Re: Dr Grim Lab Results Finally

[Guest guest]

Licia,

You will find out that there is a great deal that your

doctors aren't telling you, either because they don't

know or are too busy to really take the time to look.

I'm in about the same boat you are, with PA and

tanking kidney's. Please listen to Dr.Grim in general,

but particularly about allowing doctors to give you

contrast dye during a CT scan. It can cause the

kidney's to fail, as it did with me.

Do not trust your Nephrologist to necessarily think of

that. When my BUN, GFR and Creatine readings went bad

after my first CT scan, my Nephrologist never

connected the dots, so he gave me a second scan with

contrast dye a couple of months later. How brilliant

is that? Giving someone with failing kidney's a

contrast dye that can be known to cause kidney damage

is just plain bad medicine, but that sort of thing

happens all the time with doctors.

This is a wonderful group and you will learn a lot

here as well as get a lot of good advice.

By the way, I think it was Study Circle who was

interested in any link between alcoholism and CKD, so

I'll add my info here. I seldom drink alcohol at all,

not because I'm trying to control it, but because I

have no taste for it. Period. My mother died of

alcoholism, but didn't start drinking until after I

was grown, so there was no exposure during gestation

or childhood.

Dianne

F 68, bi-lateral adenomas, CKD, 75mg Spiro, 50mg

Atenolol.

--- Licia wrote:

> What?? Why aren't my doctors telling  me that?

>

>

>

>

>

>

>

>

>

> You have significant renal disease. Please get all

> of ur creatives you can find as far back as u can

> and send to us.  

>

>  

>

>

>

>

>

>

>

>

>

[Guest guest]

Yes - thanks Dr. Grim!!

 

It always dumbfounds me when i read posts that

sound like folks think that medical care is a right

and that all doctors are to blame for not connecting

all the dots to solve your problem. Educate yourself

so you can help them, help you. That is what this

forum is for. Most of us here have learned alot from

the grace and generosity of Dr. Grim. The human body

is extremely complex. Medicine is an art, as well a a

science. You are dealing with other humans who are

there trying to assist as many people as they can.

They dont always get it right...as we all know first

hand.  I have had doctors from every ethic background

working on my case. Racism has nothing to do with your

diagnostic process and there is no place for it on

this forum. That said, I will assume you were being

funny in your comment, so I am not offended, this time

around. We all get scared when we are facing life

altering conditions. Relax, be gentle, and become a

sponge for the knowledge and wisdom you can gleen from

this forum. I have personnally learned alot here. We

are absolutely very lucky to have a retired specialist

giving back to the world and possibly helping many

here save their own lives. So, welcome to the forum

and I hope it can provide you with some guidance to improve your

life.

 

============================================================================

45-Male-Caucasian, 5'9"- 234lbs, PA Diagnosed

2007 Suspected Hyperplasia-No tumors on CT - No AVS.

Meds: 50mg Spiro, 1200mg Calcium, 500mg

Magnesium, 100,000UI Vit D (weekly), 20mg Omeprazole

Side effects: Gynecomastia, stomach

inflammation

Other Diags: GERD, Hiatal Hernia, Metabolic Syndrome -

PreDiabetic, Secondary Hyperparathyroidism caused by

Renal calcium leak, Bone Cyct in left Femoral Head and

Pelvis. Benign Lung Nodules, Fibromyalgia, Scarring on

Right Kidney Lower Pole

DASH: Started DASHing 5/3/2011

From:

Valarie

To:

hyperaldosteronism

Sent:

Thursday, May 12, 2011 4:43 PM

Subject:

RE: Dr Grim Lab Results

Finally

 

With all due

respect, Sojourn, most of us here have

had shoddy care.  What

exactly does race have to do with it? 

I am offended.

 

Val

 

From:

hyperaldosteronism

[mailto:hyperaldosteronism ]

On Behalf Of Licia

 

I

wish I could sew these

incompetent,

laxadazicle(spl) half

ass racist!! Whooo, now

I feel better.

 

Sojourn

[Guest guest]

Appointment Details

General Information

What:

Office Visit with W Hanna, DO

When:

Friday June 22, 2001 3:15 PM (45 minutes)

Where:

Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)

Reason for Visit:

NEW PATIENTPHYSICAL-EXAM

Phone:

Vitals

Blood Pressure:

100/58

Weight:

119 lb (53.978 kg)

Follow-Up Instructions

Return visit in approximately 2 weeks, need old records endocrine and family doctor

Medications Prescribed During This Visit

Name

Start Date

Discontinued Date

NORVASC TABS 2.5 MG OR

6/22/2001

SYNTHROID TABS 75 MCG OR

6/22/2001

6/29/2001

Routine Orders

Name

Type

OB REFERRAL OP

Referral

Future Orders

Name

Expected Date

Expiration Date

Type

TSH

6/23/2001

7/22/2001

Lab

COMPR METAB PANEL

6/23/2001

7/22/2001

Lab

CBC/DIFF

6/23/2001

7/22/2001

Lab

HCG, BETA (QUAN)

6/23/2001

7/22/2001

Lab

T4, FREE

6/23/2001

8/22/2001

Lab

T3, FREE

6/23/2001

8/22/2001

Lab

***************************************************************************

General Information

What:

Office Visit with W Hanna, DO

When:

Wednesday July 11, 2001 3:00 PM (15 minutes)

Where:

Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)

Reason for Visit:

FOLLOW UP

Phone:

Vitals

Blood Pressure:

124/70

Temperature:

98.6

Weight:

122 lb (55.339 kg)

Follow-Up Instructions

Return visit in approximately 3 weeks

Future Orders

Name

Expected Date

Expiration Date

Type

T3, FREE

7/12/2001

8/1/2001

Lab

T4, FREE

7/12/2001

8/1/2001

Lab

CBC/DIFF

7/12/2001

8/1/2001

Lab

IRON

7/12/2001

8/1/2001

Lab

IRON BINDING CAP

7/12/2001

8/1/2001

Lab

FERRITIN

7/12/2001

8/1/2001

Lab

************************************************************************************

General Information

What:

Office Visit with W Hanna, DO

When:

Tuesday August 14, 2001 4:00 PM (15 minutes)

Where:

Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)

Reason for Visit:

FOLLOW UP

Phone:

Vitals

Blood Pressure:

118/62

Temperature:

98.1

Weight:

129 lb 10 oz (58.798 kg)

Follow-Up Instructions

Return visit in approximately 3 months

Back to the Past Appointments List

*************************************************************

This appt/results are w/Endo: I was pregnant and this is prolly when all the madness began when discovered that I had Graves Disease. I was taking these nast behind pills to

regulate my thyroid. they began w/a P, through my pregnancy.

Appointment Details

General Information

What:

Office Visit with Ralph H Starkey, MD

When:

Friday March 08, 2002 11:15 AM (15 minutes)

Where:

Endocrinology F7, Danville (Foss Clinic 7)

Reason for Visit:

FOLLOW UP

Phone:

Vitals

Blood Pressure:

144/80

Weight:

134 lb (60.782 kg)

Follow-Up Instructions

Return visit in approximately 2 months, thyroid follow up

Discontinued Medications

Name

Start Date

Discontinued Date

PRENATAL 1+1 TABS OR

6/22/2001

3/8/2002

PROPYLTHIOURACIL TABS 50 MG OR

7/11/2001

3/8/2002

******************************************************************************

General Information

What:

Office Visit with W Hanna, DO

When:

Tuesday September 10, 2002 11:30 AM (15 minutes)

Where:

Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)

Reason for Visit:

FOLLOW UP

Phone:

Vitals

Blood Pressure:

144/84

Weight:

126 lb (57.153 kg)

Follow-Up Instructions

Return visit in approximately 1 month

Medications Prescribed During This Visit

Name

Start Date

Discontinued Date

LISINOPRIL 10 MG OR TABS

9/10/2002

12/20/2002

Routine Orders

Name

Type

DERMATOLOGY REFERRAL OP

Referral

Appointment Details

General Information

What:

Office Visit with W Hanna, DO

When:

Thursday July 17, 2003 10:00 AM (45 minutes)

Where:

Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)

Reason for Visit:

PHYSICAL-EXAM

Phone:

Vitals

Blood Pressure:

152/92

Height:

5' 1.8" (1.57 m)

Weight:

125 lb 9.6 oz (56.972 kg)

Follow-Up Instructions

Return Visit PRN, if symptoms worsen or fail to improve.

