Re: Re: Treating PA DASH and MCB Dr. Grim approach.

[Guest guest]

Not always estimated - not exactly 100% most likely, but not estimated.

Subject: Re: Treating PA DASH and MCB Dr. Grim approach.To: hyperaldosteronism Date: Saturday, October 22, 2011, 5:11 PM

The term is estimated ejection fraction. It is part of a echo cardiogram. It is an estimate of how much blood your heart is pumping > >>>> >>>Â > >>>>> >>>>> >>>>How do they finally determine what the adequate dosage is to manage my PA? Is it simply doing a bp reading or will there be another blood test, or a pee test? And, in two weeks or so if nothing is regulated do they just keep

adding a higher dose; wait a week or two and repeat the process?> >>>>> >>>>I began Spiro 2 weeks ago on a very lose dose, 12.5 mg. But last week my bp numbers were crazy high, the highest I have ever seen my bp. I returned that day to the doctors and they immediately put me up to 50 mg Spiro. In two days it will be a week on the 50 mg dose. A few days after they increased the Spiro they have since added back another bp med to try and get everything to calm down while giving Spiro a chance to get going. I go in tomorrow to the nephorologist for another check and perhaps more tweaking.> >>>>> >>>>How will I know 50 mg is enough? And, if it isn't what do I expect to be the next step? I would really like to be on one drug, not the cocktail they used to keep me on~~4 drugs at age 30~~13 years ago!> >>>>> >>>>So, spiro suppresses aldosterone.

But, am I correct in understanding that it is getting the renin working again that brings the bp numbers down? If so, what gets renin back to normal working order, too? Just suppressing Aldosterone? How does the tricky balance of aldo to renin get back again to normal?> >>>>> >>>>Also, do I ask every time I'm in the doctors office for a k test too?> >>>>> >>>>Thanks for reading and any feedback is always appreciated!> >>>>> >>>>-> >>>>> >>> >>> >>> >> >> >> >> >>

[Guest guest]

Oh, , many thanks. I will schedule echo on Monday, and this site is extremely helpful for me.Natalia To: hyperaldosteronism Sent: Saturday, October 22, 2011 5:53 PMSubject: Re: Treating PA DASH and MCB Dr. Grim approach.

Natalia, try this site for all you wanted to know about EF and your heart: http://www.chfpatients.com/faq/ef.htm

- 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.

> > >>>

> > >>>Â

> > >>>>

> > >>>>

> > >>>>How do they finally determine what the adequate dosage is to manage my PA? Is it simply doing a bp reading or will there be another blood test, or a pee test? And, in two weeks or so if nothing is regulated do they just keep adding a higher dose; wait a week or two and repeat the process?

> > >>>>

> > >>>>I began Spiro 2 weeks ago on a very lose dose, 12.5 mg. But last week my bp numbers were crazy high, the highest I have ever seen my bp. I returned that day to the doctors and they immediately put me up to 50 mg Spiro. In two days it will be a week on the 50 mg dose. A few days after they increased the Spiro they have since added back another bp med to try and get everything to calm down while giving Spiro a chance to get going. I go in tomorrow to the nephorologist for another check and perhaps more tweaking.

> > >>>>

> > >>>>How will I know 50 mg is enough? And, if it isn't what do I expect to be the next step? I would really like to be on one drug, not the cocktail they used to keep me on~~4 drugs at age 30~~13 years ago!

> > >>>>

> > >>>>So, spiro suppresses aldosterone. But, am I correct in understanding that it is getting the renin working again that brings the bp numbers down? If so, what gets renin back to normal working order, too? Just suppressing Aldosterone? How does the tricky balance of aldo to renin get back again to normal?

> > >>>>

> > >>>>Also, do I ask every time I'm in the doctors office for a k test too?

> > >>>>

> > >>>>Thanks for reading and any feedback is always appreciated!

> > >>>>

> > >>>>-

> > >>>>

> > >>

> > >>

> > >>

> > >

> > >

> > >

> > >

> > >

> >

>

[Guest guest]

Well an estimate of how well your heart empties. If it does not empty well it is called heart failure vTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

The term is estimated ejection fraction. It is part of a echo cardiogram. It is an estimate of how much blood your heart is pumping

> >>>

> >>>Â

> >>>>

> >>>>

> >>>>How do they finally determine what the adequate dosage is to manage my PA? Is it simply doing a bp reading or will there be another blood test, or a pee test? And, in two weeks or so if nothing is regulated do they just keep adding a higher dose; wait a week or two and repeat the process?

> >>>>

> >>>>I began Spiro 2 weeks ago on a very lose dose, 12.5 mg. But last week my bp numbers were crazy high, the highest I have ever seen my bp. I returned that day to the doctors and they immediately put me up to 50 mg Spiro. In two days it will be a week on the 50 mg dose. A few days after they increased the Spiro they have since added back another bp med to try and get everything to calm down while giving Spiro a chance to get going. I go in tomorrow to the nephorologist for another check and perhaps more tweaking.

> >>>>

> >>>>How will I know 50 mg is enough? And, if it isn't what do I expect to be the next step? I would really like to be on one drug, not the cocktail they used to keep me on~~4 drugs at age 30~~13 years ago!

> >>>>

> >>>>So, spiro suppresses aldosterone. But, am I correct in understanding that it is getting the renin working again that brings the bp numbers down? If so, what gets renin back to normal working order, too? Just suppressing Aldosterone? How does the tricky balance of aldo to renin get back again to normal?

> >>>>

> >>>>Also, do I ask every time I'm in the doctors office for a k test too?

> >>>>

> >>>>Thanks for reading and any feedback is always appreciated!

> >>>>

> >>>>-

> >>>>

> >>

> >>

> >>

> >

> >

> >

> >

> >

>

[Guest guest]

Not sure why you need an echo? Well to many cards the indication for ANC e echo is a heart. Drhumor Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Oh, , many thanks. I will schedule echo on Monday, and this site is extremely helpful for me.Natalia To: hyperaldosteronism Sent: Saturday, October 22, 2011 5:53 PMSubject: Re: Treating PA DASH and MCB Dr. Grim approach.

Natalia, try this site for all you wanted to know about EF and your heart: http://www.chfpatients.com/faq/ef.htm

- 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.

> > >>>

> > >>>Â

> > >>>>

> > >>>>

> > >>>>How do they finally determine what the adequate dosage is to manage my PA? Is it simply doing a bp reading or will there be another blood test, or a pee test? And, in two weeks or so if nothing is regulated do they just keep adding a higher dose; wait a week or two and repeat the process?

> > >>>>

> > >>>>I began Spiro 2 weeks ago on a very lose dose, 12.5 mg. But last week my bp numbers were crazy high, the highest I have ever seen my bp. I returned that day to the doctors and they immediately put me up to 50 mg Spiro. In two days it will be a week on the 50 mg dose. A few days after they increased the Spiro they have since added back another bp med to try and get everything to calm down while giving Spiro a chance to get going. I go in tomorrow to the nephorologist for another check and perhaps more tweaking.

> > >>>>

> > >>>>How will I know 50 mg is enough? And, if it isn't what do I expect to be the next step? I would really like to be on one drug, not the cocktail they used to keep me on~~4 drugs at age 30~~13 years ago!

> > >>>>

> > >>>>So, spiro suppresses aldosterone. But, am I correct in understanding that it is getting the renin working again that brings the bp numbers down? If so, what gets renin back to normal working order, too? Just suppressing Aldosterone? How does the tricky balance of aldo to renin get back again to normal?

> > >>>>

> > >>>>Also, do I ask every time I'm in the doctors office for a k test too?

> > >>>>

> > >>>>Thanks for reading and any feedback is always appreciated!

> > >>>>

> > >>>>-

> > >>>>

> > >>

> > >>

> > >>

> > >

> > >

> > >

> > >

> > >

> >

>

[Guest guest]

They can do a stress echo in some places. Reg stress test is not very reliable with HTN and or old MI. One thing to do would be to get all of your fold EKGS for yout team to look at and when BP AND K better. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

My PPC referred me when he saw that I had an old infarct in my recent EKG. He wanted stress test, I declined.Natalia To: "hyperaldosteronism " <hyperaldosteronism >Sent: Saturday, October 22, 2011 11:44 PMSubject: Re: Re:

Treating PA DASH and MCB Dr. Grim approach.

Not sure why you need an echo? Well to many cards the indication for ANC e echo is a heart. Drhumor Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Oh, , many thanks. I will schedule echo on Monday, and this site is extremely helpful for me.Natalia To: hyperaldosteronism Sent: Saturday, October 22, 2011 5:53 PMSubject: Re: Treating PA DASH and MCB Dr. Grim approach.

Natalia, try this site for all you wanted to know about EF and your heart: http://www.chfpatients.com/faq/ef.htm

- 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.

> > >>>

> > >>>Â

> > >>>>

> > >>>>

> > >>>>How do they finally determine what the adequate dosage is to manage my PA? Is it simply doing a bp reading or will there be another blood test, or a pee test? And, in two weeks or so if nothing is regulated do they just keep adding a higher dose; wait a week or two and repeat the process?

> > >>>>

> > >>>>I began Spiro 2 weeks ago on a very lose dose, 12.5 mg. But last week my bp numbers were crazy high, the highest I have ever seen my bp. I returned that day to the doctors and they immediately put me up to 50 mg Spiro. In two days it will be a week on the 50 mg dose. A few days after they increased the Spiro they have since added back another bp med to try and get everything to calm down while giving Spiro a chance to get going. I go in tomorrow to the nephorologist for another check and perhaps more tweaking.

> > >>>>

> > >>>>How will I know 50 mg is enough? And, if it isn't what do I expect to be the next step? I would really like to be on one drug, not the cocktail they used to keep me on~~4 drugs at age 30~~13 years ago!

> > >>>>

> > >>>>So, spiro suppresses aldosterone. But, am I correct in understanding that it is getting the renin working again that brings the bp numbers down? If so, what gets renin back to normal working order, too? Just suppressing Aldosterone? How does the tricky balance of aldo to renin get back again to normal?

> > >>>>

> > >>>>Also, do I ask every time I'm in the doctors office for a k test too?

> > >>>>

> > >>>>Thanks for reading and any feedback is always appreciated!

> > >>>>

> > >>>>-

> > >>>>

> > >>

> > >>

> > >>

> > >

> > >

> > >

> > >

> > >

> >

>