Re: filing complaints with medical board

[Guest guest]

You know, more of us should do this. I just found out how simple it is: for

anyone in California, the form can be found here:

http://mbc.ca.gov/consumer/complaint_info.html

I've often thought of pursuing a lawsuit myself (for those unfamiliar with my

story, my last primary care doc dismissed my PA as " typical middle-aged woman

problems " and while it prompted me to change docs and get a diagnosis and

everything ended well, I've long felt that the same doctor might wreck yet

another middle-aged woman's life with his ignorance).

-msmith1928

Successful left laparoscopic adrenalectomy 10/13/11

> > > > >> >

> > > > >> > > Question regarding avs testing. I had an adenoma on my left

> > > > >> gland removed Feb 2nd. Potassium has since returned to normal range

> > > > >> 5.0 actually. BP remains on the high side, around 160/105. I never

> > > > >> was offered AVS test. Having severe bouts with anxiety,

> > > > >> irritability, like PMS times 10, most of the time! My family is fed

> > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone over

> > > > >> production? I have endo appt. March 1st. I've requested aldo renin

> > > > >> tests again. Anything else I should ask the Endo? Still taking hctz

> > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and

> > > > >> Atenolol 50 mg.

> > > > >> > > Thanks guys

> > > > >> > >

> > > > >> >

> > > > >>

> > > > >

> > > > >

> > > > >

> > > > >

> > > >

> > >

> > >

> > >

> > >

> > > TODAY(Beta) • Powered by

> > > Horse rescued from sinking mud

> > > It took three hours for emergency workers to finally free 18-year-old

Astro.

> > > Privacy Policy

> >

>

[Guest guest]

Until you teach him otherwise you are correct. I would at least send him a copy of my evolution paper. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 7:45, msmith_1928 <janeray1940@...> wrote:

You know, more of us should do this. I just found out how simple it is: for anyone in California, the form can be found here:

http://mbc.ca.gov/consumer/complaint_info.html

I've often thought of pursuing a lawsuit myself (for those unfamiliar with my story, my last primary care doc dismissed my PA as "typical middle-aged woman problems" and while it prompted me to change docs and get a diagnosis and everything ended well, I've long felt that the same doctor might wreck yet another middle-aged woman's life with his ignorance).

-msmith1928

Successful left laparoscopic adrenalectomy 10/13/11

> > > > >> >

> > > > >> > > Question regarding avs testing. I had an adenoma on my left

> > > > >> gland removed Feb 2nd. Potassium has since returned to normal range

> > > > >> 5.0 actually. BP remains on the high side, around 160/105. I never

> > > > >> was offered AVS test. Having severe bouts with anxiety,

> > > > >> irritability, like PMS times 10, most of the time! My family is fed

> > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone over

> > > > >> production? I have endo appt. March 1st. I've requested aldo renin

> > > > >> tests again. Anything else I should ask the Endo? Still taking hctz

> > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and

> > > > >> Atenolol 50 mg.

> > > > >> > > Thanks guys

> > > > >> > >

> > > > >> >

> > > > >>

> > > > >

> > > > >

> > > > >

> > > > >

> > > >

> > >

> > >

> > >

> > >

> > > TODAY(Beta) • Powered by

> > > Horse rescued from sinking mud

> > > It took three hours for emergency workers to finally free 18-year-old Astro.

> > > Privacy Policy

> >

>

[Guest guest]

I did send him a copy, the day I was first diagnosed! Also sent one to the head

of his medical group, along with an explanation of how the doctor in question

was negligent. I never heard back from the doctor, and only got a cursory " we'll

look into it " form letter from the medical group head.

Every other doctor who saw me and failed to diagnose my PA has received a copy

of your paper as well. Funny how none of them responded

> > > > > > >> >

> > > > > > >> > > Question regarding avs testing. I had an adenoma on my left

> > > > > > >> gland removed Feb 2nd. Potassium has since returned to normal

range

> > > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I

never

> > > > > > >> was offered AVS test. Having severe bouts with anxiety,

> > > > > > >> irritability, like PMS times 10, most of the time! My family is

fed

> > > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone

over

> > > > > > >> production? I have endo appt. March 1st. I've requested aldo

renin

> > > > > > >> tests again. Anything else I should ask the Endo? Still taking

hctz

> > > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and

> > > > > > >> Atenolol 50 mg.

> > > > > > >> > > Thanks guys

> > > > > > >> > >

> > > > > > >> >

> > > > > > >>

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > > > > TODAY(Beta) • Powered by

> > > > > Horse rescued from sinking mud

> > > > > It took three hours for emergency workers to finally free 18-year-old

Astro.

