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Monday, January 9, 2012 9:18 AM Subject: Re: Re: Symptoms and Thanks She he low renins before. I recall this was when she was adItted when dehydrated. This can cause high renin as both tKicks adrenal to make more aldo to hold onto salt to repair dehydreationMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 9, 2012, at 6:11, Francis Bill SUSPECTED PA <georgewbill@...> wrote: Isn't renin of 74.16 very high? If someone is diabetic and has somewhat high cholesterol at more as risk of having renal artery stenosis? With Renin this high isn't it more likely that DX would be secondary hyperaldosteronism? I do know she could have both Primary and secondary as she says she has adrenal tumor. > > > >> > > > > > > > > > >> > > > >> > > > > > > > > > >> > > > >> > > > > > > > > > >> Did I answer your question, ? > > > >> > > > > > > > > > >> In the time when I had this visit to my > > PCP I already subscribed > > > >> > > > > > > > > > >> to this group and learned about spiro and > > eplerenone, but I didn't > > > >> > > > > > > > > > >> communicate either with group or with Dr. > > Grim yet. I started > > > >> > > > > > > > > > >> eplerenone without any proof and hope, > > just out of desperation, > > > >> > > > > > > > > > >> since my BP and my condition were killing > > me and EVERY BB, Calcium > > > >> > > > > > > > > > >> channel, and other made me feel terrible. > > No mention that clonidine > > > >> > > > > > > > > > >> almost killed me. > > > >> > > > > > > > > > >> After the first day on eplerenone, my BP > > was 130/80 - I do not > > > >> > > > > > > > > > >> remember that I ever had this BP in my life. > > > >> > > > > > > > > > >> > > > >> > > > > > > > > > >> Natalia > > > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@> > > > >> > > > > > > > > > >> "hyperaldosteronism " <hyperaldosteronism > > > >> > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > >

January 11, 2012

Never seen a case of both in same pt. Well I may have seen one but did not recognize it.CE Grim MDOn Jan 11, 2012, at 5:36 PM, Francis Bill SUSPECTED PA wrote: How did they check kidney artery? I believe they are both the the same > > > > >> > > > > > > > > > >> > > > > >> > > > > > > > > > >> > > > > >> > > > > > > > > > >> Did I answer your question, ? > > > > >> > > > > > > > > > >> In the time when I had this visit to my > > > PCP I already subscribed > > > > >> > > > > > > > > > >> to this group and learned about spiro and > > > eplerenone, but I didn't > > > > >> > > > > > > > > > >> communicate either with group or with Dr. > > > Grim yet. I started > > > > >> > > > > > > > > > >> eplerenone without any proof and hope, > > > just out of desperation, > > > > >> > > > > > > > > > >> since my BP and my condition were killing > > > me and EVERY BB, Calcium > > > > >> > > > > > > > > > >> channel, and other made me feel terrible. > > > No mention that clonidine > > > > >> > > > > > > > > > >> almost killed me. > > > > >> > > > > > > > > > >> After the first day on eplerenone, my BP > > > was 130/80 - I do not > > > > >> > > > > > > > > > >> remember that I ever had this BP in my life. > > > > >> > > > > > > > > > >> > > > > >> > > > > > > > > > >> Natalia > > > > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@> > > > > >> > > > > > > > > > >> "hyperaldosteronism " <hyperaldosteronism > > > > >> > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > >

January 12, 2012

We are already there :-) From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Tuesday, January 10, 2012 6:26 PM Subject: Re: Symptoms and Thanks

The something else can be old age.

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

> > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > >> > >> > ÃƒÆ’Ã¢â‚¬Å¡

> > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin,

> > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some

> > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt eplerenone ;

> > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > > > >> > >> > ÃƒÆ’Ã¢â‚¬Å¡

> > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 12, 2012

This is true. Still hopefuly we have a few more years left.

