Guest guest Posted January 8, 2008 Report Share Posted January 8, 2008 This story should get you to the Mayo Clinic. I forget if you have ever been tested for pheochromocytoma. Somehow we need to develop a mini Hx that can be included with each persons note that summarizes the Hx in a standard form. That way I dont have to keep asking these questions. At least when one describes spells with fluctuating BP always add: I have been tested for pheochromocytoma with blood or urine tests. I need to work on a " card " that will summarized this for each person as part of their signature perhaps. Suggestions? In a message dated 1/8/08 9:32:39 AM, val@... writes: > > Just an update for the list. Yesterday, I was determined to go to Mayo in > MN and even made the initial call. As many of you know, I have been going > through an " episode. " An " episode " is defined as > 1) Sweats > 2) Probable paralysis with the sweats, very rarely and probably after too > much salt. > 3) Extreme anxiety > 4) BP as high as 210/114 > 5) Inability to sleep > 6) Headache, usually hits when I can get the anxiety to resolve for a while. > 7) Muscle contractions. My chiropractor finally told me to stop trying to > lift weights (2 lb) because lifting always sends me into spasms. > 8) Weakness. Some days I can't walk 1/2 mile; other days, I can walk and > work. > > During an episode in 2005, my ARR was 32.5. From my reading, that is > suggestive of PA but not determinative. CT in 2005 showed nothing > irregular. I had a parathyroid adenoma removed in 1999. > > This is where I was last night. I had written Dr. Grim privately and he > suggested I write to the list so all can learn. > > As of tonight, I just don't know what to do. I feel almost normal and am > appropriately sleepy (a rare occurrence)! My BP today was 145/80. My pulse > the last few days has decreased from the high 80's to the mid/low 70's. I > had blood tests done today including aldo and renin. I think I'm going to > wait and see what they say. > > I am taking tram/HCTZ 37.5-25 as of two weeks ago (HCTZ for five years > before that). Perhaps my calmness is the result of rising K. I'm thinking > I should perhaps try some other BP meds before I give up and go to Mayo. > Perhaps a different med (not a diuretic) would lessen my metabolic syndrome. > I just don't know what to do. > > These episodes seem to be precipitated by the substitution of a tiny amount > of T3 (2.25 mcg) for about 25 mcg of T4. The episodes take literally > several months to subside, but I have had major episodes without taking any > T3 nor a diuretic. I want to take T3 because of the heart-event severity of > low T3 and I keep thinking a higher T3 would help me lose weight. I've > always lost a few pounds on that regimen until a big episode starts and I > give it all up. I took Actos for six months for a barely elevated BG - and > gained ten pounds. Then took metformin for a few months, had constant > hypoglycemia and had to eat fruit nearly constantly. I gained seven pounds > on that. I am NOT a food junkie. If I didn't get the shakes, I could > almost live without food. I DASH. > > My T3 is always low. Below is an article about " low T3 syndrome. " I have > lipid problems just like my mother. As the years went on, her life was not > quality. I think she was hypothyroid all her life. You probably understand > it all but may be interested in the article. > > This morning, I was up at 5 a.m. with the sweats but my BP is down to > 129/83. Anxiety level is medium as opposed to extreme. > > Val > > Low T3 article: > > > cid:image001.gif@... > > Published online before print January 20, 2003, > doi:10.1161/ doi:10.1161/<wb doi:10.11 > > (Circulation 2003;107:708. > > A more recent <http://circ.http://circ.http://circ.<wbrhttp://cirhttp:> > version of this article appeared on February 11, 2003 > Submitted on September 26, 2002 > Accepted on October 17, 2002 > Low-T3 Syndrome. A Strong Prognostic Predictor of Death in Patients With > Heart Disease > Giorgio Iervasi MD*, Alessandro Pingitore MD, PhD, Patrizia Landi BSc, Mauro > Raciti BSc, Ripoli PhD, Scarlattini BSc, L'Abbate MD, > and Luigi Donato MD > From C.N.R. Clinical Physiology Institute and Scuola Superiore di Studi > Univeritari S. (A.L.A.), Pisa, Italy. > * To whom correspondence should be addressed. E-mail: iervasi@.... > Background-- Background--<wbr>Clinical and experimental data have sug > negative impact of low-T3 state on the prognosis of cardiac diseases. The > aim of the present prospective study was to assess the role of thyroid > hormones in the prognosis of patient population with heart disease. > Methods and Results--A total of 573 consecutive cardiac patients underwent > thyroid function profile evaluation. They were divided in two subgroups: > group I, 173 patients with low T3, ie, with free T3 (fT3) <3.1 pmol/L, and > group II, 400 patients with normal fT3 > (cid:image003.png@... pmol/L). We considered cumulative and > cardiac death events. During the 1-year follow-up, there were 25 cumulative > deaths in group I and 12 in group II (14.4% versus 3%, P<0.0001); cardiac > deaths were 13 in group I and 6 in group II (7.5% versus 1.5%, P=0.0006). > According to the model, fT3 was the most important predictor of > cumulative death (hazard ratio 3.582, P<0.0001), followed by > dyslipidemia (HR 2.955, P=0.023), age (HR 1.051, P<0.005), and left > ventricular ejection fraction (HR 1.037, P=0.006). At the logistic > multivariate analysis, fT3 was the highest independent predictor of death > (HR 0.395, P=0.003). A prevalence of low fT3 levels was found in patients > with NYHA class III-IV illness compared with patients with NYHA class I-II > (cid:image004.gif@.... 5.65, P=0.019). > Conclusions- Conclusions-<wbr>-Low-T3 syndrome is a strong predictor o > patients and might be directly implicated in the poor prognosis of cardiac > patients. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2008 Report Share Posted January 8, 2008 Always mention you have a parathryoid adenoma removed. There are a number of syndromes called MENs that are associated with this. One diad is Para + pheo as I recall. goggle MENs (mixed endocrine neoplasia) for images to see if you have funny things on you tongue. May your pressure be low! Clarence E. Grim, BS, MS, MD Senior Consultant to Shared Care Research and Consulting, Inc. (sharedcareinc.com) Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI Clinical Professor of Nursing, Univ. of WI, Milwaukee Specializing in Difficult to Control High Blood Pressure and the Physiology and History of Survival During Hard Times and Heart Disease today. ************** Start the year off right. Easy ways to stay in shape. http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2008 Report Share Posted January 8, 2008 My early morning BP was 129/83. I drank whey protein powder with water and put on 0.75 mg transdermal estradiol. Two hours later, it was 154/84. Tonight, I'm as nervous and headachey as always. BP= 178/92. The improvement lasted only 12 hours. We have been moving and all my records are packed. I'm so nervous I can't unpack and put stuff away. No one, especially the CU endo, ever mentioned pheo. Of course, once she determined it was not Cushing's, she had nothing to say. I do believe, however, that I think I remember a urine metanephrine test that was elevated, and one that was normal. I'll ask new doc for a plasma metanephrine. Any other test I should ask for? I had aldo/renin yesterday but no results yet. I've already had a parathyroid adenoma removed. I quit taking calcium quite a while back and I'm losing bone. Lost another inch in height. Started adult life at 4' 10.5 " so don't have a lot to lose. I guess I'll soon fit the definition of " little old lady. " I'll write Val's story and put it in the files. Sometimes I think I'm just crazy but keep reminding myself that being crazy doesn't raise aldo, decrease bone density, or grow parathyroid adenomas. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of lowerbp2@... This story should get you to the Mayo Clinic. I forget if you have ever been tested for pheochromocytoma. Somehow we need to develop a mini Hx that can be included with each persons note that summarizes the Hx in a standard form. That way I dont have to keep asking these questions. At least when one describes spells with fluctuating BP always add: I have been tested for pheochromocytoma with blood or urine tests. I need to work on a " card " that will summarized this for each person as part of their signature perhaps. Suggestions? In a message dated 1/8/08 9:32:39 AM, val@... <mailto:val%40wyosip.com> writes: > > Just an update for the list. Yesterday, I was determined to go to Mayo in > MN and even made the initial call. As many of you know, I have been going > through an " episode. " An " episode " is defined as > 1) Sweats > 2) Probable paralysis with the sweats, very rarely and probably after too > much salt. > 3) Extreme anxiety > 4) BP as high as 210/114 > 5) Inability to sleep > 6) Headache, usually hits when I can get the anxiety to resolve for a while. > 7) Muscle contractions. My chiropractor finally told me to stop trying to > lift weights (2 lb) because lifting always sends me into spasms. > 8) Weakness. Some days I can't walk 1/2 mile; other days, I can walk and > work. > > During an episode in 2005, my ARR was 32.5. From my reading, that is > suggestive of PA but not determinative. CT in 2005 showed nothing > irregular. I had a parathyroid adenoma removed in 1999. > > This is where I was last night. I had written Dr. Grim privately and he > suggested I write to the list so all can learn. > > As of tonight, I just don't know what to do. I feel almost normal and am > appropriately sleepy (a rare occurrence)! My BP today was 145/80. My pulse > the last few days has decreased from the high 80's to the mid/low 70's. I > had blood tests done today including aldo and renin. I think I'm going to > wait and see what they say. > > I am taking tram/HCTZ 37.5-25 as of two weeks ago (HCTZ for five years > before that). Perhaps my calmness is the result of rising K. I'm thinking > I should perhaps try some other BP meds before I give up and go to Mayo. > Perhaps a different med (not a diuretic) would lessen my metabolic syndrome. > I just don't know what to do. > > These episodes seem to be precipitated by the substitution of a tiny amount > of T3 (2.25 mcg) for about 25 mcg of T4. The episodes take literally > several months to subside, but I have had major episodes without taking any > T3 nor a diuretic. I want to take T3 because of the heart-event severity of > low T3 and I keep thinking a higher T3 would help me lose weight. I've > always lost a few pounds on that regimen until a big episode starts and I > give it all up. I took Actos for six months for a barely elevated BG - and > gained ten pounds. Then took metformin for a few months, had constant > hypoglycemia and had to eat fruit nearly constantly. I gained seven pounds > on that. I am NOT a food junkie. If I didn't get the shakes, I could > almost live without food. I DASH. > > My T3 is always low. Below is an article about " low T3 syndrome. " I have > lipid problems just like my mother. As the years went on, her life was not > quality. I think she was hypothyroid all her life. You probably understand > it all but may be interested in the article. > > This morning, I was up at 5 a.m. with the sweats but my BP is down to > 129/83. Anxiety level is medium as opposed to extreme. > > Val Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2008 Report Share Posted January 8, 2008 Wow Val, sounds like my PA symptoms 10-15 years ago when still in stage 2-3. I didn't know what to do either, so just kept trying other BP meds that didn't work (for BP, low K or the spectrum of other symptoms that have little probative clinical value to anyone except the patient). Those next 10-15 years at 140/80 to 155/90 (relying only on office measurements like most doctors seem content to do, I didn't find out until too late that daily periodicity can produce a very different average) got me a case of LVH or muscle-bound left ventricle which, together with the worsening low K episodes put me into the hospital with a few defibrillations and one morphine IM to the heart. Close calls with two major correlatives for sudden death cardiac arrest (LVH & low K). Now that I do know what to do, I'd demand immediately either (1) a 2 week aldactone test, or (2) dex suppression to see what happens to my BP and K in the first case, BP in the second. Better still, start the aldactone while waiting for serum aldo and plasma renin, and conduct 24-hour urines on both and ACTH. I will never believe the common doctor refrain that it doesn't matter if your BP is above 140 " for awhile " again - unless going off aldactone or inspra for AVS prepping for possible removal of a one-sided overproducing adrenal bump or hyperplasia. Those 2-3 weeks might be worth the risk in the later stages - to me after my nightmare. Sorry to be a nudge, Dave Valarie wrote: > > Just an update for the list. Yesterday, I was determined to go to Mayo in > MN and even made the initial call. As many of you know, I have been going > through an " episode. " An " episode " is defined as > 1) Sweats > 2) Probable paralysis with the sweats, very rarely and probably after too > much salt. > 3) Extreme anxiety > 4) BP as high as 210/114 > 5) Inability to sleep > 6) Headache, usually hits when I can get the anxiety to resolve for a > while. > 7) Muscle contractions. My chiropractor finally told me to stop trying to > lift weights (2 lb) because lifting always sends me into spasms. > 8) Weakness. Some days I can't walk 1/2 mile; other days, I can walk and > work. > > During an episode in 2005, my ARR was 32.5. From my reading, that is > suggestive of PA but not determinative. CT in 2005 showed nothing > irregular. I had a parathyroid adenoma removed in 1999. > > This is where I was last night. I had written Dr. Grim privately and he > suggested I write to the list so all can learn. > > As of tonight, I just don't know what to do. I feel almost normal and am > appropriately sleepy (a rare occurrence)! My BP today was 145/80. My pulse > the last few days has decreased from the high 80's to the mid/low 70's. I > had blood tests done today including aldo and renin. I think I'm going to > wait and see what they say. > > I am taking tram/HCTZ 37.5-25 as of two weeks ago (HCTZ for five years > before that). Perhaps my calmness is the result of rising K. I'm thinking > I should perhaps try some other BP meds before I give up and go to Mayo. > Perhaps a different med (not a diuretic) would lessen my metabolic > syndrome. > I just don't know what to do. > > These episodes seem to be precipitated by the substitution of a tiny > amount > of T3 (2.25 mcg) for about 25 mcg of T4. The episodes take literally > several months to subside, but I have had major episodes without > taking any > T3 nor a diuretic. I want to take T3 because of the heart-event > severity of > low T3 and I keep thinking a higher T3 would help me lose weight. I've > always lost a few pounds on that regimen until a big episode starts and I > give it all up. I took Actos for six months for a barely elevated BG - and > gained ten pounds. Then took metformin for a few months, had constant > hypoglycemia and had to eat fruit nearly constantly. I gained seven pounds > on that. I am NOT a food junkie. If I didn't get the shakes, I could > almost live without food. I DASH. > > My T3 is always low. Below is an article about " low T3 syndrome. " I have > lipid problems just like my mother. As the years went on, her life was not > quality. I think she was hypothyroid all her life. You probably understand > it all but may be interested in the article. > > This morning, I was up at 5 a.m. with the sweats but my BP is down to > 129/83. Anxiety level is medium as opposed to extreme. > > Val > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2008 Report Share Posted January 8, 2008 Well, when I google MENs, I get men, men's pants, men's no-no, men's groups, etc. (joke - hehe) When I google images for mixed endocrine neoplasia, I see pictures of white spots and black spots. Is that what I'm looking for? My tongue is uniform and pink. I think it looks " normal. " Thank God! It has a couple of little cracks toward the front but I think I've always had that. My very good dentist always looks around and has never said anything. I go every four months for periodontal care. He was voted " Best of Boulder " a few years ago. I started seeing him when he was a mere 28 years old. He's now in his mid-forties and still gorgeous. But I digress .. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of lowerbp2@... Always mention you have a parathryoid adenoma removed. There are a number of syndromes called MENs that are associated with this. One diad is Para + pheo as I recall. goggle MENs (mixed endocrine neoplasia) for images to see if you have funny things on you tongue. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 go to PUBMED also called MEA MEN Syndrome and M.E.N. 1: Parathyroid, Pituitary, Pancreas ... The behavior and type of endocrine overactivity is different. MEN 1 is also known as MEA 1 (Multiple Endocrine Adenomatosis Type 1) and Wermer's Syndrome .... www.endocrineweb.com/MEN/MEN1.html - 20k - Cached - Similar pages May your pressure be low! Clarence E. Grim, BS, MS, MD Senior Consultant to Shared Care Research and Consulting, Inc. (sharedcareinc.com) Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI Clinical Professor of Nursing, Univ. of WI, Milwaukee Specializing in Difficult to Control High Blood Pressure and the Physiology and History of Survival During Hard Times and Heart Disease today. ************** Start the year off right. Easy ways to stay in shape. http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 PS: Mayo should jump at this story. May your pressure be low! Clarence E. Grim, BS, MS, MD Senior Consultant to Shared Care Research and Consulting, Inc. (sharedcareinc.com) Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI Clinical Professor of Nursing, Univ. of WI, Milwaukee Specializing in Difficult to Control High Blood Pressure and the Physiology and History of Survival During Hard Times and Heart Disease today. ************** Start the year off right. Easy ways to stay in shape. http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 Always better to back titrate as when you stop suddenly you may get a real rebound in heart rate, BP and irregular heart beats. I would be surprised if Ativan affected skiped heart beats but it might. On Apr 19, 2008, at 2:37 PM, Valarie wrote: > I titrated per suggestion last night + took Ambien CR for the first > time + > resumed cal/mag supplement. > > 6 p.m. 2.5 mg > midnight 5 mg > 6 a.m. 7.5 mg (on and off sweats during the morning and heavy chest > feeling) > noon 10 mg (big sweat by 12:40. Heavy feeling in chest/need deep > breaths by > 1:30 p.m.) > > I think propranolol increases sweating. Sweating increases the > anxiety. > Anxiety increases BP. Therefore, I am theorizing that propranolol is > not > good for me. Heart is not skipping though. I can't go for a walk when > I > feel this heaviness. > > Is it safe to just discontinue it or should I taper down? I can > usually > knock out any heart skips with Ativan if necessary until I get doc to > change > med. She's out of the office until 4/25 but does get messages. > > I had a better night. After I got up to take the 6 a.m. dose, I was > able to > go back to bed for an hour and doze, without anxiety and little > sweating. > > Took 125 mg spiro yesterday. Increased to 150 mg today. > > So, I got 6 solid hours of sleep instead of 4 or 5. Makes a huge > difference. If I could get rid of the chest heaviness, I'd feel almost > normal today. I don't know how much difference the Ambien CR made - > maybe a > lot. What makes you wake up? The need to pee? That should be getting better with Spiro > > Haven't taken any Ativan today. > > Val > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 Usually the sweats wake me up and then I need to use the bathroom. I always lie back down, trying to sleep, but the anxiousness overcomes and I get up. This morning, I could lie there for a hour. I guess one day does is not a trend. I'm going to 1/2 the propranolol every six hours. Been having sweats all day. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim What makes you wake up? The need to pee? That should be getting better with Spiro Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 A full bladder can cause profound sympathetic discharge. This can result in very wide swings in BP and is seem post op and in quadriplegics. Also one reason we ask people to pee before we measure their BP. How much water do you pass when you go? If a lot it suggests your bladder was very full and may have caused a sympathtic spell. Are you taking any drugs that might decrease your ability to sense a full bladder before it get excessively full? Sleeping meds?? On Apr 19, 2008, at 4:38 PM, Valarie wrote: > Usually the sweats wake me up and then I need to use the bathroom. I > always > lie back down, trying to sleep, but the anxiousness overcomes and I > get up. > This morning, I could lie there for a hour. I guess one day does is > not a > trend. I'm going to 1/2 the propranolol every six hours. Been having > sweats all day. > > Val May your pressure be low! CE Grim BS, MS, MD High Blood Pressure Consulting Specializing in Difficult to Manage High Blood Pressure Consult the following at for details bloodpressureline hyperaldosteronism Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 The sick thing is it took my husband listening to my heart when I was having a " gripping episode " /anxiety. I took two Ativan (1/2 mg each) and three hours later, my heart had quit skipping. GP listened to it and said I had a murmur. Endo hasn't listened. I was in a high anxiety state when I saw both of them. I don't know if the anxiety is causing the skips or if the skips cause the anxiety. And I don't know what's causing the sweats but propropranolol is making them worse. Maybe not sleeping for months and months causes anxiety. I'm not going to spend thousands of $$$ on this shrink. I need meds to get me over the hump and that's all. Certainly, I'm in much better shape than I was a month ago. I've been on spiro since 3/22. I've also cut my T4 down, probably not long enough to make a valid observation.. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim I would be surprised if Ativan affected skiped heart beats but it might. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 Ambien (Ambien CR as of last night), and right now, I need it. I used to be able to get up and go and then go right on sleeping. That was before I was doing it every 1/2 hour, of course. Interesting about the effect of a full bladder. It seems that I do pass a lot, but I'm drinking a lot of water now since I don't have a coffee to nurse all day. My mouth gets dry. The thing I've really noticed is that in the day, I'm not going every hour or less. Last summer, I had to go before we made the 10-mile drive between here and the old house, and then go again upon arrival. I can go somewhere now without having to stake out the nearest restroom. It all came on so gradually that I didn't realize I had a problem. Maybe I'll set an alarm and get up after three hours. I know I could go back to sleep at three hours. I'm not sure I should break