Guest guest Posted November 13, 2011 Report Share Posted November 13, 2011 Thank you for sharing your good news. I hope your husband's BP continues to go down. Lucy Sage Sent from my Verizon Wireless Phone Morton wrote: >Husband is on day 6 of DASH, V8, high K diet. Highest morning BP (upon >waking) has been 140/100 (down from 170/115). Daytime BP's for the first >time in YEARS in the 120-130/80-90 range (was rarely below 160/100 during >the day). He feels great I am SO relieved that his BP is stable. Working on >weaning off of BP meds (except Inspra). Less than a month until >adrenalectomy and grateful his BP is now stable going into surgery. Will >keep you posted, but wanted to update and thank you! > > > > > >> ** >> >> >> Suspect he needs more eplere and diet K and less Na. >> Many of themeds u >> He is on don't work IN. PA and most can control BP WITH only MCB and DASH >> >> >> May your pressure be low! >> >> CE Grim MS, MD >> Specializing in Difficult >> Hypertension >> >> >> >> >> >> >> Thanks for your response. >> He's never been on spiro. Only reason is he was given choice by MD to go >> w/spiro or inspra and inspra seemed to have less side effects. >> Did read your article which was helpful in understanding PA, however have >> not had an opportunity to share w/his neph. Plan to this week. >> Will ask neph for the urine Na and K to see what he needs to on the dash >> plan and have him start V8. >> Thank you for getting the info needed to start conversation w/his doctor! >> >> >> >> >>> ** >>> >>> >>> Yes have Neph check urine Na and K to see what he needs to do on the >>> DASH PLAN. Strong FH of stroke suggests GRA ESP if I bump on adrenal >>> scans. >>> >>> Eplerenone does is low for severe PA WAS HE EVER on Spiro? >>> >>> I can assure you once he begins to DASH TO the max as validAted by urine >>> N and k Bp will become much better and he will feel like a new man. Many of >>> the meds he is on do not work on PA. HAVE you or your Neph not yet read my >>> evolution of PA Article. If not you will not understand >>> The problem. >>> >>> >>> >>> May your pressure be low! >>> >>> CE Grim MS, MD >>> Specializing in Difficult >>> Hypertension >>> >>> >>> >>> >>> >>> Hi, >>> New to this group, but glad I found it. It's nice to know that my husband >>> is not the only one that had a long road to diagnosis and treatment. >>> >>> My husband is 42 yo., slightly overweight. Started having severe BP >>> issues about 4 years ago out of the blue after being completely healthy. >>> Also started having anxiety and depression at same time. Diagnosed w/ PA 2 >>> years ago after undergoing testing/labs for PA. Had to take 120meq of K per >>> day x 6 mo when first dx d/t levels around 2.2. Thankfully His K has been >>> pretty stable recently on 20 meq twice daily. He is currently managed by >>> nephrologist. They did a CT scan 1.5 years ago and did not see any tumors. >>> Managed w/meds OK (with frequent adjustments) until about 6 months ago when >>> nothing he takes seems to work at all except prn clonidine which we >>> recently found out causes rebound hypertension. A " good " BP for him lately >>> has been anything below 160/100. Spikes often as high as 190 for systolic >>> and 156 for diastolic. Crazy. He can barely make it through the work week, >>> is exhausted and just drained all the time. >>> >>> His nephrologist order the AVS in Sept. AVS showed the left adrenal >>> producing way excessive amounts of aldosterone. He was referred to surgeon >>> and set for adrenaletcomy in middle of Dec. >>> >>> So, my only goal in life is to ensure he does not have a stroke between >>> down and then. He has been trying to adapt to the dash diet (admittedly he >>> has some work to do on this). He has a huge family hx of strokes and high >>> BP. HIs nephrologist has been responsive to the need for med changes, but >>> difficulty finding a combo that works. Just added the hydralazine last week >>> which has helped quite a bit, but still having really high spikes. He's >>> currently taking the following for BP: >>> >>> inspra 100mg once daily >>> atenolol 100mg once daily >>> lisinopril 20mg once daily >>> imdur 60mg once daily >>> hydralazine 40mg three times daily >>> clonidine 0.1mg (prn for systolic BP over 160) >>> >>> Any other recommendations for managing BP until surgery? We are grateful >>> for the light at the end of the tunnel w/adrenalectomy. I read several of >>> the posts here on adrenalectomy stories which have been very helpful. >>> >>> Thanks! >>> >>> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2011 Report Share Posted November 13, 2011 DASH AWAY DASH AWAY DASH AWAY ALL. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension Thank you for sharing your good news. I hope your husband's BP continues to go down. Lucy Sage Sent from my Verizon Wireless Phone Morton wrote: >Husband is on day 6 of DASH, V8, high K diet. Highest morning BP (upon >waking) has been 140/100 (down from 170/115). Daytime BP's for the first >time in YEARS in the 120-130/80-90 range (was rarely below 160/100 during >the day). He feels great I am SO relieved that his BP is stable. Working on >weaning off of BP meds (except Inspra). Less than a month until >adrenalectomy and grateful his BP is now stable going into surgery. Will >keep you posted, but wanted to update and thank you! > > > > > >> ** >> >> >> Suspect he needs more eplere and diet K and less Na. >> Many of themeds u >> He is on don't work IN. PA and most can control BP WITH only MCB and DASH >> >> >> May your pressure be low! >> >> CE Grim MS, MD >> Specializing in Difficult >> Hypertension >> >> >> >> >> >> >> Thanks for your response. >> He's never been on spiro. Only reason is he was given choice by MD to go >> w/spiro or inspra and inspra seemed to have less side effects. >> Did read your article which was helpful in understanding PA, however have >> not had an opportunity to share w/his neph. Plan to this week. >> Will ask neph for the urine Na and K to see what he needs to on the dash >> plan and have him start V8. >> Thank you for getting the info needed to start conversation w/his doctor! >> >> >> >> >>> ** >>> >>> >>> Yes have Neph check urine Na and K to see what he needs to do on the >>> DASH PLAN. Strong FH of stroke suggests GRA ESP if I bump on adrenal >>> scans. >>> >>> Eplerenone does is low for severe PA WAS HE EVER on Spiro? >>> >>> I can assure you once he begins to DASH TO the max as validAted by urine >>> N and k Bp will become much better and he will feel like a new man. Many of >>> the meds he is on do not work on PA. HAVE you or your Neph not yet read my >>> evolution of PA Article. If not you will not understand >>> The problem. >>> >>> >>> >>> May your pressure be low! >>> >>> CE Grim MS, MD >>> Specializing in Difficult >>> Hypertension >>> >>> >>> >>> >>> >>> Hi, >>> New to this group, but glad I found it. It's nice to know that my husband >>> is not the only one that had a long road to diagnosis and treatment. >>> >>> My husband is 42 yo., slightly overweight. Started having severe BP >>> issues about 4 years ago out of the blue after being completely healthy. >>> Also started having anxiety and depression at same time. Diagnosed w/ PA 2 >>> years ago after undergoing testing/labs for PA. Had to take 120meq of K per >>> day x 6 mo when first dx d/t levels around 2.2. Thankfully His K has been >>> pretty stable recently on 20 meq twice daily. He is currently managed by >>> nephrologist. They did a CT scan 1.5 years ago and did not see any tumors. >>> Managed w/meds OK (with frequent adjustments) until about 6 months ago when >>> nothing he takes seems to work at all except prn clonidine which we >>> recently found out causes rebound hypertension. A "good" BP for him lately >>> has been anything below 160/100. Spikes often as high as 190 for systolic >>> and 156 for diastolic. Crazy. He can barely make it through the work week, >>> is exhausted and just drained all the time. >>> >>> His nephrologist order the AVS in Sept. AVS showed the left adrenal >>> producing way excessive amounts of aldosterone. He was referred to surgeon >>> and set for adrenaletcomy in middle of Dec. >>> >>> So, my only goal in life is to ensure he does not have a stroke between >>> down and then. He has been trying to adapt to the dash diet (admittedly he >>> has some work to do on this). He has a huge family hx of strokes and high >>> BP. HIs nephrologist has been responsive to the need for med changes, but >>> difficulty finding a combo that works. Just added the hydralazine last week >>> which has helped quite a bit, but still having really high spikes. He's >>> currently taking the following for BP: >>> >>> inspra 100mg once daily >>> atenolol 100mg once daily >>> lisinopril 20mg once daily >>> imdur 60mg once daily >>> hydralazine 40mg three times daily >>> clonidine 0.1mg (prn for systolic BP over 160) >>> >>> Any other recommendations for managing BP until surgery? We are grateful >>> for the light at the end of the tunnel w/adrenalectomy. I read several of >>> the posts here on adrenalectomy stories which have been very helpful. >>> >>> Thanks! >>> >>> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2011 Report Share Posted November 13, 2011 Is someone in the Christmas spirit? lol ============================================================================45-Male-Caucasian, 5'9"- 242lbs, PA Diagnosed 2007 Suspected Hyperplasia-No tumors on CT - No AVS.Meds: 50mg Inspra, 40meq Potassium, 2400mg Calcium, 1000mg Magnesium, 100,000UI Vit D (weekly), 20mg OmeprazoleSide effects: Gynecomastia, stomach inflammation (from potassium citrate)Other Diags: GERD, Hiatal Hernia, Metabolic Syndrome - PreDiabetic, Secondary Hyperparathyroidism caused by Renal calcium leak, Bone Cyct in left Femoral Head and Pelvis. Benign Lung Nodules, Fibromyalgia, Scarring on Right Kidney Lower Pole, Right Flank PainDASH: Started "sort of" DASHing 5/3/2011Status: Last Urine K/Na ratio was 1.1. But total of Na high alsoInitial Presenting Symptom: Muscle twitching all over body with low normal K, Mg, Ca, Low Ionized Ca, High PTH, low Vitamin DTo: "hyperaldosteronism " <hyperaldosteronism >Sent: Sunday, November 13, 2011 8:23 PMSubject: Re: new here DASH AWAY DASH AWAY DASH AWAY ALL. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension Thank you for sharing your good news. I hope your husband's BP continues to go down. Lucy Sage Sent from my Verizon Wireless Phone Morton wrote: >Husband is on day 6 of DASH, V8, high K diet. Highest morning BP (upon >waking) has been 140/100 (down from 170/115). Daytime BP's for the first >time in YEARS in the 120-130/80-90 range (was rarely below 160/100 during >the day). He feels great I am SO relieved that his BP is stable. Working on >weaning off of BP meds (except Inspra). Less than a month until >adrenalectomy and grateful his BP is now stable going into surgery. Will >keep you posted, but wanted to update and thank you! > > > > > >> ** >> >> >> Suspect he needs more eplere and diet K and less Na. >> Many of themeds u >> He is on don't work IN. PA and most can control BP WITH only MCB and DASH >> >> >> May your pressure be low! >> >> CE Grim MS, MD >> Specializing in Difficult >> Hypertension >> >> >> >> >> >> >> Thanks for your response. >> He's never been on spiro. Only reason is he was given choice by MD to go >> w/spiro or inspra and inspra seemed to have less side effects. >> Did read your article which was helpful in understanding PA, however have >> not had an opportunity to share w/his neph. Plan to this week. >> Will ask neph for the urine Na and K to see what he needs to on the dash >> plan and have him start V8. >> Thank you for getting the info needed to start conversation w/his doctor! >> >> >> >> >>> ** >>> >>> >>> Yes have Neph check urine Na and K to see what he needs to do on the >>> DASH PLAN. Strong FH of stroke suggests GRA ESP if I bump on adrenal >>> scans. >>> >>> Eplerenone does is low for severe PA WAS HE EVER on Spiro? >>> >>> I can assure you once he begins to DASH TO the max as validAted by urine >>> N and k Bp will become much better and he will feel like a new man. Many of >>> the meds he is on do not work on PA. HAVE you or your Neph not yet read my >>> evolution of PA Article. If not you will not understand >>> The problem. >>> >>> >>> >>> May your pressure be low! >>> >>> CE Grim MS, MD >>> Specializing in Difficult >>> Hypertension >>> >>> >>> >>> >>> >>> Hi, >>> New to this group, but glad I found it. It's nice to know that my husband >>> is not the only one that had a long road to diagnosis and treatment. >>> >>> My husband is 42 yo., slightly overweight. Started having severe BP >>> issues about 4 years ago out of the blue after being completely healthy. >>> Also started having anxiety and depression at same time. Diagnosed w/ PA 2 >>> years ago after undergoing testing/labs for PA. Had to take 120meq of K per >>> day x 6 mo when first dx d/t levels around 2.2. Thankfully His K has been >>> pretty stable recently on 20 meq twice daily. He is currently managed by >>> nephrologist. They did a CT scan 1.5 years ago and did not see any tumors. >>> Managed w/meds OK (with frequent adjustments) until about 6 months ago when >>> nothing he takes seems to work at all except prn clonidine which we >>> recently found out causes rebound hypertension. A "good" BP for him lately >>> has been anything below 160/100. Spikes often as high as 190 for systolic >>> and 156 for diastolic. Crazy. He can barely make it through the work week, >>> is exhausted and just drained