Re: VA - MyhealtheVet System

January 9, 2012

At CBOC. I think they are working on a secure network or something. Will find out more tomorrow. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 9, 2012, at 11:02, <jclark24p@...> wrote:

Francis, Do you have "New Message" in the top left corner? If so click on it and you should get the panel and be able to address the professionls on your team. If not I'd email .Mock@... and ask him. (He is the IT person at WRJ.

Dr. G., I don't know how it works on your end. Are you in a hospital center or a CBOC, I can't talk to doctors at the CBOC yet. I do find the nurses on my team are very good with it.

.....

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

> > > > > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it

> > > > > > > > > seems that you

> > > > > > > > > > > > > > > >> have the same Conn's that most of us have. Start to

> > > > > > > > > Dash

> > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

> > > > > > > > > afraid, try

> > > > > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

> > > > > > > > > behaves better

> > > > > > > > > > > > > > > >> with this medication, that's it! Don't wait 6

> > > > > > > months

> > > > > > > > > until your

> > > > > > > > > > > > > > > >> appointment and some more years until you are going

> > > > > > > > > to be

> > > > > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still

> > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > >> > >> > ÃƒÆ’Ã‚Æ’ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

> > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis,

> > > > > > > 2000

> > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still

> > > > > > > > > have some

> > > > > > > > > > > > > > > >> occasional problems with BP, K and Na when over-

> > > > > > > salt

> > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > > > > > > >> > >> > Subject: Symptoms and

> > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > >> > >> > ÃƒÆ’Ã‚Æ’ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden

> > > > > > > onset

> > > > > > > > > hypertension,

> > > > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

> > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a

> > > > > > > 58 yo

> > > > > > > > > male, retired

> > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal

> > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for

> > > > > > > > > past 20 years.

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

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

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

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

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> > > > > > >

> > > > > >

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> > > >

> > >

> >

>

January 9, 2012

You team can do that on their computer so U can see it. CAn even do 2 on same screen. I let my pts watch over my shoulder as I review thei numbers. A plot is worth a lot of words. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 9, 2012, at 11:23, <jclark24p@...> wrote:

Dr. Grim, you should get someone to show you the tracking portion from the PTN's point of view. Doctor can't see them directly, I don't know why, but I graph 1 month on one side with 1 year in graph on the back and take a hard copy of BP, HR and BS to my provider for each appt. In my personal it should be manditory for each person using the system! Here's raw data for December:

Date Time Systolic Diastolic Edit Delete

01/02/2012 141 72

01/01/2012 145 81

12/31/2011 164 84

12/30/2011 157 81

12/28/2011 143 76

12/24/2011 133 79

12/23/2011 130 76

12/22/2011 136 78

12/21/2011 137 80

12/20/2011 137 80

12/19/2011 135 78

12/18/2011 139 75

12/17/2011 122 73

12/16/2011 135 71

12/15/2011 122 55

12/14/2011 136 79

12/13/2011 141 76

12/12/2011 142 80

12/11/2011 142 78

12/10/2011 143 80

12/09/2011 139 77

12/07/2011 138 77

12/06/2011 144 79

12/05/2011 133 76

12/04/2011 140 77

290 items found, displaying 1 to 25

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it

> > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > >> have the same Conn's that most of us have. Start to

> > > > > > > > > > Dash

> > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

> > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

> > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > >> with this medication, that's it! Don't wait 6

> > > > > > > > months

> > > > > > > > > > until your

> > > > > > > > > > > > > > > > >> appointment and some more years until you are going

> > > > > > > > > > to be

> > > > > > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still

> > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > >> > >> > ÃƒÆ’Ã‚Æ’ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

> > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis,

> > > > > > > > 2000

> > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still

> > > > > > > > > > have some

> > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na when over-

> > > > > > > > salt

> > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > > > > > > > >> > >> > Subject: Symptoms and

> > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > >> > >> > ÃƒÆ’Ã‚Æ’ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden

> > > > > > > > onset

> > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

> > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a

> > > > > > > > 58 yo

> > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal

> > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for

> > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

If I remember right they were introducing to hospitals first. I know I use a

CBOC for my Psyco Issues and can't communicate directly with them. I have had

my PCP forward a message to them when I asked about Spiro interfering with

Cymbalta but I don't know how she did that. (BTW I expect to address that issue

again tomorrow when we tlk bout the two trials that I sent them - by snail mail

I might add!)

