Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 Dr Grim, could the fact that I've been eating low sodium throughout the diagnostic process be causing a false positive for PA? My doctor didn't put me on a high sodium diet prior to testing for several reasons, mainly because I knew I would be so sick that I couldn't work. When I take in too much salt, I get severe headaches and nausea. Will post lab results when I have them. Spiro is not an option for me, and diet alone isn't enough - my unmedicated BP averages about 145/93 these days. I haven't tried Inspra yet but would really prefer to explore any alternatives to taking pills the rest of my life - I'm only 45 and plan on being around a good long time I tend to be really sensitive to medications and find more often than not, the side effects make me feel worse than the problems they are treating. - msmith1928 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > My doctor just called with the results of last week's aldosterone > > suppresion test/oral sodium loading test. As expected, my aldo was > > off the charts high, both serum and urine. (I can post numbers when > > I have a hard copy in front of me, if anyone is interested.) The > > interesting thing my doctor observed was that I did not excrete a > > lot of sodium - he believes it's because my diet is very low sodium. > > (I believe it's still trapped in my body in the form of the extra 2 > > pounds I've been carrying around since the test!) > > > > This gives me the go-ahead for AVS, or, interestingly, he said I > > could skip the AVS and have the adrenalectomy. I want to be good and > > certain that the culprit is my left adrenal before surgery, so I > > think I'm going through with the AVS first. I'm aware of the high > > risk of inconclusive results, and the risks of the procedure in > > general. > > > > This brings up two questions: how common is it to skip the AVS > > entirely? I only heard of that recently from another member here; I > > had been under the impression that standard protocol was AVS before > > surgery. > > > > And, long shot I know, but - anybody here have their AVS done at > > UCLA? Or anywhere in the greater Los Angeles area? If you have an > > interventional radiologist in the area that you'd recommend, please > > let me know. Thanks! > > > > - msmith1928 > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone > > 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg > > spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; > > low sodium, fructose- and grain-free diet > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 Hi msmith, I'm guessing you may have seen my post where I referenced I was proceeding with my laparoscopic adrenalectomy, " no AVS, no salt loading, no B.S. " ! Let me extrapolate and explain my position. First, one of my unexplained issues is a pain that radiates from my right flank area, read kidney, to my right testicle. I have been telling doctors about this for more than 6 years and when they told me they were going to look for a tumor in one of my Adrenal glands I suggested they only needed to look at the rt. one! That's where it is, a 12 x 13 mm adenoma! I`m not necessarily saying the tumor itself is causing the pain but I think it is a direct cause of the pain so I want it gone. If my theory is right, in addition to BP drugs I can get off the narcotic that I'm on for the pain. (I haven't been able to confirm that suspicion but was encouraged when I found the Cortisol in Cushing`s disease could cause a similar pain.) When asked about that condition on this website I got the response that, " We have never surveyed that particular point " and I have since heard from a couple of people who had similar pains. Why did I choose to proceed directly to the adrenalectomy instead of treating with meds? I was watching a show on TV the other night and they had a situation they called " Suicide by Cop " where the individual forced the cop to shoot him to commit suicide. Looking at all the meds. I've been taking and their side effects, I wonder if I have not been " Committing Suicide by Rx " ! :>) On a serious note, Spironolactone would probably be a good option if I wanted to go the medicine route but quite honestly I don't like some of the side effects. (I realize there are alternatives if I don't want to get too chesty but with my mind quite well made up I didn't bother to pursue.) Spiro was how my Nephrologists identified my disease. He put me on a 25 mg dose twice a day and it has done wonders. (I've so far gotten off 3 of 7 BP meds and Potassium Supp. and my BP has been: 100/48, 114/59, 103/52 and 95/58 so far this week. Just waiting for Dr. to call and tell me which is the next one I should ditch!) I don't have any interest in undoing that plus loosing 4-6 weeks while Spiro clears my system just so we could risk ruining my good Adrenal gland just so we could run a test that was going to have no bearing on my decision! Some people, including a well known Doctor, say meds are the way to go but I don't know if it cures all the symptoms or only the BP problems. There are also reputable people and organizations that say removal is the way to go and suggest steps like AVS are only necessary if you haven't identified a tumor some other way. Some places I researched so you can look yourself if you care to: American Association of Endocrine Surgeons - They have very good 2 page explanation including a flow chart of the process, my primary care physician will get a copy! (They actually skip the AVS if you are under 40, I just lied about my age and justified it because I was under 40 when it started, it just took them 35 years to find it!) THE HORMONE FOUNDATION, " When a tumor is the cause medication and lifestyle changes can be used to treat PA. However, surgery is usually recommended. " Center for Pancreatic and Biliary Diseases, University of Southern California, Department of Surgery, " Surgical removal of the adrenal gland where the tumor is located is the treatment of choice. " NATIONAL ADRENAL DISEASE FOUNDTION (NADF) Looks at Aldosterone, Cortisol and Androgens or Adrenaline in the same document, " and if they are non-functioning follow up with CT Imagining every 6 to 12 months. If they grow it should be removed because there is a potential it will become malignant. " I considered the impact of postponing and decided there could be a good possibility that if I wait too long my health might decline to a point where an operation might not be feasible in a few years. (I'm not too optimistic after this last year when I added COPD with full time oxygen and Diabetes Type II to my list of aliments! Add to that the fact that I am Morbidly Obese and I think God may have been " showing me the way " when he led me to a surgeon who lists Adrenal and Bariatric surgery among his specialties. (He said a BMI of 52 didn't scare him a bit!) He didn't hesitate at all to recommend the surgery once he saw my ct-scans and lab reports. He said he didn't have any need to study it further. I also noted there were quite a few people who originally opted to treat with medication and then opted to proceed with the surgery at a later date. The only reason I could see to wait was if I decided to die before I decided I needed to operate - THAT IS NOT AN OPTION! The sites/organizations I mentioned are quite easy to find with a web search. If you have trouble, let me know and I'll list the exact address. If you get to the point of looking into having your Adrenal Gland removed Laparoscopically there is an excellent document published by " the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) " . Check it out at: www.sages.org/publication/id/PI14 This is rather " long winded " but hopefully you found it worth while and maybe a little thought provoking if you made it this far. Good Luck in all your travels! > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > - msmith1928 > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 Hi , wow - I could almost use that logic, that I was under 40 when the symptoms started, and proceed straight to the adrenalectomy My specialist is strongly in favor of doing just that, but if I can find an experienced interventional radiologist and get my insurance to cover it, I still want the AVS. I've got a strong suspicion that mine is going to turn out to be bilateral - absolutely nothing to back this up, just my gut feeling. And my gut feeling has been right about a lot of things throughout this illness. " Committing Suicide by Rx " - seriously, I know where you're coming from on this one. My last internist had me on a miles-long list of BP meds, each with worse side effects than the previous, including increasing my BP (CCBs and ARBs have that effect on some of us). My current medical team assures me that the years I was on these meds didn't harm me in any way, but really - nobody knows. They kept my BP in a higher range than it is unmedicated, so that can't be good. I do know this - people who say " meds are the way to go " have probably never experienced the side effects of spiro themselves. I took it for a short time and it was unbearable. I understand that the risks of meds are more reversable than the risks of AVS and/or surgery, but the way I felt on spiro made life almost not worth living. Have you set a date for your surgery? Please keep us posted of your progress! - msmith1928 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > > > > - msmith1928 > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 Dr. Grim, I am really surprised and disappointed that you belittled my sources as " not having 40+ years of practice " and " Surgeons who are going to recommend surgery " . I spent a great amount of time and energy researching and verifying my information (I didn't have $500!) It does a disservice to your 500+ members who may want to investigate the whole picture. You don't need to keep repeating your intro, at least as far as I'm concerned, I've seen it many times! Just to make sure nobody misunderstands their creditability, here are their credentials taken directly from their respective web sites: About AAES The American Association of Endocrine Surgeons (AAES) is dedicated to the advancement of the science and art of endocrine surgery. Our members have clinical expertise in and research interests that focus on endocrine surgical diseases. They are certified by either the American Board of Surgery of the United States, the Royal College of Surgeons of Canada or the equivalent governing boards in Mexico and South America. Our membership has recently expanded to include international leaders in endocrine surgery and allied specialists that have