Re: Symptoms and Thanks

January 6, 2012

And is your life $20?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

The free part of this is very limited so can't find out much information.

> > >> > >> >

> > >> > >> > According to your analyses and symptoms, it seems that you

> > >> have the same Conn's that most of us have. Start to Dash

> > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > >> with this medication, that's it! Don't wait 6 months until your

> > >> appointment and some more years until you are going to be

> > >> diagnosed. Some of us, including myself, are still undiagnosed

> > >> after several years and many doctors.

> > >> > >> >

> > >> > >> > Ã‚

> > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > >> 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 when over-salt eplerenone ;

> > >> on private consultation with Dr Grim.

> > >> > >> >

> > >> > >> > ________________________________

> > >> > >> > From: lff_409 <.>

> > >> > >> > To:

> > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > >> > >> > Subject: Symptoms and Thanks

> > >> > >> >

> > >> > >> > Ã‚

> > >> > >> > First of all, thanks to all that responded.

> > >> > >> >

> > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

> > >> > >> >

> > >> > >>

> > >> >

> > >>

> > >

> >

>

January 6, 2012

This is what they have to look at and they can print out stuff for patients. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I don't want to play Dr but I would like to see what Information VA Dr have to look at. Not that I would understand a lot of what they look at.

> > > > >> > >> >

> > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > >> have the same Conn's that most of us have. Start to Dash

> > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > >> appointment and some more years until you are going to be

> > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > >> after several years and many doctors.

> > > > >> > >> >

> > > > >> > >> > Ã‚

> > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > >> 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 when over-salt eplerenone ;

> > > > >> on private consultation with Dr Grim.

> > > > >> > >> >

> > > > >> > >> > ________________________________

> > > > >> > >> > From: lff_409 <.>

> > > > >> > >> > To:

> > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > >> > >> > Subject: Symptoms and Thanks

> > > > >> > >> >

> > > > >> > >> > Ã‚

> > > > >> > >> > First of all, thanks to all that responded.

> > > > >> > >> >

> > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

> > > > >> > >> >

> > > > >> > >>

> > > > >> >

> > > > >>

> > > > >

> > > >

> > >

> >

>

January 6, 2012

Which tests?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I also believe not eating enough protein will give abnormal test numbers.

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

> > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > >> > >> > Ã‚

> > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > > > > > > >> 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 when over-salt eplerenone ;

> > > > > > > > > >> on private consultation with Dr Grim.

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

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

> > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > >> > >> > To:

> > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > >> > >> > Ã‚

> > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

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

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

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

> > > > > > > > > >>

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 6, 2012

Have not looked at the file yet. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I certainly agree a doctor visit would be in order, she has some red numbers that should be explained. I would even say a Nephroligst consult would be in order if it hasn't happened.

I was also hoping Dr. G. would check in on that high renin number.

> > > > > > > > > >>

> > > > > > > > > >> Did I answer your question, ?

> > > > > > > > > >> In the time when I had this visit to my PCP I already subscribed

> > > > > > > > > >> to this group and learned about spiro and eplerenone, but I didn't

> > > > > > > > > >> communicate either with group or with Dr. Grim yet. I started

> > > > > > > > > >> eplerenone without any proof and hope, just out of desperation,

> > > > > > > > > >> since my BP and my condition were killing me and EVERY BB, Calcium

> > > > > > > > > >> channel, and other made me feel terrible. No mention that clonidine

> > > > > > > > > >> almost killed me.

> > > > > > > > > >> After the first day on eplerenone, my BP was 130/80 - I do not

> > > > > > > > > >> remember that I ever had this BP in my life.

> > > > > > > > > >>

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

> > > > > > > > > >> From: Bingham <jlkbbk2003@>

> > > > > > > > > >> To: "hyperaldosteronism " <hyperaldosteronism

> > > > > > > > > >>

January 6, 2012

Thank both of you, and Francis. My endo saw the results and said nothing. Dr. Grim saw them too and said nothing alarming. I am on eplerenone, not on spiro, and epelrenone is not on your list, . I don't take any medications from this list and I eat enough proteins. It's worried me because I feel that my kidneys don't work properly and even on eplerenone I go 5 - 6 times at night. I definitely will schedule the appointment with nephro. Please, play doctors with my data, I appreciate it very much. I am not so sophisticated as both of you are and it helps me a lot. I will be always grateful for any information you can give me.

