Re: Francis - New PCP

[Guest guest]

Nor do they take it correctly to use the clinic measurements for reliable guide to Dx and Rx.The electronic devices they use in some places have not passed the AAMI or ISH validation protocols and are rarely calibrated. They do not measure arm to select cuff etc.CE Grim MD 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. > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

The power of the Salt Institute in spreading information that most can eat as much salt as you like. CE Grim MD 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. > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

I have NEVER had a doctor tell me I could eat all the salt I wanted!

To answer your question, Yes, I would consider a DO or gynecologist as my PCP.

As I indicated, my wife was treated my a DO for 25 - 30 years and he delivered

two babies for us. And for all I know, my current PCP could be a gynecologist.

She has one of those convertable exam tables, I just require she remove those

stirrups before I get onto it! BTW, she's quite experienced teaching how to do

a breast self-exam!

- 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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> >

>

[Guest guest]

I understand he has symptoms that make you suspect he may have PA and agree a

trial of Spiro would help if you have a record to compare the before and after.

In fact That is how the same VA DXed my PA. (Of course I had no renin (0.1) and

two labs that suggested PA was possible.)

- 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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>

[Guest guest]

As to the IG being involved. Might want to go to there Web page.

http://www.va.gov/oig/

Then this one where you will find this Patient health care dispute go to Patient

Advocate at your local VA medical facility.

If you are taking your B/P as you say you are then you know B/P is never the

same in any two readings both numbers can change by 10 with in a few heart

beats. So don't know how VA validated you device as you decribe.

http://www.va.gov/oig/hotline/faq.asp#not-covered

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

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

[Guest guest]

Since the readings are from the VA and they have more current numbers and they

have very nice graphs to look at. Then why are you saying no wonder Dr gets

confused?

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

> > > > > > > > > > > > > > >> > > > > > > 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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[Guest guest]

All gages need to be calibrated as over time the moving parts wear.

Here is some information on how they should be calibrated.

Not likely to find many medical centers that will check home devices this way.

Until you know the gage on device has been calibrated then how can you say it is

giving you the right information.

Making sure that measuring instruments are properly calibrated is critical to

quality manufacturing operations. A gage that doesn't read accurately and

repeatably can compromise the integrity of quality control and quality assurance

documentation, and destroy confidence in measuring results. At their worst,

inaccurate gages can result in the production of nonconforming parts.

Gage calibration determines the deviation from the true value of the indication

supplied by a measuring instrument. The results of the calibration process can

be used for gage adjustment. Calibration goes beyond simple adjustment, however.

A calibrated gage can be traced back to a master source. Traceability provides

the value added to the calibration process.

Two factors distinguish in-house calibration services from independent sources.

First is the lab environment. The precision control and accurate measurement of

environmental conditions is the chief difference between an average industrial

gage laboratory and labs like those found at NIST. Temperature, barometric

pressure, humidity, elevation above sea level and latitude as it affects the

gravitational constant must be controlled if measuring instruments are to be

accurately calibrated.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

As inaccurate as it may have been, Dr. Webster used her cuff, I sat in the side

chair and rested my arm on exam table and back supported and feet flat on the

floor. She took BP and while she wrote it down I put my automatic cuff on the

same arm. After settling for a minute or so I pressed the button exactly as I

do every morning and when it reported the results we compared and came to the

conclusion that she was off by 1 point! It's a hell of alot better than

shrugging your sholders and saying " I don't know so I won't bother taking it -

I'll just guess it is high " !

It's your life so you decide what is important to you. I have decided my heart

is important to me so taking BP, recording, graphing, and sharing with my health

care team is a small price to pay. I can show them that my BP was 153/77 (taken

incorrectly) on 4/29/2008 and 122/67 (taken correctly) this morning. IMHO it is

stupid to allow anyone to make healthcare decisions based on inaccurate

information!

- 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

I have eliminated the gauge problem by going from an analog gauge to a digital

readout thereby eliminating all those moving parts! That leaves just the pump

as moving parts and that is only necessary to get the pressure high enough in

the blader. I'm not sure how electronic impulses deteriorate over time.

- 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

Dr. Grim, have you ever tried to listen whe an automatic cuff was running? I

assume you could do this and would try it if the dogs hadn't chewed my

stethoscope!

- 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

Still have to have part of gauge something has to read pressure and convert to

digital read out. Of course chip to do this can malfunction as well.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

In my experience, a chip/circuit board works until it fails and I've seen

thousands of them in my 27 years of computer support! Engineers, of which I had

3, use to use meters to check which chip to replace before we started changing

the whole board. I used to turn it over and look for a burn spot! It worked

~80% of the time and we got way better turn around when they adopted my

methodology!

My guess and it is only a guess is there some type of microphone that closes

when it " hears " blood flow giving the SBP number and opens when it no longer

" hears " anything giving the DBP! This is only a guess but if you want to donate

the one you don't use anyway I'd be happy to cut it open and see if I can figure

it out!

- 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

With the device I have read doesn't alway display the same way a guage would.

The cuff I have has a place for manual gauge. Was going to check my hearing and

device with a gauge from manual device I had. Problem is when I pulled line off

gauge something turned on the gauge and it no longer was on 0.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

Then you are lucky. Very prominent nephrologist in a leading teaching USA hospital told it to me. Endocrinologist confirmed that. My PCP said the same! NataliaTo: hyperaldosteronism Sent: Thursday, November 3, 2011 1:46 AMSubject: Re: Francis -

New PCP

I have NEVER had a doctor tell me I could eat all the salt I wanted!

