Guest guest Posted May 13, 2012 Report Share Posted May 13, 2012 After many years of uncontrollable high BP I was diagnosed in November 2011 with Conn's, in for a right adrenalectomy tomorrow May 13th Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2012 Report Share Posted June 8, 2012 Would like to review your AVS numbers as they are sometimes interpreted incorrectly. Need complete story to give you best advice based on our experiences here and my 50 years of doing this. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 8, 2012, at 8:35, Sara <sara212729@...> wrote: Hi everyone! I just got my test results back from my adrenal vein sampling. The excess aldosterone is coming from the left adrenal (35 x higher), which is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any tips on recovery? I have a toddler and a baby and was just wondering what I should expect. Also I am worried that if I get one adrenal out at such a young age (31) if something could go wrong with the other adrenal down the road. I don't want to have to be stuck on steroids or anything. Any advice is greatly appreciated. So glad to have this group. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2012 Report Share Posted June 8, 2012 You will want to have some help with the children for a few days. If your other adrenal develops an adenoma, the treatment is a mineralocorticoid blocker (spiro or Inspra), not a steroid. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Sara Hi everyone! I just got my test results back from my adrenal vein sampling. The excess aldosterone is coming from the left adrenal (35 x higher), which is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any tips on recovery? I have a toddler and a baby and was just wondering what I should expect. Also I am worried that if I get one adrenal out at such a young age (31) if something could go wrong with the other adrenal down the road. I don't want to have to be stuck on steroids or anything. Any advice is greatly appreciated. So glad to have this group. . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2012 Report Share Posted June 8, 2012 Does anyone know the chances of getting another tumor on the other adrenal gland? That would be terrible. > > You will want to have some help with the children for a few days. If your > other adrenal develops an adenoma, the treatment is a mineralocorticoid > blocker (spiro or Inspra), not a steroid. > > > > Val > > > > From: hyperaldosteronism > [mailto:hyperaldosteronism ] On Behalf Of Sara > > > Hi everyone! I just got my test results back from my adrenal vein sampling. > The excess aldosterone is coming from the left adrenal (35 x higher), which > is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any > tips on recovery? I have a toddler and a baby and was just wondering what I > should expect. Also I am worried that if I get one adrenal out at such a > young age (31) if something could go wrong with the other adrenal down the > road. I don't want to have to be stuck on steroids or anything. Any advice > is greatly appreciated. So glad to have this group. > > . > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId > =43906/stime=1339162511/nc1=3848643/nc2=5191951/nc3=5191950> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2012 Report Share Posted June 8, 2012 My adrenalectomy was December 15, 2010. I was 40 years old. My doctor did robotic surgery.Recovery was short and pretty easy for me. I only took a week off work. I'm A medical social worker so my job was not physically demanding and my girls Were both 14 so no little kids. After a year and a half, I still feel amazing! The surgery let me lead a normal life again when I thought that was never going to even be a possibility. Good luck!Juli, 42y F, post adrenalectomySent from my iPhoneOn Jun 8, 2012, at 8:35 AM, "Sara" <sara212729@...> wrote: Hi everyone! I just got my test results back from my adrenal vein sampling. The excess aldosterone is coming from the left adrenal (35 x higher), which is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any tips on recovery? I have a toddler and a baby and was just wondering what I should expect. Also I am worried that if I get one adrenal out at such a young age (31) if something could go wrong with the other adrenal down the road. I don't want to have to be stuck on steroids or anything. Any advice is greatly appreciated. So glad to have this group. = Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2012 Report Share Posted June 8, 2012 Perhaps Dr. Grim can give you some statistics on that. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of SaraDoes anyone know the chances of getting another tumor on the other adrenal gland? That would be terrible. >> You will want to have some help with the children for a few days. If your> other adrenal develops an adenoma, the treatment is a mineralocorticoid> blocker (spiro or Inspra), not a steroid.. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2012 Report Share Posted June 10, 2012 I think we have a paper by in our files showing that adrenal hyperplasia is much more common at autopsy than single ADENOMAS. I have just requested an update from him in fact. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 9, 2012, at 22:50, <jclark24p@...