Re: Stowasser et al, Lab. Investigation of PA Discussion

[Guest guest]

They seem to make a point for eplerenone over spirolactone due to its " neglible

blockade of the androgen receptor " .

Is there any reason to be on Spiro other than cost? (This is NOT intended to be

gender specific.) I sometimes wonder what the " extre junk " does to the female

body systems!

- 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): 125/73

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

Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

>

> I have started a new thread because this review article raised a bunch of

questions for me.

>

> They recommend rescanning tumors not removed be scanned at 6mos, 12mos and

then every 3-5yrs.

>

> This appears to be a choice between rediation or a potential growing tumor

hence cancer maybe. ??

>

> I have heard suggestions that rescanning is " not necessary " , how do you know

all is well?

>

> - 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): 125/73

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

> Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

>

[Guest guest]

They suggest determining the extent renin becomes 'unsuppressed' is a useful

indication of the degree of blockade of aldosterone effect.

Is this a test that should be employed as we try to determine the correct dose?

Is this a valid test to be sure PA isn't starting to reappear prior to

uncontrolled BP?

- 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): 125/73

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

Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> >

> > I have started a new thread because this review article raised a bunch of

questions for me.

> >

> > They recommend rescanning tumors not removed be scanned at 6mos, 12mos and

then every 3-5yrs.

> >

> > This appears to be a choice between rediation or a potential growing tumor

hence cancer maybe. ??

> >

> > I have heard suggestions that rescanning is " not necessary " , how do you know

all is well?

> >

> > - 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): 125/73

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

> > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> >

>

[Guest guest]

The statement, " if PA was longstanding it may take some time for 'complete'

blockade of the mineralocorticoid receptor to result in renin becoming

'unsurpressed'. " raises a couple of questions.

I have established that it " took 10 months for spiro to fully work " . We have

credited this as an excess NA problem. I now wonder if this was a major

contributing factor? Has anybody tried to quantify " some time " ? I wonder if

this is a reason many doctors titrate MCBs too high and too fast (IMHO)!

- 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): 125/73

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

Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > >

> > > I have started a new thread because this review article raised a bunch of

questions for me.

> > >

> > > They recommend rescanning tumors not removed be scanned at 6mos, 12mos and

then every 3-5yrs.

> > >

> > > This appears to be a choice between rediation or a potential growing tumor

hence cancer maybe. ??

> > >

> > > I have heard suggestions that rescanning is " not necessary " , how do you

know all is well?

> > >

> > > - 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): 125/73

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

> > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200

MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > >

> >

>

[Guest guest]

Makes me wonder how standard it is to even check renin after starting MCBs. I

was only on spiro for a short time but all that was ever checked was my BP and

my K.

> > > >

> > > > I have started a new thread because this review article raised a bunch

of questions for me.

> > > >

> > > > They recommend rescanning tumors not removed be scanned at 6mos, 12mos

and then every 3-5yrs.

> > > >

> > > > This appears to be a choice between rediation or a potential growing

tumor hence cancer maybe. ??

> > > >

> > > > I have heard suggestions that rescanning is " not necessary " , how do you

know all is well?

> > > >

> > > > - 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):

125/73

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

> > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200

MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > >

> > >

> >

>

[Guest guest]

" given that aldosterone excess is now known to induce adverse cardiovascular

effects independently of its effects on blood pressure "

causes my final questions for now. I am particularly addressing LVH, OSA and DM

at this point. (I am not nieve enough to think this is the ONLY mitigating

factor but wonder how much a contributing factor it might be!)

By my estimation it took a long time to resolve, 10 mos after BP resolution. Is

the reversal, if there is any, sequential also? (Do other adverse conditions

occur prior to BP going north?)

Should all this hinge on a periodic urine test?

Is all the previous a good reason to reopen the review and reconsider surgery

over meds if one has a tumor? PA snuck up on me once, how do I keep it from

happening twice? (Fool me once etc, fool me twice...!

- 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): 125/73

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

Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > >

> > > > I have started a new thread because this review article raised a bunch

of questions for me.

