Re: Am I wrong to be nagative about surgery

[Guest guest]

Most likely if u DASH U WILL only need Spiro for BP. IF U READ my evolution article u will understand why u don't need all the other meds as they don't work in PA. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 7, 2012, at 17:54, Alan <alanttt3@...> wrote:

My doctor is advising AVS with a view to adrenalectomy – I have to let him know if I wish to proceed in a few days time. But I have already decided that I am against surgery. The choice is take a few pills every day or subject myself to another battery of tests followed by surgery – with all the hassle and discomfort that implies. To me it's no brainer – keep taking the tablets.

That this will be done under Britain's NHS where the nursing care be negligent - and there is a risk of MRSA makes surgery even less attractive. There is always a risk of coming out of hospital sicker than you went in in the UK.

The only benefit of the surgery according to the doctor is that I can stop taking the medication, which are Spironolactone and a cocktail of five conventional BP drugs. The meds are effectively controlling my BP and I can live with the side effects - so I don't really know why the doctor is advising surgery

Have I misunderstood something - am I wrong to be so negative about surgery?

[Guest guest]

Alan, You provide far less information than a murder mystery on TV!

I can't find your story or much information other than you suffer(ed)

gynecomastia on low dose Spironlactone and your doctor wanted to evaluate you

for Gonadal Vein Embolisation. I'm going to take a chance and assume you have

PA, still have gynecomastia and are still treting with low dose Spironolactone.

If any of this is false stop reading and give us your complete story!

Why are you still on 5 BP Meds? Tell us what they are and dosage but they are

probably doing nothing but giving you side effects! Most regular BP meds will

not work with PA, see chapter C167 of the Hypertension Primer - fourth edition.

If you are still experiencing gynecomastia your doctor should switch you to

Eplerenone immediately. You need to know how tht is hndled in Britian, it took

three tries for me to even get it approved! I base that suggestion on my own

case and the extensive research I have done. It appears gyneo often reverses

but many claim it is less likely after a year.

I have no idea what " Gonadal Vein Embolisation " but I can guess the " Gonadal

Vein " portion might have something to do with male sexual organs and maybe

hormones affected by them. Did you get any results from your doctor? I surmize

that if it affects testosterone and your testosterone/estrogen balance was

impacted then the fact that spironolactone angtagonizes androgen (male sex

hormone) caused a further imbalance thereby causing the Gynecomastia!

I see msmith has checked in and I won't echo her comments but I will say I have

been following her case closely and my decision to proceed to AVS is based alot

on her experience. I have applied to join a study at NIH and hope to get

answers to many of my questions there but until I do please consider my comments

" one man's opinion " !

If you want to give us your story and hve specific questions I would be happy to

try and answer them.

- 65 yo super ob., fastidious 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, AmlodipineBesylate

5mg, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11

to prepare for AVS.

>

> My doctor is advising AVS with a view to adrenalectomy – I have to let him

know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

>

> That this will be done under Britain's NHS where the nursing care be negligent

- and there is a risk of MRSA makes surgery even less attractive. There is

always a risk of coming out of hospital sicker than you went in in the UK.

>

> The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

>

> Have I misunderstood something - am I wrong to be so negative about surgery?

>

[Guest guest]

Alan, You provide far less information than a murder mystery on TV!

I can't find your story or much information other than you suffer(ed)

gynecomastia on low dose Spironlactone and your doctor wanted to evaluate you

for Gonadal Vein Embolisation. I'm going to take a chance and assume you have

PA, still have gynecomastia and are still treting with low dose Spironolactone.

If any of this is false stop reading and give us your complete story!

Why are you still on 5 BP Meds? Tell us what they are and dosage but they are

probably doing nothing but giving you side effects! Most regular BP meds will

not work with PA, see chapter C167 of the Hypertension Primer - fourth edition.

If you are still experiencing gynecomastia your doctor should switch you to

Eplerenone immediately. You need to know how tht is hndled in Britian, it took

three tries for me to even get it approved! I base that suggestion on my own

case and the extensive research I have done. It appears gyneo often reverses

but many claim it is less likely after a year.

I have no idea what " Gonadal Vein Embolisation " but I can guess the " Gonadal

Vein " portion might have something to do with male sexual organs and maybe

hormones affected by them. Did you get any results from your doctor? I surmize

that if it affects testosterone and your testosterone/estrogen balance was

impacted then the fact that spironolactone angtagonizes androgen (male sex

hormone) caused a further imbalance thereby causing the Gynecomastia!

I see msmith has checked in and I won't echo her comments but I will say I have

been following her case closely and my decision to proceed to AVS is based alot

on her experience. I have applied to join a study at NIH and hope to get

answers to many of my questions there but until I do please consider my comments

" one man's opinion " !

If you want to give us your story and hve specific questions I would be happy to

try and answer them.

- 65 yo super ob., fastidious 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, AmlodipineBesylate

5mg, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11

to prepare for AVS.

>

> My doctor is advising AVS with a view to adrenalectomy – I have to let him

know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

>

> That this will be done under Britain's NHS where the nursing care be negligent

- and there is a risk of MRSA makes surgery even less attractive. There is

always a risk of coming out of hospital sicker than you went in in the UK.

>

> The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

>

> Have I misunderstood something - am I wrong to be so negative about surgery?

>

[Guest guest]

Hi Allan

I agree with others, why are you on 5 meds? That is an indication to me that

your team may not fully understand your condition.