To answer your question, Yes, I would consider a DO or gynecologist as my PCP. As I indicated, my wife was treated my a DO for 25 - 30 years and he delivered two babies for us. And for all I know, my current PCP could be a gynecologist. She has one of those convertable exam tables, I just require she remove those stirrups before I get onto it! BTW, she's quite experienced teaching how to do a breast self-exam!

- 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.

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

We need to reeducate them. Did they think had PA A at the time. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Then you are lucky. Very prominent nephrologist in a leading teaching USA hospital told it to me. Endocrinologist confirmed that. My PCP said the same! NataliaTo: hyperaldosteronism Sent: Thursday, November 3, 2011 1:46 AMSubject: Re: Francis -

New PCP

I have NEVER had a doctor tell me I could eat all the salt I wanted!

To answer your question, Yes, I would consider a DO or gynecologist as my PCP. As I indicated, my wife was treated my a DO for 25 - 30 years and he delivered two babies for us. And for all I know, my current PCP could be a gynecologist. She has one of those convertable exam tables, I just require she remove those stirrups before I get onto it! BTW, she's quite experienced teaching how to do a breast self-exam!

- 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.

> > > > > > > > >

> > > > > > > > > So, what are you doing now? What was your BP during the visit? Did you ask him to try eplerenone? As we discussed here, it's for BP, not even approved for PA.

> > > > > > > > >

> > > > > > > > >

> > > > > > > > > Natalia

> > > > > > > > >

> > > > > > > > > Â

> > > > > > > > >

> > > > > > > > > ________________________________

> > > > > > > > > From: Francis Bill SUSPECTED PA <georgewbill@>

> > > > > > > > > To: hyperaldosteronism

> > > > > > > > > Sent: Friday, October 28, 2011 5:45 PM

> > > > > > > > > Subject: Re: Francis - New PCP

> > > > > > > > >

> > > > > > > > >

> > > > > > > > > Â

> > > > > > > > > Had my visit with my new PCP at the VA Think at this point believe it was just a waste of time. When I told him I thought I had PA he told me PA is very rare That My B/P wasn't high enough nor my K low enough to have it. Tried to tell him Pa wasn't so rare and my B/P has been close to 199/100 and my K had been 3.2. Told me low K was due to being on diuretics and my B/P was a bit higher then it should be wasn't high enough for PA. When I asked about the adrenal tumor said it is a very common finding on CT It became point less to try to get him to think I might have PA.

> > > > > > > > >

> > > > > > > > > 64 y old N.H. Vet with possible PA BP readings as high 199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fluid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left kidney which measures 34 HU, greater than expected for a simple cyst.

> > > > > > > > > 3 NEG stress tests 2 NEG ECHO

> > > > > > > > >

> > > > > > & g

[Guest guest]

Dr grim you asked me to give more about my shaking.

I Believe the shaking started in mar of 2007 about a month after starting HCTZ.

But can't remember the order of shaking events. I do know that on 3/11/o7 I went

to ED because during the night My legs starting shaking. I also had high WBC

count and temp of 101. Was admitted with fever of unknown origin. No cause was

found. It was also during this visit that my K was found to be 3.2.

Also have had a few times where I would shiver when not really cold. Also once

after being for UTI Had both a high heart rate and shivering Went to ED Was told

this could happen as body was getting rid of infection. I also believe the

shaking has been happing during sleep. I have sleep number bed so mattress is

very light. Many times during the night the mattress would slide 4 to 6 in.

Some history starting from last fall I went to Dr and ED many times Had SX much

like UTI with Back pain in kidney area some urine showed Blood cells but

culture neg for bacteria. Progressively feeling worse increasing brain fog

feeling getter more shortness of breath with no one finding cause. K during this

time was running 3.8 to 3.9.

Visit to immediate care on 04 Jan 2011 was seen by a PA (he is the only

provider that didn't think I looked very good and later told me I was as white

as a sheet of paper) Ordered many blood tests and EKG. all neg. or normal. More

visits to ED to both VA and Dartmouth by now having a lot of shortness of

breath heart rate 100+ and problems walking as legs just do not seen to move

right and felt like lower leg muscles tightening up.

During this time the shaking starting again. First it started in bed and I

crossed my arms they started shaking After getting up and sitting in chair legs

started shaking went to VA ED shaking was enough to cause bed to shake Dr asked

me a few questions an then sent me home. a few days later went to Dartmouth ED

was hitched to heart monitor and legs were shaking enough to that nurse had to

move probe as it was recording Respiratory of 110. Dr had no answer as to why I

was shaking and sent me home.

At the time I was drinking low NA V8 but not all the time. I then drank it more

and for about 6 months shaking stopped. now it is back as well as the shortness

of breath.

Since I am hard to get blood from can not trust K is what test shows it is.

64 y old N.H. Vet with possable PA BP readings as high 199/100 K drop from 4.3

to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fulid retention

Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to

describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2

cm exophytic low density lesion off the mid pole of the left kidney which

measures 34 HU, greater than expected for a simple cyst.