> > > >

> > > > They recommend rescanning tumors not removed be scanned at 6mos, 12mos

and then every 3-5yrs.

> > > >

> > > > This appears to be a choice between rediation or a potential growing

tumor hence cancer maybe. ??

> > > >

> > > > I have heard suggestions that rescanning is " not necessary " , how do you

know all is well?

> > > >

> > > > - 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):

125/73

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

> > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200

MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > >

> > >

> >

>

[Guest guest]

Yes, it happened to me twice already. I was excellent on 50 mg of eplerenone and 40 mg Micardis for about 7.5 months. All of a sudden, I started to feel much worse and in 5 days my BP spiked to 200/120, when it was 125/75 almost always all these 7.5 months. I was hospitalized twice during August - September. Now I am on twice more eplerenone and twice more Micardis. My BP goes pretty well down to normal with occasional spikes, but I feel very badly and have good days maybe once a week, even if I am Dashing much more. Unfortunately for me surgery is not an option, since AVS showed that my right clean adrenal produces more hormones that left one with adenoma. I don't know what is the explanation for doing badly after such an excellent period of time.

Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.To: hyperaldosteronism Sent: Monday, October 17, 2011 6:09 PMSubject: Re: Stowasser et al, Lab. Investigation of PA Discussion

"given that aldosterone excess is now known to induce adverse cardiovascular effects independently of its effects on blood pressure"

causes my final questions for now. I am particularly addressing LVH, OSA and DM at this point. (I am not nieve enough to think this is the ONLY mitigating factor but wonder how much a contributing factor it might be!)

By my estimation it took a long time to resolve, 10 mos after BP resolution. Is the reversal, if there is any, sequential also? (Do other adverse conditions occur prior to BP going north?)

Should all this hinge on a periodic urine test?

Is all the previous a good reason to reopen the review and reconsider surgery over meds if one has a tumor? PA snuck up on me once, how do I keep it from happening twice? (Fool me once etc, fool me twice...!

- 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): 125/73

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

Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > >

> > > > I have started a new thread because this review article raised a bunch of questions for me.

> > > >

> > > > They recommend rescanning tumors not removed be scanned at 6mos, 12mos and then every 3-5yrs.

> > > >

> > > > This appears to be a choice between rediation or a potential growing tumor hence cancer maybe. ??

> > > >

> > > > I have heard suggestions that rescanning is "not necessary", how do you know all is well?

> > > >

> > > > - 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): 125/73

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

> > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > >

> > >

> >

>

[Guest guest]

One needs to balance the risk and costs of repeat scanning IMHO. If you go to pubmed there is a recent review from the German PA registry with 400 + pts and see what they are doing. In 45 years I have only see one adrenal cancer and it was 6 cm and could be seen on a routine IVP-an old test for RAS. So the big ones are better taken out I would agree with that but no controlled series. CE Grim MD I have started a new thread because this review article raised a bunch of questions for me. They recommend rescanning tumors not removed be scanned at 6mos, 12mos and then every 3-5yrs. This appears to be a choice between rediation or a potential growing tumor hence cancer maybe. ?? I have heard suggestions that rescanning is "not necessary", how do you know all is well? - 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): 125/73 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

[Guest guest]

Could be but I think the BP and how the pt is feeling (and you have to tell your Dr if yo do not feel well) is the best indicator if the aldo salt poisoning is not being blocked enough.CE Grim MD They suggest determining the extent renin becomes 'unsuppressed' is a useful indication of the degree of blockade of aldosterone effect. Is this a test that should be employed as we try to determine the correct dose? Is this a valid test to be sure PA isn't starting to reappear prior to uncontrolled BP? - 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): 125/73 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > I have started a new thread because this review article raised a bunch of questions for me. > > > > They recommend rescanning tumors not removed be scanned at 6mos, 12mos and then every 3-5yrs. > > > > This appears to be a choice between rediation or a potential growing tumor hence cancer maybe. ?? > > > > I have heard suggestions that rescanning is "not necessary", how do you know all is well? > > > > - 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): 125/73 > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > >

[Guest guest]

There has not really been a good study looking at this. Again the BP and how the pt feels is the most important issue.At least till we learn more.CE Grim MD Makes me wonder how standard it is to even check renin after starting MCBs. I was only on spiro for a short time but all that was ever checked was my BP and my K. > > > > > > > > I have started a new thread because this review article raised a bunch of questions for me. > > > > > > > > They recommend rescanning tumors not removed be scanned at 6mos, 12mos and then every 3-5yrs. > > > > > > > > This appears to be a choice between rediation or a potential growing tumor hence cancer maybe. ?? > > > > > > > > I have heard suggestions that rescanning is "not necessary", how do you know all is well? > > > > > > > > - 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): 125/73 > > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > >

[Guest guest]

aldo excess is not known to produce problems in the absence of excess salt is my interpretation of the lit and physiology.CE Grim MD "given that aldosterone excess is now known to induce adverse cardiovascular effects independently of its effects on blood pressure" causes my final questions for now. I am particularly addressing LVH, OSA and DM at this point. (I am not nieve enough to think this is the ONLY mitigating factor but wonder how much a contributing factor it might be!) By my estimation it took a long time to resolve, 10 mos after BP resolution. Is the reversal, if there is any, sequential also? (Do other adverse conditions occur prior to BP going north?) Should all this hinge on a periodic urine test? Is all the previous a good reason to reopen the review and reconsider surgery over meds if one has a tumor? PA snuck up on me once, how do I keep it from happening twice? (Fool me once etc, fool me twice...! - 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): 125/73 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > I have started a new thread because this review article raised a bunch of questions for me. > > > > > > > > They recommend rescanning tumors not removed be scanned at 6mos, 12mos and then every 3-5yrs. > > > > > > > > This appears to be a choice between rediation or a potential growing tumor hence cancer maybe. ?? > > > > > > > > I have heard suggestions that rescanning is "not necessary", how do you know all is well? > > > > > > > > - 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): 125/73 > > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > >

[Guest guest]

It is my opinion that you are on too many BP meds for the situation. But then I am not seeing you like your reg team is.Mature small women can be very sensitive to BP meds IME. CEGrim MD Yes, it happened to me twice already. I was excellent on 50 mg of eplerenone and 40 mg Micardis for about 7.5 months. All of a sudden, I started to feel much worse and in 5 days my BP spiked to 200/120, when it was 125/75 almost always all these 7.5 months. I was hospitalized twice during August - September. Now I am on twice more eplerenone and twice more Micardis. My BP goes pretty well down to normal with occasional spikes, but I feel very badly and have good days maybe once a week, even if I am Dashing much more. Unfortunately for me surgery is not an option, since AVS showed that my right clean adrenal produces more hormones that left one with adenoma. I don't know what is the explanation for doing badly after such an excellent period of time. Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.To: hyperaldosteronism Sent: Monday, October 17, 2011 6:09 PMSubject: Re: Stowasser et al, Lab. Investigation of PA Discussion "given that aldosterone excess is now known to induce adverse cardiovascular effects independently of its effects on blood pressure" causes my final questions for now. I am particularly addressing LVH, OSA and DM at this point. (I am not nieve enough to think this is the ONLY mitigating factor but wonder how much a contributing factor it might be!) By my estimation it took a long time to resolve, 10 mos after BP resolution. Is the reversal, if there is any, sequential also? (Do other adverse conditions occur prior to BP going north?) Should all this hinge on a periodic urine test? Is all the previous a good reason to reopen the review and reconsider surgery over meds if one has a tumor? PA snuck up on me once, how do I keep it from happening twice? (Fool me once etc, fool me twice...! - 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): 125/73 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > I have started a new thread because this review article raised a bunch of questions for me. > > > > > > > > They recommend rescanning tumors not removed be scanned at 6mos, 12mos and then every 3-5yrs. > > > > > > > > This appears to be a choice between rediation or a potential growing tumor hence cancer maybe. ?? > > > > > > > > I have heard suggestions that rescanning is "not necessary", how do you know all is well? > > > > > > > > - 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): 125/73 > > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > >

[Guest guest]

Dr don't always hear you when you tell them you don't feel well.

