Re: Francis - New PCP

October 31, 2011

Do you have a home BP cuff? If not the VA should provide one, atleast they did

for me, a LifeSource UA767.

> > > > > > > >> > > > > >

> > > > > > > >> > > > > > > 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 31, 2011

Since they don't do it correctly the only thing you can assume is that it is

garbage! Control your own destiny and take it yourself!

- 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 31, 2011

Francis, did you read very sad e-mails from lyndahnaz last days with a subject line "Suspect PA no DX" ?Lynda has normal BP, but all other symptoms are terrible and they are the same as you and I and all others here have. It reminds your case. Natalia To: "hyperaldosteronism " <hyperaldosteronism >Sent: Sunday, October 30, 2011 11:17 AMSubject: Re: Re: Francis - New PCP

I would suggest that if BP is not at goal you would like to try spironolactone as you have been reading about its use in drug resistant HTN(uncontrolled on / meds) and you have an adrenal bump on CT. All good reasons to give Spiro a trial. Then ask for the reasons it should not be tried in your situation. Finally ask what does this Dr think the bump is doing?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

He didn't take much history He had read what was in my record. Did ask about the recent ED visit and how my shortness of breath was doing. Got to see this a bit as taking off my shoes was enough to bring it on. He also got to see the shaking (Kinetic Activity) thing I get.

It was not very long into the visit when I asked about PA. He really has no ideas except my weight. Have a B/P check on the 10th doing this to see how changing meds are working.

Did have blood test for HbA1C no results yet. Wants me to talk with the behaver modification person. Will see how this goes maybe I can get them to believe there is really something wrong like PA. Next PCP appt will be in 4 months.

Not likely to get referral until Dr thinks PA.

> > > > >> > > > > >

> > > > >> > > > > > > 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 31, 2011

She and MD needx to know that a BP in the normal range for most may be HTN FOR her. Need more Hx of BP AS FAR BACK AS she can go and needs to reread the evolution of PA article. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Francis, did you read very sad e-mails from lyndahnaz last days with a subject line "Suspect PA no DX" ?Lynda has normal BP, but all other symptoms are terrible and they are the same as you and I and all others here have. It reminds your case. Natalia To: "hyperaldosteronism " <hyperaldosteronism >Sent: Sunday, October 30, 2011 11:17 AMSubject: Re: Re: Francis - New PCP

I would suggest that if BP is not at goal you would like to try spironolactone as you have been reading about its use in drug resistant HTN(uncontrolled on / meds) and you have an adrenal bump on CT. All good reasons to give Spiro a trial. Then ask for the reasons it should not be tried in your situation. Finally ask what does this Dr think the bump is doing?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

He didn't take much history He had read what was in my record. Did ask about the recent ED visit and how my shortness of breath was doing. Got to see this a bit as taking off my shoes was enough to bring it on. He also got to see the shaking (Kinetic Activity) thing I get.

It was not very long into the visit when I asked about PA. He really has no ideas except my weight. Have a B/P check on the 10th doing this to see how changing meds are working.

Did have blood test for HbA1C no results yet. Wants me to talk with the behaver modification person. Will see how this goes maybe I can get them to believe there is really something wrong like PA. Next PCP appt will be in 4 months.

Not likely to get referral until Dr thinks PA.

> > > > >>

> > > > >> If you don't mind my asking, are your levels indicative of

> > > someone with PA? I am trying to decipher my most recent blood work.

> > > Thanks!

> > > > >>

> > > > >> >

> > > > >> >27 y/o , 115 lb at 5'6, female with 4+ year history of

> > > hypertension (Avg 135/95). Recently taken off of all bp meds because

> > > of resistance to them. Currentl

November 2, 2011

Got results of labs that were done at visit last week They checked hemoglobin

A1C results was 5.7. Says this is good Cholesterol total 200 HDL 43 LDL 128 and

TRIG 145 also says this is good.

It is signed Dean DO. Would this be a reason that he isn't up to speed

on PA?

> > > > > > > >> > > > > >

> > > > > > > >> > > > > > > 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.

> > > > > > > >> > > > > > >

> > > > > > > >> > > > > >

> > > > > > > >> > > > >

> > > > > > > >> > > >

> > > > > > > >> > >

> > > > > > > >> >

> > > > > > > >>

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

Is this your new PCP? I wouldn't jump to any conclusions based on his training.

My wife's PCP for many years was a DO and he delivered our last two children.

In fact she drove ~30 miles one way to Bethel and still would be if he hadn't

retired!

