Guest guest Posted June 25, 2012 Report Share Posted June 25, 2012 Yea! You go girl!! Bet they suddenly start finding a whole bunch of cases of that "rare" syndrome of PA.You and I are in about the same frame of mind Phyllis. PA has taken its toll on our health, but we can still help others to find a diagnosis quicker, and hopefully with less long-term damage than we have. I blab about PA to anyone I can, so that when they come across someone they know with high BP and low K, they may be able to remember to mention something to them about trouble with their adrenals. Dianne 69, bi-lateral adenomas 1.2cm rt, 1cm left 25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July 2010 Had to demand tests to confirm PA, from scoffing NP CKD. Kidney function fell after use of contrast dye during CT scan 8/2010. Now on 50mg Spiro, 12.5mg Atenolol BP avg. 130/70 Dashing with very low Na (aim for 1,000mg) and high enough K to keep me in range, but not so high as to further damage kidneys. From: Phyllis <phylisrn@...>Subject: PA Educationhyperaldosteronism Date: Monday, June 25, 2012, 11:20 AM I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine. Potassium was also low. Now how likely is it that two people from one unit develop a rare disease? I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference. I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lack of a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro. I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them. 5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2012 Report Share Posted June 25, 2012 Phyllis and DianneYou guys are awesome. Thanks for the UFO and " Your not alone " pep talk to ;)Means a lot to me. I was lucky enough to fall in the right hands and find this group quickly.The doctors all thought I was to young and physically fit to ignore my BP problems. Thank goodness. Back in 2006 when I was first dianised with hypertension they told me to lose weight. So I lost 40 lbs and my BP got worse! Guess its not always the weight huh? I think sometimes there is a stigma with that and PA patients get overlooked. When all you have to do is run the ratio. How hard is that? It should be standard procedure with all docs when diagnosing hypertension.To: hyperaldosteronism From: dianstrong@...Date: Mon, 25 Jun 2012 13:12:49 -0700Subject: Re: PA Education Yea! You go girl!! Bet they suddenly start finding a whole bunch of cases of that " rare " syndrome of PA.You and I are in about the same frame of mind Phyllis. PA has taken its toll on our health, but we can still help others to find a diagnosis quicker, and hopefully with less long-term damage than we have. I blab about PA to anyone I can, so that when they come across someone they know with high BP and low K, they may be able to remember to mention something to them about trouble with their adrenals. Dianne 69, bi-lateral adenomas 1.2cm rt, 1cm left 25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July 2010 Had to demand tests to confirm PA, from scoffing NP CKD. Kidney function fell after use of contrast dye during CT scan 8/2010. Now on 50mg Spiro, 12.5mg Atenolol BP avg. 130/70 Dashing with very low Na (aim for 1,000mg) and high enough K to keep me in range, but not so high as to further damage kidneys. --- On Mon, 6/25/12, Phyllis <phylisrn@...> wrote:From: Phyllis <phylisrn@...>Subject: PA EducationTo: hyperaldosteronism Date: Monday, June 25, 2012, 11:20 AM I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine. Potassium was also low. Now how likely is it that two people from one unit develop a rare disease? I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference. I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lack of a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro. I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them. 5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2012 Report Share Posted June 25, 2012 Amazing. Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a "we don't know" and a new med to add on to the other 3...........ugh...... Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about "looking" like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a "we don't know" and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not. Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. But this is what were up against .....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be "that" patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. From: Phyllis <phylisrn@...>Subject: PA Educationhyperaldosteronism Date: Monday, June 25, 2012, 1:20 PM I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine.Potassium was also low. Now how likely is it that two people from one unit develop a rare disease?I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference.I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lackof a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro.I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them.5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia,current meds Spiro 25mg, Benicar 20mg bid, dashingPhyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2012 Report Share Posted June 25, 2012 It's so pathetic how most physicians don't give a c**p about low K. They keep adding the latest BB/diuretic on the top of your current medication although they know already that did not worked for you. I almost think that the IBM WATSON computer can do a better job at medical diagnosis that most of the today's young doctors. Sorry for the rant! > > > >  > Amazing. >  > Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a " we don't know " and a new med to add on to the other 3...........ugh...... >  >  > Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about " looking " like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a " we don't know " and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not. >  > Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. >  > But this is what were up against > ....