Re: NIH experience

[Guest guest]

Oh, and I asked one of my Drs. today about the PET scan and told him about the

British using it as an alternative to AVS...he wants the link to the studies on

it...anyone have that handy? He says it is not in this protocol, only used here

if there is a very large adenoma and some other unusual circumstances. He was

puzzled that it would be used instead of AVS; I got the feeling he did not think

it was apples to apples thing...more of a apples to orange and not close.

>

> I flew standby to Baltimore and was put in first class. I had a glass of

Pinot Grigio and before I knew it we were landing. Got off the plane and made

my way to the Super Shuttle which I had reserved since the NIH airport shuttle

doesn't run on Saturday's. I was the last drop off and then the NIH experience

really began. The Super Shuttle driver went to the Main Entrance which was

locked. (The whole place is locked, secured, gated, manned with it's own police

staff, very visibly). There was a sign to proceed to the South Entrance, so we

did. The guy at the gate (armed guard) said we had to go back out to get badges

and he had to get cleared through commercial vehicle inspection. I went through

Checkpoint Charlie (between East and West Germany prior to the fall of the

Berlin Wall) and it reminded me of that. After the dogs, the half dozen police

guards, etc had cleared the van and my ID, we were given our badges and went to

the South gate again. We were allowed through and he dropped me and my luggage

off at the Clinical Research Center. There was no one in sight. I saw a sign

at the information desk that directed me to admissions. It was quite a walk,

but I found it. There was a lady there (not another soul anywhere) and she

asked if she could help me? I told her my name and said I was here for

admission and she found me in her system, had me sign stuff, gave me an armband

and took me upstairs. Upstairs looks like a hospital. We went to the nurses

station and the nurse took me to my room. He said, first order your dinner and

handed me a menu and a phone. I quickly read the menu, called the number on the

menu and was put on hold for 13 minutes. (Order your meals early). I ordered a

spinach salad, you can put whatever you want on it and get whatever dressing you

want too. I also ordered a baked potato and steamed brocolli. The salad was

great. The baked potato must've been microwaved, it was weird and the brocolli

was too steamed and hospital tasting. I ordered the same salad for lunch today

with a grilled cheese (low fat, low sodium) sandwich and decided I might live on

spinach salads while I'm here. After the dinner stuff, I got checked in by

nursing staff; they went over my meds etc. and told me about the 24 hour urine

testing. The whole time you are here (7-10 days), you do the urine

testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in

your room. After that, it was vitals and uneventful.

>

> I was awakened today at 5:30 or so; they took my vitals and told me to pee to

start the urine testing. Then, I saw 3 doctors all whom were various levels of

fellows and they all had consents to sign and histories to take; questions about

various aspects of my health and records. I was seen by a social worker and

screened for mental health issues. I was seen by a bio ethics person who wanted

to make sure I knew what I was consenting to, and understood the living will

documents. I am currently waiting on someone who is going to do an EKG. I had

to apply for a IT security screen to get a password for the internet and it took

all day today to process, but alas, I have it! I spent most of the day today

with all of that and had a lot of time to get some work done that I brought with

me. So, it was a pretty relaxing day and very informative.

>

> If I can, I will post how tomorrow goes, etc. I won't get any results until

Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons

of bloodwork ( they are putting two lines in tomorrow am), saline supression

test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US

of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and

acth and an acth stim test. I am having more cardiac stuff too based on

something they are worried about from today as well, but not everyone would have

that. Then, I will know quite a bit of results and have a pow wow. Then we

decide what to do from there based on what they have. If necessary, I would have

the AVS on Friday. Then it would take a week to get those results, so I could

go home on Saturday or Sunday, then they call with the AVS results and we go

from there as far as surgery or whatever. I signed a thing today that I

understood that they would like me to come back in a year and repeat all of this

too, if I have something to follow. I don't have too, but they'd like it.

>

> So, there you have it...my NIH experience thus far!