all the time. >>> >>> His nephrologist order the AVS in Sept. AVS showed the left adrenal >>> producing way excessive amounts of aldosterone. He was referred to surgeon >>> and set for adrenaletcomy in middle of Dec. >>> >>> So, my only goal in life is to ensure he does not have a stroke between >>> down and then. He has been trying to adapt to the dash diet (admittedly he >>> has some work to do on this). He has a huge family hx of strokes and high >>> BP. HIs nephrologist has been responsive to the need for med changes, but >>> difficulty finding a combo that works. Just added the hydralazine last week >>> which has helped quite a bit, but still having really high spikes. He's >>> currently taking the following for BP: >>> >>> inspra 100mg once daily >>> atenolol 100mg once daily >>> lisinopril 20mg once daily >>> imdur 60mg once daily >>> hydralazine 40mg three times daily >>> clonidine 0.1mg (prn for systolic BP over 160) >>> >>> Any other recommendations for managing BP until surgery? We are grateful >>> for the light at the end of the tunnel w/adrenalectomy. I read several of >>> the posts here on adrenalectomy stories which have been very helpful. >>> >>> Thanks! >>> >>> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2011 Report Share Posted November 13, 2011 You understand the success of ADX is prob less than 50% for a cure. Reason we recommend surgery only if DASH and MCBs fail to get to goal. I do not recall age in his thumbnail. Trust you have filled out our database so you can help us help future patients.Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database.CE Grim MD Welcome to the exciting world of Hyperaldosteronism You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Your life is in the hands of those who measure your BP. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. There is a brief discussion of this in my Evolution Article. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 1-4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. I call this Dr. Grim’s “Quick Pee Test” for PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database. 8. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. Husband is on day 6 of DASH, V8, high K diet. Highest morning BP (upon waking) has been 140/100 (down from 170/115). Daytime BP's for the first time in YEARS in the 120-130/80-90 range (was rarely below 160/100 during the day). He feels great I am SO relieved that his BP is stable. Working on weaning off of BP meds (except Inspra). Less than a month until adrenalectomy and grateful his BP is now stable going into surgery. Will keep you posted, but wanted to update and thank you! Suspect he needs more eplere and diet K and less Na. Many of themeds uHe is on don't work IN. PA and most can control BP WITH only MCB and DASH May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension Thanks for your response. He's never been on spiro. Only reason is he was given choice by MD to go w/spiro or inspra and inspra seemed to have less side effects.Did read your article which was helpful in understanding PA, however have not had an opportunity to share w/his neph. Plan to this week. Will ask neph for the urine Na and K to see what he needs to on the dash plan and have him start V8.Thank you for getting the info needed to start conversation w/his doctor! Yes have Neph check urine Na and K to see what he needs to do on the DASH PLAN. Strong FH of stroke suggests GRA ESP if I bump on adrenal scans. Eplerenone does is low for severe PA WAS HE EVER on Spiro? I can assure you once he begins to DASH TO the max as validAted by urine N and k Bp will become much better and he will feel like a new man. Many of the meds he is on do not work on PA. HAVE you or your Neph not yet read my evolution of PA Article. If not you will not understand The problem. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension Hi, New to this group, but glad I found it. It's nice to know that my husband is not the only one that had a long road to diagnosis and treatment. My husband is 42 yo., slightly overweight. Started having severe BP issues about 4 years ago out of the blue after being completely healthy. Also started having anxiety and depression at same time. Diagnosed w/ PA 2 years ago after undergoing testing/labs for PA. Had to take 120meq of K per day x 6 mo when first dx d/t levels around 2.2. Thankfully His K has been pretty stable recently on 20 meq twice daily. He is currently managed by nephrologist. They did a CT scan 1.5 years ago and did