Re: Question about AVS and Surgery recovery times

[Guest guest]

Hi ,

I've already had one AVS and am scheduled for my second one this Friday, so

hopefully I can answer some of your questions.

I missed one day of work for my first AVS - the day of the procedure, which was

on Friday. The day after I did nothing but sleep - I've never been sedated

before and was just really, really out of it. But by Monday I was fine and went

back to work.

I'm still not sure I'm a candidate for surgery but was told to plan to be off

from work for two to six weeks. It seems to be highly individual - some people

are back to normal in a week, others take longer.

As for getting off spiro - it interferes with the AVS results. How long it takes

to get out of your system seems to be something nobody agrees on - 6 weeks seems

to be the standard, but one of my doctors didn't think waiting was necessary (I

opted to wait anyway after my failed three-week spiro trial). And I've seen Dr.

Grim recommend waiting three months, IIRC.

I know the AVS procedure can vary by facility, but if you have any questions

please feel free to ask me and I'll tell you what I remember (I was completely

unconscious most of the day). Despite the fact that my results were inconclusive

the first time around, it really was not that big of a deal. Most of the info

out there on the web tells of the negative, and really, my experience with it

was quite the opposite.

Except for those darned inconclusive results Oh well.

-msmith1928

Nulliparous female, 46, 5'3 " , 120 lbs, polymenorrhea, hyperinsulinemia,

hereditary fructose intolerance, lactose intolerance, probable gluten

intolerance. Current meds are K 20 MEQ 4x/day, singulair 10mg, norethindrone

..35mg to regulate polymenorrhea, cyclobenzaprine 5-10mg when needed,

fexofenadine 180mg as needed. Low sodium, fructose- and grain-free diet. Known

drug allergies include PCN, sulfa, tetracycline. 1cm left adrenal nodule, supine

aldosterone 28.5/renin 0.2, potassium <2.9 (when not taking supplements); spiro

caused gynecomastia and polymenorrhea

> What is a reasonable time off of work for the AVS proceedure? How many days

did you miss if for your AVS?

>

> How soon can one return to work after surgery if all goes well? Is one week

vacation enough to schedule for surgery?

>

> Why does someone need to be off Spiro before AVS? Both of my endos told me

that getting off Spiro was not necessary for the AVS procedure.

[Guest guest]

I have been participating in the group for a couple of months so I am aware of the fact that surgery is only recommended if meds fail. In fact, my endo at Mayo agrees with this theory. My endo that I see locally agrees with this as well, but is considering surgery in my case for various reasons. Surgery is not a given at this point, but I have some questions to prepare. I start a new job on Monday and I am a little concerned about time off of work due to AVS and surgery. What is a reasonable time off of work for the AVS proceedure? How many days did you miss if for your AVS?I day to several weeks How soon can one return to work after surgery if all goes well? Is one week vacation enough to schedule for surgery?1 week to several weeks. Why does someone need to be off Spiro before AVS? Both of my endos told me that getting off Spiro was not necessary for the AVS procedure. Most recommend off it but one can do it and if results not clear then redo off spiro. Thanks for the info. Spiro is working sporadically. I think my endo is leaning towards surgery, but he is waiting on results from neurology and cardiology before he makes his recommendation.How is the DASHing doing? This will decrease your need for spiro or Inspra (by to 50 x lower dose needed) and make many things better. See Bravo article in our files and take to your team.Ask your team to check a spot urine for Na, K and creatinine to see how well you are doing and if you need to make changes.Keep us posted.CE Grim MD

[Guest guest]

Several weeks off for AVS? Is that only due to a complication? Other responses

have been 1 day off work for AVS. What would be the reason for several weeks

off work just for AVS?

>

> > I have been participating in the group for a couple of months so I

> > am aware of the fact that surgery is only recommended if meds fail.

> > In fact, my endo at Mayo agrees with this theory. My endo that I see

> > locally agrees with this as well, but is considering surgery in my

> > case for various reasons. Surgery is not a given at this point, but

> > I have some questions to prepare.

> >

> > I start a new job on Monday and I am a little concerned about time

> > off of work due to AVS and surgery.

> >

> > What is a reasonable time off of work for the AVS proceedure? How

> > many days did you miss if for your AVS?

> >

>

> I day to several weeks

> >

> > How soon can one return to work after surgery if all goes well? Is

> > one week vacation enough to schedule for surgery?

> >

>

> 1 week to several weeks.

>

> >

> > Why does someone need to be off Spiro before AVS? Both of my endos

> > told me that getting off Spiro was not necessary for the AVS

> > procedure.

> >

>

> Most recommend off it but one can do it and if results not clear then

> redo off spiro.

>

> >

> > Thanks for the info. Spiro is working sporadically. I think my endo

> > is leaning towards surgery, but he is waiting on results from

> > neurology and cardiology before he makes his recommendation.

> >

>

> How is the DASHing doing? This will decrease your need for spiro or

> Inspra (by to 50 x lower dose needed) and make many things better. See

> Bravo article in our files and take to your team.

>

> Ask your team to check a spot urine for Na, K and creatinine to see

> how well you are doing and if you need to make changes.

>

> Keep us posted.

>

> CE Grim MD

>

>

> >

> >

> >

> >

>

[Guest guest]

It is called bleeding when they puncture the adrenal vein. But unusual. Cannot predict for an individual of course.It is called risk analysis.So you put in what risks you can tolerate and the costs and out comes a prediction for the average but never for the individual.See Clinical Epidemiology by and Sackett. or maybe even Wikipedia.CE Grim MD Several weeks off for AVS? Is that only due to a complication? Other responses have been 1 day off work for AVS. What would be the reason for several weeks off work just for AVS? > > > I have been participating in the group for a couple of months so I > > am aware of the fact that surgery is only recommended if meds fail. > > In fact, my endo at Mayo agrees with this theory. My endo that I see > > locally agrees with this as well, but is considering surgery in my > > case for various reasons. Surgery is not a given at this point, but > > I have some questions to prepare. > > > > I start a new job on Monday and I am a little concerned about time > > off of work due to AVS and surgery. > > > > What is a reasonable time off of work for the AVS proceedure? How > > many days did you miss if for your AVS? > > > > I day to several weeks > > > > How soon can one return to work after surgery if all goes well? Is > > one week vacation enough to schedule for surgery? > > > > 1 week to several weeks. > > > > > Why does someone need to be off Spiro before AVS? Both of my endos > > told me that getting off Spiro was not necessary for the AVS > > procedure. > > > > Most recommend off it but one can do it and if results not clear then > redo off spiro. > > > > > Thanks for the info. Spiro is working sporadically. I think my endo > > is leaning towards surgery, but he is waiting on results from > > neurology and cardiology before he makes his recommendation. > > > > How is the DASHing doing? This will decrease your need for spiro or > Inspra (by to 50 x lower dose needed) and make many things better. See > Bravo article in our files and take to your team. > > Ask your team to check a spot urine for Na, K and creatinine to see > how well you are doing and if you need to make changes. > > Keep us posted. > > CE Grim MD > > > > > > > > > > >

[Guest guest]

Hi- I too only took one day for the AVS procedure. I was very lightly sedated

and very conscious during this procedure. I was at the facility all day...we

arrived at 10am started prepping fairly quickly left at 3pm. No pain or

discomfort following this procedure.

Laporascopic adrenalectomy- 2 nights in the hospital 1 week recovery at home.

More recovery than I expected. Abdomen was sore.

Why risk a meaningless AVS report? If it were me then I would wait till spiro is

out of system.

good luck.

>

> I have been participating in the group for a couple of months so I am aware of

the fact that surgery is only recommended if meds fail. In fact, my endo at

Mayo agrees with this theory. My endo that I see locally agrees with this as

well, but is considering surgery in my case for various reasons. Surgery is not

a given at this point, but I have some questions to prepare.

>

> I start a new job on Monday and I am a little concerned about time off of work

due to AVS and surgery.

>

> What is a reasonable time off of work for the AVS proceedure? How many days

did you miss if for your AVS?

>

> How soon can one return to work after surgery if all goes well? Is one week

vacation enough to schedule for surgery?

>

> Why does someone need to be off Spiro before AVS? Both of my endos told me

that getting off Spiro was not necessary for the AVS procedure.

>

> Thanks for the info. Spiro is working sporadically. I think my endo is

leaning towards surgery, but he is waiting on results from neurology and

cardiology before he makes his recommendation.

>

>

>

[Guest guest]

And the reasons he is considering surgery are????Remember it is you that is getting operated on not him.CE Grim MD Hi- I too only took one day for the AVS procedure. I was very lightly sedated and very conscious during this procedure. I was at the facility all day...we arrived at 10am started prepping fairly quickly left at 3pm. No pain or discomfort following this procedure. Laporascopic adrenalectomy- 2 nights in the hospital 1 week recovery at home. More recovery than I expected. Abdomen was sore. Why risk a meaningless AVS report? If it were me then I would wait till spiro is out of system. good luck. > > I have been participating in the group for a couple of months so I am aware of the fact that surgery is only recommended if meds fail. In fact, my endo at Mayo agrees with this theory. My endo that I see locally agrees with this as well, but is considering surgery in my case for various reasons. Surgery is not a given at this point, but I have some questions to prepare. > > I start a new job on Monday and I am a little concerned about time off of work due to AVS and surgery. > > What is a reasonable time off of work for the AVS proceedure? How many days did you miss if for your AVS? > > How soon can one return to work after surgery if all goes well? Is one week vacation enough to schedule for surgery? > > Why does someone need to be off Spiro before AVS? Both of my endos told me that getting off Spiro was not necessary for the AVS procedure. > > Thanks for the info. Spiro is working sporadically. I think my endo is leaning towards surgery, but he is waiting on results from neurology and cardiology before he makes his recommendation. > > >

[Guest guest]

I apologize. I did not mean to suggest that he run into surgery. I'm sure you

already highly impressed DASHing. Personally, what I wanted 4 the AVS is to be

at a facility that does it regularly and successfully. It was my understanding

that there are not many facilities that are able to boast high success rates. I

thought I saw mention of trying it with meds and then risking a second procedure

if the first report was not useful. That doesn't make sense to me. I'd want it

done right the first time. I had two drs tell me I had to be off Inspra for 6

weeks prior to Adrenal vein sampling but other than the PA I have no other

health problems. BTW If they're drawing and testing aldosterone wouldn't an

aldosterone antagonist make the #s/results unreliable?

> > >

> > > I have been participating in the group for a couple of months so I

> > am aware of the fact that surgery is only recommended if meds fail.

> > In fact, my endo at Mayo agrees with this theory. My endo that I see

> > locally agrees with this as well, but is considering surgery in my

> > case for various reasons. Surgery is not a given at this point, but

> > I have some questions to prepare.

> > >

> > > I start a new job on Monday and I am a little concerned about time

> > off of work due to AVS and surgery.

> > >

> > > What is a reasonable time off of work for the AVS proceedure? How

> > many days did you miss if for your AVS?

> > >

> > > How soon can one return to work after surgery if all goes well? Is

> > one week vacation enough to schedule for surgery?

> > >

> > > Why does someone need to be off Spiro before AVS? Both of my endos

> > told me that getting off Spiro was not necessary for the AVS

> > procedure.

