Re: Is Adrenal Vein Sampling more effective to detect a tumor than MRI or Cat Scan?

April 7, 2012

And dex suppression testing to confirm.CE Grim MDOn Apr 7, 2012, at 8:18 AM, Francis Bill SUSPECTED PA wrote: AVS isn't the normal way to test for too much cortisol production. This is done by 24 hr urine or doing blood or Saliva tests during the 24 hr. If you are making too much cortisol then would have to test pituitary gland as well. Might want to search cushings for more information. Note that there is Cushing's disease caused by Pituitary adenomas and Cushing's syndrome caused by adrenal adenomas or taking meds like Prednisone > > > > > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia constantly instead of a tumor that Adrenal Vein Sampling may detect a tumor more efficiently? > > > > > > > > > > > > > > > If that is true than why not do Adrenal Vein Sampling for everyone whose MRI just shows hyperplasia? > > > > > > > > > > > > > > > > > > > >

April 7, 2012

Beer here. CE Grim MDOn Apr 7, 2012, at 8:46 AM, Francis Bill SUSPECTED PA wrote: It is possible he has done 1000. Depends on if he does most all AVS at NIH. looks likes many of the trials are trying to get 2000 people in them. > > > > > > > > > > > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia > > > > > > constantly instead of a tumor that Adrenal Vein Sampling may detect a > > > > > > tumor more efficiently? > > > > > > > > > > > > > > > > > > > > > > > > If that is true than why not do Adrenal Vein Sampling for everyone > > > > > > whose MRI just shows hyperplasia? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

April 7, 2012

Please send reference for this. CE Grim MDOn Apr 7, 2012, at 8:54 AM, Francis Bill SUSPECTED PA wrote: New scanners can now show something the size of a grain of sand. > > > > > > > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia > > > > constantly instead of a tumor that Adrenal Vein Sampling may detect a > > > > tumor more efficiently? > > > > > > > > > > > > > > > > > > If that is true than why not do Adrenal Vein Sampling for everyone > > > > whose MRI just shows hyperplasia? > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

April 7, 2012

Will have to find it again but if you recall I posted about the new scanner that

Mayo had that stated this.

> > > > > > >

> > > > > > > > Is it true that if an MRI or Cat Scan just shows

> > hyperplasia

> > > > > > constantly instead of a tumor that Adrenal Vein Sampling may

> > detect a

> > > > > > tumor more efficiently?

> > > > > > > >

> > > > > > > > If that is true than why not do Adrenal Vein Sampling

> > for everyone

> > > > > > whose MRI just shows hyperplasia?

> > > > > > > >

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> > > > > >

> > > > >

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April 7, 2012

From my first posting.

Information on one of Mayo new scanners.

SCOTTSDALE, Ariz. — A new, high-definition computerized tomography (CT) scanner

capable of seeing internal structures in the human body as thin as a grain of

sand is now in place at Mayo Clinic in Arizona and shows promise of setting the

new standard for clarity in CT imaging.

Called the LightSpeed CT750 HD, the device has the potential to transform the

way physicians diagnose and treat life-threatening diseases. The system detects

small images with greater clarity (33 percent greater detail through the body

than traditional scans and up to 47 percent greater detail in the heart) and is

seen as a key enhancement in detecting potential medical problems.

The bottom line for patients is that not only does the scanner greatly improve

the speed and quality of the images, the dose of radiation can be reduced up to

50 percent across the entire body and as much as 83 percent for cardiac scans.

The new LightSpeed scanner at Mayo is one of only two in use to date in the U.S.

The system, developed by GE Healthcare, uses a new scintillator (a substance

that glows when hit by high-energy particles) design that was developed by

changing the molecular structure of garnets, a group of minerals used as

gemstones that are popular in jewelry-making. Using bright yellow garnets,

engineers were able to develop a scintillator capable of delivering image data

100 times faster.

" This promising new scanner lets us look at an image in far greater detail and

with significant radiation dose reduction, a combination that is a technological

leap in enhancement of patient care, " said Amy Hara, M.D., Diagnostic Radiology,

Mayo Clinic in Arizona. " Importantly, this more focused imaging will hopefully

enable physicians to diagnose disease earlier and with greater accuracy. "

One of the first Mayo patients to be evaluated by the new CT scanner (the week

of July 21, 2008) had previously been recommended to undergo conventional

coronary angiography (a more invasive procedure requiring sedation in which a

catheter is inserted into the heart) to evaluate a suspected coronary artery

blockage. Instead, he underwent a coronary artery CT angiogram on the new CT

scanner and was able to avoid the more invasive coronary angiogram and sedation.

Since that initial use of the new scanner, 30 patients were evaluated by the new

high definition device in its first week of operation.

###

About Mayo Clinic

Mayo Clinic is a nonprofit worldwide leader in medical care, research and

education for people from all walks of life. For more information, visit

MayoClinic.com or MayoClinic.org/news.

> > > > > > > >

> > > > > > > > > Is it true that if an MRI or Cat Scan just shows

> > > hyperplasia

> > > > > > > constantly instead of a tumor that Adrenal Vein Sampling may

> > > detect a

> > > > > > > tumor more efficiently?

> > > > > > > > >

> > > > > > > > > If that is true than why not do Adrenal Vein Sampling

> > > for everyone

> > > > > > > whose MRI just shows hyperplasia?

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

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April 8, 2012

yes. those tests were done prior to AVS, then the AVS showed more cortisol on

the left than the right; more aldo on the right than the left. Then they did a

1mg. dex suppression test, followed by an 8 mg dex suppression test. All

confirmed cushings or hypercortisolemia as well as bilateral hyperplasia,

bilateral nodules, and hyperaldosteronism. The AVS was helpful as a part of all

this. It still is not lateralized enough for surgery and they have recommended

further eval of the cortisol issue. They think it''s from the adrenals, due to

the AVS and the other tests, but I guess they are still either wanting to double

check ectopic sources, pituitary, and/or lateralization issues. I am not sure

yet. More info later this week. What do you know about Cushing's/cortisol

concurrent with Conn's/hyperaldo?

> > > > > >

> > > > > > > Is it true that if an MRI or Cat Scan just shows

> > hyperplasia constantly instead of a tumor that Adrenal Vein Sampling

> > may detect a tumor more efficiently?

> > > > > > >

> > > > > > > If that is true than why not do Adrenal Vein Sampling for

> > everyone whose MRI just shows hyperplasia?

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

April 8, 2012

It is my opinion and experience at NIH, that AVS in NOT done only if you want

surgery. They do AVS to help DETERMINE if surgery is an OPTION or to try to

lateralize the problem. They only do AVS if other tests and imaging(s) confirm

the need for it, however, it is not correct that it is only done if you want to

have surgery. It is done as part of the diagnostic process whether you end up

having surgery or not. I had AVS, and as of yet, surgery has not been

recommended as a treatment option at this time.

> > > > >

> > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > > > tumor more efficiently?

> > > > > >

> > > > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > > > whose MRI just shows hyperplasia?

> > > > > >

> > > > >

> > > >

> > >

> >

>

April 8, 2012

Understand that I am in a trial that is doing current state of the art study. I

sometimes have a thought process that may be " outside the box " and sometimes

come up with some unique answers. I look as myself as the beagle chasing the

bunny, them, and let me just last night the beagle caught the bunny about 4:40

am. Let's just say until that bunny got caught this beagle has been in a state

of hyperarrasal with IMHO activation of both MDD and PTSD and add a 2day LOW DEX

test followed immediately by a 2 day HIGH DEX! (Dex is apparently a sugar. So

double a normal dose of flight/fight syndrome and add 3 times the normal sugar

and what do you have? One fast beagle or one big fight! Let's just say I kept

that beagle headed in the right mode for 98% of the ride (flight) and then

quickly changed direction to the fight direction! Read with caution but

when you tell your nurse you have completed your hunt and are ready to hit the

rack, and agree immediately after the 6am med and Bp check you are going to bed

(you know your body and you know that when you go to sleep and as long as you

sleep 30 minutes whenever you get up you are up for the next round. In the

private world this cycle I have done this cycle and was up 68 out of 72 hours.

I'm getting old because I had to take 4 breaks this time in 72 hours, 2hr, 3 hr,

and one 2hour out of respect for my newly assigned project nurse who has been

assigned to the project. She is a youngish nurse from bulgeria 10 yrs in

country. I respect her and she is on the up swing and she has the opportunity

for a ride of a lifetime if she hangs on. I will give her the intro of a life

time and I have complete confidence she is equal to the task!

Oh by the way,The first straw last night was when I was asking another nurse for

a document and she printed it. The job I took her away from was solitair, she

only had 2 PTNs and was bored! The second was responding to her question when

she asked if I was " only a H. S. graduate and I confirmed and actually had 3 CR

HRS (intro to poly sci) taken to evaluate feasibility not content (was not ready

at the time, IMHO, but is now if built correctly! She responded something like

good luck catching them. I politely showed the one sentence that said my puppy

had their rabit securily in it's graph 15 minutes later! I didn't have to say

another word, she knew she had challenged the wrong HS graduate. It's not how

you learn it is what you learn and how you use it. The final straw was when it

took her 35 minutes to " put me to bed " . That was one pill and BP, HR and BS

taken with and automatic cuff and she decided to swap out the 24 hour urines.

She must have got lost because because she didn't return for thirty minutes and

the low oxygen alarm was going off for 15 of them! I was dosing in the chair

and when I arroused she suggested, recommended I stay put and I am sure she was

not kidding. I suggested I preferred to sleep in a bed so I could use my bi-pap

machine! Is she a canidate for rehab? IMPO No. She is a candidate for the

soup line. I could have tanked for BP this time instead of low oxygen. Quality

of care mandates you check every time! And the urine collection was safe in a

dedicated refridgerator and should have been after the PTN was in bed. As

valuable as every drop of that liquid gold is, there is one thing more valuable!

She may also have made a mistake by suggesting I could withdraw from the

protocol, I'm sure some will think that was not her place to speak up I'm

pretty sure management will think I am a more valueble option.

Sorry everyone, but sometimes you " attack the ones you love " . If this turns out

as I think it could very well be the most successful project in my career and

not as the puppy. Bp is down to 142/69. last DEX is in the processor and I am

going to bed. If I do not sign a confidentiality clause tomorrow and Put I in

Teaim you will be the firs to know! Otherwise you will be the first that I tell

when it is lifted.

> > > > >

> > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > > > tumor more efficiently?

> > > > > >

> > > > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > > > whose MRI just shows hyperplasia?

> > > > > >

> > > > >

> > > >

> > >

> >

>

April 8, 2012

Maggie I heard they are building a new pool and calling it MaggieKatYelow! BTW,

I think I won the " Stick " contest 7 including 3 from VAD (one done during saline

surpression test) Dr. said it couldn " t be done, Nurse said test was over then

since she couldn't draw blood! God I love it, who is in control? The one that

has control!

> > > > > > > > >

> > > > > > > > > > Is it true that if an MRI or Cat Scan just shows

> > hyperplasia

> > > > > > > > constantly instead of a tumor that Adrenal Vein Sampling

> > may detect a

> > > > > > > > tumor more efficiently?

> > > > > > > > > >

> > > > > > > > > > If that is true than why not do Adrenal Vein

> > Sampling for everyone

> > > > > > > > whose MRI just shows hyperplasia?

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

April 8, 2012

Alot more than I did a couple days ago! What a ride.

> > > > > > >

> > > > > > > > Is it true that if an MRI or Cat Scan just shows

> > > hyperplasia constantly instead of a tumor that Adrenal Vein Sampling

> > > may detect a tumor more efficiently?

> > > > > > > >

> > > > > > > > If that is true than why not do Adrenal Vein Sampling for

> > > everyone whose MRI just shows hyperplasia?

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

April 9, 2012

They are likely doing this in as many as they can to learn more about what testing methods work best at predicting cure. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 8, 2012, at 17:52, maggiekat7 <ljurkovic@...> wrote:

It is my opinion and experience at NIH, that AVS in NOT done only if you want surgery. They do AVS to help DETERMINE if surgery is an OPTION or to try to lateralize the problem. They only do AVS if other tests and imaging(s) confirm the need for it, however, it is not correct that it is only done if you want to have surgery. It is done as part of the diagnostic process whether you end up having surgery or not. I had AVS, and as of yet, surgery has not been recommended as a treatment option at this time.

> > > > >

> > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > > > tumor more efficiently?

> > > > > >

> > > > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > > > whose MRI just shows hyperplasia?

> > > > > >

> > > > >

> > > >

> > >

> >

>

April 9, 2012

Hmm the use of. cortisol to dx adrenal cushings should be done with dex to suppress normal adrenal. But interesting. Keep us posted. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 8, 2012, at 17:31, maggiekat7 <ljurkovic@...> wrote:

yes. those tests were done prior to AVS, then the AVS showed more cortisol on the left than the right; more aldo on the right than the left. Then they did a 1mg. dex suppression test, followed by an 8 mg dex suppression test. All confirmed cushings or hypercortisolemia as well as bilateral hyperplasia, bilateral nodules, and hyperaldosteronism. The AVS was helpful as a part of all this. It still is not lateralized enough for surgery and they have recommended further eval of the cortisol issue. They think it''s from the adrenals, due to the AVS and the other tests, but I guess they are still either wanting to double check ectopic sources, pituitary, and/or lateralization issues. I am not sure yet. More info later this week. What do you know about Cushing's/cortisol concurrent with Conn's/hyperaldo?

> > > > > >

> > > > > > > Is it true that if an MRI or Cat Scan just shows

> > hyperplasia constantly instead of a tumor that Adrenal Vein Sampling

> > may detect a tumor more efficiently?

> > > > > > >

> > > > > > > If that is true than why not do Adrenal Vein Sampling for

> > everyone whose MRI just shows hyperplasia?

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

April 9, 2012

Will need to see what they can see n the adrenal. Suspect they were talking about calcium in arteries. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 7, 2012, at 13:09, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

From my first posting.

Information on one of Mayo new scanners.

SCOTTSDALE, Ariz. â€” A new, high-definition computerized tomography (CT) scanner