Re: Re: Back On Spro!!

[Guest guest]

It is dietary I can assure you.Look at the salt content of Lemon pepper.etc and be sure it is not garlic salt.Get the DASH book.How is your work pattern now compared to 10 years ago as far as walking etc.CE Grim MDYou must think I'm a bimbo, you mean Salt intake. LOL Yes I have not used in ages. I use Lemon Pepper hot peppers/season/paprika, garlic/powder. Honestly I was never this heavey since all this med juggling. I never had to exercise, my mother wasthin and petite. it's the meds and i know it. I don't eat like it's going out of style. And I get full easy. It's not dietary. I know it.S. To: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 7:21:49 PMSubject: Re: Re: Back On Spro!! How clear is it than u have PA. I CAN'T tell by your signature nTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension What do you mean, does not work in " PA". so u gain weight w/ pressure dropping? But I stopped taking Spiro, and I havelost weight. My breast were enlarged, and I put on about 20lbs. Yikes!! LiciaTo: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 5:52:50 PMSubject: Re: Re: Back On Spro!! My guess is that most lose some WT on Spiro or eplero. You gained WT on others because they do not work in PA. or as pressure drops you retain salt with excess Aldo. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension Hi Sojourner, I recently posted asking about the downside of long term spiro use because I'm worried about the same thing - I can't take spiro, but if adrenalectomy isn't an option for me I may have to start eplerenone and I am terrified of it making me fat! Every BP med I've taken has made me gain weight (that falls right off when I stop the meds without changing anything else).Have you tried eplerenone? And if so, did it have the same side effect?- msmith192845, female, 5'3", 120 lbs, 1cm left adrenal nodule, supine aldosterone 28.5/renin 0.2, potassium <2.9 (when not taking supplements); 25mg spiro caused gynecomastia; no HTN meds; current meds are 20MEQ K 2x/day, singulair 10mg, norethindrone .35mg, cyclobenzaprine 5-10mg when needed; low sodium, fructose- and grain-free diet>> Yuk, I hate Spiro!! It makes me fat!! What if I don't take it, what will happen. I was recently told to stop taking the hydrochlorizide/water pill, and start taking spiro again, due to my vitimin d levels on the floor, and potassium levels. Why can't I just take labetalol and vitamin D and a potassium supplement?>

[Guest guest]

Please read the following intro you should have gotten when you first got here.CE Grim MD Welcome to the exciting world of Hyperaldosteronism You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Your life is in the hands of those who measure your BP. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. There is a brief discussion of this in my Evolution Article. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 1-4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. I call this Dr. Grim’s “Quick Pee Test” for PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database. 8. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. What guidelines? Please expand.Thanks. To: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 9:06:02 PMSubject: Re: Re: Back On Spro!! Did they draw the K using our guidelines. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I now remember why I was told to get off of Spiro, my potassium was TOO HIGH, and the Dr thought I was going to havea heart attack. Now my potassium is too low. What is this all about, do u need to just wake up and maintain this disease?And have blood work every other day?Just got on the scale and am 148lbs. Shaking my head. I stopped drinking beer for lent/fasting and I thoughtfor sure all that barely/hop weight would pair me down at least ten lbs. Nope, I lost like 4lbs. In those 40days. S. To: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 7:27:31 PMSubject: Re: Re: Back On Spro!! Card will usually lower BP some and cause salt retention. May need sleep BP TO SEE BP effect. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension What about if the meds *raise* pressure? When I stopped Diovan and Cardizem, my average BP dropped from 165/95 to around 140/90 within a matter of days. And I dropped 10 pounds in 2 weeks.I figured that something about the HTN meds was causing water/salt retention, so your explanation makes perfect sense to me - except my BP wasn't lowered.- msmith192845, female, 5'3", 120 lbs, 1cm left adrenal nodule, supine aldosterone28.5/renin 0.2, potassium <2.9 (when not taking supplements); 25mg spiro causedgynecomastia; no HTN meds; current meds are 20MEQ K 2x/day, singulair 10mg,norethindrone .35mg, cyclobenzaprine 5-10mg when needed; low sodium, fructose-and grain-free diet> >> >> >> > Yuk, I hate Spiro!! It makes me fat!! What if I don't take it, what will happen. I was recently told to stop taking the hydrochlorizide/water pill, and start taking spiro again, due to my vitimin d levels on the floor, and potassium levels. Why can't I just take labetalol and vitamin D and a potassium supplement?> >> >> >> > > > >>

