Guest guest Posted July 6, 2011 Report Share Posted July 6, 2011 Thanks! I actually spoke to both my GP and my Endocrinologist this morning. My Endocrinologist was very apologetic that he did not see this on the report a month ago but was also concerned that not one of my doctors up to this point had mentioned it either. He took the time to ask me a lot of questions. I had pneumonia two years ago and he said odds are it was caused by that, but because I’m a smoker he wants to be cautious and order another CAT scan so he can do a comparison. The original CAT scan was done in March. The conversation with my GP was completely different. He asked me no questions, and rushed me off the phone saying it’s nothing to worry about. I also showed the report to my sister in law who is a nurse. She said the reason it was probably missed was because it was only mentioned in the ‘study notes’ and not in the ‘impression notes’. She said that doctors usually only read the impression notes. I guess this is true, because when my GP looked at it, he said he didn’t see anything about the lung. I had to point out where I read it on the report. I’ve read a lot of posts here about having to be your own patient advocate, and I’m learning how true this is. We are all human and make mistakes. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PASent: Wednesday, July 06, 2011 10:22 AMTo: hyperaldosteronism Subject: Re: CAT Scan report is part right. But may need a second CT scan to make sure. Your GP should be the one you should talk to. Many things can cause granulomas. > > > As far as the lung stuff, " Calcified " means it is nothing to worry about...aka - not cancer. I have a bunch of them in my lungs, and even some that are not calcified. They are very common, like 1 out of 10 people have them. 1 out of 2 over the age of 50, so I am told. You can relax. They are not anything at all to worry about, which is why they didnt even talk about it. SO STOP WORRYING! I worried myself sick about these stupid things. No connection to PA. Hope that helps.> > > > ============================================================================> > 45-Male-Caucasian, 5'9 " - 234lbs, PA Diagnosed 2007 Suspected Hyperplasia-No tumors on CT - No AVS.> > Meds: 100mg Spiro, 1800mg Calcium, 1000mg 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, Right Flank Pain> > DASH: Started " sort of " DASHing 5/3/2011> > > > > > To: hyperaldosteronism > > Sent: Tuesday, July 5, 2011 3:34 PM> > Subject: CAT Scan report> > > > > > Hi,> > > > I just completed the last of my urine tests and my doctor has confirmed PA and referred me to a surgeon at Penn in Philadelphia (Dr. Fraker) for next steps and possible AVS testing. I needed to pick up a copy of my CAT SCAN disc and report to send to him prior to the appointment. I just picked it up, and read through it. Just below the information about the adenoma was this:> > > > There no acute infectious or inflammatory lung consolidations present. Linear band of parenchymal density> > within the anterior segment of left lower lobe compatible with scarring or partial atelectasis. Subpleural calcified> > granuloma measuring 4 mm the subpleural left upper lobe.> > > > Not one of the doctors I have seen since this all began in March has mentioned anything about my lung, so I think I'm in a bit of shock. I don't know what to do with this. I don't know what it means. Is this something I should talk to my Endocronologist about? Or the Surgeon? Or my GP? I'm completely confused and not sure where to go with it. Maybe it's nothing to worry about? Does this have any connection with my PA? I would think not, but I'm new to all of this. If anyone has had a similar situation, I'd very much appreciate your imput. Thanks!> > > > > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2011 Report Share Posted July 6, 2011 If no one has not told you to stop smoking yet I am telling you now. Do not worry about the lung issue as long as you smoke. The smoking will get you first.CE Grim MDThanks! I actually spoke to both my GP and my Endocrinologist this morning. My Endocrinologist was very apologetic that he did not see this on the report a month ago but was also concerned that not one of my doctors up to this point had mentioned it either. He took the time to ask me a lot of questions. I had pneumonia two years ago and he said odds are it was caused by that, but because I’m a smoker he wants to be cautious and order another CAT scan so he can do a comparison. The original CAT scan was done in March. The conversation with my GP was completely different. He asked me no questions, and rushed me off the phone saying it’s nothing to worry about. I also showed the report to my sister in law who is a nurse. She said the reason it was probably missed was because it was only mentioned in the ‘study notes’ and not in the ‘impression notes’. She said that doctors usually only read the impression notes. I guess this is true, because when my GP looked at it, he said he didn’t see anything about the lung. I had to point out where I read it on the report. I’ve read a lot of posts here about having to be your own patient advocate, and I’m learning how true this is. We are all human and make mistakes. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PASent: Wednesday, July 06, 2011 10:22 AMTo: hyperaldosteronism Subject: Re: CAT Scan report is part right. But may need a second CT scan to make sure. Your GP should be the one you should talk to. Many things can cause granulomas. > > > As far as the lung stuff, "Calcified" means it is nothing to worry about...aka - not cancer. I have a bunch of them in my lungs, and even some that are not calcified. They are very common, like 1 out of 10 people have them. 1 out of 2 over the age of 50, so I am told. You can relax. They are not anything at all to worry about, which is why they didnt even talk about it. SO STOP WORRYING! I worried myself sick about these stupid things. No connection to PA. Hope that helps.> > > > ============================================================================> > 45-Male-Caucasian, 5'9"- 234lbs, PA Diagnosed 2007 Suspected Hyperplasia-No tumors on CT - No AVS.> > Meds: 100mg Spiro, 1800mg Calcium, 1000mg 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, Right Flank Pain> > DASH: Started "sort of" DASHing 5/3/2011> > > > > > To: hyperaldosteronism > > Sent: Tuesday, July 5, 2011 3:34 PM> > Subject: CAT Scan report> > > > > > Hi,> > > > I just completed the last of my urine tests and my doctor has confirmed PA and referred me to a surgeon at Penn in Philadelphia (Dr. Fraker) for next steps and possible AVS testing. I needed to pick up a copy of my CAT SCAN disc and report to send to him prior to the appointment. I just picked it up, and read through it. Just below the information about the adenoma was this:> > > > There no acute infectious or inflammatory lung consolidations present. Linear band of parenchymal density> > within the anterior segment of left lower lobe compatible with scarring or partial atelectasis. Subpleural calcified> > granuloma measuring 4 mm the subpleural left upper lobe.> > > > Not one of the doctors I have seen since this all began in March has mentioned anything about my lung, so I think I'm in a bit of shock. I don't know what to do with this. I don't know what it means. Is this something I should talk to my Endocronologist about? Or the Surgeon? Or my GP? I'm completely confused and not sure where to go with it. Maybe it's nothing to worry about? Does this have any connection with my PA? I would think not, but I'm new to all of this. If anyone has had a similar situation, I'd very much appreciate your imput. Thanks!> > > > > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2011 Report Share Posted July 7, 2011 You need to see a Nephrologist who is also Board Certified as a Hypertension Specialist by the American Society of Hypertension. Otherwise he may not know the broad base of HTN.Adding an ACE to spiro might help BP if spiro increased renin enough that there is something to work on. What has your recent renin and aldo been?Also Lisionpril is an ACE so you are on it?CE Grim MD We may be human and all make mistakes but unless we are driving a car or holding a gun it probably doesn't impact other's life like a doctor's mistake will!I'm still looking for a Nepheroligist who knows how to treat PA. My current one was very insistant that I add an ACEI class med to counteract vasoconstriction. (Dr. Grim has posed a question about this that I am still trying to get an answer to.)Today I read an article posted by Francis and came across this and I quote, "The risk of hyperkalemia with spironolactone isincreased in older patients and diabetics; if used in combination withACE inhibitors, ARBs, or nonsteroidal anti-inflammatory agents; and inparticular, in patients with chronic kidney disease."Let's see, I'm only almost 65, have DM2, on Spiro 75MG, Lisinoprol and he was trying to increase my CKD to Stage III. Wonder if he even checked my K, It has been 4.5 to 5.0 (ref 3,5 - 5.0) for the last 2 years! (And he bragged about treating the total PTN!) I might add my PCP has had me on a 2wk recall to keep an eye on it but Nephrology never mentioned it or anything abour salt substitute, or salt for that matter! They just scheduled a 6month recall! It's about time I speak with the Dept. Chair again or maybe the Patient Advocate! - 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP being watched after Oral Surgery and associated dietary changes.Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, Type II Diab. and PTSDMeds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Methadone 10 MG(titrating off S-L-O-W-L-Y) , Metoprolol Tartrate 200 MG, Metformin 2000MG, Lisinopril 2.5MG and Spironolactone 75 MG. > > > > > As far as the lung stuff, "Calcified" means it is nothing to worry> about...aka - not cancer. I have a bunch of them in my lungs, and even some> that are not calcified. They are very common, like 1 out of 10 people have> them. 1 out of 2 over the age of 50, so I am told. You can relax. They are> not anything at all to worry about, which is why they didnt even talk about> it. SO STOP WORRYING! I worried myself sick about these stupid things. No> connection to PA. Hope that helps.> > > > > >> ============================================================================> > > 45-Male-Caucasian, 5'9"- 234lbs, PA Diagnosed 2007 Suspected> Hyperplasia-No tumors on CT - No AVS.