> wrote: I am certainly aware of your biases as you are probably aware of mine! I believe in thorough and proper testing and to never assume until all tests have been done. I never believed in "trial and error", probably because it confuses computers! I also believe there can be co-existing causes for HTN so if an ADx does not cure it after a period of time (most professionals give it up to a year) testing should be repeated. I think my experience with spironolactone taking 10months to get all SX of PA under control after controlling BP is an example. (I'm a month into testing eplerenone with the same experience, BP running 130/70 but flank & testis pain continues!) I'm assuming that if kidneys, veins and arteries or heart have been damaged the HTN will continue. It would be interesting if anyone has tried to treat with ACE, ARB, etc. class meds. They should work if renin has returned, right? I'm not exactly sure how MCBs work but if you were treating with meds and a new adenoma became functionl wouldn't you need to increase the dosage? Also, do you know of anybody who has validted your hypothesis? (I would seem someone would have done it at autopsy and if indeed it was true they would be less likely to recommend ADx. In fact the <40 difference would make even less sense.) > > > > > > > > > > You will want to have some help with the children for a few days. If your > > > > > other adrenal develops an adenoma, the treatment is a mineralocorticoid > > > > > blocker (spiro or Inspra), not a steroid. > > > > > > > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism > > > > > [mailto:hyperaldosteronism ] On Behalf Of Sara > > > > > > > > > > > > > > > Hi everyone! I just got my test results back from my adrenal vein sampling. > > > > > The excess aldosterone is coming from the left adrenal (35 x higher), which > > > > > is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any > > > > > tips on recovery? I have a toddler and a baby and was just wondering what I > > > > > should expect. Also I am worried that if I get one adrenal out at such a > > > > > young age (31) if something could go wrong with the other adrenal down the > > > > > road. I don't want to have to be stuck on steroids or anything. Any advice > > > > > is greatly appreciated. So glad to have this group. > > > > > > > > > > . > > > > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId > > > > > =43906/stime=1339162511/nc1=3848643/nc2=5191951/nc3=5191950> > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2012 Report Share Posted June 10, 2012 Sure, if someone can point me in the right direction - is there a link to the database? Or do I just need to fill out the whole PA questionnaire again? Thanks. > > > > > > > > > > > > > > > > You will want to have some help with the children for a few days. If your > > > > > > > > other adrenal develops an adenoma, the treatment is a mineralocorticoid > > > > > > > > blocker (spiro or Inspra), not a steroid. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism > > > > > > > > [mailto:hyperaldosteronism ] On Behalf Of Sara > > > > > > > > > > > > > > > > > > > > > > > > Hi everyone! I just got my test results back from my adrenal vein sampling. > > > > > > > > The excess aldosterone is coming from the left adrenal (35 x higher), which > > > > > > > > is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any > > > > > > > > tips on recovery? I have a toddler and a baby and was just wondering what I > > > > > > > > should expect. Also I am worried that if I get one adrenal out at such a > > > > > > > > young age (31) if something could go wrong with the other adrenal down the > > > > > > > > road. I don't want to have to be stuck on steroids or anything. Any advice > > > > > > > > is greatly appreciated. So glad to have this group. > > > > > > > > > > > > > > > > . > > > > > > > > > > > > > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId > > > > > > > > =43906/stime=1339162511/nc1=3848643/nc2=5191951/nc3=5191950> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2012 Report Share Posted June 10, 2012 If removing the adenoma worked the aldo will be low immediately after it is out and renin will start up. Ideally the K will go high the day after. If not then prob bumps on the other side making Aldo as well. Unfortunately most don't recheck renin and Aldo a day or so after surgery. I do. And urge others to do so as well. Was you delay in response to Spiro related to not DASHING when first put on it? U can out salt Spiro. If enough is given and titrated up quickly should not take 10 months. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 9, 2012, at 22:50, <jclark24p@...