[Guest guest]

usually give it all at once but start 4 x a day is OK. I go up to 400 depending on BP and K responseIf you read Bravo's article in our files you will see that one pt with PA who required 600 mg spiro a day was able to decrease it to 25 mg a day when eating a low salt diet.The choice is yours.CE Grim MDYes, back to the spiro, I am prescribed, 100mgs a day/25mg 4x's a day. is that overkill? SojournerTo: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 9:06:02 PMSubject: Re: Re: Back On Spro!! Did they draw the K using our guidelines. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I now remember why I was told to get off of Spiro, my potassium was TOO HIGH, and the Dr thought I was going to havea heart attack. Now my potassium is too low. What is this all about, do u need to just wake up and maintain this disease?And have blood work every other day?Just got on the scale and am 148lbs. Shaking my head. I stopped drinking beer for lent/fasting and I thoughtfor sure all that barely/hop weight would pair me down at least ten lbs. Nope, I lost like 4lbs. In those 40days. S. To: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 7:27:31 PMSubject: Re: Re: Back On Spro!! Card will usually lower BP some and cause salt retention. May need sleep BP TO SEE BP effect. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension What about if the meds *raise* pressure? When I stopped Diovan and Cardizem, my average BP dropped from 165/95 to around 140/90 within a matter of days. And I dropped 10 pounds in 2 weeks.I figured that something about the HTN meds was causing water/salt retention, so your explanation makes perfect sense to me - except my BP wasn't lowered.- msmith192845, female, 5'3", 120 lbs, 1cm left adrenal nodule, supine aldosterone28.5/renin 0.2, potassium <2.9 (when not taking supplements); 25mg spiro causedgynecomastia; no HTN meds; current meds are 20MEQ K 2x/day, singulair 10mg,norethindrone .35mg, cyclobenzaprine 5-10mg when needed; low sodium, fructose-and grain-free diet> >> >> >> > Yuk, I hate Spiro!! It makes me fat!! What if I don't take it, what will happen. I was recently told to stop taking the hydrochlorizide/water pill, and start taking spiro again, due to my vitimin d levels on the floor, and potassium levels. Why can't I just take labetalol and vitamin D and a potassium supplement?> >> >> >> > > > >>

[Guest guest]

Esp if you DASH.CE Grim MDSpiro 100mg/d seems enough for my 10mm left adenoma! Max.Yes, back to the spiro, I am prescribed, 100mgs a day/25mg 4x's a day. is that overkill? Sojourner

[Guest guest]

Okay. Thank you so much. That is sooo, impressive that you studied with Dr. Drew. Amazing!!!

Good night Dr. Grim.

To: hyperaldosteronism Cc: Clarence Grim Sent: Tue, May 3, 2011 10:50:40 PMSubject: Re: Re: Back On Spro!!

usually give it all at once but start 4 x a day is OK. I go up to 400 depending on BP and K response

If you read Bravo's article in our files you will see that one pt with PA who required 600 mg spiro a day was able to decrease it to 25 mg a day when eating a low salt diet.

The choice is yours.

CE Grim MD

Yes, back to the spiro, I am prescribed, 100mgs a day/25mg 4x's a day. is that overkill?

Sojourner

To: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 9:06:02 PMSubject: Re: Re: Back On Spro!!

Did they draw the K using our guidelines. Tiped sad Send form mi iPhone ;-)

May your pressure be low!

CE Grim MD

Specializing in Difficult

Hypertension

I now remember why I was told to get off of Spiro, my potassium was TOO HIGH, and the Dr thought I was going to have

a heart attack. Now my potassium is too low. What is this all about, do u need to just wake up and maintain this disease?

And have blood work every other day?

Just got on the scale and am 148lbs. Shaking my head. I stopped drinking beer for lent/fasting and I thought

for sure all that barely/hop weight would pair me down at least ten lbs. Nope, I lost like 4lbs. In those 40days.

S.

To: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 7:27:31 PMSubject: Re: Re: Back On Spro!!

Card will usually lower BP some and cause salt retention. May need sleep BP TO SEE BP effect. Tiped sad Send form mi iPhone ;-)

May your pressure be low!