demonstrated a similar focus of practice. The AAES is committed to providing surgical expertise in diseases of the thyroid, parathyroid, adrenal glands as well as in neuroendocrine tumors of the pancreas and GI tract. Our goal is to discover and promote the best treatments for endocrine disease to help improve our patients' lives. THE HORMONE FOUNDATION is the public education affiliate of The Endocrine Society according to their website. Vision for The Endocrine Society The Endocrine Society will be the leading organization for scientists and physicians involved in the study of hormones and metabolism, molecular, cellular and systems communication and related fields. Acknowledged as the foremost authority for scientific and clinical leadership and innovation, the Society will continue to pioneer basic science and discovery and clinical care that lead to enhanced treatment and cures for endocrine diseases. The Society's unique strength reflects a synergy among its diverse membership of basic researchers, clinical investigators, and physicians in practice. As a leader in fostering this synergy internationally, Society programs and services will emphasize the integration of the field and the importance of basic research and its translation to patient care. The Society will be a leader in shaping policy affecting research and patient care, closely coordinating with domestic and international partners. The Society will enhance its efforts both to advocate for increased funding for biomedical research and to ensure that the work of its clinicians is appropriately valued by health care systems. The Society will also be widely recognized for its excellent patient and public information programs through the Hormone Foundation. The Endocrine Society will solidify and expand its reputation for excellent journals, meetings, and educational programs. Students, trainees, and young professionals will be attracted to the Society by its vibrant programs which will provide opportunities to work at the cutting edge of research and practice. Our Mission The National Adrenal Diseases Foundation is a 501©(3) non-profit organization dedicated to providing support, information and education to individuals having 's disease as well as other diseases of the adrenal glands. Individuals suffering from 's disease are often misdiagnosed or go for long painful periods without proper diagnosis. Symptoms of this disease frequently and most dramatically include a darkening of the skin that may look like an inappropriate tan on a person who feels quite ill with the vague symptoms of worsening fatigue, loss of appetite and slow, gradual weight loss. Blood pressure is low and falls further upon standing, producing lightheadedness, sometimes to the point of fainting, and nausea, often to the point of vomiting. Because of salt loss, a craving for salt in any shape or form is common. Individuals with 's disease or another disease of the adrenal glands can expect to live a normal life span as long as the proper medical care is received and the correct dose of replacement medication is taken every day. NADF is committed to bringing information regarding these rare diseases into the public's awareness to facilitate early diagnosis and treatment. NADF sponsors support groups across the country allowing for an exchange of ideas and feelings by individuals who share a common illness. NADF members receive quarterly newsletters, educational materials, and access to a library of related information. NADF does not receive funding from the U.S. Government. NADF is committed to bringing information regarding these rare diseases into the public's awareness to facilitate early diagnosis and treatment. NADF sponsors support groups across the country allowing for an exchange of ideas and feelings by individuals who share a common illness. NADF members receive quarterly newsletters, educational materials, and access to a library of related information. Individuals with 's disease or another disease of the adrenal glands can expect to live a crisis-free life as long as the proper medical care is received and the correct dose of replacement medication is taken every day. The newly diagnosed can look to NADF for information from our " Facts You Need To Know " and other pamphlets. Anyone wishing to correspond with a fellow addisonian or find understanding through participation in a support group need look no further than NADF. > > > > > > My doctor just called with the results of last week's aldosterone > > suppresion test/oral sodium loading test. As expected, my aldo was > > off the charts high, both serum and urine. (I can post numbers when > > I have a hard copy in front of me, if anyone is interested.) The > > interesting thing my doctor observed was that I did not excrete a > > lot of sodium - he believes it's because my diet is very low sodium. > > (I believe it's still trapped in my body in the form of the extra 2 > > pounds I've been carrying around since the test!) > > > > > > This gives me the go-ahead for AVS, or, interestingly, he said I > > could skip the AVS and have the adrenalectomy. I want to be good and > > certain that the culprit is my left adrenal before surgery, so I > > think I'm going through with the AVS first. I'm aware of the high > > risk of inconclusive results, and the risks of the procedure