up what little sleep I get. My BP has been running pretty low first thing in the morning - 123/81 this morning. Then it rises a bit by noon - today 136/89. If I let myself get too nervous, it would be up to 144 or so. Compare that to 165 - 185 before. My natural coping mechanism for the last 3 or 4 years has been to stay home and avoid any interaction or pressure. When I had the pheo test (2/08), I put out 3300 cc. It seems that when I had it three years ago, it was more like 2400. I still need to find my tests. I am alone for a few days while DH visits his mother. We were just talking on IM and I just came to the realization that, even though I still complain a lot, I'm in much, much better shape than I was a month ago. I was not born with patience and have not learned it well. This disease didn't come on overnight. My family came for Easter and I had to dope up on Ativan to keep the nerves/gripping at bay for the short time they were here. I was terribly weak compared to now. At Christmas, I couldn't get the right names on the right presents. I don't feel as stupid as I did then. I ordered everything off the Internet as store shopping was beyond my physical ability. Maybe 150 spiro will be my sweet spot. I hope you understand my appreciation. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim A full bladder can cause profound sympathetic discharge. This can result in very wide swings in BP and is seem post op and in quadriplegics. Also one reason we ask people to pee before we measure their BP. How much water do you pass when you go? If a lot it suggests your bladder was very full and may have caused a sympathtic spell. Are you taking any drugs that might decrease your ability to sense a full bladder before it get excessively full? Sleeping meds?? On Apr 19, 2008, at 4:38 PM, Valarie wrote: > Usually the sweats wake me up and then I need to use the bathroom. I > always > lie back down, trying to sleep, but the anxiousness overcomes and I > get up. > This morning, I could lie there for a hour. I guess one day does is > not a > trend. I'm going to 1/2 the propranolol every six hours. Been having > sweats all day. > > Val May your pressure be low! CE Grim BS, MS, MD High Blood Pressure Consulting Specializing in Difficult to Manage High Blood Pressure Consult the following at for details bloodpressureline hyperaldosteronism Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 I recall you said you might have mitral valve prolapse which can cause a heart murmur. I guess I would be nervous if my Endo listened to my heart. In all probability and my experience most doctors have never had anyone with known good hearing listen with them with a double stethoscope to be sure they can even hear. So when any Dr or nurse listens to your heart it is fair to ask the last time their hearing was tested and their ability to hear heart and blood pressure sounds validated as accurate. Most will have to sheepishly say either never or not since training. Scary right? On Apr 19, 2008, at 5:20 PM, Valarie wrote: > The sick thing is it took my husband listening to my heart when I was > having > a " gripping episode " /anxiety. I took two Ativan (1/2 mg each) and > three > hours later, my heart had quit skipping. GP listened to it and said I > had a > murmur. Endo hasn't listened. I was in a high anxiety state when I saw > both of them. I don't know if the anxiety is causing the skips or if > the > skips cause the anxiety. And I don't know what's causing the sweats > but > propropranolol is making them worse. Maybe not sleeping for months and > months causes anxiety. > > I'm not going to spend thousands of $$$ on this shrink. I need meds > to get > me over the hump and that's all. Certainly, I'm in much better shape > than I > was a month ago. I've been on spiro since 3/22. I've also cut my T4 > down, > probably not long enough to make a valid observation.. > > Val > > From: hyperaldosteronism > [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim > > I would be surprised if Ativan affected skiped heart beats but it > might. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 On Apr 19, 2008, at 6:09 PM, Valarie wrote: > Ambien (Ambien CR as of last night), and right now, I need it. I used > to be > able to get up and go and then go right on sleeping. That was before > I was > doing it every 1/2 hour, of course. Interesting about the effect of a > full > bladder. It seems that I do pass a lot, but I'm drinking a lot of > water now > since I don't have a coffee to nurse all day. My mouth gets dry. The > thing > I've really noticed is that in the day, I'm not going every hour or > less. > Last summer, I had to go before we made the 10-mile drive between > here and > the old house, and then go again upon arrival. I can go somewhere now > without having to stake out the nearest restroom. It all came on so > gradually that I didn't realize I had a problem. Probably ADH resistant of your kidney due to low K then. This should be getting better with spiro. > > > Maybe I'll set an alarm and get up after three hours. I know I could > go > back to sleep at three hours. I'm not sure I should break up what > little > sleep I get. My BP has been running pretty low first thing in the > morning - > 123/81 this morning. Then it rises a bit by noon - today 136/89. If I > let > myself get too nervous, it would be up to 144 or so. I would say this is normal. > Compare that to 165 - > 185 before. My natural coping mechanism for the last 3 or 4 years has > been > to stay home and avoid any interaction or pressure. > > When I had the pheo test (2/08), I put out 3300 cc. It seems that > when I > had it three years ago, it was more like 2400. I still need to find my > tests. > > I am alone for a few days while DH visits his mother. We were just > talking > on IM and I just came to the realization that, even though I still > complain > a lot, I'm