CE Grim MD

Specializing in Difficult

Hypertension

What about if the meds *raise* pressure? When I stopped Diovan and Cardizem, my average BP dropped from 165/95 to around 140/90 within a matter of days. And I dropped 10 pounds in 2 weeks.I figured that something about the HTN meds was causing water/salt retention, so your explanation makes perfect sense to me - except my BP wasn't lowered.- msmith192845, female, 5'3", 120 lbs, 1cm left adrenal nodule, supine aldosterone28.5/renin 0.2, potassium <2.9 (when not taking supplements); 25mg spiro causedgynecomastia; no HTN meds; current meds are 20MEQ K 2x/day, singulair 10mg,norethindrone .35mg, cyclobenzaprine 5-10mg when needed; low sodium, fructose-and grain-free diet> >> >> >> > Yuk, I hate Spiro!! It makes me fat!! What if I don't take it, what will happen. I was recently told to stop taking the hydrochlorizide/water pill, and start taking spiro again, due to my vitimin d levels on the floor, and potassium levels. Why can't I just take labetalol and vitamin D and a potassium supplement?> >> >> >> > > > >>

[Guest guest]

No I did not know Dr. Drew as he died at 45 in a car wreck in 1950. I worked at the R. Drew Medical School, Luther King Hospital in South Central LA as a Professor of Medicine and Director of the Hypertension Research Program for 10 years (1984-94). At the same time I was a Professor of Medicine in Residence at UCLA.Okay. Thank you so much. That is sooo, impressive that you studied with Dr. Drew. Amazing!!!Good night Dr. Grim. To: hyperaldosteronism Cc: Clarence Grim Sent: Tue, May 3, 2011 10:50:40 PMSubject: Re: Re: Back On Spro!! usually give it all at once but start 4 x a day is OK. I go up to 400 depending on BP and K responseIf you read Bravo's article in our files you will see that one pt with PA who required 600 mg spiro a day was able to decrease it to 25 mg a day when eating a low salt diet.The choice is yours.CE Grim MDYes, back to the spiro, I am prescribed, 100mgs a day/25mg 4x's a day. is that overkill? SojournerTo: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 9:06:02 PMSubject: Re: Re: Back On Spro!! Did they draw the K using our guidelines. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I now remember why I was told to get off of Spiro, my potassium was TOO HIGH, and the Dr thought I was going to havea heart attack. Now my potassium is too low. What is this all about, do u need to just wake up and maintain this disease?And have blood work every other day?Just got on the scale and am 148lbs. Shaking my head. I stopped drinking beer for lent/fasting and I thoughtfor sure all that barely/hop weight would pair me down at least ten lbs. Nope, I lost like 4lbs. In those 40days. S. To: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, May 3, 2011 7:27:31 PMSubject: Re: Re: Back On Spro!! Card will usually lower BP some and cause salt retention. May need sleep BP TO SEE BP effect. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension What about if the meds *raise* pressure? When I stopped Diovan and Cardizem, my average BP dropped from 165/95 to around 140/90 within a matter of days. And I dropped 10 pounds in 2 weeks.I figured that something about the HTN meds was causing water/salt retention, so your explanation makes perfect sense to me - except my BP wasn't lowered.- msmith192845, female, 5'3", 120 lbs, 1cm left adrenal nodule, supine aldosterone28.5/renin 0.2, potassium <2.9 (when not taking supplements); 25mg spiro causedgynecomastia; no HTN meds; current meds are 20MEQ K 2x/day, singulair 10mg,norethindrone .35mg, cyclobenzaprine 5-10mg when needed; low sodium, fructose-and grain-free diet> >> >> >> > Yuk, I hate Spiro!! It makes me fat!! What if I don't take it, what will happen. I was recently told to stop taking the hydrochlorizide/water pill, and start taking spiro again, due to my vitimin d levels on the floor, and potassium levels. Why can't I just take labetalol and vitamin D and a potassium supplement?> >> >> >> > > > >>

[Guest guest]

A trip down memory lane. You were there at "Killer King" when I was back in the mid 80's Dr G!. I worked for Ambulance Service out of Southgateand Lynwood 85-90. We were the paramedic service for adjacent Lynwood and I also worked in Southgate for years though the area around King - LA COUNTY'S 41 - was our area, but we couldn't be stationed there for safety reasons. Willowbrook was one dangerous place - all of Southcentral was, but I was young and naive then so it was GREAT training in learning to understand personalities = good and bad, fast thinking and reactions, scene control, rapidly sizing up a scene and recognizing a critical threat in seconds. After we had our first child though my eyes were "opened" and I did not want to be out there anymore. We moved to Tulsa, Ok and took my "street skills" with me as a paramedic

until I started teaching FT out there in OK for 5 years before PA school (2001).