> > > > > Privacy Policy

> > > >

> > >

> >

> >

>

[Guest guest]

I knew many of the people who had treated me (refilled my bp meds really) back in TX on a professional level thru the years, but I still sent them the paper of Dr Grims and gave it to the people here and actually talked to most of them or emailed them. I hope they are now looking for PA more often.

My NP I was seeing here in AZ responded well to my case after the fact (she didn't find it or dx it, but was understanding of it when cardiologist did find it) but then we've had some arguments about it since when she doesn't follow the guidelines and gets only a serum renin and aldosterone on patients (doesn't stop any other meds either) and then decides it's definitely NOT PA. I have suggested to her, because a couple of the patients have been self pay so they will not go to a specialist if we sent them, to go ahead and try a trial of spiro (these are pts already known to be resistant to multiple meds for HTN) but they will not do it. They say it's not that (PA) and start some other med - that still doesn't work! I still have not resolved everything I need to professionally to take these patients so my hands are a bit tied.

Just an example of something that I have been talking about, that even for me who I know can be very confident and opinionated myself, don't understand from them and what I've been discussing about getting someone - a doc - to lean the direction we want them too. No matter how confident or arrogant I can be or seem to be I don't completely disrespect someone elses ideas or opinions either (doesn't mean I am not willing to debate it either), and I am always open to finding that missing part I may have missed - for the patients sake. So I don't get it, for instance the resistance to the spiro thing, why a simple thing will not be done. If it was narcs, or something experimental or dangerous (spiro has side effects, some not pleasant, but nothing considered too dangerous) I would get it. But it's not.

I have had to start going to a new clinic because I now work at that one and had been a patient, with the NP above, who says she will do this and that (like some more blood tests etc), but then never does, and when I ask if they want me to make an appt they say no, but then don't do it, or refill my meds, and when I ask they seem to get perturbed. So it seems we deal with it on all levels.

I have no idea why, or what their (the other NP in the practice is brand new) deal is, but they will not do it with the trying spiro or doing the tests right. I gave them Dr G's papers also. They WILL start another med, but not spiro. I have zero idea why unless it is just that someone else suggested it so the ego says no way.

In some ways I find it funny how incredibly aggressive they are in regards to an initial BP med and cholesterol meds - which DO have a fairly dangerous profile, yet the PA and resistant HTN thing they won't do.

From: msmith_1928 <janeray1940@...>Subject: Re: filing complaints with medical boardhyperaldosteronism Date: Friday, March 2, 2012, 1:41 PM

I did send him a copy, the day I was first diagnosed! Also sent one to the head of his medical group, along with an explanation of how the doctor in question was negligent. I never heard back from the doctor, and only got a cursory "we'll look into it" form letter from the medical group head.Every other doctor who saw me and failed to diagnose my PA has received a copy of your paper as well. Funny how none of them responded > > > > > > >> >> > > > > > >> > > Question regarding avs testing. I had an adenoma on my left > > > > > > >> gland removed Feb 2nd. Potassium has since returned to normal range > > > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I never > > > > > > >> was offered AVS test. Having severe bouts with anxiety, > > > > > > >>

irritability, like PMS times 10, most of the time! My family is fed > > > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone over > > > > > > >> production? I have endo appt. March 1st. I've requested aldo renin > > > > > > >> tests again. Anything else I should ask the Endo? Still taking hctz > > > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and > > > > > > >> Atenolol 50 mg.> > > > > > >> > > Thanks guys> > > > > > >> > >> > > > > > >> >> > > > > > >>> > > > > > >> > > > > > >> > > > > > >> > > > > > >> > > > > >> >

> > > > > > > > > > > > > > > > > > > > > > > TODAY(Beta) • Powered by > > > > > Horse rescued from sinking mud> > > > > It took three hours for emergency workers to finally free 18-year-old Astro.> > > > > Privacy Policy> > > >> > >> > > >>

[Guest guest]

With luck they read it and Are doing a better job. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 11:41, msmith_1928 <janeray1940@...> wrote:

I did send him a copy, the day I was first diagnosed! Also sent one to the head of his medical group, along with an explanation of how the doctor in question was negligent. I never heard back from the doctor, and only got a cursory "we'll look into it" form letter from the medical group head.