Where are you located in the UK?

What hospital?

Have you had a CT scan that shows a " bump " ?

Chris

>

> My doctor is advising AVS with a view to adrenalectomy – I have to let him

know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

>

> That this will be done under Britain's NHS where the nursing care be negligent

- and there is a risk of MRSA makes surgery even less attractive. There is

always a risk of coming out of hospital sicker than you went in in the UK.

>

> The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

>

> Have I misunderstood something - am I wrong to be so negative about surgery?

>

[Guest guest]

Hi Allan

I agree with others, why are you on 5 meds? That is an indication to me that

your team may not fully understand your condition.

Where are you located in the UK?

What hospital?

Have you had a CT scan that shows a " bump " ?

Chris

>

> My doctor is advising AVS with a view to adrenalectomy – I have to let him

know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

>

> That this will be done under Britain's NHS where the nursing care be negligent

- and there is a risk of MRSA makes surgery even less attractive. There is

always a risk of coming out of hospital sicker than you went in in the UK.

>

> The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

>

> Have I misunderstood something - am I wrong to be so negative about surgery?

>

[Guest guest]

Alan, many of the concerns you have, plus your worries and due caution are over things quite consistent across the board in our developed countries. MRSA is a risk every where, and is known to populate hospitals even across our oceans. That is a risk even walking through a hospital, BUT just on that topic MRSA is by no means a death knell, and it is a methycillin resistant staph, but tends to responds to other antibiotics and can be treated either way. Still we share your caution on it.

From another voice - and I have never had surgery of any kind and I am 44 yo and work as a physician assistant - what's equal to your advanced practice nurse, so I understand quite a bit from both sides of the doctors stethescope. Surgery petrifies me too, but I have not really had to "refuse" one yet through this.

I did go 5 + years of severe HTN 160+/130 daily for 5 +years. ONLY spiro caused an immediate drop in BP after a mere 2 doses and I was able to put aside the 5 meds I was on at that time. I am doing well on spiro, and I actually DASH well and get in exercise - even if it is a tiny bit of exercise that day I DO IT!. For 2 weeks now I have been without my spiro and my BP is doing great.

Just aome food for thought. I am not out of the wouds, but I work hard staying and getting healthier and I believe in the DASH diet as a healthy life changing diet.

I keep getting better at each step and my docs have never mentioned any surgeries. If things got worse they might, but I fight hard to get better without it. You should fight and make a holistic plan to get better and stronger and show then how committed you are to not having surgery.

Go show them

From: <jclark24p@...>Subject: Re: Am I wrong to be nagative about surgeryhyperaldosteronism Date: Wednesday, March 7, 2012, 9:32 PM

Alan, You provide far less information than a murder mystery on TV!I can't find your story or much information other than you suffer(ed) gynecomastia on low dose Spironlactone and your doctor wanted to evaluate you for Gonadal Vein Embolisation. I'm going to take a chance and assume you have PA, still have gynecomastia and are still treting with low dose Spironolactone. If any of this is false stop reading and give us your complete story!Why are you still on 5 BP Meds? Tell us what they are and dosage but they are probably doing nothing but giving you side effects! Most regular BP meds will not work with PA, see chapter C167 of the Hypertension Primer - fourth edition.If you are still experiencing gynecomastia your doctor should switch you to Eplerenone immediately. You need to know how tht is hndled in Britian, it took three tries for me to even get it approved! I base that suggestion on my own case and the extensive

research I have done. It appears gyneo often reverses but many claim it is less likely after a year.I have no idea what "Gonadal Vein Embolisation" but I can guess the "Gonadal Vein" portion might have something to do with male sexual organs and maybe hormones affected by them. Did you get any results from your doctor? I surmize that if it affects testosterone and your testosterone/estrogen balance was impacted then the fact that spironolactone angtagonizes androgen (male sex hormone) caused a further imbalance thereby causing the Gynecomastia!I see msmith has checked in and I won't echo her comments but I will say I have been following her case closely and my decision to proceed to AVS is based alot on her experience. I have applied to join a study at NIH and hope to get answers to many of my questions there but until I do please consider my comments "one man's opinion"!If you want to give us your story and hve specific

questions I would be happy to try and answer them. - 65 yo super ob., fastidious 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, AmlodipineBesylate 5mg, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.>> My doctor is advising AVS with a view to adrenalectomy – I have to let him know if I wish to proceed in a few days time. But I have already

decided that I am against surgery. The choice is take a few pills every day or subject myself to another battery of tests followed by surgery – with all the hassle and discomfort that implies. To me it's no brainer – keep taking the tablets.> > That this will be done under Britain's NHS where the nursing care be negligent - and there is a risk of MRSA makes surgery even less attractive. There is always a risk of coming out of hospital sicker than you went in in the UK.> > The only benefit of the surgery according to the doctor is that I can stop taking the medication, which are Spironolactone and a cocktail of five conventional BP drugs. The meds are effectively controlling my BP and I can live with the side effects - so I don't really know why the doctor is advising surgery > > Have I misunderstood something - am I wrong to be so negative about

surgery?>

[Guest guest]

Like the others have said, it would be good to know more about your

circumstances.

For me it was a no brainer to have surgery, even though I was only on Spiro, and

my BP was well controlled by that.

