Re: Re: New diagnosis and surgery

[Guest guest]

I do hope you don't have ANY surgery without prior adrenal vein sampling.

As I recall, they don't do AVS at UCSF.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of alexchisholm93

Thanks for your prompt reply. I had a battery of tests done last week and

was put on

50mg of Spiro starting this past Monday. I am slowly going off the ACE and

still take

10mg of Norvasc. My renin was measured in June and was low at <0.1 and

Aldosterone

urine was 65.8 mcg. I've been on the DASH diet for at least a year trying to

bring my BP

down. It stays in the 140/85-150/95 range without medication. I'm seeing my

Endocrinologist Friday, anything else I should ask him. He has been at UCSF

for many

years though specializes in thyroid.

[Guest guest]

Ask him if he had P'A who would he go to?

As your BP is doing so well on DASH you may not need much spiro. Keep

us posted.

CE Grim MD

On Dec 17, 2008, at 12:20 PM, Valarie wrote:

> I do hope you don't have ANY surgery without prior adrenal vein

> sampling.

> As I recall, they don't do AVS at UCSF.

>

> Val

>

> From: hyperaldosteronism

> [mailto:hyperaldosteronism ] On Behalf Of

> alexchisholm93

>

> Thanks for your prompt reply. I had a battery of tests done last

> week and

> was put on

> 50mg of Spiro starting this past Monday. I am slowly going off the

> ACE and

> still take

> 10mg of Norvasc. My renin was measured in June and was low at <0.1 and

> Aldosterone

> urine was 65.8 mcg. I've been on the DASH diet for at least a year

> trying to

> bring my BP

> down. It stays in the 140/85-150/95 range without medication. I'm

> seeing my

> Endocrinologist Friday, anything else I should ask him. He has been

> at UCSF

> for many

> years though specializes in thyroid.

>

>

[Guest guest]

Thanks. I'm a little confused on the need for AVS since there is clearly a good

size adenoma on the right adrenal. I understand the concept of bilateral

hyperplasia but isn't the existence of the adenoma a pretty clear indication

that that's what is generating the high level of aldosterone? My Endocrinologist

hasn't mentioned AVS but I'll bring it up in my Fri. visit.  I just started

researching everything so please bear with me! This group is a great resource.

________________________________

From: Clarence Grim <lowerbp2@...>

hyperaldosteronism

Sent: Wednesday, December 17, 2008 11:35:42 AM

Subject: Re: Re: New diagnosis and surgery

Ask him if he had P'A who would he go to?

As your BP is doing so well on DASH you may not need much spiro. Keep

us posted.

CE Grim MD

On Dec 17, 2008, at 12:20 PM, Valarie wrote:

> I do hope you don't have ANY surgery without prior adrenal vein

> sampling.

> As I recall, they don't do AVS at UCSF.

>

> Val

>

> From: hyperaldosteronism

> [mailto:hyperaldosteronism] On Behalf Of

> alexchisholm93

>

> Thanks for your prompt reply. I had a battery of tests done last

> week and

> was put on

> 50mg of Spiro starting this past Monday. I am slowly going off the

> ACE and

> still take

> 10mg of Norvasc. My renin was measured in June and was low at <0.1 and

> Aldosterone

> urine was 65.8 mcg. I've been on the DASH diet for at least a year

> trying to

> bring my BP

> down. It stays in the 140/85-150/95 range without medication. I'm

> seeing my

> Endocrinologist Friday, anything else I should ask him. He has been

> at UCSF

> for many

> years though specializes in thyroid.

>

>

[Guest guest]

The Evol of Primary Aldosteronism and why it is so common in drug

resistant HTN.

On Dec 17, 2008, at 9:34 AM, alexchisholm93 wrote:

> Dr Grim, which article should I be looking at. Is it in the Files

> area? Thanks.

>

>

> > > > I've always had low PB so when it started to rise

> approximately 3

> > > years ago

> > > > I was surprised.

> > > > I'm a 46 yo female in otherwise stellar condition, low BMI

> and no

> > > family

> > > > history of

> > > > hypertension. I was put on a thiazide drug which seemed to be

> > > lowering my

> > > > potassium. An

> > > > ACE inhibitor was added but potassium was still low. 2.5 years

> > > later I had

> > > > my aldosterone

> > > > tested and it came back high. It was actually tested in July of

> > > this year

> > > > but my MD. didn't

> > > > follow up on it. Had a CT last week which revealed 24mm

> adenoma on

> > > my right

> > > > adrenal. I

> > > > also have a kidney stone in the UVJ on my left side. I had

> passed

> > > a kidney

> > > > stone in April of

> > > > this year (is this the worst pain known to man - I think it is).

> > > Will be

> > > > seeing surgeon for

> > > > consultation in a few days. Not looking forward to surgery but

> > > would love to

> > > > feel better and

> > > > hopefully have BP stabilize.

> > > >

> > > >

> > >

> >

> >

> >

[Guest guest]

I amnot an MD but my cardiologist says there can still be a defect in

the adrenal showing no adenoma in a CT .......... go figure. What do

you think CG?

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

========================================-----------------------

On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

> Thanks. I'm a little confused on the need for AVS since there is

> clearly a good size adenoma on the right adrenal. I understand the

> concept of bilateral hyperplasia but isn't the existence of the

> adenoma a pretty clear indication that that's what is generating the

> high level of aldosterone? My Endocrinologist hasn't mentioned AVS but

> I'll bring it up in my Fri. visit.  I just started researching

> everything so please bear with me! This group is a great resource.

>

> ________________________________

> From: Clarence Grim <lowerbp2@...>

> hyperaldosteronism

> Sent: Wednesday, December 17, 2008 11:35:42 AM

> Subject: Re: Re: New diagnosis and surgery

>

> Ask him if he had P'A who would he go to?

>

> As your BP is doing so well on DASH you may not need much spiro. Keep

> us posted.

>

> CE Grim MD

> On Dec 17, 2008, at 12:20 PM, Valarie wrote:

>

> > I do hope you don't have ANY surgery without prior adrenal vein

> > sampling.

> > As I recall, they don't do AVS at UCSF.

> >

> > Val

> >

> > From: hyperaldosteronism

> > [mailto:hyperaldosteronism] On Behalf Of

> > alexchisholm93

> >

> > Thanks for your prompt reply. I had a battery of tests done last

> > week and

> > was put on

> > 50mg of Spiro starting this past Monday. I am slowly going off the

> > ACE and

> > still take

> > 10mg of Norvasc. My renin was measured in June and was low at <0.1

> and

> > Aldosterone

> > urine was 65.8 mcg. I've been on the DASH diet for at least a year

> > trying to

> > bring my BP

> > down. It stays in the 140/85-150/95 range without medication. I'm

> > seeing my

> > Endocrinologist Friday, anything else I should ask him. He has been

> > at UCSF

> > for many

> > years though specializes in thyroid.

> >

> >

[Guest guest]

Not sure what he means by a defect? Most adenomas are too small to

be seem with a CT as you will note in my article. When they evolve

(grow) enough they can be seen.

Many other adrenal problems can cause HTN without showing up on CT:

GRA AME etc as described in article.

CE Grim MD

On Dec 17, 2008, at 2:10 PM, Arthur Springer wrote:

> I amnot an MD but my cardiologist says there can still be a defect in

> the adrenal showing no adenoma in a CT .......... go figure. What do

> you think CG?

> ------------------------------

> ========================================-----------------------

>

> On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

>

> > Thanks. I'm a little confused on the need for AVS since there is

> > clearly a good size adenoma on the right adrenal. I understand the

> > concept of bilateral hyperplasia but isn't the existence of the

> > adenoma a pretty clear indication that that's what is generating the

> > high level of aldosterone? My Endocrinologist hasn't mentioned

> AVS but

> > I'll bring it up in my Fri. visit. I just started researching

> > everything so please bear with me! This group is a great resource.

> >

> > ________________________________

> > From: Clarence Grim <lowerbp2@...>

> > hyperaldosteronism

> > Sent: Wednesday, December 17, 2008 11:35:42 AM

> > Subject: Re: Re: New diagnosis and surgery

> >

> > Ask him if he had P'A who would he go to?

> >

> > As your BP is doing so well on DASH you may not need much spiro.

> Keep

> > us posted.

> >

> > CE Grim MD

> > On Dec 17, 2008, at 12:20 PM, Valarie wrote:

> >

> > > I do hope you don't have ANY surgery without prior adrenal vein

> > > sampling.

> > > As I recall, they don't do AVS at UCSF.

> > >

> > > Val

> > >

> > > From: hyperaldosteronism

> > > [mailto:hyperaldosteronism] On Behalf Of

> > > alexchisholm93

> > >

> > > Thanks for your prompt reply. I had a battery of tests done last

> > > week and

> > > was put on

> > > 50mg of Spiro starting this past Monday. I am slowly going off the

> > > ACE and

> > > still take

> > > 10mg of Norvasc. My renin was measured in June and was low at <0.1

> > and

> > > Aldosterone

> > > urine was 65.8 mcg. I've been on the DASH diet for at least a year

> > > trying to

> > > bring my BP

> > > down. It stays in the 140/85-150/95 range without medication. I'm

> > > seeing my

> > > Endocrinologist Friday, anything else I should ask him. He has

> been

> > > at UCSF

> > > for many

> > > years though specializes in thyroid.

> > >

> > >

[Guest guest]

Big adenomas come from small adenomas. At least 50% will be bilateral

likely nearly all if followed long enough in my opinion and experience.

There are lots of things that can look like an adenoma that are not

on CT.

I have been involved in the old days in taking out such things as a

large lipoma of the adrenal that looked like an adenoma

Never again. Only operate if the aldo coming from that gland is high

compared to other one.

CE Grim MD

On Dec 17, 2008, at 1:43 PM, Chisholm wrote:

> Thanks. I'm a little confused on the need for AVS since there is

> clearly a good size adenoma on the right adrenal. I understand the

> concept of bilateral hyperplasia but isn't the existence of the

> adenoma a pretty clear indication that that's what is generating

> the high level of aldosterone? My Endocrinologist hasn't mentioned

> AVS but I'll bring it up in my Fri. visit. I just started

> researching everything so please bear with me! This group is a

> great resource.

>

> ________________________________

> From: Clarence Grim <lowerbp2@...>

> hyperaldosteronism

> Sent: Wednesday, December 17, 2008 11:35:42 AM

> Subject: Re: Re: New diagnosis and surgery

>

> Ask him if he had P'A who would he go to?

>

> As your BP is doing so well on DASH you may not need much spiro. Keep

> us posted.

>

> CE Grim MD

> On Dec 17, 2008, at 12:20 PM, Valarie wrote:

>

> > I do hope you don't have ANY surgery without prior adrenal vein

> > sampling.

> > As I recall, they don't do AVS at UCSF.

> >

> > Val

> >

> > From: hyperaldosteronism

> > [mailto:hyperaldosteronism] On Behalf Of

> > alexchisholm93

> >

> > Thanks for your prompt reply. I had a battery of tests done last

> > week and

> > was put on

> > 50mg of Spiro starting this past Monday. I am slowly going off the

> > ACE and

> > still take

> > 10mg of Norvasc. My renin was measured in June and was low at

> <0.1 and

> > Aldosterone

> > urine was 65.8 mcg. I've been on the DASH diet for at least a year

> > trying to

> > bring my BP

> > down. It stays in the 140/85-150/95 range without medication. I'm

> > seeing my

> > Endocrinologist Friday, anything else I should ask him. He has been

> > at UCSF

> > for many

> > years though specializes in thyroid.

> >

> >

[Guest guest]

It's because of that that he feels AVS is the surest guide.

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

•••••••••

On Dec 17, 2008, at 3:20 PM, Clarence Grim wrote:

> Not sure what he means by a defect? Most adenomas are too small to

> be seem with a CT as you will note in my article. When they evolve

> (grow) enough they can be seen.

>

> Many other adrenal problems can cause HTN without showing up on CT:

> GRA AME etc as described in article.

>

> CE Grim MD

>

> On Dec 17, 2008, at 2:10 PM, Arthur Springer wrote:

>

> > I amnot an MD but my cardiologist says there can still be a defect

> in

> > the adrenal showing no adenoma in a CT .......... go figure. What do

> > you think CG?

> > ------------------------------

> > ========================================-----------------------

> >

> > On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

> >

> > > Thanks. I'm a little confused on the need for AVS since there is

> > > clearly a good size adenoma on the right adrenal. I understand the

> > > concept of bilateral hyperplasia but isn't the existence of the

> > > adenoma a pretty clear indication that that's what is generating

> the

> > > high level of aldosterone? My Endocrinologist hasn't mentioned

> > AVS but

> > > I'll bring it up in my Fri. visit. I just started researching

> > > everything so please bear with me! This group is a great resource.