Every other doctor who saw me and failed to diagnose my PA has received a copy of your paper as well. Funny how none of them responded

> > > > > > >> >

> > > > > > >> > > Question regarding avs testing. I had an adenoma on my left

> > > > > > >> gland removed Feb 2nd. Potassium has since returned to normal range

> > > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I never

> > > > > > >> was offered AVS test. Having severe bouts with anxiety,

> > > > > > >> irritability, like PMS times 10, most of the time! My family is fed

> > > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone over

> > > > > > >> production? I have endo appt. March 1st. I've requested aldo renin

> > > > > > >> tests again. Anything else I should ask the Endo? Still taking hctz

> > > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and

> > > > > > >> Atenolol 50 mg.

> > > > > > >> > > Thanks guys

> > > > > > >> > >

> > > > > > >> >

> > > > > > >>

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > > > > TODAY(Beta) • Powered by

> > > > > Horse rescued from sinking mud

> > > > > It took three hours for emergency workers to finally free 18-year-old Astro.

> > > > > Privacy Policy

> > > >

> > >

> >

> >

>

[Guest guest]

You might want to give them several of calhouns papers an the use of Spiro in drug resistant HTN. I think I refer to one if them in my article. If they won't use Spiro them recommend inspra whic is approved for HTN AND WORKS VERY WELL. ESP in low renin high Aldo HTN which is what IS THese forms of HTN DO NOT respond to BB OE ACES OR ARBS OR RENI INHIBITORS. Again clearly descussed in the title May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 15:30, Bingham <jlkbbk2003@...> wrote:

I knew many of the people who had treated me (refilled my bp meds really) back in TX on a professional level thru the years, but I still sent them the paper of Dr Grims and gave it to the people here and actually talked to most of them or emailed them. I hope they are now looking for PA more often.

My NP I was seeing here in AZ responded well to my case after the fact (she didn't find it or dx it, but was understanding of it when cardiologist did find it) but then we've had some arguments about it since when she doesn't follow the guidelines and gets only a serum renin and aldosterone on patients (doesn't stop any other meds either) and then decides it's definitely NOT PA. I have suggested to her, because a couple of the patients have been self pay so they will not go to a specialist if we sent them, to go ahead and try a trial of spiro (these are pts already known to be resistant to multiple meds for HTN) but they will not do it. They say it's not that (PA) and start some other med - that still doesn't work! I still have not resolved everything I need to professionally to take these patients so my hands are a bit tied.

Just an example of something that I have been talking about, that even for me who I know can be very confident and opinionated myself, don't understand from them and what I've been discussing about getting someone - a doc - to lean the direction we want them too. No matter how confident or arrogant I can be or seem to be I don't completely disrespect someone elses ideas or opinions either (doesn't mean I am not willing to debate it either), and I am always open to finding that missing part I may have missed - for the patients sake. So I don't get it, for instance the resistance to the spiro thing, why a simple thing will not be done. If it was narcs, or something experimental or dangerous (spiro has side effects, some not pleasant, but nothing considered too dangerous) I would get it. But it's not.

I have had to start going to a new clinic because I now work at that one and had been a patient, with the NP above, who says she will do this and that (like some more blood tests etc), but then never does, and when I ask if they want me to make an appt they say no, but then don't do it, or refill my meds, and when I ask they seem to get perturbed. So it seems we deal with it on all levels.

I have no idea why, or what their (the other NP in the practice is brand new) deal is, but they will not do it with the trying spiro or doing the tests right. I gave them Dr G's papers also. They WILL start another med, but not spiro. I have zero idea why unless it is just that someone else suggested it so the ego says no way.

In some ways I find it funny how incredibly aggressive they are in regards to an initial BP med and cholesterol meds - which DO have a fairly dangerous profile, yet the PA and resistant HTN thing they won't do.

From: msmith_1928 <janeray1940@...>Subject: Re: filing complaints with medical boardhyperaldosteronism Date: Friday, March 2, 2012, 1:41 PM

I did send him a copy, the day I was first diagnosed! Also sent one to the head of his medical group, along with an explanation of how the doctor in question was negligent. I never heard back from the doctor, and only got a cursory "we'll look into it" form letter from the medical group head.Every other doctor who saw me and failed to diagnose my PA has received a copy of your paper as well. Funny how none of them responded > > > > > > >> >> > > > > > >> > > Question regarding avs testing. I had an adenoma on my left > > > > > > >> gland removed Feb 2nd. Potassium has since returned to normal range > > > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I never > > > > > > >> was offered AVS test. Having severe bouts with anxiety, > > > > > > >>

irritability, like PMS times 10, most of the time! My family is fed > > > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone over > > > > > > >> production? I have endo appt. March 1st. I've requested aldo renin > > > > > > >> tests again. Anything else I should ask the Endo? Still taking hctz > > > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and > > > > > > >> Atenolol 50 mg.> > > > > > >> > > Thanks guys> > > > > > >> > >> > > > > > >> >> > > > > > >>> > > > > > >> > > > > > >> > > > > > >> > > > > > >> > > > > >> >