not see any tumors. Managed w/meds OK (with frequent adjustments) until about 6 months ago when nothing he takes seems to work at all except prn clonidine which we recently found out causes rebound hypertension. A "good" BP for him lately has been anything below 160/100. Spikes often as high as 190 for systolic and 156 for diastolic. Crazy. He can barely make it through the work week, is exhausted and just drained all the time. His nephrologist order the AVS in Sept. AVS showed the left adrenal producing way excessive amounts of aldosterone. He was referred to surgeon and set for adrenaletcomy in middle of Dec. So, my only goal in life is to ensure he does not have a stroke between down and then. He has been trying to adapt to the dash diet (admittedly he has some work to do on this). He has a huge family hx of strokes and high BP. HIs nephrologist has been responsive to the need for med changes, but difficulty finding a combo that works. Just added the hydralazine last week which has helped quite a bit, but still having really high spikes. He's currently taking the following for BP: inspra 100mg once daily atenolol 100mg once daily lisinopril 20mg once daily imdur 60mg once daily hydralazine 40mg three times daily clonidine 0.1mg (prn for systolic BP over 160) Any other recommendations for managing BP until surgery? We are grateful for the light at the end of the tunnel w/adrenalectomy. I read several of the posts here on adrenalectomy stories which have been very helpful. Thanks! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2011 Report Share Posted November 13, 2011 Getting there! Clarence Grimlowerbp2@...Seasons Greetings and Is someone in the Christmas spirit? lol ============================================================================45-Male-Caucasian, 5'9"- 242lbs, PA Diagnosed 2007 Suspected Hyperplasia-No tumors on CT - No AVS.Meds: 50mg Inspra, 40meq Potassium, 2400mg Calcium, 1000mg Magnesium, 100,000UI Vit D (weekly), 20mg OmeprazoleSide effects: Gynecomastia, stomach inflammation (from potassium citrate)Other Diags: GERD, Hiatal Hernia, Metabolic Syndrome - PreDiabetic, Secondary Hyperparathyroidism caused by Renal calcium leak, Bone Cyct in left Femoral Head and Pelvis. Benign Lung Nodules, Fibromyalgia, Scarring on Right Kidney Lower Pole, Right Flank PainDASH: Started "sort of" DASHing 5/3/2011Status: Last Urine K/Na ratio was 1.1. But total of Na high alsoInitial Presenting Symptom: Muscle twitching all over body with low normal K, Mg, Ca, Low Ionized Ca, High PTH, low Vitamin DTo: "hyperaldosteronism " <hyperaldosteronism >Sent: Sunday, November 13, 2011 8:23 PMSubject: Re: new here DASH AWAY DASH AWAY DASH AWAY ALL. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension Thank you for sharing your good news. I hope your husband's BP continues to go down. Lucy Sage Sent from my Verizon Wireless Phone Morton wrote: >Husband is on day 6 of DASH, V8, high K diet. Highest morning BP (upon >waking) has been 140/100 (down from 170/115). Daytime BP's for the first >time in YEARS in the 120-130/80-90 range (was rarely below 160/100 during >the day). He feels great I am SO relieved that his BP is stable. Working on >weaning off of BP meds (except Inspra). Less than a month until >adrenalectomy and grateful his BP is now stable going into surgery. Will >keep you posted, but wanted to update and thank you! > > > > > >> ** >> >> >> Suspect he needs more eplere and diet K and less Na. >> Many of themeds u >> He is on don't work IN. PA and most can control BP WITH only MCB and DASH >> >> >> May your pressure be low! >> >> CE Grim MS, MD >> Specializing in Difficult >> Hypertension >> >> >> >> >> >> >> Thanks for your response. >> He's never been on spiro. Only reason is he was given choice by MD to go >> w/spiro or inspra and inspra seemed to have less side effects. >> Did read your article which was helpful in understanding PA, however have >> not had an opportunity to share w/his neph. Plan to this week. >> Will ask neph for the urine Na and K to see what he needs to on the dash >> plan and have him start V8. >> Thank you for getting the info needed to start conversation w/his doctor! >> >> >> >> >>> ** >>> >>> >>> Yes have Neph check urine Na and K to see what he needs to do on the >>> DASH PLAN. Strong FH of stroke suggests GRA ESP if I bump on adrenal >>> scans. >>> >>> Eplerenone does is low for severe PA WAS HE EVER on Spiro? >>> >>> I can assure you once he begins to DASH TO the max as validAted by urine >>> N and k Bp will become