>

[Guest guest]

Great to have a first hand report. Remember that your urine is liquid gold so collect it exactly as instructed. Be sure they measure your urine volume during the saline infusion. Suspect they will do this but if Not be sure they do and tell us how much u per during this. See dr Grim's pee test for PA during the saline in our intro. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 11, 2012, at 19:08, maggiekat7 <ljurkovic@...> wrote:

I flew standby to Baltimore and was put in first class. I had a glass of Pinot Grigio and before I knew it we were landing. Got off the plane and made my way to the Super Shuttle which I had reserved since the NIH airport shuttle doesn't run on Saturday's. I was the last drop off and then the NIH experience really began. The Super Shuttle driver went to the Main Entrance which was locked. (The whole place is locked, secured, gated, manned with it's own police staff, very visibly). There was a sign to proceed to the South Entrance, so we did. The guy at the gate (armed guard) said we had to go back out to get badges and he had to get cleared through commercial vehicle inspection. I went through Checkpoint Charlie (between East and West Germany prior to the fall of the Berlin Wall) and it reminded me of that. After the dogs, the half dozen police guards, etc had cleared the van and my ID, we were given our badges and went to the South gate again. We were allowed

through and he dropped me and my luggage off at the Clinical Research Center. There was no one in sight. I saw a sign at the information desk that directed me to admissions. It was quite a walk, but I found it. There was a lady there (not another soul anywhere) and she asked if she could help me? I told her my name and said I was here for admission and she found me in her system, had me sign stuff, gave me an armband and took me upstairs. Upstairs looks like a hospital. We went to the nurses station and the nurse took me to my room. He said, first order your dinner and handed me a menu and a phone. I quickly read the menu, called the number on the menu and was put on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you can put whatever you want on it and get whatever dressing you want too. I also ordered a baked potato and steamed brocolli. The salad was great. The baked potato must've been microwaved, it was weird and the brocolli was too

steamed and hospital tasting. I ordered the same salad for lunch today with a grilled cheese (low fat, low sodium) sandwich and decided I might live on spinach salads while I'm here. After the dinner stuff, I got checked in by nursing staff; they went over my meds etc. and told me about the 24 hour urine testing. The whole time you are here (7-10 days), you do the urine testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in your room. After that, it was vitals and uneventful.

I was awakened today at 5:30 or so; they took my vitals and told me to pee to start the urine testing. Then, I saw 3 doctors all whom were various levels of fellows and they all had consents to sign and histories to take; questions about various aspects of my health and records. I was seen by a social worker and screened for mental health issues. I was seen by a bio ethics person who wanted to make sure I knew what I was consenting to, and understood the living will documents. I am currently waiting on someone who is going to do an EKG. I had to apply for a IT security screen to get a password for the internet and it took all day today to process, but alas, I have it! I spent most of the day today with all of that and had a lot of time to get some work done that I brought with me. So, it was a pretty relaxing day and very informative.

If I can, I will post how tomorrow goes, etc. I won't get any results until Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons of bloodwork ( they are putting two lines in tomorrow am), saline supression test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff too based on something they are worried about from today as well, but not everyone would have that. Then, I will know quite a bit of results and have a pow wow. Then we decide what to do from there based on what they have. If necessary, I would have the AVS on Friday. Then it would take a week to get those results, so I could go home on Saturday or Sunday, then they call with the AVS results and we go from there as far as surgery or whatever. I signed a thing today that I understood that they would like me to come back in a year and

repeat all of this too, if I have something to follow. I don't have too, but they'd like it.

So, there you have it...my NIH experience thus far!

[Guest guest]

Tell him to join our site to keep up to date. And recommend us to any others u see there who are there for PA STUDIES. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 11, 2012, at 19:17, maggiekat7 <ljurkovic@...> wrote:

Oh, and I asked one of my Drs. today about the PET scan and told him about the British using it as an alternative to AVS...he wants the link to the studies on it...anyone have that handy? He says it is not in this protocol, only used here if there is a very large adenoma and some other unusual circumstances. He was puzzled that it would be used instead of AVS; I got the feeling he did not think it was apples to apples thing...more of a apples to orange and not close.

>

> I flew standby to Baltimore and was put in first class. I had a glass of Pinot Grigio and before I knew it we were landing. Got off the plane and made my way to the Super Shuttle which I had reserved since the NIH airport shuttle doesn't run on Saturday's. I was the last drop off and then the NIH experience really began. The Super Shuttle driver went to the Main Entrance which was locked. (The whole place is locked, secured, gated, manned with it's own police staff, very visibly). There was a sign to proceed to the South Entrance, so we did. The guy at the gate (armed guard) said we had to go back out to get badges and he had to get cleared through commercial vehicle inspection. I went through Checkpoint Charlie (between East and West Germany prior to the fall of the Berlin Wall) and it reminded me of that. After the dogs, the half dozen police guards, etc had cleared the van and my ID, we were given our badges and went to the South gate again. We were allowed through