> > > > > > > > > > > > > > > > > > > > > > > TODAY(Beta) • Powered by > > > > > Horse rescued from sinking mud> > > > > It took three hours for emergency workers to finally free 18-year-old Astro.> > > > > Privacy Policy> > > >> > >> > > >>

[Guest guest]

, I can give you a couple reasons you might not want to try Spiro! (5 actually) Actually those can be watched for and taken care of with the correct monitoring and taking timely action but that is another story!

Take this to them and never mention PA, Conn's, Hyperaldosteronism, etc.

[PMID]:

14573330

[Au] Autor:

Nishizaka MK; Zaman MA; Calhoun DA

[Ad] Address:

Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, Alabama, USA. marikn@...

[Ti] Title:

Efficacy of low-dose spironolactone in subjects with resistant hypertension.

[so] Source:

Am J Hypertens;16(11 Pt 1):925-30, 2003 Nov.

[is] ISSN:

0895-7061

[Cp] Country of publication:

United States

[La] Language:

eng

[Ab] Abstract:

BACKGROUND: Previous reports have demonstrated the antihypertensive efficacy of high doses of spironolactone in subjects with primary aldosteronism and, to a lesser degree, subjects with resistant hypertension. METHODS: In current analysis, we examined the antihypertensive benefit of adding low-dose spironolactone to multidrug regimens that included a diuretic and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) in subjects with resistant hypertension with and without primary aldosteronism. Subjects referred for resistant hypertension were evaluated with an early morning plasma renin activity, 24-h urinary aldosterone and sodium during a high dietary salt ingestion. The diagnosis of primary aldosteronism was confirmed with a renin activity <1.0 ng/mL/h, urinary aldosterone >12 mug/24 h and urinary sodium >200 mEq/24 h. After biochemical evaluation, spironolactone (12.5 to 25 mg/d) was added to each subject's antihypertensive regimen. If blood pressure (BP) remained uncontrolled, the dose of spironolactone was titrated up to 50 mg/d. Follow-up BP was determined at 6 weeks, 3 months, and 6 months. RESULTS: A total number of 76 subjects were included in the analysis, 34 of whom had biochemical primary aldosteronism. Low-dose spironolactone was associated with an additional mean decrease in BP of 21 +/- 21/10 +/- 14 mm Hg at 6 weeks and 25 +/- 20/12 +/- 12 mm Hg at 6-month follow-up. The BP reduction was similar in subjects with and without primary aldosteronism and was additive to the use of ACE inhibitors, ARBs, and diuretics. CONCLUSIONS: We conclude that low-dose spironolactone provides significant additive BP reduction in African American and white subjects with resistant hypertension with and without primary aldosteronism.

If that doesn't hold water tell them to review the full article that referenced it:

http://www.scielo.br/scielo.php?script=sci_arttext & pid=S0066-782X2007000600009 & lng=en & nrm=iso & tlng=en

"Mechanisms and treatment of resistant hypertension"

Pimenta; A. Calhoun; Suzanne Oparil

Department of Hypertension and Nephrology, Instituto Dante Pazzanese de Cardiologia, Vascular Biology and Hypertension Program, University of Alabama at Birmingham - São o, SP - Brazil - Birmingham, AL - USA

If that doesn't wash have "S-T-U-P-I-D" tatooed on their forehead so othet PTNs will be forwarned! They need to learn to "Think outside the Box" until we get Low Renin HTN & PA moved inside the box where it belongs!

> > > > > > > >> >> > > > > > > >> > > Question regarding avs testing. I had an adenoma on my left > > > > > > > >> gland removed Feb 2nd. Potassium has since returned to normal range > > > > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I never > > > > > > > >> was offered AVS test. Having severe bouts with anxiety, > > > > > > > >> irritability, like PMS times 10, most of the time! My family is fed > > > > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone over > > > > > > > >> production? I have endo appt. March 1st. I've requested aldo renin > > > > > > > >> tests again. Anything else I should ask the Endo? Still taking hctz > > > > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and > > > > > > > >> Atenolol 50 mg.> > > > > > > >> > > Thanks guys> > > > > > > >> > >> > > > > > > >> >> > > > > > > >>> > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > >> > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > TODAY(Beta) • Powered by > > > > > > Horse rescued from sinking mud> > > > > > It took three hours for emergency workers to finally free 18-year-old Astro.> > > > > > Privacy Policy> > > > >> > > >> > > > > >> >>