Dr. Grim, what should I worry about and what should I ask the nephro? What kind of additional tests do I need to get?I have to repeat Cscan or MRI in 2 - 3 months and that worries me also in respect to my kidneys function. Many thanks, Natalia To: hyperaldosteronism Sent: Friday, January 6, 2012 10:47 PM

Subject: Re: Symptoms and Thanks

I certainly agree a doctor visit would be in order, she has some red numbers that should be explained. I would even say a Nephroligst consult would be in order if it hasn't happened.

I was also hoping Dr. G. would check in on that high renin number.

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

> > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > >> > >> > Ã‚

> > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > > > > > > >> 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 when over-salt eplerenone ;

> > > > > > > > > >> on private consultation with Dr Grim.

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

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

> > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > >> > >> > To:

> > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > >> > >> > Ã‚

> > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

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

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

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

> > > > > > > > > >>

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 6, 2012

A visit to Snopes would be indicated here I think. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Itâ€™s because the Communist regime in USSR used to pull out peopleâ€™s adrenal glands and sell them to the West J BTW, when I had done my research, I had done it in both, English and Russian. And I had found much more comprehensive articles about PA in Russian than in English. Even Wikipedia's article is much longer and more interesting. I was extremely surprised. Natalia

January 6, 2012

Dr. Grim, you looked at this file back in October, when I have sent it to you directly. I attached the file again. Natalia To: "hyperaldosteronism " <hyperaldosteronism > Sent: Friday, January 6, 2012 11:55 PM Subject:

Re: Re: Symptoms and Thanks

Have not looked at the file yet. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I certainly agree a doctor visit would be in order, she has some red numbers that should be explained. I would even say a Nephroligst consult would be in order if it hasn't happened.

I was also hoping Dr. G. would check in on that high renin number.

> > > > > > > > > >>

> > > > > > > > > >> Did I answer your question, ?

> > > > > > > > > >> In the time when I had this visit to my PCP I already subscribed

> > > > > > > > > >> to this group and learned about spiro and eplerenone, but I didn't

> > > > > > > > > >> communicate either with group or with Dr. Grim yet. I started

> > > > > > > > > >> eplerenone without any proof and hope, just out of desperation,

> > > > > > > > > >> since my BP and my condition were killing me and EVERY BB, Calcium

> > > > > > > > > >> channel, and other made me feel terrible. No mention that clonidine

> > > > > > > > > >> almost killed me.

> > > > > > > > > >> After the first day on eplerenone, my BP was 130/80 - I do not

> > > > > > > > > >> remember that I ever had this BP in my life.

> > > > > > > > > >>

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

> > > > > > > > > >> From: Bingham <jlkbbk2003@>

> > > > > > > > > >> To: "hyperaldosteronism " <hyperaldosteronism

> > > > > > > > > >>

1 of 1 File(s)

urine and blood tests_2011.xls

January 6, 2012

Natalia, Your HbA1C (BS) numbers are are showing red but I'm not sure where they

got the range. (0.0 to 5.6 does not sound right to me. In fact zero is deadly

as I understand it!) My lab shows 6.0 as the high cutoff number but my T2DM

staff want it between 6.0 and 6.5. They are concerned it will get too low if I

go any lower.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C

Spironolactone 12/20/2011 due to adverse SX.

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

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems

that you

> > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

afraid, try

> > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

behaves better

> > > > > > > > > > >> with this medication, that's it! Don't wait 6 months

until your

> > > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > > >> diagnosed. Some of us, including myself, are still

undiagnosed

> > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

adrenal adenoma,

> > > > > > > > > > >> 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 when over-salt

eplerenone ;

> > > > > > > > > > >> on private consultation with Dr Grim.

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

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

> > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > >> > >> > To:

> > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset

hypertension,

> > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia,

> > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo

male, retired

> > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland

tumor and

> > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past

20 years.

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 6, 2012

Maybe epler is too new! Here is what drugs.com says: " BUN/Creatinine: Serum

creatinine increased in a dose-related manner. Mean increases ranged from 0.01

mg/dL at 50 mg daily to 0.03 mg/dL at 400 mg daily. Increases in blood urea

nitrogen to greater than 30 mg/dL and serum creatinine to greater than 2 mg/dL

were reported for 0.5% and 0.2%, respectively, of patients administered

Eplerenone and 0% of placebo-treated patients. (Maybe they figured it was so

little an effect it wasn't worth mentioning!)

I also noticed this re: sodium " Sodium: Serum sodium decreased in a dose-related

manner. Mean decreases ranged from 0.7 mEq/L at 50 mg daily to 1.7 mEq/L at 400

mg daily. Decreases in sodium (<135 mEq/L) were reported for 2.3% of patients

administered Eplerenone and 0.6% of placebo-treated patients. "

There some info for when you talk about your red numbers with your doctor.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C

Spironolactone 12/20/2011 due to adverse SX.

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

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems

that you

> > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

afraid, try

> > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

behaves better

> > > > > > > > > > >> with this medication, that's it! Don't wait 6 months

until your

> > > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > > >> diagnosed. Some of us, including myself, are still

undiagnosed

> > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

adrenal adenoma,

> > > > > > > > > > >> 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 when over-salt

eplerenone ;

> > > > > > > > > > >> on private consultation with Dr Grim.

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

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

> > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > >> > >> > To:

> > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset

hypertension,

> > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia,

> > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo

male, retired

> > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland

tumor and

> > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past

20 years.

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 7, 2012

With an income of 1,021 a month even spending $20 is something I have to think

about. And the $20 is for only 7 days.

> > > > >> > >> >

> > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > >> have the same Conn's that most of us have. Start to Dash

> > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > >> appointment and some more years until you are going to be

> > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > >> after several years and many doctors.

> > > > >> > >> >

> > > > >> > >> > Ã‚

> > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > >> 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 when over-salt eplerenone ;

> > > > >> on private consultation with Dr Grim.

> > > > >> > >> >

> > > > >> > >> > ________________________________

> > > > >> > >> > From: lff_409 <.>

> > > > >> > >> > To:

> > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > >> > >> > Subject: Symptoms and Thanks

> > > > >> > >> >

> > > > >> > >> > Ã‚

> > > > >> > >> > First of all, thanks to all that responded.

> > > > >> > >> >

> > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

> > > > >> > >> >

> > > > >> > >>

> > > > >> >

> > > > >>

> > > > >

> > > >

> > >

> >

>

January 7, 2012

One of the reasons to give epler is to help lower sodium.

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

> > > > > > > > > > > >> > >> > According to your analyses and symptoms, it

seems that you

> > > > > > > > > > > >> have the same Conn's that most of us have. Start to

Dash

> > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

afraid, try

> > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

behaves better

> > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months

until your

> > > > > > > > > > > >> appointment and some more years until you are going to

be

> > > > > > > > > > > >> diagnosed. Some of us, including myself, are still

undiagnosed

> > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

adrenal adenoma,

> > > > > > > > > > > >> 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 when over-salt

eplerenone ;

> > > > > > > > > > > >> on private consultation with Dr Grim.

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

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

> > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > > >> > >> > Subject: Symptoms and

Thanks

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

> > > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset

hypertension,

> > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia,

> > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo

male, retired

> > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal

gland tumor and

> > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for

past 20 years.

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 7, 2012

More normal B/P and blood sugar can stop or reverse kidney damage. Might also

want to get cholesterol lower.

> > > > >> >

> > > > >> > According to your analyses and symptoms, it seems that you have the

same Conn's that most of us have. Start to Dash IMMEDIATELY, if you feel better

and if you are not afraid, try spiro or eplerenone, even small dosage. If your

BP behaves better with this medication, that's it! Don't wait 6 months until

your appointment and some more years until you are going to be diagnosed. Some

of us, including myself, are still undiagnosed after several years and many

doctors.

> > > > >> >

> > > > >> > ÃƒÆ'Ã¢â‚¬Å¡

> > > > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

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 when over-salt eplerenone ; on private consultation with Dr Grim.

> > > > >> >

> > > > >> > ________________________________

> > > > >> > From: lff_409 <.>

> > > > >> > To:

> > > > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > >> > Subject: Symptoms and Thanks

> > > > >> >

> > > > >> > ÃƒÆ'Ã¢â‚¬Å¡

> > > > >> > First of all, thanks to all that responded.

> > > > >> >

> > > > >> > My GP sent me to the Endo for new sudden onset hypertension,

slightly Low K (3.1), heat intolerance, weakness, tachycardia, headache,

fatigue, and emotional swings. I am a 58 yo male, retired firefighter. Only

other medical Hx is small Pineal gland tumor and hashimoto thyroiditis

controlled with synthesis for past 20 years.