and he dropped me and my luggage off at the Clinical Research Center. There was no one in sight. I saw a sign at the information desk that directed me to admissions. It was quite a walk, but I found it. There was a lady there (not another soul anywhere) and she asked if she could help me? I told her my name and said I was here for admission and she found me in her system, had me sign stuff, gave me an armband and took me upstairs. Upstairs looks like a hospital. We went to the nurses station and the nurse took me to my room. He said, first order your dinner and handed me a menu and a phone. I quickly read the menu, called the number on the menu and was put on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you can put whatever you want on it and get whatever dressing you want too. I also ordered a baked potato and steamed brocolli. The salad was great. The baked potato must've been microwaved, it was weird and the brocolli was too steamed and

hospital tasting. I ordered the same salad for lunch today with a grilled cheese (low fat, low sodium) sandwich and decided I might live on spinach salads while I'm here. After the dinner stuff, I got checked in by nursing staff; they went over my meds etc. and told me about the 24 hour urine testing. The whole time you are here (7-10 days), you do the urine testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in your room. After that, it was vitals and uneventful.

>

> I was awakened today at 5:30 or so; they took my vitals and told me to pee to start the urine testing. Then, I saw 3 doctors all whom were various levels of fellows and they all had consents to sign and histories to take; questions about various aspects of my health and records. I was seen by a social worker and screened for mental health issues. I was seen by a bio ethics person who wanted to make sure I knew what I was consenting to, and understood the living will documents. I am currently waiting on someone who is going to do an EKG. I had to apply for a IT security screen to get a password for the internet and it took all day today to process, but alas, I have it! I spent most of the day today with all of that and had a lot of time to get some work done that I brought with me. So, it was a pretty relaxing day and very informative.

>

> If I can, I will post how tomorrow goes, etc. I won't get any results until Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons of bloodwork ( they are putting two lines in tomorrow am), saline supression test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff too based on something they are worried about from today as well, but not everyone would have that. Then, I will know quite a bit of results and have a pow wow. Then we decide what to do from there based on what they have. If necessary, I would have the AVS on Friday. Then it would take a week to get those results, so I could go home on Saturday or Sunday, then they call with the AVS results and we go from there as far as surgery or whatever. I signed a thing today that I understood that they would like me to come back in a year and

repeat all of this too, if I have something to follow. I don't have too, but they'd like it.

>

> So, there you have it...my NIH experience thus far!

>

[Guest guest]

Thanks for the update Maggie. Sounds like some don't get Sundays off and they

will find something to occupy your time! Is all the security to keep you in or

others out? ;>)

Look forward to your updates.

>

> I flew standby to Baltimore and was put in first class. I had a glass of

Pinot Grigio and before I knew it we were landing. Got off the plane and made

my way to the Super Shuttle which I had reserved since the NIH airport shuttle

doesn't run on Saturday's. I was the last drop off and then the NIH experience

really began. The Super Shuttle driver went to the Main Entrance which was

locked. (The whole place is locked, secured, gated, manned with it's own police

staff, very visibly). There was a sign to proceed to the South Entrance, so we

did. The guy at the gate (armed guard) said we had to go back out to get badges

and he had to get cleared through commercial vehicle inspection. I went through

Checkpoint Charlie (between East and West Germany prior to the fall of the

Berlin Wall) and it reminded me of that. After the dogs, the half dozen police

guards, etc had cleared the van and my ID, we were given our badges and went to

the South gate again. We were allowed through and he dropped me and my luggage

off at the Clinical Research Center. There was no one in sight. I saw a sign

at the information desk that directed me to admissions. It was quite a walk,

but I found it. There was a lady there (not another soul anywhere) and she

asked if she could help me? I told her my name and said I was here for

admission and she found me in her system, had me sign stuff, gave me an armband

and took me upstairs. Upstairs looks like a hospital. We went to the nurses

station and the nurse took me to my room. He said, first order your dinner and

handed me a menu and a phone. I quickly read the menu, called the number on the

menu and was put on hold for 13 minutes. (Order your meals early). I ordered a

spinach salad, you can put whatever you want on it and get whatever dressing you

want too. I also ordered a baked potato and steamed brocolli. The salad was

great. The baked potato must've been microwaved, it was weird and the brocolli

was too steamed and hospital tasting. I ordered the same salad for lunch today

with a grilled cheese (low fat, low sodium) sandwich and decided I might live on

spinach salads while I'm here. After the dinner stuff, I got checked in by

nursing staff; they went over my meds etc. and told me about the 24 hour urine

testing. The whole time you are here (7-10 days), you do the urine

testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in

your room. After that, it was vitals and uneventful.