in > > general. > > > > > > This brings up two questions: how common is it to skip the AVS > > entirely? I only heard of that recently from another member here; I > > had been under the impression that standard protocol was AVS before > > surgery. > > > > > > And, long shot I know, but - anybody here have their AVS done at > > UCLA? Or anywhere in the greater Los Angeles area? If you have an > > interventional radiologist in the area that you'd recommend, please > > let me know. Thanks! > > > > > > > > > - msmith1928 > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone > > 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg > > spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; > > low sodium, fructose- and grain-free diet > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2011 Report Share Posted March 2, 2011 You mentioned: " There is no reason to do repeat scans est with the risk of radiation " . I presume that was in the reference to repeating the CT imaging every 6 to 12 months in the NADF recomendation if you chose to leave it. If that is the case, how do you monitor them for growth? Their contention is that if they get very large, " there is a significant potential that it will become milignant " . > > > > > > My doctor just called with the results of last week's aldosterone > > suppresion test/oral sodium loading test. As expected, my aldo was > > off the charts high, both serum and urine. (I can post numbers when > > I have a hard copy in front of me, if anyone is interested.) The > > interesting thing my doctor observed was that I did not excrete a > > lot of sodium - he believes it's because my diet is very low sodium. > > (I believe it's still trapped in my body in the form of the extra 2 > > pounds I've been carrying around since the test!) > > > > > > This gives me the go-ahead for AVS, or, interestingly, he said I > > could skip the AVS and have the adrenalectomy. I want to be good and > > certain that the culprit is my left adrenal before surgery, so I > > think I'm going through with the AVS first. I'm aware of the high > > risk of inconclusive results, and the risks of the procedure in > > general. > > > > > > This brings up two questions: how common is it to skip the AVS > > entirely? I only heard of that recently from another member here; I > > had been under the impression that standard protocol was AVS before > > surgery. > > > > > > And, long shot I know, but - anybody here have their AVS done at > > UCLA? Or anywhere in the greater Los Angeles area? If you have an > > interventional radiologist in the area that you'd recommend, please > > let me know. Thanks! > > > > > > > > > - msmith1928 > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone > > 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg > > spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; > > low sodium, fructose- and grain-free diet > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 No date yet because I need to know exactly how $$$'s work. (My wallet is less impacted if the VA will do a referral.) The other angle I can persue is I have private ins. with Medicare Part A as secondary. I also want to contact NIH to understand exactly what they are studying. (There is one that lists at least 7 conditions. Being fat with Conn's and a Diabetic, I can address 3 of the 7!) Probably my biggest concern might be getting home to Vermont after the surgery. Regarding your direction, it looks great as far as I'm concermed If you want the AVS to be as certain as possible - go for it! I might feel differently if I wasn't considering my pain issue. Dr. Grim, do you want to take a stab at that? During my research I started to wonder if maybe some specialists were beginning to stray away from " the Gold Standard " (AVS) and rely more on CT-scans as their quality improves. I get the feeling that and experience may be where the 40-yr old threshold came in. (Ofcourse money and the Government and insurance companies probably have something to say about it!) > > > > > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > > > > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > > > > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > > > > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > > > > > > > - msmith1928 > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 You need to read this. http://f1.grp.yahoofs.com/v1/0JBvTdREU_eCt0nGgFjqcfqVjkKyKncQ6M4-FSOBSBz72HyiO3C\ QexOnilW36TPBswjU7LsAdHZu76gRy0RuG5hU0DjdyEBXlw/Endocrine_Society_PA_Guidelines.\ pdf Sprio will work in some that don't have PA. You could have a kidney problem making you BP high. It you have have done enough research you will see that 80% of adrenal gland tumors do nothing. This means that only 20% need treatment. How can Dr tell just by CT scan that your tumor is one of the 20% that is causing you problems. Only way to to find out is by proper testing by the Endocrine Society PA Guidelines. > > > > > > > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > > > > > > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > > > > > > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > > > > > > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > > > > > > > > > > - msmith1928 > > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 VA not likely to pay DHMC to do this surgery. They