> > >

> > > ________________________________

> > > From: Clarence Grim <lowerbp2@...>

> > > hyperaldosteronism

> > > Sent: Wednesday, December 17, 2008 11:35:42 AM

> > > Subject: Re: Re: New diagnosis and surgery

> > >

> > > Ask him if he had P'A who would he go to?

> > >

> > > As your BP is doing so well on DASH you may not need much spiro.

> > Keep

> > > us posted.

> > >

> > > CE Grim MD

> > > On Dec 17, 2008, at 12:20 PM, Valarie wrote:

> > >

> > > > I do hope you don't have ANY surgery without prior adrenal vein

> > > > sampling.

> > > > As I recall, they don't do AVS at UCSF.

> > > >

> > > > Val

> > > >

> > > > From: hyperaldosteronism

> > > > [mailto:hyperaldosteronism] On Behalf Of

> > > > alexchisholm93

> > > >

> > > > Thanks for your prompt reply. I had a battery of tests done last

> > > > week and

> > > > was put on

> > > > 50mg of Spiro starting this past Monday. I am slowly going off

> the

> > > > ACE and

> > > > still take

> > > > 10mg of Norvasc. My renin was measured in June and was low at

> <0.1

> > > and

> > > > Aldosterone

> > > > urine was 65.8 mcg. I've been on the DASH diet for at least a

> year

> > > > trying to

> > > > bring my BP

> > > > down. It stays in the 140/85-150/95 range without medication.

> I'm

> > > > seeing my

> > > > Endocrinologist Friday, anything else I should ask him. He has

> > been

> > > > at UCSF

> > > > for many

> > > > years though specializes in thyroid.

> > > >

> > > >

[Guest guest]

Roughly 40% of adenomas do not show up on CT.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Arthur Springer

I amnot an MD but my cardiologist says there can still be a defect in

the adrenal showing no adenoma in a CT .......... go figure.

[Guest guest]

Depends on how small of an " adenoma " you are talking about.

If big adenomas come from small adenomas---- then all must not be

visible at some point in their evolution.

CE Grim

On Dec 17, 2008, at 7:09 PM, Valarie wrote:

> Roughly 40% of adenomas do not show up on CT.

>

> Val

>

> From: hyperaldosteronism

> [mailto:hyperaldosteronism ] On Behalf Of Arthur

> Springer

>

> I amnot an MD but my cardiologist says there can still be a defect in

> the adrenal showing no adenoma in a CT .......... go figure.

>

>

[Guest guest]

In that he is correct. I suggest he considers excess production of

aldo from one gland a defect?

CE Grim MD

On Dec 17, 2008, at 2:37 PM, Arthur Springer wrote:

> It's because of that that he feels AVS is the surest guide.

> ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

> ••

> •••••••••

> On Dec 17, 2008, at 3:20 PM, Clarence Grim wrote:

>

>> Not sure what he means by a defect? Most adenomas are too small to

>> be seem with a CT as you will note in my article. When they evolve

>> (grow) enough they can be seen.

>>

>> Many other adrenal problems can cause HTN without showing up on CT:

>> GRA AME etc as described in article.

>>

>> CE Grim MD

>>

>> On Dec 17, 2008, at 2:10 PM, Arthur Springer wrote:

>>

>>> I amnot an MD but my cardiologist says there can still be a defect

>> in

>>> the adrenal showing no adenoma in a CT .......... go figure. What do

>>> you think CG?

>>> ------------------------------

>>> ========================================-----------------------

>>>

>>> On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

>>>

>>>> Thanks. I'm a little confused on the need for AVS since there is

>>>> clearly a good size adenoma on the right adrenal. I understand the

>>>> concept of bilateral hyperplasia but isn't the existence of the

>>>> adenoma a pretty clear indication that that's what is generating

>> the

>>>> high level of aldosterone? My Endocrinologist hasn't mentioned

>>> AVS but

>>>> I'll bring it up in my Fri. visit. I just started researching

>>>> everything so please bear with me! This group is a great resource.

>>>>

>>>> ________________________________

>>>> From: Clarence Grim <lowerbp2@...>

>>>> hyperaldosteronism

>>>> Sent: Wednesday, December 17, 2008 11:35:42 AM

>>>> Subject: Re: Re: New diagnosis and surgery

>>>>

>>>> Ask him if he had P'A who would he go to?

>>>>

>>>> As your BP is doing so well on DASH you may not need much spiro.

>>> Keep

>>>> us posted.

>>>>

>>>> CE Grim MD

>>>> On Dec 17, 2008, at 12:20 PM, Valarie wrote:

>>>>

>>>>> I do hope you don't have ANY surgery without prior adrenal vein

>>>>> sampling.

>>>>> As I recall, they don't do AVS at UCSF.

>>>>>

>>>>> Val

>>>>>

>>>>> From: hyperaldosteronism

>>>>> [mailto:hyperaldosteronism] On Behalf Of

>>>>> alexchisholm93

>>>>>

>>>>> Thanks for your prompt reply. I had a battery of tests done last

>>>>> week and

>>>>> was put on

>>>>> 50mg of Spiro starting this past Monday. I am slowly going off

>> the

>>>>> ACE and

>>>>> still take

>>>>> 10mg of Norvasc. My renin was measured in June and was low at

>> <0.1

>>>> and

>>>>> Aldosterone

>>>>> urine was 65.8 mcg. I've been on the DASH diet for at least a

>> year

>>>>> trying to

>>>>> bring my BP

>>>>> down. It stays in the 140/85-150/95 range without medication.

>> I'm

>>>>> seeing my

>>>>> Endocrinologist Friday, anything else I should ask him. He has

>>> been

>>>>> at UCSF

>>>>> for many

>>>>> years though specializes in thyroid.

>>>>>

>>>>>

[Guest guest]

You can have lumps and bumps that don't over-produce aldosterone, and you

can have an over-producing adenoma the size of a grain of sand, and not

visible on CT.

Val

From: Chisholm

Thanks. I'm a little confused on the need for AVS since there is clearly a

good size adenoma on the right adrenal. I understand the concept of

bilateral hyperplasia but isn't the existence of the adenoma a pretty clear

indication that that's what is generating the high level of aldosterone? My

Endocrinologist hasn't mentioned AVS but I'll bring it up in my Fri. visit.