>

> I was awakened today at 5:30 or so; they took my vitals and told me to pee to

start the urine testing. Then, I saw 3 doctors all whom were various levels of

fellows and they all had consents to sign and histories to take; questions about

various aspects of my health and records. I was seen by a social worker and

screened for mental health issues. I was seen by a bio ethics person who wanted

to make sure I knew what I was consenting to, and understood the living will

documents. I am currently waiting on someone who is going to do an EKG. I had

to apply for a IT security screen to get a password for the internet and it took

all day today to process, but alas, I have it! I spent most of the day today

with all of that and had a lot of time to get some work done that I brought with

me. So, it was a pretty relaxing day and very informative.

>

> If I can, I will post how tomorrow goes, etc. I won't get any results until

Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons

of bloodwork ( they are putting two lines in tomorrow am), saline supression

test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US

of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and

acth and an acth stim test. I am having more cardiac stuff too based on

something they are worried about from today as well, but not everyone would have

that. Then, I will know quite a bit of results and have a pow wow. Then we

decide what to do from there based on what they have. If necessary, I would have

the AVS on Friday. Then it would take a week to get those results, so I could

go home on Saturday or Sunday, then they call with the AVS results and we go

from there as far as surgery or whatever. I signed a thing today that I

understood that they would like me to come back in a year and repeat all of this

too, if I have something to follow. I don't have too, but they'd like it.

>

> So, there you have it...my NIH experience thus far!

>

[Guest guest]

Showed him the site today, but couldn't find the link...or message that it was

in...

> > >

> > > I flew standby to Baltimore and was put in first class. I had a glass of

Pinot Grigio and before I knew it we were landing. Got off the plane and made my

way to the Super Shuttle which I had reserved since the NIH airport shuttle

doesn't run on Saturday's. I was the last drop off and then the NIH experience

really began. The Super Shuttle driver went to the Main Entrance which was

locked. (The whole place is locked, secured, gated, manned with it's own police

staff, very visibly). There was a sign to proceed to the South Entrance, so we

did. The guy at the gate (armed guard) said we had to go back out to get badges

and he had to get cleared through commercial vehicle inspection. I went through

Checkpoint Charlie (between East and West Germany prior to the fall of the

Berlin Wall) and it reminded me of that. After the dogs, the half dozen police

guards, etc had cleared the van and my ID, we were given our badges and went to

the South gate again. We were allowed through and he dropped me and my luggage

off at the Clinical Research Center. There was no one in sight. I saw a sign at

the information desk that directed me to admissions. It was quite a walk, but I

found it. There was a lady there (not another soul anywhere) and she asked if

she could help me? I told her my name and said I was here for admission and she

found me in her system, had me sign stuff, gave me an armband and took me

upstairs. Upstairs looks like a hospital. We went to the nurses station and the

nurse took me to my room. He said, first order your dinner and handed me a menu

and a phone. I quickly read the menu, called the number on the menu and was put

on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you

can put whatever you want on it and get whatever dressing you want too. I also

ordered a baked potato and steamed brocolli. The salad was great. The baked

potato must've been microwaved, it was weird and the brocolli was too steamed

and hospital tasting. I ordered the same salad for lunch today with a grilled

cheese (low fat, low sodium) sandwich and decided I might live on spinach salads

while I'm here. After the dinner stuff, I got checked in by nursing staff; they

went over my meds etc. and told me about the 24 hour urine testing. The whole

time you are here (7-10 days), you do the urine testing...pee in a hat, transfer

it to a jug, put jug in the specimin fridge in your room. After that, it was

vitals and uneventful.

> > >

> > > I was awakened today at 5:30 or so; they took my vitals and told me to pee

to start the urine testing. Then, I saw 3 doctors all whom were various levels

of fellows and they all had consents to sign and histories to take; questions

about various aspects of my health and records. I was seen by a social worker

and screened for mental health issues. I was seen by a bio ethics person who

wanted to make sure I knew what I was consenting to, and understood the living

will documents. I am currently waiting on someone who is going to do an EKG. I

had to apply for a IT security screen to get a password for the internet and it

took all day today to process, but alas, I have it! I spent most of the day

today with all of that and had a lot of time to get some work done that I

brought with me. So, it was a pretty relaxing day and very informative.