have there own surgeons that can do this. Even if you have to go to Boston. If meds work then even less likey VA will do surgery. > > > > > > > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > > > > > > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > > > > > > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > > > > > > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > > > > > > > > > > - msmith1928 > > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 Francis, I had a problem when I tried to access your hyperlink, this is what I got: Oops! This link appears to be broken Tell me where you were trying to send me, I'm really interested in what you have found. I have observations/commets re. your coments but will reserve them until see the whole picture. > > > > > > > > > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > > > > > > > > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > > > > > > > > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > > > > > > > > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > > > > > > > > > > > > > - msmith1928 > > > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 You make this statement based on what? I am quite aware how the VA operates and I have found out one thing, You never know if you don't ask! Does the VA have sleep studies available " in Boston " ? I had my last two, a month apart because I failed the first, done at DHMC and paid for by the VA! Regarding my experiences with VA services: My Dad, a disabled Vet, received his care at the VA in WRJ for over 50 yrs. In addition to " normal " care and some " minor " operations he gave them in excess of 5,000 volunteer hours! That was the last hospital he was in before being moved to full time care for Alzhimer. My Mom, a disabled Vet, recieved all her care, except for when she was having 6 babies, at the VA in WRJ for over 65 yrs. She actually passed away, in my arms, in their Hospitaitly Room (an excellent facility I might add. My Brother, just a " normal " vet who did his 2yrs. at the Pentagon, had his medical service at the VA in WRJ. for over 20 yrs. They did his Kidney Transplant. He actually Passed away at DHMC after the VA transfered him because they don't do dialisis (he was in intensive care with a ruptured colon and his " rented kidneys " were starting to fail after 13 yrs). Myself, just a " normal " 4-yr vet with SEA service, have had my medical service provided by the VA in WRJ since 2005. With the exception of the sleep studies, everything has been done at tne VA in WRJ. (They did tell me I would have to go to Jamica Plains for my eye surgey when it came time! Oh yes, that reminds me - my brother had his eye surgery in the VA in Albany. I provided that introduction so that you might feel comfortable that I had some idea how " the system " works! I had my Primary Care Doctor at the VA, Dr. Webster, set up my appointment with the doctor at DHMC because we (read both of us) were not comfortable with the level of experience and answers we were getting " within the systems " . I figured I could have " drilled down " and eventially got what I needed but didn't want to wait. I can always look at the DHMC visit as a " second opinion " . By the way, it cost me a $40 co-pay and it costs me a $50 co-pay at the VA, even if I see a resident - GO FIGURE! (By the way, Dr. Laycock said he got a lot of the laproscopic surgeries fron the VA because they didn't have the experience nor facilities " over there " .) KEEP THOSE CARDS AND LETTERS COMING IN - ANSWERING THEM BEATS GOING OUT IN THE COLD! For you people in warm country, it's 12 degrees at noon today with a " Bluebird sky " ! We set an all time record for snow here in Vermont for Feb. with over 44 inches! ;>) > > > > > > > > > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > > > > > > > > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > > > > > > > > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > > > > > > > > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > > > > > > > > > > > > > - msmith1928 > > > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 EMR stands for what? I didn't recognize that one but I have witnessed quite a bit that I think is on the forefront. For instance they have just opened a feature where the patient can access labs on line! Won't it be nice if you as a consulting physician had access to all lab results and commments from visits by attending Ph going back (with security and my approval of course)! You mentioned 30-45 mins per patient - Dr. Webster got way behind the day I introduced her to PA (and provided her your position paper). After 1hr and 20mins she asked if there was anything else, she was running behind! I told her she hadn't listened to my heart/lungs yet! (I wasn't concerened, I had been with Pulmanary Drs. 2-days prior!) I think that speaks well of her realizing she was being educated on something that would be very important in her future practice. I'm confident she will " spread the word " around WRJ! BTW, Don't be in too much of a hurry to take advantage of your reservation in that Ger. and Hospice unit- WE STILL NEED YOU! > > > > > > > > > > > > > > My doctor just called with the results of last week's > > aldosterone suppresion test/oral sodium loading test. As expected, > > my aldo was off the charts high, both serum