Re: PA in the VA. Study in UC .

[Guest guest]

He was familiar with JNC7 and in fact he was even aware of some of the content

in JNC8 (I corrected him and used your term, " JNC-LATE " !) We were talking about

BP goals for DM PTNs. He also knew about the changes driven by the ACCORD study

and I explained the JCURVE and the difference between goals whether you were

protecting from heart attack or stroke. (A previous TIA may bias my goals!)

>

> > I had an appointment with the Neper. at the VA and found out I had a

> > " very rare " disease! That was the start of his training lesson! When

> > I stopped him and told him it accounted for 10% or more of the

> > people with resistnt HTN he tried to pass over it but I didn't let

> > him.

> >

> > After a little discussion he declaired it wasn't that high at the

> > VA! I corrected him again and told him I bet it was and that the

> > problem was that nobody " was smart enough to DX it! " (Sorry )

> > He pointed out that they " found my case " so I provided the timeline:

> > Adenoma visable on a 2005 scan, renin = 0.1 on 2/22/2007 with a note

> > from the lab " PA probable " and put on Spironolactone on June 2010

> > and " Proper testing done a month later while on 7 BP meds including

> > Spironolactone! " I thought they might need to refine the procedure!

> >

> > I gave him a copy of the JNC7 reference card on " Prevention,

> > Detection, Evaluation and Treatment of High BP " from NIH. He

> > actually took 5 minutes and reviewed it, thought it was pretty good

> > and tried to give it back. I told it was his to keep and he should

> > start by making sure there was a copy in every treatment area so the

> > PCP's would understand the importance!

> >

> > We then talked a little about NIH and he was very interested. He

> > said most of it wasn't really his responsibility but he would be

> > really intrested in seeing the results of all the testing. I

> > promised him a copy! (Maybe he can shake something loose from the

> > inside!)

> >

> > We wrapped it up with him telling me how much he appreciated having

> > a PTN that cared enough to do the research I had done. He said I was

> > " really challenging his memory " ! Probably the best 45 minutes he had

> > spent recently, IMHO. (The PTNs behind me may not agree since we

> > went slightly over our 20 minute allotment!)

> >

> >

>

[Guest guest]

This in in our files.

>

> > I had an appointment with the Neper. at the VA and found out I had a

> > " very rare " disease! That was the start of his training lesson! When

> > I stopped him and told him it accounted for 10% or more of the

> > people with resistnt HTN he tried to pass over it but I didn't let

> > him.

> >

> > After a little discussion he declaired it wasn't that high at the

> > VA! I corrected him again and told him I bet it was and that the

> > problem was that nobody " was smart enough to DX it! " (Sorry )

> > He pointed out that they " found my case " so I provided the timeline:

> > Adenoma visable on a 2005 scan, renin = 0.1 on 2/22/2007 with a note

> > from the lab " PA probable " and put on Spironolactone on June 2010

> > and " Proper testing done a month later while on 7 BP meds including

> > Spironolactone! " I thought they might need to refine the procedure!

> >

> > I gave him a copy of the JNC7 reference card on " Prevention,

> > Detection, Evaluation and Treatment of High BP " from NIH. He

> > actually took 5 minutes and reviewed it, thought it was pretty good

> > and tried to give it back. I told it was his to keep and he should

> > start by making sure there was a copy in every treatment area so the

> > PCP's would understand the importance!

> >

> > We then talked a little about NIH and he was very interested. He

> > said most of it wasn't really his responsibility but he would be

> > really intrested in seeing the results of all the testing. I

> > promised him a copy! (Maybe he can shake something loose from the

> > inside!)

> >

> > We wrapped it up with him telling me how much he appreciated having

> > a PTN that cared enough to do the research I had done. He said I was

> > " really challenging his memory " ! Probably the best 45 minutes he had

> > spent recently, IMHO. (The PTNs behind me may not agree since we

> > went slightly over our 20 minute allotment!)

> >

> >

>