Re: Francis - New PCP

October 24, 2011

Belive he is a resident.

>

> Are you getting a real doctor this time or another resident?

>

> I was at the VA today and found out the new Neprologist was as I hoped, Dr.

Luiz Kolankiewicz. He was the one I saw back in December and seemed to know

about PA. I thought asked the right questions. You might suggest a referral if

appropriate!

>

> I also heard Dr. , Chief - Pulmonary Section, passed away from a massive

heart attack! 46 y/o, great shape and exersized every day! I told Dr. Webster

that was it, I was going to remain fat, dumb and happy!

>

> - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt.

flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76

HR 60

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

> Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin,

Metformin 2000MG and Spironolactone 50 MG.

>

October 24, 2011

Bet he had a strong FH or other risk factors. Dropping dead from a heart attack does not come out of the Blue. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Are you getting a real doctor this time or another resident?

I was at the VA today and found out the new Neprologist was as I hoped, Dr. Luiz Kolankiewicz. He was the one I saw back in December and seemed to know about PA. I thought asked the right questions. You might suggest a referral if appropriate!

I also heard Dr. , Chief - Pulmonary Section, passed away from a massive heart attack! 46 y/o, great shape and exersized every day! I told Dr. Webster that was it, I was going to remain fat, dumb and happy!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

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

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

October 24, 2011

May he was ignoring his HTN LIKE he was yours. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Are you getting a real doctor this time or another resident?

I was at the VA today and found out the new Neprologist was as I hoped, Dr. Luiz Kolankiewicz. He was the one I saw back in December and seemed to know about PA. I thought asked the right questions. You might suggest a referral if appropriate!

I also heard Dr. , Chief - Pulmonary Section, passed away from a massive heart attack! 46 y/o, great shape and exersized every day! I told Dr. Webster that was it, I was going to remain fat, dumb and happy!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

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

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

October 24, 2011

Residents are real doctors - they just haven't finished their specialized training/internship/residency. Might not be any better then any doc in the old days until they 3+ years under their belt no matter what. Many a resident though might not have experience, but may not have the prejudices or arrogance to instantly say they "know" what something is. They may order tests that an attending may not and sometimes are right for doing it, sometimes they did it for no reason that experience may have known. So some give and take probably. But they are real doctors. Interns are not, residents are.

Subject: Re: Francis - New PCPTo: hyperaldosteronism Date: Monday, October 24, 2011, 5:29 PM

Belive he is a resident. >> Are you getting a real doctor this time or another resident?> > I was at the VA today and found out the new Neprologist was as I hoped, Dr. Luiz Kolankiewicz. He was the one I saw back in December and seemed to know about PA. I thought asked the right questions. You might suggest a referral if appropriate!> > I also heard Dr. , Chief - Pulmonary Section, passed away from a massive heart attack! 46 y/o, great shape and exersized every day! I told Dr. Webster that was it, I was going to remain fat, dumb and happy!> > - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain.

Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60> Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.> Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.>

October 24, 2011

I may have been implying my biases! I had a good resident, in fact I needed a

new one because the first was promoted to the " Top Resident " position. I think

they do well in traditional situations. I find they are less apt to step

outside the norm for fear of looking like a fool! Every decision is reviewed

and they have to justify their action! The other side of the coin is asking for

help, referring to a specialist fo DX, for the same reason.

Now, I didn't accept the next one when I found I was going " to have to train

another one " . We had been gaining nothing and I felt I needed someone with more

experience and lucked out and got a good one. She knew she had gone as far as

she could and jumped on a consult when the opportunity arose. It take

confidence to say " I don't know " !

Now, before you think I am totally biased against a new doctor, I have a

standard invite with my PCP to include any student that may be shadowing her

during any procedure and let them participate where appropriate! (I actually

wrote her a letter to this effect.)

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

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

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> >

> > Are you getting a real doctor this time or another resident?

> >

> > I was at the VA today and found out the new Neprologist was as I hoped, Dr.

Luiz Kolankiewicz. He was the one I saw back in December and seemed to know

about PA. I thought asked the right questions. You might suggest a referral if

appropriate!

> >

> > I also heard Dr. , Chief - Pulmonary Section, passed away from a

massive heart attack! 46 y/o, great shape and exersized every day! I told Dr.

