Guest guest Posted July 12, 2011 Report Share Posted July 12, 2011 And how did she interpret them?If BP not better you might want to have her re-read my Evolition of PA article and why it is so common in drug resistant HTN today so she understands better what is going on.Is BP better?What is she using as an end point that the ACEI is helping anything other than her concern that "everyone" needs an ACEI. Many would measure urine protein or micro albumin in DM and HTN. Of course lowering Na intake has been as successful in reversing proteinuria in HTN as drugs.At least since 1944. Take her a copy of Dr.Kempner's papers in our files. I will bet you a beer she has never read them. And that she will be impressed with what a low sodium diet can do in even malignant HTN.CE Grim MDJust received an update from PCP with latest labs. (She has had me on a 2week recall for 3 recalls to keep track of K as we add an ACEI. I had expressed my concerns!)GLUCOSE: 96! (2nd consecutive time in range since 2007!)UREA NITROGEN: 20CREATININE: 0.98SODIUM: 136POTASSIUM: 4.8CHLORIDE: 107CO2: 16L (I had been experiencing diarrhea)ANION GAP 13eGFR: 77SIGNED LYNN WEBSTER, 7/7/2011 5:04PM(I know she had Fri. off so she must have worked late Thurs. to get her week completed!) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 12, 2011 Report Share Posted July 12, 2011 Excellent and keep up the good work and reporting. Next with excellent DASHing I predict that HbA1c will be much better and you can work with your team on reducing/stoppinglisionpril and metformin and metformin if given for HTN.See if your team which document your DASH success with urine Na and K at next visit. As I recall the last urine showed good high K/Na ratio but 24 hr Na (intake) was on high side.But may have you confused with others here.CE Grim MDJust wanted to point out a couple changes in my signature: I'm finally off all narcotics and have been for a week! NO PAIN STILL! I've started reporting BP again and pretty darn good if I may brag! (My research indicates up to 75% of the people with DM2 can't hit goal of 130/80! One number I don't normally report is blood sugar but my meter reports averages: 7day=143, 30day=145 with a goal of 140 (almost there!)Everybody in unison with a great big, "ATTABOY" and then it's, "Over to the Orchard and off to the Garden, a DASHing we will go!" (or something close to it!) Next number I'm working on is BMI! - 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: 130/77Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2. and PTSDMeds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG, Metformin 2000MG, Lisinopril 2.5MG and Spironolactone 75 MG. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2011 Report Share Posted July 15, 2011 Dr. Grim, thanks so much fo clearing up the difference between ACE and Spiro. When I spoke with Dr. Robey, the chair of the Nepr. Dept, on 5/11 he spoke of Proteinuria that I have " variably exhibited in the past, w/ most recent result neg. " He went on to explain that he too would RX an ACEI IF (enphasis mine) proteinuria was cearly documented & attributed to DN. He went on to state that I was unhappy with his concurrence with the original Dr. I'm still trying to conquer the english language but I don't think his explaination was consistant with his conclusion, ie. he said ACEI IF while Dr. said ACEI NOW! I'm simply not interested in taking meds. that do nothing but produce side effects, those days are over! I will discuss this with them at my meeting. Thanks again. - 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: 130/77 Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2. and PTSD Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG, Metformin 2000MG and Spironolactone 75 MG. > > > > > > > Just received an update from PCP with latest labs. (She has had me > > > > on a 2week recall for 3 recalls to keep track of K as we add an > > > > ACEI. I had expressed my concerns!) > > > > > > > > GLUCOSE: 96! (2nd consecutive time in range since 2007!) > > > > UREA NITROGEN: 20 > > > > CREATININE: 0.98 > > > > SODIUM: 136 > > > > POTASSIUM: 4.8 > > > > CHLORIDE: 107 > > > > CO2: 16L (I had been experiencing diarrhea) > > > > ANION GAP 13 > > > > eGFR: 77 > > > > > > > > SIGNED LYNN WEBSTER, 7/7/2011 5:04PM > > > > (I know she had Fri. off so she must have worked late Thurs. to get > > > > her week completed!) > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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