and urine. (I can post > > numbers when I have a hard copy in front of me, if anyone is > > interested.) The interesting thing my doctor observed was that I did > > not excrete a lot of sodium - he believes it's because my diet is > > very low sodium. (I believe it's still trapped in my body in the > > form of the extra 2 pounds I've been carrying around since the test!) > > > > > > > > > > > > > > This gives me the go-ahead for AVS, or, interestingly, he > > said I could skip the AVS and have the adrenalectomy. I want to be > > good and certain that the culprit is my left adrenal before surgery, > > so I think I'm going through with the AVS first. I'm aware of the > > high risk of inconclusive results, and the risks of the procedure in > > general. > > > > > > > > > > > > > > This brings up two questions: how common is it to skip the > > AVS entirely? I only heard of that recently from another member > > here; I had been under the impression that standard protocol was AVS > > before surgery. > > > > > > > > > > > > > > And, long shot I know, but - anybody here have their AVS > > done at UCLA? Or anywhere in the greater Los Angeles area? If you > > have an interventional radiologist in the area that you'd recommend, > > please let me know. Thanks! > > > > > > > > > > > > > > > > > > > > > - msmith1928 > > > > > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, > > aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking > > supplements); 25mg spiro caused gynecomastia, no meds currently > > except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 I had my sleep study done at DHMC also. They wanted to send me to Boston but waiting list was to long. ED Dr wanted to do a tilt table test on me. I am not sure if DHMC can do this test but more then like they can with all the other testing they do there. They wanted me to go to Boston for this test. My PCP told me he didn't thing the tilt table test would show anything away. So I did not do it. The have one of the best eye surgeons there is. but you say the VA wants you to go to Jamica Plains for your eye surgey. Now some DHMC Dr and surgeons do also work at the VA. It does seem you have a much better Dr at the VA then I do. > > > > > > > > > > > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > > > > > > > > > > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > > > > > > > > > > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > > > > > > > > > > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > > > > > > > > > > > > > > > > - msmith1928 > > > > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 WHY USEFUL FEATURE IS DISABLED? Because Dr grim needs help to turn it on. He has tried to turn it on but it doesn't seem to work. > |> > |> Francis, I had a problem when I tried to access your hyperlink, this > |> is what I got: Oops! This link appears to be broken > |> > |> Tell me where you were trying to send me, I'm really interested in > |> what you have found. > |> > |> I have observations/commets re. your coments but will reserve them > |> until see the whole picture. > |> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 Should have said DHMC has one of the best eye surgeons there is. > > > > > > > > > > > > > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > > > > > > > > > > > > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > > > > > > > > > > > > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > > > > > > > > > > > > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > > > > > > > > > > > > > > > > > > > - msmith1928 > > > > > > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 Interestingly I'm at the same stage - doctor called today with a positive diagnosis of primary aldosteronism. Given my age (under 40 - just), general health (great), blood test results (clear cut) and an MRI that revealed a 21mm adenoma on one adrenal gland, she's 97% sure (no idea where that figure came from - will meet in person next week to find out more) that it's an APA. So is recommending skipping the AVS (which would only give a 99% certainty at best) and going straight to the adrenalectomy. I'm tending to agree - and certainly have no wish to be on drugs for life so am naturally leaning towards surgery vs. Spiro (although I'll be going on that for the short term). There have been limited studies here (I'm in Zürich, Switzerland) that surgery in the case of APA tends to be very effective. When I was in the earlier stages of diagnosis, I posted on this board to try and understand the pros and cons of surgery vs. drugs and still haven't seen a clear balance of argument so I'm sure there are points I've missed. Now I'm just trusting the judgement of my local experts. Hester > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > - msmith1928 > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 Hi Hester, sounds like a pretty similar situation to mine - otherwise great general health, clear-cut lab results, presence of an adenoma. I think my specialist may have said based on all of that, he's 99% sure that the adenoma is the culprit and that skipping the AVS is an option. As you have noted, there is very little information out there on the pros and cons of surgery vs. meds. As Dr. Grim has mentioned, we only hear from the people who are having problems. Once the problems are solved, the