Medications Prescribed During This Visit

Name

Start Date

Discontinued Date

LISINOPRIL 40 MG OR TABS

7/17/2003

Future Orders

Name

Expected Date

Expiration Date

Type

T3, FREE

7/18/2003

9/17/2003

Lab

T4, FREE

7/18/2003

9/17/2003

Lab

TSH

7/18/2003

9/17/2003

Lab

BASIC METAB PANEL, BMP

7/18/2003

9/17/2003

Lab

Discontinued Medications

Name

Start Date

Discontinued Date

GHS DERMAZINC/CLOBETASOL 0.05% COMPOUND

12/10/2002

7/17/2003

CIPRO 500 MG OR TABS

12/24/2002

7/17/2003

Back to the Past Appointments List

Back to the Past Appointments List

***************************************************************************

Medications Prescribed During This Visit

Name

Start Date

Discontinued Date

TOPROL XL 100 MG PO TB24

8/22/2007

12/3/2008

SYNTHROID 75 MCG OR TABS

8/22/2007

8/31/2007

MICONAZOLE NITRATE 2 % EX CREA

8/22/2007

10/11/2007

Routine Orders

Name

Type

GYN REFERRAL OP

Referral

TSH

Lab

LIPID PANEL

Lab

COMPR METAB PANEL

Lab

CBC

Lab

Future Orders

Name

Expected Date

Expiration Date

Type

TSH

8/22/2007

8/21/2008

Lab

LIPID PANEL

8/22/2007

8/21/2008

Lab

COMPR METAB PANEL

8/22/2007

8/21/2008

Lab

CBC

8/22/2007

8/21/2008

Lab

Discontinued Medications

Name

Start Date

Discontinued Date

LISINOPRIL 40 MG OR TABS

8/27/2003

8/22/2007

LISINOPRIL 20 MG OR TABS

7/15/2003

8/22/2007

BLEPH-10 10 % OP SOLN

3/24/2003

8/22/2007

Back to the Past Appointments List

****************************************************************************

Appointment Details

General Information

What:

Office Visit with , DO

When:

Friday August 31, 2007 11:20 AM (20 minutes)

Where:

Family Practice Kistler Clinic, Wilkes-Barre (Kistler Clinic)

Reason for Visit:

ABNORMAL TEST RESULTS

Phone:

Vitals

Blood Pressure:

114/76

Pulse:

83

Temperature:

97.9

Temp source:

Tympanic

Respiration:

18

Weight:

138 lb (62.596 kg)

Follow-Up Instructions

Return in about 6 months (around 2/29/2008).

Medications Prescribed During This Visit

Name

Start Date

Discontinued Date

SYNTHROID 88 MCG OR TABS

8/31/2007

5/5/2008

Discontinued Medications

Name

Start Date

Discontinued Date

SYNTHROID 75 MCG OR TABS

8/22/2007

8/31/2007

***************************************************************

Appointment Details

General Information

What:

Office Visit with Aliasgar Z Chittalia, MD

When:

Tuesday September 22, 2009 1:40 PM (20 minutes)

Where:

Internal Medicine, South Wilkes Barre (Int Med South WB)

Reason for Visit:

FOLLOW UP

Phone:

Vitals

Blood Pressure:

122/80

Pulse:

78

Temperature:

97.5

Temp source:

Tympanic

Respiration:

20

Weight:

148 lb (67.132 kg)

Follow-Up Instructions

Return in about 3 months (around 12/22/2009).

Routine Orders

Name

Type

CBC/DIFF

Lab

COMPR METAB PANEL

Lab

TSH

Lab

LIPID PANEL

Lab

Discontinued Medications

Name

Start Date

Discontinued Date

DEBROX 6.5 % OT SOLN

8/11/2009

9/22/2009

Ok Dr. It normal ten years ago and ovr the past 5yrs nose dived. Why?

Sojourn

2009:

Component Results

Component

Your Value

Standard Range

Units

Flag

BUN

26

6 - 20

mg/dL

H

CREATININE

2.1

0.7 - 1.5

mg/dL

H

SODIUM

137

135 - 146

mmol/L

POTASSIUM

5.1

3.5 - 5.1

mmol/L

CHLORIDE

99

98 - 111

mmol/L

CO2

27

22 - 32

mmol/L

GLUCOSE

102

70 - 120

mg/dL

ALBUMIN

4.4

3.8 - 5.0

g/dL

AST

24

10 - 35

U/L

ALKALINE PHOSPHATASE

68

25 - 125

U/L

BILIRUBIN, TOTAL

0.4

0.3 - 1.3

mg/dL

CALCIUM

9.8

8.3 - 10.5

mg/dL

PROTEIN

7.8

6.0 - 8.3

g/dL

ALT

19

10 - 35

U/L

ANION GAP

11

7 - 15

mEq/L

GFR ESTIMATED

27.0

>60 -

mL/min

L

General Information

Collected:

10/13/2009 2:31 PM

Resulted:

10/13/2009 10:15 PM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

**************************************************************************

out This Test

Component Results

Component

Your Value

Standard Range

Units

Flag

BUN

14

6 - 20

mg/dL

CREATININE

1.4

0.7 - 1.5

mg/dL

SODIUM

141

135 - 146

mmol/L

POTASSIUM

3.3

3.5 - 5.1

mmol/L

L

CHLORIDE

95

98 - 111

mmol/L

L

CO2

32

22 - 32

mmol/L

GLUCOSE

95

70 - 120

mg/dL

ALBUMIN

4.2

3.8 - 5.0

g/dL

AST

37

8 - 46

U/L

ALKALINE PHOSPHATASE

90

25 - 125

U/L

BILIRUBIN, TOTAL

0.2

0.3 - 1.3

mg/dL

L

CALCIUM

9.5

8.3 - 10.5

mg/dL

PROTEIN

8.0

6.0 - 8.3

g/dL

ALT

26

8 - 50

U/L

ANION GAP

14

7 - 15

mEq/L

GFR ESTIMATED

43.2

>60 -

mL/min

L

General Information

Collected:

12/8/2008 9:23 AM

Resulted:

12/8/2008 6:31 PM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

*************************************************************************

Component

Your Value

Standard Range

Units

Flag

ALDOSTERONE,SERUM

74

*** -

ng/dL

ALDOSTERONE,SERUM

(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Adult Reference Ranges for Aldosterone, LC/MS/MS:Upright 8:00 - 10:00 am < or = 28 ng/dLUpright 4:00 - 6:00 pm < or = 21 ng/dLSupine 8:00 - 10:00 am 3 - 16 ng/dL

PLASMA RENIN ACT

0.1

*** -

ng/mL/h

PLASMA RENIN ACT

(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Reference Ranges for Plasma Renin Activity:Nonhypertensive adults(upright/sitting): 0.65-5.0 ng/mL/hNonhypertensive children:Supine Upright/Sitting(ng/mL/h) (ng/mL/h)3-12 Months 15.0 or Less1-3 Years 10.0 or Less4-6 Years 7.5 or Less 15.0 or Less7-9 Years 5.9 or Less 17.0 or Less10-12 Years 5.3 or Less 16.0 or Less13-15 Years 4.4 or Less 16.0 or Less**Pediatric data from J Pediatrics (1976) 89:256;Pediat Res (1979) 13:817; and Eur J Pediatr (1994)153:284.Clinical Cutoffs for Hypertensive Individuals(ng/mL/h)Low-renin sodium/volume-mediatedhypertension likely: <0.65Primary aldosteronism possible: <0.65Renin-mediated hypertension likely: >=0.65Renovascular hypertension possible: >1.5Renovascular hypertension more likely: >10.0Approximately 1/3 of subjects

with essential hyper-tension have low-renin (PRA <0.65 ng/mL/h) hyper-tension, while the remainder have PRA values above0.65 ng/mL/h. Treatment with medications such asdiuretics or ACE inhibitors increase PRA levels.This test was developed and its performancecharacteristics have been determined by QuestDiagnostics Nichols Institute, Chantilly, VA.It has not been cleared or approved by the U.S.Food and Drug Administration. The FDA has determinedthat such clearance or approval is not necessary.Performance characteristics refer to the analyticalperformance of the test.

ALDOSTERONE/PRA RAT

740.0

1.5 - 18.2

Ratio

H

General Information

Collected:

12/23/2008 3:40 PM

Resulted:

12/31/2008 3:25 AM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

**********************************************

Component Results

Component

Your Value

Standard Range

Units

Flag

FOBT (EIA)

NEGATIVE

NEG -

General Information

Collected:

12/16/2008 3:00 PM

Resulted:

12/17/2008 12:01 PM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

*************************************************************************

Component

Your Value

Standard Range

Units

Flag

BUN

8

6 - 20

mg/dL

CREATININE

1.1

0.7 - 1.5

mg/dL

SODIUM

141

135 - 146

mmol/L

POTASSIUM

3.9

3.5 - 5.1

mmol/L

CHLORIDE

100

98 - 111

mmol/L

CO2

30

22 - 32

mmol/L

GLUCOSE

91

70 - 120

mg/dL

ALBUMIN

4.2

3.8 - 5.0

g/dL

AST

26

8 - 46

U/L

ALKALINE PHOSPHATASE

56

25 - 125

U/L

BILIRUBIN, TOTAL

0.3

0.3 - 1.3

mg/dL

CALCIUM

9.4

8.3 - 10.5

mg/dL

PROTEIN

7.7

6.0 - 8.3

g/dL

ALT

14

8 - 50

U/L

ANION GAP

11

7 - 15

mEq/L

GFR ESTIMATED

57.4

>60.0 -

mL/min

L

General Information

Collected:

8/22/2007 11:42 AM

Resulted:

8/22/2007 9:54 PM

Ordered By:

, DO

Result Status:

Final result

**************************************************************

Component Results

Component

Your Value

Standard Range

Units

Flag

BUN

10

6 - 20

mg/dL

CREATININE

1.0

0.7 - 1.5

mg/dL

SODIUM

140

135 - 146

mmol/L

POTASSIUM

3.5

[Guest guest]