I just started researching everything so please bear with me! This group is

a great resource.

[Guest guest]

Precisely. If both glands are producing too much aldosterone, then most

likely you will have to be on Aldactone/Spirolactone or Inspra for a long

time and dash for ever.

A tumor shown on a CT scan may not be the cause of your adrenal gland

producing too much aldosterone. This has happened to some of our members

(such as Dave), who ended up with taking out the wrong gland.

Who is your endocrinologist?

I had my AVS done 3 years ago in UCSF and they didn't go in the gland thus

gave erroneous lab results. I've heard from other members here since, that

they have stopped doing AVS's all together. The surgeon I saw, Dr. Duh at

UCSF was very sure that my high amount of aldosterone and very low renin was

caused by a tumor, even the radiologist who took the scan read the scan as a

5mm tumor in the right side. This turned out not to be true when I went to

Mayo Clinic. Cat Scan there did not show a tumor and the AVS showed I had

hyperplasia. Its better to be sure than to end up taking the wrong gland

out.

Farah

On Wed, Dec 17, 2008 at 6:38 PM, alexchisholm93 <alexchisholm93@...>wrote:

> Question: so if I had AVS done and it showed high aldo coming from

> both glands would I want to leave the tumor alone and just stay on

> the spiro? Is the point that the surgery would be useless in curing

> the HTN, high aldo and low K? Thanks.

>

>

> > >

> > > > I do hope you don't have ANY surgery without prior adrenal vein

> > > > sampling.

> > > > As I recall, they don't do AVS at UCSF.

> > > >

> > > > Val

> > > >

> > > > From: hyperaldosteronism

> > > > [mailto:hyperaldosteronism] On Behalf Of

> > > > alexchisholm93

> > > >

> > > > Thanks for your prompt reply. I had a battery of tests done last

> > > > week and

> > > > was put on

> > > > 50mg of Spiro starting this past Monday. I am slowly going off

> the

> > > > ACE and

> > > > still take

> > > > 10mg of Norvasc. My renin was measured in June and was low at

> > > <0.1 and

> > > > Aldosterone

> > > > urine was 65.8 mcg. I've been on the DASH diet for at least a

> year

> > > > trying to

> > > > bring my BP

> > > > down. It stays in the 140/85-150/95 range without medication.

> I'm

> > > > seeing my

> > > > Endocrinologist Friday, anything else I should ask him. He has

> been

> > > > at UCSF

> > > > for many

> > > > years though specializes in thyroid.

> > > >

> > > >

[Guest guest]

Yes, along with all other signs:

low K, ankle edema, high BP.

On Dec 17, 2008, at 9:12 PM, Clarence Grim wrote:

> In that he is correct. I suggest he considers excess production of

> aldo from one gland a defect?

>

> CE Grim MD

> On Dec 17, 2008, at 2:37 PM, Arthur Springer wrote:

>

>> It's because of that that he feels AVS is the surest guide.

>> ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

>> ••

>> •••••••••

>> On Dec 17, 2008, at 3:20 PM, Clarence Grim wrote:

>>

>>> Not sure what he means by a defect? Most adenomas are too small to

>>> be seem with a CT as you will note in my article. When they evolve

>>> (grow) enough they can be seen.

>>>

>>> Many other adrenal problems can cause HTN without showing up on CT:

>>> GRA AME etc as described in article.

>>>

>>> CE Grim MD

>>>

>>> On Dec 17, 2008, at 2:10 PM, Arthur Springer wrote:

>>>

>>>> I amnot an MD but my cardiologist says there can still be a defect

>>> in

>>>> the adrenal showing no adenoma in a CT .......... go figure. What do

>>>> you think CG?

>>>> ------------------------------

>>>> ========================================-----------------------

>>>>

>>>> On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

>>>>

>>>>> Thanks. I'm a little confused on the need for AVS since there is

>>>>> clearly a good size adenoma on the right adrenal. I understand the

>>>>> concept of bilateral hyperplasia but isn't the existence of the

>>>>> adenoma a pretty clear indication that that's what is generating

>>> the

>>>>> high level of aldosterone? My Endocrinologist hasn't mentioned

>>>> AVS but

>>>>> I'll bring it up in my Fri. visit. I just started researching

>>>>> everything so please bear with me! This group is a great resource.

>>>>>

>>>>> ________________________________

>>>>> From: Clarence Grim <lowerbp2@...>

>>>>> hyperaldosteronism

>>>>> Sent: Wednesday, December 17, 2008 11:35:42 AM

>>>>> Subject: Re: Re: New diagnosis and surgery

>>>>>

>>>>> Ask him if he had P'A who would he go to?

>>>>>

>>>>> As your BP is doing so well on DASH you may not need much spiro.

>>>> Keep

>>>>> us posted.

>>>>>

>>>>> CE Grim MD

>>>>> On Dec 17, 2008, at 12:20 PM, Valarie wrote:

>>>>>

>>>>>> I do hope you don't have ANY surgery without prior adrenal vein

>>>>>> sampling.

>>>>>> As I recall, they don't do AVS at UCSF.

>>>>>>

>>>>>> Val

>>>>>>

>>>>>> From: hyperaldosteronism

>>>>>> [mailto:hyperaldosteronism] On Behalf Of

>>>>>> alexchisholm93

>>>>>>

>>>>>> Thanks for your prompt reply. I had a battery of tests done last

>>>>>> week and

>>>>>> was put on

>>>>>> 50mg of Spiro starting this past Monday. I am slowly going off

>>> the

>>>>>> ACE and

>>>>>> still take

>>>>>> 10mg of Norvasc. My renin was measured in June and was low at

>>> <0.1

>>>>> and

>>>>>> Aldosterone

>>>>>> urine was 65.8 mcg. I've been on the DASH diet for at least a

>>> year

>>>>>> trying to

>>>>>> bring my BP

>>>>>> down. It stays in the 140/85-150/95 range without medication.

>>> I'm

>>>>>> seeing my

>>>>>> Endocrinologist Friday, anything else I should ask him. He has

>>>> been

>>>>>> at UCSF

>>>>>> for many

>>>>>> years though specializes in thyroid.

>>>>>>

>>>>>>

[Guest guest]

Actually edema is not common in PA. Due to what is called aldo

escape. Mechanism unknown.

What other meds are you taking?

Norvasc would be very common cause of edema.