generally don't hang around posting to message boards, or seek them out in the first place. It's very nerve-wracking, to say the least! Please keep us posted of your progress and your decisions. - msmith1928 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > > My doctor just called with the results of last week's aldosterone suppresion test/oral sodium loading test. As expected, my aldo was off the charts high, both serum and urine. (I can post numbers when I have a hard copy in front of me, if anyone is interested.) The interesting thing my doctor observed was that I did not excrete a lot of sodium - he believes it's because my diet is very low sodium. (I believe it's still trapped in my body in the form of the extra 2 pounds I've been carrying around since the test!) > > > > This gives me the go-ahead for AVS, or, interestingly, he said I could skip the AVS and have the adrenalectomy. I want to be good and certain that the culprit is my left adrenal before surgery, so I think I'm going through with the AVS first. I'm aware of the high risk of inconclusive results, and the risks of the procedure in general. > > > > This brings up two questions: how common is it to skip the AVS entirely? I only heard of that recently from another member here; I had been under the impression that standard protocol was AVS before surgery. > > > > And, long shot I know, but - anybody here have their AVS done at UCLA? Or anywhere in the greater Los Angeles area? If you have an interventional radiologist in the area that you'd recommend, please let me know. Thanks! > > > > > > - msmith1928 > > 45, female, 5'3 " , 120 lbs, 1cm left adrenal nodule, aldosterone 42.3, renin 0.5, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia, no meds currently except 20MEQ K 2x/day; low sodium, fructose- and grain-free diet > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 I had my left adrenal removed in December 2010....I had a CT scan that showed a Mass on my right adrenal but my endo said I need the AVS to make sure that is the right one to remove.........LOW AN ..BEHOLD it was not the right adrenal that was causing my problems it was the left one......Thanks to the AVS which I had problems with but all worked out, I would have had the wrong one removed. and probably would have to take meds for the rest of my life..........Just though you would like something else to think about before you have surgery......which could be the wrong adrenal removed......or maybe the right one.........you just never know........and get someone that has alot of knowledge with AVS and with experience....Just my opinion......... Marie Re: up next, AVS Interestingly I'm at the same stage - doctor called today with a positive diagnosis of primary aldosteronism. Given my age (under 40 - just), general health (great), blood test results (clear cut) and an MRI that revealed a 21mm adenoma on one adrenal gland, she's 97% sure (no idea where that figure came from - will meet in person next week to find out more) that it's an APA. So is recommending skipping the AVS (which would only give a 99% certainty at best) and going straight to the adrenalectomy. I'm tending to agree - and certainly have no wish to be on drugs for life so am naturally leaning towards surgery vs. Spiro (although I'll be going on that for the short term).There have been limited studies here (I'm in Zürich, Switzerland) that surgery in the case of APA tends to be very effective. When I was in the earlier stages of diagnosis, I posted on this board to try and understand the pros and cons of surgery vs. drugs and still haven't seen a clear balance of argument so I'm sure there are points I've missed. Now I'm just trusting the judgement of my local experts. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 I do see a fair number of patients, more on the NORD site than on this one, who talk about how they've had to increase their meds to extremely high doses over the years, and how they've given up hope. Dr. Grim, would your opinion be that these are the people who are only taking meds and not DASHing? > > > As you have noted, there is very little information out there on the > > pros and cons of surgery vs. meds. As Dr. Grim has mentioned, we > > only hear from the people who are having problems. Once the problems > > are solved, the generally don't hang around posting to message > > boards, or seek them out in the first place. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 Marie, THANK YOU for sharing this. This is exactly what my concern is, and why I am opting for the AVS. Could you tell us what problems you had with the AVS? > > > I had my left adrenal removed in December 2010....I had a CT scan that showed a Mass on my right adrenal but my endo said I need the AVS to make sure that is the right one to remove.........LOW AN ..BEHOLD it was not the right adrenal that was causing my problems it was the left one......Thanks to the AVS which I had problems with but all worked out, I would have had the wrong one removed. and probably would have to take meds for the rest of my life..........Just though you would like something else to think about before you have surgery......which could be the wrong adrenal removed......or maybe the right one.........you just never know........and get someone that has alot of knowledge with AVS and with