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C

Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > > > > > > > > >> > >> > According to your analyses and

symptoms, it

> > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > >> have the same Conn's that most of us have.

Start to

> > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you

are not

> > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If

your BP

> > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > >> with this medication, that's it! Don't wait

6

> > > > > > > > > months

> > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > >> appointment and some more years until you

are going

> > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including myself,

are still

> > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2

cm left

> > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg

Micardis,

> > > > > > > > > 2000

> > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing;

still

> > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na when

over-

> > > > > > > > > salt

> > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45

PM

> > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all that

responded.

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

> > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new

sudden

> > > > > > > > > onset

> > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance,

weakness,

> > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional swings. I

am a

> > > > > > > > > 58 yo

> > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is small

Pineal

> > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with

synthesis for

> > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

In your case that would be okay with me because I bet NObody gets away with

taking BP incorrectly! In my case you might as well print it on toilet paper -

garbage in/garbage out if done by my team!

Agree re: the value of a plot. That's why I give them them two pictures. Last

month = current and 6, 12 or 24 month shows history or trends. If I show 24

months I can show before DX, when spiro started, when PA totally resolved, when

I started DASHing, upward trend and when I stopped spiro! (Hopfully I'll be

able to also show how great life is w/o the tumor soon!)

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C

Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > > > > > > > > > >> > >> > According to your analyses and

symptoms, it

> > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > >> have the same Conn's that most of us

have. Start to

> > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if

you are not

> > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small dosage.

If your BP

> > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > >> with this medication, that's it! Don't

wait 6

> > > > > > > > > > months

> > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > >> appointment and some more years until you

are going

> > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including myself,

are still

> > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with

2 cm left

> > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg

Micardis,

> > > > > > > > > > 2000

> > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam;

Dashing; still

> > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na

when over-

> > > > > > > > > > salt

> > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45

PM

> > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all that

responded.

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

> > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new

sudden

> > > > > > > > > > onset

> > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance,

weakness,

> > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional swings.

I am a

> > > > > > > > > > 58 yo

> > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is

small Pineal

> > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with

synthesis for

> > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

CBOC may be the way that they let us Vets look at our records.

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

> > > > > > > > > > > > > > > > > > >> > >> > According to your analyses and

symptoms, it

> > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > >> have the same Conn's that most of us

have. Start to

> > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if

you are not

> > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small dosage.

If your BP

> > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > >> with this medication, that's it! Don't

wait 6

> > > > > > > > > > months

> > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > >> appointment and some more years until you

are going

> > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including myself,

are still

> > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with

2 cm left

> > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg

Micardis,

> > > > > > > > > > 2000

> > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam;

Dashing; still

> > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na

when over-

> > > > > > > > > > salt

> > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45

PM

> > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all that

responded.

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

> > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new

sudden

> > > > > > > > > > onset

> > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance,

weakness,

> > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional swings.

I am a

> > > > > > > > > > 58 yo

> > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is

small Pineal

> > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with

synthesis for

> > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

Don't understand. CBOC = Community Based Outpatient Clinic (Fort Ethan )

in my dictionary.

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

> > > > > > > > > > > > > > > > > > > >> > >> > According to your analyses and

symptoms, it

> > > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > > >> have the same Conn's that most of us

have. Start to

> > > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if

you are not

> > > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small dosage.

If your BP

> > > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > > >> with this medication, that's it! Don't

wait 6

> > > > > > > > > > > months

> > > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > > >> appointment and some more years until

you are going

> > > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including

myself, are still

> > > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F

with 2 cm left

> > > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg

Micardis,

> > > > > > > > > > > 2000

> > > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam;

Dashing; still

> > > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na

when over-

> > > > > > > > > > > salt

> > > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012

1:45 PM

> > > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all that

responded.

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

> > > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for

new sudden

> > > > > > > > > > > onset

> > > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance,

weakness,

> > > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional

swings. I am a

> > > > > > > > > > > 58 yo

> > > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is

small Pineal

> > > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with

synthesis for

> > > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

Yes I know what CBOC means. But why would the VA be updating web security If

that was all there was to it? This link says something about CBOC Web-Based

Materials and Tools (for VA CBOC Nurse Managers with password access) Then has

this listed after Would you think any thing in this list would need password

access?

