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I would check with your team there but generally recommend hFH salt diet before AVS. Be certain they use ACTH. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 10, 2012, at 21:39, Virginia Wall <virgwall@...> wrote:

The date for my AVS is getting closer and I have some questions. I thought there was a file on proper AVS testing but I can't find it? Since I have been off the spiro about 4 weeks I have tried to keep my Na under 1,000 mg/day because even at 1,500 I wasn't feeling much better. Will being that low in Na alter the AVS results? Should I increase my Na shortly before the test? Thanks. Virginia Wall31 year old femaleDASHingAVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs bidPrenatal vitaminBreastfeeding; 5 month

old with G6PDD

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Ok I will ask. I already asked about ACTH and the endo told me they do use that. Is there anything else I should ask? What do you consider a "high" salt diet? For how many days prior?Virginia Wall31 year old femaleDASHingAVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs bidPrenatal vitaminBreastfeeding; 5 month old with G6PDDOn Jun 10, 2012, at 9:55 PM, Clarence Grim <lowerbp2@...> wrote:

I would check with your team there but generally recommend hFH salt diet before AVS. Be certain they use ACTH. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 10, 2012, at 21:39, Virginia Wall <virgwall@...> wrote:

The date for my AVS is getting closer and I have some questions. I thought there was a file on proper AVS testing but I can't find it? Since I have been off the spiro about 4 weeks I have tried to keep my Na under 1,000 mg/day because even at 1,500 I wasn't feeling much better. Will being that low in Na alter the AVS results? Should I increase my Na shortly before the test? Thanks. Virginia Wall31 year old femaleDASHingAVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs bidPrenatal vitaminBreastfeeding; 5 month

old with G6PDD

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Again Check with what they want you to do first. They will likely not believe you are on a really low sodium diet. I would think a week of say 3000 mg Na should be enough but check with them and keep an eye on BP. If it goes up I would drop back to where u are now. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 10, 2012, at 21:59, Virginia Wall <virgwall@...> wrote:

Ok I will ask. I already asked about ACTH and the endo told me they do use that. Is there anything else I should ask? What do you consider a "high" salt diet? For how many days prior?Virginia Wall31 year old femaleDASHingAVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs bidPrenatal vitaminBreastfeeding; 5 month old with G6PDDOn Jun 10, 2012, at 9:55 PM, Clarence Grim <lowerbp2@...> wrote:

I would check with your team there but generally recommend hFH salt diet before AVS. Be certain they use ACTH. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 10, 2012, at 21:39, Virginia Wall <virgwall@...> wrote:

The date for my AVS is getting closer and I have some questions. I thought there was a file on proper AVS testing but I can't find it? Since I have been off the spiro about 4 weeks I have tried to keep my Na under 1,000 mg/day because even at 1,500 I wasn't feeling much better. Will being that low in Na alter the AVS results? Should I increase my Na shortly before the test? Thanks. Virginia Wall31 year old femaleDASHingAVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs bidPrenatal vitaminBreastfeeding; 5

month

old with G6PDD

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Don't you think it's inevitable it would go up?  Or does it usually take longer?  In your opinion is there an acceptible range for my BP to go up in that week?  I've got a call out to the endocrinologist, I just wanted your take on it first.  Thanks!

On Mon, Jun 11, 2012 at 12:48 AM, Clarence Grim <lowerbp2@...> wrote:

 

Again Check with what they want you to do first. They will likely not believe you are on a really low sodium diet. I would think a week of say 3000 mg Na should be enough but check with them and keep an eye on BP. If it goes up I would drop back to where u are now. 

May your pressure be low!

CE Grim MS, MD

Specializing in Difficult

Hypertension

On Jun 10, 2012, at 21:59, Virginia Wall <virgwall@...> wrote:

 

Ok I will ask. I already asked about ACTH and the endo told me they do use that. Is there anything else I should ask? What do you consider a " high " salt diet? For how many days prior?