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

> > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it

seems that you

> > > > > > > > > > > > >> have the same Conn's that most of us have. Start to

Dash

> > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

afraid, try

> > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

behaves better

> > > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months

until your

> > > > > > > > > > > > >> appointment and some more years until you are going

to be

> > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still

undiagnosed

> > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > >> > >> > ÃƒÆ'Ã¢â‚¬Å¡

> > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

adrenal adenoma,

> > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000

mg metformin,

> > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still

have some

> > > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt

eplerenone ;

> > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > > > >> > >> > Subject: Symptoms and

Thanks

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

> > > > > > > > > > > > >> > >> > ÃƒÆ'Ã¢â‚¬Å¡

> > > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset

hypertension,

> > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia,

> > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo

male, retired

> > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal

gland tumor and

> > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for

past 20 years.

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 12, 2012

Max, could you please, to resend the graph? Now somehow I cannot find your posting in this topic. Sorry. Natalia From: StudyCircle <studycircle@...> hyperaldosteronism Sent: Tuesday, January 10, 2012 8:00 PM Subject: RE: Re: Symptoms and Thanks

Natalia, Click on ORIGINAL and see the graph in original size you can see all the text. Max. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia KamnevaSent: 2012-Jan-10 18:31hyperaldosteronism Subject: Re: Re: Symptoms and Thanks Max, Could you, please, tell max-min on vertical ax? Cannot see them. Natalia From: Clarence Grim <lowerbp2@...>"hyperaldosteronism " <hyperaldosteronism > Sent: Sunday, January 8, 2012 2:12 AMSubject: Re: Re: Symptoms and Thanks What caused the big drop do u think. CT?Recommend you give him a copy of the Hypertension Primer to get him up to speed. May your pressure be low! CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 7, 2012, at 18:30, StudyCircle <studycircle@...> wrote: Thanks Dr. Grim for

this info. When I noticed my GFR was improving and discussed it with my doc he rejected the possibility although I was showing him my GFR chart (attached). Max.62M L adenoma by NP59 scan. Aldos=1065â€¦2056 [28-860]

pmol/L, Renin=6 [<30] ng/L. med combo #76={Spiro=100, Amlo=2x5mg, Indap=2.5mg, Ramip=2x2.5mg, Metf=2x500mg, Crestor=20mg, Feno=67mg, K.Cl=6x20mEq, Motilium 3x10mg}{K=4.4}{not DASHing but low-salt diet just slightly above craving while keeping K/Na ratio constant, heat intolerance, insulin resistance} A fall in eGFR with epeler or any other drug that lowers BP may well be the result of lowering the perfusion pressure to a damaged glomerlus (kidney). If the damage was due to the HTN or high salt/aldo then we expect it to improve over time. This has been documented over 40 years ago with older BP meds. So the issue is does the Dr. have enough experience to wait this out and see if renal function improves. If not, and low diet Na is documented by urine testing if pt has PA, then may want to choose another BP med. And watch eGFR as well with it. CE Grim. On Jan 7, 2012, at 10:41 AM, wrote:

January 12, 2012

It is in Attachments Folder at link:

hyperaldosteronism/attachments/folder/0/lis\

t

Max.

> >Â

> Â

>

January 12, 2012

, I am not switching from epler to spiro. I followed your research very accurately and I am aware of all side-effects of spiro. But then the discussion on my condition raised some questions about side-effects of epler. Particulary, why my kidneys don't function normally anymore and why my renin is so high and folks said that it's probable that epler has some bad sideffects still unknown. That's why I made a decision to continue on epler (don't know for how long) and see if my kidneys' function behave. That's what Dr. Grim also recommends. As for your pointer to this study, I didn't understand anything:-)

Do you mean that's okay to take lorazepam or it's not? I am trying to tapper it off and take it in a daytime only if my BP going up very much, but I almost cannot sleep without it, so I take it at night time. Thank you very much and sorry for my long Russian-English sentences. NataliaFrom: <jclark24p@...> hyperaldosteronism Sent: Tuesday, January 10, 2012 8:57 PM Subject: Re: Symptoms and Thanks

Natalia, remind me why you are switching from epler to spiro. If you have been following my research lately, I don't know of anything in spiro that you need. In fact, IMHO, there may be things you don't need! I particularily zeroed in on the lorazepam which appears to potentially be affected by cortisol. Cortisol appears to be affected by spironolactone. Cymbalta appears to be similarily affected and I will be discussing it with my doctors tomorrow. (I have not researched elpereone so I do not know if there is a similr issue.)

