Guest guest Posted August 4, 2012 Report Share Posted August 4, 2012 Dont tell me about the diastolic. Tell me what the systolic is doing. Also check seated and standing BP each time for a few days-in your spare time preparing for exams. May your salt intake and pressure be low!Clarence Grim BS, MS, MDRetired (Semi) Professor of MedicineMedical College of Wisconsin, UCLA, R Drew, Indiana U and U of MO Columbia.Board Certified Internal Medicine, Geriatrics, Hypertension SpecialistSpecializing in difficult to control high blood pressure especially the numerous forms of Primary Aldsoteronism.Mission: Training you and your health care team to get BP, HbA1 and lipids to goal by merging lifestyle and pharmaceutical modalities.ALL advice given by me MUST be discussed with your heath care team. They know you best. Don't gamble with your life. Don't become a cyberchondriac by looking at fringe groups on the web. We encourage members of your health care team to join our efforts to learn what is new as well to update what is old but still best in the BP business. 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 But do the BP correctly. Clarence Grim MDlowerbp2@... On Aug 4, 2012, at 8:37 PM, Grim Clarence wrote: Dont tell me about the diastolic. Tell me what the systolic is doing. Also check seated and standing BP each time for a few days-in your spare time preparing for exams. May your salt intake and pressure be low!Clarence Grim BS, MS, MDRetired (Semi) Professor of MedicineMedical College of Wisconsin, UCLA, R Drew, Indiana U and U of MO Columbia.Board Certified Internal Medicine, Geriatrics, Hypertension SpecialistSpecializing in difficult to control high blood pressure especially the numerous forms of Primary Aldsoteronism.Mission: Training you and your health care team to get BP, HbA1 and lipids to goal by merging lifestyle and pharmaceutical modalities.ALL advice given by me MUST be discussed with your heath care team. They know you best. Don't gamble with your life. Don't become a cyberchondriac by looking at fringe groups on the web. We encourage members of your health care team to join our efforts to learn what is new as well to update what is old but still best in the BP business. 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 Phil, I wouldn't be afraid of Spironolactone but I would approach it with my eyes wide open. Gynocomastia set in real early for me but nobody would switch me to Eplerenone because it wasn't painful and that is the factor I would insist they pay attention to. The other thing that happened early is that I lost most of my body hair below my neck. If either or both those conditions developed I would insist on a testosterone test. (The other option might be to test testosterone first!) The biggest problem for me was they didn't make the switch early enough. I have done a lot of research and found the critical time period is a year and SX's are reversable usually if you make the switch prior to that. I also have a couple other factors to consider that my research turned up: 1) Age = 65. T starts to decrease at age 35 and decreases ~1%-2%/yr to age 70. 2) I have T2DM and T is impacted in up to 75% of men with DM. 3) I was exposed to Dioxon (Agent Orange) in Vietnam. There is research that shows this could make lower the results of both PSA and T. An indictor may be that my PSA came back at .22! But testosterone was low at 1.27 when the minimum should be >1.95. So I guess you could say I am a perfect asshole with a micro-penis! (My therapists tells me to always look for the humor in it, I see her again on Tuesday!) Hope this helps.... > > > > > > > > > > > > > > > > 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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