Virginia Wall

31 year old female

DASHing

AVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO

3 cm adenoma in right adrenal

Diagnosed February 2012

Low K & High BP since appx. 2007

Possible family history of hyperaldosteronism

Meds: K Cl 20 meq 2 tabs bid

Prenatal vitamin

Breastfeeding; 5 month old with G6PDD

On Jun 10, 2012, at 9:55 PM, Clarence Grim <lowerbp2@...> wrote:

 

I would check with your team there but generally recommend hFH salt diet before AVS. Be certain they use ACTH. 

May your pressure be low!

CE Grim MS, MD

Specializing in Difficult

Hypertension

On Jun 10, 2012, at 21:39, Virginia Wall <virgwall@...> wrote:

 

The date for my AVS is getting closer and I have some questions. I thought there was a file on proper AVS testing but I can't find it? Since I have been off the spiro about 4 weeks I have tried to keep my Na under 1,000 mg/day because even at 1,500 I wasn't feeling much better. Will being that low in Na alter the AVS results? Should I increase my Na shortly before the test? Thanks. 

Virginia Wall

31 year old female

DASHing

AVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO

3 cm adenoma in right adrenal

Diagnosed February 2012

Low K & High BP since appx. 2007

Possible family history of hyperaldosteronism

Meds: K Cl 20 meq 2 tabs bid

Prenatal vitamin

Breastfeeding; 5 month old with G6PDD

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Some will do it in one day others take longer.CE Grim MdOn Jun 12, 2012, at 6:32 PM, Virginia Wall wrote: Don't you think it's inevitable it would go up? Or does it usually take longer? In your opinion is there an acceptible range for my BP to go up in that week? I've got a call out to the endocrinologist, I just wanted your take on it first. Thanks! On Mon, Jun 11, 2012 at 12:48 AM, Clarence Grim <lowerbp2@...> wrote: Again Check with what they want you to do first. They will likely not believe you are on a really low sodium diet. I would think a week of say 3000 mg Na should be enough but check with them and keep an eye on BP. If it goes up I would drop back to where u are now. May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension On Jun 10, 2012, at 21:59, Virginia Wall <virgwall@...> wrote: Ok I will ask. I already asked about ACTH and the endo told me they do use that. Is there anything else I should ask? What do you consider a "high" salt diet? For how many days prior? Virginia Wall 31 year old female DASHing AVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO 3 cm adenoma in right adrenal Diagnosed February 2012 Low K & High BP since appx. 2007 Possible family history of hyperaldosteronism Meds: K Cl 20 meq 2 tabs bid Prenatal vitamin Breastfeeding; 5 month old with G6PDD On Jun 10, 2012, at 9:55 PM, Clarence Grim <lowerbp2@...> wrote: I would check with your team there but generally recommend hFH salt diet before AVS. Be certain they use ACTH. May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension On Jun 10, 2012, at 21:39, Virginia Wall <virgwall@...> wrote: The date for my AVS is getting closer and I have some questions. I thought there was a file on proper AVS testing but I can't find it? Since I have been off the spiro about 4 weeks I have tried to keep my Na under 1,000 mg/day because even at 1,500 I wasn't feeling much better. Will being that low in Na alter the AVS results? Should I increase my Na shortly before the test? Thanks. Virginia Wall 31 year old female DASHing AVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO 3 cm adenoma in right adrenal Diagnosed February 2012 Low K & High BP since appx. 2007 Possible family history of hyperaldosteronism Meds: K Cl 20 meq 2 tabs bid Prenatal vitamin Breastfeeding; 5 month old with G6PDD