I did a quick look/see and found one study that might show you some of what is going on. (I admit I don't have the knowledge and education to understand most of it but that is why I refer it to my doctors!) I didn't have much time to research tonight becuse I need to update info for my appt. tomorrow, sorry.)

Here is a summary of the trial: (BTW, you are on double the dose they tested.)

Source:

http://www.nature.com/npp/journal/v29/n3/full/1300365a.html

Interdose Elevation in Plasma Cortisol During Chronic Treatment with Alprazolam but not Lorazepam in the Elderly

Nunzio Pomara1,2, M Willoughby1, C Ritchie3, J Sidtis1,2, J Greenblatt4 and B Nemeroff5

1Geriatric Psychiatry Program, S Kline Institute for Psychiatric Research, Orangeburg, NY, USA

2Department of Psychiatry, New York University School of Medicine, New York, NY, USA

3Department of Pathology, Emory School of Medicine, Atlanta, GA, USA

4Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine Boston, MA, USA

5Department of Psychiatry, Emory School of Medicine, Atlanta, GA, USA

Correspondence: N Pomara, Geriatric Psychiatry Program, S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Bldg. 35, Orangeburg, NY 10962, USA. Tel: +845 398 5579; Fax:+845 398 5575; E-mail: pomara@...

Summary

Neither the low alprazolam nor the high and low lorazepam dose had any significant effect on plasma cortisol either acutely or during chronic treatment. The reductions in plasma cortisol that have been reported in response to acute doses of these compounds have involved higher doses than those employed in the current study. For instance, Loach and Fisher (1975) reported that 1.5 mg of lorazepam attenuated cortisol response to presurgical stress and, more recently, Collomp et al (1994) reported a similar effect of a 2 mg lorazepam dose on the cortisol response to exercise. The lack of a significant cortisol response to lorazepam in the present report may well be due to the low doses used. Additionally, although anxiolytic activity of a 1.0 mg lorazepam dose is generally thought to be equivalent to 0.50 mg alprazolam (Ashton, 1994), only the latter resulted in reduced plasma cortisol levels. Thus, it is possible that nonequivalence of doses, or differences

in potency, and/or in their intrinsic pharmacological effects in geriatric subjects might have contributed to these observations.

In summary, our results suggest that chronic treatment with alprazolam, but not lorazepam, is associated with plasma cortisol elevations prior to the first morning dose. This increase may reflect an early stage of drug withdrawal. At the same time, a tolerance for cognitive toxicity appears to develop. Since alprazolam and lorazepam remain widely prescribed BZPs and are often taken for months or years, especially in the elderly, it is of potential clinical significance to confirm the differential effects on interdose cortisol levels and HPA axis activation. This may lead to a better understanding of factors that may contribute to an increased risk for drug escalation and dependence during chronic treatments with these compounds.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> >> > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you

> >> > > > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> >> > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> >> > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> >> > > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your

> >> > > > > > > > > > > > >> appointment and some more years until you are going to be

> >> > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> >> > > > > > > > > > > > >> after several years and many doctors.

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

> >> > > > > > > > > > > > >> > >> > ÃƒÆ’Ã¢â‚¬Å¡

> >> > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> >> > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin,

> >> > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some

> >> > > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt eplerenone ;

> >> > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> >> > > > > > > > > > > > >> > >> > ________________________________

> >> > > > > > > > > > > > >> > >> > From: lff_409 <.>

> >> > > > > > > > > > > > >> > >> > To:

> >> > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> >> > > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> >> > > > > > > > > > > > >> > >> > ÃƒÆ’Ã¢â‚¬Å¡

> >> > > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> >> > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> >> > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> >> > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> >> > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> >> > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