> wrote: I am certainly aware of your biases as you are probably aware of mine! I believe in thorough and proper testing and to never assume until all tests have been done. I never believed in "trial and error", probably because it confuses computers! I also believe there can be co-existing causes for HTN so if an ADx does not cure it after a period of time (most professionals give it up to a year) testing should be repeated. I think my experience with spironolactone taking 10months to get all SX of PA under control after controlling BP is an example. (I'm a month into testing eplerenone with the same experience, BP running 130/70 but flank & testis pain continues!) I'm assuming that if kidneys, veins and arteries or heart have been damaged the HTN will continue. It would be interesting if anyone has tried to treat with ACE, ARB, etc. class meds. They should work if renin has returned, right? I'm not exactly sure how MCBs work but if you were treating with meds and a new adenoma became functionl wouldn't you need to increase the dosage? Also, do you know of anybody who has validted your hypothesis? (I would seem someone would have done it at autopsy and if indeed it was true they would be less likely to recommend ADx. In fact the <40 difference would make even less sense.) > > > > > > > > > > You will want to have some help with the children for a few days. If your > > > > > other adrenal develops an adenoma, the treatment is a mineralocorticoid > > > > > blocker (spiro or Inspra), not a steroid. > > > > > > > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism > > > > > [mailto:hyperaldosteronism ] On Behalf Of Sara > > > > > > > > > > > > > > > Hi everyone! I just got my test results back from my adrenal vein sampling. > > > > > The excess aldosterone is coming from the left adrenal (35 x higher), which > > > > > is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any > > > > > tips on recovery? I have a toddler and a baby and was just wondering what I > > > > > should expect. Also I am worried that if I get one adrenal out at such a > > > > > young age (31) if something could go wrong with the other adrenal down the > > > > > road. I don't want to have to be stuck on steroids or anything. Any advice > > > > > is greatly appreciated. So glad to have this group. > > > > > > > > > > . > > > > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId > > > > > =43906/stime=1339162511/nc1=3848643/nc2=5191951/nc3=5191950> > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2012 Report Share Posted June 10, 2012 Did u take any sinus stuff that contains ephedrine.May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 9, 2012, at 23:24, Bingham <jlkbbk2003@...> wrote: You're assuming the dose would need to be increased based on a new adenoma producing MORE aldsoterone than was there previously, I guess? But I suspect it is not a pure linear relationship meaning we have to keep upping the spiro based on the level of aldosterone. But looking at numbers people have put up, and their reports of good luck on spiro or epe, this does not seem to be the case. If that is the only cause of HTN, and if one keeps sodium down, it appears aldosterone doesn't reach that threshhold either way and may be fairly inert in relationship to our pressure. In the normal person, aldosterone and renin (and the whole complement of hormones, steriods, proteins etc) are released in response to an issue we have, usually low volume of some sort - blood loss, dehydration, etc. and that triggers it. - it is not just being released ad lib like in you and I due to the adrenal problems. In your case, you have documented on the list a myriad of problems you have, many which contribute to, or cause HTN, other than just PA. So an MCB may take longer to work in you because PA is not your only problem, or the MCB DIDN'T ever work and it was something else. And did we account for ALL other measures taken in the 10 months that may have contributed to lowering your pressure? Like OSA treatment or improved treatment? PTSD treatment or a change in meds that can cause HTN? Blood sugar control? and anything else that may have done it instead of the spiro? My case is different. I do not have mutliple diagnoses or a colorful health history. My life is as full as the rest of us with tragedy and hard times and I have stress, and have seen things the average person will never see, even in my teens (remember I worked out in South Central Los Angeles as a medic), but I am so blessed I am not saddled with depression or mental health issues, thank heavens. I have had some run-ins with hyperthyroidism - don't know why, but it is okay right now. Most other issues I had were related to PA/low K. Spiro brought my pressure down in 2 doses, and it is well documented that I had very high uncontrolled HTN for at least 7-8 years prior to that, on many many meds and treatments, and no effect. I say it again for those reading for the first time, that I was 180/140 the very day (night) I started spiro, AND I was on 5 meds at that time with it that high, and in 2 doses of spiro it was 120/80. So I have no doubt spiro did it for me. I was 43 yo at the time (2010). One more day of 180/140 could have been my CVA day and my wifes widowmaker anniversary. So trial and error, in my case worked. Well trial worked, and wasn't the error side to find out, and that may have saved my life. I am glad I do not have the opposite to report on. BTW they only checked aldo and renin after I was on spiro. They have never done a single test right. But I am not going off of spiro to find out. I went too long with HTN to begin with and who knows what hidden damage has not reared it's head yet. So for me, I am not hung up on testing. I know what it is, not to perfection, but the clues are there at least in relation to HTN and hypokalemia. I keep sodium low and I do not even have to take the spiro - I did last week a couople of times as I got a bad sinus infection and it seemed to keep my pressure up - I am eating less so I don't know why. But last few days I have been okay. Not a perfect science, but I know what does work. If it changes we explore. From: <jclark24p@...