My logic was:

- Spiro doesn't stop the hormones being produced, it merely masks the effects on

your BP by blocking the receivers in your kidneys (my layman's take on it). So:

1. What else are those hormones doing? Not much research.

2. Meantime that hormone producing nodule on your adrenal gland can continue to

get bigger & more active.

- Successful surgery has several good predictors, amongst them:

1. Longevity of condition

2. Size of Adenoma

3. Age

So I reckoned my best chances of successful surgery were sooner rather than

later. Why would I pump my body full of drugs for years and wait for them to

fail before I decided to have surgeery, by which time the outcome of surgery was

likely to be unsuccessful too?

But I'm young(ish), fit, healthy & I live in Switzerland where the hospitals are

probably better controlled so I had no concern about my ability to recover from

surgery. Having said that, my decision would have been the same under the NHS.

If I were older or had other health issues that made surgery itself daunting, my

decision would have been different.

H

>

> My doctor is advising AVS with a view to adrenalectomy – I have to let him

know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

>

> That this will be done under Britain's NHS where the nursing care be negligent

- and there is a risk of MRSA makes surgery even less attractive. There is

always a risk of coming out of hospital sicker than you went in in the UK.

>

> The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

>

> Have I misunderstood something - am I wrong to be so negative about surgery?

>

[Guest guest]

>

> My doctor is advising AVS with a view to adrenalectomy – I have to let him

know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

>

> That this will be done under Britain's NHS where the nursing care be negligent

- and there is a risk of MRSA makes surgery even less attractive. There is

always a risk of coming out of hospital sicker than you went in in the UK.

>

> The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

>

> Have I misunderstood something - am I wrong to be so negative about surgery?

>

Thanks to everyone for taking the time to reply and give the benefit of their

considerable expertise.

In reply to those that have asked for more information, I am 60 years old ,

overweight and a heavy-drinker. I also have other health problems including

asthma and lower back pain that make taking any meaningful exercise difficult.

I also had a stomach ulcer but it hasn't caused me a problem for years.

Several people have asked why I am on five BP drugs. I assume given my age and

poor health that I probably have primary hypertension in addition to the

secondary hypertension caused by hyperaldosteronism. Over the years as one

drug after anther failed to control my BP – the solution was always to add

another drug and now the doctors have finally found a cocktail that works they

don't want to change it.

This to me is another argument against surgery, as I will probably still require

BP drugs even if surgery is successful. So I could be subjecting myself to all

disadvantages and risks of surgery just to have one pill removed my current 16

tablets a day – see monthly repeat prescription below.

I am also concerned about having to give up Spironolactone for the 6 weeks

required to allow AVS to be effective as I know from past experience that my BP

will go through the roof. I recorded numbers as high as 198\89 when I once

tried doing without Spiro as an experiment.

I will be most grateful for any further advice anyone can provide in response

the extra information I have provided.

Monthly repeat prescription -

28 10.0 mg Bisoprolol Fumerate tablets (one per day)

84 4.0 mg Doxazosin tablets (three per day)

28 32.0 mg Candesartan tablets (one per day)

28 50.0 mg Spirononlactone tablets (one per day)

28 200.0 mcg Moxonidine tablets (one per day)

56 20.0 mg Omeprazole capsules (one per day)

200 Solpadol Capsules (maximum 8 per day)

Two Ventolin inhalers (as required)

[Guest guest]

Just my two cents...I echo on the MRSA issue...just dealt with major staph

infection myself and that's not, in my opinion a good reason to avoid surgery.

If risks outweigh benefits is the motto, is it not?

So, the risks and the benefits...that's what I would discuss further with your

doctors...and with yourself, I guess.

Personally, I've had many surgeries, including 3 c-sections, appendectomy,

hysterectomy, wrist surgery, laparoscopies for gyno stuff, ovarian cysts and

what not...I hate the IV's. I hate the nurse that preps you that can never get

the IV in. I always refuse catheters. But, otherwise, if you have a good

surgeon who has a good reason for the surgery and you need it to make your

quality of life better or without it, you'll die, well, surgery isn't all that

bad. Make sure you get good pain management post op and make sure everyone who

you have contact with is practicing infection control...

I guess AVS is optional, as is adrenalectomy, but what is clear is each of us

has our own personal stuff going on. I want AVS because I want information and

for us here in the US, currently, it appears to be the gold standard for that.

I could go on Spiro or Epler and forget all the labs and just take those meds,

but my sense is that if my adrenal gland is producing tumors, I want to know

more about that. I want to know as much about that as possible. I also don't

want to take meds that I don't need long term. I want a diagnosis confirmed. I

will then look at all the info and their recommendations and make a decision

after the AVS. Part of that involves my concept of tumors. My concept of a

tumor is that it can grow and morph and turn into something worse. I want to

know exactly what abnormal tissue I am dealing with.

For you, in UK, why not do the PET scan?

So, for me, the AVS risks don't outweigh the benefits esp. since I think the

docs I am using can and will get it right. Hope is good!

> >

> > My doctor is advising AVS with a view to adrenalectomy – I have to let him

know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

> >

> > That this will be done under Britain's NHS where the nursing care be

negligent - and there is a risk of MRSA makes surgery even less attractive.

There is always a risk of coming out of hospital sicker than you went in in the

UK.

> >

> > The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

> >

> > Have I misunderstood something - am I wrong to be so negative about

surgery?