3 NEG stress tests 2 NEG EHCO

meds I now take and was on for the two PRA ratio test. PAR ratio wasn't high to

DX PA

ATENOLOL25MG TRIAMTERENE50MG POTASSIUM CHLORIDE 20MEQ

FUROSEMIDE 60MG TAB.

Information from first Test done at the VA and quest labs. RENIN: 1.8 ng/mL/hr

Current Range 0.65-5.0 ng/mL/hr

SERUM ALDOS: 16 ng/dL Current adult reference range:

Upright 8:00-10:00 am < or = 28 ng/dL

Upright 4:00-6:00 pm < or = 21 ng/dL

Supine 8:00-10:00 am 3-16 ng/dL

Test done At Dartmouth RENIN ACTIVITY .8 no range given

ALDOSTERONE 5.5 range <=21

> > > > > > > > > > >

> > > > > > > > > > > So, what are you doing now? What was your BP during the

visit? Did you ask him to try eplerenone? As we discussed here, it's for BP, not

even approved for PA.

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > > Natalia

> > > > > > > > > > >

> > > > > > > > > > > ÃÆ'‚

> > > > > > > > > > >

> > > > > > > > > > > ________________________________

> > > > > > > > > > > From: Francis Bill SUSPECTED PA <georgewbill@>

> > > > > > > > > > > To: hyperaldosteronism

> > > > > > > > > > > Sent: Friday, October 28, 2011 5:45 PM

> > > > > > > > > > > Subject: Re: Francis - New PCP

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > > ÃÆ'‚

> > > > > > > > > > > Had my visit with my new PCP at the VA Think at this point

believe it was just a waste of time. When I told him I thought I had PA he told

me PA is very rare That My B/P wasn't high enough nor my K low enough to have

it. Tried to tell him Pa wasn't so rare and my B/P has been close to 199/100 and

my K had been 3.2. Told me low K was due to being on diuretics and my B/P was a

bit higher then it should be wasn't high enough for PA. When I asked about the

adrenal tumor said it is a very common finding on CT It became point less to try

to get him to think I might have PA.

> > > > > > > > > > >

> > > > > > > > > > > 64 y old N.H. Vet with possible PA BP readings as high

199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE

fluid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog

Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left

adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left

kidney which measures 34 HU, greater than expected for a simple cyst.

> > > > > > > > > > > 3 NEG stress tests 2 NEG ECHO

> > > > > > > > > > >

> > > > > > > > & g

>

[Guest guest]

Do all limbs shake at once or just one. Does it get worse when you reach for something. The fact that it got better witb low Na V8 screams low K. How are u doing on lowering Na intake do u think? A salt load will aggravate the low K problem. Can u tie say a pizza binge or even just a few pieces to any of these spells?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Dr grim you asked me to give more about my shaking.

I Believe the shaking started in mar of 2007 about a month after starting HCTZ. But can't remember the order of shaking events. I do know that on 3/11/o7 I went to ED because during the night My legs starting shaking. I also had high WBC count and temp of 101. Was admitted with fever of unknown origin. No cause was found. It was also during this visit that my K was found to be 3.2.

Also have had a few times where I would shiver when not really cold. Also once after being for UTI Had both a high heart rate and shivering Went to ED Was told this could happen as body was getting rid of infection. I also believe the shaking has been happing during sleep. I have sleep number bed so mattress is very light. Many times during the night the mattress would slide 4 to 6 in.

Some history starting from last fall I went to Dr and ED many times Had SX much like UTI with Back pain in kidney area some urine showed Blood cells but culture neg for bacteria. Progressively feeling worse increasing brain fog feeling getter more shortness of breath with no one finding cause. K during this time was running 3.8 to 3.9.

Visit to immediate care on 04 Jan 2011 was seen by a PA (he is the only provider that didn't think I looked very good and later told me I was as white as a sheet of paper) Ordered many blood tests and EKG. all neg. or normal. More visits to ED to both VA and Dartmouth by now having a lot of shortness of breath heart rate 100+ and problems walking as legs just do not seen to move right and felt like lower leg muscles tightening up.

During this time the shaking starting again. First it started in bed and I crossed my arms they started shaking After getting up and sitting in chair legs started shaking went to VA ED shaking was enough to cause bed to shake Dr asked me a few questions an then sent me home. a few days later went to Dartmouth ED was hitched to heart monitor and legs were shaking enough to that nurse had to move probe as it was recording Respiratory of 110. Dr had no answer as to why I was shaking and sent me home.

At the time I was drinking low NA V8 but not all the time. I then drank it more and for about 6 months shaking stopped. now it is back as well as the shortness of breath.

Since I am hard to get blood from can not trust K is what test shows it is.

64 y old N.H. Vet with possable PA BP readings as high 199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fulid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left kidney which measures 34 HU, greater than expected for a simple cyst.

3 NEG stress tests 2 NEG EHCO

meds I now take and was on for the two PRA ratio test. PAR ratio wasn't high to DX PA

ATENOLOL25MG TRIAMTERENE50MG POTASSIUM CHLORIDE 20MEQ

FUROSEMIDE 60MG TAB.