> > > Meds: 100mg Spiro, 1800mg Calcium, 1000mg 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, Right Flank Pain> > > DASH: Started "sort of" DASHing 5/3/2011> > > > > > From: lisa_mongeau <lisamongeau@>> > > To: hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> > > > Sent: Tuesday, July 5, 2011 3:34 PM> > > Subject: CAT Scan report> > > > > > > > > Hi,> > > > > > I just completed the last of my urine tests and my doctor has confirmed> PA and referred me to a surgeon at Penn in Philadelphia (Dr. Fraker) for> next steps and possible AVS testing. I needed to pick up a copy of my CAT> SCAN disc and report to send to him prior to the appointment. I just picked> it up, and read through it. Just below the information about the adenoma was> this:> > > > > > There no acute infectious or inflammatory lung consolidations present.> Linear band of parenchymal density> > > within the anterior segment of left lower lobe compatible with scarring> or partial atelectasis. Subpleural calcified> > > granuloma measuring 4 mm the subpleural left upper lobe.> > > > > > Not one of the doctors I have seen since this all began in March has> mentioned anything about my lung, so I think I'm in a bit of shock. I don't> know what to do with this. I don't know what it means. Is this something I> should talk to my Endocronologist about? Or the Surgeon? Or my GP? I'm> completely confused and not sure where to go with it. Maybe it's nothing to> worry about? Does this have any connection with my PA? I would think not,> but I'm new to all of this. If anyone has had a similar situation, I'd very> much appreciate your imput. Thanks!> > > > > > > > > > > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 8, 2011 Report Share Posted July 8, 2011 Right spiro will do the job. ACE not likely to help and has not been tested in PA that I can find with spiro and ACE. CE Grim MDSorry but we needa Nephrologist who knows his a_ _ from a hole in the ground! We are apparently surviving with "Rent-A-Doc's" judging from the last 3 I have seen. This is not ment to to be a slam, right Dr. Grim, but you take what you get and don't have time to build a relationship.Most recent tests were7/8/2010 when RENIN was .51 and ALDOS was 15, right after I was DXed and started on Spiro. I have an appt. with my PCP on the 22nd and will shoot her an email to include these tests in the workup.Yes, Lisionpril was their ACE of choice. They threw such a fit that I agreed on the condition they would stop the Furosemide as Dr. Grim suggested! (Before you ask Endema is gone!) We started at a low dose (2.5) and plan to go to target (20) if I tolerate okay. Just wish I knew how to tell if it is doing anything. My research says vasoconstriction, their stated reason for ACEI, is countered by both Spiro. and ACEI's but I didn't have enough years of college to convince them!I need to find a Nerhrologist who knows how to treat PA, DM2 and CKD and whatever else if they keep screwing around! (Actually they can RX whatever they want, I decide what to do with it!) - 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP being watched after Oral Surgery and associated dietary changes.Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, Type II Diab. and PTSDMeds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Methadone 10 MG(titrating off S-L-O-W-L-Y) , Metoprolol Tartrate 200 MG, Metformin 2000MG, Lisinopril 2.5MG and Spironolactone 75 MG. > > > >> > > > > As far as the lung stuff, "Calcified" means it is nothing to > > worry> > > about...aka - not cancer. I have a bunch of them in my lungs, and > > even some> > > that are not calcified. They are very common, like 1 out of 10 > > people have> > > them. 1 out of 2 over the age of 50, so I am told. You can relax. > > They are> > > not anything at all to worry about, which is why they didnt even > > talk about> > > it. SO STOP WORRYING! I worried myself sick about these stupid > > things. No> > > connection to PA. Hope that helps.> > > > >> > > > >> > > > > = > > = > > = > > = > > = > > = > > ======================================================================> > > > > 45-Male-Caucasian, 5'9"- 234lbs, PA Diagnosed 2007 Suspected> > > Hyperplasia-No tumors on CT - No AVS.> > > > > Meds: 100mg Spiro, 1800mg Calcium, 1000mg 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, Right Flank Pain> > > > > DASH: Started "sort of" DASHing 5/3/2011> > > > >> > > > > From: lisa_mongeau <lisamongeau@>> > > > > To: hyperaldosteronism > > > <mailto:hyperaldosteronism%40yahoogroups.com>> > > > > Sent: Tuesday, July 5, 2011 3:34 PM> > > > > Subject: CAT Scan report> > > > >> > > > >> > > > > Hi,> > > > >> > > > > I just completed the last of my urine tests and my doctor has > > confirmed> > > PA and referred me to a surgeon at Penn in Philadelphia (Dr. > > Fraker) for> > > next steps and possible AVS testing. I needed to pick up a copy of > > my CAT> > > SCAN disc and report to send to him prior to the appointment. I > > just picked> > > it up, and read through it. Just below the information about the > > adenoma was> > > this:> > > > >> > > > > There no acute infectious or inflammatory lung consolidations > > present.> > > Linear band of parenchymal density> > > > > within the anterior segment of left lower lobe compatible with > > scarring> > > or partial atelectasis. Subpleural calcified> > > > > granuloma measuring 4 mm the subpleural left upper lobe.