Re: Re: Adrenal Vein Sampling. Request for Brief Hx at head or foot of note.

[Guest guest]

Looks like they were worried about pheo and have excluded it. but

should have done aldos in AVS as well IMHO.

Always send normal values for the lab used. Do you have them for the

renin and aldo esp. Did they ever do a 24 hr urine aldo.

Review our files on how to be sure they got an good K measurement

when they draw your blood.

Very low serum Na is of intetrest. What did they think was causing it?

What are normal for cats in their lab?

Tell your health care team and Neph about blood in urine and left

pain. Any Hx of kidney stones?

If problems due to excess MC then should be getting better but will

likely need much more spiro, but working up every week or 2 is one

way to do it.

GENERAL NOTE TO ALL: I HAVE FILLED OUT A HYPOTHETICAL SAMPLE.

SUGGESTIONS FROM OTHERS WELCOME.

Would also like for all to have a brief overview of your Hx (say at

head or foot of note). As we have so many pts it is hard for me to

keep them all straight. If doing it in office I would have access to

this information to jog my memory. Would think we need to develop a

standard form.

Such as: 44 y/o Caucasian female married nurse from Wayout, OH with

HTN since XXXX. Highest BP has been XXX/XXX. First noted low K

problems in XXXX. Nocutria x times/night, Lowest K has been 2.5. Hx

of muscle cramps.

I can tell my BP is high by XXXX.

I measure my home BP with a XXXdevice every X days and the average is

XXX/XXX.

Renin of 0.1 units (normal 2-10 units) and aldo of 30 units(normal of

10-40 units) done XXXX and ratio of 300.

Chest X-ray, EKG,Echo

Abd CT or MRI

AVS results:

The following BP meds have been tried and their results were:

Diuretics, BB, ACE, ARBS, CCBs, MCA (mineralocorticoid antagonist).

FH of low K, HTN stroke etc.

Other health problems

Major surgeries if any

Current meds: current BP: current symptoms.

Clarence Grim

lowerbp2@...

On Dec 25, 2008, at 11:05 PM, jacca07 wrote:

>

> >

> > Need your renin ,

> > Aldo and K Hx

>

> Only results I have are from - August 07 - when testing was done in

> Brisbane. Was admitted for observation in 08, and comment was probably

> pericarditis/myocarditis (no proof in echo though). Here is what I

> have:

> AVS - Right Adrenaline 6.1 Noradrenaline 5.0 (Nov 07)

> Left Adrenaline 106 Noradrenaline 22

> Right Adrenaline 5.0 Noradrenaline 4.4

> Left Adrenaline 145 Noradrenaline 32

> Potassium 4-4.5

> Aldo/Renin Ratio supine 110, upright 80 (no salt diet and on

> hypertensives at the time).

> Urea 9.7

> Chol 7.5

> Plasma Cat Adrenaline 1.4 Noradrenaline 4.1 (Nov 07)

> Bicarb 17

> Sodium 120

> Don't know if this is of any use. I am in the too hard basket I

> think. Amazes me!! I have not had a single night without heart issues

> in 16 months, high BP, getting higher. Recently had gastroscopy to

> check digestive, BP dropped through the floor, vasovagal during AVS,

> dental anaes. heart into overdrive, recent CT scan of adenoma

> (11mm) BP

> through the roof, massive kidney pain,collapsed, shakes, felt like I

> had hold of a live power line...Have only been on the spiro for a few

> days but GP wants it up to 25mg.. the tingling and chest pain has

> eased, and I notice the rapid jumping of my chest over heart starts

> the

> minute I move in bed, always around 3am but BP is always 160/105 at

> this time. Getting more pain over left flank now, sweating, recent

> blood spotting in urine. I am wondering if I should try a

> Nephrologist,

> have tried every other sort of specialist!! Thank you Dr Grim for your

> interest.

>

>

>