in much, much better shape than I was a month ago. I was > not > born with patience and have not learned it well. This disease didn't > come > on overnight. My family came for Easter and I had to dope up on > Ativan to > keep the nerves/gripping at bay for the short time they were here. I > was > terribly weak compared to now. At Christmas, I couldn't get the right > names > on the right presents. I don't feel as stupid as I did then. I ordered > everything off the Internet as store shopping was beyond my physical > ability. Maybe 150 spiro will be my sweet spot. > We will need to keep observering and increasing till we are certain. > I hope you understand my appreciation. > > Val > > From: hyperaldosteronism > [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim > > A full bladder can cause profound sympathetic discharge. This can > result in very wide swings in BP and is seem post op and in > quadriplegics. Also one reason we ask people to pee before we measure > their BP. > > How much water do you pass when you go? If a lot it suggests your > bladder was very full and may have caused a sympathtic spell. > > Are you taking any drugs that might decrease your ability to sense a > full bladder before it get excessively full? Sleeping meds?? > > On Apr 19, 2008, at 4:38 PM, Valarie wrote: > > > Usually the sweats wake me up and then I need to use the bathroom. I > > always > > lie back down, trying to sleep, but the anxiousness overcomes and I > > get up. > > This morning, I could lie there for a hour. I guess one day does is > > not a > > trend. I'm going to 1/2 the propranolol every six hours. Been having > > sweats all day. > > > > Val > May your pressure be low! > > CE Grim BS, MS, MD > High Blood Pressure Consulting > Specializing in Difficult to Manage High Blood Pressure > Consult the following at for details > bloodpressureline > hyperaldosteronism > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 I called my brother tonight and talked for two hours. It has been months and months since I've initiated an unnecessary telephone call. I don't even answer the phone if DH is here. I don't know what normal feels like, but that's more normal than I have been in at least six years. Still don't know if it's a trend - too afraid to get too excited. If it weren't for this list and you, I'd be on Prozac and five BP meds that don't work. BP tonight after long phone call = 124/85. My God I appreciate you! Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim We will need to keep observering and increasing till we are certain. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 The Fen-Phen doc said I had the mildest level of mitral valve regurgitation (based on his echo - 2003). I do have a murmur, first heard prior to PTH surgery (1999) when BP was sky-high. Still need to find my file. Yes, what goes on is scary. Brother took his daughter to Mayo in Phoenix. She had been dragging for several years and had sky-high Vitamin D levels. The doc had her mother leave the room and then asked neice if her father had ever abused her. Tried to give her Prozac. This girl is a Goldwater scholar. Turns out, she had Lyme disease and they remembered a tick bite and rash when she was little. Mayo missed it. Are they teaching medical students psychology, social work, or medicine? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim So when any Dr or nurse listens to your heart it is fair to ask the last time their hearing was tested and their ability to hear heart and blood pressure sounds validated as accurate. Most will have to sheepishly say either never or not since training. Scary right? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2008 Report Share Posted April 19, 2008 They say they were. Guess you heard the one about the prostitute who got Lyme Disease but kept working. It was said she took a ticking but kept on licking. On Apr 19, 2008, at 11:58 PM, Valarie wrote: > The Fen-Phen doc said I had the mildest level of mitral valve > regurgitation > (based on his echo - 2003). I do have a murmur, first heard prior to > PTH > surgery (1999) when BP was sky-high. Still need to find my file. > > Yes, what goes on is scary. Brother took his daughter to Mayo in > Phoenix. > She had been dragging for several years and had sky-high Vitamin D > levels. > The doc had her mother leave the room and then asked neice if her > father had > ever abused her. Tried to give her Prozac. This girl is a Goldwater > scholar. Turns out, she had Lyme disease and they remembered a tick > bite > and rash when she was little. Mayo missed it. > > Are they teaching medical students psychology, social work, or > medicine? > > Val > > From: hyperaldosteronism > [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim > > So when any Dr or nurse listens to your heart it is fair to ask the > last time their hearing was tested and their ability to hear heart and > blood pressure sounds validated as accurate. Most will have to > sheepishly say either never or not since training. > > Scary right? > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2008 Report Share Posted April 20, 2008 Valarie wrote: > > Maybe not sleeping for months and > months causes anxiety. > > --see the overwhelming data both clinical and lab in Wm C Dement's > book " The Promise of Sleep. " Gads, it could easily explain everything > - and I do mean everything - you've cited here. > dave > Val > > From: hyperaldosteronism > <mailto:hyperaldosteronism%40> > [mailto:hyperaldosteronism > <mailto:hyperaldosteronism%40>] On Behalf Of Clarence Grim > > I would be surprised if Ativan affected skiped heart beats but it might > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2008 Report Share Posted April 20, 2008 I ordered it. Amazon's " one click " shopping could really burn up the $$. Too easy. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Dave Valarie wrote: > > Maybe not sleeping for months and > months causes anxiety. > > --see the overwhelming data both clinical and lab in Wm C Dement's > book " The Promise of Sleep. " Gads, it could easily explain everything > - and I do mean everything - you've cited here. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2008 Report Share Posted April 20, 2008 Val: This is just a thought..but weighing in on the " chest heaviness " . Hard to say if it is the same thing that I experience as the " kicked in chest feeling " , but sure sounds similar. I keep thinking back to the first time that I ever experienced it and it was after taking Yasmin for a couple of weeks. As you may or may not now, Yasmin contains a spiro cousin (drospirenone) that can cause problems if you have adrenal disease. I had worked out after taking Yasmin for a while (doc had told me that he thought I had PCOS due to ration of LH to FSH) and woke up next am so weak/tired/depressed that I couldn't lift my head. I called my GP and she ran labs including CKP for some reason. CKP and muscle enzymes were EXTREMELY elevated. I had not worked out any harder than usual. She was so concerned about it (called a rheumy) that she had me come in EVERY day for CKP testing, sed rate, etc. She advised me to go OFF the Yasmin, which I did and she called their side effect hotline. Enzymes came down and I was okay within about a week and a half. I had that " feeling " again this week and had the elevated BUN/creat ratio. Have to find out if she did CKP again or lab missed it on requisition. Are you absolutely CERTAIN that it isn't the increase in spiro that caused this? And, do you think it might be helpful to check CPK and CBC/CMP? Sincerely hope this is helpful and not more confusion, Angie > > I titrated per suggestion last night + took Ambien CR for the first time + > resumed cal/mag supplement. > > 6 p.m. 2.5 mg > midnight 5 mg > 6 a.m. 7.5 mg (on and off sweats during the morning and heavy chest feeling) > noon 10 mg (big sweat by 12:40. Heavy feeling in chest/need deep breaths by > 1:30 p.m.) > > I think propranolol increases sweating. Sweating increases the anxiety. > Anxiety increases BP. Therefore, I am theorizing that propranolol is not > good for me. Heart is not skipping though. I can't go for a walk when I > feel this heaviness. > > Is it safe to just discontinue it or should I taper down? I can usually > knock out any heart skips with Ativan if necessary until I get doc to change > med. She's out of the office until 4/25 but does get messages. > > I had a better night. After I got up to take the 6 a.m. dose, I was able to > go back to bed for an hour and doze, without anxiety and little sweating. > > Took 125 mg spiro yesterday. Increased to 150 mg today. > > So, I got 6 solid hours of sleep instead of 4 or 5. Makes a huge > difference. If I could get rid of the chest heaviness, I'd feel almost > normal today. I don't know how much difference the Ambien CR made - maybe a > lot. > > Haven't taken any Ativan today. > > Val > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2008 Report Share Posted April 20, 2008 There is an article in our Medline files about drospirenone that you may find interesting. I've copied it below. I am quite positive it is not the spiro. The heavy chest feeling comes on within an hour of taking Inderal (a short-acting BB). I've dropped it down to 5 mg (from 10) and the feeling is not as bad. I'm thinking the feeling comes from the Inderal quickly dropping my heart rate. It leaves after a couple of hours. The " gripping " and low blood sugar feeling have stopped so that is encouraging. I need to get on a very low-dose, long-acting BB. I was so encouraged last night but stayed up to past midnight to take the last dose of BB. I could feel the heavy chest before I dozed off. Then, the sweats started at 4:30 a.m. If I could just stop the early morning sweats and could sleep, I'd be feeling much better. I ate some rice cakes before bed. Tonight, I'm going to take a little protein and see if that changes anything. I'm tired. Val Am J Hypertens. 2007 Dec;20(12):1334-7. Laboratory diagnosis of primary aldosteronism, and drospirenone-ethinylestradiol therapy. Pizzolo F, Pavan C, Corrocher R, Olivieri O. Unit of Internal Medicine, Department of Clinical and Experimental Medicine, University of Verona, Policlinico Borgo Roma, Verona, Italy. francesca.pizzolo@... BACKGROUND: Primary aldosteronism is recognized as the most frequent cause of secondary hypertension. Screening for primary aldosteronism by determination of the aldosterone-to-renin ratio (ARR) is much more frequently performed in current practice. However, most antihypertensive medications interfere with ARR determination, and although verapamil and alpha-adrenergic blockers are considered sufficiently neutral, the specific drugs which should be discontinued before ARR screening are a matter of debate. Our objective was to evaluate the possible interference of a new progestin with antimineralocorticoid activity (drospirenone) on the determination of ARR and the diagnosis of primary aldosteronism. METHODS AND RESULTS: We describe an instance of a false-positive laboratory diagnosis of primary aldosteronism (by both screening and confirmatory test) in a normotensive 34-year-old healthy woman taking Yasmin (drospirenone + ethinylestradiol) (Shering S.p.A., Milan, Italy). Subsequent ARR values during Yasmin therapy changed during the menstrual cycle (days 7, 14, 21, and 28 were tested), reaching values above the screening ARR threshold that led to a suspicion of primary aldosteronism just before menses. In contrast, during a drug-free menstrual cycle, the ARR remained constantly below the screening ARR threshold. CONCLUSIONS: We report for the first time that drospirenone may interfere with laboratory screening and confirmatory testing for the diagnosis of primary aldosteronism. As a