>Subject: Re: Adrenalectomyhyperaldosteronism Date: Saturday, June 9, 2012, 10:50 PM I am certainly aware of your biases as you are probably aware of mine! I believe in thorough and proper testing and to never assume until all tests have been done. I never believed in "trial and error", probably because it confuses computers! I also believe there can be co-existing causes for HTN so if an ADx does not cure it after a period of time (most professionals give it up to a year) testing should be repeated. I think my experience with spironolactone taking 10months to get all SX of PA under control after controlling BP is an example. (I'm a month into testing eplerenone with the same experience, BP running 130/70 but flank & testis pain continues!)I'm assuming that if kidneys, veins and arteries or heart have been damaged the HTN will continue. It would be interesting if anyone has tried to treat with ACE, ARB, etc. class meds. They should work if renin has returned, right?I'm not exactly sure how MCBs work but if you were treating with meds and a new adenoma became functionl wouldn't you need to increase the dosage? Also, do you know of anybody who has validted your hypothesis? (I would seem someone would have done it at autopsy and if indeed it was true they would be less likely to recommend ADx. In fact the <40 difference would make even less sense.)> > > > >> > > > > You will want to have some help with the children for a few days. If your> > > > > other adrenal develops an adenoma, the treatment is a mineralocorticoid> > > > > blocker (spiro or Inspra), not a steroid.> > > > > > > > > > > > > > > > > > > > Val> > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism > > > > > [mailto:hyperaldosteronism ] On Behalf Of Sara> > > > > > > > > > > > > > > Hi everyone! I just got my test results back from my adrenal vein sampling.> > > > > The excess aldosterone is coming from the left adrenal (35 x higher), which> > > > > is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any> > > > > tips on recovery? I have a toddler and a baby and was just wondering what I> > > > > should expect. Also I am worried that if I get one adrenal out at such a> > > > > young age (31) if something could go wrong with the other adrenal down the> > > > > road. I don't want to have to be stuck on steroids or anything. Any advice> > > > > is greatly appreciated. So glad to have this group. > > > > > > > > > > .> > > > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId> > > > > =43906/stime=1339162511/nc1=3848643/nc2=5191951/nc3=5191950>> > > > >> > > > > > > >> > >> > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2012 Report Share Posted June 10, 2012 Just go to the database and use new date. I will resend intro which has details. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 10, 2012, at 17:54, msmith_1928 <janeray1940@...> wrote: Sure, if someone can point me in the right direction - is there a link to the database? Or do I just need to fill out the whole PA questionnaire again? Thanks. > > > > > > > > > > > > > > > > You will want to have some help with the children for a few days. If your > > > > > > > > other adrenal develops an adenoma, the treatment is a mineralocorticoid > > > > > > > > blocker (spiro or Inspra), not a steroid. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism > > > > > > > > [mailto:hyperaldosteronism ] On Behalf Of Sara > > > > > > > > > > > > > > > > > > > > > > > > Hi everyone! I just got my test results back from my adrenal vein sampling. > > > > > > > > The excess aldosterone is coming from the left adrenal (35 x higher), which > > > > > > > > is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any > > > > > > > > tips on recovery? I have a toddler and a baby and was just wondering what I > > > > > > > > should expect. Also I am worried that if I get one adrenal out at such a > > > > > > > > young age (31) if something could go wrong with the other adrenal down the > > > > > > > > road. I don't want to have to be stuck on steroids or anything. Any advice > > > > > > > > is greatly appreciated. So glad to have this group. > > > > > > > > > > > > > > > > . > > > > > > > > > > > > > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId > > > > > > > > =43906/stime=1339162511/nc1=3848643/nc2=5191951/nc3=5191950> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2012 Report Share Posted June 10, 2012 If renin has returned to normal yes. Good evidence that no more excess aldo. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 9, 2012, at 22:50, <jclark24p@...