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be " that " patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. >  >  Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2012 Report Share Posted June 25, 2012 After a bout of Afib and confirmed low K, my PCP prescribed a diuretic along with my three other meds for my HBP. When I developed an arrhythmia he suggested that I eat more bananas.Enjoy your rant. From: "lvasiliu@..." <lvasiliu@...> To: hyperaldosteronism Sent: Monday, June 25, 2012 7:58 PM Subject: Re: PA Education It's so pathetic how most physicians don't give a c**p about low K. They keep adding the latest BB/diuretic on the top of your current medication although they know already that did not worked for you. I almost think that the IBM WATSON computer can do a better job at medical diagnosis that most of the today's young doctors. Sorry for the rant! > > > >  > Amazing. >  > Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a "we don't know" and a new med to add on to the other 3...........ugh...... >  >  > Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about "looking" like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a "we don't know" and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not. >  > Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. >  > But this is what were up against > ....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be "that" patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. >  >  Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2012 Report Share Posted June 25, 2012 I'm not familiar with your story Fred. Can you include a thumbnail? Cybil 36 y.o. female Dx with hyperaldo a week ago Low K+.Mg.Ca. Just started spiro and DASHing Neg. CT LVH Sent from my Verizon Wireless Phone lvasiliu@... wrote: > > >It's so pathetic how most physicians don't give a c**p about low K. >They keep adding the latest BB/diuretic on the top of your current medication although they know already that did not worked for you. > >I almost think that the IBM WATSON computer can do a better job at medical diagnosis that most of the today's young doctors. > >Sorry for the rant! > > > >> >> >> >>  >> Amazing. >>  >> Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a " we don't know " and a new med to add on to the other 3...........ugh...... >>  >>  >> Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about " looking " like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a " we don't know " and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not. >>  >> Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. >>  >> But this is what were up against >> ....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be " that " patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. >>  >>  > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2012 Report Share Posted June 25, 2012 Fred, I think I found the problem! I did a Pubmed on "(arrhythmia) AND monkey" and came up with 142,412 hits (try it)! The problem is they are not taught the difference between Humans and Monkeys! > >> > > > > >  > > Amazing. > >  > > Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a "we don't know" and a new med to add on to the other 3...........ugh......> >  > >  > > Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about "looking" like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a "we don't know" and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not.> >  > > Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. > >  > > But this is what were up against > > ....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be "that" patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. > >  > >  > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2012 Report Share Posted June 25, 2012 It would not be bad if it was just missed by one PCP. It was missed by two PCP's, two cardiologists and two endocrinologists. All of which had all my labs available which showed low K. From: <jclark24p@...> hyperaldosteronism Sent: Monday, June 25, 2012 8:41 PM Subject: Re: PA Education Fred, I think I found the problem! I did a Pubmed on "(arrhythmia) AND monkey" and came up with 142,412 hits (try it)! The problem is they are not taught the difference between Humans and Monkeys! > >> > > > > >  > > Amazing. > >  > > Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a "we don't know" and a new med to add on to the other 3...........ugh......> >  > >  > > Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about "looking" like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a "we don't know" and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not.> >  > > Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. > >  > > But this is what were up against > > ....