Diabetes Mellitus. Did you see our list of abbreviations at the end of the welcome? 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. I was on Norvasc and then it was switched is seems things started going hay wire. I will look and see if that is on my record. What is DM? I don't take any acetamenophin or rarely, you mean tylenol?Sojourn Ok Dr. It normal ten years ago and ovr the past 5yrs nose dived. Why? Sojourn 2009: Component ResultsComponentYour ValueStandard RangeUnitsFlagBUN266 - 20mg/dLHCREATININE2.10.7 - 1.5mg/dLHSODIUM137135 - 146mmol/LPOTASSIUM5.13.5 - 5.1mmol/LCHLORIDE9998 - 111mmol/LCO22722 - 32mmol/LGLUCOSE10270 - 120mg/dLALBUMIN4.43.8 - 5.0g/dLAST2410 - 35U/LALKALINE PHOSPHATASE6825 - 125U/LBILIRUBIN, TOTAL0.40.3 - 1.3mg/dLCALCIUM9.88.3 - 10.5mg/dLPROTEIN7.86.0 - 8.3g/dLALT1910 - 35U/LANION GAP117 - 15mEq/LGFR ESTIMATED27.0>60 - mL/minLGeneral InformationCollected:10/13/2009 2:31 PMResulted:10/13/2009 10:15 PMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result************************************************************************** out This TestComponent ResultsComponentYour ValueStandard RangeUnitsFlagBUN146 - 20mg/dLCREATININE1.40.7 - 1.5mg/dLSODIUM141135 - 146mmol/LPOTASSIUM3.33.5 - 5.1mmol/LLCHLORIDE9598 - 111mmol/LLCO23222 - 32mmol/LGLUCOSE9570 - 120mg/dLALBUMIN4.23.8 - 5.0g/dLAST378 - 46U/LALKALINE PHOSPHATASE9025 - 125U/LBILIRUBIN, TOTAL0.20.3 - 1.3mg/dLLCALCIUM9.58.3 - 10.5mg/dLPROTEIN8.06.0 - 8.3g/dLALT268 - 50U/LANION GAP147 - 15mEq/LGFR ESTIMATED43.2>60 - mL/minLGeneral InformationCollected:12/8/2008 9:23 AMResulted:12/8/2008 6:31 PMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result ************************************************************************* ComponentYour ValueStandard RangeUnitsFlagALDOSTERONE,SERUM74*** - ng/dLALDOSTERONE,SERUM(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Adult Reference Ranges for Aldosterone, LC/MS/MS:Upright 8:00 - 10:00 am < or = 28 ng/dLUpright 4:00 - 6:00 pm < or = 21 ng/dLSupine 8:00 - 10:00 am 3 - 16 ng/dL PLASMA RENIN ACT0.1*** - ng/mL/hPLASMA RENIN ACT(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Reference Ranges for Plasma Renin Activity:Nonhypertensive adults(upright/sitting): 0.65-5.0 ng/mL/hNonhypertensive children:Supine Upright/Sitting(ng/mL/h) (ng/mL/h)3-12 Months 15.0 or Less1-3 Years 10.0 or Less4-6 Years 7.5 or Less 15.0 or Less7-9 Years 5.9 or Less 17.0 or Less10-12 Years 5.3 or Less 16.0 or Less13-15 Years 4.4 or Less 16.0 or Less**Pediatric data from J Pediatrics (1976) 89:256;Pediat Res (1979) 13:817; and Eur J Pediatr (1994)153:284.Clinical Cutoffs for Hypertensive Individuals(ng/mL/h)Low-renin sodium/volume-mediatedhypertension likely: <0.65Primary aldosteronism possible: <0.65Renin-mediated hypertension likely: >=0.65Renovascular hypertension possible: >1.5Renovascular hypertension more likely: >10.0Approximately 1/3 of subjects with essential hyper-tension have low-renin (PRA <0.65 ng/mL/h) hyper-tension, while the remainder have PRA values above0.65 ng/mL/h. Treatment with medications such asdiuretics or ACE inhibitors increase PRA levels.This test was developed and its performancecharacteristics have been determined by QuestDiagnostics Nichols Institute, Chantilly, VA.It has not been cleared or approved by the U.S.Food and Drug Administration. The FDA has determinedthat such clearance or approval is not necessary.Performance characteristics refer to the analyticalperformance of the test. ALDOSTERONE/PRA RAT740.01.5 - 18.2RatioHGeneral InformationCollected:12/23/2008 3:40 PMResulted:12/31/2008 3:25 AMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result ********************************************** Component ResultsComponentYour ValueStandard RangeUnitsFlagFOBT (EIA)NEGATIVENEG - General InformationCollected:12/16/2008 3:00 PMResulted:12/17/2008 12:01 PMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result ************************************************************************* ComponentYour ValueStandard RangeUnitsFlagBUN86 - 20mg/dLCREATININE1.10.7 - 1.5mg/dLSODIUM141135 - 146mmol/LPOTASSIUM3.93.5 - 5.1mmol/LCHLORIDE10098 - 111mmol/LCO23022 - 32mmol/LGLUCOSE9170 - 120mg/dLALBUMIN4.23.8 - 5.0g/dLAST268 - 46U/LALKALINE PHOSPHATASE5625 - 125U/LBILIRUBIN, TOTAL0.30.3 - 1.3mg/dLCALCIUM9.48.3 - 10.5mg/dLPROTEIN7.76.0 - 8.3g/dLALT148 - 50U/LANION GAP117 - 15mEq/LGFR ESTIMATED57.4>60.0 - mL/minLGeneral InformationCollected:8/22/2007 11:42 AMResulted:8/22/2007 9:54 PMOrdered By: , DOResult Status:Final result ************************************************************** Component ResultsComponentYour ValueStandard RangeUnitsFlagBUN106 - 20mg/dLCREATININE1.00.7 - 1.5mg/dLSODIUM140135 - 146mmol/LPOTASSIUM3.5

[Guest guest]

Ok. I love this group. It is turning into my Order of The Day!!

At Least my Dr's did not give me any contrast. They knew enough

although it almost happened until I opened my mouth and said,

my kidneys are fried. please. I am real intrested in the nose dive

as I have been gathering labs and meds and sending them to Dr Grim.

Just 2yrs ago my Creatin was perfect. I don't understand. But hbp, explains

it all and the up and down of meds is enough to make you cry!! Thank you

for your feed back.

Licia

PS same with alchol and gestation my mom never drank until we were all adults, I did love to party in the 80's and stopped completely in 1991 for ten years. then when mother died, I lost it for a bit and drank myself to oblivion but lately past 2yrs I'm finally coming into my own and getting over all the bullshit I'm not in a funk/state of mind. I wonder if stress has anything to do with this whole ball of wax. BC I was in a long term relationship engaged and then it was so messed up emotionally, having to share my children and moved back to my home town and travel for the past 6yrs back and forth to VA, not to mention rejection and a broken engagement. So the past 8yrs have been hell for me!! It is stress related I know it.

Licia> > >

> > > > > You have significant renal disease. Please get all> of ur creatives you can find as far back as u can> and send to us. > > > > > > > > > > >

[Guest guest]

Oh Ok. I'm not a diabetic. I think it is stress Dr. Grim.

Licia

Ok Dr. It normal ten years ago and ovr the past 5yrs nose dived. Why?

Sojourn

2009:

Component Results

Component

Your Value

Standard Range

Units

Flag

BUN

26

6 - 20

mg/dL

H

CREATININE

2.1

0.7 - 1.5

mg/dL

H

SODIUM

137

135 - 146

mmol/L

POTASSIUM

5.1

3.5 - 5.1

mmol/L

CHLORIDE

99

98 - 111

mmol/L

CO2

27

22 - 32

mmol/L

GLUCOSE

102

70 - 120

mg/dL

ALBUMIN

4.4

3.8 - 5.0

g/dL

AST

24

10 - 35

U/L

ALKALINE PHOSPHATASE

68

25 - 125

U/L

BILIRUBIN, TOTAL

0.4

0.3 - 1.3

mg/dL

CALCIUM

9.8

8.3 - 10.5

mg/dL

PROTEIN

7.8

6.0 - 8.3

g/dL

ALT

19

10 - 35

U/L

ANION GAP

11

7 - 15

mEq/L

GFR ESTIMATED

27.0

>60 -

mL/min

L

General Information

Collected:

10/13/2009 2:31 PM

Resulted:

10/13/2009 10:15 PM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

**************************************************************************

out This Test

Component Results

Component

Your Value

Standard Range

Units

Flag

BUN

14

6 - 20

mg/dL

CREATININE

1.4

0.7 - 1.5

mg/dL

SODIUM

141

135 - 146

mmol/L

POTASSIUM

3.3

3.5 - 5.1

mmol/L

L

CHLORIDE

95

98 - 111

mmol/L

L

CO2

32

22 - 32

mmol/L

GLUCOSE

95

70 - 120

mg/dL

ALBUMIN

4.2

3.8 - 5.0

g/dL

AST

37

8 - 46

U/L

ALKALINE PHOSPHATASE

90

25 - 125

U/L

BILIRUBIN, TOTAL

0.2

0.3 - 1.3

mg/dL

L

CALCIUM

9.5

8.3 - 10.5

mg/dL

PROTEIN

8.0

6.0 - 8.3

g/dL

ALT

26

8 - 50

U/L

ANION GAP

14

7 - 15

mEq/L

GFR ESTIMATED

43.2

>60 -

mL/min

L

General Information

Collected:

12/8/2008 9:23 AM

Resulted:

12/8/2008 6:31 PM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

*************************************************************************

Component

Your Value

Standard Range

Units

Flag

ALDOSTERONE,SERUM

74

*** -

ng/dL

ALDOSTERONE,SERUM

(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Adult Reference Ranges for Aldosterone, LC/MS/MS:Upright 8:00 - 10:00 am < or = 28 ng/dLUpright 4:00 - 6:00 pm < or = 21 ng/dLSupine 8:00 - 10:00 am 3 - 16 ng/dL