Information from first Test done at the VA and quest labs. RENIN: 1.8 ng/mL/hr

Current Range 0.65-5.0 ng/mL/hr

SERUM ALDOS: 16 ng/dL Current adult reference range:

Upright 8:00-10:00 am < or = 28 ng/dL

Upright 4:00-6:00 pm < or = 21 ng/dL

Supine 8:00-10:00 am 3-16 ng/dL

Test done At Dartmouth RENIN ACTIVITY .8 no range given

ALDOSTERONE 5.5 range <=21

> > > > > > > > >

> > > > > > > > > Francis, 143/80 is better than any reading I get at the VA. Did they take 3 and average 2 after sitting etc, etc? This is also a lot lower than the 199/100 you've been reporting. If you assume the same range for renin at Dartmouth, both your renin test are within range and aldo is also. I know Dr. Grim said once you had PA but I'm not sure what he saw that made him come to that conclusion. He usually requires a 24h urine as I recall.

> > > > > > > > >

> > > > > > > > > Have you ever tried stopping the atenolol? Both it and lisinopril are ACE inhibitors and if I understand it correctly work on angiotenisn which starts as renin. Since my renin was .1 they didn't do anything but with yours being within range they may be doing something!

> > > > > > > > >

> > > > > > > > > What was the timeframe for your two tests?

> > > > > > > > >

> > > > > > > > > - 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 Is

[Guest guest]

Depends on how I am sitting but both legs sometimes both shake. when I was in ED

with monitor on both legs were shaking. If I sit and cross my legs one of my

feet will start shaking.

Do not think both arms has shaked at the same time. If I cross them a one of

them will shake. sometimes with arms hanging one hand will shake ihen will

switch to other side or sometimes it it the fingers that shake. They do not

shake when I am reaching or useing them.

Haven't had a big sodium load for a while.

> > > > > > > > > > >

> > > > > > > > > > > Francis, 143/80 is better than any reading I get at the

VA. Did they take 3 and average 2 after sitting etc, etc? This is also a lot

lower than the 199/100 you've been reporting. If you assume the same range for

renin at Dartmouth, both your renin test are within range and aldo is also. I

know Dr. Grim said once you had PA but I'm not sure what he saw that made him

come to that conclusion. He usually requires a 24h urine as I recall.

> > > > > > > > > > >

> > > > > > > > > > > Have you ever tried stopping the atenolol? Both it and

lisinopril are ACE inhibitors and if I understand it correctly work on

angiotenisn which starts as renin. Since my renin was .1 they didn't do anything

but with yours being within range they may be doing something!

> > > > > > > > > > >

> > > > > > > > > > > What was the timeframe for your two tests?

> > > > > > > > > > >

> > > > > > > > > > > - 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 Is

>

[Guest guest]

That sounds alot like a low mag issueSent from my Palm Pre on the Now Network from Sprint

Dr grim you asked me to give more about my shaking.

I Believe the shaking started in mar of 2007 about a month after starting HCTZ. But can't remember the order of shaking events. I do know that on 3/11/o7 I went to ED because during the night My legs starting shaking. I also had high WBC count and temp of 101. Was admitted with fever of unknown origin. No cause was found. It was also during this visit that my K was found to be 3.2.

Also have had a few times where I would shiver when not really cold. Also once after being for UTI Had both a high heart rate and shivering Went to ED Was told this could happen as body was getting rid of infection. I also believe the shaking has been happing during sleep. I have sleep number bed so mattress is very light. Many times during the night the mattress would slide 4 to 6 in.

Some history starting from last fall I went to Dr and ED many times Had SX much like UTI with Back pain in kidney area some urine showed Blood cells but culture neg for bacteria. Progressively feeling worse increasing brain fog feeling getter more shortness of breath with no one finding cause. K during this time was running 3.8 to 3.9.

Visit to immediate care on 04 Jan 2011 was seen by a PA (he is the only provider that didn't think I looked very good and later told me I was as white as a sheet of paper) Ordered many blood tests and EKG. all neg. or normal. More visits to ED to both VA and Dartmouth by now having a lot of shortness of breath heart rate 100+ and problems walking as legs just do not seen to move right and felt like lower leg muscles tightening up.

During this time the shaking starting again. First it started in bed and I crossed my arms they started shaking After getting up and sitting in chair legs started shaking went to VA ED shaking was enough to cause bed to shake Dr asked me a few questions an then sent me home. a few days later went to Dartmouth ED was hitched to heart monitor and legs were shaking enough to that nurse had to move probe as it was recording Respiratory of 110. Dr had no answer as to why I was shaking and sent me home.

At the time I was drinking low NA V8 but not all the time. I then drank it more and for about 6 months shaking stopped. now it is back as well as the shortness of breath.

Since I am hard to get blood from can not trust K is what test shows it is.

64 y old N.H. Vet with possable PA BP readings as high 199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fulid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left kidney which measures 34 HU, greater than expected for a simple cyst.

3 NEG stress tests 2 NEG EHCO

meds I now take and was on for the two PRA ratio test. PAR ratio wasn't high to DX PA

ATENOLOL25MG TRIAMTERENE50MG POTASSIUM CHLORIDE 20MEQ

FUROSEMIDE 60MG TAB.