consequence, this drug should be withdrawn in hypertensive women investigated for secondary hypertension. Although drospirenone was demonstrated to possess antihypertensive properties when taken as postmenopausal hormonal replacement therapy, its use for contraceptive purposes needs to be more carefully investigated. PMID: 18047926 [PubMed - indexed for MEDLINE] > > Are you absolutely CERTAIN that it isn't the increase in spiro that > caused this? And, do you think it might be helpful to check CPK and > CBC/CMP? Sincerely hope this is helpful and not more confusion, > Angie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2008 Report Share Posted April 20, 2008 I don't really understand CKP testing. I can't find it at labtestsonline.org I've had tightly bound muscles, especially in my calves, for years. They seemed to be in a constant state of contraction and pain. I asked my masseuse to work on one last year. When she felt it, she was amazed and made me promise to drink lots of water after. Since being on spiro, those muscles have softened up. I'm sure it is the increased K I'm enjoying. BTW, my 14 years of misdiagnosed ankylosing spondylitis hell was based on one elevated sed rate test. It never came back elevated after the initial one. He didn't know what to do so he gave me NSAIDS and disregarded the high calcium. BTW, my Lyme disease niece, after going to Mayo Phoenix, diagnosed herself from the Internet and found a doctor in Colorado Springs to treat her. I diagnosed myself from the Internet and then found Dr. Grim. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of aviano237 Val: This is just a thought..but weighing in on the " chest heaviness " . Hard to say if it is the same thing that I experience as the " kicked in chest feeling " , but sure sounds similar. I keep thinking back to the first time that I ever experienced it and it was after taking Yasmin for a couple of weeks. As you may or may not now, Yasmin contains a spiro cousin (drospirenone) that can cause problems if you have adrenal disease. I had worked out after taking Yasmin for a while (doc had told me that he thought I had PCOS due to ration of LH to FSH) and woke up next am so weak/tired/depressed that I couldn't lift my head. I called my GP and she ran labs including CKP for some reason. CKP and muscle enzymes were EXTREMELY elevated. I had not worked out any harder than usual. She was so concerned about it (called a rheumy) that she had me come in EVERY day for CKP testing, sed rate, etc. She advised me to go OFF the Yasmin, which I did and she called their side effect hotline. Enzymes came down and I was okay within about a week and a half. I had that " feeling " again this week and had the elevated BUN/creat ratio. Have to find out if she did CKP again or lab missed it on requisition. Are you absolutely CERTAIN that it isn't the increase in spiro that caused this? And, do you think it might be helpful to check CPK and CBC/CMP? Sincerely hope this is helpful and not more confusion, Angie > > I titrated per suggestion last night + took Ambien CR for the first time + > resumed cal/mag supplement. > > 6 p.m. 2.5 mg > midnight 5 mg > 6 a.m. 7.5 mg (on and off sweats during the morning and heavy chest feeling) > noon 10 mg (big sweat by 12:40. Heavy feeling in chest/need deep breaths by > 1:30 p.m.) > > I think propranolol increases sweating. Sweating increases the anxiety. > Anxiety increases BP. Therefore, I am theorizing that propranolol is not > good for me. Heart is not skipping though. I can't go for a walk when I > feel this heaviness. > > Is it safe to just discontinue it or should I taper down? I can usually > knock out any heart skips with Ativan if necessary until I get doc to change > med. She's out of the office until 4/25 but does get messages. > > I had a better night. After I got up to take the 6 a.m. dose, I was able to > go back to bed for an hour and doze, without anxiety and little sweating. > > Took 125 mg spiro yesterday. Increased to 150 mg today. > > So, I got 6 solid hours of sleep instead of 4 or 5. Makes a huge > difference. If I could get rid of the chest heaviness, I'd feel almost > normal today. I don't know how much difference the Ambien CR made - maybe a > lot. > > Haven't taken any Ativan today. > > Val > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2008 Report Share Posted April 20, 2008 Ummmm..could it be that the " false positive " wasn't false at all? and that the weakness, etc. that I experienced, was in fact, provoked, genetically probable PA? I don't remember what my BP's were at the time, darn it. Your article seems somewhat contradictory to the expected, unless the estrogen form is increasing the aldo. At least for me, estradiol increases " the racing " which at this point (further testing required) also correlated with increased aldo/low renin, among other things. Drospirenone SHOULD lower aldo, if acts like spiro, shouldn't it??? Maybe Dr. Grim can weigh in. I don't think I can take Yasmin. Furthermore (maybe Dr. Grim can enlighten us), I'm not clear on what the " adrenal disease " that the label speaks of is..is it hyPOaldosteronism? 's (low cortisol?), what? I'm also a little concerned about taking spiro for the same reason and right now my BP's are good (this AM was 113/63, resting pulse 60 BPMs), so I assume that I don't need it EXCEPT maybe to lower androgen levels which technically right now are also within range (68 ng/dl). Take the CPK and CMP/CBC advice for what it's worth..sometimes labs can be telling, however. Later, Angie > > > > Are you absolutely CERTAIN that it isn't the increase in spiro that > > caused this? And, do you think it might be helpful to check CPK and > > CBC/CMP? Sincerely hope this is helpful and not more confusion, > > Angie > > > > > Quote Link to comment Share on other sites More sharing options...
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