> >

>

>

>

> Thanks to everyone for taking the time to reply and give the benefit of their

considerable expertise.

>

> In reply to those that have asked for more information, I am 60 years old ,

overweight and a heavy-drinker. I also have other health problems including

asthma and lower back pain that make taking any meaningful exercise difficult.

I also had a stomach ulcer but it hasn't caused me a problem for years.

>

> Several people have asked why I am on five BP drugs. I assume given my age

and poor health that I probably have primary hypertension in addition to the

secondary hypertension caused by hyperaldosteronism. Over the years as one

drug after anther failed to control my BP – the solution was always to add

another drug and now the doctors have finally found a cocktail that works they

don't want to change it.

>

>

>

> This to me is another argument against surgery, as I will probably still

require BP drugs even if surgery is successful. So I could be subjecting myself

to all disadvantages and risks of surgery just to have one pill removed my

current 16 tablets a day – see monthly repeat prescription below.

>

> I am also concerned about having to give up Spironolactone for the 6 weeks

required to allow AVS to be effective as I know from past experience that my BP

will go through the roof. I recorded numbers as high as 198\89 when I once

tried doing without Spiro as an experiment.

>

> I will be most grateful for any further advice anyone can provide in response

the extra information I have provided.

>

> Monthly repeat prescription -

>

> 28 10.0 mg Bisoprolol Fumerate tablets (one per day)

> 84 4.0 mg Doxazosin tablets (three per day)

> 28 32.0 mg Candesartan tablets (one per day)

> 28 50.0 mg Spirononlactone tablets (one per day)

> 28 200.0 mcg Moxonidine tablets (one per day)

>

> 56 20.0 mg Omeprazole capsules (one per day)

> 200 Solpadol Capsules (maximum 8 per day)

> Two Ventolin inhalers (as required)

>

[Guest guest]

In all likelyhood the only BP MED u need if you have also salt HTN AKA PA then the only drug u will need is Spiro and low salt. The reason u needed all the others is that except for Spiro they do not work in PA. REVIEW my evolution of PA AGAIN and see if that helps. Keep us posted. If gynecomastia develops then u will need to be switched to eerie one. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 8, 2012, at 13:44, Alan <alanttt3@...> wrote:

>

> My doctor is advising AVS with a view to adrenalectomy – I have to let him know if I wish to proceed in a few days time. But I have already decided that I am against surgery. The choice is take a few pills every day or subject myself to another battery of tests followed by surgery – with all the hassle and discomfort that implies. To me it's no brainer – keep taking the tablets.

>

> That this will be done under Britain's NHS where the nursing care be negligent - and there is a risk of MRSA makes surgery even less attractive. There is always a risk of coming out of hospital sicker than you went in in the UK.

>

> The only benefit of the surgery according to the doctor is that I can stop taking the medication, which are Spironolactone and a cocktail of five conventional BP drugs. The meds are effectively controlling my BP and I can live with the side effects - so I don't really know why the doctor is advising surgery

>

> Have I misunderstood something - am I wrong to be so negative about surgery?

>

Thanks to everyone for taking the time to reply and give the benefit of their considerable expertise.

In reply to those that have asked for more information, I am 60 years old , overweight and a heavy-drinker. I also have other health problems including asthma and lower back pain that make taking any meaningful exercise difficult. I also had a stomach ulcer but it hasn't caused me a problem for years.

Several people have asked why I am on five BP drugs. I assume given my age and poor health that I probably have primary hypertension in addition to the secondary hypertension caused by hyperaldosteronism. Over the years as one drug after anther failed to control my BP – the solution was always to add another drug and now the doctors have finally found a cocktail that works they don't want to change it.

This to me is another argument against surgery, as I will probably still require BP drugs even if surgery is successful. So I could be subjecting myself to all disadvantages and risks of surgery just to have one pill removed my current 16 tablets a day – see monthly repeat prescription below.

I am also concerned about having to give up Spironolactone for the 6 weeks required to allow AVS to be effective as I know from past experience that my BP will go through the roof. I recorded numbers as high as 198\89 when I once tried doing without Spiro as an experiment.

I will be most grateful for any further advice anyone can provide in response the extra information I have provided.

Monthly repeat prescription -

28 10.0 mg Bisoprolol Fumerate tablets (one per day)

84 4.0 mg Doxazosin tablets (three per day)

28 32.0 mg Candesartan tablets (one per day)

28 50.0 mg Spirononlactone tablets (one per day)

28 200.0 mcg Moxonidine tablets (one per day)

56 20.0 mg Omeprazole capsules (one per day)

200 Solpadol Capsules (maximum 8 per day)

Two Ventolin inhalers (as required)

[Guest guest]

Good keep us posted. Big tumors ways come from smaller tumors. So yours have been there for some time. Likely years. Remember that for also to do its damage one has to eat excess salt. How much is excess? Enough to raise your BP I SUSPECT. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 8, 2012, at 16:46, maggiekat7 <ljurkovic@...> wrote:

Just my two cents...I echo on the MRSA issue...just dealt with major staph infection myself and that's not, in my opinion a good reason to avoid surgery. If risks outweigh benefits is the motto, is it not?

So, the risks and the benefits...that's what I would discuss further with your doctors...and with yourself, I guess.