much better and he will feel like a new man. Many of >>> the meds he is on do not work on PA. HAVE you or your Neph not yet read my >>> evolution of PA Article. If not you will not understand >>> The problem. >>> >>> >>> >>> May your pressure be low! >>> >>> CE Grim MS, MD >>> Specializing in Difficult >>> Hypertension >>> >>> >>> >>> >>> >>> Hi, >>> New to this group, but glad I found it. It's nice to know that my husband >>> is not the only one that had a long road to diagnosis and treatment. >>> >>> My husband is 42 yo., slightly overweight. Started having severe BP >>> issues about 4 years ago out of the blue after being completely healthy. >>> Also started having anxiety and depression at same time. Diagnosed w/ PA 2 >>> years ago after undergoing testing/labs for PA. Had to take 120meq of K per >>> day x 6 mo when first dx d/t levels around 2.2. Thankfully His K has been >>> pretty stable recently on 20 meq twice daily. He is currently managed by >>> nephrologist. They did a CT scan 1.5 years ago and did not see any tumors. >>> Managed w/meds OK (with frequent adjustments) until about 6 months ago when >>> nothing he takes seems to work at all except prn clonidine which we >>> recently found out causes rebound hypertension. A "good" BP for him lately >>> has been anything below 160/100. Spikes often as high as 190 for systolic >>> and 156 for diastolic. Crazy. He can barely make it through the work week, >>> is exhausted and just drained all the time. >>> >>> His nephrologist order the AVS in Sept. AVS showed the left adrenal >>> producing way excessive amounts of aldosterone. He was referred to surgeon >>> and set for adrenaletcomy in middle of Dec. >>> >>> So, my only goal in life is to ensure he does not have a stroke between >>> down and then. He has been trying to adapt to the dash diet (admittedly he >>> has some work to do on this). He has a huge family hx of strokes and high >>> BP. HIs nephrologist has been responsive to the need for med changes, but >>> difficulty finding a combo that works. Just added the hydralazine last week >>> which has helped quite a bit, but still having really high spikes. He's >>> currently taking the following for BP: >>> >>> inspra 100mg once daily >>> atenolol 100mg once daily >>> lisinopril 20mg once daily >>> imdur 60mg once daily >>> hydralazine 40mg three times daily >>> clonidine 0.1mg (prn for systolic BP over 160) >>> >>> Any other recommendations for managing BP until surgery? We are grateful >>> for the light at the end of the tunnel w/adrenalectomy. I read several of >>> the posts here on adrenalectomy stories which have been very helpful. >>> >>> Thanks! >>> >>> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2011 Report Share Posted November 17, 2011 Are you taking other meds to control your bp? I am currently taking 2 others. They may end up increasing the spiro...idk. I'm just hoping my potassium doesn't drop really low b/c I was told to stop taking the supplement w/the spiro. I go for lab on Monday. Re: new here Greetings! I am about 3 weeks behind you in starting spiro. 25 mg wasn't enough for me and I had to up mine to 100 mg. But, only by monitoring my bp daily and keeping in touch with my nephorologist did I have to do that. And, I personally do take k supplementation along with magensium and when I was last in had did blood work and it showed I was in the normal range. Keep up the good work and be sure to ask lots of questions. We all can learn from each others experiences. > > Hi. I am newly diagnosed with hyperaldo. My primary Dr. started me on 25mg of Spiro. I've only been taking it for a few days. Is this dosage enough to start lowering my aldo. He also told me to stop my potassium supplements but I'm nervous about my potassium dropping even though spiro is a potassium sparing diuretic. I don't want to end up back in ER with 2.5 potassium. I'm praying this medicine actually works for me as my bp ha Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2011 Report Share Posted November 18, 2011 Lisinopril gave me a horrible cough so I will not go back on it anyways. I'm taking Norvasc and Lebetalol in addition to Spiro. Re: Re: new here Dash to need fewer meds. Remind your Dr that lisinopril will not work in PA. TAKE him my evolution article after u have read it and it will become clear. May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension > My bp sky rocketed right at the same time as I started on a very low dose of spiro so the doc had put me on Lisinopril, 10 mg. But now that the spiro is working at a higher dose so well I began to experience some dizziness. I contacted my dr and he told me I could lower the lisinopril dosage to half. > > My goal has always been to be on as few meds as possible. > So, in my quest for lower bp I lost 35 pounds, exercise regularly and eat only real whole non-processed foods. I maintain that life style and my goal is to only be on spiro and at the lowest possible dosage that maintains my bp. > > I have a .1 cm cyst on my right adrenal gland and at this time I chose to keep my adrenal Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2011 Report Share Posted November 18, 2011 I am on low salt diet and walk 30 min. - 1 hr a day. But somedays I feel horrible and feel lke I can't function. I was wondering what role iron plays in bp b/c I was tol I'm slightly anemic. Feel tired alot and have muscle spasms and headaches.... does spiro help with these symptoms? Re: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2011 Report Share Posted November 18, 2011 Again, classic low potassium. This is not to say this is the only problem, but most likely and you're talking to a bunch of people who know the low potassium symptoms well. > I'm with u on that. I hate being on 3 different meds to control my bp. Maybe at my next appt. I will talk to dr. about increasing spiro to 50mg and maybe going off one of my other meds...idk. I've only been on spiro 5 days and my bp average is better than before but still have muscle spasms and headaches. I didn't think the spiro would start lowering my bp so soon. Just gotta see what it's doing to my potassium level. Thank God I decided to change primary dr b/c my old one wasn't treating me properly and just didn't seem to know what to do...smh.> > Re: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2011 Report Share Posted November 18, 2011 So how much sodium did u eat today? There is an iPhone ap that will do that for u. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension Again, classic low potassium. This is not to say this is the only problem, but most likely and you're talking to a bunch of people who know the low potassium symptoms well. > I'm with u on that. I hate being on 3 different meds to control my bp. Maybe at my next appt. I will talk to dr. about increasing spiro to 50mg and maybe going off one of my other meds...idk. I've only been on spiro 5 days and my bp average is better than before but still have muscle spasms and headaches. I didn't think the spiro would start lowering my bp so soon. Just gotta see what it's doing to my potassium level. Thank God I decided to change primary dr b/c my old one wasn't treating me properly and just didn't seem to know what to do...smh.> > Re: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2011 Report Share Posted November 18, 2011 About 1400mg today. It's hard b/c it can add up quickly. Re: Re: new here > To: hyperaldosteronism > Date: Friday, November 18, 2011, 8:23 AM > > > I am on low salt diet and walk 30 min. - 1 hr a day. But somedays I feel horrible and feel lke I can't function. I was wondering what role iron plays in bp b/c I was tol I'm slightly anemic. Feel tired alot and have muscle spasms and headaches.... does spiro help with these sym Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2011 Report Share Posted November 18, 2011 That is good but recommend u have dr measure u Na K to be sure. If Na is not less than K in urine you need to see why. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension About 1400mg today. It's hard b/c it can add up quickly. Re: Re: new here > To: hyperaldosteronism > Date: Friday, November 18, 2011, 8:23 AM > > > I am on low salt diet and walk 30 min. - 1 hr a day. But somedays I feel horrible and feel lke I can't function. I was wondering what role iron plays in bp b/c I was tol I'm slightly anemic. Feel tired alot and have muscle spasms and headaches.... does spiro help with these sym Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2011 Report Share Posted November 18, 2011 Thanks. I'm learning alot here. Re: Re: new here > > So how much sodium did u eat today? There is an iPhone ap that will do that for u. > > May your pressure be low! > > CE Grim MS, MD > Specializing in Difficult > Hypertension > > > > > Again, classic low potassium. This is not to say this is the only problem, but most likely and you're talking to a bunc Quote Link to comment Share on other sites More sharing options...
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