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

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

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

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

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

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

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

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

> >> > > > > > > > >

> >> > > > > > > >

> >> > > > > > >

> >> > > > > >

> >> > > > >

> >> > > >

> >> > >

> >> >

> >>

> >

>

January 12, 2012

From your posting (see below the whole thing):>A fall in eGFR with epeler or any other drug that lowers BP may well be the result of lowering the >perfusion pressure to a damaged glomerlus (kidney). If the damage was due to the HTN or high >salt/aldo then we expect it to improve over time... If not, and low diet Na is documented by urine >testing if pt has PA, then may want to choose another BP med.> Not sure what u mean. If doing well I would not change. Yes, I feel much better on epler, but my eGFR is low and other kidneys function tests are not good. So, for how long should I experiment with epler before changing it to spiro? No other medications are considered be me at all. Many thanks, Natalia From: Clarence Grim <lowerbp2@...> To:

"hyperaldosteronism " <hyperaldosteronism > Sent: Wednesday, January 11, 2012 12:47 AM Subject: Re: Re: Symptoms and Thanks

Not sure what u mean. If doing well I would not change. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 10, 2012, at 16:28, Natalia Kamneva <natalia_kamneva@...> wrote:

Who long do you recommend to wait on epler until switching it to sipro, Dr. Grim? Natalia From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc:

Clarence Grim <lowerbp2@...> Sent: Saturday, January 7, 2012 1:18 PM Subject: Re: Re: Symptoms

and Thanks

A fall in eGFR with epeler or any other drug that lowers BP may well be the result of lowering the perfusion pressure to a damaged glomerlus (kidney). If the damage was due to the HTN or high salt/aldo then we expect it to improve over time. This has been documented over 40 years ago with older BP meds. So the issue is does the Dr. have enough experience to wait this out and see if renal function improves. If not, and low diet Na is documented by urine testing if pt has PA, then may want to choose another BP med. And watch eGFR as well with it.CE Grim. On Jan 7, 2012, at 10:41 AM, wrote: I pointed out sodium because it appears to be trending down BUT I don't

know what else was going; diarrhea, too much beer or water, etc. Probably easier to review yourself at: http://www.diagnose-me.com/cond/C549291.html If I had to guess I might think your doctor is looking for a larger database to determine if changes are needed. When did you start Epler? - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you > > > > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try > > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better > > > > > > > > > > > > >>

with this medication, that's it! Don't wait 6 months until your > > > > > > > > > > > > >> appointment and some more years until you are going to be > > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed > > > > > > > > > > > > >> after several years and many doctors. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > Ãƒâ€š > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, > > > > > >

> > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some > > > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt eplerenone ; > > > > > > > > > > > > >> on private consultation with Dr Grim. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > ________________________________ > > > > > > > > > > > > >> > >> > From: lff_409 <.> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> >

Sent: Monday, January 2, 2012 1:45 PM > > > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > Ãƒâ€š > > > > > > > > > > > > >> > >> > First of all, thanks to all that responded. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension, > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia, > > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired > > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and > > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >

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

January 12, 2012

Thanks a lot. But what? :-) NataliaFrom: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Wednesday, January 11, 2012 12:47 AM Subject: Re: Re: Symptoms and Thanks

Not a renin tumor. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 10, 2012, at 17:23, Natalia Kamneva <natalia_kamneva@...> wrote:

So, in my case it might be low Na intake + epler ? It also might be renin secreting tumor, but how likely it's if my renin was 0.1 before starting epler? Tumor was there before. Natalia From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Saturday, January 7, 2012 1:28 PM Subject: Re: Re: Symptoms and Thanks

low Na intake, BP lowering drugs, renin secreting tumor, estrogens, pregnancy, rare syndromes like Bartter's but low BP. On Jan 6, 2012, at 10:31 PM, wrote: Dr. Grim, what causes the high renin? 74.16 (0.25-5.82) - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > >> > > > > > > > > > >> > >> > > > > > > > > > >> > >> > > > > > > > > > >> Did I answer your question, ? > >> > > > > > > > > > >> In the time when I had this visit to my PCP I already subscribed > >> > > > > > > > > > >> to this group and learned about spiro and eplerenone, but I didn't > >> > > > > > > > > > >> communicate either with group or with Dr. Grim yet. I started > >> > > > > > > > > > >> eplerenone without any proof and hope, just out of desperation, > >> >

