Re: Cleveland Clinic Question for Dr. Grim and Natalia

[Guest guest]

If you have a good PCP lets try to work with him or her. That way you don't have to travel and we educate the local team.Is this a possiblitiy?You have contracted with me for 1 year and I would love to work on this with you and your team. I will see how I can find in Columbus.I know several in Neph there.CE Grim MD Hello! Update: My second Endo was even worse than my first if you can believe that. I will be meeting with my PCP tomorrow to get a referral into The Cleveland Clinic and possibly another Endo and Neph. Dr. Grim - You mentioned Dr. Bravo however I can't find him in the directory for the Cleveland Clinic. Do you happen to have his information? Do you also know of any Endo's and Nephorologist in the Columbus Area that are GOOD DOCTORS? The Hospitals in the area are Grant, Riverside, St. Ann's and my favorite Dublin Methodist. Natalia - You mentioned Dr. Joyce Shin at the Cleveland Clinic. Have you been treated by her or know someone that has? Was it for PA or something else? Tired of wasting my time with incompetent doctor's and really losing patience. I guess the only good thing is my anxiety has now been replaced by anger and I am pretty focused on that. Although going to the Cleveland Clinic will cost me more time off work it will probably be a quicker resolution than what I am currently experiencing and just to make myself feel better I will be sending letters to both Endo's to let them know how I feel. Thanks, Kellie

[Guest guest]

I do like my PCP however she has been frank from the beginning that

this is way over her head.  She had never heard of PA until the

report came over from the hospital for future testing for me last

year.  We are going to pursue the Cleveland Clinic so I am kind of

excited about that. I am coming off the Spiro this weekend and going

back to K tablets to speed up the future testing with the Cleveland

Clinic. I'm looking forward to not sweating as much coming off the

Spiro as it was really getting in the way of life. I am concerned

about the K tabs causing stomach upset as that is when my stomach

problems started last year.

M - you haven't had any weight

gain on K tabs have you?

Dr. Grim - if you can come up with a

good endo or neph in the meantime here in town let me know. I know I

am contracted with you through next year so once I find a good team

I plan on pulling you in for the resolution of this ordeal.

Thanks,

Kellie

 

If you have a good PCP lets try to work with him or her.

 That way you don't have to travel and we educate the

local team.

Is this a possiblitiy?

You have contracted with me for 1 year and I would love

to work on this with you and your team. 

I will see how I can find in Columbus.

I know several in Neph there.

CE Grim MD

 

Hello!

Update:  My second Endo was even worse than my

first if you can believe that. I will be meeting

with my PCP tomorrow to get a referral into The

Cleveland Clinic and possibly another Endo and

Neph.

Dr. Grim -

You mentioned Dr. Bravo however I can't find him

in the directory for the Cleveland Clinic. Do

you happen to have his information? 

Do you also know of any Endo's and Nephorologist

in the Columbus Area that are GOOD DOCTORS? The

Hospitals in the area are Grant, Riverside, St.

Ann's and my favorite Dublin Methodist.

Natalia -

You mentioned Dr. Joyce Shin at the Cleveland

Clinic. Have you been treated by her or know

someone that has? Was it for PA or something

else?

Tired of wasting my time with incompetent

doctor's and really losing patience. I guess the

only good thing is my anxiety has now been

replaced by anger and I am pretty focused on

that. Although going to the Cleveland Clinic

will cost me more time off work it will probably

be a quicker resolution than what I am currently

experiencing and just to make myself feel better

I will be sending letters to both Endo's to let

them know how I feel. 

Thanks,

Kellie

[Guest guest]