> > > > >> >

> > > > >>

> > > >

> > >

> >

>

January 7, 2012

When A Dr that you know you can trust what they say says there is nothing

alarming may be right. Doesn't always mean every thing is normal just what is

abnormal isn't likely to be a real problem for many years. Something else will

likely end your life before that problem need to be adderssed.

What you need to know is based on you kidney test would Dr Grim tell you to have

or not have contast dye during scans.

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

> > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems

that you

> > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

afraid, try

> > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

behaves better

> > > > > > > > > > >> with this medication, that's it! Don't wait 6 months

until your

> > > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > > >> diagnosed. Some of us, including myself, are still

undiagnosed

> > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

adrenal adenoma,

> > > > > > > > > > >> 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 when over-salt

eplerenone ;

> > > > > > > > > > >> on private consultation with Dr Grim.

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

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

> > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > >> > >> > To:

> > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset

hypertension,

> > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia,

> > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo

male, retired

> > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland

tumor and

> > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past

20 years.

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 7, 2012

I pointed out sodium because it appears to be trending down BUT I don't know

what else was going; diarrhea, too much beer or water, etc. Probably easier to

review yourself at:

http://www.diagnose-me.com/cond/C549291.html

If I had to guess I might think your doctor is looking for a larger database to

determine if changes are needed. When did you start Epler?

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C

Spironolactone 12/20/2011 due to adverse SX.

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

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it

seems that you

> > > > > > > > > > > > >> have the same Conn's that most of us have. Start to

Dash

> > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

afraid, try

> > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

behaves better

> > > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months

until your

> > > > > > > > > > > > >> appointment and some more years until you are going

to be

> > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still

undiagnosed

> > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

adrenal adenoma,

> > > > > > > > > > > > >> 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 when over-salt

eplerenone ;

> > > > > > > > > > > > >> on private consultation with Dr Grim.

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

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

> > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > > > >> > >> > Subject: Symptoms and

Thanks

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

> > > > > > > > > > > > >> > >> > Ã‚

> > > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset

hypertension,

> > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia,

> > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo

male, retired

> > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal

gland tumor and

> > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for

past 20 years.

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 7, 2012

A fall in eGFR with epeler or any other drug that lowers BP may well be the result of lowering the perfusion pressure to a damaged glomerlus (kidney). If the damage was due to the HTN or high salt/aldo then we expect it to improve over time. This has been documented over 40 years ago with older BP meds. So the issue is does the Dr. have enough experience to wait this out and see if renal function improves. If not, and low diet Na is documented by urine testing if pt has PA, then may want to choose another BP med. And watch eGFR as well with it.CE Grim. I pointed out sodium because it appears to be trending down BUT I don't know what else was going; diarrhea, too much beer or water, etc. Probably easier to review yourself at: http://www.diagnose-me.com/cond/C549291.html If I had to guess I might think your doctor is looking for a larger database to determine if changes are needed. When did you start Epler? - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you > > > > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try > > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better > > > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your > > > > > > > > > > > > >> appointment and some more years until you are going to be > > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed > > > > > > > > > > > > >> after several years and many doctors. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > Ã‚ > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, > > > > > > > > > > > > >> 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 when over-salt eplerenone ; > > > > > > > > > > > > >> on private consultation with Dr Grim. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > ________________________________ > > > > > > > > > > > > >> > >> > From: lff_409 <.> > > > > > > > > > > > > >> > >> > To: > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM > > > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > Ã‚ > > > > > > > > > > > > >> > >> > First of all, thanks to all that responded. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension, > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia, > > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired > > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and > > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

January 7, 2012

low Na intake, BP lowering drugs, renin secreting tumor, estrogens, pregnancy, rare syndromes like Bartter's but low BP. Dr. Grim, what causes the high renin? 74.16 (0.25-5.82) - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > >> > > > > > > > > > >> > >> > > > > > > > > > >> > >> > > > > > > > > > >> Did I answer your question, ? > >> > > > > > > > > > >> In the time when I had this visit to my PCP I already subscribed > >> > > > > > > > > > >> to this group and learned about spiro and eplerenone, but I didn't > >> > > > > > > > > > >> communicate either with group or with Dr. Grim yet. I started > >> > > > > > > > > > >> eplerenone without any proof and hope, just out of desperation, > >> > > > > > > > > > >> since my BP and my condition were killing me and EVERY BB, Calcium > >> > > > > > > > > > >> channel, and other made me feel terrible. No mention that clonidine > >> > > > > > > > > > >> almost killed me. > >> > > > > > > > > > >> After the first day on eplerenone, my BP was 130/80 - I do not > >> > > > > > > > > > >> remember that I ever had this BP in my life. > >> > > > > > > > > > >> > >> > > > > > > > > > >> Natalia > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@> > >> > > > > > > > > > >> To: "hyperaldosteronism " <hyperaldosteronism > >> > > > > > > > > > >> > > > > > > >