> > >

> > > Thanks for the info. Spiro is working sporadically. I think my

> > endo is leaning towards surgery, but he is waiting on results from

> > neurology and cardiology before he makes his recommendation.

> > >

> > >

> > >

> >

> >

>

[Guest guest]

Thanks for the info. Spiro is working sporadically. I think my

> > endo is leaning towards surgery, but he is waiting on results from

> > neurology and cardiology before he makes his recommendation.

This remark strikes me as interesting.... I often wondered if the adrenal/nodule

was on a monthly cycle as far as production and over expression of its hormones.

Maybe it makes sense to ask if there is a way to monitor for such a pattern?

>

> > I have been participating in the group for a couple of months so I

> > am aware of the fact that surgery is only recommended if meds fail.

> > In fact, my endo at Mayo agrees with this theory. My endo that I see

> > locally agrees with this as well, but is considering surgery in my

> > case for various reasons. Surgery is not a given at this point, but

> > I have some questions to prepare.

> >

> > I start a new job on Monday and I am a little concerned about time

> > off of work due to AVS and surgery.

> >

> > What is a reasonable time off of work for the AVS proceedure? How

> > many days did you miss if for your AVS?

> >

>

> I day to several weeks

> >

> > How soon can one return to work after surgery if all goes well? Is

> > one week vacation enough to schedule for surgery?

> >

>

> 1 week to several weeks.

>

> >

> > Why does someone need to be off Spiro before AVS? Both of my endos

> > told me that getting off Spiro was not necessary for the AVS

> > procedure.

> >

>

> Most recommend off it but one can do it and if results not clear then

> redo off spiro.

>

> >

> > Thanks for the info. Spiro is working sporadically. I think my endo

> > is leaning towards surgery, but he is waiting on results from

> > neurology and cardiology before he makes his recommendation.

> >

>

> How is the DASHing doing? This will decrease your need for spiro or

> Inspra (by to 50 x lower dose needed) and make many things better. See

> Bravo article in our files and take to your team.

>

> Ask your team to check a spot urine for Na, K and creatinine to see

> how well you are doing and if you need to make changes.

>

> Keep us posted.

>

> CE Grim MD

>

>

> >

> >

> >

> >

>

[Guest guest]

Excellent question but don not know answer for certain. It will depend on the assay used. We do know that most antibody assays arBvery specific MCBs by blocking Aldo will increase renin and may increase Aldo as well. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I apologize. I did not mean to suggest that he run into surgery. I'm sure you already highly impressed DASHing. Personally, what I wanted 4 the AVS is to be at a facility that does it regularly and successfully. It was my understanding that there are not many facilities that are able to boast high success rates. I thought I saw mention of trying it with meds and then risking a second procedure if the first report was not useful. That doesn't make sense to me. I'd want it done right the first time. I had two drs tell me I had to be off Inspra for 6 weeks prior to Adrenal vein sampling but other than the PA I have no other health problems. BTW If they're drawing and testing aldosterone wouldn't an aldosterone antagonist make the #s/results unreliable?

> > >

> > > I have been participating in the group for a couple of months so I

> > am aware of the fact that surgery is only recommended if meds fail.

> > In fact, my endo at Mayo agrees with this theory. My endo that I see

> > locally agrees with this as well, but is considering surgery in my

> > case for various reasons. Surgery is not a given at this point, but

> > I have some questions to prepare.

> > >

> > > I start a new job on Monday and I am a little concerned about time

> > off of work due to AVS and surgery.

> > >

> > > What is a reasonable time off of work for the AVS proceedure? How

> > many days did you miss if for your AVS?

> > >

> > > How soon can one return to work after surgery if all goes well? Is

> > one week vacation enough to schedule for surgery?

> > >

> > > Why does someone need to be off Spiro before AVS? Both of my endos

> > told me that getting off Spiro was not necessary for the AVS

> > procedure.

> > >

> > > Thanks for the info. Spiro is working sporadically. I think my

> > endo is leaning towards surgery, but he is waiting on results from

> > neurology and cardiology before he makes his recommendation.

> > >

> > >

> > >

> >

> >

>

[Guest guest]

Yes measure Aldo cortisol am and pm and estrogens daily for a few months as well as bp and Daily 24 hr urine Na and K not a small task. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Thanks for the info. Spiro is working sporadically. I think my

> > endo is leaning towards surgery, but he is waiting on results from

> > neurology and cardiology before he makes his recommendation.

This remark strikes me as interesting.... I often wondered if the adrenal/nodule was on a monthly cycle as far as production and over expression of its hormones. Maybe it makes sense to ask if there is a way to monitor for such a pattern?

>

> > I have been participating in the group for a couple of months so I

> > am aware of the fact that surgery is only recommended if meds fail.

> > In fact, my endo at Mayo agrees with this theory. My endo that I see

> > locally agrees with this as well, but is considering surgery in my

> > case for various reasons. Surgery is not a given at this point, but

> > I have some questions to prepare.

> >

> > I start a new job on Monday and I am a little concerned about time

> > off of work due to AVS and surgery.

> >

> > What is a reasonable time off of work for the AVS proceedure? How

> > many days did you miss if for your AVS?

> >

>

> I day to several weeks

> >

> > How soon can one return to work after surgery if all goes well? Is

> > one week vacation enough to schedule for surgery?

> >

>

> 1 week to several weeks.

>

> >

> > Why does someone need to be off Spiro before AVS? Both of my endos

> > told me that getting off Spiro was not necessary for the AVS

> > procedure.

> >

>

> Most recommend off it but one can do it and if results not clear then

> redo off spiro.