Webster that was it, I was going to remain fat, dumb and happy!

> >

> > - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt.

flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR

60

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

> > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin,

Metformin 2000MG and Spironolactone 50 MG.

> >

>

October 24, 2011

Happend to a middle age guy at work who was running on the treadmill. He was also in great shape...so I too will just walk and not risk it. hehe ============================================================================45-Male-Caucasian, 5'9"- 242lbs, PA Diagnosed 2007 Suspected Hyperplasia-No tumors on CT - No AVS.Meds: 50mg Inspra, 40meq Potassium, 2400mg Calcium, 1000mg Magnesium, 100,000UI Vit D (weekly), 20mg OmeprazoleSide effects: Gynecomastia, stomach inflammation (from potassium citrate)Other Diags: GERD, Hiatal Hernia, Metabolic Syndrome - PreDiabetic, Secondary Hyperparathyroidism caused by Renal calcium leak, Bone Cyct in left Femoral Head and Pelvis. Benign Lung Nodules, Fibromyalgia, Scarring on Right

Kidney Lower Pole, Right Flank PainDASH: Started "sort of" DASHing 5/3/2011Status: Last Urine K/Na ratio was 1.1. But total of Na high alsoInitial Presenting Symptom: Muscle twitching all over body with low normal K, Mg, Ca, Low Ionized Ca, High PTH, low Vitamin DFrom:

Clarence Grim To: "hyperaldosteronism " <hyperaldosteronism >Sent: Monday, October 24, 2011 6:24 PMSubject: Re: Francis - New PCP

Bet he had a strong FH or other risk factors. Dropping dead from a heart attack does not come out of the Blue. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Are you getting a real doctor this time or another resident?

I was at the VA today and found out the new Neprologist was as I hoped, Dr. Luiz Kolankiewicz. He was the one I saw back in December and seemed to know about PA. I thought asked the right questions. You might suggest a referral if appropriate!

I also heard Dr. , Chief - Pulmonary Section, passed away from a massive heart attack! 46 y/o, great shape and exersized every day! I told Dr. Webster that was it, I was going to remain fat, dumb and happy!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

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

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

October 24, 2011

They may have more training, if I am in a major trama situation I might opt for

a particular PA if he is available! Knowledge is gained many different ways and

many times is depentent on retaining it!

> > >

> > > Are you getting a real doctor this time or another resident?

> > >

> > > I was at the VA today and found out the new Neprologist was as I hoped,

Dr. Luiz Kolankiewicz. He was the one I saw back in December and seemed to know

about PA. I thought asked the right questions. You might suggest a referral if

appropriate!

> > >

> > > I also heard Dr. , Chief - Pulmonary Section, passed away from a

massive heart attack! 46 y/o, great shape and exersized every day! I told Dr.

Webster that was it, I was going to remain fat, dumb and happy!

> > >

> > > - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt.

flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR

60

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

> > > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin,

Metformin 2000MG and Spironolactone 50 MG.

> > >

> >

>

October 24, 2011

When I ended up in the ER on the way home from my AVS, the young resident who

attended to me was familiar with PA & knew exactly what to do. He was the only

health care professional who knew about. I figured it was because medical

schools are teaching that PA is not as rare as once thought. The doctor

Lucy Sage

Sent from my Verizon Wireless Phone

wrote:

>They may have more training, if I am in a major trama situation I might opt for

a particular PA if he is available! Knowledge is gained many different ways and

many times is depentent on retaining it!

>

>> > >

>> > > Are you getting a real doctor this time or another resident?

>> > >

>> > > I was at the VA today and found out the new Neprologist was as I hoped,

Dr. Luiz Kolankiewicz. He was the one I saw back in December and seemed to know

about PA. I thought asked the right questions. You might suggest a referral if

appropriate!

>> > >

>> > > I also heard Dr. , Chief - Pulmonary Section, passed away from a

massive heart attack! 46 y/o, great shape and exersized every day! I told Dr.

Webster that was it, I was going to remain fat, dumb and happy!

>> > >

>> > > - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt.

flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR

60

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

>> > > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin,

Metformin 2000MG and Spironolactone 50 MG.