CE Grim MD

On Dec 17, 2008, at 9:23 PM, Arthur Springer wrote:

> Yes, along with all other signs:

> low K, ankle edema, high BP.

> On Dec 17, 2008, at 9:12 PM, Clarence Grim wrote:

>

> > In that he is correct. I suggest he considers excess production of

> > aldo from one gland a defect?

> >

> > CE Grim MD

> > On Dec 17, 2008, at 2:37 PM, Arthur Springer wrote:

> >

> >> It's because of that that he feels AVS is the surest guide.

> >>

> ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

> >> ••

> >> •••••••••

> >> On Dec 17, 2008, at 3:20 PM, Clarence Grim wrote:

> >>

> >>> Not sure what he means by a defect? Most adenomas are too small to

> >>> be seem with a CT as you will note in my article. When they evolve

> >>> (grow) enough they can be seen.

> >>>

> >>> Many other adrenal problems can cause HTN without showing up on

> CT:

> >>> GRA AME etc as described in article.

> >>>

> >>> CE Grim MD

> >>>

> >>> On Dec 17, 2008, at 2:10 PM, Arthur Springer wrote:

> >>>

> >>>> I amnot an MD but my cardiologist says there can still be a

> defect

> >>> in

> >>>> the adrenal showing no adenoma in a CT .......... go figure.

> What do

> >>>> you think CG?

> >>>> ------------------------------

> >>>> ========================================-----------------------

> >>>>

> >>>> On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

> >>>>

> >>>>> Thanks. I'm a little confused on the need for AVS since there is

> >>>>> clearly a good size adenoma on the right adrenal. I

> understand the

> >>>>> concept of bilateral hyperplasia but isn't the existence of the

> >>>>> adenoma a pretty clear indication that that's what is generating

> >>> the

> >>>>> high level of aldosterone? My Endocrinologist hasn't mentioned

> >>>> AVS but

> >>>>> I'll bring it up in my Fri. visit. I just started researching

> >>>>> everything so please bear with me! This group is a great

> resource.

> >>>>>

> >>>>> ________________________________

> >>>>> From: Clarence Grim <lowerbp2@...>

> >>>>> hyperaldosteronism

> >>>>> Sent: Wednesday, December 17, 2008 11:35:42 AM

> >>>>> Subject: Re: Re: New diagnosis and surgery

> >>>>>

> >>>>> Ask him if he had P'A who would he go to?

> >>>>>

> >>>>> As your BP is doing so well on DASH you may not need much spiro.

> >>>> Keep

> >>>>> us posted.

> >>>>>

> >>>>> CE Grim MD

> >>>>> On Dec 17, 2008, at 12:20 PM, Valarie wrote:

> >>>>>

> >>>>>> I do hope you don't have ANY surgery without prior adrenal vein

> >>>>>> sampling.

> >>>>>> As I recall, they don't do AVS at UCSF.

> >>>>>>

> >>>>>> Val

> >>>>>>

> >>>>>> From: hyperaldosteronism

> >>>>>> [mailto:hyperaldosteronism] On Behalf Of

> >>>>>> alexchisholm93

> >>>>>>

> >>>>>> Thanks for your prompt reply. I had a battery of tests done

> last

> >>>>>> week and

> >>>>>> was put on

> >>>>>> 50mg of Spiro starting this past Monday. I am slowly going off

> >>> the

> >>>>>> ACE and

> >>>>>> still take

> >>>>>> 10mg of Norvasc. My renin was measured in June and was low at

> >>> <0.1

> >>>>> and

> >>>>>> Aldosterone

> >>>>>> urine was 65.8 mcg. I've been on the DASH diet for at least a

> >>> year

> >>>>>> trying to

> >>>>>> bring my BP

> >>>>>> down. It stays in the 140/85-150/95 range without medication.

> >>> I'm

> >>>>>> seeing my

> >>>>>> Endocrinologist Friday, anything else I should ask him. He has

> >>>> been

> >>>>>> at UCSF

> >>>>>> for many

> >>>>>> years though specializes in thyroid.

> >>>>>>

> >>>>>>

[Guest guest]

Interesting. I thought salt retention caused edema.

I was addressing diagnostic criteria, not current condition which has

improved after 4 mos. medication.

Inspra 50 mg. twice daily

Norvasc cut in half ... down to 5 mg. once daily.

BP now 120-140/70-75. Ankle edema and fatigue reduced substantially.

Sleep normalizing.

10 more meds for heart, copd etc.

••••••••••••••••••••••••••â€\

¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â\

€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢â€¢

••••••••••••••

On Dec 18, 2008, at 11:28 AM, Clarence Grim wrote:

> Actually edema is not common in PA. Due to what is called aldo

> escape. Mechanism unknown.

>

> What other meds are you taking?

>

>

> Norvasc would be very common cause of edema.

>

> CE Grim MD

>

>

> On Dec 17, 2008, at 9:23 PM, Arthur Springer wrote:

>

>> Yes, along with all other signs:

>> low K, ankle edema, high BP.

>> On Dec 17, 2008, at 9:12 PM, Clarence Grim wrote:

>>

>>> In that he is correct. I suggest he considers excess production of

>>> aldo from one gland a defect?

>>>

>>> CE Grim MD

>>> On Dec 17, 2008, at 2:37 PM, Arthur Springer wrote:

>>>

>>>> It's because of that that he feels AVS is the surest guide.

>>>>

>>

••••••••••••••••••••••••••••••••••••••••\

••••••••••••••••••••••••••••••

>>>> ••

>>>> •••••••••

>>>> On Dec 17, 2008, at 3:20 PM, Clarence Grim wrote:

>>>>

>>>>> Not sure what he means by a defect? Most adenomas are too small to

>>>>> be seem with a CT as you will note in my article. When they evolve

>>>>> (grow) enough they can be seen.

>>>>>

>>>>> Many other adrenal problems can cause HTN without showing up on

>> CT:

>>>>> GRA AME etc as described in article.

>>>>>

>>>>> CE Grim MD

>>>>>

>>>>> On Dec 17, 2008, at 2:10 PM, Arthur Springer wrote:

>>>>>

>>>>>> I amnot an MD but my cardiologist says there can still be a

>> defect

>>>>> in

>>>>>> the adrenal showing no adenoma in a CT .......... go figure.

>> What do

>>>>>> you think CG?