>

> >

> > Thanks for the info. Spiro is working sporadically. I think my endo

> > is leaning towards surgery, but he is waiting on results from

> > neurology and cardiology before he makes his recommendation.

> >

>

> How is the DASHing doing? This will decrease your need for spiro or

> Inspra (by to 50 x lower dose needed) and make many things better. See

> Bravo article in our files and take to your team.

>

> Ask your team to check a spot urine for Na, K and creatinine to see

> how well you are doing and if you need to make changes.

>

> Keep us posted.

>

> CE Grim MD

>

>

> >

> >

> >

> >

>

[Guest guest]

Hi ~ Dr. Young efficiently schedules ALL appointments, from diagnosis through surgery. Here is the timeline for our recent experience at Mayo: 1.) July 20th consult - Dr. Young - diagnosis: Primary Aldosteronism (based on labs and CT.)

2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional Radiology (selected by Dr. Young)3.) July 25th - result of AVS - Dr. Young revealed aldosterone numbers: 23,000 on the left and 440 on the

right. Surgery option discussed and chosen.4.) July 27th - Adrenalectomy - Dr. , General Surgery (selected by Dr. Young)Current

status: Potassium level -- high normal (5.2 at Mayo); subsequently, all supplementation has now ceased. (Previously taking 60 mEq of potassium.) Excess urination has been eliminated. Blood pressure under better control with one less med.

In our followup visit, I told Dr. Young about you... that you have been to Mayo but are hoping for treatment in St. Louis. Please let me know if you would like additional information -- including how to contact Dr. Young. Take good care,

KK in Houston TXTo: hyperaldosteronism Sent: Monday, August 15, 2011 12:12 PMSubject: Question about AVS and Surgery recovery times

I have been participating in the group for a couple of months so I am aware of the fact that surgery is only recommended if meds fail. In fact, my endo at Mayo agrees with this theory. My endo that I see locally agrees with this as well, but is considering surgery in my case for various reasons. Surgery is not a given at this point, but I have some questions to prepare.

I start a new job on Monday and I am a little concerned about time off of work due to AVS and surgery.

What is a reasonable time off of work for the AVS proceedure? How many days did you miss if for your AVS?

How soon can one return to work after surgery if all goes well? Is one week vacation enough to schedule for surgery?

Why does someone need to be off Spiro before AVS? Both of my endos told me that getting off Spiro was not necessary for the AVS procedure.

Thanks for the info. Spiro is working sporadically. I think my endo is leaning towards surgery, but he is waiting on results from neurology and cardiology before he makes his recommendation.

[Guest guest]

Excellent results. Keep us posted for the next 5 years at least so we will have long term followup of good cSuccess. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Hi ~ Dr. Young efficiently schedules ALL appointments, from diagnosis through surgery. Here is the timeline for our recent experience at Mayo: 1.) July 20th consult - Dr. Young - diagnosis: Primary Aldosteronism (based on labs and CT.)

2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional Radiology (selected by Dr. Young)3.) July 25th - result of AVS - Dr. Young revealed aldosterone numbers: 23,000 on the left and 440 on the

right. Surgery option discussed and chosen.4.) July 27th - Adrenalectomy - Dr. , General Surgery (selected by Dr. Young)Current

status: Potassium level -- high normal (5.2 at Mayo); subsequently, all supplementation has now ceased. (Previously taking 60 mEq of potassium.) Excess urination has been eliminated. Blood pressure under better control with one less med.

In our followup visit, I told Dr. Young about you... that you have been to Mayo but are hoping for treatment in St. Louis. Please let me know if you would like additional information -- including how to contact Dr. Young. Take good care,

KK in Houston TXTo: hyperaldosteronism Sent: Monday, August 15, 2011 12:12 PMSubject: Question about AVS and Surgery recovery times

I have been participating in the group for a couple of months so I am aware of the fact that surgery is only recommended if meds fail. In fact, my endo at Mayo agrees with this theory. My endo that I see locally agrees with this as well, but is considering surgery in my case for various reasons. Surgery is not a given at this point, but I have some questions to prepare.

I start a new job on Monday and I am a little concerned about time off of work due to AVS and surgery.

What is a reasonable time off of work for the AVS proceedure? How many days did you miss if for your AVS?

How soon can one return to work after surgery if all goes well? Is one week vacation enough to schedule for surgery?

Why does someone need to be off Spiro before AVS? Both of my endos told me that getting off Spiro was not necessary for the AVS procedure.

Thanks for the info. Spiro is working sporadically. I think my endo is leaning towards surgery, but he is waiting on results from neurology and cardiology before he makes his recommendation.

[Guest guest]

BTW I consider a cure as normal BP with meds. Be certain to get the detailed pathology report for both you and your family.Post a copy in our files for long term followup.CE Grim MD Hi ~ Dr. Young efficiently schedules ALL appointments, from diagnosis through surgery. Here is the timeline for our recent experience at Mayo: 1.) July 20th consult - Dr. Young - diagnosis: Primary Aldosteronism (based on labs and CT.) 2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional Radiology (selected by Dr. Young)3.) July 25th - result of AVS - Dr. Young revealed aldosterone numbers: 23,000 on the left and 440 on the right. Surgery option discussed and chosen.4.) July 27th - Adrenalectomy - Dr. , General Surgery (selected by Dr. Young)Current status: Potassium level -- high normal (5.2 at Mayo); subsequently, all supplementation has now ceased. (Previously taking 60 mEq of potassium.) Excess urination has been eliminated. Blood pressure under better control with one less med. In our followup visit, I told Dr. Young about you... that you have been to Mayo but are hoping for treatment in St. Louis. Please let me know if you would like additional information -- including how to contact Dr. Young. Take good care, KK in Houston TXTo: hyperaldosteronism Sent: Monday, August 15, 2011 12:12 PMSubject: Question about AVS and Surgery recovery times I have been participating in the group for a couple of months so I am aware of the fact that surgery is only recommended if meds fail. In fact, my endo at Mayo agrees with this theory. My endo that I see locally agrees with this as well, but is considering surgery in my case for various reasons. Surgery is not a given at this point, but I have some questions to prepare. I start a new job on Monday and I am a little concerned about time off of work due to AVS and surgery. What is a reasonable time off of work for the AVS proceedure? How many days did you miss if for your AVS? How soon can one return to work after surgery if all goes well? Is one week vacation enough to schedule for surgery? Why does someone need to be off Spiro before AVS? Both of my endos told me that getting off Spiro was not necessary for the AVS procedure. Thanks for the info. Spiro is working sporadically. I think my endo is leaning towards surgery, but he is waiting on results from neurology and cardiology before he makes his recommendation.

[Guest guest]

Don't you mean without meds?

>

> >

> > Hi ~ Dr. Young efficiently schedules ALL appointments, from

> > diagnosis through surgery. Here is the timeline for our recent

> > experience at Mayo:

> >

> > 1.) July 20th consult - Dr. Young - diagnosis: Primary

> > Aldosteronism (based on labs and CT.)

> >

> > 2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional

> > Radiology (selected by Dr. Young)

> >

> > 3.) July 25th - result of AVS - Dr. Young revealed aldosterone

> > numbers: 23,000 on the left and 440 on the right. Surgery option

> > discussed and chosen.

> >

> > 4.) July 27th - Adrenalectomy - Dr. , General Surgery

> > (selected by Dr. Young)

> >

> > Current status: Potassium level -- high normal (5.2 at Mayo);

> > subsequently, all supplementation has now ceased. (Previously

> > taking 60 mEq of potassium.) Excess urination has been eliminated.

> > Blood pressure under better control with one less med.

> >

> > In our followup visit, I told Dr. Young about you... that you have

> > been to Mayo but are hoping for treatment in St. Louis. Please let

> > me know if you would like additional information -- including how to

> > contact Dr. Young.

> >

> > Take good care,

> > KK in Houston TX

> >

> >

> > To: hyperaldosteronism

> > Sent: Monday, August 15, 2011 12:12 PM

> > Subject: Question about AVS and Surgery

> > recovery times

> >

> >

> > I have been participating in the group for a couple of months so I

> > am aware of the fact that surgery is only recommended if meds fail.

> > In fact, my endo at Mayo agrees with this theory. My endo that I see

> > locally agrees with this as well, but is considering surgery in my

> > case for various reasons. Surgery is not a given at this point, but

> > I have some questions to prepare.

> >

> > I start a new job on Monday and I am a little concerned about time

> > off of work due to AVS and surgery.

> >

> > What is a reasonable time off of work for the AVS proceedure? How

> > many days did you miss if for your AVS?

> >

> > How soon can one return to work after surgery if all goes well? Is

> > one week vacation enough to schedule for surgery?

> >

> > Why does someone need to be off Spiro before AVS? Both of my endos

> > told me that getting off Spiro was not necessary for the AVS

> > procedure.

> >

> > Thanks for the info. Spiro is working sporadically. I think my endo

> > is leaning towards surgery, but he is waiting on results from

> > neurology and cardiology before he makes his recommendation.

> >

> >

> >

> >

> >

> >

> >

>

[Guest guest]

Ah yes BP must be normal without BP meds to be a cure in my book.CE Grim MDOn Aug 21, 2011, at 7:39 PM, Francis Bill SUSPECTED PA wrote: Don't you mean without meds? > > > > > Hi ~ Dr. Young efficiently schedules ALL appointments, from > > diagnosis through surgery. Here is the timeline for our recent > > experience at Mayo: > > > > 1.) July 20th consult - Dr. Young - diagnosis: Primary > > Aldosteronism (based on labs and CT.) > > > > 2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional > > Radiology (selected by Dr. Young) > > > > 3.) July 25th - result of AVS - Dr. Young revealed aldosterone > > numbers: 23,000 on the left and 440 on the right. Surgery option > > discussed and chosen. > > > > 4.) July 27th - Adrenalectomy - Dr. , General Surgery > > (selected by Dr. Young) > > > > Current status: Potassium level -- high normal (5.2 at Mayo); > > subsequently, all supplementation has now ceased. (Previously > > taking 60 mEq of potassium.) Excess urination has been eliminated. > > Blood pressure under better control with one less med. > > > > In our followup visit, I told Dr. Young about you... that you have > > been to Mayo but are hoping for treatment in St. Louis. Please let > > me know if you would like additional information -- including how to > > contact Dr. Young. > > > > Take good care, > > KK in Houston TX > > > > > > To: hyperaldosteronism > > Sent: Monday, August 15, 2011 12:12 PM > > Subject: Question about AVS and Surgery > > recovery times > > > > > > I have been participating in the group for a couple of months so I > > am aware of the fact that surgery is only recommended if meds fail. > > In fact, my endo at Mayo agrees with this theory. My endo that I see > > locally agrees with this as well, but is considering surgery in my > > case for various reasons. Surgery is not a given at this point, but > > I have some questions to prepare. > > > > I start a new job on Monday and I am a little concerned about time > > off of work due to AVS and surgery. > > > > What is a reasonable time off of work for the AVS proceedure? How > > many days did you miss if for your AVS? > > > > How soon can one return to work after surgery if all goes well? Is > > one week vacation enough to schedule for surgery? > > > > Why does someone need to be off Spiro before AVS? Both of my endos > > told me that getting off Spiro was not necessary for the AVS > > procedure. > > > > Thanks for the info. Spiro is working sporadically. I think my endo > > is leaning towards surgery, but he is waiting on results from > > neurology and cardiology before he makes his recommendation. > > > > > > > > > > > > > > >

[Guest guest]

Ah yes BP must be normal without BP meds to be a cure in my book.CE Grim MDOn Aug 21, 2011, at 7:39 PM, Francis Bill SUSPECTED PA wrote: Don't you mean without meds? > > > > > Hi ~ Dr. Young efficiently schedules ALL appointments, from > > diagnosis through surgery. Here is the timeline for our recent > > experience at Mayo: > > > > 1.) July 20th consult - Dr. Young - diagnosis: Primary > > Aldosteronism (based on labs and CT.) > > > > 2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional > > Radiology (selected by Dr. Young) > > > > 3.) July 25th - result of AVS - Dr. Young revealed aldosterone > > numbers: 23,000 on the left and 440 on the right. Surgery option > > discussed and chosen. > > > > 4.) July 27th - Adrenalectomy - Dr. , General Surgery > > (selected by Dr. Young) > > > > Current status: Potassium level -- high normal (5.2 at Mayo); > > subsequently, all supplementation has now ceased. (Previously > > taking 60 mEq of potassium.) Excess urination has been eliminated. > > Blood pressure under better control with one less med. > > > > In our followup visit, I told Dr. Young about you... that you have > > been to Mayo but are hoping for treatment in St. Louis. Please let > > me know if you would like additional information -- including how to > > contact Dr. Young. > > > > Take good care, > > KK in Houston TX > > > > > > To: hyperaldosteronism > > Sent: Monday, August 15, 2011 12:12 PM > > Subject: Question about AVS and Surgery > > recovery times > > > > > > I have been participating in the group for a couple of months so I > > am aware of the fact that surgery is only recommended if meds fail. > > In fact, my endo at Mayo agrees with this theory. My endo that I see > > locally agrees with this as well, but is considering surgery in my > > case for various reasons. Surgery is not a given at this point, but > > I have some questions to prepare. > > > > I start a new job on Monday and I am a little concerned about time > > off of work due to AVS and surgery. > > > > What is a reasonable time off of work for the AVS proceedure? How > > many days did you miss if for your AVS? > > > > How soon can one return to work after surgery if all goes well? Is > > one week vacation enough to schedule for surgery? > > > > Why does someone need to be off Spiro before AVS? Both of my endos > > told me that getting off Spiro was not necessary for the AVS > > procedure. > > > > Thanks for the info. Spiro is working sporadically. I think my endo > > is leaning towards surgery, but he is waiting on results from > > neurology and cardiology before he makes his recommendation. > > > > > > > > > > > > > > >

[Guest guest]

Hubby is about your age -- 64 today, in fact. Decades of hypertension, some of it familial in nature. We're not expecting everything to be roses; right now, a reduction in BP meds is satisfactory. Still monitoring BP, K+ and Creatinine. With adrenalectomy, excessive urination has been eliminated -- an issue we've been trying to resolve via local -ologists, post radical prostatectomy (9/09). To:

hyperaldosteronism Sent: Sunday, August 21, 2011 6:39 PMSubject: Re: Question about AVS and Surgery recovery times

Don't you mean without meds?

>

> >

> > Hi ~ Dr. Young efficiently schedules ALL appointments, from

> > diagnosis through surgery. Here is the timeline for our recent

> > experience at Mayo:

> >

> > 1.) July 20th consult - Dr. Young - diagnosis: Primary

> > Aldosteronism (based on labs and CT.)

> >

> > 2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional

> > Radiology (selected by Dr. Young)

> >

> > 3.) July 25th - result of AVS - Dr. Young revealed aldosterone

> > numbers: 23,000 on the left and 440 on the right. Surgery option

> > discussed and chosen.

> >

> > 4.) July 27th - Adrenalectomy - Dr. , General Surgery

> > (selected by Dr. Young)

> >

> > Current status: Potassium level -- high normal (5.2 at Mayo);

> > subsequently, all supplementation has now ceased. (Previously

> > taking 60 mEq of potassium.) Excess urination has been eliminated.

> > Blood pressure under better control with one less med.

> >

> > In our followup visit, I told Dr. Young about you... that you have

> > been to Mayo but are hoping for treatment in St. Louis. Please let

> > me know if you would like additional information -- including how to

> > contact Dr. Young.

> >

> > Take good care,

> > KK in Houston TX

> >

> >

> > To: hyperaldosteronism

> > Sent: Monday, August 15, 2011 12:12 PM

> > Subject: Question about AVS and Surgery

> > recovery times

> >

> >

> > I have been participating in the group for a couple of months so I

> > am aware of the fact that surgery is only recommended if meds fail.

> > In fact, my endo at Mayo agrees with this theory. My endo that I see

> > locally agrees with this as well, but is considering surgery in my

> > case for various reasons. Surgery is not a given at this point, but

> > I have some questions to prepare.

> >

> > I start a new job on Monday and I am a little concerned about time

> > off of work due to AVS and surgery.

> >

> > What is a reasonable time off of work for the AVS proceedure? How

> > many days did you miss if for your AVS?

> >

> > How soon can one return to work after surgery if all goes well? Is

> > one week vacation enough to schedule for surgery?

> >

> > Why does someone need to be off Spiro before AVS? Both of my endos

> > told me that getting off Spiro was not necessary for the AVS

> > procedure.

> >

> > Thanks for the info. Spiro is working sporadically. I think my endo

> > is leaning towards surgery, but he is waiting on results from

> > neurology and cardiology before he makes his recommendation.