Information from first Test done at the VA and quest labs. RENIN: 1.8 ng/mL/hr

Current Range 0.65-5.0 ng/mL/hr

SERUM ALDOS: 16 ng/dL Current adult reference range:

Upright 8:00-10:00 am < or = 28 ng/dL

Upright 4:00-6:00 pm < or = 21 ng/dL

Supine 8:00-10:00 am 3-16 ng/dL

Test done At Dartmouth RENIN ACTIVITY .8 no range given

ALDOSTERONE 5.5 range <=21

> > > > > > > > > > >

> > > > > > > > > > > So, what are you doing now? What was your BP during the visit? Did you ask him to try eplerenone? As we discussed here, it's for BP, not even approved for PA.

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > > Natalia

> > > > > > > > > > >

> > > > > > > > > > > ÃÆ'‚

> > > > > > > > > > >

> > > > > > > > > > > ________________________________

> > > > > > > > > > > From: Francis Bill SUSPECTED PA <georgewbill@>

> > > > > > > > > > > To: hyperaldosteronism

> > > > > > > > > > > Sent: Friday, October 28, 2011 5:45 PM

> > > > > > > > > > > Subject: Re: Francis - New PCP

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > > ÃÆ'‚

> > > > > > > > > > > Had my visit with my new PCP at the VA Think at this point believe it was just a waste of time. When I told him I thought I had PA he told me PA is very rare That My B/P wasn't high enough nor my K low enough to have it. Tried to tell him Pa wasn't so rare and my B/P has been close to 199/100 and my K had been 3.2. Told me low K was due to being on diuretics and my B/P was a bit higher then it should be wasn't high enough for PA. When I asked about the adrenal tumor said it is a very common finding on CT It became point less to try to get him to think I might have PA.

> > > > > > > > > > >

> > > > > > > > > > > 64 y old N.H. Vet with possible PA BP readings as high 199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fluid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left kidney which measures 34 HU, greater than expected for a simple cyst.

> > > > > > > > > > > 3 NEG stress tests 2 NEG ECHO

> > > > > > > > > > >

> > > > > > > > & g

>

[Guest guest]

FB: shaking like someone with Parkinson's or jerking or both with or without muscle cramps/spasms Do hands draw up like a claw hand? Do toes draw up?Where in back were the pains and did they spread anywhere else?Any tingling around mouth or else where. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

That sounds alot like a low mag issueSent from my Palm Pre on the Now Network from Sprint

Dr grim you asked me to give more about my shaking.

I Believe the shaking started in mar of 2007 about a month after starting HCTZ. But can't remember the order of shaking events. I do know that on 3/11/o7 I went to ED because during the night My legs starting shaking. I also had high WBC count and temp of 101. Was admitted with fever of unknown origin. No cause was found. It was also during this visit that my K was found to be 3.2.

Also have had a few times where I would shiver when not really cold. Also once after being for UTI Had both a high heart rate and shivering Went to ED Was told this could happen as body was getting rid of infection. I also believe the shaking has been happing during sleep. I have sleep number bed so mattress is very light. Many times during the night the mattress would slide 4 to 6 in.

Some history starting from last fall I went to Dr and ED many times Had SX much like UTI with Back pain in kidney area some urine showed Blood cells but culture neg for bacteria. Progressively feeling worse increasing brain fog feeling getter more shortness of breath with no one finding cause. K during this time was running 3.8 to 3.9.

Visit to immediate care on 04 Jan 2011 was seen by a PA (he is the only provider that didn't think I looked very good and later told me I was as white as a sheet of paper) Ordered many blood tests and EKG. all neg. or normal. More visits to ED to both VA and Dartmouth by now having a lot of shortness of breath heart rate 100+ and problems walking as legs just do not seen to move right and felt like lower leg muscles tightening up.

During this time the shaking starting again. First it started in bed and I crossed my arms they started shaking After getting up and sitting in chair legs started shaking went to VA ED shaking was enough to cause bed to shake Dr asked me a few questions an then sent me home. a few days later went to Dartmouth ED was hitched to heart monitor and legs were shaking enough to that nurse had to move probe as it was recording Respiratory of 110. Dr had no answer as to why I was shaking and sent me home.

At the time I was drinking low NA V8 but not all the time. I then drank it more and for about 6 months shaking stopped. now it is back as well as the shortness of breath.

Since I am hard to get blood from can not trust K is what test shows it is.

64 y old N.H. Vet with possable PA BP readings as high 199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fulid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left kidney which measures 34 HU, greater than expected for a simple cyst.

3 NEG stress tests 2 NEG EHCO

meds I now take and was on for the two PRA ratio test. PAR ratio wasn't high to DX PA

ATENOLOL25MG TRIAMTERENE50MG POTASSIUM CHLORIDE 20MEQ

FUROSEMIDE 60MG TAB.

Information from first Test done at the VA and quest labs. RENIN: 1.8 ng/mL/hr

Current Range 0.65-5.0 ng/mL/hr

SERUM ALDOS: 16 ng/dL Current adult reference range:

Upright 8:00-10:00 am < or = 28 ng/dL

Upright 4:00-6:00 pm < or = 21 ng/dL

Supine 8:00-10:00 am 3-16 ng/dL

Test done At Dartmouth RENIN ACTIVITY .8 no range given

ALDOSTERONE 5.5 range <=21

> > > > > > > > >

> > > > > > > > > Francis, 143/80 is better than any reading I get at the VA. Did they take 3 and average 2 after sitting etc, etc? This is also a lot lower than the 199/100 you've been reporting. If you assume the same range for renin at Dartmouth, both your renin test are within range and aldo is also. I know Dr. Grim said once you had PA but I'm not sure what he saw that made him come to that conclusion. He usually requires a 24h urine as I recall.