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Well now I'm torn. I called my endo as Dr Grim instructed. Initially I spoke with the resident "assistant" regarding this question about if I should continue my low sodium diet before AVS. It was obvious that this question caught him off guard, and he told me to go ahead and eat a normal Na diet of about 2,000 mg a few days before my AVS. He called me back today though, and it seems as though he tried to get some advice from someone more knowledgeable and he told me there is no need to change my diet at all, I can continue with the low Na, less than 1,000 mg a day. I am having a hard time getting my Drs to call Dr Grim because it seems as though they don't think they need help. They come across as "know-it-alls who know nothing." I want to make sure my AVS is very clear with no room for error and I am inclined to listen to Dr Grim, and eat appx 3,000 mg Na/day for a week prior. I haven't been able to find any research on this. Doesn't more Na cause your aldo to increase? So if I limit myself enough is my aldo possibly close to normal?Virginia Wall31 year old femaleDASHingAVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs bidPrenatal vitaminBreastfeeding; 5 month old with G6PDDOn Jun 13, 2012, at 12:28 AM, Clarence Grim <lowerbp2@...> wrote:

Some will do it in one day others take longer.CE Grim MdOn Jun 12, 2012, at 6:32 PM, Virginia Wall wrote: Don't you think it's inevitable it would go up? Or does it usually take longer? In your opinion is there an acceptible range for my BP to go up in that week? I've got a call out to the endocrinologist, I just wanted your take on it first. Thanks! On Mon, Jun 11, 2012 at 12:48 AM, Clarence Grim <lowerbp2@...> wrote: Again Check with what they want you to do first. They will likely not believe you are on a really low sodium diet. I would think a week of say 3000 mg Na should be enough but check with them and keep an eye on BP. If it goes up I would drop back to where u are now. May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension On Jun 10, 2012, at 21:59, Virginia Wall <virgwall@...> wrote: Ok I will ask. I already asked about ACTH and the endo told me they do use that. Is there anything else I should ask? What do you consider a "high" salt diet? For how many days prior? Virginia Wall 31 year old female DASHing AVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO 3 cm adenoma in right adrenal Diagnosed February 2012 Low K & High BP since appx. 2007 Possible family history of hyperaldosteronism Meds: K Cl 20 meq 2 tabs bid Prenatal vitamin Breastfeeding; 5 month old with G6PDD On Jun 10, 2012, at 9:55 PM, Clarence Grim <lowerbp2@...> wrote: I would check with your team there but generally recommend hFH salt diet before AVS. Be certain they use ACTH. May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension On Jun 10, 2012, at 21:39, Virginia Wall <virgwall@...> wrote: The date for my AVS is getting closer and I have some questions. I thought there was a file on proper AVS testing but I can't find it? Since I have been off the spiro about 4 weeks I have tried to keep my Na under 1,000 mg/day because even at 1,500 I wasn't feeling much better. Will being that low in Na alter the AVS results? Should I increase my Na shortly before the test? Thanks. Virginia Wall 31 year old female DASHing AVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO 3 cm adenoma in right adrenal Diagnosed February 2012 Low K & High BP since appx. 2007 Possible family history of hyperaldosteronism Meds: K Cl 20 meq 2 tabs bid Prenatal vitamin Breastfeeding; 5 month old with G6PDD

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FWIW, I was eating well under 1000 Mg of Na per day at the time of my AVS...

nothing was ever said to me to do otherwise, and my AVS results showed clear

lateralization to the left.

> >>>>

> >>>>>

> >>>>>

> >>>>> The date for my AVS is getting closer and I have some questions. I

thought there was a file on proper AVS testing but I can't find it? Since I have

been off the spiro about 4 weeks I have tried to keep my Na under 1,000 mg/day

because even at 1,500 I wasn't feeling much better. Will being that low in Na

alter the AVS results? Should I increase my Na shortly before the test? Thanks.

> >>>>>

> >>>>>

> >>>>> Virginia Wall

> >>>>> 31 year old female

> >>>>> DASHing

> >>>>> AVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO

> >>>>> 3 cm adenoma in right adrenal

> >>>>> Diagnosed February 2012

> >>>>> Low K & High BP since appx. 2007

> >>>>> Possible family history of hyperaldosteronism

> >>>>> Meds: K Cl 20 meq 2 tabs bid

> >>>>> Prenatal vitamin

> >>>>> Breastfeeding; 5 month old with G6PDD

> >>>>>

> >>>>

> >>>

> >>

> >>

> >>

> >>

> >>

> >

> >

>

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you could tell him I was a resident in Endo with Dr. Conn in 1969-70. Prob before he was born. CE Grim MDOn Jun 15, 2012, at 5:09 PM, Virginia Wall wrote: Well now I'm torn. I called my endo as Dr Grim instructed. Initially I spoke with the resident "assistant" regarding this question about if I should continue my low sodium diet before AVS. It was obvious that this question caught him off guard, and he told me to go ahead and eat a normal Na diet of about 2,000 mg a few days before my AVS. He called me back today though, and it seems as though he tried to get some advice from someone more knowledgeable and he told me there is no need to change my diet at all, I can continue with the low Na, less than 1,000 mg a day. I am having a hard time getting my Drs to call Dr Grim because it seems as though they don't think they need help. They come across as "know-it-alls who know nothing." I want to make sure my AVS is very clear with no room for error and I am inclined to listen to Dr Grim, and eat appx 3,000 mg Na/day for a week prior. I haven't been able to find any research on this. Doesn't more Na cause your aldo to increase? So if I limit myself enough is my aldo possibly close to normal?Virginia Wall31 year old femaleDASHingAVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs bidPrenatal vitaminBreastfeeding; 5 month old with G6PDDOn Jun 13, 2012, at 12:28 AM, Clarence Grim <lowerbp2@...> wrote: Some will do it in one day others take longer.CE Grim MdOn Jun 12, 2012, at 6:32 PM, Virginia Wall wrote: Don't you think it's inevitable it would go up? Or does it usually take longer? In your opinion is there an acceptible range for my BP to go up in that week? I've got a call out to the endocrinologist, I just wanted your take on it first. Thanks! On Mon, Jun 11, 2012 at 12:48 AM, Clarence Grim <lowerbp2@...> wrote: Again Check with what they want you to do first. They will likely not believe you are on a really low sodium diet. I would think a week of say 3000 mg Na should be enough but check with them and keep an eye on BP. If it goes up I would drop back to where u are now. May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension On Jun 10, 2012, at 21:59, Virginia Wall <virgwall@...> wrote: Ok I will ask. I already asked about ACTH and the endo told me they do use that. Is there anything else I should ask? What do you consider a "high" salt diet? For how many days prior? Virginia Wall 31 year old female DASHing AVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO 3 cm adenoma in right adrenal Diagnosed February 2012 Low K & High BP since appx. 2007 Possible family history of hyperaldosteronism Meds: K Cl 20 meq 2 tabs bid Prenatal vitamin Breastfeeding; 5 month old with G6PDD On Jun 10, 2012, at 9:55 PM, Clarence Grim <lowerbp2@...> wrote: I would check with your team there but generally recommend hFH salt diet before AVS. Be certain they use ACTH. May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension On Jun 10, 2012, at 21:39, Virginia Wall <virgwall@...> wrote: The date for my AVS is getting closer and I have some questions. I thought there was a file on proper AVS testing but I can't find it? Since I have been off the spiro about 4 weeks I have tried to keep my Na under 1,000 mg/day because even at 1,500 I wasn't feeling much better. Will being that low in Na alter the AVS results? Should I increase my Na shortly before the test? Thanks. Virginia Wall 31 year old female DASHing AVS scheduled June 27, 2012 at BJC Hospital St. Louis, MO 3 cm adenoma in right adrenal Diagnosed February 2012 Low K & High BP since appx. 2007 Possible family history of hyperaldosteronism Meds: K Cl 20 meq 2 tabs bid Prenatal vitamin Breastfeeding; 5 month old with G6PDD

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