[Guest guest]

More recent studies from Dr Calhoun's team has shown a powerful effect of a low sodium diet AKA DASH in these drug resistant HTN with borderline high Aldo. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 21:12, <jclark24p@...> wrote:

, I can give you a couple reasons you might not want to try Spiro! (5 actually) Actually those can be watched for and taken care of with the correct monitoring and taking timely action but that is another story!

Take this to them and never mention PA, Conn's, Hyperaldosteronism, etc.

[PMID]:

14573330

[Au] Autor:

Nishizaka MK; Zaman MA; Calhoun DA

[Ad] Address:

Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, Alabama, USA. marikn@...

[Ti] Title:

Efficacy of low-dose spironolactone in subjects with resistant hypertension.

[so] Source:

Am J Hypertens;16(11 Pt 1):925-30, 2003 Nov.

[is] ISSN:

0895-7061

[Cp] Country of publication:

United States

[La] Language:

eng

[Ab] Abstract:

BACKGROUND: Previous reports have demonstrated the antihypertensive efficacy of high doses of spironolactone in subjects with primary aldosteronism and, to a lesser degree, subjects with resistant hypertension. METHODS: In current analysis, we examined the antihypertensive benefit of adding low-dose spironolactone to multidrug regimens that included a diuretic and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) in subjects with resistant hypertension with and without primary aldosteronism. Subjects referred for resistant hypertension were evaluated with an early morning plasma renin activity, 24-h urinary aldosterone and sodium during a high dietary salt ingestion. The diagnosis of primary aldosteronism was confirmed with a renin activity <1.0 ng/mL/h, urinary aldosterone >12 mug/24 h and urinary sodium >200 mEq/24 h. After biochemical evaluation, spironolactone (12.5 to 25 mg/d) was added to each subject's antihypertensive regimen. If blood pressure (BP) remained uncontrolled, the dose of spironolactone was titrated up to 50 mg/d. Follow-up BP was determined at 6 weeks, 3 months, and 6 months. RESULTS: A total number of 76 subjects were included in the analysis, 34 of whom had biochemical primary aldosteronism. Low-dose spironolactone was associated with an additional mean decrease in BP of 21 +/- 21/10 +/- 14 mm Hg at 6 weeks and 25 +/- 20/12 +/- 12 mm Hg at 6-month follow-up. The BP reduction was similar in subjects with and without primary aldosteronism and was additive to the use of ACE inhibitors, ARBs, and diuretics. CONCLUSIONS: We conclude that low-dose spironolactone provides significant additive BP reduction in African American and white subjects with resistant hypertension with and without primary aldosteronism.

If that doesn't hold water tell them to review the full article that referenced it:

http://www.scielo.br/scielo.php?script=sci_arttext & pid=S0066-782X2007000600009 & lng=en & nrm=iso & tlng=en

"Mechanisms and treatment of resistant hypertension"

Pimenta; A. Calhoun; Suzanne Oparil

Department of Hypertension and Nephrology, Instituto Dante Pazzanese de Cardiologia, Vascular Biology and Hypertension Program, University of Alabama at Birmingham - São o, SP - Brazil - Birmingham, AL - USA

If that doesn't wash have "S-T-U-P-I-D" tatooed on their forehead so othet PTNs will be forwarned! They need to learn to "Think outside the Box" until we get Low Renin HTN & PA moved inside the box where it belongs!

> > > > > > > > > > > > > > > Sadly NOTHING gaurantees you will be listened to except an imminent > > > > > > > > lawsuit, but it can up your chances!> > > > > > > >> > > > > > > > No matter what many will not go over an entire list with you - so > > > > > > > > just a caution - so prioritize the top 3 things as they will have > > > > > > > > you discuss what is the most important. You may g

[Guest guest]

And to search pubmed for Spiro in drug resistant HTN. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 21:12, <jclark24p@...> wrote:

, I can give you a couple reasons you might not want to try Spiro! (5 actually) Actually those can be watched for and taken care of with the correct monitoring and taking timely action but that is another story!

Take this to them and never mention PA, Conn's, Hyperaldosteronism, etc.

[PMID]:

14573330

[Au] Autor:

Nishizaka MK; Zaman MA; Calhoun DA

[Ad] Address:

Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, Alabama, USA. marikn@...

