Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 First, it is just as well you stopped the coversyl, it will not work with PA so I would expect no change unless you lost a side effect! (It is an ACE inhibitor and you have to have renin for them to work.) You previously mentioned trouble sleeping and staying asleep. Do you have or have you been checked for sleep apnea? Do you snore? 2) Let's talk about stress/anxitey. I don't know if the adenoma can increase it but if you have a co-existing cortisol problem stress will increase cortsol exacerbating the problem. Have you been checked for excess cortisol, particularly a late night test? (I presume if you had full blown Cushing's Syndrome somebody would notice but they are finding extra cortisol or an inappropriate rhythm (subclinical cushing's) is co-existing with PA more often than they once thought.) 3) You talked about sodium intake today, which sounds low IMHO. It is usually a job to get down around 1200/day so make sure you are including everything, reading labels and paying attention to portion control. Are you dashing? If you aren't seeing any improvement I would guess it is still a sodium issue and MCB's won't work until you get it right as measured by a urine test. Do you have anything going on beside PA and HTN? A thumbnail would help until we get to know you. > > Dr Grim (or anyone with advice) > > Most of my story came out in a previous message: I'm currently having some problems that are concerning me. > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to hospital with BP = 220/120 (ish) > Diagnosed with Conn's July 11th. > Bloodwork, Ultrasound and CT scan confirmed this. > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl > No improvement in BP...starts off @ 140/90 in the morning and drifts to ~ 170/110 in the evening. > July 17 - Increase in Coversyl to 8mg > No improvement in BP - start getting headaches (all day) shortly after. > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > Aug 2 - Dizzy & headache all day > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain fog > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > My diastolic has not gone below 90 mmHg in a month. > My sodium intake has been around 400mg today (4:30pm) > This all on a Friday before a long weekend!...there's no help available (except hospital...and they don't know ANYTHING!) > > Dr. Grim: > 1) I'm looking for any advice you can give on what I should do, please> > > Dr. Grim & All: > 2) Can anybody confirm that stress/anxiety " triggers " the adenoma making the situation worse? (when I get this dizzy, from HTN or otherwise, my body " thinks " there's something wrong and it triggers " anxiety rushes " inside, this makes things worse). > 3) How come Inspra is not controlling the aldosterone? > 4) I feel REALLY awful right now...is this temporary?...how can I get some relief? > > Phil > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 You may want to hire me as a one on one consultant to work with you and your team to get back to feeling better.My fee is $500 for 1 year. This gives you and your team one on one access to my expertise by email, tele, iChat etc. Clarence Grim MDlowerbp2@... On Aug 3, 2012, at 3:32 PM, philvsphil wrote: Dr Grim (or anyone with advice) Most of my story came out in a previous message: I'm currently having some problems that are concerning me. Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to hospital with BP = 220/120 (ish)amolodipine alone a this does may not do much for PA especially if you are eating more than 1500 mg of sodium a day. Diagnosed with Conn's July 11th. Bloodwork, Ultrasound and CT scan confirmed this. Nodule on right adrenal gland ~ 1.8 x 1.4 cm. Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L July 11 - Started on 50mg Eplerenone (Inspra) No a very big dose of eplereonone for full blown PA. & 4mg Coversyl No improvement in BP...starts off @ 140/90 in the morning and drifts to ~ 170/110 in the evening. July 17 - Increase in Coversyl to 8mg Covesyl will not work in PA.Review my evolution article and take to your team. No improvement in BP - start getting headaches (all day) shortly after.B Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. Aug 2 - Dizzy & headache all day Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain fog When dizzy always check your standing BP as well as a post exercise BP such as stepping up and down on a step 10 times. BP: 8am=134/90, 11am=150/93, 1pm=173/106 My diastolic has not gone below 90 mmHg in a month.Is you device accurate on you for diastolic BP. focus on the top number. My sodium intake has been around 400mg today (4:30pm)average 1500 mg a day and 4700 mg a day of K. This all on a Friday before a long weekend!...there's no help available (except hospital...and they don't know ANYTHING!) Dr. Grim: 1) I'm looking for any advice you can give on what I should do, please> Dr. Grim & All: 2) Can anybody confirm that stress/anxiety "triggers" the adenoma making the situation worse? (when I get this dizzy, from HTN or otherwise, my body "thinks" there's something wrong and it triggers "anxiety rushes" inside, this makes things worse).Stress has little to do with it. 3) How come Inspra is not controlling the aldosterone?Need more Eplere and less Na and More K 4) I feel REALLY awful right now...is this temporary?...how can I get some relief?DASH Phil Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 Thanks for the response Re sleep: I have sleep apnea (although not obese, 230lbs @ 6'-1 " ...just a little big). I use a CPAP machine every night, all night. I have not been checked for excess cortisol, haven't been checked for Cushing's, and don't show any symptoms. I will certainly get the late night cortisol checked! As mentioned in a previous note, I have not been able to sleep through the night for over 3 years (every night), I have tried to explain to doctors that I feel these little " rushes " sometimes at night and/or wake up feeling like I just had one. Re sodium: I read every label on each bit of food/liquid I put in my mouth. I'm fairly confident on my accuracy. I have been " afraid " of sodium for a while now because of the HUGE reaction - HTN - (before PA Dx). I just ordered the DASH book, but I'm very good about monitoring my sodium intake...and I never eat any processed meat (that almost kills me), or many processed foods at all. Lots of fruit and vegetables, fresh meat, water etc...my only real weakness is chocolate...I do have some breakdowns with this. Other major symptoms, other than PA and HTN (in order of severity - some may be related to PA & HTN): Insomnia (fall asleep fine, wake up often - every 1-1/2 hours, pee often) Brain fog (huge cloud in my head that's under pressure) Fatigue (seriously unmotivated to do anything - everything is a struggle) Anxiety (panic attacks every on - changed to general anxiety disorder over time) Concentration (can barely read a book without drifting away) Memory (short term is worse) Weight gain (+30 lbs over 3 years - with a better diet) Muscle weakness (general loss of strength) Vision decline (2x worse than 2 years ago) ....I've been Dx with everything under the sun!!! I don't know about the " thumbnail " , I will figure this out and input some data. Phil > > > > Dr Grim (or anyone with advice) > > > > Most of my story came out in a previous message: I'm currently having > some problems that are concerning me. > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to > hospital with BP = 220/120 (ish) > > Diagnosed with Conn's July 11th. > > Bloodwork, Ultrasound and CT scan confirmed this. > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl > > No improvement in BP...starts off @ 140/90 in the morning and drifts > to ~ 170/110 in the evening. > > July 17 - Increase in Coversyl to 8mg > > No improvement