So many Memories out at MLK/ Drew Med center there for me as that is where I cut my teeth at age 18 to 22.....watched a Sheriff shoot a guy about 10 feet from me at Century Blvd and Imperial in Lynwood as I stood next to my unit. The guy was retarded (the victim, not the cop...but....) and had a gun threatening people - but it was a revolver with no chamber. Cop pulled up next to me, got behind his door, told the guy to "drop it" the guy turned and that was it. Two shots right at the umbilucus. I didn't even know there was an issue until the cop screeched to a halt next to me. I was first one to him, but he didn't make it. Cop did the right thing not knowing, but man - MLK didn't save him. They didn't save many and are shut down now. I saw so many chests cracked right there in the ER, many emergency/traumatic c-sections right on the ER tables. The floors were lined with patients at 5am and 5pm. Crazy times....

But it was MLK, USC (an easy 1/2 hour or more drive for us) or Harbor UCLA (another 1/2 hour) as a trauma center so we didn't like those early AM traumas as we were driving more than we were treating and got no sleep.......dove for cover once as I came out of King's ER when some gang bangers came running in looking for another gang member, shots were fired into the wall, but the "safety police" - remember those guys and gals? - got it under control fast and no one got hurt. Found bullet holes in our units sometimes, but I never recalled hearing shots or being shot at directly. Scary times, but strangely exciting too.

Sorry guys and gals....just reminiscing...

43 yo 5'10" 170lbs male PA-C and EMT-P w/ PA responded well to spiro and DASH. PA led to development of a murmur, LVH, and combined with Hyperthyroidism a real CHF like lifestyle - which lifestyle was turned upside down in 2009, but now doing much better. Had an Average BP 160/120 (170/130 AVERAGE when TSH was also low!) for many years on 5 BP meds and now 130/80 on only 25mg/day spiro and DASH alone!

Okay. Thank you so much. That is sooo, impressive that you studied with Dr. Drew. Amazing!!!

Good night Dr. Grim.

[Guest guest]

Ah yes. My office was in the building just across from the ER. Have a few tales as well.Many a morning I could track someone thru the parking lot to the ER entrance by drops of blood or vomit.Was there during the 1994 Rodney King riots. One of my buddies who worked in ER wrote a paper on treating through the chest gunshot wounds as an out patient if wound was clean and pt stable. I think he had 357 cases. Someone at the conference asked him about wounds due to 357s but he had to be reminded that he was talking about 357 cases.Before the middle east wars the military send Drs to be trained in how to manage gunshot wounds. CE Grim MDA trip down memory lane. You were there at "Killer King" when I was back in the mid 80's Dr G!. I worked for Ambulance Service out of Southgateand Lynwood 85-90. We were the paramedic service for adjacent Lynwood and I also worked in Southgate for years though the area around King - LA COUNTY'S 41 - was our area, but we couldn't be stationed there for safety reasons. Willowbrook was one dangerous place - all of Southcentral was, but I was young and naive then so it was GREAT training in learning to understand personalities = good and bad, fast thinking and reactions, scene control, rapidly sizing up a scene and recognizing a critical threat in seconds. After we had our first child though my eyes were "opened" and I did not want to be out there anymore. We moved to Tulsa, Ok and took my "street skills" with me as a paramedic until I started teaching FT out there in OK for 5 years before PA school (2001). So many Memories out at MLK/ Drew Med center there for me as that is where I cut my teeth at age 18 to 22.....watched a Sheriff shoot a guy about 10 feet from me at Century Blvd and Imperial in Lynwood as I stood next to my unit. The guy was retarded (the victim, not the cop...but....) and had a gun threatening people - but it was a revolver with no chamber. Cop pulled up next to me, got behind his door, told the guy to "drop it" the guy turned and that was it. Two shots right at the umbilucus. I didn't even know there was an issue until the cop screeched to a halt next to me. I was first one to him, but he didn't make it. Cop did the right thing not knowing, but man - MLK didn't save him. They didn't save many and are shut down now. I saw so many chests cracked right there in the ER, many emergency/traumatic c-sections right on the ER tables. The floors were lined with patients at 5am and 5pm. Crazy times.... But it was MLK, USC (an easy 1/2 hour or more drive for us) or Harbor UCLA (another 1/2 hour) as a trauma center so we didn't like those early AM traumas as we were driving more than we were treating and got no sleep.......dove for cover once as I came out of King's ER when some gang bangers came running in looking for another gang member, shots were fired into the wall, but the "safety police" - remember those guys and gals? - got it under control fast and no one got hurt. Found bullet holes in our units sometimes, but I never recalled hearing shots or being shot at directly. Scary times, but strangely exciting too. Sorry guys and gals....just reminiscing... 43 yo 5'10" 170lbs male PA-C and EMT-P w/ PA responded well to spiro and DASH. PA led to development of a murmur, LVH, and combined with Hyperthyroidism a real CHF like lifestyle - which lifestyle was turned upside down in 2009, but now doing much better. Had an Average BP 160/120 (170/130 AVERAGE when TSH was also low!) for many years on 5 BP meds and now 130/80 on only 25mg/day spiro and DASH alone! Okay. Thank you so much. That is sooo, impressive that you studied with Dr. Drew. Amazing!!!Good night Dr. Grim.

