Guest guest Posted November 20, 2011 Report Share Posted November 20, 2011 Reading and remembering are not the same of course. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension Don't think any of the Dr I have see in the past 5 years have read or have not understood them. > > > >> > >> I just wanted to share a bit of humor. > >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note: > >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP. > >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2011 Report Share Posted November 20, 2011 I bet anxiety has as many physical causes as mental ones too, but it's always work, family, and life as the cause - and sometimes it adds to it, but this stuff is "normal", not abnormal. So rare tot hem it could never be that 2.5 K level now could it (and who knows what the mag level could have been because we don't check it).> > > >> > >> I just wanted to share a bit of humor.> >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note:> >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP.> >> > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2011 Report Share Posted November 20, 2011 We would love to see the spread sheet as well. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension That is a great idea! I will send it along with my Excel spreadsheet I made on my K+ values over the years and the ridiculous blood pressure readings. > > > I just wanted to share a bit of humor. > > > > I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > > > > Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note: > > > > "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > > > > For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > > > > My doctor lost "the bet". > > > > I am looking for a new PCP. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2011 Report Share Posted November 20, 2011 They obviously have not been reading any hypertension related items for the last 12 years as the hottest thing is how common PA is now that it is so easy to test for it. So you want to send them my 6 year old review that discusses why it is turning up more in the drug resistant HTN. THE Derm guy must have graduated years ago also as that is whT was taught before 1970. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension I have read my records a dozen times. The common denominator is that the doctor always questioned me about having any stress. Of course I was a normal woman with a job, a family and aging parents. Who doesn't have stress? It seems that it was so easy to explain away his failure in helping control my pressure by just labeling me with stress. That surely didn't address the K+ level but maybe the doc was hoping I never noticed. I saw my very renowned dermatologist the other day and he told me that PA is very very rare. There you go. I think that doctors are not even considering PA because in their mind, it is so rare. Stress is more common. In hyperaldosteronism , Clarence Grim wrote: > > Guess they had never read the guidelines. Do you have any suggestions as to why they never read the guidelines? > May your pressure be low! > > CE Grim MS, MD > Specializing in Difficult > Hypertension > > > > > "ibet" is latin for "oops". Reading the records is funny. I had the one when I was an inpatient that said, and I just looked at again, "patient refuses to take anymore of his blood pressure medication as he feels it is making his heart rate too slow". When I "refused" the BP meds, and it was ONLY metoprolol 100mg, my heart rate was 37 and I had been throwing up and falling over when standing. No mention is made of the heart rate in the notes. Vitals were only listed later. Ahhhh love medicine....... > > > > Oh and they hassled me at the time when I refused it. But jokes on them. I was low K, had gone in for sever HTN 160ish/140ish, they did s 24 hr urine and blood but no renin or aldosterone was done. Just catecholamines. They never considered PA. It was found 2 months later > > > > > > > > > > Sent from my Palm Pre on the Now Network from Sprint > > > > > > > > > > You bet your life. > > > > > > > > May your pressure be low! > > > > CE Grim MS, MD > > Specializing in Difficult > > Hypertension > > > > > > > >> > >> I just wanted to share a bit of humor. > >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note: > >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP. > >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2011 Report Share Posted November 20, 2011 Also plot drugs tried and failed and why they were abandoned. And note each time dx of anxiety was mentioned. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension That is a great idea! I will send it along with my Excel spreadsheet I made on my K+ values over the years and the ridiculous blood pressure readings. > > > I just wanted to share a bit of humor. > > > > I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > > > > Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note: > > > > "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > > > > For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > > > > My doctor lost "the bet". > > > > I am looking for a new PCP. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2011 Report Share Posted November 20, 2011 We have to get the medical establishment to quit thinking it's a zebra with only 3 legs. It may not be AS common as essential HTN, but in resistant HTN it is likely one of the most probable causes - the research gives a near 20% down to less than 1% in different studies and articles as to the incidence of it so no wonder others have a hard time with it. They don't hesitate to look for a pheo. I mean really, it IS simple. Low K, resistant HTN, or a sudden low K and no decrease in BP with HCTZ, peeing all night with no evidence of DM (or even when DM is controlled but BP is not), then look for it. Just look for it damn it. It feels like it's never ending and I have no explanation. The other day one of the NP's had a 36 year-old with long term HTN, on 3 meds, and feeling like hell. They were checking aldo and renin, and I told them they had to get the 24 hr urine not just blood aldo. We didn't have his records yet, but he thought he had had a low potassium before too, as he surely had s/s of it today. But I told them, since cost is a factor for this guy and he may not even get the urine and labs (many agree before they leave since they are embarrased to tell us they can't get it) and as bad as the guy felt (he was very physcially fit too!) to try a trial of spiro ( he was self-pay and couldn't afford the cardio I guess yet) and see if we see have a result. I have no idea why, but the 2 NP's consulted with each other and decided to start him on an expensive new renin blocker. Insane. He likely won't go buy it anyway. He was 150's over 118 I recall on his BP. (I have been a PA longer than both have been NP's combined, and I suggested it nicely, but.......one went to University of Phoenix's NP program - where clinicals were only 3 months long and in one place the entire time!) I let them know they might just be dead wrong and gave them a copy of Dr G's paper I have no recollection whatsoever of Conn's in the actual teaching in the PA program at the University of Utah's physician assistant program, I knew of it, but because I had to do my own research due to my HTN, and long after. I know I read about it as I have some recall of it, but held it in the same esteem my colleagues did as being rare. In the hospital for me, they checked only for that glorious pheo - which IS incredibly rare - but blew off the PA even though I was inpatient 5 days (and I been in the same hospital for low K before and had about 10 ER visits always with low K). No one EVER checked a renin and aldo until I was already on spiro, but after being started on it while being 180/140 (that day) on 5 meds in the cardiologists office I wasn't stopping it now with such a dramatic response to it. Plus I do believe there is some evidence that the sudden spikes can be the most dangerous (immediately that is, maybe not long term) and I wasn't going to chance it after all those years of the severe HTN by stopping it. I went in super high BP that hospital stay (I recall 180/140 again) and left with what they must have thought was good at 150/110-120. Story of my life to that point - well the previous 5-6 years anyway Like many on here as we discussed it was always the HCTZ or stress in the docs opinion - even if it had been months since I had stopped it. After a while, you just get so tired of fighting them. My low K and then hyperthyroidism at the time made my brain not function well so I just let them do their thing, knowing it would be the same old thing - stress, anxiety, HCTZ, and they'd check my heart for the 100th time, just praying someone might look the right way, but they never did and then they'd say ....well they usually said absolutely nothing at the end. Just tried to add a 5th or 6 th med. Don't think any of the Dr I have see in the past 5 years have read or have not understood them. > > > >> > >> I just wanted to share a bit of humor.> >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note:> >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP.> >> > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2011 Report Share Posted November 20, 2011 It is OK to ask the NPs if they have read JNC 7 from cover to cover. I am betting a beer they have not. I made everyone in my office read it including the secretary. Secretaries can be very important in transferring information to the patient if they understand the importance of high blood pressure.Indeed -it is OK to ask yourself if you have read any of the JNC's from cover to cover? and then ask all you work with the same question. If they say no: ask why? It is only the most common chronic disease reason patients visit their health care providers. So not to have read and understand the last JNC is nearly criminal in my mind. CE Grim MD We have to get the medical establishment to quit thinking it's a zebra with only 3 legs. It may not be AS common as essential HTN, but in resistant HTN it is likely one of the most probable causes - the research gives a near 20% down to less than 1% in different studies and articles as to the incidence of it so no wonder others have a hard time with it. They don't hesitate to look for a pheo. I mean really, it IS simple. Low K, resistant HTN, or a sudden low K and no decrease in BP with HCTZ, peeing all night with no evidence of DM (or even when DM is controlled but BP is not), then look for it. Just look for it damn it. It feels like it's never ending and I have no explanation. The other day one of the NP's had a 36 year-old with long term HTN, on 3 meds, and feeling like hell. They were checking aldo and renin, and I told them they had to get the 24 hr urine not just blood aldo. We didn't have his records yet, but he thought he had had a low potassium before too, as he surely had s/s of it today. But I told them, since cost is a factor for this guy and he may not even get the urine and labs (many agree before they leave since they are embarrased to tell us they can't get it) and as bad as the guy felt (he was very physcially fit too!) to try a trial of spiro ( he was self-pay and couldn't afford the cardio I guess yet) and see if we see have a result. I have no idea why, but the 2 NP's consulted with each other and decided to start him on an expensive new renin blocker. Insane. He likely won't go buy it anyway. He was 150's over 118 I recall on his BP. (I have been a PA longer than both have been NP's combined, and I suggested it nicely, but.......one went to University of Phoenix's NP program - where clinicals were only 3 months long and in one place the entire time!) I let them know they might just be dead wrong and gave them a copy of Dr G's paper I have no recollection whatsoever of Conn's in the actual teaching in the PA program at the University of Utah's physician assistant program, I knew of it, but because I had to do my own research due to my HTN, and long after. I know I read about it as I have some recall of it, but held it in the same esteem my colleagues did as being rare. In the hospital for me, they checked only for that glorious pheo - which IS incredibly rare - but blew off the PA even though I was inpatient 5 days (and I been in the same hospital for low K before and had about 10 ER visits always with low K). No one EVER checked a renin and aldo until I was already on spiro, but after being started on it while being 180/140 (that day) on 5 meds in the cardiologists office I wasn't stopping it now with such a dramatic response to it. Plus I do believe there is some evidence that the sudden spikes can be the most dangerous (immediately that is, maybe not long term) and I wasn't going to chance it after all those years of the severe HTN by stopping it. I went in super high BP that hospital stay (I recall 180/140 again) and left with what they must have thought was good at 150/110-120. Story of my life to that point - well the previous 5-6 years anyway Like many on here as we discussed it was always the HCTZ or stress in the docs opinion - even if it had been months since I had stopped it. After a while, you just get so tired of fighting them. My low K and then hyperthyroidism at the time made my brain not function well so I just let them do their thing, knowing it would be the same old thing - stress, anxiety, HCTZ, and they'd check my heart for the 100th time, just praying someone might look the right way, but they never did and then they'd say ....well they usually said absolutely nothing at the end. Just tried to add a 5th or 6 th med. Don't think any of the Dr I have see in the past 5 years have read or have not understood them. > > > >> > >> I just wanted to share a bit of humor.> >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note:> >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP.> >> > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2011 Report Share Posted November 20, 2011 My guess is that the new renin inhibitor will be worthless in PA as the renin is already very low. Should almost be a good diagnositc test for PA. Ie no response the likely PA.Let us know how the patient does.CE Grim MD We have to get the medical establishment to quit thinking it's a zebra with only 3 legs. It may not be AS common as essential HTN, but in resistant HTN it is likely one of the most probable causes - the research gives a near 20% down to less than 1% in different studies and articles as to the incidence of it so no wonder others have a hard time with it. They don't hesitate to look for a pheo. I mean really, it IS simple. Low K, resistant HTN, or a sudden low K and no decrease in BP with HCTZ, peeing all night with no evidence of DM (or even when DM is controlled but BP is not), then look for it. Just look for it damn it. It feels like it's never ending and I have no explanation. The other day one of the NP's had a 36 year-old with long term HTN, on 3 meds, and feeling like hell. They were checking aldo and renin, and I told them they had to get the 24 hr urine not just blood aldo. We didn't have his records yet, but he thought he had had a low potassium before too, as he surely had s/s of it today. But I told them, since cost is a factor for this guy and he may not even get the urine and labs (many agree before they leave since they are embarrased to tell us they can't get it) and as bad as the guy felt (he was very physcially fit too!) to try a trial of spiro ( he was self-pay and couldn't afford the cardio I guess yet) and see if we see have a result. I have no idea why, but the 2 NP's consulted with each other and decided to start him on an expensive new renin blocker. Insane. He likely won't go buy it anyway. He was 150's over 118 I recall on his BP. (I have been a PA longer than both have been NP's combined, and I suggested it nicely, but.......one went to University of Phoenix's NP program - where clinicals were only 3 months long and in one place the entire time!) I let them know they might just be dead wrong and gave them a copy of Dr G's paper I have no recollection whatsoever of Conn's in the actual teaching in the PA program at the University of Utah's physician assistant program, I knew of it, but because I had to do my own research due to my HTN, and long after. I know I read about it as I have some recall of it, but held it in the same esteem my colleagues did as being rare. In the hospital for me, they checked only for that glorious pheo - which IS incredibly rare - but blew off the PA even though I was inpatient 5 days (and I been in the same hospital for low K before and had about 10 ER visits always with low K). No one EVER checked a renin and aldo until I was already on spiro, but after being started on it while being 180/140 (that day) on 5 meds in the cardiologists office I wasn't stopping it now with such a dramatic response to it. Plus I do believe there is some evidence that the sudden spikes can be the most dangerous (immediately that is, maybe not long term) and I wasn't going to chance it after all those years of the severe HTN by stopping it. I went in super high BP that hospital stay (I recall 180/140 again) and left with what they must have thought was good at 150/110-120. Story of my life to that point - well the previous 5-6 years anyway Like many on here as we discussed it was always the HCTZ or stress in the docs opinion - even if it had been months since I had stopped it. After a while, you just get so tired of fighting them. My low K and then hyperthyroidism at the time made my brain not function well so I just let them do their thing, knowing it would be the same old thing - stress, anxiety, HCTZ, and they'd check my heart for the 100th time, just praying someone might look the right way, but they never did and then they'd say ....well they usually said absolutely nothing at the end. Just tried to add a 5th or 6 th med. Don't think any of the Dr I have see in the past 5 years have read or have not understood them. > > > >> > >> I just wanted to share a bit of humor.> >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note:> >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP.> >> > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2011 Report Share Posted November 20, 2011 I've read it and more than once and especially since learning my lesson the hard way I don't want anyone else to ever have to - as a patient. But reading is my thing, and I read fast and with great comprehension, but I will just copy my copy and bring it up at the next clinic meeting next week and give them one. Maybe we go through it for the required education bit by bit?????? Don't think any of the Dr I have see in the past 5 years have read or have not understood them. > > > >> > >> I just wanted to share a bit of humor.> >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note:> >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP.> >> > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2011 Report Share Posted November 21, 2011 I have found that that is also useful. What I do is to assign a section at a time. Then sit down with the group and go for each part and have different folks lead the discussion.CE Grim MD I've read it and more than once and especially since learning my lesson the hard way I don't want anyone else to ever have to - as a patient. But reading is my thing, and I read fast and with great comprehension, but I will just copy my copy and bring it up at the next clinic meeting next week and give them one. Maybe we go through it for the required education bit by bit?????? Don't think any of the Dr I have see in the past 5 years have read or have not understood them. > > > >> > >> I just wanted to share a bit of humor.> >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note:> >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP.> >> > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2011 Report Share Posted November 21, 2011 I'll do that! Thanks Don't think any of the Dr I have see in the past 5 years have read or have not understood them. > > > >> > >> I just wanted to share a bit of humor.> >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note:> >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP.> >> > > > >>I Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2011 Report Share Posted November 21, 2011 Another good source is the AHA HYPERTENSION PRIMER. RECOMMEND YOU get one for your office lib if they do not have it. Very best book is Kaplan's Clinical hypertension. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension I'll do that! Thanks Don't think any of the Dr I have see in the past 5 years have read or have not understood them. > > > >> > >> I just wanted to share a bit of humor.> >> > >> I requested my records from my family doctor dating back to 2002 when I presented there with a K+ of 4.7 and resistant hypertension. (this after seeing 2 other doctors since '95 who were unable to control my blood pressure). Reading my office notes after what I know now, there is so much evidence of PA that it makes me ill just thinking about what I endured. The potassium started dropping almost immediately to where a 3.3 reading prompted the doc to actually write himself a note to address Potassium level at next office visit, which he never did. This while I was heavily medicated with Cartia XT, Diovan/HCT and a high dose of Metoprolol! > >> > >> Fast forward to 2011, my doctor left to be a hospitalist and I was forced to accept the new guy from another office. At my last office visit in September, I had addressed serious concerns as to why my potassium was jumping all over the place. It was 3.0 in May and June, up to 4.0 after three supplements a day, back down to 3.5 in spite of those supplements. Now I know what the doctor thought since I have the records and I quote his office note:> >> > >> "Hypokalemia, and Anxiety. Decreased Potassium level due to diuretic, I bet". > >> > >> For those of you who don't remember me, I self-referred myself to UPMC Renal Clinic where I was diagnosed with PA. The doc added Spiro, took me off K+ supplements, potassium now normal. Blood pressure better than ever and have started a reduction in medication due to low readings. Not to mention how much better I feel! > >> > >> My doctor lost "the bet". > >> > >> I am looking for a new PCP.> >> > > > >>I Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (21) Recent Activity: Quote Link to comment Share on other sites More sharing options...
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