> > >

> > > If I can, I will post how tomorrow goes, etc. I won't get any results

until Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests,

tons of bloodwork ( they are putting two lines in tomorrow am), saline

supression test, ct scan (with contrast), ekg, supine/upright renin/aldo,

cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test,

dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff

too based on something they are worried about from today as well, but not

everyone would have that. Then, I will know quite a bit of results and have a

pow wow. Then we decide what to do from there based on what they have. If

necessary, I would have the AVS on Friday. Then it would take a week to get

those results, so I could go home on Saturday or Sunday, then they call with the

AVS results and we go from there as far as surgery or whatever. I signed a thing

today that I understood that they would like me to come back in a year and

repeat all of this too, if I have something to follow. I don't have too, but

they'd like it.

> > >

> > > So, there you have it...my NIH experience thus far!

> > >

> >

> >

>

[Guest guest]

I thought of your " liquid gold " metaphor today while collecting it...it is a lot

easier to do as an inpatient than it was as an outpatient and I'm confident they

won't lose it like my docs at home did. I apparently get details about each

test as it comes up, but I appreciate the heads up. I asked about the 2

catheters and they routinely do what you said to do.

They just did my EKG...showed left ventricle hypertrophy. Normal

otherwise....according to the tech who did it.

>

> > I flew standby to Baltimore and was put in first class. I had a glass of

Pinot Grigio and before I knew it we were landing. Got off the plane and made my

way to the Super Shuttle which I had reserved since the NIH airport shuttle

doesn't run on Saturday's. I was the last drop off and then the NIH experience

really began. The Super Shuttle driver went to the Main Entrance which was

locked. (The whole place is locked, secured, gated, manned with it's own police

staff, very visibly). There was a sign to proceed to the South Entrance, so we

did. The guy at the gate (armed guard) said we had to go back out to get badges

and he had to get cleared through commercial vehicle inspection. I went through

Checkpoint Charlie (between East and West Germany prior to the fall of the

Berlin Wall) and it reminded me of that. After the dogs, the half dozen police

guards, etc had cleared the van and my ID, we were given our badges and went to

the South gate again. We were allowed through and he dropped me and my luggage

off at the Clinical Research Center. There was no one in sight. I saw a sign at

the information desk that directed me to admissions. It was quite a walk, but I

found it. There was a lady there (not another soul anywhere) and she asked if

she could help me? I told her my name and said I was here for admission and she

found me in her system, had me sign stuff, gave me an armband and took me

upstairs. Upstairs looks like a hospital. We went to the nurses station and the

nurse took me to my room. He said, first order your dinner and handed me a menu

and a phone. I quickly read the menu, called the number on the menu and was put

on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you

can put whatever you want on it and get whatever dressing you want too. I also

ordered a baked potato and steamed brocolli. The salad was great. The baked

potato must've been microwaved, it was weird and the brocolli was too steamed

and hospital tasting. I ordered the same salad for lunch today with a grilled

cheese (low fat, low sodium) sandwich and decided I might live on spinach salads

while I'm here. After the dinner stuff, I got checked in by nursing staff; they

went over my meds etc. and told me about the 24 hour urine testing. The whole

time you are here (7-10 days), you do the urine testing...pee in a hat, transfer

it to a jug, put jug in the specimin fridge in your room. After that, it was

vitals and uneventful.

> >

> > I was awakened today at 5:30 or so; they took my vitals and told me to pee

to start the urine testing. Then, I saw 3 doctors all whom were various levels

of fellows and they all had consents to sign and histories to take; questions

about various aspects of my health and records. I was seen by a social worker

and screened for mental health issues. I was seen by a bio ethics person who

wanted to make sure I knew what I was consenting to, and understood the living

will documents. I am currently waiting on someone who is going to do an EKG. I

had to apply for a IT security screen to get a password for the internet and it

took all day today to process, but alas, I have it! I spent most of the day

today with all of that and had a lot of time to get some work done that I

brought with me. So, it was a pretty relaxing day and very informative.

> >

> > If I can, I will post how tomorrow goes, etc. I won't get any results until

Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons

of bloodwork ( they are putting two lines in tomorrow am), saline supression

test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US

of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and

acth and an acth stim test. I am having more cardiac stuff too based on

something they are worried about from today as well, but not everyone would have

that. Then, I will know quite a bit of results and have a pow wow. Then we

decide what to do from there based on what they have. If necessary, I would have

the AVS on Friday. Then it would take a week to get those results, so I could go

home on Saturday or Sunday, then they call with the AVS results and we go from

there as far as surgery or whatever. I signed a thing today that I understood

that they would like me to come back in a year and repeat all of this too, if I

have something to follow. I don't have too, but they'd like it.