> > > > > > > > >

> > > > > > > > > Have you ever tried stopping the atenolol? Both it and lisinopril are ACE inhibitors and if I understand it correctly work on angiotenisn which starts as renin. Since my renin was =

[Guest guest]

I swear, Francis, you have all the symptoms of Lyme, Babesia, and maybe Bartonella.  Assuming other problems are ruled out, shortness of breath is a cornerstone symptom of Babesia.  Plus, you live in the northeast.  I had terrible shaking that has pretty much resolved with Lyme treatment.  Another on this list wrote to me last night and reported her health - Lyme, Babesia, Bartonella - all, including HTN, resolving with Lyme treatment.  I hope she will post her experience to the list. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PA Dr grim you asked me to give more about my shaking. I Believe the shaking started in mar of 2007 about a month after starting HCTZ. But can't remember the order of shaking events. I do know that on 3/11/o7 I went to ED because during the night My legs starting shaking. I also had high WBC count and temp of 101. Was admitted with fever of unknown origin. No cause was found. It was also during this visit that my K was found to be 3.2. Also have had a few times where I would shiver when not really cold. Also once after being for UTI Had both a high heart rate and shivering Went to ED Was told this could happen as body was getting rid of infection. I also believe the shaking has been happing during sleep. I have sleep number bed so mattress is very light. Many times during the night the mattress would slide 4 to 6 in. Some history starting from last fall I went to Dr and ED many times Had SX much like UTI with Back pain in kidney area some urine showed Blood cells but culture neg for bacteria. Progressively feeling worse increasing brain fog feeling getter more shortness of breath with no one finding cause. K during this time was running 3.8 to 3.9. Visit to immediate care on 04 Jan 2011 was seen by a PA (he is the only provider that didn't think I looked very good and later told me I was as white as a sheet of paper) Ordered many blood tests and EKG. all neg. or normal. More visits to ED to both VA and Dartmouth by now having a lot of shortness of breath heart rate 100+ and problems walking as legs just do not seen to move right and felt like lower leg muscles tightening up. During this time the shaking starting again. First it started in bed and I crossed my arms they started shaking After getting up and sitting in chair legs started shaking went to VA ED shaking was enough to cause bed to shake Dr asked me a few questions an then sent me home. a few days later went to Dartmouth ED was hitched to heart monitor and legs were shaking enough to that nurse had to move probe as it was recording Respiratory of 110. Dr had no answer as to why I was shaking and sent me home. At the time I was drinking low NA V8 but not all the time. I then drank it more and for about 6 months shaking stopped. now it is back as well as the shortness of breath. Since I am hard to get blood from can not trust K is what test shows it is. 64 y old N.H. Vet with possable PA BP readings as high 199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fulid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left kidney which measures 34 HU, greater than expected for a simple cyst. 3 NEG stress tests 2 NEG EHCO meds I now take and was on for the two PRA ratio test. PAR ratio wasn't high to DX PAATENOLOL25MG TRIAMTERENE50MG POTASSIUM CHLORIDE 20MEQ FUROSEMIDE 60MG TAB.Information from first Test done at the VA and quest labs. RENIN: 1.8 ng/mL/hrCurrent Range 0.65-5.0 ng/mL/hrSERUM ALDOS: 16 ng/dL Current adult reference range:Upright 8:00-10:00 am < or = 28 ng/dLUpright 4:00-6:00 pm < or = 21 ng/dLSupine 8:00-10:00 am 3-16 ng/dLTest done At Dartmouth RENIN ACTIVITY .8 no range givenALDOSTERONE 5.5 range <=21> > > > > > > > > > >> > > > > > > > > > > So, what are you doing now? What was your BP during the visit? Did you ask him to try eplerenone? As we discussed here, it's for BP, not even approved for PA. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Natalia> > > > > > > > > > > > > > > > > > > > > > ÃÆ'‚ > > > > > > > > > > > > > > > > > > > > > > ________________________________> > > > > > > > > > > From: Francis Bill SUSPECTED PA <georgewbill@>> > > > > > > > > > > To: hyperaldosteronism > > > > > > > > > > > Sent: Friday, October 28, 2011 5:45 PM> > > > > > > > > > > Subject: Re: Francis - New PCP> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ÃÆ'‚ > > > > > > > > > > > Had my visit with my new PCP at the VA Think at this point believe it was just a waste of time. When I told him I thought I had PA he told me PA is very rare That My B/P wasn't high enough nor my K low enough to have it. Tried to tell him Pa wasn't so rare and my B/P has been close to 199/100 and my K had been 3.2. Told me low K was due to being on diuretics and my B/P was a bit higher then it should be wasn't high enough for PA. When I asked about the adrenal tumor said it is a very common finding on CT It became point less to try to get him to think I might have PA. > > > > > > > > > > > > > > > > > > > > > > 64 y old N.H. Vet with possible PA BP readings as high 199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fluid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left kidney which measures 34 HU, greater than expected for a simple cyst. > > > > > > > > > > > 3 NEG stress tests 2 NEG ECHO > > > > > > > > > > > > > > > > > > > & g>

[Guest guest]

It is also symptomatic of a chronic low K and likely the other things that follow such as low mag and low calcium which are often ignored more than the low K is. The drinking of more V8 and feeling better is a great clue and l bet the extra K overcame the deficit hyperalsteronism caused especially given you weren't taking any. A normal K diet is not enough to overcome the chronic loss and the peeing 20 times a day. You would have to have the leak plugged (treat the PA) or supplement with K or increase the dietary K like you did.