PLASMA RENIN ACT

0.1

*** -

ng/mL/h

PLASMA RENIN ACT

(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Reference Ranges for Plasma Renin Activity:Nonhypertensive adults(upright/sitting): 0.65-5.0 ng/mL/hNonhypertensive children:Supine Upright/Sitting(ng/mL/h) (ng/mL/h)3-12 Months 15.0 or Less1-3 Years 10.0 or Less4-6 Years 7.5 or Less 15.0 or Less7-9 Years 5.9 or Less 17.0 or Less10-12 Years 5.3 or Less 16.0 or Less13-15 Years 4.4 or Less 16.0 or Less**Pediatric data from J Pediatrics (1976) 89:256;Pediat Res (1979) 13:817; and Eur J Pediatr (1994)153:284.Clinical Cutoffs for Hypertensive Individuals(ng/mL/h)Low-renin sodium/volume-mediatedhypertension likely: <0.65Primary aldosteronism possible: <0.65Renin-mediated hypertension likely: >=0.65Renovascular hypertension possible: >1.5Renovascular hypertension more likely: >10.0Approximately 1/3 of subjects

with essential hyper-tension have low-renin (PRA <0.65 ng/mL/h) hyper-tension, while the remainder have PRA values above0.65 ng/mL/h. Treatment with medications such asdiuretics or ACE inhibitors increase PRA levels.This test was developed and its performancecharacteristics have been determined by QuestDiagnostics Nichols Institute, Chantilly, VA.It has not been cleared or approved by the U.S.Food and Drug Administration. The FDA has determinedthat such clearance or approval is not necessary.Performance characteristics refer to the analyticalperformance of the test.

ALDOSTERONE/PRA RAT

740.0

1.5 - 18.2

Ratio

H

General Information

Collected:

12/23/2008 3:40 PM

Resulted:

12/31/2008 3:25 AM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

**********************************************

Component Results

Component

Your Value

Standard Range

Units

Flag

FOBT (EIA)

NEGATIVE

NEG -

General Information

Collected:

12/16/2008 3:00 PM

Resulted:

12/17/2008 12:01 PM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

*************************************************************************

Component

Your Value

Standard Range

Units

Flag

BUN

8

6 - 20

mg/dL

CREATININE

1.1

0.7 - 1.5

mg/dL

SODIUM

141

135 - 146

mmol/L

POTASSIUM

3.9

3.5 - 5.1

mmol/L

CHLORIDE

100

98 - 111

mmol/L

CO2

30

22 - 32

mmol/L

GLUCOSE

91

70 - 120

mg/dL

ALBUMIN

4.2

3.8 - 5.0

g/dL

AST

26

8 - 46

U/L

ALKALINE PHOSPHATASE

56

25 - 125

U/L

BILIRUBIN, TOTAL

0.3

0.3 - 1.3

mg/dL

CALCIUM

9.4

8.3 - 10.5

mg/dL

PROTEIN

7.7

6.0 - 8.3

g/dL

ALT

14

8 - 50

U/L

ANION GAP

11

7 - 15

mEq/L

GFR ESTIMATED

57.4

>60.0 -

mL/min

L

General Information

Collected:

8/22/2007 11:42 AM

Resulted:

8/22/2007 9:54 PM

Ordered By:

, DO

Result Status:

Final result

**************************************************************

Component Results

Component

Your Value

Standard Range

Units

Flag

BUN

10

6 - 20

mg/dL

CREATININE

1.0

0.7 - 1.5

mg/dL

SODIUM

140

135 - 146

mmol/L

POTASSIUM

3.5

[Guest guest]

It always dumbfounds me when i read posts that sound like folks think that medical care is a right and that all doctors are to blame for not connecting all the dots to solve your problem. Educate yourself so you can help them, help you. That is what this forum is for. Most of us here have learned alot from the grace and generosity of Dr. Grim. The human body is extremely complex. Medicine is an art, as well a a science. You are dealing with other humans who are there trying to assist as many people as they can. They dont always get it right...as we all know first hand. I have had doctors from every ethic background working on my case. Racism has nothing to do with your diagnostic process and there is no place for it on this forum. That said, I will assume you were being funny in your comment, so I am not offended, this time around. We all get scared when we are facing life altering conditions. Relax, be gentle, and become a sponge for the knowledge and wisdom you can gleen from this forum. I have personnally learned alot here. We are absolutely very lucky to have a retired specialist giving back to the world and possibly helping many here save their own lives. So, welcome to the forum and I hope it can provide you with some guidance to improve your life. ============================================================================45-Male-Caucasian, 5'9"- 234lbs, PA Diagnosed 2007 Suspected Hyperplasia-No tumors on CT - No AVS.Meds: 50mg Spiro, 1200mg Calcium, 500mg Magnesium, 100,000UI Vit D (weekly), 20mg OmeprazoleSide effects: Gynecomastia, stomach inflammationOther Diags: GERD, Hiatal Hernia, Metabolic Syndrome - PreDiabetic, Secondary Hyperparathyroidism caused by Renal calcium leak, Bone Cyct in left Femoral Head and Pelvis. Benign Lung Nodules, Fibromyalgia, Scarring on Right Kidney Lower PoleDASH: Started DASHing 5/3/2011To: hyperaldosteronism Sent: Thursday, May 12, 2011 4:43 PMSubject: RE: Dr Grim Lab Results Finally With all due respect, Sojourn, most of us here have had shoddy care. What exactly does race have to do with it? I am offended. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Licia I wish I could sew these incompetent, laxadazicle(spl) half ass racist!! Whooo, now I feel better. Sojourn

[Guest guest]

Thats why HTN and Diabetes are called silent killers. . . .they slowly work

their damage

>Ok. I love this group. It is turning into my Order of The Day!!

>At Least my Dr's did not give me any contrast. They knew enough

>although it almost happened until I opened my mouth and said,

>my kidneys are fried. please. I am real intrested in the nose dive

>as I have been gathering labs and meds and sending them to Dr Grim.

>Just 2yrs ago my Creatin was perfect. I don't understand. But hbp, explains

>it all and the up and down of meds is enough to make you cry!! Thank you

>for your feed back.

> 

>Licia

> 

>PS same with alchol and gestation my mom never drank until we were all adults,

I did love to party in the 80's and stopped completely in 1991 for ten years.

then when mother died, I lost it for a bit and drank myself to oblivion but

lately past 2yrs I'm finally coming into my own and getting over all the

bullshit I'm not in a funk/state of mind. I wonder if stress has anything to do

with this whole ball of wax. BC I was in a long term relationship engaged and

then it was so messed up emotionally, having to share my children and moved back

to my home town and travel for the past 6yrs back and forth to VA, not to

mention rejection and a broken engagement. So the past 8yrs have been hell for

me!! It is stress related I know it.

> 

>Licia

>

>

>>

>>

>>

>>

>>

>>

>>

>> You have significant renal disease. Please get all

>> of ur creatives you can find as far back as u can

>> and send to us.  

>>

>>  

>>

>>

>>

>>

>>

>>

>>

>>

>>

>

>

>

>

>

>

[Guest guest]

I'll chime in on the stress factor. In the past four years I

Lost my Grandmother..four beloved cats..and between my husband and I we have had

three job losses since 2007. I don't think all that is the primary cause but it

certainly didn't help!

Kellie Sent from my Samsung Epicâ„¢ 4G

Licia wrote:

>Ok. I love this group. It is turning into my Order of The Day!!

>At Least my Dr's did not give me any contrast. They knew enough

>although it almost happened until I opened my mouth and said,

>my kidneys are fried. please. I am real intrested in the nose dive

>as I have been gathering labs and meds and sending them to Dr Grim.

>Just 2yrs ago my Creatin was perfect. I don't understand. But hbp, explains

>it all and the up and down of meds is enough to make you cry!! Thank you

>for your feed back.

> 

>Licia

> 

>PS same with alchol and gestation my mom never drank until we were all adults,

I did love to party in the 80's and stopped completely in 1991 for ten years.

then when mother died, I lost it for a bit and drank myself to oblivion but

lately past 2yrs I'm finally coming into my own and getting over all the

bullshit I'm not in a funk/state of mind. I wonder if stress has anything to do

with this whole ball of wax. BC I was in a long term relationship engaged and

then it was so messed up emotionally, having to share my children and moved back

to my home town and travel for the past 6yrs back and forth to VA, not to

mention rejection and a broken engagement. So the past 8yrs have been hell for

me!! It is stress related I know it.

> 

>Licia

>

>

>>

>>

>>

>>

>>

>>

>>

>> You have significant renal disease. Please get all

>> of ur creatives you can find as far back as u can

>> and send to us.  

>>

>>  

>>

>>

>>

>>

>>

>>

>>

>>

>>

>

>

>

>

>

>

[Guest guest]

The stress causes your pressure and so on. I know it is a factor. But what do you do.

I have been praying and going to church trying to stay calm, etc but it is really hard

when u are up against the ropes sometimes.

