Guest guest Posted August 18, 2011 Report Share Posted August 18, 2011 Excellent news and a good strategy on the cost issue. This makes it the same cost as Why are you starting Eplerenone if you are going to have surgery if AVS lateralizes. ;-)But it should get BP and K under control before surgery.You might ask them to check your urine for Na and K while you are there. CE Grim MD Just thought I'd share this, because I was surprised. My second AVS is tomorrow and I'm supposed to start eplerenone the next day. I just stopped by the pharmacy to pick it up and was surprised to find that there were no insurance hassles whatsoever - $10 copay, no questions asked. My doc always indicates the Dx as HTN rather than hyperaldo; I think this helps since eplerenone is approved for HTN but still considered off-label for hyperaldo. -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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2011 Report Share Posted August 18, 2011 Why? Because it took six weeks to get the AVS results last time around, so there's no reason to expect it will be any quicker this time. So might as well start now, although I'm a bit hesitant - if the AVS is inconclusive again, I do plan to repeat it and would rather not lose another 6 weeks of waiting for meds to clear. Still working this out with my doc I'm not asking the hospital to do anything extra - I'm sure it will cost ten times as much to have urine Na and K checked there as it would at my doctor's office. You're really into the " compliance " thing, I get that. I'm sure 99.9% of your patients cheat. But you need to get that I'm not ignorant about food. I've been reading labels as long as they have existed and have never eaten in a fast food restaurant in my life - there is no hidden sodium sneaking into my diet. Food with extra sodium makes me sick; and NOTHING tastes so good that it's worth getting sick over. The real problem is the lack of K in my diet. Unless someone wants to trade me a liver that knows how to metabolize fructose, that ain't gonna change > > > Just thought I'd share this, because I was surprised. My second AVS > > is tomorrow and I'm supposed to start eplerenone the next day. I > > just stopped by the pharmacy to pick it up and was surprised to find > > that there were no insurance hassles whatsoever - $10 copay, no > > questions asked. My doc always indicates the Dx as HTN rather than > > hyperaldo; I think this helps since eplerenone is approved for HTN > > but still considered off-label for hyperaldo. > > > > -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 > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2011 Report Share Posted August 18, 2011 Good luck with your AVS and may the " result Gods " smile on you and make it a short 6 weeks! (We may never know if you are salt sensitive!) ;>) ....john > > > > > Just thought I'd share this, because I was surprised. My second AVS > > > is tomorrow and I'm supposed to start eplerenone the next day. I > > > just stopped by the pharmacy to pick it up and was surprised to find > > > that there were no insurance hassles whatsoever - $10 copay, no > > > questions asked. My doc always indicates the Dx as HTN rather than > > > hyperaldo; I think this helps since eplerenone is approved for HTN > > > but still considered off-label for hyperaldo. > > > > > > -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 > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2011 Report Share Posted August 18, 2011 Good luck with your AVS and may the " result Gods " smile on you and make it a short 6 weeks! (We may never know if you are salt sensitive!) ;>) ....john > > > > > Just thought I'd share this, because I was surprised. My second AVS > > > is tomorrow and I'm supposed to start eplerenone the next day. I > > > just stopped by the pharmacy to pick it up and was surprised to find > > > that there were no insurance hassles whatsoever - $10 copay, no > > > questions asked. My doc always indicates the Dx as HTN rather than > > > hyperaldo; I think this helps since eplerenone is approved for HTN > > > but still considered off-label for hyperaldo. > > > > > > -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 > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2011 Report Share Posted August 18, 2011 Thanks ! I'm still expecting to end up being told it's been cancelled when I get there. 's Law and all... I think the fact that I can gain seven pounds from a single restaurant meal is all the proof I need that I am " salt sensitive " > > > > > > > Just thought I'd share this, because I was surprised. My second AVS > > > > is tomorrow and I'm supposed to start eplerenone the next day. I > > > > just stopped by the pharmacy to pick it up and was surprised to find > > > > that there were no insurance hassles whatsoever - $10 copay, no > > > > questions asked. My doc always indicates the Dx as HTN rather than > > > > hyperaldo; I think this helps since eplerenone is approved for HTN > > > > but still considered off-label for hyperaldo. > > > > > > > > -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 > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2011 Report Share Posted August 19, 2011 OK, now that we have a DX of SS does that change the RX to control PA? (Like will she likely need to reduce circulating NA in order for MCBs to take effect? (I presume the challenge is similar whether she take Spiro or Elpr.) Just trying to get my money's worth out of this Primer you recommended!) - 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. > > > > > > > > > > > Just thought I'd share this, because I was surprised. My > > second AVS > > > > > > is tomorrow and I'm supposed to start eplerenone the next > > day. I > > > > > > just stopped by the pharmacy to pick it up and was surprised > > to find > > > > > > that there were no insurance hassles whatsoever - $10 copay, > > no > > > > > > questions asked. My doc always indicates the Dx as HTN > > rather than > > > > > > hyperaldo; I think this helps since eplerenone is approved > > for HTN > > > > > > but still considered off-label for hyperaldo. > > > > > > > > > > > > -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 > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2011 Report Share Posted August 19, 2011 OK, now that we have a DX of SS does that change the RX to control PA? (Like will she likely need to reduce circulating NA in order for MCBs to take effect? (I presume the challenge is similar whether she take Spiro or Elpr.) Just trying to get my money's worth out of this Primer you recommended!) - 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. > > > > > > > > > > > Just thought I'd share this, because I was surprised. My > > second AVS > > > > > > is tomorrow and I'm supposed to start eplerenone the next > > day. I > > > > > > just stopped by the pharmacy to pick it up and was surprised > > to find > > > > > > that there were no insurance hassles whatsoever - $10 copay, > > no > > > > > > questions asked. My doc always indicates the Dx as HTN > > rather than > > > > > > hyperaldo; I think this helps since eplerenone is approved > > for HTN > > > > > > but still considered off-label for hyperaldo. > > > > > > > > > > > > -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 > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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