> >

> > So, there you have it...my NIH experience thus far!

> >

> >

>

[Guest guest]

LVH is not normal and associated with HTN and high salt diet. It is called hypertensive heart disease. But not to worry. Studies have shown that a low sodium intake (such as DASH) can return the heart size quickly to normal PA (may also need MCBs) or not. Rice diet does it in a month or two. If your team there has never read about the rice-fruit diet to treat even malignant HTN give them a copy of the NY Acad of Science in our files from 1946 by Dr. W. Kempner.It is still amazing what low salt can do in the direst of HTN diseases-at least in 50% of them back then. CE Grim MDOn Mar 11, 2012, at 10:05 PM, maggiekat7 wrote: I thought of your "liquid gold" metaphor today while collecting it...it is a lot easier to do as an inpatient than it was as an outpatient and I'm confident they won't lose it like my docs at home did. I apparently get details about each test as it comes up, but I appreciate the heads up. I asked about the 2 catheters and they routinely do what you said to do. They just did my EKG...showed left ventricle hypertrophy. Normal otherwise....according to the tech who did it. > > > I flew standby to Baltimore and was put in first class. I had a glass of Pinot Grigio and before I knew it we were landing. Got off the plane and made my way to the Super Shuttle which I had reserved since the NIH airport shuttle doesn't run on Saturday's. I was the last drop off and then the NIH experience really began. The Super Shuttle driver went to the Main Entrance which was locked. (The whole place is locked, secured, gated, manned with it's own police staff, very visibly). There was a sign to proceed to the South Entrance, so we did. The guy at the gate (armed guard) said we had to go back out to get badges and he had to get cleared through commercial vehicle inspection. I went through Checkpoint Charlie (between East and West Germany prior to the fall of the Berlin Wall) and it reminded me of that. After the dogs, the half dozen police guards, etc had cleared the van and my ID, we were given our badges and went to the South gate again. We were allowed through and he dropped me and my luggage off at the Clinical Research Center. There was no one in sight. I saw a sign at the information desk that directed me to admissions. It was quite a walk, but I found it. There was a lady there (not another soul anywhere) and she asked if she could help me? I told her my name and said I was here for admission and she found me in her system, had me sign stuff, gave me an armband and took me upstairs. Upstairs looks like a hospital. We went to the nurses station and the nurse took me to my room. He said, first order your dinner and handed me a menu and a phone. I quickly read the menu, called the number on the menu and was put on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you can put whatever you want on it and get whatever dressing you want too. I also ordered a baked potato and steamed brocolli. The salad was great. The baked potato must've been microwaved, it was weird and the brocolli was too steamed and hospital tasting. I ordered the same salad for lunch today with a grilled cheese (low fat, low sodium) sandwich and decided I might live on spinach salads while I'm here. After the dinner stuff, I got checked in by nursing staff; they went over my meds etc. and told me about the 24 hour urine testing. The whole time you are here (7-10 days), you do the urine testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in your room. After that, it was vitals and uneventful. > > > > I was awakened today at 5:30 or so; they took my vitals and told me to pee to start the urine testing. Then, I saw 3 doctors all whom were various levels of fellows and they all had consents to sign and histories to take; questions about various aspects of my health and records. I was seen by a social worker and screened for mental health issues. I was seen by a bio ethics person who wanted to make sure I knew what I was consenting to, and understood the living will documents. I am currently waiting on someone who is going to do an EKG. I had to apply for a IT security screen to get a password for the internet and it took all day today to process, but alas, I have it! I spent most of the day today with all of that and had a lot of time to get some work done that I brought with me. So, it was a pretty relaxing day and very informative. > > > > If I can, I will post how tomorrow goes, etc. I won't get any results until Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons of bloodwork ( they are putting two lines in tomorrow am), saline supression test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff too based on something they are worried about from today as well, but not everyone would have that. Then, I will know quite a bit of results and have a pow wow. Then we decide what to do from there based on what they have. If necessary, I would have the AVS on Friday. Then it would take a week to get those results, so I could go home on Saturday or Sunday, then they call with the AVS results and we go from there as far as surgery or whatever. I signed a thing today that I understood that they would like me to come back in a year and repeat all of this too, if I have something to follow. I don't have too, but they'd like it. > > > > So, there you have it...my NIH experience thus far! > > > > >

[Guest guest]

All part of the protocol...have to be seen by social work staff w/i 24 hours of

admission, likewise with other folks. All the people here seem to like being

here even on Sunday, including Dr. L, whom I met today. He's shorter than I am;

a small guy that doesn't look anything like I had imagined him from the phone

contact. Very enthusiastic about anything research related to adenomas, PA,

endocrine. Very cool to finally meet him. I thanked him profusely.