[Ti] Title:

Efficacy of low-dose spironolactone in subjects with resistant hypertension.

[so] Source:

Am J Hypertens;16(11 Pt 1):925-30, 2003 Nov.

[is] ISSN:

0895-7061

[Cp] Country of publication:

United States

[La] Language:

eng

[Ab] Abstract:

BACKGROUND: Previous reports have demonstrated the antihypertensive efficacy of high doses of spironolactone in subjects with primary aldosteronism and, to a lesser degree, subjects with resistant hypertension. METHODS: In current analysis, we examined the antihypertensive benefit of adding low-dose spironolactone to multidrug regimens that included a diuretic and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) in subjects with resistant hypertension with and without primary aldosteronism. Subjects referred for resistant hypertension were evaluated with an early morning plasma renin activity, 24-h urinary aldosterone and sodium during a high dietary salt ingestion. The diagnosis of primary aldosteronism was confirmed with a renin activity <1.0 ng/mL/h, urinary aldosterone >12 mug/24 h and urinary sodium >200 mEq/24 h. After biochemical evaluation, spironolactone (12.5 to 25 mg/d) was added to each subject's antihypertensive regimen. If blood pressure (BP) remained uncontrolled, the dose of spironolactone was titrated up to 50 mg/d. Follow-up BP was determined at 6 weeks, 3 months, and 6 months. RESULTS: A total number of 76 subjects were included in the analysis, 34 of whom had biochemical primary aldosteronism. Low-dose spironolactone was associated with an additional mean decrease in BP of 21 +/- 21/10 +/- 14 mm Hg at 6 weeks and 25 +/- 20/12 +/- 12 mm Hg at 6-month follow-up. The BP reduction was similar in subjects with and without primary aldosteronism and was additive to the use of ACE inhibitors, ARBs, and diuretics. CONCLUSIONS: We conclude that low-dose spironolactone provides significant additive BP reduction in African American and white subjects with resistant hypertension with and without primary aldosteronism.

If that doesn't hold water tell them to review the full article that referenced it:

http://www.scielo.br/scielo.php?script=sci_arttext & pid=S0066-782X2007000600009 & lng=en & nrm=iso & tlng=en

"Mechanisms and treatment of resistant hypertension"

Pimenta; A. Calhoun; Suzanne Oparil

Department of Hypertension and Nephrology, Instituto Dante Pazzanese de Cardiologia, Vascular Biology and Hypertension Program, University of Alabama at Birmingham - São o, SP - Brazil - Birmingham, AL - USA

If that doesn't wash have "S-T-U-P-I-D" tatooed on their forehead so othet PTNs will be forwarned! They need to learn to "Think outside the Box" until we get Low Renin HTN & PA moved inside the box where it belongs!

> > > > > > > > > > > > > > > Sadly NOTHING gaurantees you will be listened to except an imminent > > > > > > > > lawsuit, but it can up your chances!> > > > > > > >> > > > > > > > No matter what many will not go over an entire list with you - so > > > > > > > > just a caution - so prioritize the top 3 things as they will have > > > > > > > > you discuss what is the most important. You may g

[Guest guest]

Also note the date of this pub. So it is not new info and anyone should know his ref by now who does HTN. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 21:12, <jclark24p@...> wrote:

, I can give you a couple reasons you might not want to try Spiro! (5 actually) Actually those can be watched for and taken care of with the correct monitoring and taking timely action but that is another story!

Take this to them and never mention PA, Conn's, Hyperaldosteronism, etc.

[PMID]:

14573330

[Au] Autor:

Nishizaka MK; Zaman MA; Calhoun DA

[Ad] Address:

Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, Alabama, USA. marikn@...

[Ti] Title:

Efficacy of low-dose spironolactone in subjects with resistant hypertension.

[so] Source:

Am J Hypertens;16(11 Pt 1):925-30, 2003 Nov.