in BP - start getting headaches (all day) shortly > after. > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > Aug 2 - Dizzy & headache all day > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain > fog > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > My diastolic has not gone below 90 mmHg in a month. > > My sodium intake has been around 400mg today (4:30pm) > > This all on a Friday before a long weekend!...there's no help > available (except hospital...and they don't know ANYTHING!) > > > > Dr. Grim: > > 1) I'm looking for any advice you can give on what I should do, > please> > > > > Dr. Grim & All: > > 2) Can anybody confirm that stress/anxiety " triggers " the adenoma > making the situation worse? (when I get this dizzy, from HTN or > otherwise, my body " thinks " there's something wrong and it triggers > " anxiety rushes " inside, this makes things worse). > > 3) How come Inspra is not controlling the aldosterone? > > 4) I feel REALLY awful right now...is this temporary?...how can I get > some relief? > > > > Phil > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 Clarence Grim MDlowerbp2@... On Aug 3, 2012, at 9:58 PM, philvsphil wrote: Thanks for the response Re sleep: I have sleep apnea (although not obese, 230lbs @ 6'-1"...just a little big). I use a CPAP machine every night, all night. I have not been checked for excess cortisol, haven't been checked for Cushing's, and don't show any symptoms. I will certainly get the late night cortisol checked! As mentioned in a previous note, I have not been able to sleep through the night for over 3 years (every night), I have tried to explain to doctors that I feel these little "rushes" sometimes at night and/or wake up feeling like I just had one. Re sodium: I read every label on each bit of food/liquid I put in my mouth. I'm fairly confident on my accuracy. I have been "afraid" of sodium for a while now because of the HUGE reaction - HTN - (before PA Dx).Most have PA 10+ years before Dx is made so I just ordered the DASH book, but I'm very good about monitoring my sodium intake...and I never eat any processed meat (that almost kills me), or many processed foods at all. Lots of fruit and vegetables, fresh meat, water etc...my only real weakness is chocolate...I do have some breakdowns with this. Other major symptoms, other than PA and HTN (in order of severity - some may be related to PA & HTN): Insomnia (fall asleep fine, wake up often - every 1-1/2 hours, pee often)CPAP may not be workingPeeing is due to low K and too much Na and PA. Brain fog (huge cloud in my head that's under pressure) Fatigue (seriously unmotivated to do anything - everything is a struggle) Anxiety (panic attacks every on - changed to general anxiety disorder over time) Concentration (can barely read a book without drifting away) Memory (short term is worse) Weight gain (+30 lbs over 3 years - with a better diet)Do you look like a pt with Cushing's? Google Cushing's the look at images. Muscle weakness (general loss of strength)CAn be due to PA (most likely) or Cushing's very rare. Vision decline (2x worse than 2 years ago) ....I've been Dx with everything under the sun!!! I don't know about the "thumbnail", I will figure this out and input some data. Phil > > > > Dr Grim (or anyone with advice) > > > > Most of my story came out in a previous message: I'm currently having > some problems that are concerning me. > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to > hospital with BP = 220/120 (ish) > > Diagnosed with Conn's July 11th. > > Bloodwork, Ultrasound and CT scan confirmed this. > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl > > No improvement in BP...starts off @ 140/90 in the morning and drifts > to ~ 170/110 in the evening. > > July 17 - Increase in Coversyl to 8mg > > No improvement in BP - start getting headaches (all day) shortly > after. > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > Aug 2 - Dizzy & headache all day > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain > fog > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > My diastolic has not gone below 90 mmHg in a month. > > My sodium intake has been around 400mg today (4:30pm) > > This all on a Friday before a long weekend!...there's no help > available (except hospital...and they don't know ANYTHING!) > > > > Dr. Grim: > > 1) I'm looking for any advice you can give on what I should do, > please> > > > > Dr. Grim & All: > > 2) Can anybody confirm that stress/anxiety "triggers" the adenoma > making the situation worse? (when I get this dizzy, from HTN or > otherwise, my body "thinks" there's something wrong and it triggers > "anxiety rushes" inside, this makes things worse). > > 3) How come Inspra is not controlling the aldosterone? > > 4) I feel REALLY awful right now...is this temporary?...how can I get > some relief? > > > > Phil > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 Thanks for your notes Dr. Grim I going to seriously consider the $500, but right now I'm broke...46 year old student, Inspra is $108/month @ 50mg, I've got to wrap my head around what is best long term (and my doctor is not covered under our health plan, so he's costing me thousands as well - he's pretty good, he's the only one who recognized and diagnosed PA)...but right now surgery is looking like an viable option...just can't wrap my head around all this right now. Do you have any other Canadian clients? The one question I would like you to comment on is: I have become severely dizzy w/ headache w/ severe brain fog....am I likely having a side effect from Inspra (now that I've moved up to 100mg from 50mg)?...I feel REALLY crappy and I've been really good with my diet?!?!?!? I'm worried about taking the full 100mg tomorrow morning. I don't want to pass out. I swear my Na was less than 1000 today, my K intake I will need to figure out...but whenever I get blood work done my K is reasonable ~ 3 - 3.9...I'm pretty good about eating high K foods & drinks. Phil > > > Dr Grim (or anyone with advice) > > > > Most of my story came out in a previous message: I'm currently having some problems that are concerning me. > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to hospital with BP = 220/120 (ish) > > > amolodipine alone a this does may not do much for PA especially if you are eating more than 1500 mg of sodium a day. > > > > Diagnosed with Conn's July 11th. > > Bloodwork, Ultrasound and CT scan confirmed this. > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > July 11 - Started on 50mg Eplerenone (Inspra) > > > > No a very big dose of eplereonone for full blown PA. > > > & 4mg Coversyl > > No improvement in BP...starts off @ 140/90 in the morning and drifts to ~ 170/110 in the evening. > > July 17 - Increase in Coversyl to 8mg > > > > Covesyl will not work in PA. > Review my evolution article and take to your team. > > No improvement in BP - start getting headaches (all day) shortly after.B > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > Aug 2 - Dizzy & headache all day > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain fog > > > > When dizzy always check your standing BP as well as a post exercise BP such as stepping up and down on a step 10 times. > > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > My diastolic has not gone below 90 mmHg in a month. > > > > Is you device accurate on you for diastolic BP. focus on the top number. > > My sodium intake has been around 400mg today (4:30pm) > > > average 1500 mg a day and 4700 mg a day of K. > > This all on a Friday before a long weekend!...there's no help available (except hospital...and they don't know ANYTHING!) > > > > Dr. Grim: > > 1) I'm looking for any advice you can give on what I should do, please> > > > > Dr. Grim & All: > > 2) Can anybody confirm that stress/anxiety " triggers " the adenoma making the