Re: Adrenelectomy numbers

[Guest guest]

40 yo WFM, 5 kids, Marine wife, L adenoma, R unable to AVSSaw the endocrinoligist today and though I had a work up in 2007 it is like starting over. That being said I liked the guy. My appt. was actually with the endocrine surgeon and not the Conn expert, but he said he did 4-5 adrenelecomies a month. Does that sound like a pretty good number to be proficient? As he practices at a cancer center he said he often takes the fat tissue around adrenal - if it seems like it could be cancerous. Is that good or bad?Also, my bloodwork showed Aldo at 33 ng/dL Plasma Renin Activity .14 and Normal is .25-5.82Aldo/PRA ratio is 235.7 normal is .9 - .28.9You have early PA if you do not have low blood K.The results of my 24 hour urine collection were unavailable, it was not salt suppressed anyway.The sodium in the urine will see if you were not salt loaded.He said Aldo was high, but not that High and he is going to do an MRI to see if tumor had grown alot. If it has he thinks it should come out as it could mean cancer. Does that sound reasonable or too invasive too fast?The MRI is a waste of time and $ IMHOCancer is very rare. I have seen one in 40 years.If you read our guidelines it should be taken in the am before meds, breaffast after 5 min rest take 3 average last 2 that is your pressure. You can take it any other time but we do not know what to do with it. Thank you for your input. It is appreciated. Also, Dr. Grim would you recommend your BP being taken in the morning before eating? I thought I read that somewhere? Would you recommend taking it at other times? I brought the BP protocol sheet and asked the lady if she could wait five minutes - "By the time I get the cuff on it will be five minutes" Maybe on Mercury, but certainly not on earth. After the second one five minutes later I asked her if she could take it manually and she told me we didn't need to.Take her our consumer's guidelines and tell her you want it done correctly. Your Dr is making life and death decisions based on her BP. If she does not do it correctly complain to Dr and the clinic manager. Tell them you are going to complain to the state Board.Hang in there.Getting BP cuff this weekend. Will calibrate it with my doctor and monitor myself!!!Happy Valentine's Day

[Guest guest]

surgery for adrenal cancer is different than for Conn's but no problem taking the fat. So he sounds like he does a lot.Are most minimally invasive?CE Grim MD40 yo WFM, 5 kids, Marine wife, L adenoma, R unable to AVSSaw the endocrinoligist today and though I had a work up in 2007 it is like starting over. That being said I liked the guy. My appt. was actually with the endocrine surgeon and not the Conn expert, but he said he did 4-5 adrenelecomies a month. Does that sound like a pretty good number to be proficient? As he practices at a cancer center he said he often takes the fat tissue around adrenal - if it seems like it could be cancerous. Is that good or bad?Also, my bloodwork showed Aldo at 33 ng/dL Plasma Renin Activity .14 and Normal is .25-5.82Aldo/PRA ratio is 235.7 normal is .9 - .28.9The results of my 24 hour urine collection were unavailable, it was not salt suppressed anyway.He said Aldo was high, but not that High and he is going to do an MRI to see if tumor had grown alot. If it has he thinks it should come out as it could mean cancer. Does that sound reasonable or too invasive too fast?Thank you for your input. It is appreciated. Also, Dr. Grim would you recommend your BP being taken in the morning before eating? I thought I read that somewhere? Would you recommend taking it at other times? I brought the BP protocol sheet and asked the lady if she could wait five minutes - "By the time I get the cuff on it will be five minutes" Maybe on Mercury, but certainly not on earth. After the second one five minutes later I asked her if she could take it manually and she told me we didn't need to.Getting BP cuff this weekend. Will calibrate it with my doctor and monitor myself!!!Happy Valentine's Day

[Guest guest]

Does that mean if I have low blood K I have a further progressed form? I do have low blood K. I believe 2.9 where 3.6 - 5.4 was normal.You have early PA if you do not have low blood K.Do you recommend calling and telling him I won't have it? He was pretty insistent that I do this first. Since my husband is military I sometimes feel that providers test like crazy. The MRI is a waste of time and $ IMHOCancer is very rare. I have seen one in 40 years.Dr. Grim, I have been reading so much from this site. It is a treasure trove of info. I remembered the three times and averaging the last two, just wasn't sure about measuring it at other times of the

day.If you read our guidelines it should be taken in the am before meds, breaffast after 5 min rest take 3 average last 2 that is your pressure. You can take it any other time but we do not know what to do with it.

