Re: AVS and K

[Guest guest]

Hi Lucy, having been through AVS twice now I can tell you that each time, my K

has dropped from around 4.0 on admittance to 2.9 after the procedure. The

facility where I've had it done won't even release an AVS patient unless their K

is 3.8 or higher, which makes me think it's a pretty common occurrence.

I'm guessing that two things cause this dramatic drop: the fact that we're not

taking our usual K tabs the day of the procedure, and the surge of aldosterone

that is caused by the ACTH during the procedure. If I'm wrong, someone please

set me straight.

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> > > First of all, I would like to thank everyone in this group for sharing

your experience with and knowledge of aldosteronism. It has helped me immensely.

I asked for feedback about a month ago and have wanted to post on this site

again for some time, but I don't have a lot of extra energy (I need 10 hours of

sleep a night) and it took a while to digest everything and learn the lingo.

And, I still have a lot to learn! I printed the list of medical acronyms, read

Dr. Grim's Evolution, doing so very slowly, googling every word I did not

understand. (I also gave it to my endo, who took it but returned it to me when

I left) and have purchased the DASH book. At first, I thought I didn't need to

watch my salt, since I make most of my meals from fresh food, but I realized

there are times that I use canned veggies which are full of salt and there is

salt in premade salad dressings, soy milk and the cereal I eat. I plan to

purchase the HTN primer soon. I have added a thumbnail at the end of this,

which I believe is too long. Any suggestions for how to abbreviate it are

appreciated. I hope to add my story to the files in the near future.

> > >

> > > I had an AVS done by Dr. Cristos Georgiades at s Hopkins Hospital on

Monday, August 22. As a result of all the experience and suggestions I read here

(particularly that of msmith), I found out that Dr. Georgiades has done the

procedure approximately 100 and only missed the right adrenal vein twice. I

have had a very good experience with IR department at JHH. They have been

extremely helpful and good about promptly returning phone calls and providing

information without rushing me. Nonetheless, my procedure was 8 AM on Monday

and we had to be there at 6:30 AM. We live near burg, PA, which is about

90 miles or a 1.5 hour drive to Baltimore, so my husband and I were up at 4 AM

that morning. They took me to the procedure room at 8:30 AM and there were six

people in the room for the procedure: two doctors (Dr. G and a fellow); two

nurses; and two technicians. They used a conscious sedation (fentanyl and

versed). It took about two hours and they were able to find my right adrenal

vein and get samples from it. They told me that they got over 40 samples total

from my right and left adrenal veins. I was taken to the recovery room where

two RNs massaged a hematoma right by the incision on my left leg. After two

hours, they told me I could eat lunch, but all they had was cookies, fruit juice

and sandwiches. Since I am gluten-intolerant and don't eat sugar or food that

is high sugar like fruit juice, my husband got the softest food that met my

restrictions he could find in the cafeteria (pork, rice, squash and a fresh

fruit cup). After another two hours and about four walks around the recovery

room, I was released.

> > >

> > > About halfway home (20 miles from the Pennsylvania border), I felt

nauseous, so I grabbed the trash bag. Then, my husband tells me that I tossed

my head back, flailed my arms, made alien sounds, and proceeded to throw up all

over myself. Afterwards, my head dropped and I turned grey. My husband had

pulled over at this point and shook me until I came to. I continued to throw up

pretty violently in the bag. It was pretty gross coming out of my nose and I

think it was stuck in my esophagus, so I had to cough a lot out of me. My

husband called 911. The EMT came and gave me IV Zofran and I was taken by

ambulance to the ER at York Hospital in Pennsylvania. They gave me IV fluids,

an EKG, a chest X-ray and took blood samples. My K was down to 2.5, so they

gave me 40 MEQ of K mixed with a saline solution. (Fortunately I remembered

msmith talking about how much the IV K hurt, so I expressed concern and got the

diluted K.) The only person who had heard of Aldoteronism was the resident who

attended to me. After I few hours and some more Zofran, I felt like I could

eat, so they gave me some applesauce and crackers, which I followed with 50 MEQ

of my Klor-Con Eff. They released me close to midnight and we made it home

safely.

> > >

> > > I tried to post a similar message yesterday, but when I hit send, I got a

message that it was not successful. When I tried to go back, my message was

gone, so today I wrote this as a Word document that I saved first.

> > >

> > > I have an appt. with my PCP on Monday. I will be taking her Dr. Grim's

Evolution. I hope to get my results by phone from Dr. Georgiades next Wednesday

and I see my kidney specialist next Thursday to whom I will also be taking Dr.

Grim's Evolution and requesting a copy of the AVS report.

> > >

> > > Thank you again for sharing all your experiences and support!

> > >

> > > ~ Lucy Sage

> > >

> > > 58 yr. old female/5'5 " /135 lb/6.7 mm left adrenal mass/AVS 8-22-11

> > >

> > > Conditions: PA, Hypokalemia, HTN (BP ranges from 118/73 to165/81),

migraine, migraine, osteoarthritis, spinal stenosis, rhinitis, PND, chronic

gastritis, mild neutropenia, hypogammaglobulimenia, skin cancer (all types) &

hemorrhage in right retina.

> > >

> > > Symptoms: fatigue, nausea, tingling, weakness, nocturia, brain fog

anxiety & depression,.

> > >

> > > Medications: 175 MEQ Klor-Con TAB EFF, 5 mg Amlodopine, 20 mg Lisiniprol,

30 mg Cymbalta, 81 mg aspirin, 10 mg loratadine, 20 mg ranitidine, 0.1%

protopic, 10 mcg. Vagifem, 1.04 g fiber caps, 1200 mg calcium w/ magnesium & D,

800 I.U. vitamin D, multivitamin, 1000 mg vitamin C, 1000 mcg Biotin, 1000 mg

fish oil.

> > >

> > > Diet: no sugar, limited gluten (1 serving/week) due to gluten

intolerance, high veggie and fruit, limited carbs (2-4 servings/ day) and

protein (8-12 oz/day), low fat (3-6 servings/day) no alcohol, limiting salt & no

nicotine. Walk dog 2.5 miles/day.

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