situation worse? (when I get this dizzy, from HTN or otherwise, my body " thinks " there's something wrong and it triggers " anxiety rushes " inside, this makes things worse). > > > Stress has little to do with it. > > > 3) How come Inspra is not controlling the aldosterone? > > > > Need more Eplere and less Na and More K > > 4) I feel REALLY awful right now...is this temporary?...how can I get some relief? > > > > DASH > > > > Phil > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 Dr Grim CPAP is working - been to sleep clinic for confirmation Peeing has improved since implementing high K (it was accidental, I just started liking and eating/drinking high K foods and drinks. Don't look like Cushing's images. Just have " rushes " & symptoms that could be related to occasional high cortisol releases...if that makes sense...just trying to help. Phil > > > > > > > > Dr Grim (or anyone with advice) > > > > > > > > Most of my story came out in a previous message: I'm currently having > > > some problems that are concerning me. > > > > > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to > > > hospital with BP = 220/120 (ish) > > > > Diagnosed with Conn's July 11th. > > > > Bloodwork, Ultrasound and CT scan confirmed this. > > > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > > > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl > > > > No improvement in BP...starts off @ 140/90 in the morning and drifts > > > to ~ 170/110 in the evening. > > > > July 17 - Increase in Coversyl to 8mg > > > > No improvement in BP - start getting headaches (all day) shortly > > > after. > > > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > > > Aug 2 - Dizzy & headache all day > > > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain > > > fog > > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > > > My diastolic has not gone below 90 mmHg in a month. > > > > My sodium intake has been around 400mg today (4:30pm) > > > > This all on a Friday before a long weekend!...there's no help > > > available (except hospital...and they don't know ANYTHING!) > > > > > > > > Dr. Grim: > > > > 1) I'm looking for any advice you can give on what I should do, > > > please> > > > > > > > > Dr. Grim & All: > > > > 2) Can anybody confirm that stress/anxiety " triggers " the adenoma > > > making the situation worse? (when I get this dizzy, from HTN or > > > otherwise, my body " thinks " there's something wrong and it triggers > > > " anxiety rushes " inside, this makes things worse). > > > > 3) How come Inspra is not controlling the aldosterone? > > > > 4) I feel REALLY awful right now...is this temporary?...how can I get > > > some relief? > > > > > > > > Phil > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 Understand cost issue. Thought everything was covered under Canadian system. $500 is not thousands down here.What is BP when dizzy.Add 1 cup of low Na spicy V-8 daily and see what happens.So you are on no other meds? Clarence Grim MDlowerbp2@... On Aug 3, 2012, at 10:28 PM, philvsphil wrote: Thanks for your notes Dr. Grim I going to seriously consider the $500, but right now I'm broke...46 year old student, Inspra is $108/month @ 50mg, I've got to wrap my head around what is best long term (and my doctor is not covered under our health plan, so he's costing me thousands as well - he's pretty good, he's the only one who recognized and diagnosed PA)...but right now surgery is looking like an viable option...just can't wrap my head around all this right now. Do you have any other Canadian clients? The one question I would like you to comment on is: I have become severely dizzy w/ headache w/ severe brain fog....am I likely having a side effect from Inspra (now that I've moved up to 100mg from 50mg)?...I feel REALLY crappy and I've been really good with my diet?!?!?!? I'm worried about taking the full 100mg tomorrow morning. I don't want to pass out. I swear my Na was less than 1000 today, my K intake I will need to figure out...but whenever I get blood work done my K is reasonable ~ 3 - 3.9...I'm pretty good about eating high K foods & drinks. Phil > > > Dr Grim (or anyone with advice) > > > > Most of my story came out in a previous message: I'm currently having some problems that are concerning me. > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to hospital with BP = 220/120 (ish) > > > amolodipine alone a this does may not do much for PA especially if you are eating more than 1500 mg of sodium a day. > > > > Diagnosed with Conn's July 11th. > > Bloodwork, Ultrasound and CT scan confirmed this. > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > July 11 - Started on 50mg Eplerenone (Inspra) > > > > No a very big dose of eplereonone for full blown PA. > > > & 4mg Coversyl > > No improvement in BP...starts off @ 140/90 in the morning and drifts to ~ 170/110 in the evening. > > July 17 - Increase in Coversyl to 8mg > > > > Covesyl will not work in PA. > Review my evolution article and take to your team. > > No improvement in BP - start getting headaches (all day) shortly after.B > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > Aug 2 - Dizzy & headache all day > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain fog > > > > When dizzy always check your standing BP as well as a post exercise BP such as stepping up and down on a step 10 times. > > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > My diastolic has not gone below 90 mmHg in a month. > > > > Is you device accurate on you for diastolic BP. focus on the top number. > > My sodium intake has been around 400mg today (4:30pm) > > > average 1500 mg a day and 4700 mg a day of K. > > This all on a Friday before a long weekend!...there's no help available (except hospital...and they don't know ANYTHING!) > > > > Dr. Grim: > > 1) I'm looking for any advice you can give on what I should do, please> > > > > Dr. Grim & All: > > 2) Can anybody confirm that stress/anxiety "triggers" the adenoma making the situation worse? (when I get this dizzy, from HTN or otherwise, my body "thinks" there's something wrong and it triggers "anxiety rushes" inside, this makes things worse). > > > Stress has little to do with it. > > > 3) How come Inspra is not controlling the aldosterone? > > > > Need more Eplere and less Na and More K > > 4) I feel REALLY awful right now...is this temporary?...how can I get some relief? > > > > DASH > > > > Phil > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 Peeing is related to low K in body. Upping K and eplerenone should help.Spiro is much much cheaper if cost is a problem.Compare price at your pharm and get on it and off eplere as many will require 200-300 of eplere. Use difference to fund the Consulting fee. Where do you live I may know someone who is a local expert. Clarence Grim MD On Aug 3, 2012, at 10:37 PM, philvsphil wrote: Dr Grim CPAP is working - been to sleep clinic for confirmation Peeing has improved since implementing high K (it was accidental, I just started liking and eating/drinking high K foods and drinks. Don't look like Cushing's images. Just have "rushes" & symptoms that could be related to occasional high cortisol releases...if that makes sense...just trying to help. Phil > > > > > > > > Dr Grim (or anyone with advice) > > > > > > > > Most of my story came out in a previous message: I'm currently having > > > some problems that are concerning me. > > > > > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to > > > hospital with BP = 220/120 (ish) > > > > Diagnosed with Conn's July 11th. > > > > Bloodwork, Ultrasound and CT scan confirmed this. > > > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > > > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl > > > > No improvement in BP...starts off @ 140/90 in the morning and drifts > > > to ~ 170/110 in the evening. > > > > July 17 - Increase in