Personally, I've had many surgeries, including 3 c-sections, appendectomy, hysterectomy, wrist surgery, laparoscopies for gyno stuff, ovarian cysts and what not...I hate the IV's. I hate the nurse that preps you that can never get the IV in. I always refuse catheters. But, otherwise, if you have a good surgeon who has a good reason for the surgery and you need it to make your quality of life better or without it, you'll die, well, surgery isn't all that bad. Make sure you get good pain management post op and make sure everyone who you have contact with is practicing infection control...

I guess AVS is optional, as is adrenalectomy, but what is clear is each of us has our own personal stuff going on. I want AVS because I want information and for us here in the US, currently, it appears to be the gold standard for that.

I could go on Spiro or Epler and forget all the labs and just take those meds, but my sense is that if my adrenal gland is producing tumors, I want to know more about that. I want to know as much about that as possible. I also don't want to take meds that I don't need long term. I want a diagnosis confirmed. I will then look at all the info and their recommendations and make a decision after the AVS. Part of that involves my concept of tumors. My concept of a tumor is that it can grow and morph and turn into something worse. I want to know exactly what abnormal tissue I am dealing with.

For you, in UK, why not do the PET scan?

So, for me, the AVS risks don't outweigh the benefits esp. since I think the docs I am using can and will get it right. Hope is good!

> >

> > My doctor is advising AVS with a view to adrenalectomy – I have to let him know if I wish to proceed in a few days time. But I have already decided that I am against surgery. The choice is take a few pills every day or subject myself to another battery of tests followed by surgery – with all the hassle and discomfort that implies. To me it's no brainer – keep taking the tablets.

> >

> > That this will be done under Britain's NHS where the nursing care be negligent - and there is a risk of MRSA makes surgery even less attractive. There is always a risk of coming out of hospital sicker than you went in in the UK.

> >

> > The only benefit of the surgery according to the doctor is that I can stop taking the medication, which are Spironolactone and a cocktail of five conventional BP drugs. The meds are effectively controlling my BP and I can live with the side effects - so I don't really know why the doctor is advising surgery

> >

> > Have I misunderstood something - am I wrong to be so negative about surgery?

> >

>

>

>

> Thanks to everyone for taking the time to reply and give the benefit of their considerable expertise.

>

> In reply to those that have asked for more information, I am 60 years old , overweight and a heavy-drinker. I also have other health problems including asthma and lower back pain that make taking any meaningful exercise difficult. I also had a stomach ulcer but it hasn't caused me a problem for years.

>

> Several people have asked why I am on five BP drugs. I assume given my age and poor health that I probably have primary hypertension in addition to the secondary hypertension caused by hyperaldosteronism. Over the years as one drug after anther failed to control my BP – the solution was always to add another drug and now the doctors have finally found a cocktail that works they don't want to change it.

>

>

>

> This to me is another argument against surgery, as I will probably still require BP drugs even if surgery is successful. So I could be subjecting myself to all disadvantages and risks of surgery just to have one pill removed my current 16 tablets a day – see monthly repeat prescription below.

>

> I am also concerned about having to give up Spironolactone for the 6 weeks required to allow AVS to be effective as I know from past experience that my BP will go through the roof. I recorded numbers as high as 198\89 when I once tried doing without Spiro as an experiment.

>

> I will be most grateful for any further advice anyone can provide in response the extra information I have provided.

>

> Monthly repeat prescription -

>

> 28 10.0 mg Bisoprolol Fumerate tablets (one per day)

> 84 4.0 mg Doxazosin tablets (three per day)

> 28 32.0 mg Candesartan tablets (one per day)

> 28 50.0 mg Spirononlactone tablets (one per day)

> 28 200.0 mcg Moxonidine tablets (one per day)

>

> 56 20.0 mg Omeprazole capsules (one per day)

> 200 Solpadol Capsules (maximum 8 per day)

> Two Ventolin inhalers (as required)

>

[Guest guest]

Dr. G,

I have no accurate labs for Na, however, have been dashing since oct, 2007,

after my husband's MI. In short order, I will have those labs done as well, so

I will let you know!

> > > >

> > > > My doctor is advising AVS with a view to adrenalectomy †" I have to let

him know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or subject

myself to another battery of tests followed by surgery †" with all the hassle

and discomfort that implies. To me it's no brainer †" keep taking the tablets.

> > > >

> > > > That this will be done under Britain's NHS where the nursing care be

negligent - and there is a risk of MRSA makes surgery even less attractive.

There is always a risk of coming out of hospital sicker than you went in in the

UK.

> > > >

> > > > The only benefit of the surgery according to the doctor is that I can

stop taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can live

with the side effects - so I don't really know why the doctor is advising

surgery

> > > >

> > > > Have I misunderstood something - am I wrong to be so negative about

surgery?

> > > >

> > >

> > >

> > >

> > > Thanks to everyone for taking the time to reply and give the benefit of

their considerable expertise.

> > >

> > > In reply to those that have asked for more information, I am 60 years old

, overweight and a heavy-drinker. I also have other health problems including

asthma and lower back pain that make taking any meaningful exercise difficult. I

also had a stomach ulcer but it hasn't caused me a problem for years.

> > >

> > > Several people have asked why I am on five BP drugs. I assume given my age

and poor health that I probably have primary hypertension in addition to the

secondary hypertension caused by hyperaldosteronism. Over the years as one drug

after anther failed to control my BP †" the solution was always to add another

drug and now the doctors have finally found a cocktail that works they don't

want to change it.

> > >

> > >

> > >

> > > This to me is another argument against surgery, as I will probably still

require BP drugs even if surgery is successful. So I could be subjecting myself

to all disadvantages and risks of surgery just to have one pill removed my

current 16 tablets a day †" see monthly repeat prescription below.

> > >

> > > I am also concerned about having to give up Spironolactone for the 6 weeks

required to allow AVS to be effective as I know from past experience that my BP

will go through the roof. I recorded numbers as high as 198\89 when I once tried

doing without Spiro as an experiment.

> > >

> > > I will be most grateful for any further advice anyone can provide in

response the extra information I have provided.

> > >

> > > Monthly repeat prescription -

> > >

> > > 28 10.0 mg Bisoprolol Fumerate tablets (one per day)

> > > 84 4.0 mg Doxazosin tablets (three per day)

> > > 28 32.0 mg Candesartan tablets (one per day)

> > > 28 50.0 mg Spirononlactone tablets (one per day)

> > > 28 200.0 mcg Moxonidine tablets (one per day)

> > >

> > > 56 20.0 mg Omeprazole capsules (one per day)

> > > 200 Solpadol Capsules (maximum 8 per day)

> > > Two Ventolin inhalers (as required)

> > >

> >

> >

>

[Guest guest]

Alan, thanks for the info, that makes my suggestion easy. Remember to include

your doctor with any changes!

It's apparent you do not want surgery and that is your choice and a good one.

You should have your doc change you to Eplerenone because of gynecomstia. They

say Spiro is " more effective " , I think that just means you the dosage is

different and you need a higher dose of Epler. (Two different medicines so it

is like comparing apples to oranges!) The big difference is that it doesn't

mess with your testosterone! (You really don't need anyone reducing your

testosterone unless you want a transgender change or are a sex offender and the

law is trying to control you. (Besides, God is already working on that at a

rate of 1%/year after 35!)

The only way to know if you need the extra BP meds is to try eliminating them. I

was on 7 and my BP remained the same when I stopped 3 and actually went down on

two, didn't check on the first one. I cut the last one, a beta blocker, to half

the dose. That one was more for my doctor so she didn't have a heart attack!

;>)

I did not look up your meds but many BP meds affect your kidneys nd liver so if

the provide nothing but side effects you don't need them. Being a

" heavy-drinker " , those are two orgsns you may already be stressing! (No

judgement intended!)

My BP was well controlled (120's/low70's) HR ~60, HbA1C ~6.2 nd I lost about 25

lbs and felt great on 25mg bid of spiro. My LVH got better so I no longer

needed supplemental oxygen! My flank pain & testis pain went away, Life was

good! Gynecomastia had shown up early and I developed bumps in my breast and

after a benign mammogram I decided enough was enough. I had trouble getting

Epler approved so I started washing spiro to prepare for AVS.

Delaying surgery is certainly a good option providing they haven't found a large

tumor (over 3cm). Keep us posted and your doctor should have offered you this

option, IMHO.

> >

> > My doctor is advising AVS with a view to adrenalectomy – I have to let him

know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

> >

> > That this will be done under Britain's NHS where the nursing care be

negligent - and there is a risk of MRSA makes surgery even less attractive.

There is always a risk of coming out of hospital sicker than you went in in the

UK.

> >

> > The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

> >

> > Have I misunderstood something - am I wrong to be so negative about

surgery?

> >

>

>

>

> Thanks to everyone for taking the time to reply and give the benefit of their

considerable expertise.

>

> In reply to those that have asked for more information, I am 60 years old ,

overweight and a heavy-drinker. I also have other health problems including

asthma and lower back pain that make taking any meaningful exercise difficult.

I also had a stomach ulcer but it hasn't caused me a problem for years.

>

> Several people have asked why I am on five BP drugs. I assume given my age

and poor health that I probably have primary hypertension in addition to the

secondary hypertension caused by hyperaldosteronism. Over the years as one

drug after anther failed to control my BP – the solution was always to add

another drug and now the doctors have finally found a cocktail that works they

don't want to change it.

>

>

>

> This to me is another argument against surgery, as I will probably still

require BP drugs even if surgery is successful. So I could be subjecting myself

to all disadvantages and risks of surgery just to have one pill removed my

current 16 tablets a day – see monthly repeat prescription below.

>

> I am also concerned about having to give up Spironolactone for the 6 weeks

required to allow AVS to be effective as I know from past experience that my BP

will go through the roof. I recorded numbers as high as 198\89 when I once

tried doing without Spiro as an experiment.

>

> I will be most grateful for any further advice anyone can provide in response

the extra information I have provided.

>

> Monthly repeat prescription -

>

> 28 10.0 mg Bisoprolol Fumerate tablets (one per day)

> 84 4.0 mg Doxazosin tablets (three per day)

> 28 32.0 mg Candesartan tablets (one per day)

> 28 50.0 mg Spirononlactone tablets (one per day)

> 28 200.0 mcg Moxonidine tablets (one per day)

>

> 56 20.0 mg Omeprazole capsules (one per day)

> 200 Solpadol Capsules (maximum 8 per day)

> Two Ventolin inhalers (as required)

>

[Guest guest]

> >

> > My doctor is advising AVS with a view to adrenalectomy – I have to let him

know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

> >

> > That this will be done under Britain's NHS where the nursing care be

negligent - and there is a risk of MRSA makes surgery even less attractive.