[Guest guest]

Good Morning:

Still impressive Dr. Grim. I read his story and that is great that he has a hospial in his namesake, didn't know that.

S.

To: hyperaldosteronism Sent: Wed, May 4, 2011 1:14:56 AMSubject: Re: Re: Back On Spro!!

A trip down memory lane. You were there at "Killer King" when I was back in the mid 80's Dr G!. I worked for Ambulance Service out of Southgateand Lynwood 85-90. We were the paramedic service for adjacent Lynwood and I also worked in Southgate for years though the area around King - LA COUNTY'S 41 - was our area, but we couldn't be stationed there for safety reasons. Willowbrook was one dangerous place - all of Southcentral was, but I was young and naive then so it was GREAT training in learning to understand personalities = good and bad, fast thinking and reactions, scene control, rapidly sizing up a scene and recognizing a critical threat in seconds. After we had our first child though my eyes were "opened" and I did not want to be out there anymore. We moved to Tulsa, Ok and took my "street skills" with me as a paramedic until I started teaching FT out there in OK for 5 years before PA school (2001).

So many Memories out at MLK/ Drew Med center there for me as that is where I cut my teeth at age 18 to 22.....watched a Sheriff shoot a guy about 10 feet from me at Century Blvd and Imperial in Lynwood as I stood next to my unit. The guy was retarded (the victim, not the cop...but....) and had a gun threatening people - but it was a revolver with no chamber. Cop pulled up next to me, got behind his door, told the guy to "drop it" the guy turned and that was it. Two shots right at the umbilucus. I didn't even know there was an issue until the cop screeched to a halt next to me. I was first one to him, but he didn't make it. Cop did the right thing not knowing, but man - MLK didn't save him. They didn't save many and are shut down now. I saw so many chests cracked right there in the ER, many emergency/traumatic c-sections right on the ER tables. The floors were lined with patients at 5am and 5pm. Crazy times....

But it was MLK, USC (an easy 1/2 hour or more drive for us) or Harbor UCLA (another 1/2 hour) as a trauma center so we didn't like those early AM traumas as we were driving more than we were treating and got no sleep.......dove for cover once as I came out of King's ER when some gang bangers came running in looking for another gang member, shots were fired into the wall, but the "safety police" - remember those guys and gals? - got it under control fast and no one got hurt. Found bullet holes in our units sometimes, but I never recalled hearing shots or being shot at directly. Scary times, but strangely exciting too.

Sorry guys and gals....just reminiscing...

43 yo 5'10" 170lbs male PA-C and EMT-P w/ PA responded well to spiro and DASH. PA led to development of a murmur, LVH, and combined with Hyperthyroidism a real CHF like lifestyle - which lifestyle was turned upside down in 2009, but now doing much better. Had an Average BP 160/120 (170/130 AVERAGE when TSH was also low!) for many years on 5 BP meds and now 130/80 on only 25mg/day spiro and DASH alone!

Okay. Thank you so much. That is sooo, impressive that you studied with Dr. Drew. Amazing!!!

Good night Dr. Grim.