> >

> >

> >

> >

> >

> >

> >

>

[Guest guest]

Hi Dr. G: We have the path report... it was a tiny 9mm (mm not cm) tumor on the left side, not apparent on the (locally ordered) CT-Abd. But the hyperplasia *was* apparent -- Dr. Young was kind enough to explain what we were looking at on the X-ray: the gland on the left was about 3X larger than the normal-appearing one on the right. A very powerful little adenoma was causing all the havoc. In our view, improved health is worth a thousand "cures". ~ KKFrom: Clarence Grim

To: hyperaldosteronism Sent: Sunday, August 21, 2011 6:25 PMSubject: Re: Question about AVS and Surgery recovery times

BTW I consider a cure as normal BP with meds. Be certain to get the detailed pathology report for both you and your family.Post a copy in our files for long term followup.CE Grim MD Hi ~ Dr. Young efficiently schedules ALL appointments, from diagnosis through surgery. Here is the timeline for our recent experience at Mayo: 1.) July 20th consult - Dr. Young - diagnosis: Primary Aldosteronism (based on labs and

CT.) 2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional Radiology (selected by Dr. Young)3.) July 25th - result of AVS - Dr. Young revealed aldosterone numbers: 23,000 on the left and 440 on the right. Surgery option discussed and chosen.4.) July 27th - Adrenalectomy - Dr. , General Surgery (selected by Dr. Young)Current status: Potassium level -- high normal (5.2 at Mayo); subsequently, all supplementation has now ceased. (Previously taking 60 mEq of potassium.) Excess urination has been eliminated. Blood pressure under better control with one less med. In our followup visit, I told Dr. Young about you... that you have been to Mayo but are hoping for treatment in St. Louis. Please let me know if you would like additional information --

including how to contact Dr. Young. Take good care, KK in Houston TXTo: hyperaldosteronism Sent: Monday, August 15, 2011 12:12 PMSubject: Question about AVS and

Surgery recovery times I have been participating in the group for a couple of months so I am aware of the fact that surgery is only recommended if meds fail. In fact, my endo at Mayo agrees with this theory. My endo that I see locally agrees with this as well, but is considering surgery in my case for various reasons. Surgery is not a given at this point, but I have some questions to prepare. I start a new job on Monday and I am a little concerned about time off of work due to AVS and surgery. What is a reasonable time off of work for the AVS proceedure? How many days did you miss if for your AVS? How soon can one return to work after surgery if all goes well? Is one week vacation enough to schedule for surgery? Why does someone need to be off Spiro before AVS? Both of my endos told me that

getting off Spiro was not necessary for the AVS procedure. Thanks for the info. Spiro is working sporadically. I think my endo is leaning towards surgery, but he is waiting on results from neurology and cardiology before he makes his recommendation.

[Guest guest]

Hi Dr. G: We have the path report... it was a tiny 9mm (mm not cm) tumor on the left side, not apparent on the (locally ordered) CT-Abd. But the hyperplasia *was* apparent -- Dr. Young was kind enough to explain what we were looking at on the X-ray: the gland on the left was about 3X larger than the normal-appearing one on the right. A very powerful little adenoma was causing all the havoc. In our view, improved health is worth a thousand "cures". ~ KKFrom: Clarence Grim

To: hyperaldosteronism Sent: Sunday, August 21, 2011 6:25 PMSubject: Re: Question about AVS and Surgery recovery times

BTW I consider a cure as normal BP with meds. Be certain to get the detailed pathology report for both you and your family.Post a copy in our files for long term followup.CE Grim MD Hi ~ Dr. Young efficiently schedules ALL appointments, from diagnosis through surgery. Here is the timeline for our recent experience at Mayo: 1.) July 20th consult - Dr. Young - diagnosis: Primary Aldosteronism (based on labs and

CT.) 2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional Radiology (selected by Dr. Young)3.) July 25th - result of AVS - Dr. Young revealed aldosterone numbers: 23,000 on the left and 440 on the right. Surgery option discussed and chosen.4.) July 27th - Adrenalectomy - Dr. , General Surgery (selected by Dr. Young)Current status: Potassium level -- high normal (5.2 at Mayo); subsequently, all supplementation has now ceased. (Previously taking 60 mEq of potassium.) Excess urination has been eliminated. Blood pressure under better control with one less med. In our followup visit, I told Dr. Young about you... that you have been to Mayo but are hoping for treatment in St. Louis. Please let me know if you would like additional information --

including how to contact Dr. Young. Take good care, KK in Houston TXTo: hyperaldosteronism Sent: Monday, August 15, 2011 12:12 PMSubject: Question about AVS and

Surgery recovery times I have been participating in the group for a couple of months so I am aware of the fact that surgery is only recommended if meds fail. In fact, my endo at Mayo agrees with this theory. My endo that I see locally agrees with this as well, but is considering surgery in my case for various reasons. Surgery is not a given at this point, but I have some questions to prepare. I start a new job on Monday and I am a little concerned about time off of work due to AVS and surgery. What is a reasonable time off of work for the AVS proceedure? How many days did you miss if for your AVS? How soon can one return to work after surgery if all goes well? Is one week vacation enough to schedule for surgery? Why does someone need to be off Spiro before AVS? Both of my endos told me that

getting off Spiro was not necessary for the AVS procedure. Thanks for the info. Spiro is working sporadically. I think my endo is leaning towards surgery, but he is waiting on results from neurology and cardiology before he makes his recommendation.