>>>>>> ------------------------------

>>>>>> ========================================-----------------------

>>>>>>

>>>>>> On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

>>>>>>

>>>>>>> Thanks. I'm a little confused on the need for AVS since there is

>>>>>>> clearly a good size adenoma on the right adrenal. I

>> understand the

>>>>>>> concept of bilateral hyperplasia but isn't the existence of the

>>>>>>> adenoma a pretty clear indication that that's what is generating

>>>>> the

>>>>>>> high level of aldosterone? My Endocrinologist hasn't mentioned

>>>>>> AVS but

>>>>>>> I'll bring it up in my Fri. visit. I just started researching

>>>>>>> everything so please bear with me! This group is a great

>> resource.

>>>>>>>

>>>>>>> ________________________________

>>>>>>> From: Clarence Grim <lowerbp2@...>

>>>>>>> hyperaldosteronism

>>>>>>> Sent: Wednesday, December 17, 2008 11:35:42 AM

>>>>>>> Subject: Re: Re: New diagnosis and surgery

>>>>>>>

>>>>>>> Ask him if he had P'A who would he go to?

>>>>>>>

>>>>>>> As your BP is doing so well on DASH you may not need much spiro.

>>>>>> Keep

>>>>>>> us posted.

>>>>>>>

>>>>>>> CE Grim MD

>>>>>>> On Dec 17, 2008, at 12:20 PM, Valarie wrote:

>>>>>>>

>>>>>>>> I do hope you don't have ANY surgery without prior adrenal vein

>>>>>>>> sampling.

>>>>>>>> As I recall, they don't do AVS at UCSF.

>>>>>>>>

>>>>>>>> Val

>>>>>>>>

>>>>>>>> From: hyperaldosteronism

>>>>>>>> [mailto:hyperaldosteronism] On Behalf Of

>>>>>>>> alexchisholm93

>>>>>>>>

>>>>>>>> Thanks for your prompt reply. I had a battery of tests done

>> last

>>>>>>>> week and

>>>>>>>> was put on

>>>>>>>> 50mg of Spiro starting this past Monday. I am slowly going off

>>>>> the

>>>>>>>> ACE and

>>>>>>>> still take

>>>>>>>> 10mg of Norvasc. My renin was measured in June and was low at

>>>>> <0.1

>>>>>>> and

>>>>>>>> Aldosterone

>>>>>>>> urine was 65.8 mcg. I've been on the DASH diet for at least a

>>>>> year

>>>>>>>> trying to

>>>>>>>> bring my BP

>>>>>>>> down. It stays in the 140/85-150/95 range without medication.

>>>>> I'm

>>>>>>>> seeing my

>>>>>>>> Endocrinologist Friday, anything else I should ask him. He has

>>>>>> been

>>>>>>>> at UCSF

>>>>>>>> for many

>>>>>>>> years though specializes in thyroid.

>>>>>>>>

>>>>>>>>

[Guest guest]

Except in most cases of PA.

It will get better when Norvac stopped.

CE Grim MD

On Dec 18, 2008, at 10:49 AM, Arthur Springer wrote:

> Interesting. I thought salt retention caused edema.

> I was addressing diagnostic criteria, not current condition which has

> improved after 4 mos. medication.

> Inspra 50 mg. twice daily

> Norvasc cut in half ... down to 5 mg. once daily.

> BP now 120-140/70-75. Ankle edema and fatigue reduced substantially.

> Sleep normalizing.

> 10 more meds for heart, copd etc.

> •••••••••••••••••••••••

> •••••••••••••••••••••••

> •••••••••••••••••••••••

> •••

> ••••••••••••••

>

> On Dec 18, 2008, at 11:28 AM, Clarence Grim wrote:

>

> > Actually edema is not common in PA. Due to what is called aldo

> > escape. Mechanism unknown.

> >

> > What other meds are you taking?

> >

> >

> > Norvasc would be very common cause of edema.

> >

> > CE Grim MD

> >

> >

> > On Dec 17, 2008, at 9:23 PM, Arthur Springer wrote:

> >

> >> Yes, along with all other signs:

> >> low K, ankle edema, high BP.

> >> On Dec 17, 2008, at 9:12 PM, Clarence Grim wrote:

> >>

> >>> In that he is correct. I suggest he considers excess production of

> >>> aldo from one gland a defect?

> >>>

> >>> CE Grim MD

> >>> On Dec 17, 2008, at 2:37 PM, Arthur Springer wrote:

> >>>

> >>>> It's because of that that he feels AVS is the surest guide.

> >>>>

> >> •••••••••••••••••••••••••••••••••

> •••••••••••••••••••••••••••••••••••

> ••

> >>>> ••

> >>>> •••••••••

> >>>> On Dec 17, 2008, at 3:20 PM, Clarence Grim wrote:

> >>>>

> >>>>> Not sure what he means by a defect? Most adenomas are too

> small to

> >>>>> be seem with a CT as you will note in my article. When they

> evolve

> >>>>> (grow) enough they can be seen.

> >>>>>

> >>>>> Many other adrenal problems can cause HTN without showing up on

> >> CT:

> >>>>> GRA AME etc as described in article.

> >>>>>

> >>>>> CE Grim MD

> >>>>>

> >>>>> On Dec 17, 2008, at 2:10 PM, Arthur Springer wrote:

> >>>>>

> >>>>>> I amnot an MD but my cardiologist says there can still be a

> >> defect

> >>>>> in

> >>>>>> the adrenal showing no adenoma in a CT .......... go figure.

> >> What do

> >>>>>> you think CG?

> >>>>>> ------------------------------

> >>>>>> ========================================-----------------------

> >>>>>>

> >>>>>> On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

> >>>>>>

> >>>>>>> Thanks. I'm a little confused on the need for AVS since

> there is

> >>>>>>> clearly a good size adenoma on the right adrenal. I

> >> understand the

> >>>>>>> concept of bilateral hyperplasia but isn't the existence of

> the

> >>>>>>> adenoma a pretty clear indication that that's what is

> generating

> >>>>> the

> >>>>>>> high level of aldosterone? My Endocrinologist hasn't mentioned

> >>>>>> AVS but

> >>>>>>> I'll bring it up in my Fri. visit. I just started researching

> >>>>>>> everything so please bear with me! This group is a great

> >> resource.