CBOC Contact List

Quickly access phone numbers and e-mail addresses for Health Net's CBOC Programs

staff and Clinic Nurse Managers.

Newsletters

The quarterly staff newsletter, Partners in Care, focuses on Health Net's

partnership with VA and our subcontractors to provide high quality patient care

to America's Veterans. Read about CBOC provider and clinic staff

accomplishments, what veterans are saying about their care, and how Health Net

reaches out to honor veterans in the community.

Health Net's quarterly newsletter, Healthy Veterans for Life, provides veterans

and their families with important health information and reminders, proactive

wellness tips, and other health resources. The publication encourages veterans

to be their own health advocate and to work with their CBOC primary care

physician to achieve mental and physical well-being.

Reference Guides and Manuals

Clinic staff may easily access Health Net's Orientation Manual, Desk Reference

Manual and Reference Guides.

Reports

Access PMR and SHEP Reports.

Help

A Frequently Asked Questions guide provides an overview on patient care services

provided at Health Net's clinics.

I would guess CBOCs can access records through there systems then it is possible

they could add to it so any VET can access there record

https://www.hnfs.com/va/content/cboc/index.jsp

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

> > > > > > > > > > > > > > > > > > > > >> > >> > According to your analyses and

symptoms, it

> > > > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > > > >> have the same Conn's that most of us

have. Start to

> > > > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and

if you are not

> > > > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small

dosage. If your BP

> > > > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > > > >> with this medication, that's it!

Don't wait 6

> > > > > > > > > > > > months

> > > > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > > > >> appointment and some more years until

you are going

> > > > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including

myself, are still

> > > > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F

with 2 cm left

> > > > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg

Micardis,

> > > > > > > > > > > > 2000

> > > > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam;

Dashing; still

> > > > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na

when over-

> > > > > > > > > > > > salt

> > > > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

________________________________

> > > > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012

1:45 PM

> > > > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all

that responded.

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

> > > > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for

new sudden

> > > > > > > > > > > > onset

> > > > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat

intolerance, weakness,

> > > > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional

swings. I am a

> > > > > > > > > > > > 58 yo

> > > > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is

small Pineal

> > > > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with

synthesis for

> > > > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

Ahh, I see the problem, you were hyjacking the thread. Dr. G. and I were

talking specifically about MyhealtheVet, you were expanding it to include a

different system available to CBOCs.

IMPO there are many reasons for security and the review of existing policy (I

used to be pretty good at cracking existing systems! (My record was a " failsafe

date check " which I cracked by changing the system date when I loaded the

computer, less than 2 minutes!)

I do see some items that access to should be limited on a need to know basis

like phone # and e-mail addresses but that is beyond the scope of this chat

group.

If I was the analyst, I would not use a CBOC system to allow access to their

records for all vets and it would never get beyond the feasibility study if I

was in charge! MyhealtheVet is the place for it (or something similar).

Remember, there is a difference between making it work and making it user

friendly and useable! If you talk with them I am available as a consultant but

be warned, I'm not s cheap as Dr. Grim!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C

Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > > > > > > > > > > > > >> > >> > According to your analyses

and symptoms, it

> > > > > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > > > > >> have the same Conn's that most of

us have. Start to

> > > > > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and

if you are not

> > > > > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small

dosage. If your BP

> > > > > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > > > > >> with this medication, that's it!

Don't wait 6

> > > > > > > > > > > > > months

> > > > > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > > > > >> appointment and some more years

until you are going

> > > > > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including

myself, are still

> > > > > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > > > > >> after several years and many

doctors.

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

> > > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F

with 2 cm left

> > > > > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80

mg Micardis,

> > > > > > > > > > > > > 2000

> > > > > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam;

Dashing; still

> > > > > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > > > > >> occasional problems with BP, K and

Na when over-

> > > > > > > > > > > > > salt

> > > > > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > > > > >> on private consultation with Dr

Grim.

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

________________________________

> > > > > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2,

2012 1:45 PM

> > > > > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã‚Æ'ÃƒÂ¢Ã‚â‚¬Ã‚Å¡

> > > > > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all

that responded.

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

> > > > > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo

for new sudden

> > > > > > > > > > > > > onset

> > > > > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat

intolerance, weakness,

> > > > > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional

swings. I am a

> > > > > > > > > > > > > 58 yo

> > > > > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx

is small Pineal

> > > > > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled

with synthesis for

> > > > > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

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