[is] ISSN:

0895-7061

[Cp] Country of publication:

United States

[La] Language:

eng

[Ab] Abstract:

BACKGROUND: Previous reports have demonstrated the antihypertensive efficacy of high doses of spironolactone in subjects with primary aldosteronism and, to a lesser degree, subjects with resistant hypertension. METHODS: In current analysis, we examined the antihypertensive benefit of adding low-dose spironolactone to multidrug regimens that included a diuretic and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) in subjects with resistant hypertension with and without primary aldosteronism. Subjects referred for resistant hypertension were evaluated with an early morning plasma renin activity, 24-h urinary aldosterone and sodium during a high dietary salt ingestion. The diagnosis of primary aldosteronism was confirmed with a renin activity <1.0 ng/mL/h, urinary aldosterone >12 mug/24 h and urinary sodium >200 mEq/24 h. After biochemical evaluation, spironolactone (12.5 to 25 mg/d) was added to each subject's antihypertensive regimen. If blood pressure (BP) remained uncontrolled, the dose of spironolactone was titrated up to 50 mg/d. Follow-up BP was determined at 6 weeks, 3 months, and 6 months. RESULTS: A total number of 76 subjects were included in the analysis, 34 of whom had biochemical primary aldosteronism. Low-dose spironolactone was associated with an additional mean decrease in BP of 21 +/- 21/10 +/- 14 mm Hg at 6 weeks and 25 +/- 20/12 +/- 12 mm Hg at 6-month follow-up. The BP reduction was similar in subjects with and without primary aldosteronism and was additive to the use of ACE inhibitors, ARBs, and diuretics. CONCLUSIONS: We conclude that low-dose spironolactone provides significant additive BP reduction in African American and white subjects with resistant hypertension with and without primary aldosteronism.

If that doesn't hold water tell them to review the full article that referenced it:

http://www.scielo.br/scielo.php?script=sci_arttext & pid=S0066-782X2007000600009 & lng=en & nrm=iso & tlng=en

"Mechanisms and treatment of resistant hypertension"

Pimenta; A. Calhoun; Suzanne Oparil

Department of Hypertension and Nephrology, Instituto Dante Pazzanese de Cardiologia, Vascular Biology and Hypertension Program, University of Alabama at Birmingham - São o, SP - Brazil - Birmingham, AL - USA

If that doesn't wash have "S-T-U-P-I-D" tatooed on their forehead so othet PTNs will be forwarned! They need to learn to "Think outside the Box" until we get Low Renin HTN & PA moved inside the box where it belongs!

> > > > > > > >> >> > > > > > > >> > > Question regarding avs testing. I had an adenoma on my left > > > > > > > >> gland removed Feb 2nd. Potassium has since returned to normal range > > > > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I never > > > > > > > >> was offered AVS test. Having severe bouts with anxiety, > > > > > > > >> irritability, like PMS times 10, most of the time! My family is fed > > > > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone over > > > > > > > >> production? I have endo appt. March 1st. I've requested aldo renin > > > > > > > >> tests again. Anything else I should ask the Endo? Still taking hctz > > > > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and > > > > > > > >> Atenolol 50 mg.> > > > > > > >> > > Thanks guys> > > > > > > >> > >> > > > > > > >> >> > > > > > > >>> > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > >> > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > TODAY(Beta) • Powered by > > > > > > Horse rescued from sinking mud> > > > > > It took three hours for emergency workers to finally free 18-year-old Astro.> > > > > > Privacy Policy> > > > >> > > >> > > > > >> >>

[Guest guest]

The statute of limitation for medical malpractice is two years. FYI.

> > > > > >> >

> > > > > >> > > Question regarding avs testing. I had an adenoma on my left

> > > > > >> gland removed Feb 2nd. Potassium has since returned to normal range

> > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I never

> > > > > >> was offered AVS test. Having severe bouts with anxiety,

> > > > > >> irritability, like PMS times 10, most of the time! My family is fed

> > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone over

> > > > > >> production? I have endo appt. March 1st. I've requested aldo renin

> > > > > >> tests again. Anything else I should ask the Endo? Still taking hctz

> > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and

> > > > > >> Atenolol 50 mg.

> > > > > >> > > Thanks guys

> > > > > >> > >

> > > > > >> >

> > > > > >>

> > > > > >

> > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > > >

> > > >

> > > > TODAY(Beta) • Powered by

> > > > Horse rescued from sinking mud

> > > > It took three hours for emergency workers to finally free 18-year-old

Astro.

> > > > Privacy Policy

> > >

> >

>

[Guest guest]

The statute of limitation for medical malpractice is two years. FYI.

> > > > > >> >

> > > > > >> > > Question regarding avs testing. I had an adenoma on my left

> > > > > >> gland removed Feb 2nd. Potassium has since returned to normal range

> > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I never

> > > > > >> was offered AVS test. Having severe bouts with anxiety,

> > > > > >> irritability, like PMS times 10, most of the time! My family is fed

> > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone over

> > > > > >> production? I have endo appt. March 1st. I've requested aldo renin

> > > > > >> tests again. Anything else I should ask the Endo? Still taking hctz

> > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and

> > > > > >> Atenolol 50 mg.

> > > > > >> > > Thanks guys

> > > > > >> > >

> > > > > >> >

> > > > > >>

> > > > > >

> > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > > >

> > > >

> > > > TODAY(Beta) • Powered by

> > > > Horse rescued from sinking mud

> > > > It took three hours for emergency workers to finally free 18-year-old

Astro.

> > > > Privacy Policy

> > >

> >

>

[Guest guest]

The quick look I had at kaiser gave a 2mo timeframe for filing an internal

complaint. They certainly should have given you the treatment options, put you

on the correct meds before surgery and someone should have been monitoring after

surgery! They/you are lucky you didn't crash like some have! (The more I hear

about Kaiser, I'm not sure it will amount to much but at least it will be on

record. (Remember, I'm not a doctor or a lawyer!)

> > > > > > >> >

> > > > > > >> > > Question regarding avs testing. I had an adenoma on my left

> > > > > > >> gland removed Feb 2nd. Potassium has since returned to normal

range

> > > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I

never

> > > > > > >> was offered AVS test. Having severe bouts with anxiety,

> > > > > > >> irritability, like PMS times 10, most of the time! My family is

fed

> > > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone

over

> > > > > > >> production? I have endo appt. March 1st. I've requested aldo

renin

> > > > > > >> tests again. Anything else I should ask the Endo? Still taking

hctz

> > > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and

> > > > > > >> Atenolol 50 mg.

> > > > > > >> > > Thanks guys

> > > > > > >> > >

> > > > > > >> >

> > > > > > >>

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > > > > TODAY(Beta) • Powered by

> > > > > Horse rescued from sinking mud

> > > > > It took three hours for emergency workers to finally free 18-year-old

Astro.

> > > > > Privacy Policy

> > > >

> > >

> >

>

[Guest guest]

The quick look I had at kaiser gave a 2mo timeframe for filing an internal

complaint. They certainly should have given you the treatment options, put you

on the correct meds before surgery and someone should have been monitoring after

surgery! They/you are lucky you didn't crash like some have! (The more I hear

about Kaiser, I'm not sure it will amount to much but at least it will be on

record. (Remember, I'm not a doctor or a lawyer!)

> > > > > > >> >

> > > > > > >> > > Question regarding avs testing. I had an adenoma on my left

> > > > > > >> gland removed Feb 2nd. Potassium has since returned to normal

range

> > > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I

never

> > > > > > >> was offered AVS test. Having severe bouts with anxiety,

> > > > > > >> irritability, like PMS times 10, most of the time! My family is

fed

> > > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone

over

> > > > > > >> production? I have endo appt. March 1st. I've requested aldo

renin

> > > > > > >> tests again. Anything else I should ask the Endo? Still taking

hctz

> > > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and

> > > > > > >> Atenolol 50 mg.

> > > > > > >> > > Thanks guys

> > > > > > >> > >

> > > > > > >> >

> > > > > > >>

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > > > > TODAY(Beta) • Powered by

> > > > > Horse rescued from sinking mud

> > > > > It took three hours for emergency workers to finally free 18-year-old

Astro.

> > > > > Privacy Policy

> > > >

> > >

> >

>

[Guest guest]

Doesn't seem to be the same to file a complaint with the state medical board.

> > > > > > >> >

> > > > > > >> > > Question regarding avs testing. I had an adenoma on my left

> > > > > > >> gland removed Feb 2nd. Potassium has since returned to normal

range

> > > > > > >> 5.0 actually. BP remains on the high side, around 160/105. I

never

> > > > > > >> was offered AVS test. Having severe bouts with anxiety,

> > > > > > >> irritability, like PMS times 10, most of the time! My family is

fed

> > > > > > >> up, I'm frustrated! Is it posible I had bilateral aldosterone

over

> > > > > > >> production? I have endo appt. March 1st. I've requested aldo

renin

> > > > > > >> tests again. Anything else I should ask the Endo? Still taking

hctz

> > > > > > >> 50 mg. Took myself off Amlodipine10 mg, Lisinopril 20 mg, and

> > > > > > >> Atenolol 50 mg.

> > > > > > >> > > Thanks guys

> > > > > > >> > >

> > > > > > >> >

> > > > > > >>

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > > > > TODAY(Beta) • Powered by

> > > > > Horse rescued from sinking mud

> > > > > It took three hours for emergency workers to finally free 18-year-old

Astro.

> > > > > Privacy Policy

> > > >

> > >

> >

>