January 7, 2012

BTH in general the lower the blood Na the lower the BP and vvSee G MacGregor et al. review.CE Grim MD Maybe epler is too new! Here is what drugs.com says: "BUN/Creatinine: Serum creatinine increased in a dose-related manner. Mean increases ranged from 0.01 mg/dL at 50 mg daily to 0.03 mg/dL at 400 mg daily. Increases in blood urea nitrogen to greater than 30 mg/dL and serum creatinine to greater than 2 mg/dL were reported for 0.5% and 0.2%, respectively, of patients administered Eplerenone and 0% of placebo-treated patients. (Maybe they figured it was so little an effect it wasn't worth mentioning!) I also noticed this re: sodium "Sodium: Serum sodium decreased in a dose-related manner. Mean decreases ranged from 0.7 mEq/L at 50 mg daily to 1.7 mEq/L at 400 mg daily. Decreases in sodium (<135 mEq/L) were reported for 2.3% of patients administered Eplerenone and 0.6% of placebo-treated patients." There some info for when you talk about your red numbers with your doctor. - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you > > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your > > > > > > > > > > >> appointment and some more years until you are going to be > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed > > > > > > > > > > >> after several years and many doctors. > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > Ã‚ > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, > > > > > > > > > > >> 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 when over-salt eplerenone ; > > > > > > > > > > >> on private consultation with Dr Grim. > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > ________________________________ > > > > > > > > > > >> > >> > From: lff_409 <.> > > > > > > > > > > >> > >> > To: > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > Ã‚ > > > > > > > > > > >> > >> > First of all, thanks to all that responded. > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension, > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia, > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years. > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > > > > > > > > > > >> > >> > > > > > > > > > > >> > >> > > > > > > > > > > >> > >> > > > > > > > > > > >> > > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

January 7, 2012

Thanks.

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

> > > >> > > > > > > > > > >> Did I answer your question, ?

> > > >> > > > > > > > > > >> In the time when I had this visit to my

> > PCP I already subscribed

> > > >> > > > > > > > > > >> to this group and learned about spiro and

> > eplerenone, but I didn't

> > > >> > > > > > > > > > >> communicate either with group or with Dr.

> > Grim yet. I started

> > > >> > > > > > > > > > >> eplerenone without any proof and hope,

> > just out of desperation,

> > > >> > > > > > > > > > >> since my BP and my condition were killing

> > me and EVERY BB, Calcium

> > > >> > > > > > > > > > >> channel, and other made me feel terrible.

> > No mention that clonidine

> > > >> > > > > > > > > > >> almost killed me.

> > > >> > > > > > > > > > >> After the first day on eplerenone, my BP

> > was 130/80 - I do not

> > > >> > > > > > > > > > >> remember that I ever had this BP in my life.

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

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

> > > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@>

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

<hyperaldosteronism

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

> > > >

> > >

> >

>

January 7, 2012

You. Va dr can print out the patient info for u for free. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

With an income of 1,021 a month even spending $20 is something I have to think about. And the $20 is for only 7 days.

> > > > >> > >> >

> > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > >> have the same Conn's that most of us have. Start to Dash

> > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > >> appointment and some more years until you are going to be

> > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > >> after several years and many doctors.

> > > > >> > >> >

> > > > >> > >> > Ãƒâ€š

> > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > >> 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 when over-salt eplerenone ;

> > > > >> on private consultation with Dr Grim.

> > > > >> > >> >

> > > > >> > >> > ________________________________

> > > > >> > >> > From: lff_409 <.>

> > > > >> > >> > To:

> > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > >> > >> > Subject: Symptoms and Thanks

> > > > >> > >> >

> > > > >> > >> > Ãƒâ€š

> > > > >> > >> > First of all, thanks to all that responded.