> >>>>>>>

> >>>>>>> ________________________________

> >>>>>>> From: Clarence Grim <lowerbp2@...>

> >>>>>>> hyperaldosteronism

> >>>>>>> Sent: Wednesday, December 17, 2008 11:35:42 AM

> >>>>>>> Subject: Re: Re: New diagnosis and

> surgery

> >>>>>>>

> >>>>>>> Ask him if he had P'A who would he go to?

> >>>>>>>

> >>>>>>> As your BP is doing so well on DASH you may not need much

> spiro.

> >>>>>> Keep

> >>>>>>> us posted.

> >>>>>>>

> >>>>>>> CE Grim MD

> >>>>>>> On Dec 17, 2008, at 12:20 PM, Valarie wrote:

> >>>>>>>

> >>>>>>>> I do hope you don't have ANY surgery without prior adrenal

> vein

> >>>>>>>> sampling.

> >>>>>>>> As I recall, they don't do AVS at UCSF.

> >>>>>>>>

> >>>>>>>> Val

> >>>>>>>>

> >>>>>>>> From: hyperaldosteronism

> >>>>>>>> [mailto:hyperaldosteronism] On Behalf Of

> >>>>>>>> alexchisholm93

> >>>>>>>>

> >>>>>>>> Thanks for your prompt reply. I had a battery of tests done

> >> last

> >>>>>>>> week and

> >>>>>>>> was put on

> >>>>>>>> 50mg of Spiro starting this past Monday. I am slowly going

> off

> >>>>> the

> >>>>>>>> ACE and

> >>>>>>>> still take

> >>>>>>>> 10mg of Norvasc. My renin was measured in June and was low at

> >>>>> <0.1

> >>>>>>> and

> >>>>>>>> Aldosterone

> >>>>>>>> urine was 65.8 mcg. I've been on the DASH diet for at least a

> >>>>> year

> >>>>>>>> trying to

> >>>>>>>> bring my BP

> >>>>>>>> down. It stays in the 140/85-150/95 range without medication.

> >>>>> I'm

> >>>>>>>> seeing my

> >>>>>>>> Endocrinologist Friday, anything else I should ask him. He

> has

> >>>>>> been

> >>>>>>>> at UCSF

> >>>>>>>> for many

> >>>>>>>> years though specializes in thyroid.

> >>>>>>>>

> >>>>>>>>

[Guest guest]

Norvasc causes severe adema in my mom's feet. her legs swelled up to her

knees. It took me 6 months to proove this to her doctor who insisted the

adema was caused by some kidney and liver problem that didn't show in any

lab test. Four days to get rid of the adema once she stopped taking it and a

very surprised doctor.

Farah

On Thu, Dec 18, 2008 at 8:28 AM, Clarence Grim <lowerbp2@...> wrote:

> Actually edema is not common in PA. Due to what is called aldo

> escape. Mechanism unknown.

>

> What other meds are you taking?

>

>

> Norvasc would be very common cause of edema.

>

> CE Grim MD

>

>

> On Dec 17, 2008, at 9:23 PM, Arthur Springer wrote:

>

> > Yes, along with all other signs:

> > low K, ankle edema, high BP.

> > On Dec 17, 2008, at 9:12 PM, Clarence Grim wrote:

> >

> > > In that he is correct. I suggest he considers excess production of

> > > aldo from one gland a defect?

> > >

> > > CE Grim MD

> > > On Dec 17, 2008, at 2:37 PM, Arthur Springer wrote:

> > >

> > >> It's because of that that he feels AVS is the surest guide.

> > >>

> > ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

> > >> ••

> > >> •••••••••

> > >> On Dec 17, 2008, at 3:20 PM, Clarence Grim wrote:

> > >>

> > >>> Not sure what he means by a defect? Most adenomas are too small to

> > >>> be seem with a CT as you will note in my article. When they evolve

> > >>> (grow) enough they can be seen.

> > >>>

> > >>> Many other adrenal problems can cause HTN without showing up on

> > CT:

> > >>> GRA AME etc as described in article.

> > >>>

> > >>> CE Grim MD

> > >>>

> > >>> On Dec 17, 2008, at 2:10 PM, Arthur Springer wrote:

> > >>>

> > >>>> I amnot an MD but my cardiologist says there can still be a

> > defect

> > >>> in

> > >>>> the adrenal showing no adenoma in a CT .......... go figure.

> > What do

> > >>>> you think CG?

> > >>>> ------------------------------

> > >>>> ========================================-----------------------

> > >>>>

> > >>>> On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

> > >>>>

> > >>>>> Thanks. I'm a little confused on the need for AVS since there is

> > >>>>> clearly a good size adenoma on the right adrenal. I

> > understand the

> > >>>>> concept of bilateral hyperplasia but isn't the existence of the

> > >>>>> adenoma a pretty clear indication that that's what is generating

> > >>> the

> > >>>>> high level of aldosterone? My Endocrinologist hasn't mentioned

> > >>>> AVS but

> > >>>>> I'll bring it up in my Fri. visit. I just started researching

> > >>>>> everything so please bear with me! This group is a great

> > resource.

> > >>>>>

> > >>>>> ________________________________

> > >>>>> From: Clarence Grim <lowerbp2@...>

> > >>>>> hyperaldosteronism

> > >>>>> Sent: Wednesday, December 17, 2008 11:35:42 AM

> > >>>>> Subject: Re: Re: New diagnosis and surgery

> > >>>>>

> > >>>>> Ask him if he had P'A who would he go to?

> > >>>>>

> > >>>>> As your BP is doing so well on DASH you may not need much spiro.

> > >>>> Keep

> > >>>>> us posted.

> > >>>>>

> > >>>>> CE Grim MD

> > >>>>> On Dec 17, 2008, at 12:20 PM, Valarie wrote:

> > >>>>>

> > >>>>>> I do hope you don't have ANY surgery without prior adrenal vein

> > >>>>>> sampling.

> > >>>>>> As I recall, they don't do AVS at UCSF.

> > >>>>>>

> > >>>>>> Val

> > >>>>>>

> > >>>>>> From: hyperaldosteronism

> > >>>>>> [mailto:hyperaldosteronism] On Behalf Of

> > >>>>>> alexchisholm93

> > >>>>>>

> > >>>>>> Thanks for your prompt reply. I had a battery of tests done

> > last

> > >>>>>> week and

> > >>>>>> was put on

> > >>>>>> 50mg of Spiro starting this past Monday. I am slowly going off

> > >>> the

> > >>>>>> ACE and

> > >>>>>> still take

> > >>>>>> 10mg of Norvasc. My renin was measured in June and was low at

> > >>> <0.1

> > >>>>> and

> > >>>>>> Aldosterone

> > >>>>>> urine was 65.8 mcg. I've been on the DASH diet for at least a

> > >>> year

> > >>>>>> trying to

> > >>>>>> bring my BP

> > >>>>>> down. It stays in the 140/85-150/95 range without medication.