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be "that" patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. > >  > >  > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2012 Report Share Posted June 25, 2012 On Feb. 22, 2007 my doctor was smart enough to test renin and aldo, here is the result of the renin test from Quest Diag. Lab.: RENIN 0.1 Low ng/mL/hr (0.65-5.0) Final WHITE RIVER JCT VAMROC Interpretation: Ref Range Prior to 9/27/2010-0.65 to 5.0 ng/mL/h Non-hypertensive adults: (upright/sitting) : 0.65-5.0 ng/mL/hr Clinical Cutoffs for Hypertensive Individual(ng/mL/hr)s: Low-renin sodium/volume-mediated hypertension likely: <0.65 Primary aldosteronsim possible: <0.65 Unfortunately she wasn't smart enough to go any further and figure out PA! I was finally Dxed in 2010, sure would like those 3 years back! > > > > > > > > > > > >  > > > Amazing. > > >  > > > Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a " we don't know " and a new med to add on to the other 3...........ugh...... > > >  > > >  > > > Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about " looking " like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a " we don't know " and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not. > > >  > > > Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. > > >  > > > But this is what were up against > > > ....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be " that " patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. > > >  > > >  > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2012 Report Share Posted June 26, 2012 Where are the aldo results?CE Grim MDOn Jun 25, 2012, at 6:54 PM, wrote: On Feb. 22, 2007 my doctor was smart enough to test renin and aldo, here is the result of the renin test from Quest Diag. Lab.: RENIN 0.1 Low ng/mL/hr (0.65-5.0) Final WHITE RIVER JCT VAMROC Interpretation: Ref Range Prior to 9/27/2010-0.65 to 5.0 ng/mL/h Non-hypertensive adults: (upright/sitting) : 0.65-5.0 ng/mL/hr Clinical Cutoffs for Hypertensive Individual(ng/mL/hr)s: Low-renin sodium/volume-mediated hypertension likely: <0.65 Primary aldosteronsim possible: <0.65 Unfortunately she wasn't smart enough to go any further and figure out PA! I was finally Dxed in 2010, sure would like those 3 years back! > > > > > > > > > > > >  > > > Amazing. > > >  > > > Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a "we don't know" and a new med to add on to the other 3...........ugh...... > > >  > > >  > > > Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about "looking" like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a "we don't know" and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not. > > >  > > > Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. > > >  > > > But this is what were up against > > > ....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be "that" patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. > > >  > > >  > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2012 Report Share Posted June 26, 2012 Please send or take them all my Evolution article so they stop missing all the others like you they are seeing.CE Grim MDOn Jun 25, 2012, at 6:00 PM, Fred wrote: It would not be bad if it was just missed by one PCP. It was missed by two PCP's, two cardiologists and two endocrinologists. All of which had all my labs available which showed low K. From: <jclark24p@...> hyperaldosteronism Sent: Monday, June 25, 2012 8:41 PM Subject: Re: PA Education Fred, I think I found the problem! I did a Pubmed on "(arrhythmia) AND monkey" and came up with 142,412 hits (try it)! The problem is they are not taught the difference between Humans and Monkeys! > >> > > > > >  > > Amazing. > >  > > Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a "we don't know" and a new med to add on to the other 3...........ugh......> >  > >  > > Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about "looking" like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a "we don't know" and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not.> >  > > Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. > >  > > But this is what were up against > > ....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be "that" patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. > >  > >  > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 Don't think you need a new Cardio just a good Internist who has read my evolution article and listens and cares.CE Grim MDOn Jun 25, 2012, at 1:48 PM, Bingham wrote: Amazing. Reminds me of being 40 years old sitting in a hospital bed in Lubbock Texas, supposedly one of the best heart hospitals in Texas, under the care of a prestigious cardiologist (And who I knew very well on a professional level) for uncontrolled HTN and hypokalemia (which is documented as not being my first time down that road), and I get chest CT's, echos, treadmills, you name it I get everything EXCEPT 24 hour urine, no aldo or renin check, no kidney checks, and nothing else. They even ask me a few times if I wanted something for my headache - a pain pill - that somehow never shows up x 3 seperate times where oddly the nurse was a bit more peppy though not long after they ask me if I want the pill (same nurse every time).....yet I go home with LVH and a "we don't know" and a new med to add on to the other 3...........ugh...... Fast foward to 09/2010 in Prescott Valley AZ in the hospital for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th visit to this hospital or it's ER in 2 years ALWAYS with hypokalemia and uncontrolled HTN and this time I do get a 24 hour urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or renin checked with it, just catecholamines each time, and no discussion whatsoever about my low K, though the doc talks to me a bunch about "looking" like I was in decent shape to have that kind of BP, and I go home with a new med to add to the other 4, but they sort of r/o pheo, and I get a "we don't know" and a present of the hydrazaline, which didn't work in the hospital or out of it and which I stop, or never take as I knew by then it didn't work and if 4 meds didn't do it I knew 5 would not. Then a new cardiologist a month or two later decides that spiro is the only one I haven't tried, but with my 180/140 didn't want to wait to try it. And the rest is history. 