There is always a risk of coming out of hospital sicker than you went in in the

UK.

> >

> > The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

> >

> > Have I misunderstood something - am I wrong to be so negative about

surgery?

> >

>

>

>

> Thanks to everyone for taking the time to reply and give the benefit of their

considerable expertise.

>

> In reply to those that have asked for more information, I am 60 years old ,

overweight and a heavy-drinker. I also have other health problems including

asthma and lower back pain that make taking any meaningful exercise difficult.

I also had a stomach ulcer but it hasn't caused me a problem for years.

>

> Several people have asked why I am on five BP drugs. I assume given my age

and poor health that I probably have primary hypertension in addition to the

secondary hypertension caused by hyperaldosteronism. Over the years as one

drug after anther failed to control my BP – the solution was always to add

another drug and now the doctors have finally found a cocktail that works they

don't want to change it.

>

>

>

> This to me is another argument against surgery, as I will probably still

require BP drugs even if surgery is successful. So I could be subjecting myself

to all disadvantages and risks of surgery just to have one pill removed my

current 16 tablets a day – see monthly repeat prescription below.

>

> I am also concerned about having to give up Spironolactone for the 6 weeks

required to allow AVS to be effective as I know from past experience that my BP

will go through the roof. I recorded numbers as high as 198\89 when I once

tried doing without Spiro as an experiment.

>

> I will be most grateful for any further advice anyone can provide in response

the extra information I have provided.

>

> Monthly repeat prescription -

>

> 28 10.0 mg Bisoprolol Fumerate tablets (one per day)

> 84 4.0 mg Doxazosin tablets (three per day)

> 28 32.0 mg Candesartan tablets (one per day)

> 28 50.0 mg Spirononlactone tablets (one per day)

> 28 200.0 mcg Moxonidine tablets (one per day)

>

> 56 20.0 mg Omeprazole capsules (one per day)

> 200 Solpadol Capsules (maximum 8 per day)

> Two Ventolin inhalers (as required)

>

[Guest guest]

Alan, Spiro is being tested and used in cases of HTN other than PA according to

some recent studies. The bottom line is if it works for you, why change! A

good hint might be if you can reduce other BP meds and if it affects your BP. I

certainly wouldn't let him proceed to AVS without proper pretesting like ARR but

at this point why waste your time and money!

> > >

> > > My doctor is advising AVS with a view to adrenalectomy – I have to let

him know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

> > >

> > > That this will be done under Britain's NHS where the nursing care be

negligent - and there is a risk of MRSA makes surgery even less attractive.

There is always a risk of coming out of hospital sicker than you went in in the

UK.

> > >

> > > The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

> > >

> > > Have I misunderstood something - am I wrong to be so negative about

surgery?

> > >

> >

> >

> >

> > Thanks to everyone for taking the time to reply and give the benefit of

their considerable expertise.

> >

> > In reply to those that have asked for more information, I am 60 years old ,

overweight and a heavy-drinker. I also have other health problems including

asthma and lower back pain that make taking any meaningful exercise difficult.

I also had a stomach ulcer but it hasn't caused me a problem for years.

> >

> > Several people have asked why I am on five BP drugs. I assume given my age

and poor health that I probably have primary hypertension in addition to the

secondary hypertension caused by hyperaldosteronism. Over the years as one

drug after anther failed to control my BP – the solution was always to add

another drug and now the doctors have finally found a cocktail that works they

don't want to change it.

> >

> >

> >

> > This to me is another argument against surgery, as I will probably still

require BP drugs even if surgery is successful. So I could be subjecting myself

to all disadvantages and risks of surgery just to have one pill removed my

current 16 tablets a day – see monthly repeat prescription below.

> >

> > I am also concerned about having to give up Spironolactone for the 6 weeks

required to allow AVS to be effective as I know from past experience that my BP

will go through the roof. I recorded numbers as high as 198\89 when I once

tried doing without Spiro as an experiment.

> >

> > I will be most grateful for any further advice anyone can provide in

response the extra information I have provided.

> >

> > Monthly repeat prescription -

> >

> > 28 10.0 mg Bisoprolol Fumerate tablets (one per day)

> > 84 4.0 mg Doxazosin tablets (three per day)

> > 28 32.0 mg Candesartan tablets (one per day)

> > 28 50.0 mg Spirononlactone tablets (one per day)

> > 28 200.0 mcg Moxonidine tablets (one per day)

> >

> > 56 20.0 mg Omeprazole capsules (one per day)

> > 200 Solpadol Capsules (maximum 8 per day)

> > Two Ventolin inhalers (as required)

> >

>

[Guest guest]