I had thought that I might leave the campus if I had free time; maybe get with

some of my cousins who live near here....but after getting in here and knowing

what it takes, I am here for the duration. I also thought that if the food was

bad, maybe I could order something delivered, but what a joke! I asked what

they were looking for, and was told weapons, medical weapons and that they are

on heightened security at the moment. I'm good with it. Fewer options are

good. Keeps things simple and simple is less stress. My stress level went down

exponentially today. Short term, for a week, this is fine. Long term it would

likely suck.

> >

> > I flew standby to Baltimore and was put in first class. I had a glass of

Pinot Grigio and before I knew it we were landing. Got off the plane and made

my way to the Super Shuttle which I had reserved since the NIH airport shuttle

doesn't run on Saturday's. I was the last drop off and then the NIH experience

really began. The Super Shuttle driver went to the Main Entrance which was

locked. (The whole place is locked, secured, gated, manned with it's own police

staff, very visibly). There was a sign to proceed to the South Entrance, so we

did. The guy at the gate (armed guard) said we had to go back out to get badges

and he had to get cleared through commercial vehicle inspection. I went through

Checkpoint Charlie (between East and West Germany prior to the fall of the

Berlin Wall) and it reminded me of that. After the dogs, the half dozen police

guards, etc had cleared the van and my ID, we were given our badges and went to

the South gate again. We were allowed through and he dropped me and my luggage

off at the Clinical Research Center. There was no one in sight. I saw a sign

at the information desk that directed me to admissions. It was quite a walk,

but I found it. There was a lady there (not another soul anywhere) and she

asked if she could help me? I told her my name and said I was here for

admission and she found me in her system, had me sign stuff, gave me an armband

and took me upstairs. Upstairs looks like a hospital. We went to the nurses

station and the nurse took me to my room. He said, first order your dinner and

handed me a menu and a phone. I quickly read the menu, called the number on the

menu and was put on hold for 13 minutes. (Order your meals early). I ordered a

spinach salad, you can put whatever you want on it and get whatever dressing you

want too. I also ordered a baked potato and steamed brocolli. The salad was

great. The baked potato must've been microwaved, it was weird and the brocolli

was too steamed and hospital tasting. I ordered the same salad for lunch today

with a grilled cheese (low fat, low sodium) sandwich and decided I might live on

spinach salads while I'm here. After the dinner stuff, I got checked in by

nursing staff; they went over my meds etc. and told me about the 24 hour urine

testing. The whole time you are here (7-10 days), you do the urine

testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in

your room. After that, it was vitals and uneventful.

> >

> > I was awakened today at 5:30 or so; they took my vitals and told me to pee

to start the urine testing. Then, I saw 3 doctors all whom were various levels

of fellows and they all had consents to sign and histories to take; questions

about various aspects of my health and records. I was seen by a social worker

and screened for mental health issues. I was seen by a bio ethics person who

wanted to make sure I knew what I was consenting to, and understood the living

will documents. I am currently waiting on someone who is going to do an EKG. I

had to apply for a IT security screen to get a password for the internet and it

took all day today to process, but alas, I have it! I spent most of the day

today with all of that and had a lot of time to get some work done that I

brought with me. So, it was a pretty relaxing day and very informative.

> >

> > If I can, I will post how tomorrow goes, etc. I won't get any results until

Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons

of bloodwork ( they are putting two lines in tomorrow am), saline supression

test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US

of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and

acth and an acth stim test. I am having more cardiac stuff too based on

something they are worried about from today as well, but not everyone would have

that. Then, I will know quite a bit of results and have a pow wow. Then we

decide what to do from there based on what they have. If necessary, I would have

the AVS on Friday. Then it would take a week to get those results, so I could

go home on Saturday or Sunday, then they call with the AVS results and we go

from there as far as surgery or whatever. I signed a thing today that I

understood that they would like me to come back in a year and repeat all of this

too, if I have something to follow. I don't have too, but they'd like it.

> >

> > So, there you have it...my NIH experience thus far!