2 doses and he was the Einstein in the bunch, then he had a nervous breakdown and had to stop, of course, that's how it works, so now I am looking for a new cardio. But this is what were up against ....so fight for your friend and help him fight for himself as we the patient, even with our medical backgrounds, don't want to be "that" patient we all know so I think we hold way back......but 30 years of high BP? Time to fix his problem. Crazy world this is. From: Phyllis <phylisrn@...>Subject: PA Educationhyperaldosteronism Date: Monday, June 25, 2012, 1:20 PM I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine.Potassium was also low. Now how likely is it that two people from one unit develop a rare disease?I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference.I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lackof a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro.I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them.5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia,current meds Spiro 25mg, Benicar 20mg bid, dashingPhyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 Spiro or MCB AND DASH.You can out salt spiro or MCB and not get enough K.So when you talk about aldo and HTN always talk about aldo and SALT hypertension. Without excess salt no high BP etc from excess aldo.Say it again: NO excess salt no HTN etc from excess aldo. One more time: NO excess salt no HTN etc from excess aldo. I attach somethings I have written about HTN in AA that may be of interest as well. You can do a pubmed on Grim CE for others on hypertension in AAs. You may also want to do a lecture to the residents on the Grim Hypothesis relevant to HTN in AAs. CE Grim MDOn Jun 25, 2012, at 1:12 PM, Dianne strong wrote: Yea! You go girl!! Bet they suddenly start finding a whole bunch of cases of that "rare" syndrome of PA.You and I are in about the same frame of mind Phyllis. PA has taken its toll on our health, but we can still help others to find a diagnosis quicker, and hopefully with less long-term damage than we have. I blab about PA to anyone I can, so that when they come across someone they know with high BP and low K, they may be able to remember to mention something to them about trouble with their adrenals. Dianne 69, bi-lateral adenomas 1.2cm rt, 1cm left 25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July 2010 Had to demand tests to confirm PA, from scoffing NP CKD. Kidney function fell after use of contrast dye during CT scan 8/2010. Now on 50mg Spiro, 12.5mg Atenolol BP avg. 130/70 Dashing with very low Na (aim for 1,000mg) and high enough K to keep me in range, but not so high as to further damage kidneys. From: Phyllis <phylisrn@...>Subject: PA Educationhyperaldosteronism Date: Monday, June 25, 2012, 11:20 AM I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine. Potassium was also low. Now how likely is it that two people from one unit develop a rare disease? I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference. I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lack of a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro. I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them. 5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis 2 of 2 File(s) Grim Slavery Laragh 1995.pdf Slavery paper and Frey.pdf Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 What % of your pts are AA?CE Grim MDOn Jun 25, 2012, at 11:20 AM, Phyllis wrote: I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine. Potassium was also low. Now how likely is it that two people from one unit develop a rare disease? I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference. I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lack of a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro. I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them. 5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 About 75% of our patients are AA and you know they say we all have high blood pressure,but I don't think it is that simple. Many of them have the low potassium as well. One man came in with a k of 1.0 and it wouldn't go up. He had a total of 240meq IV ( 12 aloqots iv) and k came up to 2.8) We have 99.9% residents and interns that are foreign trained and I don't think they learned how to deal with AA blood pressure. 45yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except I can't recall words at times, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis On 6/27/2012 2:46 AM, Clarence Grim wrote: What % of your pts are AA? CE Grim MD On Jun 25, 2012, at 11:20 AM, Phyllis wrote: I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine. Potassium was also low. Now how likely is it that two people from one unit develop a rare disease? I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference. I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lack of a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro. I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them. 5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 About 75% of our patients are AA and you know they say we all have high blood pressure,but I don't think it is that simple. Many of them have the low potassium as well. One man came in with a k of 1.0 and it wouldn't go up. He had a total of 240meq IV ( 12 aloqots iv) and k came up to 2.8) We have 99.9% residents and interns that are foreign trained and I don't think they learned how to deal with AA blood pressure. 45yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except I can't recall words at times, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis On 6/27/2012 2:46 AM, Clarence Grim wrote: What % of your pts are AA? CE Grim MD On Jun 25, 2012, at 11:20 AM, Phyllis wrote: I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine. Potassium was also low. Now how likely is it that two people from one unit develop a rare disease? I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference. I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lack of a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro. I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them. 5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 What difference does it make when my renin was essentially zero? I was not looking for a DX tody, I've already got that! We were talking about doctors not able or knowledgble enough to do a good DX. In this case it looked like she needed to learn to " read with comprehension " , something she probbly should have picked up sometime during her 19+ years in the eduction system, IMHO! > > > > > > > > > > > > > > > > > > > >  > > > > > Amazing. > > > > >  > > > > > Reminds me of being 40 years old sitting in a hospital bed in > > Lubbock Texas, supposedly one of the best heart hospitals in Texas, > > under the care of a prestigious cardiologist (And who I knew very > > well on a professional level) for uncontrolled HTN and hypokalemia > > (which is documented as not being my first time down that road), and > > I get chest CT's, echos, treadmills, you name it I get everything > > EXCEPT 24 hour urine, no aldo or renin check, no kidney > > checks, and nothing else. They even ask me a few times if I wanted > > something for my headache - a pain pill - that somehow never shows > > up x 3 seperate times where oddly the nurse was a > > bit more peppy though not long after they ask me if I want the pill > > (same nurse every time).....yet I go home with LVH and a > > " we don't know " and a new med to add on to the other > > 3...........ugh...... > > > > >  > > > > >  > > > > > Fast foward to 09/2010 in Prescott Valley AZ in the hospital > > for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th > > visit to this hospital or it's ER in 2 years ALWAYS with > > hypokalemia and uncontrolled HTN and this time I do get a 24 hour > > urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or > > renin checked with it, just catecholamines each time, and no > > discussion whatsoever about my low K, though the doc talks to me a > > bunch about " looking " like I was in decent shape to have that kindÃâ > > €šÃ‚ of BP, and I go home with a new med to add to the > > other 4, but they sort of r/o pheo, and I get a " we don't > > know " and a present of the hydrazaline, which didn't work in the > > hospital or out of it and which I stop, or never take as I > > knew by then it didn't work and if 4 meds didn't do it I > > knew 5 would not. > > > > >  > > > > > Then a new cardiologist a month or two later decides that > > spiro is the only one I haven't tried, but with my 180/140 didn't > > want to wait to try it. And the rest is history. 2 doses and he was > > the Einstein in the bunch, then he had a nervous breakdown and had > > to stop, of course, that's how it works, so now I am looking for a > > new cardio. > > > > >  > > > > > But this is what were up against > > > > > ....so fight for your friend and help him fight for > > himself as we the patient, even with our medical backgrounds, don't > > want to be " that " patient we all know so I think we hold way > > back......but 30 years of high BP? Time to fix his problem. > > Crazy world this is. > > > > >  > > > > >  > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 Studies show you deal with AA BP the same. The ACEI not working as well has been put forth, but recent research seems to debunk that. What do you see different about AA BP thats different from my European-American one? I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine.Potassium was also low. Now how likely is it that two people from one unit develop a rare disease?I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference.I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lackof a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro.I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them.5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia,current meds Spiro 25mg, Benicar 20mg bid, dashingPhyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 Studies show you deal with AA BP the same. The ACEI not working as well has been put forth, but recent research seems to debunk that. What do you see different about AA BP thats different from my European-American one? I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine.Potassium was also low. Now how likely is it that two people from one unit develop a rare disease?I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference.I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lackof a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro.I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them.5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia,current meds Spiro 25mg, Benicar 20mg bid, dashingPhyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 My first question would be is that person REALLY Dashing or just saying they are to please you? Low K, high BP, on spiro, I'd say that person is most likely outsalting the treatment, and then maybe a cultural difference if they are fond of their fried foods, or cooks the southern fried way, or likes their fast food. I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine.Potassium was also low. Now how likely is it that two people from one unit develop a rare disease?I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference.I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lackof