But many of us it seems, me included, have had our PA treated with spiro or epe, yet still seem to need to supplement with K. I am not certain why this is exactly. Dr G may have an answer as to why we still need the added potassium, yet like my case, I have a great BP finally well I did after the first 2 doses of spiro (started in late 2010) and that was after 5+ years of critical BP - 160/120 daily and higher, even on 5 meds at once - and like you, ER after ER visit and hospital stays with HTN, low K, AND weakness, tingles, the feeling like I couldn't use my legs, and so on, and I only DASH and take 12.5 of spiro a day .

I say DASH as my salt restriction is good, but I don't think I meet the K recommendations a day but I supplement, yet I KNOW when my K is off, but my BP is good, I no longer get up at night, and so on. This is what I meant by I don't know why I still have a low K if I don't supplememnt it. I am not getting why I still see a low K.

Subject: RE: Re: Francis - New PCPTo: hyperaldosteronism Date: Thursday, November 3, 2011, 11:54 PM

I swear, Francis, you have all the symptoms of Lyme, Babesia, and maybe Bartonella. Assuming other problems are ruled out, shortness of breath is a cornerstone symptom of Babesia. Plus, you live in the northeast. I had terrible shaking that has pretty much resolved with Lyme treatment. Another on this list wrote to me last night and reported her health - Lyme, Babesia, Bartonella - all, including HTN, resolving with Lyme treatment. I hope she will post her experience to the list.

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PA

Dr grim you asked me to give more about my shaking. I Believe the shaking started in mar of 2007 about a month after starting HCTZ. But can't remember the order of shaking events. I do know that on 3/11/o7 I went to ED because during the night My legs starting shaking. I also had high WBC count and temp of 101. Was admitted with fever of unknown origin. No cause was found. It was also during this visit that my K was found to be 3.2. Also have had a few times where I would shiver when not really cold. Also once after being for UTI Had both a high heart rate and shivering Went to ED Was told this could happen as body was getting rid of infection. I also believe the shaking has been happing during sleep. I have sleep number bed so mattress is very light. Many times during the night the mattress would slide 4 to 6 in. Some history starting from last fall I went to Dr and ED many times Had SX much like UTI with Back pain in kidney

area some urine showed Blood cells but culture neg for bacteria. Progressively feeling worse increasing brain fog feeling getter more shortness of breath with no one finding cause. K during this time was running 3.8 to 3.9. Visit to immediate care on 04 Jan 2011 was seen by a PA (he is the only provider that didn't think I looked very good and later told me I was as white as a sheet of paper) Ordered many blood tests and EKG. all neg. or normal. More visits to ED to both VA and Dartmouth by now having a lot of shortness of breath heart rate 100+ and problems walking as legs just do not seen to move right and felt like lower leg muscles tightening up. During this time the shaking starting again. First it started in bed and I crossed my arms they started shaking After getting up and sitting in chair legs started shaking went to VA ED shaking was enough to cause bed to shake Dr asked me a few questions an then sent me home. a few days later

went to Dartmouth ED was hitched to heart monitor and legs were shaking enough to that nurse had to move probe as it was recording Respiratory of 110. Dr had no answer as to why I was shaking and sent me home. At the time I was drinking low NA V8 but not all the time. I then drank it more and for about 6 months shaking stopped. now it is back as well as the shortness of breath. Since I am hard to get blood from can not trust K is what test shows it is. 64 y old N.H. Vet with possable PA BP readings as high 199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fulid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left kidney which measures 34 HU, greater than expected for a simple cyst. 3 NEG stress tests 2 NEG EHCO

meds I now take and was on for the two PRA ratio test. PAR ratio wasn't high to DX PAATENOLOL25MG TRIAMTERENE50MG POTASSIUM CHLORIDE 20MEQ FUROSEMIDE 60MG TAB.Information from first Test done at the VA and quest labs. RENIN: 1.8 ng/mL/hrCurrent Range 0.65-5.0 ng/mL/hrSERUM ALDOS: 16 ng/dL Current adult reference range:Upright 8:00-10:00 am < or = 28 ng/dLUpright 4:00-6:00 pm < or = 21 ng/dLSupine 8:00-10:00 am 3-16 ng/dLTest done At Dartmouth RENIN ACTIVITY .8 no range givenALDOSTERONE 5.5 range <=21> > > > > > > > > > >> > > > > > > > > > > So, what are you doing now? What was your BP during the visit? Did you ask him to try eplerenone? As we discussed here, it's for BP, not even approved for PA. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Natalia> > > > > > > > > > > > > > > > > > > > > > ÃÆ'‚ > > > > > > > > > > > > > > > > > > > > > > ________________________________> > > > > > > > > > > From: Francis