> wrote: I am certainly aware of your biases as you are probably aware of mine! I believe in thorough and proper testing and to never assume until all tests have been done. I never believed in "trial and error", probably because it confuses computers! I also believe there can be co-existing causes for HTN so if an ADx does not cure it after a period of time (most professionals give it up to a year) testing should be repeated. I think my experience with spironolactone taking 10months to get all SX of PA under control after controlling BP is an example. (I'm a month into testing eplerenone with the same experience, BP running 130/70 but flank & testis pain continues!) I'm assuming that if kidneys, veins and arteries or heart have been damaged the HTN will continue. It would be interesting if anyone has tried to treat with ACE, ARB, etc. class meds. They should work if renin has returned, right? I'm not exactly sure how MCBs work but if you were treating with meds and a new adenoma became functionl wouldn't you need to increase the dosage? Also, do you know of anybody who has validted your hypothesis? (I would seem someone would have done it at autopsy and if indeed it was true they would be less likely to recommend ADx. In fact the <40 difference would make even less sense.) > > > > > > > > > > You will want to have some help with the children for a few days. If your > > > > > other adrenal develops an adenoma, the treatment is a mineralocorticoid > > > > > blocker (spiro or Inspra), not a steroid. > > > > > > > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism > > > > > [mailto:hyperaldosteronism ] On Behalf Of Sara > > > > > > > > > > > > > > > Hi everyone! I just got my test results back from my adrenal vein sampling. > > > > > The excess aldosterone is coming from the left adrenal (35 x higher), which > > > > > is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any > > > > > tips on recovery? I have a toddler and a baby and was just wondering what I > > > > > should expect. Also I am worried that if I get one adrenal out at such a > > > > > young age (31) if something could go wrong with the other adrenal down the > > > > > road. I don't want to have to be stuck on steroids or anything. Any advice > > > > > is greatly appreciated. So glad to have this group. > > > > > > > > > > . > > > > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId > > > > > =43906/stime=1339162511/nc1=3848643/nc2=5191951/nc3=5191950> > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2012 Report Share Posted June 10, 2012 What would ephedrine do? I had the flu for the past few days and I took a sinus pill with decongestant yesterday. My BP has been 98/58 all day today. Dizzy all day too. I am curious exactly how sinus pills affect those with PA.My fever finally broke I am much better today.renin: .14Aldo ratio: 107.1To: hyperaldosteronism From: lowerbp2@...Date: Sun, 10 Jun 2012 18:10:25 -0500Subject: Re: Re: Adrenalectomy Did u take any sinus stuff that contains ephedrine.May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 9, 2012, at 23:24, Bingham <jlkbbk2003@...> wrote: You're assuming the dose would need to be increased based on a new adenoma producing MORE aldsoterone than was there previously, I guess? But I suspect it is not a pure linear relationship meaning we have to keep upping the spiro based on the level of aldosterone. But looking at numbers people have put up, and their reports of good luck on spiro or epe, this does not seem to be the case. If that is the only cause of HTN, and if one keeps sodium down, it appears aldosterone doesn't reach that threshhold either way and may be fairly inert in relationship to our pressure. In the normal person, aldosterone and renin (and the whole complement of hormones, steriods, proteins etc) are released in response to an issue we have, usually low volume of some sort - blood loss, dehydration, etc. and that triggers it. - it is not just being released ad lib like in you and I due to the adrenal problems. In your case, you have documented on the list a myriad of problems you have, many which contribute to, or cause HTN, other than just PA. So an MCB may take longer to work in you because PA is not your only problem, or the MCB DIDN'T ever work and it was something else. And did we account for ALL other measures taken in the 10 months that may have contributed to lowering your pressure? Like OSA treatment or improved treatment? PTSD treatment or a change in meds that can cause HTN? Blood sugar control? and anything else that may have done it instead of the spiro? My case is different. I do not have mutliple diagnoses or a colorful health history. My life is as full as the rest of us with tragedy and hard times and I have stress, and have seen things the average person will never see, even in my teens (remember I worked out in South Central Los Angeles as a medic), but I am so blessed I am not saddled with depression or mental health issues, thank heavens. I have had some run-ins with hyperthyroidism - don't know why, but it is okay right now. Most other issues I had were related to PA/low K. Spiro brought my pressure down in 2 doses, and it is well documented that I had very high uncontrolled HTN for at least 7-8 years prior to that, on many many meds and treatments, and no effect. I say it again for those reading for the first time, that I was 180/140 the very day (night) I started spiro, AND I was on 5 meds at that time with it that high, and in 2 doses of spiro it was 120/80. So I have no doubt spiro did it for me. I was 43 yo at the time (2010). One more day of 180/140 could have been my CVA day and my wifes widowmaker anniversary. So trial and error, in my case worked. Well trial worked, and wasn't the error side to find out, and that may