Licia>> >> >> >> >>

>> >> >> You have significant renal disease. Please get all>> of ur creatives you can find as far back as u can>> and send to us. >> >> >> >> >> >> >> >> >> >> >> >>>>>>

[Guest guest]

Here is what I need to see. I can do this if you hire me as your personal consultant.Set up an excel Spreadsheet or Word Table if you can. Put Dates across the topThen list down on the left most column,, BP systolic, diastolic, K , creatinine and eGFR if available , drugs and other comments.How many times a night do you get up to pee?As one who has done Medicine in the AA community for 30 years I can assure you that there is racism in Medicine.I would recommend folks try to walk in other's shoes for a while in America. CE GrimAppointment DetailsGeneral InformationWhat:Office Visit with W Hanna, DOWhen:Friday June 22, 2001 3:15 PM (45 minutes)Where:Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)Reason for Visit:NEW PATIENTPHYSICAL-EXAMPhone:VitalsBlood Pressure:100/58Weight:119 lb (53.978 kg)Follow-Up InstructionsReturn visit in approximately 2 weeks, need old records endocrine and family doctorMedications Prescribed During This VisitNameStart DateDiscontinued DateNORVASC TABS 2.5 MG OR6/22/2001SYNTHROID TABS 75 MCG OR6/22/20016/29/2001Routine OrdersNameTypeOB REFERRAL OPReferralFuture OrdersNameExpected DateExpiration DateTypeTSH6/23/20017/22/2001LabCOMPR METAB PANEL6/23/20017/22/2001LabCBC/DIFF6/23/20017/22/2001LabHCG, BETA (QUAN)6/23/20017/22/2001LabT4, FREE6/23/20018/22/2001LabT3, FREE6/23/20018/22/2001Lab *************************************************************************** General InformationWhat:Office Visit with W Hanna, DOWhen:Wednesday July 11, 2001 3:00 PM (15 minutes)Where:Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)Reason for Visit:FOLLOW UPPhone:VitalsBlood Pressure:124/70Temperature:98.6Weight:122 lb (55.339 kg)Follow-Up InstructionsReturn visit in approximately 3 weeksFuture OrdersNameExpected DateExpiration DateTypeT3, FREE7/12/20018/1/2001LabT4, FREE7/12/20018/1/2001LabCBC/DIFF7/12/20018/1/2001LabIRON7/12/20018/1/2001LabIRON BINDING CAP7/12/20018/1/2001LabFERRITIN7/12/20018/1/2001Lab ************************************************************************************ General InformationWhat:Office Visit with W Hanna, DOWhen:Tuesday August 14, 2001 4:00 PM (15 minutes)Where:Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)Reason for Visit:FOLLOW UPPhone:VitalsBlood Pressure:118/62Temperature:98.1Weight:129 lb 10 oz (58.798 kg)Follow-Up InstructionsReturn visit in approximately 3 monthsBack to the Past Appointments List ************************************************************* This appt/results are w/Endo: I was pregnant and this is prolly when all the madness began when discovered that I had Graves Disease. I was taking these nast behind pills toregulate my thyroid. they began w/a P, through my pregnancy. Appointment DetailsGeneral InformationWhat:Office Visit with Ralph H Starkey, MDWhen:Friday March 08, 2002 11:15 AM (15 minutes)Where:Endocrinology F7, Danville (Foss Clinic 7)Reason for Visit:FOLLOW UPPhone:VitalsBlood Pressure:144/80Weight:134 lb (60.782 kg)Follow-Up InstructionsReturn visit in approximately 2 months, thyroid follow upDiscontinued MedicationsNameStart DateDiscontinued DatePRENATAL 1+1 TABS OR6/22/20013/8/2002PROPYLTHIOURACIL TABS 50 MG OR7/11/20013/8/2002 ****************************************************************************** General InformationWhat:Office Visit with W Hanna, DOWhen:Tuesday September 10, 2002 11:30 AM (15 minutes)Where:Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)Reason for Visit:FOLLOW UPPhone:VitalsBlood Pressure:144/84Weight:126 lb (57.153 kg)Follow-Up InstructionsReturn visit in approximately 1 monthMedications Prescribed During This VisitNameStart DateDiscontinued DateLISINOPRIL 10 MG OR TABS9/10/200212/20/2002Routine OrdersNameTypeDERMATOLOGY REFERRAL OPReferral Appointment DetailsGeneral InformationWhat:Office Visit with W Hanna, DOWhen:Thursday July 17, 2003 10:00 AM (45 minutes)Where:Internal Medicine, Bloomsburg Reichart Road (Bloomsburg Reichart Road)Reason for Visit:PHYSICAL-EXAMPhone:VitalsBlood Pressure:152/92Height:5' 1.8" (1.57 m)Weight:125 lb 9.6 oz (56.972 kg)Follow-Up InstructionsReturn Visit PRN, if symptoms worsen or fail to improve.Medications Prescribed During This VisitNameStart DateDiscontinued DateLISINOPRIL 40 MG OR TABS7/17/2003Future OrdersNameExpected DateExpiration DateTypeT3, FREE7/18/20039/17/2003LabT4, FREE7/18/20039/17/2003LabTSH7/18/20039/17/2003LabBASIC METAB PANEL, BMP7/18/20039/17/2003LabDiscontinued MedicationsNameStart DateDiscontinued DateGHS DERMAZINC/CLOBETASOL 0.05% COMPOUND12/10/20027/17/2003CIPRO 500 MG OR TABS12/24/20027/17/2003Back to the Past Appointments List Back to the Past Appointments List *************************************************************************** Medications Prescribed During This VisitNameStart DateDiscontinued DateTOPROL XL 100 MG PO TB248/22/200712/3/2008SYNTHROID 75 MCG OR TABS8/22/20078/31/2007MICONAZOLE NITRATE 2 % EX CREA8/22/200710/11/2007Routine OrdersNameTypeGYN REFERRAL OPReferralTSHLabLIPID PANELLabCOMPR METAB PANELLabCBCLabFuture OrdersNameExpected DateExpiration DateTypeTSH8/22/20078/21/2008LabLIPID PANEL8/22/20078/21/2008LabCOMPR METAB PANEL8/22/20078/21/2008LabCBC8/22/20078/21/2008LabDiscontinued MedicationsNameStart DateDiscontinued DateLISINOPRIL 40 MG OR TABS8/27/20038/22/2007LISINOPRIL 20 MG OR TABS7/15/20038/22/2007BLEPH-10 10 % OP SOLN3/24/20038/22/2007Back to the Past Appointments List **************************************************************************** Appointment DetailsGeneral InformationWhat:Office Visit with , DOWhen:Friday August 31, 2007 11:20 AM (20 minutes)Where:Family Practice Kistler Clinic, Wilkes-Barre (Kistler Clinic)Reason for Visit:ABNORMAL TEST RESULTSPhone:VitalsBlood Pressure:114/76Pulse:83Temperature:97.9Temp source:TympanicRespiration:18Weight:138 lb (62.596 kg)Follow-Up InstructionsReturn in about 6 months (around 2/29/2008).Medications Prescribed During This VisitNameStart DateDiscontinued DateSYNTHROID 88 MCG OR TABS8/31/20075/5/2008Discontinued MedicationsNameStart DateDiscontinued DateSYNTHROID 75 MCG OR TABS8/22/20078/31/2007 *************************************************************** Appointment DetailsGeneral InformationWhat:Office Visit with Aliasgar Z Chittalia, MDWhen:Tuesday September 22, 2009 1:40 PM (20 minutes)Where:Internal Medicine, South Wilkes Barre (Int Med South WB)Reason for Visit:FOLLOW UPPhone:VitalsBlood Pressure:122/80Pulse:78Temperature:97.5Temp source:TympanicRespiration:20Weight:148 lb (67.132 kg)Follow-Up InstructionsReturn in about 3 months (around 12/22/2009).Routine OrdersNameTypeCBC/DIFFLabCOMPR METAB PANELLabTSHLabLIPID PANELLabDiscontinued MedicationsNameStart DateDiscontinued DateDEBROX 6.5 % OT SOLN8/11/20099/22/2009 Ok Dr. It normal ten years ago and ovr the past 5yrs nose dived. Why? Sojourn 2009: Component ResultsComponentYour ValueStandard RangeUnitsFlagBUN266 - 20mg/dLHCREATININE2.10.7 - 1.5mg/dLHSODIUM137135 - 146mmol/LPOTASSIUM5.13.5 - 5.1mmol/LCHLORIDE9998 - 111mmol/LCO22722 - 32mmol/LGLUCOSE10270 - 120mg/dLALBUMIN4.43.8 - 5.0g/dLAST2410 - 35U/LALKALINE PHOSPHATASE6825 - 125U/LBILIRUBIN, TOTAL0.40.3 - 1.3mg/dLCALCIUM9.88.3 - 10.5mg/dLPROTEIN7.86.0 - 8.3g/dLALT1910 - 35U/LANION GAP117 - 15mEq/LGFR ESTIMATED27.0>60 - mL/minLGeneral InformationCollected:10/13/2009 2:31 PMResulted:10/13/2009 10:15 PMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result************************************************************************** out This TestComponent ResultsComponentYour ValueStandard RangeUnitsFlagBUN146 - 20mg/dLCREATININE1.40.7 - 1.5mg/dLSODIUM141135 - 146mmol/LPOTASSIUM3.33.5 - 5.1mmol/LLCHLORIDE9598 - 111mmol/LLCO23222 - 32mmol/LGLUCOSE9570 - 120mg/dLALBUMIN4.23.8 - 5.0g/dLAST378 - 46U/LALKALINE PHOSPHATASE9025 - 125U/LBILIRUBIN, TOTAL0.20.3 - 1.3mg/dLLCALCIUM9.58.3 - 10.5mg/dLPROTEIN8.06.0 - 8.3g/dLALT268 - 50U/LANION GAP147 - 15mEq/LGFR ESTIMATED43.2>60 - mL/minLGeneral InformationCollected:12/8/2008 9:23 AMResulted:12/8/2008 6:31 PMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result ************************************************************************* ComponentYour ValueStandard RangeUnitsFlagALDOSTERONE,SERUM74*** - ng/dLALDOSTERONE,SERUM(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Adult Reference Ranges for Aldosterone, LC/MS/MS:Upright 8:00 - 10:00 am < or = 28 ng/dLUpright 4:00 - 6:00 pm < or = 21 ng/dLSupine 8:00 - 10:00 am 3 - 16 ng/dL PLASMA RENIN ACT0.1*** - ng/mL/hPLASMA RENIN ACT(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Reference Ranges for Plasma Renin Activity:Nonhypertensive adults(upright/sitting): 0.65-5.0 ng/mL/hNonhypertensive children:Supine Upright/Sitting(ng/mL/h) (ng/mL/h)3-12 Months 15.0 or Less1-3 Years 10.0 or Less4-6 Years 7.5 or Less 15.0 or Less7-9 Years 5.9 or Less 17.0 or Less10-12 Years 5.3 or Less 16.0 or Less13-15 Years 4.4 or Less 16.0 or Less**Pediatric data from J Pediatrics (1976) 89:256;Pediat Res (1979) 13:817; and Eur J Pediatr (1994)153:284.Clinical Cutoffs for Hypertensive Individuals(ng/mL/h)Low-renin sodium/volume-mediatedhypertension likely: <0.65Primary aldosteronism possible: <0.65Renin-mediated hypertension likely: >=0.65Renovascular hypertension possible: >1.5Renovascular hypertension more likely: >10.0Approximately 1/3 of subjects with essential hyper-tension have low-renin (PRA <0.65 ng/mL/h) hyper-tension, while the remainder have PRA values above0.65 ng/mL/h. Treatment with medications such asdiuretics or ACE inhibitors increase PRA levels.This test was developed and its performancecharacteristics have been determined by QuestDiagnostics Nichols Institute, Chantilly, VA.It has not been cleared or approved by the U.S.Food and Drug Administration. The FDA has determinedthat such clearance or approval is not necessary.Performance characteristics refer to the analyticalperformance of the test. ALDOSTERONE/PRA RAT740.01.5 - 18.2RatioHGeneral InformationCollected:12/23/2008 3:40 PMResulted:12/31/2008 3:25 AMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result ********************************************** Component ResultsComponentYour ValueStandard RangeUnitsFlagFOBT (EIA)NEGATIVENEG - General InformationCollected:12/16/2008 3:00 PMResulted:12/17/2008 12:01 PMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result ************************************************************************* ComponentYour ValueStandard RangeUnitsFlagBUN86 - 20mg/dLCREATININE1.10.7 - 1.5mg/dLSODIUM141135 - 146mmol/LPOTASSIUM3.93.5 - 5.1mmol/LCHLORIDE10098 - 111mmol/LCO23022 - 32mmol/LGLUCOSE9170 - 120mg/dLALBUMIN4.23.8 - 5.0g/dLAST268 - 46U/LALKALINE PHOSPHATASE5625 - 125U/LBILIRUBIN, TOTAL0.30.3 - 1.3mg/dLCALCIUM9.48.3 - 10.5mg/dLPROTEIN7.76.0 - 8.3g/dLALT148 - 50U/LANION GAP117 - 15mEq/LGFR ESTIMATED57.4>60.0 - mL/minLGeneral InformationCollected:8/22/2007 11:42 AMResulted:8/22/2007 9:54 PMOrdered By: , DOResult Status:Final result ************************************************************** Component ResultsComponentYour ValueStandard RangeUnitsFlagBUN106 - 20mg/dLCREATININE1.00.7 - 1.5mg/dLSODIUM140135 - 146mmol/LPOTASSIUM3.5