> > > >

> > > > I have started a new thread because this review article raised a

> > bunch of questions for me.

> > > >

> > > > They recommend rescanning tumors not removed be scanned at 6mos,

> > 12mos and then every 3-5yrs.

> > > >

> > > > This appears to be a choice between rediation or a potential

> > growing tumor hence cancer maybe. ??

> > > >

> > > > I have heard suggestions that rescanning is " not necessary " , how

> > do you know all is well?

> > > >

> > > > - 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): 125/73

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

> > and PTSD.

> > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol

> > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50

> > MG.

> > > >

> > >

> >

> >

>

[Guest guest]

This is the only German study I found and it only had 37 PTNs. Since they were

looking at idiopathic bilateral adrenal hyperplasia (IHA), I believe surgery

was not available and even if it was would the remission guarantee the tumor was

not growing or changing? You say you have only seen one w/cancer, How many have

the Oncology Dept. seen?

Spontaneous Remission of Idiopathic Aldosteronism after long-term treatment with

Spironolactone: Results from the German Conn's Registry

Fischer1

Main outcome measures & #8194; Complete remission of IHA was defined as normal

aldosterone to renin ratio, normal suppression test, normalization of

hypokalemia in the presence of normal blood pressure. Partial remission was

defined as normalization of normal aldosterone to renin ratio, normal

suppression test, normalization of hypokalemia in the presence of persistent

hypertension.

Results & #8194; The mean period of MR antagonist treatment was 5.8+0.7 years in

the patients. We identified 2 of 37 (5.4%) patients with spontaneous remission,

one with complete

- 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, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

>

> > I have started a new thread because this review article raised a

> > bunch of questions for me.

> >

> > They recommend rescanning tumors not removed be scanned at 6mos,

> > 12mos and then every 3-5yrs.

> >

> > This appears to be a choice between rediation or a potential growing

> > tumor hence cancer maybe. ??

> >

> > I have heard suggestions that rescanning is " not necessary " , how do

> > you know all is well?

> >

> > - 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): 125/73

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

> > PTSD.

> > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate

> > 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> >

> >

>

[Guest guest]

In an ideal world you might be right but if it was an ideal world I would never

ment you!

Now consider your back and testis ache every waking moment, you sleep a max of 1

1/2 hours at a time and maybe 5 hrs/night, you are on methadone and oxycodone.

You have been DXed w/COPD & O2 (and BTW your childhood sweetheart of 3yrs just

died of COPD 2 months ago) When they ask you how you feel and have you ever

considered hurting yourself you respond that you don't think anything could be

worse! (That gets you an invite to the backroom with a couple " wierd thinking "

individuals!)

I've set the stage, now do I assume salt poison for 10mos, test to see if renin

is unsuppressed or just bag the whole thing and have the tumor removed?

- 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, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > >

> > > > I have started a new thread because this review article raised a

> > bunch of questions for me.

> > > >

> > > > They recommend rescanning tumors not removed be scanned at 6mos,

> > 12mos and then every 3-5yrs.

> > > >

> > > > This appears to be a choice between rediation or a potential

> > growing tumor hence cancer maybe. ??

> > > >

> > > > I have heard suggestions that rescanning is " not necessary " , how

> > do you know all is well?

> > > >

> > > > - 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): 125/73

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

> > and PTSD.

> > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol

> > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50

> > MG.

> > > >

> > >

> >

> >

>

[Guest guest]

There are obviously co-morbid and preexisting conditions - is there not? - or is all and everything only tied into PA (I can see how alot could be and feel it's grand scope is under estimated)? How do you blame the conditions on only PA as I thought you have said in other postings the other conditions come from other life experiences and other issues - like the PTSD.