Here's the basic difference: " " the training, practice, credentialing, licensure,

and reimbursement of osteopathic physicians is virtually indistinguishable from

those of allopathic physicians, with 4 years of osteopathic medical school

followed by specialty and subspecialty training and [board] certification. " [7]

However, osteopathic physicians also receive an additional 300 – 500 hours in

the study of hands-on manual medicine and the body's musculoskeletal system

integrated into the medical curriculum, which is referred to as Osteopathic

manipulative medicine.[8] "

Who knows, he just might figure you out with that additional training!

- 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.

> > > > > > > > >> > > > > > >

> > > > > > > > >> > > > > >

> > > > > > > > >> > > > >

> > > > > > > > >> > > >

> > > > > > > > >> > >

> > > > > > > > >> >

> > > > > > > > >>

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

My opinion on this is that doctors with additional/complementary training, such

as osteopaths, medical acupuncturists, and naturopaths - WHO ARE ALSO M.D.s of

course - are more, not less, likely to be open-minded to figuring things out.

My current PCP is an internist/medical acupuncturist. Within five minutes of

meeting me, he suspected PA, and, as we all know, he was right.

-msmith1928

Nulliparous female, 46, 5'3 " , 115 lbs, CT showed 1cm left adrenal nodule, AVS

determined disease is unilateral, had left laparoscopic adrenalectomy on

10/13/2011. Low sodium, fructose- and grain-free diet due to hereditary fructose

intolerance, lactose intolerance, gluten intolerance (probable celiac).

> > > > > > > > > >> > > > > >

> > > > > > > > > >> > > > > > > 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.

> > > > > > > > > >> > > > > > >

> > > > > > > > > >> > > > > >

> > > > > > > > > >> > > > >

> > > > > > > > > >> > > >

> > > > > > > > > >> > >

> > > > > > > > > >> >

> > > > > > > > > >>

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

The problem is he is still training.

> > > > > > > > > >> > > > > >

> > > > > > > > > >> > > > > > > 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.

> > > > > > > > > >> > > > > > >

> > > > > > > > > >> > > > > >

> > > > > > > > > >> > > > >

> > > > > > > > > >> > > >

> > > > > > > > > >> > >

> > > > > > > > > >> >

> > > > > > > > > >>

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

Dr Grim thinks I have PA. This Dr dosn't seen to think I do as it is very rare.

One is most likey right. My bet is Dr grim is.

> > > > > > > > > > >> > > > > >

> > > > > > > > > > >> > > > > > > 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.

> > > > > > > > > > >> > > > > > >

> > > > > > > > > > >> > > > > >

> > > > > > > > > > >> > > > >

> > > > > > > > > > >> > > >

> > > > > > > > > > >> > >

> > > > > > > > > > >> >

> > > > > > > > > > >>

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

I have yet to hear WHY Dr. Grim thinks you have PA. I always understood to

confirm that DX he required a renin/aldo test in conjunction w/24 hr urine. Did

something change since 2009 that made him change his DX? In fact, I'm surprised

he even got that far since we don't even know if you have HTN since you have yet

to report an accurate reading to say nothing about two on two different

occasions!

- 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.

> > > > > > > > > > > >> > > > > > >

> > > > > > > > > > > >> > > > > >

> > > > > > > > > > > >> > > > >

> > > > > > > > > > > >> > > >

> > > > > > > > > > > >> > >

> > > > > > > > > > > >> >

> > > > > > > > > > > >>

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

If he signed with " DO " , he is a doctor! (Remember how I was corrected when I

asked if you were getting a real doctor?) I don't know if we are all still

training but most of us are still learning! (In fact, one well respected doctor

at the VA that I know of is learning quite a bit about PA and she's a MD!)

- 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.

> > > > > > > > > > >> > > > > > >

> > > > > > > > > > >> > > > > >

> > > > > > > > > > >> > > > >

> > > > > > > > > > >> > > >

> > > > > > > > > > >> > >

> > > > > > > > > > >> >

> > > > > > > > > > >>

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

For more B/P readings meds and blood K go to this link.

http://health.groups.yahoo.com/group/hyperaldosteronism/files/frankbill/

If link doesn't work go to files and frankbill medical history. There is a graph

that will move by clicking and draging it. We were trying to make a graph that

would be able to show B\P Meds given and effect of meds on B/P also was trying

to graph K at the same time.

jwwright2 was trying to help with this. As to Dr Grim thinking I have PA would

have to read his other postings.

> > > > > > > > > > > > >> > > > > >

> > > > > > > > > > > > >> > > > > > > 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.