I have taught a lot of residents (internal medicine and family practice) and fellows (Endo, Cards, Nepho) how to Dx and Rx PA so am pretty good at it. Where did your PCP graduate from? and when?I am not sure why you are going off spiro if you are doing so well.If to retest renin and aldo I prefer to have folks off of it for about 3 months. But that can be rough. You will need to have PCP follow K and you check BP daily.Would check weight as well.CE Grim MD I do like my PCP however she has been frank from the beginning that this is way over her head. She had never heard of PA until the report came over from the hospital for future testing for me last year. We are going to pursue the Cleveland Clinic so I am kind of excited about that. I am coming off the Spiro this weekend and going back to K tablets to speed up the future testing with the Cleveland Clinic. I'm looking forward to not sweating as much coming off the Spiro as it was really getting in the way of life. I am concerned about the K tabs causing stomach upset as that is when my stomach problems started last year. M - you haven't had any weight gain on K tabs have you? Dr. Grim - if you can come up with a good endo or neph in the meantime here in town let me know. I know I am contracted with you through next year so once I find a good team I plan on pulling you in for the resolution of this ordeal. Thanks, Kellie If you have a good PCP lets try to work with him or her. That way you don't have to travel and we educate the local team. Is this a possiblitiy? You have contracted with me for 1 year and I would love to work on this with you and your team. I will see how I can find in Columbus. I know several in Neph there. CE Grim MD Hello! Update: My second Endo was even worse than my first if you can believe that. I will be meeting with my PCP tomorrow to get a referral into The Cleveland Clinic and possibly another Endo and Neph. Dr. Grim - You mentioned Dr. Bravo however I can't find him in the directory for the Cleveland Clinic. Do you happen to have his information? Do you also know of any Endo's and Nephorologist in the Columbus Area that are GOOD DOCTORS? The Hospitals in the area are Grant, Riverside, St. Ann's and my favorite Dublin Methodist. Natalia - You mentioned Dr. Joyce Shin at the Cleveland Clinic. Have you been treated by her or know someone that has? Was it for PA or something else? Tired of wasting my time with incompetent doctor's and really losing patience. I guess the only good thing is my anxiety has now been replaced by anger and I am pretty focused on that. Although going to the Cleveland Clinic will cost me more time off work it will probably be a quicker resolution than what I am currently experiencing and just to make myself feel better I will be sending letters to both Endo's to let them know how I feel. Thanks, Kellie

[Guest guest]

I think she Graduated from Kansas City about 10 years ago.

In my opinion I don't think my body has adjusted well and If I don't have PA

then my first thought was to get off it but the potassium pills are wreaking

havoc with my stomach. I am having diahreah similar to preparing for a

colonoscopy everyday. It has been a week and I am close to throwing in the

towel. I had problems with it last fall but nothing like this. In the last year

my stomach went from being an iron stomach to super sensitive. The other reason

I wanted to come off Spiro was in preparation fro the Cleveland Clinic. I am

going in twice a week for blood/urine through this month and weekly in

September. Checking K blood and urine. As soon as I get the results back I will

send them to you.

> >>

> >>>

> >>> Hello!

> >>>

> >>> Update: My second Endo was even worse than my first if you can

> >>> believe that. I will be meeting with my PCP tomorrow to get a

> >>> referral into The Cleveland Clinic and possibly another Endo and

> >>> Neph.

> >>>

> >>> Dr. Grim - You mentioned Dr. Bravo however I can't find him in the

> >>> directory for the Cleveland Clinic. Do you happen to have his

> >>> information?

> >>>

> >>> Do you also know of any Endo's and Nephorologist in the Columbus

> >>> Area that are GOOD DOCTORS? The Hospitals in the area are Grant,

> >>> Riverside, St. Ann's and my favorite Dublin Methodist.

> >>>

> >>> Natalia - You mentioned Dr. Joyce Shin at the Cleveland Clinic.

> >>> Have you been treated by her or know someone that has? Was it for

> >>> PA or something else?

> >>>

> >>> Tired of wasting my time with incompetent doctor's and really

> >>> losing patience. I guess the only good thing is my anxiety has now

> >>> been replaced by anger and I am pretty focused on that. Although

> >>> going to the Cleveland Clinic will cost me more time off work it

> >>> will probably be a quicker resolution than what I am currently

> >>> experiencing and just to make myself feel better I will be sending

> >>> letters to both Endo's to let them know how I feel.

> >>>

> >>> Thanks,

> >>> Kellie

> >>

> >

> >

> >

>

[Guest guest]