Coversyl to 8mg > > > > No improvement in BP - start getting headaches (all day) shortly > > > after. > > > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > > > Aug 2 - Dizzy & headache all day > > > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain > > > fog > > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > > > My diastolic has not gone below 90 mmHg in a month. > > > > My sodium intake has been around 400mg today (4:30pm) > > > > This all on a Friday before a long weekend!...there's no help > > > available (except hospital...and they don't know ANYTHING!) > > > > > > > > Dr. Grim: > > > > 1) I'm looking for any advice you can give on what I should do, > > > please> > > > > > > > > Dr. Grim & All: > > > > 2) Can anybody confirm that stress/anxiety "triggers" the adenoma > > > making the situation worse? (when I get this dizzy, from HTN or > > > otherwise, my body "thinks" there's something wrong and it triggers > > > "anxiety rushes" inside, this makes things worse). > > > > 3) How come Inspra is not controlling the aldosterone? > > > > 4) I feel REALLY awful right now...is this temporary?...how can I get > > > some relief? > > > > > > > > Phil > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 Most likely not K repleted yet. Have team check a spot urine Na and K and creatinine ASAP. Clarence Grim MD On Aug 3, 2012, at 10:28 PM, philvsphil wrote:The one question I would like you to comment on is: I have become severely dizzy w/ headache w/ severe brain fog....am I likely having a side effect from Inspra (now that I've moved up to 100mg from 50mg)?...I feel REALLY crappy and I've been really good with my diet?!?!?!? I'm worried about taking the full 100mg tomorrow morning. I don't want to pass out. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2012 Report Share Posted August 3, 2012 Spikes in insulin leading to low blood sugars are common in many people at night and the symptoms would mimic high cortisol - sweats, anxiousness, mania (or very alert/insomnia) , heart racing, etc, but that is just one idea. A low oxygen state does that too and the body wakes often with the same symptoms. But many of those conditions - severe hypoglycemia, hypoxia, trigger that rapid stress respone so cortisol and catecholamines is kind of a factor anyway. A spike OR drop in the blood pressure while asleep could do it to, I guess, I can't say I ever knew anyone, or even me, who has there's checked or monitored all night for that. Just some ideas. I have a weird sleep issue wherein I fall asleep, but within minutes I startle awake, heart racing real fast, sweating, and a real panicked feeling and then it can take me hours to get asleep again. I am an old paramedic (old as in 45 yo now but I started on the ambulance full-time when I was 18:-)) so I developed a light sleep pattern over the years (had to semi- listen for the "tones" or an alarm all night when working) and I don't think mine is blood sugar, but maybe a sleep apnea thing. Don't have the $ for a study, but I don't fit the average profile (I am thin, small neck, HUGE brain....okay I added that last one, but it sounded good), but one never knows. It's a creepy feeling though. BTW I suffered from insomnia for YEARS and for me it was the # 1 complaint when I went to see my doc (sadly, my BP would be 180/140 and my K 2.5 but I kept getting misdiagnosed over and over and plus I had chronic low K so I felt miserable every day and the high BP was mostly silent as to me feeling worse) but when I finally fixed the K i now sleep so much better, but not great. Insomnia is a tough one, do you agree? because I find the docs or PA's or NP's always compare it to what THEY have felt in the past and when I also had hyperthyroid I could be awake for a week easy and I told them the truth but they didn't believe me, or would go "Yeah when I was in school I had trouble sleeping blah blah blah" but for me, insomnia was the thing that bothered me personally more than anything else symptom wise. It realy screws with the mind after a while. From: philvsphil <philvsphil@...>Subject: Re: Not Getting Betterhyperaldosteronism Date: Friday, August 3, 2012, 9:58 PM Thanks for the response Re sleep: I have sleep apnea (although not obese, 230lbs @ 6'-1"...just a little big). I use a CPAP machine every night, all night.I have not been checked for excess cortisol, haven't been checked for Cushing's, and don't show any symptoms. I will certainly get the late night cortisol checked! As mentioned in a previous note, I have not been able to sleep through the night for over 3 years (every night), I have tried to explain to doctors that I feel these little "rushes" sometimes at night and/or wake up feeling like I just had one.Re sodium: I read every label on each bit of food/liquid I put in my mouth. I'm fairly confident on my accuracy. I have been "afraid" of sodium for a while now because of the HUGE reaction - HTN - (before PA Dx). I just ordered the DASH book, but I'm very good about monitoring my sodium intake...and I never eat any processed meat (that almost kills me), or many processed foods at all. Lots of fruit and vegetables, fresh meat, water etc...my only real weakness is chocolate...I do have some breakdowns with this.Other major symptoms, other than PA and HTN (in order of severity - some may be related to PA & HTN):Insomnia (fall asleep fine, wake up often - every 1-1/2 hours, pee often)Brain fog (huge cloud in my head that's under pressure)Fatigue (seriously unmotivated to do anything - everything is a struggle)Anxiety (panic attacks every on - changed to general anxiety disorder over time)Concentration (can barely read a book without drifting away)Memory (short term is worse)Weight gain (+30 lbs over 3 years - with a better diet)Muscle weakness (general loss of strength)Vision decline (2x worse than 2 years ago)...I've been Dx with everything under the sun!!!I don't know about the "thumbnail", I will figure this out and input some data.Phil> >> > Dr Grim (or anyone with advice)> >> > Most of my story came out in a previous message: I'm currently having> some problems that are concerning me.> >> > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to> hospital with BP = 220/120 (ish)> > Diagnosed with Conn's July 11th.> > Bloodwork, Ultrasound and CT scan confirmed this.> > Nodule on right adrenal gland ~ 1.8 x 1.4 cm.> > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L> > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl> > No improvement in BP...starts off @ 140/90 in the morning and drifts> to ~ 170/110 in the evening.> > July 17 - Increase in Coversyl to 8mg> > No improvement in BP - start getting headaches (all day) shortly> after.> > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl.> > Aug 2 - Dizzy & headache all day> > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain> fog> > BP: 8am=134/90, 11am=150/93, 1pm=173/106> > My diastolic has not gone below 90 mmHg in a month.> > My sodium intake has been around 400mg today (4:30pm)> > This all on a Friday before a long weekend!...there's no help> available (except hospital...and they don't know ANYTHING!)> >> > Dr. Grim:> > 1) I'm looking for any advice you can give on what I should do,> please>> >> > Dr. Grim & All:> > 2) Can anybody confirm that stress/anxiety "triggers" the adenoma> making the situation worse? (when I get this dizzy, from HTN or> otherwise, my body "thinks" there's something wrong and it triggers> "anxiety rushes" inside, this makes things worse).> > 3) How come Inspra is not controlling the aldosterone?> > 4) I feel REALLY awful right now...is this temporary?...how can I get> some relief?