>> > >

>> >

>>

>

October 24, 2011

Maybe but then if you bump into an OT in Albany, a GM in Orlando , a Principal

in Fairfax or a Hairdresser in Montpelier they may know alot about PA. I

certainly hope your assumption is correct but maybe we should find out where he

went to school. It doesn't appear to be the case a Darthmouth!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

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

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> >> > >

> >> > > Are you getting a real doctor this time or another resident?

> >> > >

> >> > > I was at the VA today and found out the new Neprologist was as I hoped,

Dr. Luiz Kolankiewicz. He was the one I saw back in December and seemed to know

about PA. I thought asked the right questions. You might suggest a referral if

appropriate!

> >> > >

> >> > > I also heard Dr. , Chief - Pulmonary Section, passed away from a

massive heart attack! 46 y/o, great shape and exersized every day! I told Dr.

Webster that was it, I was going to remain fat, dumb and happy!

> >> > >

> >> > > - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous

rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave):

131/76 HR 60

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

> >> > > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin,

Metformin 2000MG and Spironolactone 50 MG.

> >> > >

> >> >

> >>

> >

>

October 24, 2011

Many times they innocently or inadvertantly, through not having the knowledge, ignore, or don't tell anyone, that there are some things happening to their body, and it seems as if it came out of no where, but often there were clues, they just didn't recognize them.

And sometimes sudden death may be the "it". Heaven knows as a paramedic in my past life we, or whoever was with them, saw many "just fall out" and that was that. It happens, but I bet it's rarer than thought because there is likely something in history or back in the past, or ignored clues. I say ignored innocently because we don't always know whats going on, or we blame our dizziness on "getting up to fast" or something else

Are you getting a real doctor this time or another resident?I was at the VA today and found out the new Neprologist was as I hoped, Dr. Luiz Kolankiewicz. He was the one I saw back in December and seemed to know about PA. I thought asked the right questions. You might suggest a referral if appropriate!I also heard Dr. , Chief - Pulmonary Section, passed away from a massive heart attack! 46 y/o, great shape and exersized every day! I told Dr. Webster that was it, I was going to remain fat, dumb and happy! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

October 24, 2011

I have a HUGE pet peeve when someone says to me "his (or her) bedside manner stinks; but they know their stuff!"

I always say that if one's bedside manner stinks they CANT know their stuff.

Can't see how not being able to figure out that being nice and caring likely does more for the patient than any medicine can - usually is a good thing. And getting through med school and all the after training and someone still can't figure that out or learn it does worry me a bit about that person as a "whole". But like any resident or attending doc or any one in any profession for that matter, it is an ability to see the big picture and put all the pieces together that counts. And like my Dad always said growing up - "Son, you can't teach someone common sense." Maybe he's right.

Subject: Re: Francis - New PCPTo: hyperaldosteronism Date: Monday, October 24, 2011, 7:23 PM

I may have been implying my biases! I had a good resident, in fact I needed a new one because the first was promoted to the "Top Resident" position. I think they do well in traditional situations. I find they are less apt to step outside the norm for fear of looking like a fool! Every decision is reviewed and they have to justify their action! The other side of the coin is asking for help, referring to a specialist fo DX, for the same reason. Now, I didn't accept the next one when I found I was going "to have to train another one". We had been gaining nothing and I felt I needed someone with more experience and lucked out and got a good one. She knew she had gone as far as she could and jumped on a consult when the opportunity arose. It take confidence to say "I don't know"!Now, before you think I am totally biased against a new doctor, I have a standard invite with my PCP to include any student that may be shadowing her during any

procedure and let them participate where appropriate! (I actually wrote her a letter to this effect.) - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > >> > Are you getting a real doctor this time or another resident?> > > > I was at the VA today and found out the new Neprologist was as I hoped, Dr. Luiz Kolankiewicz. He was the one I saw back in December and seemed to know about PA. I thought asked the right questions. You might suggest a referral if appropriate!> > > > I also heard Dr. , Chief - Pulmonary Section, passed away from a massive heart attack! 46 y/o, great shape and exersized every day! I told Dr. Webster that was it, I was going to remain fat, dumb and happy!> > > > - 65 yo super ob. male -

12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60> > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.> > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.> >>

October 24, 2011

Again he mos likely had one or more of the classic risk factors. Which may have been missed or ignored. 90% of those who die of MI at least one risk factor. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension