Re: Re: JC at NIH - Verdict

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CPAP should improve things a lot in the cortisol area but not often tested. That I can find. I am assuming the think taking the right is not likely to improve things. Do you get the numbers?A repeat in 5 years do they mean the 10 day study or just an overnight or 3 day or 6 day.I would see how you do on eplerenone and DASH. Keep us posted. CE Grim MDOn May 8, 2012, at 8:21 PM, wrote: Dr. Grim, I have a theory why they didn't want to take my right adrenal but since I wasn't in the final meeting, it is only theory. On April 21st I got this message from my attending physician, "We can find out if the adenoma harbors the mutation after we take the right adrenal out. Your AVS showed that the dominant gland is on the right side, did Dr El-Maouche contact you? I am out of town, coming back on 4/30." Thanks Dr Moraitis From that I presumed they were going to remove the right so I was quite surprised when they decided not to. I thought about it quite a bit and wonder if there is something else going on that made them want to take a "wait-n-see" attitude. 1) They said from the start the saw something in the left that caught their attention. Dr. Moraitis spent some time showing and explaining the scan but quite honestly it "was over my head"! 2) Most if not all studies recommend removal of functioning adenomas yet they didn't even offer that option. Have I suddenly become a poor candidate for surgery? Are they still considering me as a candidate for a familial form of PA,FM-III (an open question). If they come up with a soultion they will need some test subjects! 3) They recommended a follow-up DEX suppression test in 5 years. Is that normal? If I assume they still think there might be something going on on the left side would that be a reason? If that is a possibility and we removed the right today and then found a cortisol problem in the left 5 years from now where would I be? (You say NO adrenals, hmmm, might be better to have a right adrenal with a bump given those options!) A smart doctor once told me to "Avoid the removal of both like the plague!" 4) I'm just starting to look at cortisol and OSA and am wondering why that issue just came up. Not questioning it but curious. "CONCLUSIONS: Untreated compared to treated OSA is associated with marked disturbances in ACTH and cortisol secretory dynamics, resulting in prolonged tissue exposure to disordered, elevated hormone levels." (source: http://www.ncbi.nlm.nih.gov/pubmed/19820009 ) Is it considered untreated if I am on a bi-pap machine 7-8 hrs/night? So while I have one answer, I consider it only one chapter and the "research" has just started to find the "Answer"! Stay Tuned! .... > > > > > > OSA = Obstructive Sleep Aepna > > > > > > I was looking for the correct answer! I did not talk with my > > attending physician so we did not discuss it. At least four endo's > > get together and discuss and come up with recommendation. I will > > wait until I get the results before I discuss with them. > > > > > > > > > > >

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To determine if you are "better" might require a sleep study. Does your device have a chip you have read from time to time to see how you are doing?CE Grim MDOn May 8, 2012, at 8:46 PM, lk.barns wrote: According to what I just read - the treatment referred to in the study was cpap/bipap - now perhaps I am wrong but it appears you are in the "treated" group > > > > > > > > OSA = Obstructive Sleep Aepna > > > > > > > > I was looking for the correct answer! I did not talk with my > > > attending physician so we did not discuss it. At least four endo's > > > get together and discuss and come up with recommendation. I will > > > wait until I get the results before I discuss with them. > > > > > > > > > > > > > > > > >

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Sounds good. CE Grim MDOn May 9, 2012, at 6:59 AM, wrote: It has a memory card they load down once in a while. I can also read out info on a display screen. (3168 therapy hrs, 387 days > 4, 30 day ave 7.36. I think I am in compliance!) BTW, this is my 3d bi-pap machine since 2002! > > > > > > > > > > > > OSA = Obstructive Sleep Aepna > > > > > > > > > > > > I was looking for the correct answer! I did not talk with my > > > > > attending physician so we did not discuss it. At least four > > endo's > > > > > get together and discuss and come up with recommendation. I will > > > > > wait until I get the results before I discuss with them. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >