Re: Ocular damage from HTN?

[Guest guest]

Common cause of blindness before we had good drugs and folks did not believe Dr. Kempner's rice-fruit data which showed such striking reversal of HTN eye damage that they accused him and the chair of Opthal at Duke of substitution pictures. Even today his results are remarkable. Damage is due to HTN but allegedly less common in PA as high renin and AII may also play a roll.Should get better as BP gets better.Is BP the same in both arms?I have seen patients with 100 mm difference in BP in the two arms and eye Dr puzzled by HTN eye changes but nomral BPs in the low BP arm and 100 mm higher in the high BP arm.Even more rare is the pt with blockage of art to both arms and thus normal arm BP but very high aortic pressures and eye damage due to the "hidden HTN". Clarence E. Grim, BS, MS, MD

Specializing in Primary Aldosteronism, Difficult High Blood Pressure and recent evolutionary forces on high blood pressure in populations today.On Jan 12, 2012, at 10:39 AM, msmith_1928 <janeray1940@...> wrote:

Yesterday I had my first bit of bad news since the adrenalectomy in October. I'm already making plans for a second opinion, but wanted to put this out there for comment.

I had a routine eye exam with my longtime optometrist yesterday (who I have educated extensively about PA since he was very interested). He told me that he found two things that were not there at my last exam (three years ago): vascular damage consistent with that in untreated hypertensive patients, and the beginnings of macular degeneration in my left eye.

My mom has macular degeneration, but hers did not start until she was well into her 70s (she's 86 now). I did some quick and dirty research and found that while heredity is probably the biggest culprint, HTN can also trigger it.

The optometrist did not comment about the implications of the "vascular damage" other than to say that it may still reverse itself since it's only been three months since the surgery.

I'm following up with my primary care doc in a couple weeks and will also see an ophthalmologist to find out what, if anything, I can do to prevent all of this from getting worse. And trying not to freak out too much, but it's rather disturbing news to someone who uses their vision to make a living!

-msmith1928

Nulliparous female, 46, left laparoscopic adrenalectomy on 10/13/2011.

[Guest guest]

Should get better as BP gets better... Is BP the same in both arms?BP has been the same in both arms (and legs!). Average at home was 117/72 this morning; last doctor's office visit was 124/80 IIRC.I guess I shouldn't expect complete reversal of EVERYTHING in just three months... but everything else has gotten so much better that this kind of caught me by surprise.> > > Yesterday I had my first bit of bad news since the adrenalectomy in October. I'm already making plans for a second opinion, but wanted to put this out there for comment.> >> > I had a routine eye exam with my longtime optometrist yesterday (who I have educated extensively about PA since he was very interested). He told me that he found two things that were not there at my last exam (three years ago): vascular damage consistent with that in untreated hypertensive patients, and the beginnings of macular degeneration in my left eye.> >> > My mom has macular degeneration, but hers did not start until she was well into her 70s (she's 86 now). I did some quick and dirty research and found that while heredity is probably the biggest culprint, HTN can also trigger it.> >> > The optometrist did not comment about the implications of the "vascular damage" other than to say that it may still reverse itself since it's only been three months since the surgery.> >> > I'm following up with my primary care doc in a couple weeks and will also see an ophthalmologist to find out what, if anything, I can do to prevent all of this from getting worse. And trying not to freak out too much, but it's rather disturbing news to someone who uses their vision to make a living!> >> > -msmith1928> > Nulliparous female, 46, left laparoscopic adrenalectomy on 10/13/2011.> >> >>

[Guest guest]

Msmith,Don't be freak out so much. Macular degeneration is inherited. Did the optometrist give your a chart that you have to look at every week? Ask him about this chart immediately. Ask ophthalmologist to test your eyes on a special device for macular degeneration. If you definitely have it, laser surgery should be done ASAP. My ophthalmologist insists me to call him the same moment as I see the changes in this chart. Vascular damage definitely happens from high BP and it's reversible. One more point - you didn't check your vision for 3 years - it's too long, have to do it every year or two.I have the experience with both of these problems. I am diabetic and I see

ophthalmologist every year. Natalia From: msmith_1928 <janeray1940@...> hyperaldosteronism Sent: Thursday, January 12, 2012 10:39 AM Subject: Ocular damage from HTN?

Yesterday I had my first bit of bad news since the adrenalectomy in October. I'm already making plans for a second opinion, but wanted to put this out there for comment.

I had a routine eye exam with my longtime optometrist yesterday (who I have educated extensively about PA since he was very interested). He told me that he found two things that were not there at my last exam (three years ago): vascular damage consistent with that in untreated hypertensive patients, and the beginnings of macular degeneration in my left eye.

My mom has macular degeneration, but hers did not start until she was well into her 70s (she's 86 now). I did some quick and dirty research and found that while heredity is probably the biggest culprint, HTN can also trigger it.

The optometrist did not comment about the implications of the "vascular damage" other than to say that it may still reverse itself since it's only been three months since the surgery.

I'm following up with my primary care doc in a couple weeks and will also see an ophthalmologist to find out what, if anything, I can do to prevent all of this from getting worse. And trying not to freak out too much, but it's rather disturbing news to someone who uses their vision to make a living!

-msmith1928

Nulliparous female, 46, left laparoscopic adrenalectomy on 10/13/2011.

[Guest guest]

Thanks for the feedback Natalia! The optometrist didn't give me a chart like you

described, but once I find an opthalmologist I'll ask about that.

I knew MD is hereditary and that I would likely develop it when I was older, but

to hear this at only 46 really surprised me. I hadn't had my eyes checked in 3

years because the constantly fluctuating blood pressure before the adrenalectomy

caused a lot of vision fluctuations - I couldn't get an accurate prescription so

I just stuck with the one I had. Before that I've always done it annually, and

going forward will do so again.

It's my understanding that there is no surgery for the type of MD my mom has,

but when I follow up with the ophthalmologist I'll ask if that's an option for

me.

Interesting note: my distance prescription (I'm severely nearsighted) changed

considerably since the adrenalectomy. I've worn glasses since I was 7 years old,

and this is the first exam where I've been told I needed a WEAKER prescription

rather than stronger!

>

> Msmith,

>

> Don't be freak out so much. Macular degeneration is inherited. Did the

optometrist give your a chart that you have to look at every week? Ask him about

this chart immediately. Ask ophthalmologist to test your eyes on a special

device for macular degeneration.If you definitely have it, laser surgery should

be done ASAP. My ophthalmologist insists me to call him the same moment as I see

the changes in this chart.

>

>

> Vascular damage definitely happens from high BP and it's reversible.

>

>

> One more point - you didn't check your vision for 3 years - it's too long,

have to do it every year or two.

>

> I have the  experience with both of these problems. I am diabetic and I see

ophthalmologist every year.

>

>  

> Natalia

>

>

> ________________________________

> From: msmith_1928 <janeray1940@...>

> hyperaldosteronism

> Sent: Thursday, January 12, 2012 10:39 AM

> Subject: Ocular damage from HTN?

>

>

>  

> Yesterday I had my first bit of bad news since the adrenalectomy in October.

I'm already making plans for a second opinion, but wanted to put this out there

for comment.

>

> I had a routine eye exam with my longtime optometrist yesterday (who I have

educated extensively about PA since he was very interested). He told me that he

found two things that were not there at my last exam (three years ago): vascular

damage consistent with that in untreated hypertensive patients, and the

beginnings of macular degeneration in my left eye.

>

> My mom has macular degeneration, but hers did not start until she was well

into her 70s (she's 86 now). I did some quick and dirty research and found that

while heredity is probably the biggest culprint, HTN can also trigger it.

>

> The optometrist did not comment about the implications of the " vascular

damage " other than to say that it may still reverse itself since it's only been

three months since the surgery.

>

> I'm following up with my primary care doc in a couple weeks and will also see

an ophthalmologist to find out what, if anything, I can do to prevent all of

this from getting worse. And trying not to freak out too much, but it's rather

disturbing news to someone who uses their vision to make a living!

>

> -msmith1928

> Nulliparous female, 46, left laparoscopic adrenalectomy on 10/13/2011.

>

[Guest guest]

Could do a pub med on him too. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 13, 2012, at 18:57, <jclark24p@...> wrote:

As mother always said, "Opinions are like noses - everybody has one!"

Do you know Dr. Lenz? Do you know the doctor in Boston that would do the AVS? (I don't even know his/her name but hope it is not a new resident that got out of school last week!) I do know this so far:

Dr. Emmett Lenz,University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC and he was graduated in 1980 so he has had an opportunity for up to 31 years experience. He is also Licensed In: New Hampshire, North Carolina and Vermont so I presume he has prcticed in at least three places, I'll have to check if he is good enough to write his own ticket or keeps getting fired!

I guess my bottom line is I see nothing that raises a red flag but I will be checking, stay tuned.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.

> > > > > > > >

> > > > > > > > The chart that I mentioned, is called Amsler grid. Check your eyes:

> > > > > > > >

> > > > > > > >

> > > > > > > > http://www.allaboutvision.com/conditions/amsler-grid.htm

> > > > > > > >

> > > > > > > > Â

> > > > > > > > Natalia

> > > > > > > >

> > > > > > > > From: Natalia Kamneva <natalia_kamneva@>

> > > > > > > > "hyperaldosteronism " <hyperaldosteronism >

> > > > > > > > Sent: Friday, January 13, 2012 12:36 AM

> > > > > > > > Subject: Re: Ocular damage from HTN?

> > > > > > > >

> > > > > > > >

> > > > > > > > Â

> > > > > > > > Msmith,

> > > > > > > >

> > > > > > > > Don't be freak out so much. Macular degeneration is inherited. Did the optometrist give your a chart that you have to look at every week? Ask him about this chart immediately. Ask ophthalmologist to test your eyes on a special device for macular degeneration. If you definitely have it, laser surgery should be done ASAP. My ophthalmologist insists me to call him the same moment as I see the changes in this chart.

> > > > > > > >

> > > > > > > >

> > > > > > > > Vascular damage definitely happens from high BP and it's reversible.

> > > > > > > >

> > > > > > > >

> > > > > > > > One more point - you didn't check your vision for 3 years - it's too long, have to do it every year or two.

> > > > > > > >

> > > > > > > > I have the experience with both of these problems. I am diabetic and I see ophthalmologist every year.

> > > > > > > >

> > > > > > > > Â

> > > > > > > > Natalia

> > > > > > > >

> > > > > > > >

> > > > > > > > ________________________________

> > > > > > > > From: msmith_1928 <janeray1940@>

> > > > > > > > hyperaldosteronism

> > > > > > > > Sent: Thursday, January 12, 2012 10:39 AM

> > > > > > > > Subject: Ocular damage from HTN?

> > > > > > > >

> > > > > > > >

> > > > > > > > Â

> > > > > > > > Yesterday I had my first bit of bad news since the adrenalectomy in October. I'm already making plans for a second opinion, but wanted to put this out there for comment.

> > > > > > > >

> > > > > > > > I had a routine eye exam with my longtime optometrist yesterday (who I have educated extensively about PA since he was very interested). He told me that he found two things that were not there at my last exam (three years ago): vascular damage consistent with that in untreated hypertensive patients, and the beginnings of macular degeneration in my left eye.

> > > > > > > >

> > > > > > > > My mom has macular degeneration, but hers did not start until she was well into her 70s (she's 86 now). I did some quick and dirty research and found that while heredity is probably the biggest culprint, HTN can also trigger it.

> > > > > > > >

> > > > > > > > The optometrist did not comment about the implications of the "vascular damage" other than to say that it may still reverse itself since it's only been three months since the surgery.

> > > > > > > >

> > > > > > > > I'm following up with my primary care doc in a couple weeks and will also see an ophthalmologist to find out what, if anything, I can do to prevent all of this from getting worse. And trying not to freak out too much, but it's rather disturbing news to someone who uses their vision to make a living!

> > > > > > > >

> > > > > > > > -msmith1928

> > > > > > > > Nulliparous female, 46, left laparoscopic adrenalectomy on 10/13/2011.

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Hmm shoukd be a professor by now?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 13, 2012, at 19:50, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

This link says Dr Lenz has been Assistant Professor: 1985 — present

at Dartmouth.

http://www.vitals.com/doctors/Dr__Lenz

> > > > > > > > > >

> > > > > > > > > > The chart that I mentioned, is called Amsler grid. Check your eyes:

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > http://www.allaboutvision.com/conditions/amsler-grid.htm

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Natalia

> > > > > > > > > >

> > > > > > > > > > From: Natalia Kamneva <natalia_kamneva@>

> > > > > > > > > > "hyperaldosteronism " <hyperaldosteronism >

> > > > > > > > > > Sent: Friday, January 13, 2012 12:36 AM

> > > > > > > > > > Subject: Re: Ocular damage from HTN?

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Msmith,

> > > > > > > > > >

> > > > > > > > > > Don't be freak out so much. Macular degeneration is inherited. Did the optometrist give your a chart that you have to look at every week? Ask him about this chart immediately. Ask ophthalmologist to test your eyes on a special device for macular degeneration. If you definitely have it, laser surgery should be done ASAP. My ophthalmologist insists me to call him the same moment as I see the changes in this chart.

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > Vascular damage definitely happens from high BP and it's reversible.

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > One more point - you didn't check your vision for 3 years - it's too long, have to do it every year or two.

> > > > > > > > > >

> > > > > > > > > > I have the experience with both of these problems. I am diabetic and I see ophthalmologist every year.

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Natalia

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > ________________________________

> > > > > > > > > > From: msmith_1928 <janeray1940@>

> > > > > > > > > > hyperaldosteronism

> > > > > > > > > > Sent: Thursday, January 12, 2012 10:39 AM

> > > > > > > > > > Subject: Ocular damage from HTN?

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Yesterday I had my first bit of bad news since the adrenalectomy in October. I'm already making plans for a second opinion, but wanted to put this out there for comment.

> > > > > > > > > >

> > > > > > > > > > I had a routine eye exam with my longtime optometrist yesterday (who I have educated extensively about PA since he was very interested). He told me that he found two things that were not there at my last exam (three years ago): vascular damage consistent with that in untreated hypertensive patients, and the beginnings of macular degeneration in my left eye.

> > > > > > > > > >

> > > > > > > > > > My mom has macular degeneration, but hers did not start until she was well into her 70s (she's 86 now). I did some quick and dirty research and found that while heredity is probably the biggest culprint, HTN can also trigger it.

> > > > > > > > > >

> > > > > > > > > > The optometrist did not comment about the implications of the "vascular damage" other than to say that it may still reverse itself since it's only been three months since the surgery.

> > > > > > > > > >

> > > > > > > > > > I'm following up with my primary care doc in a couple weeks and will also see an ophthalmologist to find out what, if anything, I can do to prevent all of this from getting worse. And trying not to freak out too much, but it's rather disturbing news to someone who uses their vision to make a living!

> > > > > > > > > >

> > > > > > > > > > -msmith1928

> > > > > > > > > > Nulliparous female, 46, left laparoscopic adrenalectomy on 10/13/2011.

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

He has one study regarding carotid stent placement published in 2004. What

should pubmed tell me if he is a person who does his job but is not researcher

or writer?

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

pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.

> > > > > > > > > >

> > > > > > > > > > The chart that I mentioned, is called Amsler grid.

Check your eyes:

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > http://www.allaboutvision.com/conditions/amsler-grid.htm

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Natalia

> > > > > > > > > >

> > > > > > > > > > From: Natalia Kamneva <natalia_kamneva@>

> > > > > > > > > > " hyperaldosteronism "

<hyperaldosteronism >

> > > > > > > > > > Sent: Friday, January 13, 2012 12:36 AM

> > > > > > > > > > Subject: Re: Ocular damage from HTN?

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Msmith,

> > > > > > > > > >

> > > > > > > > > > Don't be freak out so much. Macular degeneration is

inherited. Did the optometrist give your a chart that you have to look at every

week? Ask him about this chart immediately. Ask ophthalmologist to test your

eyes on a special device for macular degeneration. If you definitely have it,

laser surgery should be done ASAP. My ophthalmologist insists me to call him the

same moment as I see the changes in this chart.

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > Vascular damage definitely happens from high BP and it's

reversible.

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > One more point - you didn't check your vision for 3 years -

it's too long, have to do it every year or two.

> > > > > > > > > >

> > > > > > > > > > I have the experience with both of these problems. I am

diabetic and I see ophthalmologist every year.

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Natalia

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > ________________________________

> > > > > > > > > > From: msmith_1928 <janeray1940@>

> > > > > > > > > > hyperaldosteronism

> > > > > > > > > > Sent: Thursday, January 12, 2012 10:39 AM

> > > > > > > > > > Subject: Ocular damage from HTN?

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Yesterday I had my first bit of bad news since the

adrenalectomy in October. I'm already making plans for a second opinion, but

wanted to put this out there for comment.

> > > > > > > > > >

> > > > > > > > > > I had a routine eye exam with my longtime optometrist

yesterday (who I have educated extensively about PA since he was very

interested). He told me that he found two things that were not there at my last

exam (three years ago): vascular damage consistent with that in untreated

hypertensive patients, and the beginnings of macular degeneration in my left

eye.

> > > > > > > > > >

> > > > > > > > > > My mom has macular degeneration, but hers did not start

until she was well into her 70s (she's 86 now). I did some quick and dirty

research and found that while heredity is probably the biggest culprint, HTN can

also trigger it.

> > > > > > > > > >

> > > > > > > > > > The optometrist did not comment about the implications of

the " vascular damage " other than to say that it may still reverse itself since

it's only been three months since the surgery.

> > > > > > > > > >

> > > > > > > > > > I'm following up with my primary care doc in a couple weeks

and will also see an ophthalmologist to find out what, if anything, I can do to

prevent all of this from getting worse. And trying not to freak out too much,

but it's rather disturbing news to someone who uses their vision to make a

living!

> > > > > > > > > >

> > > > > > > > > > -msmith1928

> > > > > > > > > > Nulliparous female, 46, left laparoscopic adrenalectomy on

10/13/2011.

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Maybe he believes in the old addage, " Those who can DO, those who can't, TEACH " .

(Emphasis mine!) Although I was the best of the best for years in my

professionl career at my former employer teaching was my least favorite task, I

would much prefer be troubleshooting a computer problem t 3 AM and since I was

the main troubleshooter I didn't have time to do course prepartion!

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

pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.

>- In hyperaldosteronism , Clarence Grim <lowerbp2@...> wrote:

>

> Hmm shoukd be a professor by now?

>

>

>

> May your pressure be low!

>

> CE Grim MS, MD

> Specializing in Difficult

> Hypertension

>

> On Jan 13, 2012, at 19:50, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

>

> > This link says Dr Lenz has been Assistant Professor: 1985 †" present

> > at Dartmouth.

> >

> > http://www.vitals.com/doctors/Dr__Lenz

> >

> >

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

> > > > > > > > > > > > The chart that I mentioned, is called Amsler grid.

Check your eyes:

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

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

> > > > > > > > > > > > http://www.allaboutvision.com/conditions/amsler-grid.htm

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

> > > > > > > > > > > > Â

> > > > > > > > > > > > Natalia

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

> > > > > > > > > > > > From: Natalia Kamneva <natalia_kamneva@>

> > > > > > > > > > > > " hyperaldosteronism "

<hyperaldosteronism >

> > > > > > > > > > > > Sent: Friday, January 13, 2012 12:36 AM

> > > > > > > > > > > > Subject: Re: Ocular damage from

HTN?

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

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

> > > > > > > > > > > > Â

> > > > > > > > > > > > Msmith,

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

> > > > > > > > > > > > Don't be freak out so much. Macular degeneration is

inherited. Did the optometrist give your a chart that you have to look at every

week? Ask him about this chart immediately. Ask ophthalmologist to test your

eyes on a special device for macular degeneration. If you definitely have it,

laser surgery should be done ASAP. My ophthalmologist insists me to call him the

same moment as I see the changes in this chart.

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

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

> > > > > > > > > > > > Vascular damage definitely happens from high BP and it's

reversible.

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

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

> > > > > > > > > > > > One more point - you didn't check your vision for 3

years - it's too long, have to do it every year or two.

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

> > > > > > > > > > > > I have the experience with both of these problems. I

am diabetic and I see ophthalmologist every year.

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

> > > > > > > > > > > > Â

> > > > > > > > > > > > Natalia

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

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

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

> > > > > > > > > > > > From: msmith_1928 <janeray1940@>

> > > > > > > > > > > > hyperaldosteronism

> > > > > > > > > > > > Sent: Thursday, January 12, 2012 10:39 AM

> > > > > > > > > > > > Subject: Ocular damage from HTN?

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

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

> > > > > > > > > > > > Â

> > > > > > > > > > > > Yesterday I had my first bit of bad news since the

adrenalectomy in October. I'm already making plans for a second opinion, but

wanted to put this out there for comment.

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

> > > > > > > > > > > > I had a routine eye exam with my longtime optometrist

yesterday (who I have educated extensively about PA since he was very

interested). He told me that he found two things that were not there at my last

exam (three years ago): vascular damage consistent with that in untreated

hypertensive patients, and the beginnings of macular degeneration in my left

eye.

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

> > > > > > > > > > > > My mom has macular degeneration, but hers did not start

until she was well into her 70s (she's 86 now). I did some quick and dirty

research and found that while heredity is probably the biggest culprint, HTN can

also trigger it.

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

> > > > > > > > > > > > The optometrist did not comment about the implications

of the " vascular damage " other than to say that it may still reverse itself

since it's only been three months since the surgery.

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

> > > > > > > > > > > > I'm following up with my primary care doc in a couple

weeks and will also see an ophthalmologist to find out what, if anything, I can

do to prevent all of this from getting worse. And trying not to freak out too

much, but it's rather disturbing news to someone who uses their vision to make a

living!

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

> > > > > > > > > > > > -msmith1928

> > > > > > > > > > > > Nulliparous female, 46, left laparoscopic adrenalectomy

on 10/13/2011.

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

In general those who publish their results spend more time reading and thinking about what they are doing. And probably have a better grasp of the literature. But then they may be spending more time doing and be better at that. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 14, 2012, at 7:35, <jclark24p@...> wrote:

He has one study regarding carotid stent placement published in 2004. What should pubmed tell me if he is a person who does his job but is not researcher or writer?

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.

> > > > > > > > > >

> > > > > > > > > > The chart that I mentioned, is called Amsler grid. Check your eyes:

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > http://www.allaboutvision.com/conditions/amsler-grid.htm

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Natalia

> > > > > > > > > >

> > > > > > > > > > From: Natalia Kamneva <natalia_kamneva@>

> > > > > > > > > > "hyperaldosteronism " <hyperaldosteronism >

> > > > > > > > > > Sent: Friday, January 13, 2012 12:36 AM

> > > > > > > > > > Subject: Re: Ocular damage from HTN?

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Msmith,

> > > > > > > > > >

> > > > > > > > > > Don't be freak out so much. Macular degeneration is inherited. Did the optometrist give your a chart that you have to look at every week? Ask him about this chart immediately. Ask ophthalmologist to test your eyes on a special device for macular degeneration. If you definitely have it, laser surgery should be done ASAP. My ophthalmologist insists me to call him the same moment as I see the changes in this chart.

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > Vascular damage definitely happens from high BP and it's reversible.

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > One more point - you didn't check your vision for 3 years - it's too long, have to do it every year or two.

> > > > > > > > > >

> > > > > > > > > > I have the experience with both of these problems. I am diabetic and I see ophthalmologist every year.

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Natalia

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > ________________________________

> > > > > > > > > > From: msmith_1928 <janeray1940@>

> > > > > > > > > > hyperaldosteronism

> > > > > > > > > > Sent: Thursday, January 12, 2012 10:39 AM

> > > > > > > > > > Subject: Ocular damage from HTN?

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > > Â

> > > > > > > > > > Yesterday I had my first bit of bad news since the adrenalectomy in October. I'm already making plans for a second opinion, but wanted to put this out there for comment.

> > > > > > > > > >

> > > > > > > > > > I had a routine eye exam with my longtime optometrist yesterday (who I have educated extensively about PA since he was very interested). He told me that he found two things that were not there at my last exam (three years ago): vascular damage consistent with that in untreated hypertensive patients, and the beginnings of macular degeneration in my left eye.

> > > > > > > > > >

> > > > > > > > > > My mom has macular degeneration, but hers did not start until she was well into her 70s (she's 86 now). I did some quick and dirty research and found that while heredity is probably the biggest culprint, HTN can also trigger it.

> > > > > > > > > >

> > > > > > > > > > The optometrist did not comment about the implications of the "vascular damage" other than to say that it may still reverse itself since it's only been three months since the surgery.

> > > > > > > > > >

> > > > > > > > > > I'm following up with my primary care doc in a couple weeks and will also see an ophthalmologist to find out what, if anything, I can do to prevent all of this from getting worse. And trying not to freak out too much, but it's rather disturbing news to someone who uses their vision to make a living!

> > > > > > > > > >

> > > > > > > > > > -msmith1928

> > > > > > > > > > Nulliparous female, 46, left laparoscopic adrenalectomy on 10/13/2011.

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

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(23)

[Guest guest]

Or those who think publish, those who don't don't. But that is prob an academic's bias. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 14, 2012, at 7:50, <jclark24p@...> wrote:

Maybe he believes in the old addage, "Those who can DO, those who can't, TEACH". (Emphasis mine!) Although I was the best of the best for years in my professionl career at my former employer teaching was my least favorite task, I would much prefer be troubleshooting a computer problem t 3 AM and since I was the main troubleshooter I didn't have time to do course prepartion!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.

>- In hyperaldosteronism , Clarence Grim <lowerbp2@...> wrote:

>

> Hmm shoukd be a professor by now?

>

>

>

> May your pressure be low!

>

> CE Grim MS, MD

> Specializing in Difficult

> Hypertension

>

> On Jan 13, 2012, at 19:50, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

>

> > This link says Dr Lenz has been Assistant Professor: 1985 â€" present

> > at Dartmouth.

> >

> > http://www.vitals.com/doctors/Dr__Lenz

> >

> >

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

> > > > > > > > > > > > The chart that I mentioned, is called Amsler grid. Check your eyes:

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

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

> > > > > > > > > > > > http://www.allaboutvision.com/conditions/amsler-grid.htm

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

> > > > > > > > > > > > Â

> > > > > > > > > > > > Natalia

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

> > > > > > > > > > > > From: Natalia Kamneva <natalia_kamneva@>

> > > > > > > > > > > > "hyperaldosteronism " <hyperaldosteronism >

> > > > > > > > > > > > Sent: Friday, January 13, 2012 12:36 AM

> > > > > > > > > > > > Subject: Re: Ocular damage from HTN?

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

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

> > > > > > > > > > > > Â

> > > > > > > > > > > > Msmith,

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

> > > > > > > > > > > > Don't be freak out so much. Macular degeneration is inherited. Did the optometrist give your a chart that you have to look at every week? Ask him about this chart immediately. Ask ophthalmologist to test your eyes on a special device for macular degeneration. If you definitely have it, laser surgery should be done ASAP. My ophthalmologist insists me to call him the same moment as I see the changes in this chart.

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

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

> > > > > > > > > > > > Vascular damage definitely happens from high BP and it's reversible.

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

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

> > > > > > > > > > > > One more point - you didn't check your vision for 3 years - it's too long, have to do it every year or two.

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

> > > > > > > > > > > > I have the experience with both of these problems. I am diabetic and I see ophthalmologist every year.

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

> > > > > > > > > > > > Â

> > > > > > > > > > > > Natalia

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

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

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

> > > > > > > > > > > > From: msmith_1928 <janeray1940@>

> > > > > > > > > > > > hyperaldosteronism

> > > > > > > > > > > > Sent: Thursday, January 12, 2012 10:39 AM

> > > > > > > > > > > > Subject: Ocular damage from HTN?

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

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

> > > > > > > > > > > > Â

> > > > > > > > > > > > Yesterday I had my first bit of bad news since the adrenalectomy in October. I'm already making plans for a second opinion, but wanted to put this out there for comment.

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

> > > > > > > > > > > > I had a routine eye exam with my longtime optometrist yesterday (who I have educated extensively about PA since he was very interested). He told me that he found two things that were not there at my last exam (three years ago): vascular damage consistent with that in untreated hypertensive patients, and the beginnings of macular degeneration in my left eye.

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

> > > > > > > > > > > > My mom has macular degeneration, but hers did not start until she was well into her 70s (she's 86 now). I did some quick and dirty research and found that while heredity is probably the biggest culprint, HTN can also trigger it.

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

> > > > > > > > > > > > The optometrist did not comment about the implications of the "vascular damage" other than to say that it may still reverse itself since it's only been three months since the surgery.

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

> > > > > > > > > > > > I'm following up with my primary care doc in a couple weeks and will also see an ophthalmologist to find out what, if anything, I can do to prevent all of this from getting worse. And trying not to freak out too much, but it's rather disturbing news to someone who uses their vision to make a living!

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

> > > > > > > > > > > > -msmith1928

> > > > > > > > > > > > Nulliparous female, 46, left laparoscopic adrenalectomy on 10/13/2011.

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

> > > > > > > > > > >

> > > > > > > > > >

> > > >