> > > > > > > > > > > > >> > > > > > >

> > > > > > > > > > > > >> > > > > >

> > > > > > > > > > > > >> > > > >

> > > > > > > > > > > > >> > > >

> > > > > > > > > > > > >> > >

> > > > > > > > > > > > >> >

> > > > > > > > > > > > >>

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

As to my giving the reading from my B/P device. I bought it at walmart did buy

the large cuff. If one has PVCs like I have automatic device may give false

readings. Device never has been checked so may not give right reading. Now due

to my hearing if I was to get manual device I should also have someone else

check B/P at the same time to see if I can hear the right sounds. other wise how

would I know if I was getting it right. If you look at the VA manual they do not

treat B/P based on home readings.

> > > > > > > > > > > > > >> > > > > >

> > > > > > > > > > > > > >> > > > > > > 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.

> > > > > > > > > > > > > >> > > > > > >

> > > > > > > > > > > > > >> > > > > >

> > > > > > > > > > > > > >> > > > >

> > > > > > > > > > > > > >> > > >

> > > > > > > > > > > > > >> > >

> > > > > > > > > > > > > >> >

> > > > > > > > > > > > > >>

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

Maybe I am too Russian, but I would not trust him. Sorry for my opinion. Not because he is still training, because it's not his specialty. He is preparing himself to do something different. As we saw here, almost none of PCP could diagnose PA. Would you then go to real osteopathic, chiropractor, acupuncturist, or gynecologist for DX? Even most nephrologists and endocrinologists say something terrible to all of us, like "You can eat as much salt, as you want." Natalia To: hyperaldosteronism Sent: Wednesday, November 2, 2011 9:46 PMSubject: Re: Francis - New PCP

The problem is he is still training.

> > > > > > > > > >> > > > > >

> > > > > > > > > >> > > > > > > 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.

> > > > > > > > > >> > > > > > >

> > > > > > > > > >> > > > > >

> > > > > > > > > >> > > > >

> > > > > > > > > >> > > >

> > > > > > > > > >> > >

> > > > > > > > > >> >

> > > > > > > > > >>

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

My bet too!Natalia To: hyperaldosteronism Sent: Wednesday, November 2, 2011 9:51 PMSubject: Re: Francis - New PCP

Dr Grim thinks I have PA. This Dr dosn't seen to think I do as it is very rare. One is most likey right. My bet is Dr grim is.

> > > > > > > > > > >> > > > > >

> > > > > > > > > > >> > > > > > > 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.

> > > > > > > > > > >> > > > > > >

> > > > > > > > > > >> > > > > >

> > > > > > > > > > >> > > > >

> > > > > > > > > > >> > > >

> > > > > > > > > > >> > >

> > > > > > > > > > >> >

> > > > > > > > > > >>

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 2, 2011

Depends on when and where he graduated from I suspect. Tell him I am from Kirksville Mo where the DO business first started. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Got results of labs that were done at visit last week They checked hemoglobin A1C results was 5.7. Says this is good Cholesterol total 200 HDL 43 LDL 128 and TRIG 145 also says this is good.

It is signed Dean DO. Would this be a reason that he isn't up to speed on PA?

> > > > > > > >>

> > > > > > > >> If you don't mind my asking, are your levels indicative of someone with PA? I am trying to decipher my most recent blood work. Thanks!

> > > > > > > >>

> > > > > > > >> >

> > > > > > > >> >27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 135/95). Recently taken off of all bp meds because of resistance to them. Currently awaiting a second Nephrology appointment and up-to-date blood work. Last Aldosterone Level was 88. No known underlying illnesses other than systemic hypertension.ÃƒÆ’Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡ÃƒÆ’Ã¢â‚¬Å¡Ãƒâ€š

> > > > > > > >> >

> > > > > > > >>

> > > > > > > >> ________________________________

> > > > > > > >> From:

November 3, 2011

It is not possible to DX current HTN based on information 1 1/2 to 4 years ago!

If that's what you have to go on, no wonder the doctor gets confused.

As for Dr. Grim's DX, I don't need to go back because I read his comment when he

made it. I didn't understand what it was based on then and as I recall you

seemed surprised and mentioned the fact that that was the first time he had DXed

you w/PA. In fact the last thing I remember he was suggesting a trial of spiro

to see if it did anything. (With your current records I'm not sure how he would

know if it was doing anything!)

- 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.