> > > > >> > > > > Not one of the doctors I have seen since this all began in > > March has> > > mentioned anything about my lung, so I think I'm in a bit of > > shock. I don't> > > know what to do with this. I don't know what it means. Is this > > something I> > > should talk to my Endocronologist about? Or the Surgeon? Or my GP? > > I'm> > > completely confused and not sure where to go with it. Maybe it's > > nothing to> > > worry about? Does this have any connection with my PA? I would > > think not,> > > but I'm new to all of this. If anyone has had a similar situation, > > I'd very> > > much appreciate your imput. Thanks!> > > > >> > > > >> > > > >> > > > >> > > >> > >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 8, 2011 Report Share Posted July 8, 2011 Right spiro will do the job. ACE not likely to help and has not been tested in PA that I can find with spiro and ACE. CE Grim MDSorry but we needa Nephrologist who knows his a_ _ from a hole in the ground! We are apparently surviving with "Rent-A-Doc's" judging from the last 3 I have seen. This is not ment to to be a slam, right Dr. Grim, but you take what you get and don't have time to build a relationship.Most recent tests were7/8/2010 when RENIN was .51 and ALDOS was 15, right after I was DXed and started on Spiro. I have an appt. with my PCP on the 22nd and will shoot her an email to include these tests in the workup.Yes, Lisionpril was their ACE of choice. They threw such a fit that I agreed on the condition they would stop the Furosemide as Dr. Grim suggested! (Before you ask Endema is gone!) We started at a low dose (2.5) and plan to go to target (20) if I tolerate okay. Just wish I knew how to tell if it is doing anything. My research says vasoconstriction, their stated reason for ACEI, is countered by both Spiro. and ACEI's but I didn't have enough years of college to convince them!I need to find a Nerhrologist who knows how to treat PA, DM2 and CKD and whatever else if they keep screwing around! (Actually they can RX whatever they want, I decide what to do with it!) - 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP being watched after Oral Surgery and associated dietary changes.Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, Type II Diab. and PTSDMeds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Methadone 10 MG(titrating off S-L-O-W-L-Y) , Metoprolol Tartrate 200 MG, Metformin 2000MG, Lisinopril 2.5MG and Spironolactone 75 MG. > > > >> > > > > As far as the lung stuff, "Calcified" means it is nothing to > > worry> > > about...aka - not cancer. I have a bunch of them in my lungs, and > > even some> > > that are not calcified. They are very common, like 1 out of 10 > > people have> > > them. 1 out of 2 over the age of 50, so I am told. You can relax. > > They are> > > not anything at all to worry about, which is why they didnt even > > talk about> > > it. SO STOP WORRYING! I worried myself sick about these stupid > > things. No> > > connection to PA. Hope that helps.> > > > >> > > > >> > > > > = > > = > > = > > = > > = > > = > > ======================================================================> > > > > 45-Male-Caucasian, 5'9"- 234lbs, PA Diagnosed 2007 Suspected> > > Hyperplasia-No tumors on CT - No AVS.> > > > > Meds: 100mg Spiro, 1800mg Calcium, 1000mg 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, Right Flank Pain> > > > > DASH: Started "sort of" DASHing 5/3/2011> > > > >> > > > > From: lisa_mongeau <lisamongeau@>> > > > > To: hyperaldosteronism > > > <mailto:hyperaldosteronism%40yahoogroups.com>> > > > > Sent: Tuesday, July 5, 2011 3:34 PM> > > > > Subject: CAT Scan report> > > > >> > > > >> > > > > Hi,> > > > >> > > > > I just completed the last of my urine tests and my doctor has > > confirmed> > > PA and referred me to a surgeon at Penn in Philadelphia (Dr. > > Fraker) for> > > next steps and possible AVS testing. I needed to pick up a copy of > > my CAT> > > SCAN disc and report to send to him prior to the appointment. I > > just picked> > > it up, and read through it. Just below the information about the > > adenoma was> > > this:> > > > >> > > > > There no acute infectious or inflammatory lung consolidations > > present.> > > Linear band of parenchymal density> > > > > within the anterior segment of left lower lobe compatible with > > scarring> > > or partial atelectasis. Subpleural calcified> > > > > granuloma measuring 4 mm the subpleural left upper lobe.> > > > >> > > > > Not one of the doctors I have seen since this all began in > > March has> > > mentioned anything about my lung, so I think I'm in a bit of > > shock. I don't> > > know what to do with this. I don't know what it means. Is this > > something I> > > should talk to my Endocronologist about? Or the Surgeon? Or my GP? > > I'm> > > completely confused and not sure where to go with it. Maybe it's > > nothing to> > > worry about? Does this have any connection with my PA? I would > > think not,> > > but I'm new to all of this. If anyone has had a similar situation, > > I'd very> > > much appreciate your imput. Thanks!> > > > >> > > > >> > > > >> > > > >> > > >> > >> >> >> >> Quote Link to comment Share on other sites More sharing options...
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