Subject: Re: Stowasser et al, Lab. Investigation of PA DiscussionTo: hyperaldosteronism Date: Tuesday, October 18, 2011, 11:13 AM

In an ideal world you might be right but if it was an ideal world I would never ment you!Now consider your back and testis ache every waking moment, you sleep a max of 1 1/2 hours at a time and maybe 5 hrs/night, you are on methadone and oxycodone. You have been DXed w/COPD & O2 (and BTW your childhood sweetheart of 3yrs just died of COPD 2 months ago) When they ask you how you feel and have you ever considered hurting yourself you respond that you don't think anything could be worse! (That gets you an invite to the backroom with a couple "wierd thinking" individuals!)I've set the stage, now do I assume salt poison for 10mos, test to see if renin is unsuppressed or just bag the whole thing and have the tumor removed? - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60Other Issues/Opportunities: OSA w Bi-Pap settings

13/19, DM2, and PTSD.Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > >> > > > I have started a new thread because this review article raised a > > bunch of questions for me.> > > >> > > > They recommend rescanning tumors not removed be scanned at 6mos, > > 12mos and then every 3-5yrs.> > > >> > > > This appears to be a choice between rediation or a potential > > growing tumor hence cancer maybe. ??> > > >> > > > I have heard suggestions that rescanning is "not necessary", how > > do you know all is well?> > > >> > > > - 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): 125/73> > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, > > and PTSD.> > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol > > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 > > MG.> > > >> > >> >> >>

[Guest guest]

Sorry if you misunderstood, I was intending to make NO implication of

cause/effect. I was just describing SXs when the doctor asked how I was feeling

since that and BP was how to determine if there is excess aldosterone. Would

you assume co-morbid conditions were related to PA? How many PTN have you seen

DXed with COPD on full time oxygen resolve? (My understanding there is usually

either an operation or a box involved but I am only aware of one so I can say it

happens 100% of the time!)

Let me restate. I walk into your office and my BP is 123/72 and you ask, " How

do you feel " ? I respond, " My balls ache, my back aches, I can't breathe, I

can't sleep, they say I have COPD and my first girlfriend just died from it at

age 62 and I haven't had sex in five years because something is causing ED! "

" You ask how I feel, I feel like shit, I might be better off dead!)

Your DX? Is my renin level w/i range? (Aldosterone " should " be okay, it has

never been " out of range " , remember I was DXed w/low renin HTN!)

- 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, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > >

> > > > > I have started a new thread because this review article raised a

> > > bunch of questions for me.

> > > > >

> > > > > They recommend rescanning tumors not removed be scanned at 6mos,

> > > 12mos and then every 3-5yrs.

> > > > >

> > > > > This appears to be a choice between rediation or a potential

> > > growing tumor hence cancer maybe. ??

> > > > >

> > > > > I have heard suggestions that rescanning is " not necessary " , how

> > > do you know all is well?

> > > > >

> > > > > - 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): 125/73

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

> > > and PTSD.

> > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol

> > > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50

> > > MG.

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

Gotchya....it's like don't ask if you don't want the answer. At the heighth of the PA I had so many symptoms I would get cut off so often and then just get pissed or frustrated. I call it now directed conversation wherein they ask, but don't want to really know, and then do not really get the whole picture because they don't gather all the info.

Subject: Re: Stowasser et al, Lab. Investigation of PA DiscussionTo: hyperaldosteronism Date: Tuesday, October 18, 2011, 1:18 PM

Sorry if you misunderstood, I was intending to make NO implication of cause/effect. I was just describing SXs when the doctor asked how I was feeling since that and BP was how to determine if there is excess aldosterone. Would you assume co-morbid conditions were related to PA? How many PTN have you seen DXed with COPD on full time oxygen resolve? (My understanding there is usually either an operation or a box involved but I am only aware of one so I can say it happens 100% of the time!)Let me restate. I walk into your office and my BP is 123/72 and you ask, "How do you feel"? I respond, "My balls ache, my back aches, I can't breathe, I can't sleep, they say I have COPD and my first girlfriend just died from it at age 62 and I haven't had sex in five years because something is causing ED!" "You ask how I feel, I feel like shit, I might be better off dead!)Your DX? Is my renin level w/i range? (Aldosterone "should" be okay, it has

