Re: Symptoms and Thanks

[Guest guest]

Not likely the scintiscan but a CT or a MRI. It is the contrast and not the radiation that may doe the renal damage.NSAIDs can also have an impact. CE Grim MD. 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=1065…2056 [28-860] pmol/L, Renin=6 [<30] ng/L. med combo #76={Spiro=100, Amlo=2x5mg, Indap=2.5mg, Ramip=2x2.5mg, 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.

[Guest guest]

But did you give him my article?He needs to be updated. He clearly has not seen much PA or read about it recently.CE Grim MD 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 rareFALSE-to him it must be if he thinks like this. That My B/P wasn't high enough nor my K low enough to have it. BP and K levels are not relevant to the DX of PA today.Where did he train? 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. BP level has nothing to do with PA Dx--as you know.When I asked about the adrenal tumor said it is a very common finding on CTTrue but with HTN and low K it is at least worth a trial of spiro I would recommend. Did you ask if you could try spiro as a test to see if BP and K and you are better? If not ask for it next time.Ask him to go to uptodate on his computer and read the update on PA there. CE Grim MD > > > > > > >> > >> > > > > > > > >> > >> > 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. > > > > > > >> > >> > > > > > > > >> > >> > 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 > > > > > > >> > >> > > > > > > > >> > >> > > > > > > > >> > >> > 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. > > > > > > >> > >> > > > > > > > >> > >> > > > > > > >> > >> > > > > > > >> > >> > > > > > > >> > >> > > > > > > >> > > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

,I am diabetic, so 6.4 is good for me. I am on 2000 mg of Metformin. Natalia To: hyperaldosteronism Sent: Saturday, January 7, 2012 12:53 AM Subject:

Re: Symptoms and Thanks

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.

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

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

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

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

> > > > > > > > > > >> > >> > 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.

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

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

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

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[Guest guest]

Dr. Grim, NP-59 [4.7mL(=40 MBq)131-I-Norchol] was the radioactive injection for Scintiscan. For subsequent CT 1 year later to assess adenoma’s progress size fortunately hospital did not find the need to use contrast agent….and I later was glad to know that contrast agent is one of major culprits in damaging kidneys J Scintiscan was in 3 consecutive days with an NP-59 radioactive injection some 72 hours earlier…each scan took 20-30 min and during last scan the technician found the need for injecting another dose of contrast agent while I scan was in progress and he said it was for kidney localization perhaps because he had trouble seeing distinctive highlighted regions on one kidney. This injection was 40 mBq 99mTc-MAG3. So perhaps the big drop in my eGFR around 2010-Feb maybe attributed to these two contrast agents:· 4.7mL(=40 mBq)131-I-Norchol· 40 mBq 99mTc-MAG-3 Question: so, I should not be worried about x-ray radiation itself but rather contrast agents cause kidney damage? Max. Not likely the scintiscan but a CT or a MRI. It is the contrast and not the radiation that may doe the renal damage.NSAIDs can also have an impact. CE Grim MD. 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=1065…2056 [28-860] pmol/L, Renin=6 [<30] ng/L. med combo #76={Spiro=100, Amlo=2x5mg, Indap=2.5mg, Ramip=2x2.5mg, 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.

[Guest guest]

Prob not as the amount given is usually very small and I don't think these agents have been reported to cause kidney damage. Dr. Grim, NP-59 [4.7mL(=40 MBq)131-I-Norchol] was the radioactive injection for Scintiscan. For subsequent CT 1 year later to assess adenoma’s progress size fortunately hospital did not find the need to use contrast agent….and I later was glad to know that contrast agent is one of major culprits in damaging kidneys J Scintiscan was in 3 consecutive days with an NP-59 radioactive injection some 72 hours earlier…each scan took 20-30 min and during last scan the technician found the need for injecting another dose of contrast agent while I scan was in progress and he said it was for kidney localization perhaps because he had trouble seeing distinctive highlighted regions on one kidney. This injection was 40 mBq 99mTc-MAG3. So perhaps the big drop in my eGFR around 2010-Feb maybe attributed to these two contrast agents:· 4.7mL(=40 mBq)131-I-Norchol· 40 mBq 99mTc-MAG-3 Question: so, I should not be worried about x-ray radiation itself but rather contrast agents cause kidney damage? Max. Not likely the scintiscan but a CT or a MRI. It is the contrast and not the radiation that may doe the renal damage.NSAIDs can also have an impact. CE Grim MD. 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=1065…2056 [28-860] pmol/L, Renin=6 [<30] ng/L. med combo #76={Spiro=100, Amlo=2x5mg, Indap=2.5mg, Ramip=2x2.5mg, 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.