experience....Just my opinion......... > Marie > Re: up next, AVS > > > > Interestingly I'm at the same stage - doctor called today with a positive diagnosis of primary aldosteronism. Given my age (under 40 - just), general health (great), blood test results (clear cut) and an MRI that revealed a 21mm adenoma on one adrenal gland, she's 97% sure (no idea where that figure came from - will meet in person next week to find out more) that it's an APA. So is recommending skipping the AVS (which would only give a 99% certainty at best) and going straight to the adrenalectomy. I'm tending to agree - and certainly have no wish to be on drugs for life so am naturally leaning towards surgery vs. Spiro (although I'll be going on that for the short term). > > There have been limited studies here (I'm in Z�rich, Switzerland) that surgery in the case of APA tends to be very effective. When I was in the earlier stages of diagnosis, I posted on this board to try and understand the pros and cons of surgery vs. drugs and still haven't seen a clear balance of argument so I'm sure there are points I've missed. Now I'm just trusting the judgement of my local experts. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 > You do not get HTN if you have hyperaldo unless you also eat too much salt. I totally believe people are out-salting their meds, but here is what baffles me: I eat very low sodium and unmedicated, my BP is 140s/90s. A typical day's menu: 2 eggs scrambled in olive oil, big handful of spinach, NO SALT Handful of UNSALTED almonds Salad with UNSALTED chicken breast, spinach, kale, red bell pepper, avocado, UNSALTED pecans - again, NO ADDED SALT, and absolutely no dressing Handful of UNSALTED macadamias Grilled salmon, cauliflower roasted with olive oil and pepper, NO SALT Handful of unsalted almonds I make all of this myself so I know there's NO ADDED SALT. The fish and chicken is from a natural foods store without added brine or anything like that. So - why do I still have HTN? -msmith1928 > > > > > > > As you have noted, there is very little information out there on > > the > > > > pros and cons of surgery vs. meds. As Dr. Grim has mentioned, we > > > > only hear from the people who are having problems. Once the > > problems > > > > are solved, the generally don't hang around posting to message > > > > boards, or seek them out in the first place. > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 I'll have the hard copy of the results next week, will post then. Fructose and grain intolerances prevent me from eating high K foods, but the supplements should take care of that, right? I'm lactose intolerant and avoid all dairy. > > > > > > > > > > > As you have noted, there is very little information out > > there on > > > > the > > > > > > pros and cons of surgery vs. meds. As Dr. Grim has > > mentioned, we > > > > > > only hear from the people who are having problems. Once the > > > > problems > > > > > > are solved, the generally don't hang around posting to message > > > > > > boards, or seek them out in the first place. > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 Oh and meds - sorry about that, forgot to list: singulair 10mg norethindrone .35mg cyclobenzaprine 5mg as needed potassium 20meq 2x/day > > > > > > > > > > > > > As you have noted, there is very little information out > > > there on > > > > > the > > > > > > > pros and cons of surgery vs. meds. As Dr. Grim has > > > mentioned, we > > > > > > > only hear from the people who are having problems. Once the > > > > > problems > > > > > > > are solved, the generally don't hang around posting to message > > > > > > > boards, or seek them out in the first place. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 What do you drink? > > > > > > > > > As you have noted, there is very little information out there on > > > the > > > > > pros and cons of surgery vs. meds. As Dr. Grim has mentioned, we > > > > > only hear from the people who are having problems. Once the > > > problems > > > > > are solved, the generally don't hang around posting to message > > > > > boards, or seek them out in the first place. > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 Water, coffee, and green tea, nothing added. Occasional glass of wine (like, one every few months). > > > > > > > > > > > As you have noted, there is very little information out there on > > > > the > > > > > > pros and cons of surgery vs. meds. As Dr. Grim has mentioned, we > > > > > > only hear from the people who are having problems. Once the > > > > problems > > > > > > are solved, the generally don't hang around posting to message > > > > > > boards, or seek them out in the first place. > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2011 Report Share Posted March 3, 2011 List what is in your green tea. Some can cause high BP > > > > > > > > > > > > > As you have noted, there is very little information out there on > > > > > the > > > > > > > pros and cons of surgery vs. meds. As Dr. Grim has mentioned, we > > > > > > > only hear from the people who are having problems. Once the > > > > > problems > > > > > > > are solved, the generally don't hang around posting to message > > > > > > > boards, or seek them out in the first place. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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