never been "out of range", remember I was DXed w/low renin HTN!) - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > >> > > > > I have started a new thread because this review article raised a > > > bunch of questions for me.> > > > >> > > > > They recommend rescanning tumors not removed be scanned at 6mos, > > > 12mos and then every 3-5yrs.> > > > >> > > > > This appears to be a choice between rediation or a potential > > > growing tumor hence cancer maybe. ??> > > > >> > > > > I have heard suggestions that rescanning is "not necessary", how > > > do you know all is well?>

> > > >> > > > > - 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): 125/73> > > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, > > > and PTSD.> > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol > > > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 > > > MG.> > > > >> > > >> > >> > >> >>

[Guest guest]

I would weigh carefully the risks and benefits of surgery at your age and body physic. Don't recall how well documented adherence to DASH has been. Not an easy decision to make or recommend. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

In an ideal world you might be right but if it was an ideal world I would never ment you!

Now consider your back and testis ache every waking moment, you sleep a max of 1 1/2 hours at a time and maybe 5 hrs/night, you are on methadone and oxycodone. You have been DXed w/COPD & O2 (and BTW your childhood sweetheart of 3yrs just died of COPD 2 months ago) When they ask you how you feel and have you ever considered hurting yourself you respond that you don't think anything could be worse! (That gets you an invite to the backroom with a couple "wierd thinking" individuals!)

I've set the stage, now do I assume salt poison for 10mos, test to see if renin is unsuppressed or just bag the whole thing and have the tumor removed?

- 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, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > >

> > > > I have started a new thread because this review article raised a

> > bunch of questions for me.

> > > >

> > > > They recommend rescanning tumors not removed be scanned at 6mos,

> > 12mos and then every 3-5yrs.

> > > >

> > > > This appears to be a choice between rediation or a potential

> > growing tumor hence cancer maybe. ??

> > > >

> > > > I have heard suggestions that rescanning is "not necessary", how

> > do you know all is well?

> > > >

> > > > - 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): 125/73

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

> > and PTSD.

> > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol

> > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50

> > MG.

> > > >

> > >

> >

> >

>

[Guest guest]

I recall u are feeling better now though?Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Sorry if you misunderstood, I was intending to make NO implication of cause/effect. I was just describing SXs when the doctor asked how I was feeling since that and BP was how to determine if there is excess aldosterone. Would you assume co-morbid conditions were related to PA? How many PTN have you seen DXed with COPD on full time oxygen resolve? (My understanding there is usually either an operation or a box involved but I am only aware of one so I can say it happens 100% of the time!)

Let me restate. I walk into your office and my BP is 123/72 and you ask, "How do you feel"? I respond, "My balls ache, my back aches, I can't breathe, I can't sleep, they say I have COPD and my first girlfriend just died from it at age 62 and I haven't had sex in five years because something is causing ED!" "You ask how I feel, I feel like shit, I might be better off dead!)

Your DX? Is my renin level w/i range? (Aldosterone "should" be okay, it has never been "out of range", remember I was DXed w/low renin HTN!)

- 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, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > >

> > > > > I have started a new thread because this review article raised a

> > > bunch of questions for me.

> > > > >

> > > > > They recommend rescanning tumors not removed be scanned at 6mos,

> > > 12mos and then every 3-5yrs.

> > > > >

> > > > > This appears to be a choice between rediation or a potential

> > > growing tumor hence cancer maybe. ??

> > > > >

> > > > > I have heard suggestions that rescanning is "not necessary", how

> > > do you know all is well?

> > > > >

> > > > > - 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): 125/73

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

> > > and PTSD.

> > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol

> > > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50

> > > MG.