[Guest guest]

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

> > > > > > > > >> > >> > 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.

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

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

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

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

> > > > > > > > >> > >> > 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.

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

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

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

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

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

> > > > > > > > >> >

> > > > > > > > >>

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> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

See if you can do it the next time. Or maybe you could mail it to him?I know there is not much time at an appointment esp the first time to get everything across and for the Dr. to review everything.CE Grim MD > > > > > > > > >> > >> > > > > > > > > > >> > >> > 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. > > > > > > > > >> > >> > > > > > > > > > >> > >> > 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 > > > > > > > > >> > >> > > > > > > > > > >> > >> > > > > > > > > > >> > >> > 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. > > > > > > > > >> > >> > > > > > > > > > >> > >> > > > > > > > > >> > >> > > > > > > > > >> > >> > > > > > > > > >> > >> > > > > > > > > >> > > > > > > > > > >> > > > > > > > > >> > > > > > > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Isn't renin of 74.16 very high? If someone is diabetic and has somewhat high

cholesterol at more as risk of having renal artery stenosis? With Renin this

high isn't it more likely that DX would be secondary hyperaldosteronism? I do

know she could have both Primary and secondary as she says she has adrenal

tumor.

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

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

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

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

> > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

She he low renins before. I recall this was when she was adItted when dehydrated. This can cause high renin as both tKicks adrenal to make more aldo to hold onto salt to repair dehydreationMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Isn't renin of 74.16 very high? If someone is diabetic and has somewhat high cholesterol at more as risk of having renal artery stenosis? With Renin this high isn't it more likely that DX would be secondary hyperaldosteronism? I do know she could have both Primary and secondary as she says she has adrenal tumor.

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

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

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

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

> > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Francis, providing information in advance serves me well and was a valuable tool

in my professionl career. Any time I want to discuss something I try to provide

info in advance so they can be at least as prepared as I. Last week I mailed

two trials/studies of how spironolactone affects cortisol to Drs. Gibson and

Bolton (Psyco Docs) and asked Dr. Bolton to put it on the adgenda for our Jan.

11th appointment. I'll let you know how it worked out on Thursday.

IMHO, they are showing a lack of respect if they have not taken the time to

prepare after I have provided the info. In fact I will drop the discussion and

ask for them to be prepared to discuss the next time (then ask them to schedule

the next appt. as soon s possible)! (This doesn't happen too often since I pay

a $50 copay to see a specialist and I am quite apt to remind them!) Don't worry

about pissing them off, they don't respect you anyway!

BTW, they don't have to believe Dr. Grim about how hyperaldosteronism is not as

rare s once thought, how many trials start out disputing that myth? (Note I did

not say PA since that will take them back to Dr. Conn and they will look for a

tumor and low K!)

- 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.

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

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

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

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

> > > > > > > > > > >> > >> > 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.

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Francis, do you use MyheltheVet to communicate with your PCP? Here is an

example. My PCP suggested I should stay on Spiro until I have my tumor removed

and this is my response:

" Hi Dr. Webster, This is a concise explaination of what needs to happen prior to

AVS. Also looks like we should test K+ to see what is happening w/o spiro since

we used to supplement w/potassium chloride 20meq bid. -8395

Since AVS is a lesser known procedure to you I thought I would follow up with

the ??official?? way to prepare for an AVS. BTW I spoke incorrectly about one

adrenal being more difficult, it is the right not the left due to vein

structure.

??The patients were prepared from the pharmacological standpoint by stopping

diuretics, ??-blockers, angiotensin-convertin enzyme inhibitors, and angiotensin

II receptor blockers ??2 weeks before and mineralocorticoid receptor antagonists

??6 weeks before AVS. AVS was undertaken after correction of hypokalemia, if

present, with oral or intravenous potassium ion supplementation.??