> >> > Phil> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Does your wife say you snore or stop breathing at night? Clarence Grim MD On Aug 4, 2012, at 12:40 AM, Bingham wrote: Spikes in insulin leading to low blood sugars are common in many people at night and the symptoms would mimic high cortisol - sweats, anxiousness, mania (or very alert/insomnia) , heart racing, etc, but that is just one idea. A low oxygen state does that too and the body wakes often with the same symptoms. But many of those conditions - severe hypoglycemia, hypoxia, trigger that rapid stress respone so cortisol and catecholamines is kind of a factor anyway. A spike OR drop in the blood pressure while asleep could do it to, I guess, I can't say I ever knew anyone, or even me, who has there's checked or monitored all night for that. Just some ideas. I have a weird sleep issue wherein I fall asleep, but within minutes I startle awake, heart racing real fast, sweating, and a real panicked feeling and then it can take me hours to get asleep again. I am an old paramedic (old as in 45 yo now but I started on the ambulance full-time when I was 18:-)) so I developed a light sleep pattern over the years (had to semi- listen for the "tones" or an alarm all night when working) and I don't think mine is blood sugar, but maybe a sleep apnea thing. Don't have the $ for a study, but I don't fit the average profile (I am thin, small neck, HUGE brain....okay I added that last one, but it sounded good), but one never knows. It's a creepy feeling though. BTW I suffered from insomnia for YEARS and for me it was the # 1 complaint when I went to see my doc (sadly, my BP would be 180/140 and my K 2.5 but I kept getting misdiagnosed over and over and plus I had chronic low K so I felt miserable every day and the high BP was mostly silent as to me feeling worse) but when I finally fixed the K i now sleep so much better, but not great. Insomnia is a tough one, do you agree? because I find the docs or PA's or NP's always compare it to what THEY have felt in the past and when I also had hyperthyroid I could be awake for a week easy and I told them the truth but they didn't believe me, or would go "Yeah when I was in school I had trouble sleeping blah blah blah" but for me, insomnia was the thing that bothered me personally more than anything else symptom wise. It realy screws with the mind after a while. From: philvsphil <philvsphil@...>Subject: Re: Not Getting Betterhyperaldosteronism Date: Friday, August 3, 2012, 9:58 PM Thanks for the response Re sleep: I have sleep apnea (although not obese, 230lbs @ 6'-1"...just a little big). I use a CPAP machine every night, all night.I have not been checked for excess cortisol, haven't been checked for Cushing's, and don't show any symptoms. I will certainly get the late night cortisol checked! As mentioned in a previous note, I have not been able to sleep through the night for over 3 years (every night), I have tried to explain to doctors that I feel these little "rushes" sometimes at night and/or wake up feeling like I just had one.Re sodium: I read every label on each bit of food/liquid I put in my mouth. I'm fairly confident on my accuracy. I have been "afraid" of sodium for a while now because of the HUGE reaction - HTN - (before PA Dx). I just ordered the DASH book, but I'm very good about monitoring my sodium intake...and I never eat any processed meat (that almost kills me), or many processed foods at all. Lots of fruit and vegetables, fresh meat, water etc...my only real weakness is chocolate...I do have some breakdowns with this.Other major symptoms, other than PA and HTN (in order of severity - some may be related to PA & HTN):Insomnia (fall asleep fine, wake up often - every 1-1/2 hours, pee often)Brain fog (huge cloud in my head that's under pressure)Fatigue (seriously unmotivated to do anything - everything is a struggle)Anxiety (panic attacks every on - changed to general anxiety disorder over time)Concentration (can barely read a book without drifting away)Memory (short term is worse)Weight gain (+30 lbs over 3 years - with a better diet)Muscle weakness (general loss of strength)Vision decline (2x worse than 2 years ago)...I've been Dx with everything under the sun!!!I don't know about the "thumbnail", I will figure this out and input some data.Phil> >> > Dr Grim (or anyone with advice)> >> > Most of my story came out in a previous message: I'm currently having> some problems that are concerning me.> >> > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to> hospital with BP = 220/120 (ish)> > Diagnosed with Conn's July 11th.> > Bloodwork, Ultrasound and CT scan confirmed this.> > Nodule on right adrenal gland ~ 1.8 x 1.4 cm.> > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L> > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl> > No improvement in BP...starts off @ 140/90 in the morning and drifts> to ~ 170/110 in the evening.> > July 17 - Increase in Coversyl to 8mg> > No improvement in BP - start getting headaches (all day) shortly> after.> > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl.> > Aug 2 - Dizzy & headache all day> > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain> fog> > BP: 8am=134/90, 11am=150/93, 1pm=173/106> > My diastolic has not gone below 90 mmHg in a month.> > My sodium intake has been around 400mg today (4:30pm)> > This all on a Friday before a long weekend!...there's no help> available (except hospital...and they don't know ANYTHING!)> >> > Dr. Grim:> > 1) I'm looking for any advice you can give on what I should do,> please>> >> > Dr. Grim & All:> > 2) Can anybody confirm that stress/anxiety "triggers" the adenoma> making the situation worse? (when I get this dizzy, from HTN or> otherwise, my body "thinks" there's something wrong and it triggers> "anxiety rushes" inside, this makes things worse).> > 3) How come Inspra is not controlling the aldosterone?> > 4) I feel REALLY awful right now...is this temporary?...how can I get> some relief?> >> > Phil> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Dr Grim Drugs are not generally covered...just services (surgery, doctors visits etc.). Insurance companies cover drugs, and my insurance company is currently debating whether it is covered. Some may not think so....but I'm worth at least $500, I just need to get the big picture in mind...I'm not blowing you off, I have a final exam Aug 8th, after that I'm going to take a look at money and see what my next steps are...the $500 could be the best money spent. Dizzy all day, worsens as BP increases (as day goes on), and is very much tied in to diastolic. At 90=dizzy, 100=very dizzy, 110=extremely dizzy. I'm buying V-8 today. No other meds. I do have an IV Chelation on Wednesdays of EPTA. This is supervised by the same doctor that recognized and diagnosed PA. He knew about the ratio, and ordered all the tests/scans. Considering he's a great doctor, he's not covered by health insurance. It's considered " alternate " medicine when you start treating the " cause " of the illness rather than throwing meds at the symptoms. Phil > > > > > > > Dr Grim (or anyone with advice) > > > > > > > > Most of my story came out in a previous message: I'm currently having some problems that are concerning me. > > > > > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to hospital with BP = 220/120 (ish) > > > > > > > amolodipine alone a this does may not do much for PA especially if you are eating more than 1500 mg of sodium a day. > > > > > > > > Diagnosed with Conn's July 11th. > > > > Bloodwork, Ultrasound and CT scan confirmed this. > > > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > > > July 11 - Started on 50mg Eplerenone (Inspra) > > > > > > > > > > No a very big dose of eplereonone for full blown PA. > > > > > > > & 4mg Coversyl > > > > No improvement in BP...starts off @ 140/90 in the morning and drifts to ~ 170/110 in the evening. > > > > July 17 - Increase in Coversyl to 8mg > > > > > > > > > > Covesyl will not work in PA. > > > Review my evolution article and take to your team. > > > > No improvement in BP - start getting headaches (all day) shortly after.B > > > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > > > Aug 2 - Dizzy & headache all day > > > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain fog > > > > > > > > > > When dizzy always check your standing BP as well as a post exercise BP such as stepping up and down on a step 10 times. > > > > > > > > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > > > My diastolic has not gone below 90 mmHg in a month. > > > > > > > > > > Is you device accurate on you for diastolic BP. focus on the top number. > > > > My sodium intake has been around 400mg today (4:30pm) > > > > > > > average 1500 mg a day and 4700 mg a day of K. > > > > This all on a Friday before a long weekend!...there's no help available (except hospital...and they don't know ANYTHING!) > > > > > > > > Dr. Grim: > > > > 1) I'm looking for any advice you can give on what I should do, please> > > > > > > > > Dr. Grim & All: > > > > 2) Can anybody confirm that stress/anxiety " triggers " the adenoma making the situation worse? (when I get this dizzy, from HTN or otherwise, my body " thinks " there's something wrong and it triggers " anxiety rushes " inside, this makes things worse). > > > > > > > Stress has little to do with it. > > > > > > > 3) How come Inspra is not controlling the aldosterone? > > > > > > > > > > Need more Eplere and less Na and More K > > > > 4) I feel REALLY awful right now...is this temporary?...how can I get some relief? > > > > > > > > > > DASH > > > > > > > > Phil > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Dr Grim I will work on upping K intake. As for meds: doesn't Spiro possibly cause you to grow breasts and become impotent? I'm concerned about that...I know it's my health we're talking about but it doesn't seem like a great 1st option. I live in Barrie (1 hour north of Toronto) > > > > > > > > > > > > Dr Grim (or anyone with advice) > > > > > > > > > > > > Most of my story came out in a previous message: I'm currently having > > > > > some problems that are concerning me. > > > > > > > > > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to > > > > > hospital with BP = 220/120 (ish) > > > > > > Diagnosed with Conn's July 11th. > > > > > > Bloodwork, Ultrasound and CT scan confirmed this. > > > > > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > > > > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > > > > > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl > > > > > > No improvement in BP...starts off @ 140/90 in the morning and drifts > > > > > to ~ 170/110 in the evening. > > > > > > July 17 - Increase in Coversyl to 8mg > > > > > > No improvement in BP - start getting headaches (all day) shortly > > > > > after. > > > > > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > > > > > Aug 2 - Dizzy & headache all day > > > > > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain > > > > > fog > > > > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > > > > > My diastolic has not gone below 90 mmHg in a month. > > > > > > My sodium intake has been around 400mg today (4:30pm) > > > > > > This all on a Friday before a long weekend!...there's no help > > > > > available (except hospital...and they don't know ANYTHING!) > > > > > > > > > > > > Dr. Grim: > > > > > > 1) I'm looking for any advice you can give on what I should do, > > > > > please> > > > > > > > > > > > > Dr. Grim & All: > > > > > > 2) Can anybody confirm that stress/anxiety " triggers " the adenoma > > > > > making the situation worse? (when I get this dizzy, from HTN or > > > > > otherwise, my body " thinks " there's something wrong and it triggers > > > > > " anxiety rushes " inside, this makes things worse). > > > > > > 3) How come Inspra is not controlling the aldosterone? > > > > > > 4) I feel REALLY awful right now...is this temporary?...how can I get > > > > > some relief? > > > > > > > > > > > > Phil > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Dr Grim I will get on that! Last check was July 13th: Creatinine = 101 UMOL/L eGFR = 69 ML/MIN Urate = 316 UMOL/L Sodium = 141 MMOL/L Potassium = 3.9 MMOL/L Chloride = 105 MMOL/L > > > The one question I would like you to comment on is: I have become severely dizzy w/ headache w/ severe brain fog....am I likely having a side effect from Inspra (now that I've moved up to 100mg from 50mg)?...I feel REALLY crappy and I've been really good with my diet?!?!?!? I'm worried about taking the full 100mg tomorrow morning. I don't want to pass out. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Thanks for your insight. I'll see if I can get my BP/K/Na under control and then see where my sleep is at. I highly recommend the sleep test. I don't particularly fit the profile either, but mine was pretty bad. Having the CPAP machine has improved my quality of " minimal " sleep quite a bit. > > > > > > Dr Grim (or anyone with advice) > > > > > > Most of my story came out in a previous message: I'm currently having > > some problems that are concerning me. > > > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to > > hospital with BP = 220/120 (ish) > > > Diagnosed with Conn's July 11th. > > > Bloodwork, Ultrasound and CT scan confirmed this. > > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl > > > No improvement in BP...starts off @ 140/90 in the morning and drifts > > to ~ 170/110 in the evening. > > > July 17 - Increase in Coversyl to 8mg > > > No improvement in BP - start getting headaches (all day) shortly > > after. > > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > > Aug 2 - Dizzy & headache all day > > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain > > fog > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > > My diastolic has not gone below 90 mmHg in a month. > > > My sodium intake has been around 400mg today (4:30pm) > > > This all on a Friday before a long weekend!...there's no help > > available (except hospital...and they don't know ANYTHING!) > > > > > > Dr. Grim: > > > 1) I'm looking for any advice you can give on what I should do, > > please> > > > > > > Dr. Grim & All: > > > 2) Can anybody confirm that stress/anxiety " triggers " the adenoma > > making the situation worse? (when I get this dizzy, from HTN or > > otherwise, my body " thinks " there's something wrong and it triggers > > " anxiety rushes " inside, this makes things worse). > > > 3) How come Inspra is not controlling the aldosterone? > > > 4) I feel REALLY awful right now...is this temporary?...how can I get > > some relief? > > > > > > Phil > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 I have sleep apnea and a CPAP machine. Machine has been tested as working fine. > > > > > > > > Dr Grim (or anyone with advice) > > > > > > > > Most of my story came out in a previous message: I'm currently having > > > some problems that are concerning me. > > > > > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to > > > hospital with BP = 220/120 (ish) > > > > Diagnosed with Conn's July 11th. > > > > Bloodwork, Ultrasound and CT scan confirmed this. > > > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > > > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl > > > > No improvement in BP...starts off @ 140/90 in the morning and drifts > > > to ~ 170/110 in the evening. > > > > July 17 - Increase in Coversyl to 8mg > > > > No improvement in BP - start getting headaches (all day) shortly > > > after. > > > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > > > Aug 2 - Dizzy & headache all day > > > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain > > > fog > > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > > > My diastolic has not gone below 90 mmHg in a month. > > > > My sodium intake has been around 400mg today (4:30pm) > > > > This