[Guest guest]

Indeed!

Kellie Sent from my Samsung Epicâ„¢ 4G

Licia wrote:

>The stress causes your pressure and so on. I know it is a factor. But what do

you do.

>I have been praying and going to church trying to stay calm, etc but it is

really hard

>when u are up against the ropes sometimes.

> 

>Licia

>

>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>> You have significant renal disease. Please get all

>>> of ur creatives you can find as far back as u can

>>> and send to us.  

>>>

>>>  

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>

>>

>>

>>

>>

>>

>

>

>

>

>

[Guest guest]

Thanks for the follow-up Dianne.BTW there is some reason to suspect PAs might be more sensitive to the contrast materials I would think but this has never been looked at.Another good reason we need a good database.Wonder if others here with PA have had sudden worsening of kidney function following CT or MRI or other procedures.CE Grim MDLicia,You will find out that there is a great deal that yourdoctors aren't telling you, either because they don'tknow or are too busy to really take the time to look.I'm in about the same boat you are, with PA andtanking kidney's. Please listen to Dr.Grim in general,but particularly about allowing doctors to give youcontrast dye during a CT scan. It can cause thekidney's to fail, as it did with me.Do not trust your Nephrologist to necessarily think ofthat. When my BUN, GFR and Creatine readings went badafter my first CT scan, my Nephrologist neverconnected the dots, so he gave me a second scan withcontrast dye a couple of months later. How brilliantis that? Giving someone with failing kidney's acontrast dye that can be known to cause kidney damageis just plain bad medicine, but that sort of thinghappens all the time with doctors.This is a wonderful group and you will learn a lothere as well as get a lot of good advice.By the way, I think it was Study Circle who wasinterested in any link between alcoholism and CKD, soI'll add my info here. I seldom drink alcohol at all,not because I'm trying to control it, but because Ihave no taste for it. Period. My mother died ofalcoholism, but didn't start drinking until after Iwas grown, so there was no exposure during gestationor childhood.DianneF 68, bi-lateral adenomas, CKD, 75mg Spiro, 50mgAtenolol.--- Licia wrote:> What?? Why aren't my doctors telling me that? > > > > > > > > > > You have significant renal disease. Please get all> of ur creatives you can find as far back as u can> and send to us. > > > > > > > > > > >

[Guest guest]

Yes, guess its the whole ' acceptance" thing. When looking bk ur healthy and fancy free. Can any ot this go back to normal after kidney damage? I don't want dialysis. That looks so

yukie!!! Having to clean ur system every other day. I'd rather be dead. Not really God. I know it could be worse, like my poor sister holding on to dear life in hospice w/pancreatic cancer. Sweet Lord above.

Licia>> >> >> >> >> >> >> >> You have significant renal disease. Please get all>> of ur creatives you can find as far back as u can>> and send to us. >> >> >> >> >> >> >> >> >> >> >>

>>>>>>

[Guest guest]

Ok, will do Dr.

You have significant renal disease. Please get all of ur creatives you can find as far back as u can and send to us.

[Guest guest]

Because I live in a racist community. I'm always suspect. It was not personal so please

do not take it that way. You don't know me from Adam. I am upset and already apologized.

Sojourn

Subject: RE: Dr Grim Lab Results FinallyTo: hyperaldosteronism Date: Thursday, May 12, 2011, 5:43 PM

With all due respect, Sojourn, most of us here have had shoddy care. What exactly does race have to do with it? I am offended.

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Licia

I wish I could sew these incompetent, laxadazicle(spl) half ass racist!! Whooo, now I feel better.

Sojourn

[Guest guest]

Yes, that was but I sent other test and the creatin was 37.5 forget what the bun etc were but they were better than on 2/24/11. the racist comment comes from also having Vitiliago and the dr's around here did not even know what it was, tested me like I had a fungus and consulted their journals, just weird, weird weird for the hosptial industry. Even when I was in the hosptial, in Feb, they were observing me like I was a lab rat. U just don't know. And I'm fed up.

sojourner

You have significant renal disease. Please get all of ur creatives you can find as far back as u can and send to us.

[Guest guest]