> > > > >

> > > >

> > >

> > >

> >

>

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[Guest guest]

. When u have to see 30 a day it is difficult impossible to do a good job. And one cannot bill for the time it takes as if u were a plumber or mechanic. Perhaps someone can find hat Medicare pays for a BP followup visit. Many will also have COPD, lipids DM Arthritis depression etc to think about as well. Today many are on many meds that also need to be thought about for one or more of these. The computer should help with this. Also it is critia l to involve pt in this management. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Gotchya....it's like don't ask if you don't want the answer. At the heighth of the PA I had so many symptoms I would get cut off so often and then just get pissed or frustrated. I call it now directed conversation wherein they ask, but don't want to really know, and then do not really get the whole picture because they don't gather all the info.

Subject: Re: Stowasser et al, Lab. Investigation of PA DiscussionTo: hyperaldosteronism Date: Tuesday, October 18, 2011, 1:18 PM

Sorry if you misunderstood, I was intending to make NO implication of cause/effect. I was just describing SXs when the doctor asked how I was feeling since that and BP was how to determine if there is excess aldosterone. Would you assume co-morbid conditions were related to PA? How many PTN have you seen DXed with COPD on full time oxygen resolve? (My understanding there is usually either an operation or a box involved but I am only aware of one so I can say it happens 100% of the time!)Let me restate. I walk into your office and my BP is 123/72 and you ask, "How do you feel"? I respond, "My balls ache, my back aches, I can't breathe, I can't sleep, they say I have COPD and my first girlfriend just died from it at age 62 and I haven't had sex in five years because something is causing ED!" "You ask how I feel, I feel like shit, I might be better off dead!)Your DX? Is my renin level w/i range? (Aldosterone "should" be okay, it has

never been "out of range", remember I was DXed w/low renin HTN!) - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > >> > > > > I have started a new thread because this review article raised a > > > bunch of questions for me.> > > > >> > > > > They recommend rescanning tumors not removed be scanned at 6mos, > > > 12mos and then every 3-5yrs.> > > > >> > > > > This appears to be a choice between rediation or a potential > > > growing tumor hence cancer maybe. ??> > > > >> > > > > I have heard suggestions that rescanning is "not necessary", how > > > do you know all is well?>

> > > >> > > > > - 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): 125/73> > > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, > > > and PTSD.> > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol > > > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 > > > MG.> > > > >> > > >> > >> > >> >>

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[Guest guest]

Causing Conn's only very rare is what most say. THIS would be an excellent query for the VA data base. Or even Medicare records. Which can be done if funding were available. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

This is the only German study I found and it only had 37 PTNs. Since they were looking at idiopathic bilateral adrenal hyperplasia (IHA), I believe surgery was not available and even if it was would the remission guarantee the tumor was not growing or changing? You say you have only seen one w/cancer, How many have the Oncology Dept. seen?

Spontaneous Remission of Idiopathic Aldosteronism after long-term treatment with Spironolactone: Results from the German Conn's Registry

Fischer1

Main outcome measures & #8194; Complete remission of IHA was defined as normal aldosterone to renin ratio, normal suppression test, normalization of hypokalemia in the presence of normal blood pressure. Partial remission was defined as normalization of normal aldosterone to renin ratio, normal suppression test, normalization of hypokalemia in the presence of persistent hypertension.

Results & #8194; The mean period of MR antagonist treatment was 5.8+0.7 years in the patients. We identified 2 of 37 (5.4%) patients with spontaneous remission, one with complete

- 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, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

>

> > I have started a new thread because this review article raised a

> > bunch of questions for me.

> >

> > They recommend rescanning tumors not removed be scanned at 6mos,

> > 12mos and then every 3-5yrs.

> >

> > This appears to be a choice between rediation or a potential growing

> > tumor hence cancer maybe. ??

> >

> > I have heard suggestions that rescanning is "not necessary", how do

> > you know all is well?

> >

> > - 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): 125/73

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

> > PTSD.

> > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate

> > 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> >

> >

>

[Guest guest]

, I cleaned up my response for my female PCP - It probably would have been

more candid if it was you! ;>)

Don't ask, don't tell is not an option because that is half of determining that

MCBs are doing their job to their fullest! " BP and How PTN feels " was the

answer.