> > > > >> > >> >

> > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

> > > > >> > >> >

> > > > >> > >>

> > > > >> >

> > > > >>

> > > > >

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January 7, 2012

Keep Na in diet low as possible is prob best way. Some meds will worsen function. If it took a sudden drop then suspect injury from contrast use with CT ETC. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

More normal B/P and blood sugar can stop or reverse kidney damage. Might also want to get cholesterol lower.

> > > > >> >

> > > > >> > According to your analyses and symptoms, it seems that you have the same Conn's that most of us have. Start to Dash IMMEDIATELY, if you feel better and if you are not afraid, try spiro or eplerenone, even small dosage. If your BP behaves better with this medication, that's it! Don't wait 6 months until your appointment and some more years until you are going to be diagnosed. Some of us, including myself, are still undiagnosed after several years and many doctors.

> > > > >> >

> > > > >> > ÃƒÆ’Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, 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 when over-salt eplerenone ; on private consultation with Dr Grim.

> > > > >> >

> > > > >> > ________________________________

> > > > >> > From: lff_409 <.>

> > > > >> > To:

> > > > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > >> > Subject: Symptoms and Thanks

> > > > >> >

> > > > >> > ÃƒÆ’Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > >> > First of all, thanks to all that responded.

> > > > >> >

> > > > >> > My GP sent me to the Endo for new sudden onset hypertension, slightly Low K (3.1), heat intolerance, weakness, tachycardia, headache, fatigue, and emotional swings. I am a 58 yo male, retired firefighter. Only other medical Hx is small Pineal gland tumor and hashimoto thyroiditis controlled with synthesis for past 20 years.

> > > > >> >

> > > > >>

> > > >

> > >

> >

>

January 7, 2012

Be sure they do not use contrast. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

When A Dr that you know you can trust what they say says there is nothing alarming may be right. Doesn't always mean every thing is normal just what is abnormal isn't likely to be a real problem for many years. Something else will likely end your life before that problem need to be adderssed.

What you need to know is based on you kidney test would Dr Grim tell you to have or not have contast dye during scans.

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

> > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > > > > > > > >> 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 when over-salt eplerenone ;

> > > > > > > > > > >> on private consultation with Dr Grim.

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

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

> > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > >> > >> > To:

> > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 7, 2012

Thanks Dr. Grim for this info. When I noticed my GFR was improving and discussed it with my doc he rejected the possibility although I was showing him my GFR chart (attached). Max.62M L adenoma by NP59 scan. Aldos=1065â€¦2056 [28-860] pmol/L, Renin=6 [<30] ng/L. med combo #76={Spiro=100, Amlo=2x5mg, Indap=2.5mg, Ramip=2x2.5mg,Â Metf=2x500mg, Crestor=20mg, Feno=67mg, K.Cl=6x20mEq, Motilium 3x10mg}{K=4.4}{not DASHing but low-salt diet just slightly above craving while keeping K/Na ratio constant, heat intolerance, insulin resistance} A fall in eGFR with epeler or any other drug that lowers BP may well be the result of lowering the perfusion pressure to a damaged glomerlus (kidney). If the damage was due to the HTN or high salt/aldo then we expect it to improve over time. This has been documented over 40 years ago with older BP meds. So the issue is does the Dr. have enough experience to wait this out and see if renal function improves. If not, and low diet Na is documented by urine testing if pt has PA, then may want to choose another BP med. And watch eGFR as well with it. CE Grim.

1 of 1 Photo(s)

January 8, 2012

Dr. Grim,My NP-59 scintiscan was on 2010-Feb and you were the one who picked up the cause of drop. Up to that time I had no clue how much x-ray can damage organs. I am cautious now! Last drop I suspect is due to my switching to Crestor and I am hoping to recover from that soon J Max.62M L adenoma by NP59 scan. Aldos=1065â€¦2056 [28-860] pmol/L, Renin=6 [<30] ng/L. med combo #76={Spiro=100, Amlo=2x5mg, Indap=2.5mg, Ramip=2x2.5mg,Â Metf=2x500mg, Crestor=20mg, Feno=67mg, K.Cl=6x20mEq, Motilium 3x10mg}{K=4.4}{not DASHing but low-salt diet just slightly above craving while keeping K/Na ratio constant, heat intolerance, insulin resistance} What caused the big drop do u think. CT?Recommend you give him a copy of the Hypertension Primer to get him up to speed. May your pressure be low! CE Grim MS, MDSpecializing in DifficultHypertension Thanks Dr. Grim for this info. When I noticed my GFR was improving and discussed it with my doc he rejected the possibility although I was showing him my GFR chart (attached).Max.

