Re: Re: PA at the VA, the Saga Continues

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I think I have only seen 4 in my first 2 months down here. CE Grim MDOn Feb 6, 2012, at 3:40 PM, msmith_1928 wrote: , I am reminded of the assistant IR who had done "too many to count" yet didn't get my first AVS right. Perhaps the 6 that yours has done have all been done correctly, and here's hoping that yours will be too! > > I finally caught up with the IR's assistant this afternoon, figured it was time since AVS is scheuled for Feb 22nd. The conversation was much shorter than I expected when I found out he has done 6 in the last 15 years and he's "the most experienced in the North East!" Guess PA must still be rare here in the North East! >

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In medicine many work on the SODOTO principle. See one, do one, teach one. CE Grim MDOn Feb 6, 2012, at 6:41 PM, msmith_1928 wrote: If you can get into that study, that really does seem to be the way to go. I was considering cashing out my 401K in order to do exactly that, had my second AVS gone awry. > > > > > > I finally caught up with the IR's assistant this afternoon, figured it was time since AVS is scheuled for Feb 22nd. The conversation was much shorter than I expected when I found out he has done 6 in the last 15 years and he's "the most experienced in the North East!" Guess PA must still be rare here in the North East! > > > > > >

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Excellent keep us posted. Tell the others you meet there about our site. My guess is we have about 3 times more than they have seen.CE Grim MDOn Feb 6, 2012, at 9:15 PM, wrote: I actually think I will save money! The VA's "free svc to vets" costs me $50 co-pay to see a specialist and when I add travel it costs me $192 at the VA. R/T to Bethesda is $202 and they feed me for 10 days! (Plus I don't have to stay awake and tell them where to poke me!) :>) > > > > > > > > I finally caught up with the IR's assistant this afternoon, figured it was time since AVS is scheuled for Feb 22nd. The conversation was much shorter than I expected when I found out he has done 6 in the last 15 years and he's "the most experienced in the North East!" Guess PA must still be rare here in the North East! > > > > > > > > > >

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Ahh! Recall there is a difference in seeing and recognizing. So all with drug resistant HTN (more than 3 drugs) should be screened but maybe all in Vermont eat a low sodium diet and none require this many BP meds.?On Feb 7, 2012, at 3:53 AM, wrote: If they have only seen 6 in the last 15 years here in Vermont I bet you could have field day! Let's see, if 10% = 6 that means only 60 Vets w/HTN in the lst 15 years - think it's the fresh mtn air in VT and NH? ;>) > > > > > > I finally caught up with the IR's assistant this afternoon, > > figured it was time since AVS is scheuled for Feb 22nd. The > > conversation was much shorter than I expected when I found out he > > has done 6 in the last 15 years and he's "the most experienced in > > the North East!" Guess PA must still be rare here in the North East! > > > > > > > >

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The radiologist who has done my AVS, said he had done 25. My endo said it's NOTHING and recommended me to repeat it in the National Health Institute. My nephrologist said everything was done correctly, even though AVS was done without ACTH and I was all the time on 150 mg of eplerenone. I will attach the results from my AVS and explanation of my nephrologist tomorrow. The nephrologist graduated from Harvard Medical School. He showed me the protocol of AVS, written by Yung and others, where no mention of ACTH was and going for 6 - 8 weeks without epler/sipro.When I asked him whether very high aldo/renin are bad and damaging even with low sodium diet and epler, his answer was very

interesting:"It depends on in which city a doctor lives. In NYC doctors say it's bad, in all other cities, it's not!" Natalia From: <jclark24p@...> hyperaldosteronism Sent: Monday, February 6, 2012 8:16 PM Subject: Re: PA at the VA, the Saga Continues

Your experience was the first thing I thought of! The second thing I thought of was NIH in Bethesda MD. And the third thing I did was send my PCP an e-mail asking her to send my medical HX, list of meds and a copy of the ct-scans down to land for study #NCT00005927. I think the odds of it being done correctly just increased! ;>)

I then called the Chief of Medical Services and asked his secretary to set up a meeting for me!

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> > I finally caught up with the IR's assistant this afternoon, figured it was time since AVS is scheuled for Feb 22nd. The conversation was much shorter than I expected when I found out he has done 6 in the last 15 years and he's "the most experienced in the North East!" Guess PA must still be rare here in the North East!

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They do AVS only to get insurance money…then the doc flips a coin and tells you the result because AVs has about 50% probability of correct outcome so why they should waste time on time-consuming ACTH which is really a great headache for radiologist as s/he would need assistance and time keeping …etc… during AVS plus possible mislabeling of samples…you could flip the coin yourself and save $25000 J Max. The radiologist who has done my AVS, said he had done 25. My endo said it's NOTHING and recommended me to repeat it in the National Health Institute. My nephrologist said everything was done correctly, even though AVS was done without ACTH and I was all the time on 150 mg of eplerenone. I will attach the results from my AVS and explanation of my nephrologist tomorrow. The nephrologist graduated from Harvard Medical School. He showed me the protocol of AVS, written by Yung and others, where no mention of ACTH was and going for 6 - 8 weeks without epler/sipro. When I asked him whether very high aldo/renin are bad and damaging even with low sodium diet and epler, his answer was very interesting: " It depends on in which city a doctor lives. In NYC doctors say it's bad, in all other cities, it's not! " Natalia

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Thank you, . Why it's 3 different protocols? Natalia From: <jclark24p@...> hyperaldosteronism Sent: Tuesday, February 7, 2012 9:02 PM Subject: Re: PA at the VA, the Saga Continues

Maybe your doctors haven't heard of "The Endocrine Society"! Suggest you take them a copy of their "Practice Guidelines" that is in our files so they will know what the experts say! (Page 15, 3.2.Remarks, will explain the 3 different protocols for an AVS)

The file is at: Final-Standalone-PA-Guideline.pdf

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> > > I finally caught up with the IR's assistant this afternoon, figured it was time since AVS is scheuled for Feb 22nd. The conversation was much shorter than I expected when I found out he has done 6 in the last 15 years and he's "the most experienced in the North East!" Guess PA must still be rare here in the North East!

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Hokay. You pays your money and takes your choice.Dr. Young? maybeCE Grim MDOn Feb 7, 2012, at 6:31 PM, Study Circle wrote: They do AVS only to get insurance money…then the doc flips a coin and tells you the result because AVs has about 50% probability of correct outcome so why they should waste time on time-consuming ACTH which is really a great headache for radiologist as s/he would need assistance and time keeping …etc… during AVS plus possible mislabeling of samples…you could flip the coin yourself and save $25000 J Max. The radiologist who has done my AVS, said he had done 25. My endo said it's NOTHING and recommended me to repeat it in the National Health Institute. My nephrologist said everything was done correctly, even though AVS was done without ACTH and I was all the time on 150 mg of eplerenone. I will attach the results from my AVS and explanation of my nephrologist tomorrow. The nephrologist graduated from Harvard Medical School. He showed me the protocol of AVS, written by Yung and others, where no mention of ACTH was and going for 6 - 8 weeks without epler/sipro. When I asked him whether very high aldo/renin are bad and damaging even with low sodium diet and epler, his answer was very interesting: "It depends on in which city a doctor lives. In NYC doctors say it's bad, in all other cities, it's not!" Natalia

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You can read this review and get a discussion of the reasons for 3 different.CE Grim MDOn Feb 7, 2012, at 7:12 PM, Natalia Kamneva wrote: Thank you, . Why it's 3 different protocols? Natalia From: <jclark24p@...> hyperaldosteronism Sent: Tuesday, February 7, 2012 9:02 PM Subject: Re: PA at the VA, the Saga Continues Maybe your doctors haven't heard of "The Endocrine Society"! Suggest you take them a copy of their "Practice Guidelines" that is in our files so they will know what the experts say! (Page 15, 3.2.Remarks, will explain the 3 different protocols for an AVS) The file is at: Final-Standalone-PA-Guideline.pdf > > > > > > I finally caught up with the IR's assistant this afternoon, figured it was time since AVS is scheuled for Feb 22nd. The conversation was much shorter than I expected when I found out he has done 6 in the last 15 years and he's "the most experienced in the North East!" Guess PA must still be rare here in the North East! > > > > > >