> > >>> I'm

> > >>>>>> seeing my

> > >>>>>> Endocrinologist Friday, anything else I should ask him. He has

> > >>>> been

> > >>>>>> at UCSF

> > >>>>>> for many

> > >>>>>> years though specializes in thyroid.

> > >>>>>>

> > >>>>>>

[Guest guest]

Guess he had never uses Norvasc or looked at pts feet

Sent from my iPhone

CE Grim MD

On Dec 18, 2008, at 4:27 PM, Farah Rahbar <farahbar@...> wrote:

> Norvasc causes severe adema in my mom's feet. her legs swelled up to

> her

> knees. It took me 6 months to proove this to her doctor who insisted

> the

> adema was caused by some kidney and liver problem that didn't show

> in any

> lab test. Four days to get rid of the adema once she stopped taking

> it and a

> very surprised doctor.

>

> Farah

>

> On Thu, Dec 18, 2008 at 8:28 AM, Clarence Grim <lowerbp2@...>

> wrote:

>

>> Actually edema is not common in PA. Due to what is called aldo

>> escape. Mechanism unknown.

>>

>> What other meds are you taking?

>>

>>

>> Norvasc would be very common cause of edema.

>>

>> CE Grim MD

>>

>>

>> On Dec 17, 2008, at 9:23 PM, Arthur Springer wrote:

>>

>>> Yes, along with all other signs:

>>> low K, ankle edema, high BP.

>>> On Dec 17, 2008, at 9:12 PM, Clarence Grim wrote:

>>>

>>>> In that he is correct. I suggest he considers excess production of

>>>> aldo from one gland a defect?

>>>>

>>>> CE Grim MD

>>>> On Dec 17, 2008, at 2:37 PM, Arthur Springer wrote:

>>>>

>>>>> It's because of that that he feels AVS is the surest guide.

>>>>>

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> •

>>> ••••••••••••••••••••••

>>> ••••

>>>>> ••

>>>>> •••••••••

>>>>> On Dec 17, 2008, at 3:20 PM, Clarence Grim wrote:

>>>>>

>>>>>> Not sure what he means by a defect? Most adenomas are too small

>>>>>> to

>>>>>> be seem with a CT as you will note in my article. When they

>>>>>> evolve

>>>>>> (grow) enough they can be seen.

>>>>>>

>>>>>> Many other adrenal problems can cause HTN without showing up on

>>> CT:

>>>>>> GRA AME etc as described in article.

>>>>>>

>>>>>> CE Grim MD

>>>>>>

>>>>>> On Dec 17, 2008, at 2:10 PM, Arthur Springer wrote:

>>>>>>

>>>>>>> I amnot an MD but my cardiologist says there can still be a

>>> defect

>>>>>> in

>>>>>>> the adrenal showing no adenoma in a CT .......... go figure.

>>> What do

>>>>>>> you think CG?

>>>>>>> ------------------------------

>>>>>>> ========================================-----------------------

>>>>>>>

>>>>>>> On Dec 17, 2008, at 2:43 PM, Chisholm wrote:

>>>>>>>

>>>>>>>> Thanks. I'm a little confused on the need for AVS since there

>>>>>>>> is

>>>>>>>> clearly a good size adenoma on the right adrenal. I

>>> understand the

>>>>>>>> concept of bilateral hyperplasia but isn't the existence of the

>>>>>>>> adenoma a pretty clear indication that that's what is

>>>>>>>> generating

>>>>>> the

>>>>>>>> high level of aldosterone? My Endocrinologist hasn't mentioned

>>>>>>> AVS but

>>>>>>>> I'll bring it up in my Fri. visit. I just started researching

>>>>>>>> everything so please bear with me! This group is a great

>>> resource.

>>>>>>>>

>>>>>>>> ________________________________

>>>>>>>> From: Clarence Grim <lowerbp2@...>

>>>>>>>> hyperaldosteronism

>>>>>>>> Sent: Wednesday, December 17, 2008 11:35:42 AM

>>>>>>>> Subject: Re: Re: New diagnosis and surgery

>>>>>>>>

>>>>>>>> Ask him if he had P'A who would he go to?

>>>>>>>>

>>>>>>>> As your BP is doing so well on DASH you may not need much

>>>>>>>> spiro.

>>>>>>> Keep

>>>>>>>> us posted.

>>>>>>>>

>>>>>>>> CE Grim MD

>>>>>>>> On Dec 17, 2008, at 12:20 PM, Valarie wrote:

>>>>>>>>

>>>>>>>>> I do hope you don't have ANY surgery without prior adrenal

>>>>>>>>> vein

>>>>>>>>> sampling.

>>>>>>>>> As I recall, they don't do AVS at UCSF.

>>>>>>>>>

>>>>>>>>> Val

>>>>>>>>>

>>>>>>>>> From: hyperaldosteronism

>>>>>>>>> [mailto:hyperaldosteronism] On Behalf Of

>>>>>>>>> alexchisholm93

>>>>>>>>>

>>>>>>>>> Thanks for your prompt reply. I had a battery of tests done

>>> last

>>>>>>>>> week and

>>>>>>>>> was put on

>>>>>>>>> 50mg of Spiro starting this past Monday. I am slowly going off

>>>>>> the

>>>>>>>>> ACE and

>>>>>>>>> still take

>>>>>>>>> 10mg of Norvasc. My renin was measured in June and was low at

>>>>>> <0.1

>>>>>>>> and

>>>>>>>>> Aldosterone

>>>>>>>>> urine was 65.8 mcg. I've been on the DASH diet for at least a

>>>>>> year

>>>>>>>>> trying to

>>>>>>>>> bring my BP

>>>>>>>>> down. It stays in the 140/85-150/95 range without medication.

>>>>>> I'm

>>>>>>>>> seeing my

>>>>>>>>> Endocrinologist Friday, anything else I should ask him. He has

>>>>>>> been

>>>>>>>>> at UCSF

>>>>>>>>> for many

>>>>>>>>> years though specializes in thyroid.

>>>>>>>>>

>>>>>>>>>