> > > > > > > > >> since my BP and my condition were killing me and EVERY BB, Calcium > >> > > > > > > > > > >> channel, and other made me feel terrible. No mention that clonidine > >> > > > > > > > > > >> almost killed me. > >> > > > > > > > > > >> After the first day on eplerenone, my BP was 130/80 - I do not > >> > > > > > > > > > >> remember that I ever had this BP in my life. > >> > > > > > > > > > >> > >> > > > > > > > > > >> Natalia > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@> > >> > > > > > > > > > >> "hyperaldosteronism " <hyperaldosteronism > >> > > > > > > > > > >> > > > > > > >

January 12, 2012

Francis,I wonder how long will it take to us to convince you to try spiro :-) Natalia From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Wednesday, January 11, 2012 6:51 PM Subject:

Re: Symptoms and Thanks

You are right about the IV nures note IV inserted .

Location : LEFT ARM

Size : 20

I am a hard stick most of the time it takes at least three trys before they and in the ane in the right spot. Never had blood drawn with out having tourniquet on.

POTASSIUM : 3.7

ED Dr read

EKG : SR, no acute St or T wave changes

Cardiology Fellow/MOD read

EKG with LVH and nonspecific ST/T changes

What it on the EKG report

Normal sinus rhythm

Leftward axis

Incomplete right bundle branch block

Left ventricular hypertrophy

Nonspecific ST and T wave abnormalty

This is the only EKG that has all this listed both before and after. Am told all EKGS and stress test since this one have been normal.

: pt

> > >

> > > What u want is a trial of Spiro to see if it helps BP K AND you. Most

> > important you. Only u can tell them u are not feeling well. No one else can

> > measure that. So give us a review of how you do not feel well zoned can help

> > get it organized.

>

January 12, 2012

>They must have used a dye if they thought they might put a stent in. Due you have a copy of that report. That's what I found in a medical discharge report: " Renal ultrasonogram was obtained, which showed no evidence of renal artery stenosis."> Eplerenone will work if you have stenosis. Stenosis causes you to have high Aldo.The paradox is that my aldo was 1.9 ng/dL in the time. Now, when I am for 1 year on epler it's 66 ng/dL. Still think that it might be renal stenosis?

Natalia From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Wednesday, January 11, 2012 8:32 PM Subject: Re: Symptoms and Thanks

They must have used a dye if they thought they might put a stent in. Due you have a copy of that report.

Eplerenone will work if you have stenosis. Stenosis causes you to have high Aldo.

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

> > > > > >> > > > > > > > > > >> Did I answer your question, ?

> > > > > >> > > > > > > > > > >> In the time when I had this visit to my

> > > > PCP I already subscribed

> > > > > >> > > > > > > > > > >> to this group and learned about spiro and

> > > > eplerenone, but I didn't

> > > > > >> > > > > > > > > > >> communicate either with group or with Dr.

> > > > Grim yet. I started

> > > > > >> > > > > > > > > > >> eplerenone without any proof and hope,

> > > > just out of desperation,

> > > > > >> > > > > > > > > > >> since my BP and my condition were killing

> > > > me and EVERY BB, Calcium

> > > > > >> > > > > > > > > > >> channel, and other made me feel terrible.

> > > > No mention that clonidine

> > > > > >> > > > > > > > > > >> almost killed me.

> > > > > >> > > > > > > > > > >> After the first day on eplerenone, my BP

> > > > was 130/80 - I do not

> > > > > >> > > > > > > > > > >> remember that I ever had this BP in my life.

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

> > > > > >> > > > > > > > > > >> Natalia

> > > > > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@>

> > > > > >> > > > > > > > > > >> "hyperaldosteronism " <hyperaldosteronism

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

> > > > > >

> > > > >

> > > >

> > >

> >

>

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