Bill SUSPECTED PA <georgewbill@>> > > > > > > > > > > To: hyperaldosteronism > > > > > > > > > > > Sent: Friday, October 28, 2011 5:45 PM> > > > > > > > > > > Subject: Re: Francis - New PCP> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ÃÆ'‚ > > > > > > > > > > > Had my visit with my new PCP at the VA Think at this point believe it was just a waste of time. When I told him I thought I had PA he told me PA is very rare That My B/P wasn't high enough

nor my K low enough to have it. Tried to tell him Pa wasn't so rare and my B/P has been close to 199/100 and my K had been 3.2. Told me low K was due to being on diuretics and my B/P was a bit higher then it should be wasn't high enough for PA. When I asked about the adrenal tumor said it is a very common finding on CT It became point less to try to get him to think I might have PA. > > > > > > > > > > > > > > > > > > > > > > 64 y old N.H. Vet with possible PA BP readings as high 199/100 K drop from 4.3 to 3.2 after being started 25 MG of HYDROCHLOROTHIAZIDE fluid retention Dizziness Fatigue Tachycardia PVC shortness of breath brain fog Not sure how to describe this but to say Kinetic Activity 2 cm tumor on left adrenal gland 2.2 cm exophytic low density lesion off the mid pole of the left kidney which measures 34 HU, greater than expected for a simple cyst. > > >

> > > > > > > > 3 NEG stress tests 2 NEG ECHO > > > > > > > > > > > > > > > > > > > & g>

[Guest guest]

Somewhat like Parkinson's. Don't seem to have problem with cramping of clawing

of hands or toes drawing up. Pain was in lower back right side did seen to

spread. There DX for this was muscle strain.

Have 3 test that show low PHOSPHATE 01 Nov 2008 PHOSPHATE 2.0 Low mg/dL

(2.5-5.0) 17 Feb 2011 PHOSPHATE 2.3 Low mg/dL (2.5-5.0) 24 Sep 2011 PHOSPHATE

2.1 Low mg/dL (2.5-5.0 When I asked My new PCP about this told me it wasn't low

enough to be concerned about.

Urine PH is still within normal range but seems to increasing in PH last three

have it as 7.5.

When the shortness of breath come on something thah is now happing a lot.

Breathing into a bag does slow down the recovery.

> > > > > > > > > > >

> > > > > > > > > > > Francis, 143/80 is better than any reading I get at the

VA. Did they take 3 and average 2 after sitting etc, etc? This is also a lot

lower than the 199/100 you've been reporting. If you assume the same range for

renin at Dartmouth, both your renin test are within range and aldo is also. I

know Dr. Grim said once you had PA but I'm not sure what he saw that made him

come to that conclusion. He usually requires a 24h urine as I recall.

> > > > > > > > > > >

> > > > > > > > > > > Have you ever tried stopping the atenolol? Both it and

lisinopril are ACE inhibitors and if I understand it correctly work on

angiotenisn which starts as renin. Since my renin was =

>

[Guest guest]

Forget to reply to the tingling. None in face but sometimes in hands and legs go

to sleep more often that what I think is normal. Sometimes I know that sitting

certain ways hand having legs go to sleep is normal But sometimes sitting normal

for short time and they will go to sleep.

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

> > > > > > > > > > > > Francis, 143/80 is better than any reading I get at the

VA. Did they take 3 and average 2 after sitting etc, etc? This is also a lot

lower than the 199/100 you've been reporting. If you assume the same range for

renin at Dartmouth, both your renin test are within range and aldo is also. I

know Dr. Grim said once you had PA but I'm not sure what he saw that made him

come to that conclusion. He usually requires a 24h urine as I recall.

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

> > > > > > > > > > > > Have you ever tried stopping the atenolol? Both it and

lisinopril are ACE inhibitors and if I understand it correctly work on

angiotenisn which starts as renin. Since my renin was =

> >

>

[Guest guest]

Bag only works if sob is due to anxiety and hyperventilation. I would ignore u ph does not tell us much over than you are prob reabsorbing Na and excreting K and H+ due to excess salt intake for your Aldo state. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Somewhat like Parkinson's. Don't seem to have problem with cramping of clawing of hands or toes drawing up. Pain was in lower back right side did seen to spread. There DX for this was muscle strain.

Have 3 test that show low PHOSPHATE 01 Nov 2008 PHOSPHATE 2.0 Low mg/dL (2.5-5.0) 17 Feb 2011 PHOSPHATE 2.3 Low mg/dL (2.5-5.0) 24 Sep 2011 PHOSPHATE 2.1 Low mg/dL (2.5-5.0 When I asked My new PCP about this told me it wasn't low enough to be concerned about.

Urine PH is still within normal range but seems to increasing in PH last three have it as 7.5.

When the shortness of breath come on something thah is now happing a lot. Breathing into a bag does slow down the recovery.

> > > > > > > > > > >

> > > > > > > > > > > Francis, 143/80 is better than any reading I get at the VA. Did they take 3 and average 2 after sitting etc, etc? This is also a lot lower than the 199/100 you've been reporting. If you assume the same range for renin at Dartmouth, both your renin test are within range and aldo is also. I know Dr. Grim said once you had PA but I'm not sure what he saw that made him come to that conclusion. He usually requires a 24h urine as I recall.

> > > > > > > > > > >

> > > > > > > > > > > Have you ever tried stopping the atenolol? Both it and lisinopril are ACE inhibitors and if I understand it correctly work on angiotenisn which starts as renin. Since my renin was =

>