all on a Friday before a long weekend!...there's no help > > > available (except hospital...and they don't know ANYTHING!) > > > > > > > > Dr. Grim: > > > > 1) I'm looking for any advice you can give on what I should do, > > > please> > > > > > > > > Dr. Grim & All: > > > > 2) Can anybody confirm that stress/anxiety " triggers " the adenoma > > > making the situation worse? (when I get this dizzy, from HTN or > > > otherwise, my body " thinks " there's something wrong and it triggers > > > " anxiety rushes " inside, this makes things worse). > > > > 3) How come Inspra is not controlling the aldosterone? > > > > 4) I feel REALLY awful right now...is this temporary?...how can I get > > > some relief? > > > > > > > > Phil > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Dr Grim Should I be taking a potassium supplement?...I don't think that is recommended on Inspra? > > > The one question I would like you to comment on is: I have become severely dizzy w/ headache w/ severe brain fog....am I likely having a side effect from Inspra (now that I've moved up to 100mg from 50mg)?...I feel REALLY crappy and I've been really good with my diet?!?!?!? I'm worried about taking the full 100mg tomorrow morning. I don't want to pass out. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 These are blood tests which tell nothing about what u are eating. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Aug 4, 2012, at 8:23, philvsphil <philvsphil@...> wrote: Dr Grim I will get on that! Last check was July 13th: Creatinine = 101 UMOL/L eGFR = 69 ML/MIN Urate = 316 UMOL/L Sodium = 141 MMOL/L Potassium = 3.9 MMOL/L Chloride = 105 MMOL/L > > > The one question I would like you to comment on is: I have become severely dizzy w/ headache w/ severe brain fog....am I likely having a side effect from Inspra (now that I've moved up to 100mg from 50mg)?...I feel REALLY crappy and I've been really good with my diet?!?!?!? I'm worried about taking the full 100mg tomorrow morning. I don't want to pass out. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 It depends on how much Na u r eating how much also u make and how much also blocker u are taking May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Aug 4, 2012, at 8:40, philvsphil <philvsphil@...> wrote: Dr Grim Should I be taking a potassium supplement?...I don't think that is recommended on Inspra? > > > The one question I would like you to comment on is: I have become severely dizzy w/ headache w/ severe brain fog....am I likely having a side effect from Inspra (now that I've moved up to 100mg from 50mg)?...I feel REALLY crappy and I've been really good with my diet?!?!?!? I'm worried about taking the full 100mg tomorrow morning. I don't want to pass out. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Me too, . I have horribly fractured sleep and often wake up trembling. I take sleep meds and will do that as long as it takes. Life is too short to unnecessarily struggle. On a brighter note, I got my PICC line removed yesterday - 2 years, 2 months, 10 days.  I lost over 40 pounds while on the IV. Val F, 66, BMI 26, hyperparathyroidism, hopythyroidism, higher aldosteronism, high cortisol, breast cancer, LYME disease, untreated for 24.5 years. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of BinghamBTW I suffered from insomnia for YEARS and for me it was the # 1 complaint when I went to see my doc (sadly, my BP would be 180/140 and my K 2.5 but I kept getting misdiagnosed over and over and plus I had chronic low K so I felt miserable every day and the high BP was mostly silent as to me feeling worse) but when I finally fixed the K i now sleep so much better, but not great. Insomnia is a tough one, do you agree? because I find the docs or PA's or NP's always compare it to what THEY have felt in the past and when I also had hyperthyroid I could be awake for a week easy and I told them the truth but they didn't believe me, or would go " Yeah when I was in school I had trouble sleeping blah blah blah " but for me, insomnia was the thing that bothered me personally more than anything else symptom wise. It realy screws with the mind after a while. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Phil, I had to gradually increase Inspra as I gradually decreased spiro. Inspra gave me terrible nausea when I tried to go straight to it. If it's going to work, it could take a couple of weeks for Inspra to really kick in for you, assuming you're not out-salting it. 450 mg sodium yesterday; how much the day before The sodium > ^ BP is not simultaneous for me. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of philvsphilSent: Friday, August 03, 2012 2:33 PMhyperaldosteronism Subject: Not Getting Better Dr Grim (or anyone with advice)Most of my story came out in a previous message: I'm currently having some problems that are concerning me.Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to hospital with BP = 220/120 (ish) Diagnosed with Conn's July 11th. Bloodwork, Ultrasound and CT scan confirmed this. Nodule on right adrenal gland ~ 1.8 x 1.4 cm.Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/LJuly 11 - Started on 50mg Eplerenone (Inspra) & 4mg CoversylNo improvement in BP...starts off @ 140/90 in the morning and drifts to ~ 170/110 in the evening.July 17 - Increase in Coversyl to 8mg No improvement in BP - start getting headaches (all day) shortly after.Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl.Aug 2 - Dizzy & headache all dayAug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain fog BP: 8am=134/90, 11am=150/93, 1pm=173/106My diastolic has not gone below 90 mmHg in a month.My sodium intake has been around 400mg today (4:30pm)This all on a Friday before a long weekend!...there's no help available (except hospital...and they don't know ANYTHING!)Dr. Grim: 1) I'm looking for any advice you can give on what I should do, please>Dr. Grim & All: 2) Can anybody confirm that stress/anxiety " triggers " the adenoma making the situation worse? (when I get this dizzy, from HTN or otherwise, my body " thinks " there's something wrong and it triggers " anxiety rushes " inside, this makes things worse).3) How come Inspra is not controlling the aldosterone?4) I feel REALLY awful right now...is this temporary?...how can I get some relief?Phil Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 ,I can commiserate with you on the insomnia. I have struggled with it for years, even when I was a child. Can't offer any tips--other than I know that if I stay up surfing the net (reading up on PA or adrenalectomies! LOL), I am guaranteed to be "mental" and find it harder to sleep. Lots of people have flippantly recommended herbal solutions over the years. Don't ever try Valerian if you tend toward being "cerebral". It relaxed the muscles, but left my mind wide awake--which to me, was akin to torture. Sometimes, it's in some seemingly harmless herbal teas like Celestial Seasonings. I read my ingredients carefully now!Monika Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 IV chelation therapy for what?Beware of this form of treatment. No good trials that I am aware of. But maybe there are for what he is treating you for. I recall something about Hg and Pb?CE Grim MD On Aug 4, 2012, at 8:11 AM, philvsphil wrote: Dr Grim Drugs are not generally covered...just services (surgery, doctors visits etc.). Insurance companies cover drugs, and my insurance company is currently debating whether it is covered. Some may not think so....but I'm worth at least $500, I just need to get the big picture in mind...I'm not blowing you off, I have a final exam Aug 8th, after that I'm going to take a look at money and see what my next steps are...the $500 could be the best money spent. Dizzy all day, worsens as BP increases (as day goes on), and is very much tied in to diastolic. At 90=dizzy, 100=very dizzy, 110=extremely dizzy. I'm buying V-8 today. No other meds. I do have an IV Chelation on Wednesdays of EPTA. This is supervised by the same doctor that recognized and diagnosed PA. He knew about the ratio, and ordered all the tests/scans. Considering he's a great doctor, he's not covered by health insurance. It's considered "alternate" medicine when you start treating the "cause" of the illness rather than throwing meds at the symptoms. Phil > > > > > > > Dr Grim (or anyone with advice) > > > > > > > > Most of my story came out in a previous message: I'm currently having some problems that are concerning me. > > > > > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to hospital with BP = 220/120 (ish) > > > > > > > amolodipine alone a this does may not do much for PA especially if you are eating more than 1500 mg of sodium a day. > > > > > > > > Diagnosed with Conn's July 11th. > > > > Bloodwork, Ultrasound and CT scan confirmed this. > > > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > > > July 11 - Started on 50mg Eplerenone (Inspra) > > > > > > > > > > No a very big dose of eplereonone for full blown PA. > > > > > > > & 4mg Coversyl > > > > No improvement in BP...starts off @ 140/90 in the morning and drifts to ~ 170/110 in the evening. > > > > July 17 - Increase in Coversyl to 8mg > > > > > > > > > > Covesyl will not work in PA. > > > Review my evolution article and take to your team. > > > > No improvement in BP - start getting headaches (all day) shortly after.B > > > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > > > Aug 2 - Dizzy & headache all day > > > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain fog > > > > > > > > > > When dizzy always check your standing BP as well as a post exercise BP such as stepping up and down on a step 10 times. > > > > > > > > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > > > My diastolic has not gone below 90 mmHg in a month. > > > > > > > > > > Is you device accurate on you for diastolic BP. focus on the top number. > > > > My sodium intake has been around 400mg today (4:30pm) > > > > > > > average 1500 mg a day and 4700 mg a day of K. > > > > This all on a Friday before a long weekend!...there's no help available (except hospital...and they don't know ANYTHING!) > > > > > > > > Dr. Grim: > > > > 1) I'm looking for any advice you can give on what I should do, please> > > > > > > > > Dr. Grim & All: > > > > 2) Can anybody confirm that stress/anxiety "triggers" the adenoma making the situation worse? (when I get this dizzy, from HTN or otherwise, my body "thinks" there's something wrong and it triggers "anxiety rushes" inside, this makes things worse). > > > > > > > Stress has little to do with it. > > > > > > > 3) How come Inspra is not controlling the aldosterone? > > > > > > > > > > Need more Eplere and less Na and More K > > > > 4) I feel REALLY awful right now...is this temporary?...how can I get some relief? > > > > > > > > > > DASH > > > > > > > > Phil > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Ever had a sleep study? Very common in drug resistant HTN which responds to MCB and/or DASH. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Aug 4, 2012, at 12:31, Valarie <val@...> wrote: Me too, . I have horribly fractured sleep and often wake up trembling. I take sleep meds and will do that as long as it takes. Life is too short to unnecessarily struggle. On a brighter note, I got my PICC line removed yesterday - 2 years, 2 months, 10 days. I lost over 40 pounds while on the IV. Val F, 66, BMI 26, hyperparathyroidism, hopythyroidism, higher aldosteronism, high cortisol, breast cancer, LYME disease, untreated for 24.5 years. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of BinghamBTW I suffered from insomnia for YEARS and for me it was the # 1 complaint when I went to see my doc (sadly, my BP would be 180/140 and my K 2.5 but I kept getting misdiagnosed over and over and plus I had chronic low K so I felt miserable every day and the high BP was mostly silent as to me feeling worse) but when I finally fixed the K i now sleep so much better, but not great. Insomnia is a tough one, do you agree? because I find the docs or PA's or NP's always compare it to what THEY have felt in the past and when I also had hyperthyroid I could be awake for a week easy and I told them the truth but they didn't believe me, or would go "Yeah when I was in school I had trouble sleeping blah blah blah" but for me, insomnia was the thing that bothered me personally more than anything else symptom wise. It realy screws with the mind after a while. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Not in everyone and I thought $ was important. Cost per effective mg dose is about $18 vs $100 per month at lowest dose. So if you need higher doses it adds up quickly. If you DASH to the max you may only need $9 a month spiro vs $50 fo epler.If you get tender breasts you can switch to eplere. Also if BP and K get a lot better on spiro good presumptive evidence that excess aldo is your problem. You can out salt both of these meds as well an all other BP meds.So when we are talking about the importance of salt in you life(or death) we are not kidding.What makes them think you have Liddle's.Trust you do not eat licorice every day. CE Grim MD On Aug 4, 2012, at 8:17 AM, philvsphil wrote: Dr Grim I will work on upping K intake. As for meds: doesn't Spiro possibly cause you to grow breasts and become impotent? I'm concerned about that...I know it's my health we're talking about but it doesn't seem like a great 1st option. I live in Barrie (1 hour north of Toronto) > > > > > > > > > > > > Dr Grim (or anyone with advice) > > > > > > > > > > > > Most of my story came out in a previous message: I'm currently having > > > > > some problems that are concerning me. > > > > > > > > > > > > Prior to diagnosis = 3 years on 5mg of Amlodipine - lots of visits to > > > > > hospital with BP = 220/120 (ish) > > > > > > Diagnosed with Conn's July 11th. > > > > > > Bloodwork, Ultrasound and CT scan confirmed this. > > > > > > Nodule on right adrenal gland ~ 1.8 x 1.4 cm. > > > > > > Bloodwork: Renin = <1 ng/L ----Aldosterone = 355 pmol/L > > > > > > July 11 - Started on 50mg Eplerenone (Inspra) & 4mg Coversyl > > > > > > No improvement in BP...starts off @ 140/90 in the morning and drifts > > > > > to ~ 170/110 in the evening. > > > > > > July 17 - Increase in Coversyl to 8mg > > > > > > No improvement in BP - start getting headaches (all day) shortly > > > > > after. > > > > > > Aug 1 - Increase Inspra to 100 mg and discontinue Coversyl. > > > > > > Aug 2 - Dizzy & headache all day > > > > > > Aug 3 - Very Dizzy & mild headache & mild pain in chest & severe brain > > > > > fog > > > > > > BP: 8am=134/90, 11am=150/93, 1pm=173/106 > > > > > > My diastolic has not gone below 90 mmHg in a month. > > > > > > My sodium intake has been around 400mg today (4:30pm) > > > > > > This all on a Friday before a long weekend!...there's no help > > > > > available (except hospital...and they don't know ANYTHING!) > > > > > > > > > > > > Dr. Grim: > > > > > > 1) I'm looking for any advice you can give on what I should do, > > > > > please> > > > > > > > > > > > > Dr. Grim & All: > > > > > > 2) Can anybody confirm that stress/anxiety "triggers" the adenoma > > > > > making the situation worse? (when I get this dizzy, from HTN or > > > > > otherwise, my body "thinks" there's something wrong and it triggers > > > > > "anxiety rushes" inside, this makes things worse). > > > > > > 3) How come Inspra is not controlling the aldosterone? > > > > > > 4) I feel REALLY awful right now...is this temporary?...how can I get > > > > > some relief? > > > > > > > > > > > > Phil > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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