[Guest guest]

Unilateral hyperplasia does happen. But unusual in my experience.Time will tell and keep us posted. I call tiny 1-2 mm, not 9 mm. Not sure if you mean hyperplasia was in the pathology report or just in Dr. Young's review of the CT based on the larger L gland.Thanks. CE Grim MD Hi Dr. G: We have the path report... it was a tiny 9mm (mm not cm) tumor on the left side, not apparent on the (locally ordered) CT-Abd. But the hyperplasia *was* apparent -- Dr. Young was kind enough to explain what we were looking at on the X-ray: the gland on the left was about 3X larger than the normal-appearing one on the right. A very powerful little adenoma was causing all the havoc. In our view, improved health is worth a thousand "cures". ~ KKTo: hyperaldosteronism Sent: Sunday, August 21, 2011 6:25 PMSubject: Re: Question about AVS and Surgery recovery times BTW I consider a cure as normal BP with meds. Be certain to get the detailed pathology report for both you and your family.Post a copy in our files for long term followup.CE Grim MD Hi ~ Dr. Young efficiently schedules ALL appointments, from diagnosis through surgery. Here is the timeline for our recent experience at Mayo: 1.) July 20th consult - Dr. Young - diagnosis: Primary Aldosteronism (based on labs and CT.) 2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional Radiology (selected by Dr. Young)3.) July 25th - result of AVS - Dr. Young revealed aldosterone numbers: 23,000 on the left and 440 on the right. Surgery option discussed and chosen.4.) July 27th - Adrenalectomy - Dr. , General Surgery (selected by Dr. Young)Current status: Potassium level -- high normal (5.2 at Mayo); subsequently, all supplementation has now ceased. (Previously taking 60 mEq of potassium.) Excess urination has been eliminated. Blood pressure under better control with one less med. In our followup visit, I told Dr. Young about you... that you have been to Mayo but are hoping for treatment in St. Louis. Please let me know if you would like additional information -- including how to contact Dr. Young. Take good care, KK in Houston TXTo: hyperaldosteronism Sent: Monday, August 15, 2011 12:12 PMSubject: Question about AVS and Surgery recovery times I have been participating in the group for a couple of months so I am aware of the fact that surgery is only recommended if meds fail. In fact, my endo at Mayo agrees with this theory. My endo that I see locally agrees with this as well, but is considering surgery in my case for various reasons. Surgery is not a given at this point, but I have some questions to prepare. I start a new job on Monday and I am a little concerned about time off of work due to AVS and surgery. What is a reasonable time off of work for the AVS proceedure? How many days did you miss if for your AVS? How soon can one return to work after surgery if all goes well? Is one week vacation enough to schedule for surgery? Why does someone need to be off Spiro before AVS? Both of my endos told me that getting off Spiro was not necessary for the AVS procedure. Thanks for the info. Spiro is working sporadically. I think my endo is leaning towards surgery, but he is waiting on results from neurology and cardiology before he makes his recommendation.

[Guest guest]

Unilateral hyperplasia does happen. But unusual in my experience.Time will tell and keep us posted. I call tiny 1-2 mm, not 9 mm. Not sure if you mean hyperplasia was in the pathology report or just in Dr. Young's review of the CT based on the larger L gland.Thanks. CE Grim MD Hi Dr. G: We have the path report... it was a tiny 9mm (mm not cm) tumor on the left side, not apparent on the (locally ordered) CT-Abd. But the hyperplasia *was* apparent -- Dr. Young was kind enough to explain what we were looking at on the X-ray: the gland on the left was about 3X larger than the normal-appearing one on the right. A very powerful little adenoma was causing all the havoc. In our view, improved health is worth a thousand "cures". ~ KKTo: hyperaldosteronism Sent: Sunday, August 21, 2011 6:25 PMSubject: Re: Question about AVS and Surgery recovery times BTW I consider a cure as normal BP with meds. Be certain to get the detailed pathology report for both you and your family.Post a copy in our files for long term followup.CE Grim MD Hi ~ Dr. Young efficiently schedules ALL appointments, from diagnosis through surgery. Here is the timeline for our recent experience at Mayo: 1.) July 20th consult - Dr. Young - diagnosis: Primary Aldosteronism (based on labs and CT.) 2.) July 21st - Adrenal Vein Sampling - Dr. s, Interventional Radiology (selected by Dr. Young)3.) July 25th - result of AVS - Dr. Young revealed aldosterone numbers: 23,000 on the left and 440 on the right. Surgery option discussed and chosen.4.) July 27th - Adrenalectomy - Dr. , General Surgery (selected by Dr. Young)Current status: Potassium level -- high normal (5.2 at Mayo); subsequently, all supplementation has now ceased. (Previously taking 60 mEq of potassium.) Excess urination has been eliminated. Blood pressure under better control with one less med. In our followup visit, I told Dr. Young about you... that you have been to Mayo but are hoping for treatment in St. Louis. Please let me know if you would like additional information -- including how to contact Dr. Young. Take good care, KK in Houston TXTo: hyperaldosteronism Sent: Monday, August 15, 2011 12:12 PMSubject: Question about AVS and Surgery recovery times I have been participating in the group for a couple of months so I am aware of the fact that surgery is only recommended if meds fail. In fact, my endo at Mayo agrees with this theory. My endo that I see locally agrees with this as well, but is considering surgery in my case for various reasons. Surgery is not a given at this point, but I have some questions to prepare. I start a new job on Monday and I am a little concerned about time off of work due to AVS and surgery. What is a reasonable time off of work for the AVS proceedure? How many days did you miss if for your AVS? How soon can one return to work after surgery if all goes well? Is one week vacation enough to schedule for surgery? Why does someone need to be off Spiro before AVS? Both of my endos told me that getting off Spiro was not necessary for the AVS procedure. Thanks for the info. Spiro is working sporadically. I think my endo is leaning towards surgery, but he is waiting on results from neurology and cardiology before he makes his recommendation.