Many patients without PA (allegedly) also will respond to MCBs. This has always suggested to me that they have early PA but most do not agree.So a good BP response to MCB is necessary but no sufficient evidence to most that a pt has PA. Except most forget a pt can outsalt MCBs.CE Grim MDOn Mar 9, 2012, at 4:53 PM, Alan wrote: > > > > My doctor is advising AVS with a view to adrenalectomy – I have to let him know if I wish to proceed in a few days time. But I have already decided that I am against surgery. The choice is take a few pills every day or subject myself to another battery of tests followed by surgery – with all the hassle and discomfort that implies. To me it's no brainer – keep taking the tablets. > > > > That this will be done under Britain's NHS where the nursing care be negligent - and there is a risk of MRSA makes surgery even less attractive. There is always a risk of coming out of hospital sicker than you went in in the UK. > > > > The only benefit of the surgery according to the doctor is that I can stop taking the medication, which are Spironolactone and a cocktail of five conventional BP drugs. The meds are effectively controlling my BP and I can live with the side effects - so I don't really know why the doctor is advising surgery > > > > Have I misunderstood something - am I wrong to be so negative about surgery? > > > > > > Thanks to everyone for taking the time to reply and give the benefit of their considerable expertise. > > In reply to those that have asked for more information, I am 60 years old , overweight and a heavy-drinker. I also have other health problems including asthma and lower back pain that make taking any meaningful exercise difficult. I also had a stomach ulcer but it hasn't caused me a problem for years. > > Several people have asked why I am on five BP drugs. I assume given my age and poor health that I probably have primary hypertension in addition to the secondary hypertension caused by hyperaldosteronism. Over the years as one drug after anther failed to control my BP – the solution was always to add another drug and now the doctors have finally found a cocktail that works they don't want to change it. > > > > This to me is another argument against surgery, as I will probably still require BP drugs even if surgery is successful. So I could be subjecting myself to all disadvantages and risks of surgery just to have one pill removed my current 16 tablets a day – see monthly repeat prescription below. > > I am also concerned about having to give up Spironolactone for the 6 weeks required to allow AVS to be effective as I know from past experience that my BP will go through the roof. I recorded numbers as high as 198\89 when I once tried doing without Spiro as an experiment. > > I will be most grateful for any further advice anyone can provide in response the extra information I have provided. > > Monthly repeat prescription - > > 28 10.0 mg Bisoprolol Fumerate tablets (one per day) > 84 4.0 mg Doxazosin tablets (three per day) > 28 32.0 mg Candesartan tablets (one per day) > 28 50.0 mg Spirononlactone tablets (one per day) > 28 200.0 mcg Moxonidine tablets (one per day) > > 56 20.0 mg Omeprazole capsules (one per day) > 200 Solpadol Capsules (maximum 8 per day) > Two Ventolin inhalers (as required) >

[Guest guest]

Hey Allan,

I think it is great that you have good information from this group to make clear

informed decisions that work best for you.

I just wanted to let you know that here in the UK you can get the PET scan

instead of the AVS, it is new, I get mine Tuesday. It is only offered in

Cambridge at the moment.

It is not a post code lottery but you need approval from your local NHS trust.

For this the doctor in cambridge email your local surgery with the scan info,

the trust meets 2 times per month for approvals.

I'll post more on Wednesday after I get the scan and a diagnosis.

All the best,

Chris

> > >

> > > My doctor is advising AVS with a view to adrenalectomy – I have to let

him know if I wish to proceed in a few days time. But I have already decided

that I am against surgery. The choice is take a few pills every day or

subject myself to another battery of tests followed by surgery – with all the

hassle and discomfort that implies. To me it's no brainer – keep taking the

tablets.

> > >

> > > That this will be done under Britain's NHS where the nursing care be

negligent - and there is a risk of MRSA makes surgery even less attractive.

There is always a risk of coming out of hospital sicker than you went in in the

UK.

> > >

> > > The only benefit of the surgery according to the doctor is that I can stop

taking the medication, which are Spironolactone and a cocktail of five

conventional BP drugs. The meds are effectively controlling my BP and I can

live with the side effects - so I don't really know why the doctor is

advising surgery

> > >

> > > Have I misunderstood something - am I wrong to be so negative about

surgery?

> > >

> >

> >

> >

> > Thanks to everyone for taking the time to reply and give the benefit of

their considerable expertise.

> >

> > In reply to those that have asked for more information, I am 60 years old ,

overweight and a heavy-drinker. I also have other health problems including

asthma and lower back pain that make taking any meaningful exercise difficult.

I also had a stomach ulcer but it hasn't caused me a problem for years.

> >

> > Several people have asked why I am on five BP drugs. I assume given my age

and poor health that I probably have primary hypertension in addition to the

secondary hypertension caused by hyperaldosteronism. Over the years as one

drug after anther failed to control my BP – the solution was always to add

another drug and now the doctors have finally found a cocktail that works they

don't want to change it.

> >

> >

> >

> > This to me is another argument against surgery, as I will probably still

require BP drugs even if surgery is successful. So I could be subjecting myself

to all disadvantages and risks of surgery just to have one pill removed my

current 16 tablets a day – see monthly repeat prescription below.

> >

> > I am also concerned about having to give up Spironolactone for the 6 weeks

required to allow AVS to be effective as I know from past experience that my BP

will go through the roof. I recorded numbers as high as 198\89 when I once

tried doing without Spiro as an experiment.

> >

> > I will be most grateful for any further advice anyone can provide in

response the extra information I have provided.

> >

> > Monthly repeat prescription -

> >

> > 28 10.0 mg Bisoprolol Fumerate tablets (one per day)

> > 84 4.0 mg Doxazosin tablets (three per day)

> > 28 32.0 mg Candesartan tablets (one per day)

> > 28 50.0 mg Spirononlactone tablets (one per day)

> > 28 200.0 mcg Moxonidine tablets (one per day)

> >

> > 56 20.0 mg Omeprazole capsules (one per day)

> > 200 Solpadol Capsules (maximum 8 per day)

> > Two Ventolin inhalers (as required)

> >

>