Guest guest Posted March 6, 2011 Report Share Posted March 6, 2011 Well lets say you have your scan on the day of your 40th birthday. Do you now need to automatically get an AVS. My guess is there is no data to support the 40 thing.CE Grim MDI'm also interested in the actual stats on 'much less'. If the recommendation of the AAES (if that's how they're known) is to skip AVS if you're under 40, I presume they base this on some data that supports that (my yet-to-be-supported 97%?)? Especially as over 40 they clearly recommend AVS first so it's not that they're anti-AVS. And is it even more näive to imagine that my position is currently a lifetime of drugs vs. surgery that may or may not lead to cure. And if it doesn't lead to cure, then I have a lifetime of drugs (either immediately or whenever I get a recurrence on the other side). If surgery is not successful, does that mean a higher drug requirement than if I just opt for drugs straight off? Or is it a question of life expectancy? What downside have I missed?I get the clear risk that the growth on one side could be benign and co-incidentally the other, apparently clear, side could be the trouble maker (or it could be bilateral) but if I can get a justification for 97%, that's a 3% risk I'm willing to take (topside risk given that even AVS will not necessarily give a clear picture). Especially if the only downside of the risk is a lifetime of drugs. I'm not ignoring DASH and all that but I see that as supplementary in every scenario - it's not going to effect a cure for me.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 8, 2011 Report Share Posted March 8, 2011 I think splitting hairs over the number 40 is totally off the mark and is not your question! The age is probably really 41 or 42 but 40 is easier to remember and is slightly on the conservitive side to keep the medical malpractice insurers happy. My guess is that if an AVS was a simple $36.50 blood test with almost no risk (of failure or mortality) the recommendation would be for everyone to have one. My guess is that many factors were taken into consideration and it is a finacial vs risk answer. It's the actuaries that rule the world and No, I'm not an actuary! The reality is that AVS is a rather expensive test with more risk than simply removing a sliver. Other things to consider are things like the length of time you'll have to " live with it " , likelihood it will grow and become cancerous, etc. I won't humor you with all the factors that enter into the decision (including personal biasis). And the list goes on and on, you can probably come up with as many as I can. When all is said and done you put it in a big pot an out pops a guideline. The pesimests will say you are wrong, everyone should be AVS'd while the optomists will say 45 and we can all stay " gainfully employed " for the next decade! As an aside but as a good example, this morning they are talking about the 16 year old high school student who died playing basketball. The debate goes on that maybe there should be a test for enlarged hearts. It's so simple, just a quick xray. And then you read the current " Reader's Digest " and an artic le, " News that could save your life, 15 medical breakthroughs from America's top S " octors " . Number 10 is " MORE CAUTION ABOUT TEST " . It goes on to state that, " More than one in 300 women and one in 600 men who undergo a single cardiac CT scan will develop cancer because of the radiation expsure, one study showed. " And the debate goes on - there were actually two similar student deaths last week that I heard about! > > > > > > > > > > > > > > > > > > > > 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...
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