Before we loose track of the original question, it was " is there any validity

for checking that MCBs have done their job as suggested by Stowassar et al? "

What I don't know is what renin and aldo looked like at 3mos. 6mos, 9mos and

today! If it remained unchanged could I presume excess aldosterone (this path

opens a new question - since BP is good do I hold steady w/meds or increase

meds?) If I increase spiro this opens another new question, since anything

above 25mg bid causes cronic dirrhea so do I change to Eplerone or proceed to

AVS? "

Who told you doctoring was going to be easy?

I have an opinon, believe it or not, but want to see what others say first!

- 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, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > >

> > > > > > I have started a new thread because this review article raised a

> > > > bunch of questions for me.

> > > > > >

> > > > > > They recommend rescanning tumors not removed be scanned at 6mos,

> > > > 12mos and then every 3-5yrs.

> > > > > >

> > > > > > This appears to be a choice between rediation or a potential

> > > > growing tumor hence cancer maybe. ??

> > > > > >

> > > > > > I have heard suggestions that rescanning is " not necessary " , how

> > > > do you know all is well?

> > > > > >

> > > > > > - 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): 125/73

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

> > > > and PTSD.

> > > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol

> > > > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50

> > > > MG.

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

Whatchutalkingbout! The surgeon I talked with normally does gastric bypass

laporoscopic surgery, he thought I was small! Maybe he could do a 2for! (64 is

only old by previous stds.!)

> > > > > >

> > > > > > I have started a new thread because this review article raised a

> > > > bunch of questions for me.

> > > > > >

> > > > > > They recommend rescanning tumors not removed be scanned at 6mos,

> > > > 12mos and then every 3-5yrs.

> > > > > >

> > > > > > This appears to be a choice between rediation or a potential

> > > > growing tumor hence cancer maybe. ??

> > > > > >

> > > > > > I have heard suggestions that rescanning is " not necessary " , how

> > > > do you know all is well?

> > > > > >

> > > > > > - 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): 125/73

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

> > > > and PTSD.

> > > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol

> > > > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50

> > > > MG.

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Renin has to be high enough to cause you to retain x amount of K Since high Aldo

causes low renin. Then I would think Aldo needs to be blocked to X amount. We do

not know what the X amount needs to be. What would we be looking for. Is there

any point in testing for the unknown amounts?

> > > > > > >

> > > > > > > I have started a new thread because this review article raised a

> > > > > bunch of questions for me.

> > > > > > >

> > > > > > > They recommend rescanning tumors not removed be scanned at 6mos,

> > > > > 12mos and then every 3-5yrs.

> > > > > > >

> > > > > > > This appears to be a choice between rediation or a potential

> > > > > growing tumor hence cancer maybe. ??

> > > > > > >

> > > > > > > I have heard suggestions that rescanning is " not necessary " , how

> > > > > do you know all is well?

> > > > > > >

> > > > > > > - 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): 125/73

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

> > > > > and PTSD.

> > > > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol

> > > > > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50

> > > > > MG.

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

I have 2 reports that have all 3 numbers:

2/22/2007 R=0.1, A=5, K=3.6

7/08/2010 R=0.51, A=15, K=4.6 (On 25mg Spiro for ~1mo)

Since I have never seen renin high can you explain that?

- 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, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > > > >

> > > > > > > > I have started a new thread because this review article raised a

> > > > > > bunch of questions for me.

> > > > > > > >

> > > > > > > > They recommend rescanning tumors not removed be scanned at 6mos,

> > > > > > 12mos and then every 3-5yrs.

> > > > > > > >

> > > > > > > > This appears to be a choice between rediation or a potential

> > > > > > growing tumor hence cancer maybe. ??

> > > > > > > >

> > > > > > > > I have heard suggestions that rescanning is " not necessary " , how

> > > > > > do you know all is well?

> > > > > > > >

> > > > > > > > - 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): 125/73

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

> > > > > > and PTSD.

> > > > > > > > Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol

> > > > > > Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50

> > > > > > MG.

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>