> > > > > > > > > > > > > >> > > > > > >

> > > > > > > > > > > > > >> > > > > >

> > > > > > > > > > > > > >> > > > >

> > > > > > > > > > > > > >> > > >

> > > > > > > > > > > > > >> > >

> > > > > > > > > > > > > >> >

> > > > > > > > > > > > > >>

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 3, 2011

Hmm. Ask the VA for a home BP cuff. CE Grim MDOn Oct 31, 2011, at 6:59 AM, Francis Bill SUSPECTED PA wrote: B/P has been recorded as low as 124/78 at VA. Who and what and when is taking B/P it can very a lot. Since I have more higher then lower readings I can assume It is high. Just how high is the question. > > > > > > >> > > > > > > > > > > > >> > > > > > > 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. > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > >> > > > > > > > > >> > > > > > > > > >> > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

November 3, 2011

The standard since about 1938 has been to check both arms at the first visit and then use highest arm. But recheck every year is my advice as well when one gets older than 60 as this is the only way to pick up big differences in the tow arms and serious BP measurement errors. I have seen 120 systolic in one arm and 220 in other arm. CE Grim MDOn Oct 31, 2011, at 5:45 AM, Francis Bill SUSPECTED PA wrote: Don't know which arm is highest as it has never been checked. > > > > > > >> > > > > > > > > > > > >> > > > > > > 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. > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > >> > > > > > > > > >> > > > > > > > > >> > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

November 3, 2011

Don't think they manipulate the adrenal.CE Grim MD Is this your new PCP? I wouldn't jump to any conclusions based on his training. My wife's PCP for many years was a DO and he delivered our last two children. In fact she drove ~30 miles one way to Bethel and still would be if he hadn't retired! Here's the basic difference: ""the training, practice, credentialing, licensure, and reimbursement of osteopathic physicians is virtually indistinguishable from those of allopathic physicians, with 4 years of osteopathic medical school followed by specialty and subspecialty training and [board] certification."[7] However, osteopathic physicians also receive an additional 300 – 500 hours in the study of hands-on manual medicine and the body's musculoskeletal system integrated into the medical curriculum, which is referred to as Osteopathic manipulative medicine.[8]" Who knows, he just might figure you out with that additional training! - 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. > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

November 3, 2011

Would be an interesting survey to query a group of Drs with different training and see what they learned and retained. My guess is one would not get more than about 1% of the queries done.CE Grim MD My opinion on this is that doctors with additional/complementary training, such as osteopaths, medical acupuncturists, and naturopaths - WHO ARE ALSO M.D.s of course - are more, not less, likely to be open-minded to figuring things out. My current PCP is an internist/medical acupuncturist. Within five minutes of meeting me, he suspected PA, and, as we all know, he was right. -msmith1928 Nulliparous female, 46, 5'3", 115 lbs, CT showed 1cm left adrenal nodule, AVS determined disease is unilateral, had left laparoscopic adrenalectomy on 10/13/2011. Low sodium, fructose- and grain-free diet due to hereditary fructose intolerance, lactose intolerance, gluten intolerance (probable celiac). > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > 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. > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

November 3, 2011

We are all still learning. I hope. CE Grim MD The problem is he is still training. > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > 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. > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

November 3, 2011

The problem is he cannot get his VA team to test him properly or do a trail of spironolactone.CE Grim MD Dr Grim thinks I have PA. This Dr dosn't seen to think I do as it is very rare. One is most likey right. My bet is Dr grim is. > > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > 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. > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

November 3, 2011

As I recall he got low K on diuretics, he has and adrenal bump and has renins that are low but aldo that is not. Of course he cannot get them to do proper testing and that is the reason I have recommended a trial of spiro.Fracis Bill: I think this is in your thumbnail somewhere. CE Grim MD I have yet to hear WHY Dr. Grim thinks you have PA. I always understood to confirm that DX he required a renin/aldo test in conjunction w/24 hr urine. Did something change since 2009 that made him change his DX? In fact, I'm surprised he even got that far since we don't even know if you have HTN since you have yet to report an accurate reading to say nothing about two on two different occasions! - 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. > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

November 3, 2011

Why haven't you taken it with you when you went to the VA and had it validated?

I tested mine both with the auto machine that Kalie uses and then Dr. Webster

took it in her office, wrote down what she got and then I ran mine. Results =

SBP was the same, DSP my cuff was 1 point higher - pretty damn close don't you

think?

Dr. Grim suggested you might be able to use a manual since most hearing loss is

of higher frequencies, out of the range of BP sounds. You'll never know if you

don't try!

And I have looked at the VA Manual and I have very explicitally explained to

Drs. Webster, Momin and Robie why I won't allow them to make life decisions

based on their faulty numbers. In fact, Dr. Webster reviews my graphs and

expresses her gratitude. (I believe she even commented about them in my file.)

I dare them to label me noncomplient on that issue, the IG would be involved so

fast your head would spin!

- 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.

> > > > > > > > > > > > > > >> > > > > > >

> > > > > > > > > > > > > > >> > > > > >

> > > > > > > > > > > > > > >> > > > >

> > > > > > > > > > > > > > >> > > >

> > > > > > > > > > > > > > >> > >

> > > > > > > > > > > > > > >> >

> > > > > > > > > > > > > > >>

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

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Re: Francis - New PCP

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