a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro.I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them.5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia,current meds Spiro 25mg, Benicar 20mg bid, dashingPhyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 My first question would be is that person REALLY Dashing or just saying they are to please you? Low K, high BP, on spiro, I'd say that person is most likely outsalting the treatment, and then maybe a cultural difference if they are fond of their fried foods, or cooks the southern fried way, or likes their fast food. I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine.Potassium was also low. Now how likely is it that two people from one unit develop a rare disease?I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference.I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lackof a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro.I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them.5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia,current meds Spiro 25mg, Benicar 20mg bid, dashingPhyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 Zero renin can come from a number of things. So a curious Dr. would want to know what was causing it. It would be of interest in your case if aldo has gone up since then. These includevery high salt intake-prob most commonlicorice candy, snuff, chewing tobacco or herbal flavorings.getting olderno kidneysexcess mineralocorticoid of any type or sourceBB RxApparent Mineralocorticoid Excess (AME)Some other inherited ENaC problems (Liddle's Syndrome) and other Na handling problems in the kidneys.On Jun 27, 2012, at 8:49 AM, wrote: What difference does it make when my renin was essentially zero? I was not looking for a DX tody, I've already got that! We were talking about doctors not able or knowledgble enough to do a good DX. In this case it looked like she needed to learn to "read with comprehension", something she probbly should have picked up sometime during her 19+ years in the eduction system, IMHO! > > > > > > > > > > > > > > > > > > > >  > > > > > Amazing. > > > > >  > > > > > Reminds me of being 40 years old sitting in a hospital bed in > > Lubbock Texas, supposedly one of the best heart hospitals in Texas, > > under the care of a prestigious cardiologist (And who I knew very > > well on a professional level) for uncontrolled HTN and hypokalemia > > (which is documented as not being my first time down that road), and > > I get chest CT's, echos, treadmills, you name it I get everything > > EXCEPT 24 hour urine, no aldo or renin check, no kidney > > checks, and nothing else. They even ask me a few times if I wanted > > something for my headache - a pain pill - that somehow never shows > > up x 3 seperate times where oddly the nurse was a > > bit more peppy though not long after they ask me if I want the pill > > (same nurse every time).....yet I go home with LVH and a > > "we don't know" and a new med to add on to the other > > 3...........ugh...... > > > > >  > > > > >  > > > > > Fast foward to 09/2010 in Prescott Valley AZ in the hospital > > for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th > > visit to this hospital or it's ER in 2 years ALWAYS with > > hypokalemia and uncontrolled HTN and this time I do get a 24 hour > > urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or > > renin checked with it, just catecholamines each time, and no > > discussion whatsoever about my low K, though the doc talks to me a > > bunch about "looking" like I was in decent shape to have that kindÃâ > > €šÃ‚ of BP, and I go home with a new med to add to the > > other 4, but they sort of r/o pheo, and I get a "we don't > > know" and a present of the hydrazaline, which didn't work in the > > hospital or out of it and which I stop, or never take as I > > knew by then it didn't work and if 4 meds didn't do it I > > knew 5 would not. > > > > >  > > > > > Then a new cardiologist a month or two later decides that > > spiro is the only one I haven't tried, but with my 180/140 didn't > > want to wait to try it. And the rest is history. 2 doses and he was > > the Einstein in the bunch, then he had a nervous breakdown and had > > to stop, of course, that's how it works, so now I am looking for a > > new cardio. > > > > >  > > > > > But this is what were up against > > > > > ....so fight for your friend and help him fight for > > himself as we the patient, even with our medical backgrounds, don't > > want to be "that" patient we all know so I think we hold way > > back......but 30 years of high BP? Time to fix his problem. > > Crazy world this is. > > > > >  > > > > >  > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 PA may be more common in AA.Renin tends to be very low in many normal AAs. ACE, ARB and BB data has not been debunked as I read it.Did you get my Slavery papers attached to last message which discuss physiological differences(and possible reasons for them) between AAs and EAs. I have spent the last 45 years working on this.CE Grim MDOn Jun 27, 2012, at 9:37 AM, Bingham wrote: Studies show you deal with AA BP the same. The ACEI not working as well has been put forth, but recent research seems to debunk that. What do you see different about AA BP thats different from my European-American one? I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine.Potassium was also low. Now how likely is it that two people from one unit develop a rare disease?I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference.I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lackof a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro.I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them.5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia,current meds Spiro 25mg, Benicar 20mg bid, dashingPhyllis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 Oh, Okay - I never thought of ruling all that out before checking for PA, the #1 cause of secondry HTN as I understand it! > > > > > > > > > > > > > > > > > > > > > > > > > > > >  > > > > > > > Amazing. > > > > > > >  > > > > > > > Reminds me of being 40 years old sitting in a hospital bed > > in > > > > Lubbock Texas, supposedly one of the best heart hospitals in > > Texas, > > > > under the care of a prestigious cardiologist (And who I knew very > > > > well on a professional level) for uncontrolled HTN and hypokalemia > > > > (which is documented as not being my first time down that road), > > and > > > > I get chest CT's, echos, treadmills, you name it I get everything > > > > EXCEPT 24 hour urine, no aldo or renin check, no kidney > > > > checks, and nothing else. They even ask me a few times if I wanted > > > > something for my headache - a pain pill - that somehow never shows > > > > up x 3 seperate times where oddly the nurse was a > > > > bit more peppy though not long after they ask me if I want the > > pill > > > > (same nurse every time).....yet I go home with LVH and a > > > > " we don't know " and a new med to add on to the other > > > > 3...........ugh...... > > > > > > >  > > > > > > >  > > > > > > > Fast foward to 09/2010 in Prescott Valley AZ in the hospital > > > > for uncontrolled HTN and hypokalemia, maybe my somewhere over 10th > > > > visit to this hospital or it's ER in 2 years ALWAYS with > > > > hypokalemia and uncontrolled HTN and this time I do get a 24 hour > > > > urine - twice, and CT's, ultrasounds of my kidneys, but NO aldo or > > > > renin checked with it, just catecholamines each time, and no > > > > discussion whatsoever about my low K, though the doc talks to me a > > > > bunch about " looking " like I was in decent shape to have that > > kindÃâ > > > > €šÃ‚ of BP, and I go home with a new med to add to the > > > > other 4, but they sort of r/o pheo, and I get a " we don't > > > > know " and a present of the hydrazaline, which didn't work in the > > > > hospital or out of it and which I stop, or never take as I > > > > knew by then it didn't work and if 4 meds didn't do it I > > > > knew 5 would not. > > > > > > >  > > > > > > > Then a new cardiologist a month or two later decides that > > > > spiro is the only one I haven't tried, but with my 180/140 didn't > > > > want to wait to try it. And the rest is history. 2 doses and he > > was > > > > the Einstein in the bunch, then he had a nervous breakdown and had > > > > to stop, of course, that's how it works, so now I am looking for a > > > > new cardio. > > > > > > >  > > > > > > > But this is what were up against > > > > > > > ....so fight for your friend and help him fight for > > > > himself as we the patient, even with our medical backgrounds, > > don't > > > > want to be " that " patient we all know so I think we hold way > > > > back......but 30 years of high BP? Time to fix his > > problem. > > > > Crazy world this is. > > > > > > >  > > > > > > >  > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2012 Report Share Posted June 27, 2012 They know nothing of AA history in my experience expect what they see in the movies and the news. I have trained many and had a set of recommended readings to they understood the history better.Should be mandatory in my opinion for all FMGs as well and many American trainees who also have little grasp of AA history.CE Grim MDOn Jun 27, 2012, at 4:58 AM, Phyllis wrote: About 75% of our patients are AA and you know they say we all have high blood pressure,but I don't think it is that simple. Many of them have the low potassium as well. One man came in with a k of 1.0 and it wouldn't go up. He had a total of 240meq IV ( 12 aloqots iv) and k came up to 2.8) We have 99.9% residents and interns that are foreign trained and I don't think they learned how to deal with AA blood pressure. 45yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except I can't recall words at times, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis On 6/27/2012 2:46 AM, Clarence Grim wrote: What % of your pts are AA? CE Grim MD On Jun 25, 2012, at 11:20 AM, Phyllis wrote: I am a RN in a Coronary Care Unit. I just found out another of my co-workers had a stroke and a cornea detachment from uncontrolled high blood pressure. He has had high blood pressure for 30 years. He also has the LVH, CKD, and decreased EF. He was admitted to the CCU and they were giving him norvasc, hctz, hydralazine, imdur, and labetolol 20mg q4 prn still with bp of 150/90 or higher. He is 100lbs soak and wet so they couldn't put it on his weight. Last I heard they called in a Nephro, and he ordered a 24 urine. Potassium was also low. Now how likely is it that two people from one unit develop a rare disease? I have a plan and I will present it to the Chief of residents. Everyday the residents and interns have noon conference. I will print out Dr Grims PA evolution and present a paper on PA. This is absolutely ridiculous and shameful that people are dying and being maimed for lack of a 4 dollar a month pill from Walmart. I don't understand why physicians are forgetting about Spiro? Why? In my 20 years of HBP not one doctor recommended Spiro. I have seen tons and tons of people with low potassium and uncontrolled blood pressure. I wonder if Spiro would have helped them. 5yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except slight expressive aphasia, current meds Spiro 25mg, Benicar 20mg bid, dashing Phyllis Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.