Source: http://hyper.ahajournals.org/content/53/5/761.full

Adrenocorticotropic Hormone Stimulation During Adrenal Vein Sampling for

Identifying Surgically Curable Subtypes of Primary Aldosteronism

Comparison of 3 Different Protocols

M. Seccia,

Diego Miotto,

Renzo De Toni,

Gisella Pitter,

Franco Mantero,

Achille C. Pessina,

Gian Paolo Rossi

+ Author Affiliations

From the Department of Clinical and Experimental Medicine-Internal Medicine 4

(T.M.S., R.D.T., G.P., A.C.P., G.P.R.), Institute of Radiology (D.M.), and

Department of Medical and Surgical Sciences (F.M.), University of Padua School

of Medicine, Padua, Italy.

Correspondence to Gian Paolo Rossi, DMCS-Clinica Medica 4, University Hospital,

via Giustiniani 2, 35128 Padova, Italy. E-mail gianpaolo.rossi@... "

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

> > > > > > > > > > > >> > >> > 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.

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

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

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

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

> > > > > > > > > > > >> > >> > 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

I think you first have to get your PCP to accept useing MyheltheVet to

communicate with them. Something I need to do.

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

> > > > > > > > > > > > >> > >> > 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.

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

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

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

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

> > > > > > > > > > > > >> > >> > 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

So how do I do this locally for the patients I am seeing? I am encouraging all to use it but not certain the Dr. pt communication works here.Clarence E. Grim, BS, MS, MD

Specializing in Primary Aldosteronism, Difficult High Blood Pressure and recent evolutionary forces on high blood pressure in populations today.

I think you first have to get your PCP to accept useing MyheltheVet to communicate with them. Something I need to do.

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

> > > > > > > > > > > > >> > >> > 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.

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

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

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

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

> > > > > > > > > > > > >> > >> > 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

They also seem to forget that Dr. Conn was the first to report that normokalemic

PA is common and to suggest that maybe 20% of HTN and diabetes was related to

this.



Clarence E. Grim, BS, MS, MD

Specializing in Primary Aldosteronism, Difficult High Blood Pressure and recent

evolutionary forces on high blood pressure in populations today.

> Francis, providing information in advance serves me well and was a valuable

tool in my professionl career. Any time I want to discuss something I try to

provide info in advance so they can be at least as prepared as I. Last week I

mailed two trials/studies of how spironolactone affects cortisol to Drs. Gibson

and Bolton (Psyco Docs) and asked Dr. Bolton to put it on the adgenda for our

Jan. 11th appointment. I'll let you know how it worked out on Thursday.

>

> IMHO, they are showing a lack of respect if they have not taken the time to

prepare after I have provided the info. In fact I will drop the discussion and

ask for them to be prepared to discuss the next time (then ask them to schedule

the next appt. as soon s possible)! (This doesn't happen too often since I pay a

$50 copay to see a specialist and I am quite apt to remind them!) Don't worry

about pissing them off, they don't respect you anyway!

>

> BTW, they don't have to believe Dr. Grim about how hyperaldosteronism is not

as rare s once thought, how many trials start out disputing that myth? (Note I

did not say PA since that will take them back to Dr. Conn and they will look for

a tumor and low K!)

>

> - 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.

>

>

> > > >

> > > > > 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

[Guest guest]

We need some at WRJ VA that is up to speed on PA. Bet there are hundreds that

they are miss DX.

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

> > > > > > > > > > > > >> > >> > 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.

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

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

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

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

> > > > > > > > > > > > >> > >> > 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

All I can tell you is when I go to MyheltheVet and go to email there is no

option to send email. So would guess someone has to send me email on turn

something on for me to use it.

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

> > > > > > > > > > > > > > >> > >> > 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.

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

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

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

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

> > > > > > > > > > > > > > >> > >> > 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Has your team been added? I got a note from the system and cn comunicate

directly with the 2 doctors, PA and NP. Indirectly with two nurses. Is it

added to your selection options when you log in?

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

> > > > > > > > > > > > > >> > >> > 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.

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

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

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

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

> > > > > > > > > > > > > >> > >> > 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Looks like I now can email I do see my old PCP name and others that I don't know

who they are. I have never been told who is on my team

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

> > > > > > > > > > > > > > >> > >> > 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.

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

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

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

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

> > > > > > > > > > > > > > >> > >> > 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Send them all an email and tell them you are going to be the biggest A-Hole they

ever met if they don't pull their head out and give you a good DX! You'll

probably find out who they are but end up at desk 60 so you might not want to do

that!!!

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

> > > > > > > > > > > > > > > >> > >> > 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.

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

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

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

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

> > > > > > > > > > > > > > > >> > >> > 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>