I am getting closer to finding a Dr closer to you with some contacts at OSU.i don't think traveling back and forth to Cleveland will be productive till we find a local Dr who can get to know you well and work with us on getting you on the right track.What makes you think you do not have PA?You have had low K problems for not reason (other than PA).You have had BP problemsYou got better with spiro as I recall.The task now it to find a combination of DASH and MCBs that get you back to health. Diarrhea will make your K worse. I would do V-8 instead and give you gut a rest.Keep me posted on the urine info. This will be a big help on telling us what to do. Try to do timed urines each time.Collecting a timed spot urine: Before you go to the Dr pee and throw it out. Write down time. Do not pee till you get to Dr office or if you do throw it out and start timing again. When you get to Dr. office tell them you want to do a urine check on your Na and K. Ask them to collect the entire urine and measure volume and record your start and top time on this specimen. Results can be converted to pretty good estimate of what you are eating. Especially if you have ever had a 24 hr urine done and you know your creatinine excretion per 24 hrs. If you have had more than one 24 hr urine you can keep a running average of the E creatinine/24 hours. this assumes on the 24 hr urines you did not miss any urine and it was timed precisely. I think she Graduated from Kansas City about 10 years ago. In my opinion I don't think my body has adjusted well and If I don't have PA then my first thought was to get off it but the potassium pills are wreaking havoc with my stomach. I am having diahreah similar to preparing for a colonoscopy everyday. It has been a week and I am close to throwing in the towel. I had problems with it last fall but nothing like this. In the last year my stomach went from being an iron stomach to super sensitive. The other reason I wanted to come off Spiro was in preparation fro the Cleveland Clinic. I am going in twice a week for blood/urine through this month and weekly in September. Checking K blood and urine. As soon as I get the results back I will send them to you. > >> > >>> > >>> Hello! > >>> > >>> Update: My second Endo was even worse than my first if you can > >>> believe that. I will be meeting with my PCP tomorrow to get a > >>> referral into The Cleveland Clinic and possibly another Endo and > >>> Neph. > >>> > >>> Dr. Grim - You mentioned Dr. Bravo however I can't find him in the > >>> directory for the Cleveland Clinic. Do you happen to have his > >>> information? > >>> > >>> Do you also know of any Endo's and Nephorologist in the Columbus > >>> Area that are GOOD DOCTORS? The Hospitals in the area are Grant, > >>> Riverside, St. Ann's and my favorite Dublin Methodist. > >>> > >>> Natalia - You mentioned Dr. Joyce Shin at the Cleveland Clinic. > >>> Have you been treated by her or know someone that has? Was it for > >>> PA or something else? > >>> > >>> Tired of wasting my time with incompetent doctor's and really > >>> losing patience. I guess the only good thing is my anxiety has now > >>> been replaced by anger and I am pretty focused on that. Although > >>> going to the Cleveland Clinic will cost me more time off work it > >>> will probably be a quicker resolution than what I am currently > >>> experiencing and just to make myself feel better I will be sending > >>> letters to both Endo's to let them know how I feel. > >>> > >>> Thanks, > >>> Kellie > >> > > > > > > >

[Guest guest]

Kellie, I'm convinced many doctors titrate Spiro up too fast and target too high

a goal. It would serve them well to review side effects, especially if the PTN

is experiencing something that is not expected. (You might want to check out

side effects and continue on down to the overdose section! I may be wrong but I

think there might be two deffinations of overdose, 1 - clinical and 2- what ones

body will tollerate! See if that gets a reaction!) I was on 50/25 mg of Spiro

and while bowels were normal early in the day I was experiencing the same

diarrhea you described every afternoon.

I honored my PCP's wishes and didn't change anything for a week but could resist

no longer last Friday and backed the am dose back to 25mg. You guessed it, no

diarrhea this week! BP went from 123/70 HR58 to 123/69 HR57 so it doesn't

appear to have had much effect on that!

- 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(last week ave): 123/69

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2. and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > >>

> > >>>

> > >>> Hello!

> > >>>

> > >>> Update: My second Endo was even worse than my first if you can

> > >>> believe that. I will be meeting with my PCP tomorrow to get a

> > >>> referral into The Cleveland Clinic and possibly another Endo and

> > >>> Neph.

> > >>>

> > >>> Dr. Grim - You mentioned Dr. Bravo however I can't find him in the

> > >>> directory for the Cleveland Clinic. Do you happen to have his

> > >>> information?

> > >>>

> > >>> Do you also know of any Endo's and Nephorologist in the Columbus

> > >>> Area that are GOOD DOCTORS? The Hospitals in the area are Grant,

> > >>> Riverside, St. Ann's and my favorite Dublin Methodist.

> > >>>

> > >>> Natalia - You mentioned Dr. Joyce Shin at the Cleveland Clinic.

> > >>> Have you been treated by her or know someone that has? Was it for

> > >>> PA or something else?