Stress does not cause kidney damage.CE Grim MDOh Ok. I'm not a diabetic. I think it is stress Dr. Grim. Licia Ok Dr. It normal ten years ago and ovr the past 5yrs nose dived. Why? Sojourn 2009: Component ResultsComponentYour ValueStandard RangeUnitsFlagBUN266 - 20mg/dLHCREATININE2.10.7 - 1.5mg/dLHSODIUM137135 - 146mmol/LPOTASSIUM5.13.5 - 5.1mmol/LCHLORIDE9998 - 111mmol/LCO22722 - 32mmol/LGLUCOSE10270 - 120mg/dLALBUMIN4.43.8 - 5.0g/dLAST2410 - 35U/LALKALINE PHOSPHATASE6825 - 125U/LBILIRUBIN, TOTAL0.40.3 - 1.3mg/dLCALCIUM9.88.3 - 10.5mg/dLPROTEIN7.86.0 - 8.3g/dLALT1910 - 35U/LANION GAP117 - 15mEq/LGFR ESTIMATED27.0>60 - mL/minLGeneral InformationCollected:10/13/2009 2:31 PMResulted:10/13/2009 10:15 PMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result************************************************************************** out This TestComponent ResultsComponentYour ValueStandard RangeUnitsFlagBUN146 - 20mg/dLCREATININE1.40.7 - 1.5mg/dLSODIUM141135 - 146mmol/LPOTASSIUM3.33.5 - 5.1mmol/LLCHLORIDE9598 - 111mmol/LLCO23222 - 32mmol/LGLUCOSE9570 - 120mg/dLALBUMIN4.23.8 - 5.0g/dLAST378 - 46U/LALKALINE PHOSPHATASE9025 - 125U/LBILIRUBIN, TOTAL0.20.3 - 1.3mg/dLLCALCIUM9.58.3 - 10.5mg/dLPROTEIN8.06.0 - 8.3g/dLALT268 - 50U/LANION GAP147 - 15mEq/LGFR ESTIMATED43.2>60 - mL/minLGeneral InformationCollected:12/8/2008 9:23 AMResulted:12/8/2008 6:31 PMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result ************************************************************************* ComponentYour ValueStandard RangeUnitsFlagALDOSTERONE,SERUM74*** - ng/dLALDOSTERONE,SERUM(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Adult Reference Ranges for Aldosterone, LC/MS/MS:Upright 8:00 - 10:00 am < or = 28 ng/dLUpright 4:00 - 6:00 pm < or = 21 ng/dLSupine 8:00 - 10:00 am 3 - 16 ng/dL PLASMA RENIN ACT0.1*** - ng/mL/hPLASMA RENIN ACT(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Reference Ranges for Plasma Renin Activity:Nonhypertensive adults(upright/sitting): 0.65-5.0 ng/mL/hNonhypertensive children:Supine Upright/Sitting(ng/mL/h) (ng/mL/h)3-12 Months 15.0 or Less1-3 Years 10.0 or Less4-6 Years 7.5 or Less 15.0 or Less7-9 Years 5.9 or Less 17.0 or Less10-12 Years 5.3 or Less 16.0 or Less13-15 Years 4.4 or Less 16.0 or Less**Pediatric data from J Pediatrics (1976) 89:256;Pediat Res (1979) 13:817; and Eur J Pediatr (1994)153:284.Clinical Cutoffs for Hypertensive Individuals(ng/mL/h)Low-renin sodium/volume-mediatedhypertension likely: <0.65Primary aldosteronism possible: <0.65Renin-mediated hypertension likely: >=0.65Renovascular hypertension possible: >1.5Renovascular hypertension more likely: >10.0Approximately 1/3 of subjects with essential hyper-tension have low-renin (PRA <0.65 ng/mL/h) hyper-tension, while the remainder have PRA values above0.65 ng/mL/h. Treatment with medications such asdiuretics or ACE inhibitors increase PRA levels.This test was developed and its performancecharacteristics have been determined by QuestDiagnostics Nichols Institute, Chantilly, VA.It has not been cleared or approved by the U.S.Food and Drug Administration. The FDA has determinedthat such clearance or approval is not necessary.Performance characteristics refer to the analyticalperformance of the test. ALDOSTERONE/PRA RAT740.01.5 - 18.2RatioHGeneral InformationCollected:12/23/2008 3:40 PMResulted:12/31/2008 3:25 AMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result ********************************************** Component ResultsComponentYour ValueStandard RangeUnitsFlagFOBT (EIA)NEGATIVENEG - General InformationCollected:12/16/2008 3:00 PMResulted:12/17/2008 12:01 PMOrdered By:Aliasgar Z Chittalia, MDResult Status:Final result ************************************************************************* ComponentYour ValueStandard RangeUnitsFlagBUN86 - 20mg/dLCREATININE1.10.7 - 1.5mg/dLSODIUM141135 - 146mmol/LPOTASSIUM3.93.5 - 5.1mmol/LCHLORIDE10098 - 111mmol/LCO23022 - 32mmol/LGLUCOSE9170 - 120mg/dLALBUMIN4.23.8 - 5.0g/dLAST268 - 46U/LALKALINE PHOSPHATASE5625 - 125U/LBILIRUBIN, TOTAL0.30.3 - 1.3mg/dLCALCIUM9.48.3 - 10.5mg/dLPROTEIN7.76.0 - 8.3g/dLALT148 - 50U/LANION GAP117 - 15mEq/LGFR ESTIMATED57.4>60.0 - mL/minLGeneral InformationCollected:8/22/2007 11:42 AMResulted:8/22/2007 9:54 PMOrdered By: , DOResult Status:Final result ************************************************************** Component ResultsComponentYour ValueStandard RangeUnitsFlagBUN106 - 20mg/dLCREATININE1.00.7 - 1.5mg/dLSODIUM140135 - 146mmol/LPOTASSIUM3.5

[Guest guest]

No MRI or CT done in last 2-3 years.CE Grim MDThats why HTN and Diabetes are called silent killers. . . .they slowly work their damage>Ok. I love this group. It is turning into my Order of The Day!!>At Least my Dr's did not give me any contrast. They knew enough>although it almost happened until I opened my mouth and said, >my kidneys are fried. please. I am real intrested in the nose dive>as I have been gathering labs and meds and sending them to Dr Grim.>Just 2yrs ago my Creatin was perfect. I don't understand. But hbp, explains>it all and the up and down of meds is enough to make you cry!! Thank you>for your feed back. > >Licia> >PS same with alchol and gestation my mom never drank until we were all adults, I did love to party in the 80's and stopped completely in 1991 for ten years. then when mother died, I lost it for a bit and drank myself to oblivion but lately past 2yrs I'm finally coming into my own and getting over all the bullshit I'm not in a funk/state of mind. I wonder if stress has anything to do with this whole ball of wax. BC I was in a long term relationship engaged and then it was so messed up emotionally, having to share my children and moved back to my home town and travel for the past 6yrs back and forth to VA, not to mention rejection and a broken engagement. So the past 8yrs have been hell for me!! It is stress related I know it. > >Licia>>>> >> >> >> >> >> >> >> You have significant renal disease. Please get all>> of ur creatives you can find as far back as u can>> and send to us. >> >> >> >> >> >> >> >> >> >> >> >>>>>>

[Guest guest]

The stress causes your pressure and so on. I know it is a factor. But what do you do.I have been praying and going to church trying to stay calm, etc but it is really hardwhen u are up against the ropes sometimes. Licia>> >> >> >> >> >> >> >> You have significant renal disease. Please get all>> of ur creatives you can find as far back as u can>> and send to us. >> >> >> >> >> >> >> >> >> >> >> >>>>>>

[Guest guest]

HBP does. And stress gives u HbP. Am I even close?

Ok Dr. It normal ten years ago and ovr the past 5yrs nose dived. Why?

Sojourn

2009:

Component Results

Component

Your Value

Standard Range

Units

Flag

BUN

26

6 - 20

mg/dL

H

CREATININE

2.1

0.7 - 1.5

mg/dL

H

SODIUM

137

135 - 146

mmol/L

POTASSIUM

5.1

3.5 - 5.1

mmol/L

CHLORIDE

99

98 - 111

mmol/L

CO2

27

22 - 32

mmol/L

GLUCOSE

102

70 - 120

mg/dL

ALBUMIN

4.4

3.8 - 5.0

g/dL

AST

24

10 - 35

U/L

ALKALINE PHOSPHATASE

68

25 - 125

U/L

BILIRUBIN, TOTAL

0.4

0.3 - 1.3

mg/dL

CALCIUM

9.8

8.3 - 10.5

mg/dL

PROTEIN

7.8

6.0 - 8.3

g/dL

ALT

19

10 - 35

U/L

ANION GAP

11

7 - 15

mEq/L

GFR ESTIMATED

27.0

>60 -

mL/min

L

General Information

Collected:

10/13/2009 2:31 PM

Resulted:

10/13/2009 10:15 PM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

**************************************************************************

out This Test

Component Results

Component

Your Value

Standard Range

Units

Flag

BUN

14

6 - 20

mg/dL

CREATININE

1.4

0.7 - 1.5

mg/dL

SODIUM

141

135 - 146

mmol/L

POTASSIUM

3.3

3.5 - 5.1

mmol/L

L

CHLORIDE

95

98 - 111

mmol/L

L

CO2

32

22 - 32

mmol/L

GLUCOSE

95

70 - 120

mg/dL

ALBUMIN

4.2

3.8 - 5.0

g/dL

AST

37

8 - 46

U/L

ALKALINE PHOSPHATASE

90

25 - 125

U/L

BILIRUBIN, TOTAL

0.2

0.3 - 1.3

mg/dL

L

CALCIUM

9.5

8.3 - 10.5

mg/dL

PROTEIN

8.0

6.0 - 8.3

g/dL

ALT

26

8 - 50

U/L

ANION GAP

14

7 - 15

mEq/L

GFR ESTIMATED

43.2

>60 -

mL/min

L

General Information

Collected:

12/8/2008 9:23 AM

Resulted:

12/8/2008 6:31 PM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

*************************************************************************

Component

Your Value

Standard Range

Units

Flag

ALDOSTERONE,SERUM

74

*** -

ng/dL

ALDOSTERONE,SERUM

(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Adult Reference Ranges for Aldosterone, LC/MS/MS:Upright 8:00 - 10:00 am < or = 28 ng/dLUpright 4:00 - 6:00 pm < or = 21 ng/dLSupine 8:00 - 10:00 am 3 - 16 ng/dL

PLASMA RENIN ACT

0.1

*** -

ng/mL/h

PLASMA RENIN ACT

(NOTE)*** Unable to flag abnormal result(s), please referto reference range(s) below:Reference Ranges for Plasma Renin Activity:Nonhypertensive adults(upright/sitting): 0.65-5.0 ng/mL/hNonhypertensive children:Supine Upright/Sitting(ng/mL/h) (ng/mL/h)3-12 Months 15.0 or Less1-3 Years 10.0 or Less4-6 Years 7.5 or Less 15.0 or Less7-9 Years 5.9 or Less 17.0 or Less10-12 Years 5.3 or Less 16.0 or Less13-15 Years 4.4 or Less 16.0 or Less**Pediatric data from J Pediatrics (1976) 89:256;Pediat Res (1979) 13:817; and Eur J Pediatr (1994)153:284.Clinical Cutoffs for Hypertensive Individuals(ng/mL/h)Low-renin sodium/volume-mediatedhypertension likely: <0.65Primary aldosteronism possible: <0.65Renin-mediated hypertension likely: >=0.65Renovascular hypertension possible: >1.5Renovascular hypertension more likely: >10.0Approximately 1/3 of subjects

with essential hyper-tension have low-renin (PRA <0.65 ng/mL/h) hyper-tension, while the remainder have PRA values above0.65 ng/mL/h. Treatment with medications such asdiuretics or ACE inhibitors increase PRA levels.This test was developed and its performancecharacteristics have been determined by QuestDiagnostics Nichols Institute, Chantilly, VA.It has not been cleared or approved by the U.S.Food and Drug Administration. The FDA has determinedthat such clearance or approval is not necessary.Performance characteristics refer to the analyticalperformance of the test.