[Guest guest]

I know he used the DaVinci robot some, but prefers laprascopy. I did not ask how many had to be converted to non laprascopic procedures. Will add this to my list of questions.Are most minimally invasive?CE Grim MD40 yo WFM, 5 kids, Marine wife, L adenoma, R unable to AVSSaw the endocrinoligist today and though I had a work up in 2007 it is like starting over. That being said I liked the guy. My appt. was actually with the endocrine surgeon and not the Conn expert, but he said he did 4-5 adrenelecomies a month. Does that sound like a pretty good number to be proficient?

As he practices at a cancer center he said he often takes the fat tissue around adrenal - if it seems like it could be cancerous. Is that good or bad?Also, my bloodwork showed Aldo at 33 ng/dL Plasma Renin Activity .14 and Normal is .25-5.82Aldo/PRA ratio is 235.7 normal is .9 - .28.9The results of my 24 hour urine collection were unavailable, it was not salt suppressed anyway.He said Aldo was high, but not that High and he is going to do an MRI to see if tumor had grown alot. If it has he thinks it should come out as it could mean cancer. Does that sound reasonable or too invasive too

fast?Thank you for your input. It is appreciated. Also, Dr. Grim would you recommend your BP being taken in the morning before eating? I thought I read that somewhere? Would you recommend taking it at other times? I brought the BP protocol sheet and asked the lady if she could wait five minutes - "By the time I get the cuff on it will be five minutes" Maybe on Mercury, but certainly not on earth. After the second one five minutes later I asked her if she could take it manually and she told me we didn't need to.Getting BP cuff this weekend. Will calibrate it with my doctor and monitor myself!!!Happy Valentine's Day

Don't get soaked. Take a quick peek at the forecast with theYahoo! Search weather shortcut.

[Guest guest]

yes if you reread my evolution article you will see that everyone starts with a normal K, normal aldo and normal renin. In your intro header you need to add bump size, lowest K and response to spiro. Again always include it in all of your notes. I mac mail I can add this as part of my signature.Does that mean if I have low blood K I have a further progressed form? I do have low blood K. I believe 2.9 where 3.6 - 5.4 was normal.You have early PA if you do not have low blood K.Do you recommend calling and telling him I won't have it? He was pretty insistent that I do this first. Since my husband is military I sometimes feel that providers test like crazy. If you read the Endosociety guidelines in our files they do not recommend it. What was the size of you bump?Request that they do not use contrast material as if carries some risk. As far as we know now MRI carries no risk as long as you don't have metal in you. As usual it is always a gamble.If you dont have to pay then fewer worries. I guess you and I are paying for the military folks. The MRI is a waste of time and $ IMHOCancer is very rare. I have seen one in 40 years.Dr. Grim, I have been reading so much from this site. It is a treasure trove of info. I remembered the three times and averaging the last two, just wasn't sure about measuring it at other times of the day.If you read our guidelines it should be taken in the am before meds, breaffast after 5 min rest take 3 average last 2 that is your pressure. You can take it any other time but we do not know what to do with it.

[Guest guest]

good laparoscopy is the preferred one but what you want is the one he is the best at.CEGrim MDI know he used the DaVinci robot some, but prefers laprascopy. I did not ask how many had to be converted to non laprascopic procedures. Will add this to my list of questions.Are most minimally invasive?CE Grim MD40 yo WFM, 5 kids, Marine wife, L adenoma, R unable to AVSSaw the endocrinoligist today and though I had a work up in 2007 it is like starting over. That being said I liked the guy. My appt. was actually with the endocrine surgeon and not the Conn expert, but he said he did 4-5 adrenelecomies a month. Does that sound like a pretty good number to be proficient? As he practices at a cancer center he said he often takes the fat tissue around adrenal - if it seems like it could be cancerous. Is that good or bad?Also, my bloodwork showed Aldo at 33 ng/dL Plasma Renin Activity .14 and Normal is .25-5.82Aldo/PRA ratio is 235.7 normal is .9 - .28.9The results of my 24 hour urine collection were unavailable, it was not salt suppressed anyway.He said Aldo was high, but not that High and he is going to do an MRI to see if tumor had grown alot. If it has he thinks it should come out as it could mean cancer. Does that sound reasonable or too invasive too fast?Thank you for your input. It is appreciated. Also, Dr. Grim would you recommend your BP being taken in the morning before eating? I thought I read that somewhere? Would you recommend taking it at other times? I brought the BP protocol sheet and asked the lady if she could wait five minutes - "By the time I get the cuff on it will be five minutes" Maybe on Mercury, but certainly not on earth. After the second one five minutes later I asked her if she could take it manually and she told me we didn't need to.Getting BP cuff this weekend. Will calibrate it with my doctor and monitor myself!!!Happy Valentine's DayDon't get soaked. Take a quick peek at the forecast with theYahoo! Search weather shortcut.