> > >>>

> > >>> Tired of wasting my time with incompetent doctor's and really

> > >>> losing patience. I guess the only good thing is my anxiety has now

> > >>> been replaced by anger and I am pretty focused on that. Although

> > >>> going to the Cleveland Clinic will cost me more time off work it

> > >>> will probably be a quicker resolution than what I am currently

> > >>> experiencing and just to make myself feel better I will be sending

> > >>> letters to both Endo's to let them know how I feel.

> > >>>

> > >>> Thanks,

> > >>> Kellie

> > >>

> > >

> > >

> > >

> >

>

[Guest guest]

Thanks Dr. Grim!

I do believe I have PA as I have soooo much in common with the folks on this

forum but have multiple doctors saying yes you have, no you don't have it and my

head is spinning.

One thing I know for sure is like you said my stomach needs a rest. One full

week of stomach issues thanks to K pills.

I will be picking up labs on Monday and will send them to you. Now my K is

bouncing between 4.1 and 4.9 which I think is going too far the other way.

Glad it is Friday as I am wiped out!

> > > >>

> > > >>>

> > > >>> Hello!

> > > >>>

> > > >>> Update: My second Endo was even worse than my first if you can

> > > >>> believe that. I will be meeting with my PCP tomorrow to get a

> > > >>> referral into The Cleveland Clinic and possibly another Endo and

> > > >>> Neph.

> > > >>>

> > > >>> Dr. Grim - You mentioned Dr. Bravo however I can't find him in

> > the

> > > >>> directory for the Cleveland Clinic. Do you happen to have his

> > > >>> information?

> > > >>>

> > > >>> Do you also know of any Endo's and Nephorologist in the Columbus

> > > >>> Area that are GOOD DOCTORS? The Hospitals in the area are Grant,

> > > >>> Riverside, St. Ann's and my favorite Dublin Methodist.

> > > >>>

> > > >>> Natalia - You mentioned Dr. Joyce Shin at the Cleveland Clinic.

> > > >>> Have you been treated by her or know someone that has? Was it

> > for

> > > >>> PA or something else?

> > > >>>

> > > >>> Tired of wasting my time with incompetent doctor's and really

> > > >>> losing patience. I guess the only good thing is my anxiety has

> > now

> > > >>> been replaced by anger and I am pretty focused on that. Although

> > > >>> going to the Cleveland Clinic will cost me more time off work it

> > > >>> will probably be a quicker resolution than what I am currently

> > > >>> experiencing and just to make myself feel better I will be

> > sending

> > > >>> letters to both Endo's to let them know how I feel.

> > > >>>

> > > >>> Thanks,

> > > >>> Kellie

> > > >>

> > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

-

Thanks for the information. I can't imagine a day without sitting on the toilet

a dozen times.

I will go read the overdose section and see what it says.

Thanks,

Kellie

> > > >>

> > > >>>

> > > >>> Hello!

> > > >>>

> > > >>> Update: My second Endo was even worse than my first if you can

> > > >>> believe that. I will be meeting with my PCP tomorrow to get a

> > > >>> referral into The Cleveland Clinic and possibly another Endo and

> > > >>> Neph.

> > > >>>

> > > >>> Dr. Grim - You mentioned Dr. Bravo however I can't find him in the

> > > >>> directory for the Cleveland Clinic. Do you happen to have his

> > > >>> information?

> > > >>>

> > > >>> Do you also know of any Endo's and Nephorologist in the Columbus

> > > >>> Area that are GOOD DOCTORS? The Hospitals in the area are Grant,

> > > >>> Riverside, St. Ann's and my favorite Dublin Methodist.

> > > >>>

> > > >>> Natalia - You mentioned Dr. Joyce Shin at the Cleveland Clinic.

> > > >>> Have you been treated by her or know someone that has? Was it for

> > > >>> PA or something else?

> > > >>>

> > > >>> Tired of wasting my time with incompetent doctor's and really

> > > >>> losing patience. I guess the only good thing is my anxiety has now

> > > >>> been replaced by anger and I am pretty focused on that. Although

> > > >>> going to the Cleveland Clinic will cost me more time off work it

> > > >>> will probably be a quicker resolution than what I am currently

> > > >>> experiencing and just to make myself feel better I will be sending

> > > >>> letters to both Endo's to let them know how I feel.

> > > >>>

> > > >>> Thanks,

> > > >>> Kellie

> > > >>

> > > >

> > > >

> > > >

> > >

> >

>