Re: Communicating with your Team

[Guest guest]

I will be after the 24th. I have an appt with PCP and already have a fasting

glucose to verify the accuracy of my meter. I plan to e-mail her a week in

advance with my request for tests and that is one of them. The " Proper Draw for

K " proceedure is already in the folder incase I need it! Thanks.

- 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): 122/73

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.

> > >

> > > >

> > > >

> > > > I see Dr. Bolton (FEA) On Monday and I believe she is planning on

> > > > titrating down/off Phsyco. Meds. I am wondering if Cymbalta is

> > > > serving two purposes and blocking neuropathic pain in my feet also.

> > > > Could it be the reason that while I have tingling I don't have pain?

> > > > Don't want to go thru another " act of congress " to get back on if I

> > > > stop and then need to get back on! Also, there may be other meds

> > > > more appropiate! Thought I'd give you a heads up so you could think

> > > > about it if necessary! Here is what I base the question on:

> > > > Thanks... - 8395.

> > > >

> > > > In animal models of neuropathic pain it has been found that

> > > > compounds which only block serotonin reuptake do not improve

> > > > neuropathic pain.[1][2][3][4][5][6][7][8] Similarly, compounds that

> > > > only block norepinephrine reuptake also do not improve neuropathic

> > > > pain. Compounds such as duloxetine, venlafaxine, and milnacipran

> > > > that block both serotonin reuptake and norepinephrine reuptake do

> > > > improve neuropathic pain. Antidepressants usually reduce neuropathic

> > > > pain more quickly and with smaller doses than they relieve

> > > > depression. Antidepressants therefore seem to work differently on

> > > > neuropathic pain than on depression, perhaps by activating

> > > > descending norepinephrinergic and serotonergic pathways in the

> > > > spinal cord that block pain signals from ascending to the brain.

> > > >

> > > > - 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): 122/73

> > > > 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.

> > > >

> > > >

> > >

> >

>

[Guest guest]

Good luck getting the Lab to do K draw right.

> > > >

> > > > >

> > > > >

> > > > > I see Dr. Bolton (FEA) On Monday and I believe she is planning on

> > > > > titrating down/off Phsyco. Meds. I am wondering if Cymbalta is

> > > > > serving two purposes and blocking neuropathic pain in my feet also.

> > > > > Could it be the reason that while I have tingling I don't have pain?

> > > > > Don't want to go thru another " act of congress " to get back on if I

> > > > > stop and then need to get back on! Also, there may be other meds

> > > > > more appropiate! Thought I'd give you a heads up so you could think

> > > > > about it if necessary! Here is what I base the question on:

> > > > > Thanks... - 8395.

> > > > >

> > > > > In animal models of neuropathic pain it has been found that

> > > > > compounds which only block serotonin reuptake do not improve

> > > > > neuropathic pain.[1][2][3][4][5][6][7][8] Similarly, compounds that

> > > > > only block norepinephrine reuptake also do not improve neuropathic

> > > > > pain. Compounds such as duloxetine, venlafaxine, and milnacipran

> > > > > that block both serotonin reuptake and norepinephrine reuptake do

> > > > > improve neuropathic pain. Antidepressants usually reduce neuropathic

> > > > > pain more quickly and with smaller doses than they relieve

> > > > > depression. Antidepressants therefore seem to work differently on

> > > > > neuropathic pain than on depression, perhaps by activating

> > > > > descending norepinephrinergic and serotonergic pathways in the

> > > > > spinal cord that block pain signals from ascending to the brain.

> > > > >

> > > > > - 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): 122/73

> > > > > 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.

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

the only problem I have with Don is he does leave the band on during the draw.

Some say this doesn't make the K high others do. Don't know what size needle he

uses or what order of draw he does.

By this information needle gage of 19 is what they should use

Drawing the blood through a small needle or catheter also ruptures red cells as

they pass through either. The narrower the needle or catheter, the greater is

the hemolysis. Blood collected with a 23-gauge needle has higher potassium

concentrations than blood from the same individual collected with a 19-gauge

needle. The hemolysis rate is inversely proportional to the diameter of the

needle or catheter, with the highest hemolysis rates in 24- to 20-gauge

catheters.

As to the order of draw will have to see if they do it as stated here

Potassium can become falsely elevated if the individual performing the

collection fills the tubes without regard for the proper order of draw. If the

blood from an EDTA tube, which contains potassium, carries over into a tube to

be tested for potassium, the carryover may spike the reported result and lead to

inappropriate physician intervention or the lack of intervention when it is

necessary. All specimen-collection personnel should fill tubes according to the

proper order of draw as recommended by the Clinical and Laboratory Standards

Institute, which is as follows:

* First: blood culture tubes or vials; yellow or yellow-black stopper

This oen you will not have drawn unless you have unknown infection.

* Second: sodium citrate tube (e.g., blue stopper);

* Third: serum tube with or without clot activator or gel separator (e.g., red,

gold, speckled stopper);

* Fourth: heparin tube (e.g., green stopper);

* Fifth: EDTA tube (e.g., lavender stopper); and

* Sixth: glycolytic inhibitor tube (e.g., gray stopper). (Note: Some facilities

alter this order reflecting internal studies that support a modification. Follow

your facility's policy.)

Dr Grim also think useing the tube system to send blood may increase k as well.