January 8, 2012

You say you have difficult to control high blood pressure. It is not approved to treat primary Aldo as the company figures there are so few that it is not worth the effort ($) to do the proper study. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

how do you get on epelerone when one doesn't even have an official diagnosis of PA?

------------------------------

>

>You need to mention that I am pretty certain you have PA but others are not.

>

>May your pressure be low!

>

>CE Grim MS, MD

>Specializing in Difficult

>Hypertension

>

>> Hi Barbara,

>>

>> I guess other people answered your worries about side effects of spiro. I am personally on 100 mg of eplerenone, and I don't have yet any problems with it. But I am lucky one, because my insurance pays for it.

>>

>> What I really meant by IF YOU ARE NOT AFRAID, it's different from side effects.

>> A lot of us here are waiting until being diagnosed to take these medications. And it usually takes a few years. I meant that one can start to take medications without being diagnosed and see the effect of it. That's what I have done a year ago and feel much better. And I am still not diagnosed with PA. I am scared to death even to think what might happen to me if I haven't taken this risk and haven't make my PCP to prescribe me this medication.

>>

>> Best regards,

>>

>> Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, 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.

>> From: Barbara <>

>> To:

>> Sent: Wednesday, January 4, 2012 1:13 AM

>> Subject: Re: Symptoms and Thanks

>>

>> "Start to Dash IMMEDIATELY, if you feel better and IF YOU ARE NOT AFRAID, try spiro or eplerenone, even small dosage."

>>

>> Sorry, to interrupt..but had to ask

>>

>> What do they mean "If you are not afraid"? I just started taking it 2 months ago..it works....is there something I should know about Spiro? I've been told that it is safe.

>>

>> >

>> > According to your analyses and symptoms, it seems that you have the same Conn's that most of us have. Start to Dash IMMEDIATELY, if you feel better and if you are not afraid, try spiro or eplerenone, even small dosage. If your BP behaves better with this medication, that's it! Don't wait 6 months until your appointment and some more years until you are going to be diagnosed. Some of us, including myself, are still undiagnosed after several years and many doctors.

>> >

>> > Ã‚

>> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, 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 when over-salt eplerenone ; on private consultation with Dr Grim.

>> >

>> > ________________________________

>> > From: lff_409 <.>

>> > To:

>> > Sent: Monday, January 2, 2012 1:45 PM

>> > Subject: Symptoms and Thanks

>> >

>> > Ã‚

>> > First of all, thanks to all that responded.

>> >

>> > My GP sent me to the Endo for new sudden onset hypertension, slightly Low K (3.1), heat intolerance, weakness, tachycardia, headache, fatigue, and emotional swings. I am a 58 yo male, retired firefighter. Only other medical Hx is small Pineal gland tumor and hashimoto thyroiditis controlled with synthesis for past 20 years.

>> >

>>

January 8, 2012

Question is the information My Dr can look at good enough to reverse his

thinking as I posted from my visit with him as repeated here.

Had my visit with my new PCP at the VA.

When I told him I thought I had PA he told me PA is very rare

That My B/P wasn't high enough nor my K low enough to have it. Tried to tell him

Pa wasn't so rare and my B/P has been close to 199/100 and my K had been 3.2.

Told me low K was due to being on diuretics and my B/P was a bit higher then it

should be wasn't high enough for PA. When I asked about the adrenal tumor said

it is a very common finding on CT

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

> > > > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > > > >> appointment and some more years until you are going to be

> > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > > > >> after several years and many doctors.

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

> > > > > > >> > >> > Ãƒâ€š

> > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal

adenoma,

> > > > > > >> 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 when over-salt eplerenone ;

> > > > > > >> on private consultation with Dr Grim.

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

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

> > > > > > >> > >> > From: lff_409 <.>

> > > > > > >> > >> > To:

> > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > >> > >> > Ãƒâ€š

> > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > >> > >> > My GP sent me to the Endo for new sudden onset

hypertension,

> > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male,

retired

> > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor

and

> > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20

years.

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

> > > > > > >> > >>

> > > > > > >> >

> > > > > > >>

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

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