ALDOSTERONE/PRA RAT

740.0

1.5 - 18.2

Ratio

H

General Information

Collected:

12/23/2008 3:40 PM

Resulted:

12/31/2008 3:25 AM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

**********************************************

Component Results

Component

Your Value

Standard Range

Units

Flag

FOBT (EIA)

NEGATIVE

NEG -

General Information

Collected:

12/16/2008 3:00 PM

Resulted:

12/17/2008 12:01 PM

Ordered By:

Aliasgar Z Chittalia, MD

Result Status:

Final result

*************************************************************************

Component

Your Value

Standard Range

Units

Flag

BUN

8

6 - 20

mg/dL

CREATININE

1.1

0.7 - 1.5

mg/dL

SODIUM

141

135 - 146

mmol/L

POTASSIUM

3.9

3.5 - 5.1

mmol/L

CHLORIDE

100

98 - 111

mmol/L

CO2

30

22 - 32

mmol/L

GLUCOSE

91

70 - 120

mg/dL

ALBUMIN

4.2

3.8 - 5.0

g/dL

AST

26

8 - 46

U/L

ALKALINE PHOSPHATASE

56

25 - 125

U/L

BILIRUBIN, TOTAL

0.3

0.3 - 1.3

mg/dL

CALCIUM

9.4

8.3 - 10.5

mg/dL

PROTEIN

7.7

6.0 - 8.3

g/dL

ALT

14

8 - 50

U/L

ANION GAP

11

7 - 15

mEq/L

GFR ESTIMATED

57.4

>60.0 -

mL/min

L

General Information

Collected:

8/22/2007 11:42 AM

Resulted:

8/22/2007 9:54 PM

Ordered By:

, DO

Result Status:

Final result

**************************************************************

Component Results

Component

Your Value

Standard Range

Units

Flag

BUN

10

6 - 20

mg/dL

CREATININE

1.0

0.7 - 1.5

mg/dL

SODIUM

140

135 - 146

mmol/L

POTASSIUM

3.5

[Guest guest]

It's the Meds. That is all that is left. I didn't have this problem in 2007

when on NOrvasc. Why was I even taken off of it? No one in my

family has kidney disease. I don't get how u can't tell it's from

the meds.

Licia>> >> >> >> >> >> >> >> You have significant renal disease. Please get all>> of ur creatives you can find as far back as u can>> and send to us. >> >> >> >> >> >> >> >> >> >> >> >>>>>>

[Guest guest]

Agreed. My point is valid however harsh sounding. Because I lived it. Good evening.

Sojourner

It always dumbfounds me when i read posts that sound like folks think that medical care is a right and that all doctors are to blame for not connecting all the dots to solve your problem. Educate yourself so you can help them, help you. That is what this forum is for. Most of us here have learned alot from the grace and generosity of Dr. Grim. The human body is extremely complex. Medicine is an art, as well a a science. You are dealing with other humans who are there trying to assist as many people as they can. They dont always get it right...as we all know first hand. I have had doctors from every ethic background working on my case. Racism has nothing to do with your diagnostic process and there is no place for it on this forum. That said, I will assume you were being funny in your comment, so I am not offended, this time around. We all get scared when we are facing life altering conditions.

Relax, be gentle, and become a sponge for the knowledge and wisdom you can gleen from this forum. I have personnally learned alot here. We are absolutely very lucky to have a retired specialist giving back to the world and possibly helping many here save their own lives. So, welcome to the forum and I hope it can provide you with some guidance to improve your life.

============================================================================45-Male-Caucasian, 5'9"- 234lbs, PA Diagnosed 2007 Suspected Hyperplasia-No tumors on CT - No AVS.Meds: 50mg Spiro, 1200mg Calcium, 500mg Magnesium, 100,000UI Vit D (weekly), 20mg OmeprazoleSide effects: Gynecomastia, stomach inflammationOther Diags: GERD, Hiatal Hernia, Metabolic Syndrome - PreDiabetic, Secondary Hyperparathyroidism caused by Renal calcium leak, Bone Cyct in left Femoral Head and Pelvis. Benign Lung Nodules, Fibromyalgia, Scarring on Right Kidney Lower Pole

DASH: Started DASHing 5/3/2011

To: hyperaldosteronism Sent: Thursday, May

12, 2011 4:43 PMSubject: RE: Dr Grim Lab Results Finally

With all due respect, Sojourn, most of us here have had shoddy care. What exactly does race have to do with it? I am offended.

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Licia

I wish I could sew these incompetent, laxadazicle(spl) half ass racist!! Whooo, now I feel better.

Sojourn

[Guest guest]

, thanks for that dose of reality, I really needed it tonight. I had a

Neperology appt on Apr 29th and he wanted to put me on a " new " BP med, this 6

days after what I had presumed was Spiro finally clearing the excess aldo. In

the last 10 mos I have titrated off 5 and 2 halves of the 7 BP meds I was on!

Needless to say I was/am so angery I could chew nails! I finally cooled off

enough to talk with the head of the Nepherology dept. at the local VA. Haven't

gotten far yet but I'm not done.They as much as insinuated, no wait a minute -

let me quote: " During our extended visit and, surprisingly, very intelligent,

and deep questions and discussion session, it became apparent to me that Mr.

is being 'helped'by Internet 'gurus,' 'specialists,' and 'doctors'

claiming to have similar diagnosis, are or have lived through such a diagnosis,

or are 'ultimate source of information' regarding Hyperaldosteronism. " he then

went on to say the infomation may indeed be true and accurate but they are not

looking at me as a whole person!

I can't go on any more tonight, I'm still more upset than I thought and I fell

tuesday so my typing is limited. More to come, much more - I just can't believe

someone will throw out 4 months or more of BP#,s and rely on three samples taken

one day and none of which were talen even clost to AHA Stds. Thank God Dr.

Grim, you and all you others who have encouraged me to take control and that was

okay to question a doctor. Anyway, thanks to all and I'll fill it all out next

week when my hand (and mind) feel better!

- 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank &

testicle pain.

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, Type

II Diab. and PTSD

Currently on Spiro. 50 MG and titrating last 2 BP meds preparing for

adrenalectomy, maybe. Current BP ave. 112/60.

>

>

>

>

>

>

>

> You have significant renal disease. Please get all of ur creatives you can

find as far back as u can and send to us.  

>

>  

>

[Guest guest]

Wow . They had nothing constructive to say about all the great feedback DR Grim takes the time to give us? I could see if we were getting test done, for Dr Grim, and he evaluated and matched our gen dr/s and specialists. He is proof reading our dr's and our labs. why the offense?

Licia

Subject: Re: Dr Grim Lab Results FinallyTo: hyperaldosteronism Date: Thursday, May 12, 2011, 11:29 PM

, thanks for that dose of reality, I really needed it tonight. I had a Neperology appt on Apr 29th and he wanted to put me on a "new" BP med, this 6 days after what I had presumed was Spiro finally clearing the excess aldo. In the last 10 mos I have titrated off 5 and 2 halves of the 7 BP meds I was on!Needless to say I was/am so angery I could chew nails! I finally cooled off enough to talk with the head of the Nepherology dept. at the local VA. Haven't gotten far yet but I'm not done.They as much as insinuated, no wait a minute - let me quote: "During our extended visit and, surprisingly, very intelligent, and deep questions and discussion session, it became apparent to me that Mr. is being 'helped'by Internet 'gurus,' 'specialists,' and 'doctors' claiming to have similar diagnosis, are or have lived through such a diagnosis, or are 'ultimate source of information' regarding Hyperaldosteronism." he then went on to say the

infomation may indeed be true and accurate but they are not looking at me as a whole person!I can't go on any more tonight, I'm still more upset than I thought and I fell tuesday so my typing is limited. More to come, much more - I just can't believe someone will throw out 4 months or more of BP#,s and rely on three samples taken one day and none of which were talen even clost to AHA Stds. Thank God Dr. Grim, you and all you others who have encouraged me to take control and that was okay to question a doctor. Anyway, thanks to all and I'll fill it all out next week when my hand (and mind) feel better! - 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain.Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, Type II Diab. and PTSDCurrently on Spiro. 50 MG and titrating last 2 BP meds preparing for adrenalectomy, maybe. Current BP ave. 112/60.> > > > > > > > You have significant renal disease. Please get all of ur creatives you can find as far back as u can and send to us.  > >  >