have saved my life. I am glad I do not have the opposite to report on. BTW they only checked aldo and renin after I was on spiro. They have never done a single test right. But I am not going off of spiro to find out. I went too long with HTN to begin with and who knows what hidden damage has not reared it's head yet. So for me, I am not hung up on testing. I know what it is, not to perfection, but the clues are there at least in relation to HTN and hypokalemia. I keep sodium low and I do not even have to take the spiro - I did last week a couople of times as I got a bad sinus infection and it seemed to keep my pressure up - I am eating less so I don't know why. But last few days I have been okay. Not a perfect science, but I know what does work. If it changes we explore. --- On Sat, 6/9/12, <jclark24p@...> wrote: From: <jclark24p@...>Subject: Re: AdrenalectomyTo: hyperaldosteronism Date: Saturday, June 9, 2012, 10:50 PM I am certainly aware of your biases as you are probably aware of mine! I believe in thorough and proper testing and to never assume until all tests have been done. I never believed in " trial and error " , probably because it confuses computers! I also believe there can be co-existing causes for HTN so if an ADx does not cure it after a period of time (most professionals give it up to a year) testing should be repeated. I think my experience with spironolactone taking 10months to get all SX of PA under control after controlling BP is an example. (I'm a month into testing eplerenone with the same experience, BP running 130/70 but flank & testis pain continues!)I'm assuming that if kidneys, veins and arteries or heart have been damaged the HTN will continue. It would be interesting if anyone has tried to treat with ACE, ARB, etc. class meds. They should work if renin has returned, right?I'm not exactly sure how MCBs work but if you were treating with meds and a new adenoma became functionl wouldn't you need to increase the dosage? Also, do you know of anybody who has validted your hypothesis? (I would seem someone would have done it at autopsy and if indeed it was true they would be less likely to recommend ADx. In fact the <40 difference would make even less sense.)--- In hyperaldosteronism , Clarence Grim <lowerbp2@...> wrote:>> As my bias is that most PA is due to hyperplasia then there are always small bumps on both sides. So if one comes out and u ate not cured ie no BP meds needed then there is still a little one(s) on the other side. Anyway in an individual time and and BP will tell. > > > > May your pressure be low!> > CE Grim MS, MD> Specializing in Difficult> Hypertension> > On Jun 9, 2012, at 11:23, <jclark24p@...> wrote:> > > Dr. Grim, were you having a teenage moment or was this after a Friday Night Party? Obviously she was asking about the odds of a functioning tumor in the remaining adrenal. We all know the odds of developing a nonfunctioning tumor increases as we age, hence AVS recommended after 40.> > > > I would have to guess the odds of developing a functioning tumor is extremely low. I base this on two items: the followup for either meds or surgery would be more aggressive and if you were treating with MCBs and developed a functioning tumor in the other adrenal you would need to increase your dose. I also did a few Pubmed searches and came up empty, did anyone else have any luck? (I actually found one old case study which I didn't feel worth reporting.) > > > > --- In hyperaldosteronism , Clarence Grim <lowerbp2@> wrote:> > >> > > About 90% depending on how u define it. > > > > > > > > > > > > May your pressure be low!> > > > > > CE Grim MS, MD> > > Specializing in Difficult> > > Hypertension> > > > > > On Jun 8, 2012, at 14:32, Sara <sara212729@> wrote:> > > > > > > Does anyone know the chances of getting another tumor on the other adrenal gland? That would be terrible. > > > > > > > > --- In hyperaldosteronism , " Valarie " <val@> wrote:> > > > >> > > > > You will want to have some help with the children for a few days. If your> > > > > other adrenal develops an adenoma, the treatment is a mineralocorticoid> > > > > blocker (spiro or Inspra), not a steroid.> > > > > > > > > > > > > > > > > > > > Val> > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism > > > > > [mailto:hyperaldosteronism ] On Behalf Of Sara> > > > > > > > > > > > > > > Hi everyone! I just got my test results back from my adrenal vein sampling.> > > > > The excess aldosterone is coming from the left adrenal (35 x higher), which> > > > > is the one with the 1 cm tumor. I am going to have an adrenalectomy. Any> > > > > tips on recovery? I have a toddler and a baby and was just wondering what I> > > > > should expect. Also I am worried that if I get one adrenal out at such a> > > > > young age (31) if something could go wrong with the other adrenal down the> > > > > road. I don't want to have to be stuck on steroids or anything. Any advice> > > > > is greatly appreciated. So glad to have this group. > > > > > > > > > > .> > > > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId> > > > > =43906/stime=1339162511/nc1=3848643/nc2=5191951/nc3=5191950>> > > > >> > > > > > > >> > >> > > >> Quote Link to comment Share on other sites More sharing options...
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