Re: Re: please help; do I have PA?_symptoms

[Guest guest]

Headaches with spells? WT loss or gain recently? Has K ever been low? How many times a night do you get up to pee? How often has blood K been low? Get the DASH BOOK and start tonight. You will likely begin to feel better in a few days. Add 1 cup of low sodium V-8 a day now. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I do have high BP, usually in the evening (145ish) but my BP is normal in the morning when I usually have my dr. appointments. The odd thing is that my BP spikes overnight while I am sleeping.

Last month I ended up in the ER at 2AM with BP 181/112 and a HR ~130.

The typical crisis starts with palpitations, tachycardia and shortness of breath which wakes me up. After I pee 2-3 times and do deep breathing to slow my HR & BP goes back down and my HR goes back to normal-high (usually within 1 hour). ER doctors tested me for heart attack (negative) and released me in the morning to "follow up with your physician". The DX was panic/anxiety attack ;-)

That ER night my CPK was high 277 (<175 u/L) but CKMB was normal; and I had severe thigh cramps the day before (low K?) but blood K was normal at 3.9 while in the ER.

I have almost permanent muscle twitching and cramps (arms, legs, rib muscle, neck and shoulder muscle, etc). In the evening I do have severe pain in the back of my neck, with dizziness and lightheadedness, intolerance to noise, general tiredness, legs pain (as if I ran a marathon), startling very easy and a general bad mood feeling. I am feeling depressed and moody although there is not a lot of stress in my day to day life.

Sometimes I do have tachycardia during the day. My heart starts racing for no reason (even when I sit down) without any trigger. I then feel SOB, dizzy and confused. After 15 min. into a crisis my muscle twitching becomes tremors and I usually have to sit or lay down to let it pass (pre-syncope). All my muscle will then randomly contract (like jerking) and I cannot control it for another 15 min.

The days I have a crisis I cannot concentrate, my short term memory is gone and I usually have to go to sleep to recover. Always an overnight sleep will resolve all symptoms.

I have had good and bad days. But my energy levels are way down and I am generally much weaker. The only symptom which stays even in the good days is muscle twitching but I've learned to live with it.

The other thing is that I sweat A LOT overnight but not every day. I know that I am very salt sensitive. If I eat out I usually have more profound perspiration. I guess my body is releasing H2O to regulate BP.

Sometimes I walk and after exercise I feel like I am drunk, have a hard time walking straight and I feel like my inner muscles are trembling. I usually have profuse sweating after walking (especially face & neck) and I guess K+ goes out hence the "inner tremors".

After even light exercise my HR goes up to ~120.

I do have a lot of systemic symptoms and I might have missed some. I call them "rush of adrenaline crisis" ;-). Feel free to ask any question and I will reply.

tiu

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> What are your symptoms? Do you have high blood pressure?

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[Guest guest]

So measure your BP seated standing and after exercise keeping arm position so cuff is at heart level when you measure it.I have folks stand up and down on toes 10 times for the exercise part.CE Grim MD You mentioned in previous msg that your heart rate goes up over 120 after a short time exercising (I'm assuming you're exercising stood up not sat down) which is consistent with postural orthostatic tachycardia syndrome (POTS) - which I have as well as PA and I suspect they are linked so they may be in you too. What happens to your bp when stood up/exercising - does it rise or fall significantly? Ask your drs for a tilt table test and a measurement of your epinephrine/norephinephrine levels. Or might be Cushings syndrome + POTS since you mention evening/night hyperactivity and I know this is sometimes found in Cushings. Have you had 24hr saliva cortisol measurement that shows if your cortisol level is rising rather than falling during the day? You can have this done privately if your drs wont agree to it. > > > > Headaches with spells? WT loss or gain recently? Has K ever been low? How many times a night do you get up to pee? > > How often has blood K been low? Get the DASH BOOK and start tonight. You will likely begin to feel better in a few days. Add 1 cup of low sodium V-8 a day now. > > > > Tiped sad Send form mi > > iPhone ;-) > > > > May your pressure be low! > > > > CE Grim MD > > Specializing in Difficult > > Hypertension >

[Guest guest]

I would get the PA Dx confirmed first as Cushing's is much rarer than PA. Do a google images for Cushing's and if you don't look like any of them I would put it on the back burner for now.Esp if thin.CE Grim MD You mentioned in previous msg that your heart rate goes up over 120 after a short time exercising (I'm assuming you're exercising stood up not sat down) which is consistent with postural orthostatic tachycardia syndrome (POTS) - which I have as well as PA and I suspect they are linked so they may be in you too. What happens to your bp when stood up/exercising - does it rise or fall significantly? Ask your drs for a tilt table test and a measurement of your epinephrine/norephinephrine levels. Or might be Cushings syndrome + POTS since you mention evening/night hyperactivity and I know this is sometimes found in Cushings. Have you had 24hr saliva cortisol measurement that shows if your cortisol level is rising rather than falling during the day? You can have this done privately if your drs wont agree to it. > > > > Headaches with spells? WT loss or gain recently? Has K ever been low? How many times a night do you get up to pee? > > How often has blood K been low? Get the DASH BOOK and start tonight. You will likely begin to feel better in a few days. Add 1 cup of low sodium V-8 a day now. > > > > Tiped sad Send form mi > > iPhone ;-) > > > > May your pressure be low! > > > > CE Grim MD > > Specializing in Difficult > > Hypertension >

[Guest guest]

Yes u can have Cushing's without the classical picture but I have never seen it. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Dr Grim, is there such a tumor where the release of the extra hormone either Aldo or Cortisol is done in a paroxystic fashion? Like the tumor is not active some days and then it activates in other days?

I mean to say that the lab tests need to be done on the days when the tumor is producing hormone otherwise the results will be normal.

I do not have the typical Cushing's body, but my blood Cortisol and urine 17-OHCS and 17KS were abnormal.

Can you have Cushing's but not the "moon face"? Like if the tumor is producing hormone only 1 day in a month (for example) maybe you don't get the "moon face" and weight gain?

Have you seen or heard such a PTN in your entire practice?

Thank you for all your insights!

L

PS. I am 5'10" and weight 180.

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> I would get the PA Dx confirmed first as Cushing's is much rarer than PA.

>

> Do a google images for Cushing's and if you don't look like any of

> them I would put it on the back burner for now.

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> Esp if thin.

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> CE Grim MD

[Guest guest]

That is called iatrogenic Cushing's. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Prednisone is the same as Cortisol. It is used to treat inflammatory diseases sometimes in very high doses. In some it increases your need to eat.

My brother was on it gained about 50 LB with him it became a quest to find something to eat of drink even would drink pickle juice. Others will tell you it does not affect them like this.

Maybe the same is true if you have Cushing's.

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> > > I would get the PA Dx confirmed first as Cushing's is much rarer than PA.

> > >

> > > Do a google images for Cushing's and if you don't look like any of

> > > them I would put it on the back burner for now.

> > >

> > > Esp if thin.

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> > > CE Grim MD

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