> > > > > >

> > > > > > >

> > > > > > >

> > > > > > > I see Dr. Bolton (FEA) On Monday and I believe she is planning on

> > > > > > > titrating down/off Phsyco. Meds. I am wondering if Cymbalta is

> > > > > > > serving two purposes and blocking neuropathic pain in my feet

also.

> > > > > > > Could it be the reason that while I have tingling I don't have

pain?

> > > > > > > Don't want to go thru another " act of congress " to get back on if

I

> > > > > > > stop and then need to get back on! Also, there may be other meds

> > > > > > > more appropiate! Thought I'd give you a heads up so you could

think

> > > > > > > about it if necessary! Here is what I base the question on:

> > > > > > > Thanks... - 8395.

> > > > > > >

> > > > > > > In animal models of neuropathic pain it has been found that

> > > > > > > compounds which only block serotonin reuptake do not improve

> > > > > > > neuropathic pain.[1][2][3][4][5][6][7][8] Similarly, compounds

that

> > > > > > > only block norepinephrine reuptake also do not improve neuropathic

> > > > > > > pain. Compounds such as duloxetine, venlafaxine, and milnacipran

> > > > > > > that block both serotonin reuptake and norepinephrine reuptake do

> > > > > > > improve neuropathic pain. Antidepressants usually reduce

neuropathic

> > > > > > > pain more quickly and with smaller doses than they relieve

> > > > > > > depression. Antidepressants therefore seem to work differently on

> > > > > > > neuropathic pain than on depression, perhaps by activating

> > > > > > > descending norepinephrinergic and serotonergic pathways in the

> > > > > > > spinal cord that block pain signals from ascending to the brain.

> > > > > > >

> > > > > > > - 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): 122/73

> > > > > > > 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.

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

In looking at my test they use plasma for K.

> > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > > > I see Dr. Bolton (FEA) On Monday and I believe she is planning

on

> > > > > > > > titrating down/off Phsyco. Meds. I am wondering if Cymbalta is

> > > > > > > > serving two purposes and blocking neuropathic pain in my feet

also.

> > > > > > > > Could it be the reason that while I have tingling I don't have

pain?

> > > > > > > > Don't want to go thru another " act of congress " to get back on

if I

> > > > > > > > stop and then need to get back on! Also, there may be other meds

> > > > > > > > more appropiate! Thought I'd give you a heads up so you could

think

> > > > > > > > about it if necessary! Here is what I base the question on:

> > > > > > > > Thanks... - 8395.

> > > > > > > >

> > > > > > > > In animal models of neuropathic pain it has been found that

> > > > > > > > compounds which only block serotonin reuptake do not improve

> > > > > > > > neuropathic pain.[1][2][3][4][5][6][7][8] Similarly, compounds

that

> > > > > > > > only block norepinephrine reuptake also do not improve

neuropathic

> > > > > > > > pain. Compounds such as duloxetine, venlafaxine, and milnacipran

> > > > > > > > that block both serotonin reuptake and norepinephrine reuptake

do

> > > > > > > > improve neuropathic pain. Antidepressants usually reduce

neuropathic

> > > > > > > > pain more quickly and with smaller doses than they relieve

> > > > > > > > depression. Antidepressants therefore seem to work differently

on

> > > > > > > > neuropathic pain than on depression, perhaps by activating

> > > > > > > > descending norepinephrinergic and serotonergic pathways in the

> > > > > > > > spinal cord that block pain signals from ascending to the brain.

> > > > > > > >

> > > > > > > > - 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): 122/73

> > > > > > > > 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.

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Thanks Val, we freeze ticks up here in the North Country!

>

> Tingling of the extremities is a common complaint in my Lyme group.

>

> Val

>

> From: hyperaldosteronism

> [mailto:hyperaldosteronism ] On Behalf Of

>

> Remember when you had your arm around your sweetheart for too long and it

> " went to sleep " . As the feeling started to return you had what I call a

> " tingling feeling " . That is the feeling I get in my toes but it doesn't go

> away.

>

[Guest guest]

For me, " numbness " and " tingling " were two different things. Before my K was

treated, I would completely lose any sense of feeling in my left pinky and ring

finger - I could stick pins in them and not feel anything. That's what I would

consider " numbness. "

Tingling to me is that feeling when one's arm or foot " falls asleep " and you get

a pins-and-needles, prickly sensation.

I got both with low K.

>

> > How it's different from numbness?

> >

> > Natalia

> >

> >

> > To: hyperaldosteronism

> > Sent: Sunday, October 2, 2011 6:43 PM

> > Subject: RE: Re: Communicating with your Team

> >

> >

> > A feeling of the part being asleep. Pins and needles. Itchiness.

says, below, " Remember when you had your arm around your sweetheart for

too long and it 'went to sleep'. As the feeling started to return you had what

I call a " tingling feeling " . That is the feeling I get in my toes but it doesn't

go away. "

> >

> > Val

> >

> > From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva

> >

> > Could you, please, explain to me what exactly tingling means? What kind of

sensation is it?

> >

> > Many thanks,

> >

> > Natalia

> >

> >

> >

> > Tingling of the extremities is a common complaint in my Lyme group.

> >

> > Val

> >

> > From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of

> > Remember when you had your arm around your sweetheart for too long and it

" went to sleep " . As the feeling started to return you had what I call a

" tingling feeling " . That is the feeling I get in my toes but it doesn't go away.

> > .

> >

> >

> >

> >

>