> >

>

[Guest guest]

AMEN. LVH first echo, DASH and control with spiro and second echo was fine.

I thought of your "liquid gold" metaphor today while collecting it...it is a lot easier to do as an inpatient than it was as an outpatient and I'm confident they won't lose it like my docs at home did. I apparently get details about each test as it comes up, but I appreciate the heads up. I asked about the 2 catheters and they routinely do what you said to do. They just did my EKG...showed left ventricle hypertrophy. Normal otherwise....according to the tech who did it.> > > I flew standby to Baltimore and was put in first class. I had a glass of Pinot Grigio and before I knew it we were landing. Got off the plane and made my way to the Super Shuttle which I had reserved since the NIH airport shuttle doesn't run on Saturday's. I was the last drop off and then the NIH experience really began. The Super Shuttle driver went to the Main Entrance which was locked. (The whole place is locked, secured, gated, manned with it's own police staff, very visibly). There was a sign to proceed to the South Entrance, so we did. The

guy at the gate (armed guard) said we had to go back out to get badges and he had to get cleared through commercial vehicle inspection. I went through Checkpoint Charlie (between East and West Germany prior to the fall of the Berlin Wall) and it reminded me of that. After the dogs, the half dozen police guards, etc had cleared the van and my ID, we were given our badges and went to the South gate again. We were allowed through and he dropped me and my luggage off at the Clinical Research Center. There was no one in sight. I saw a sign at the information desk that directed me to admissions. It was quite a walk, but I found it. There was a lady there (not another soul anywhere) and she asked if she could help me? I told her my name and said I was here for admission and she found me in her system, had me sign stuff, gave me an armband and took me upstairs. Upstairs looks like a hospital. We went to the nurses station and the nurse took me to my room. He

said, first order your dinner and handed me a menu and a phone. I quickly read the menu, called the number on the menu and was put on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you can put whatever you want on it and get whatever dressing you want too. I also ordered a baked potato and steamed brocolli. The salad was great. The baked potato must've been microwaved, it was weird and the brocolli was too steamed and hospital tasting. I ordered the same salad for lunch today with a grilled cheese (low fat, low sodium) sandwich and decided I might live on spinach salads while I'm here. After the dinner stuff, I got checked in by nursing staff; they went over my meds etc. and told me about the 24 hour urine testing. The whole time you are here (7-10 days), you do the urine testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in your room. After that, it was vitals and uneventful. > > >

> I was awakened today at 5:30 or so; they took my vitals and told me to pee to start the urine testing. Then, I saw 3 doctors all whom were various levels of fellows and they all had consents to sign and histories to take; questions about various aspects of my health and records. I was seen by a social worker and screened for mental health issues. I was seen by a bio ethics person who wanted to make sure I knew what I was consenting to, and understood the living will documents. I am currently waiting on someone who is going to do an EKG. I had to apply for a IT security screen to get a password for the internet and it took all day today to process, but alas, I have it! I spent most of the day today with all of that and had a lot of time to get some work done that I brought with me. So, it was a pretty relaxing day and very informative. > > > > If I can, I will post how tomorrow goes, etc. I won't get any results until Thursday.

Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons of bloodwork ( they are putting two lines in tomorrow am), saline supression test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff too based on something they are worried about from today as well, but not everyone would have that. Then, I will know quite a bit of results and have a pow wow. Then we decide what to do from there based on what they have. If necessary, I would have the AVS on Friday. Then it would take a week to get those results, so I could go home on Saturday or Sunday, then they call with the AVS results and we go from there as far as surgery or whatever. I signed a thing today that I understood that they would like me to come back in a year and repeat all of this too, if I have something to follow. I don't

have too, but they'd like it.> > > > So, there you have it...my NIH experience thus far!> > > >>

[Guest guest]

What link were you trying to find?

> > > >

> > > > I flew standby to Baltimore and was put in first class. I had a glass of

Pinot Grigio and before I knew it we were landing. Got off the plane and made my

way to the Super Shuttle which I had reserved since the NIH airport shuttle

doesn't run on Saturday's. I was the last drop off and then the NIH experience

really began. The Super Shuttle driver went to the Main Entrance which was

locked. (The whole place is locked, secured, gated, manned with it's own police

staff, very visibly). There was a sign to proceed to the South Entrance, so we

did. The guy at the gate (armed guard) said we had to go back out to get badges

and he had to get cleared through commercial vehicle inspection. I went through

Checkpoint Charlie (between East and West Germany prior to the fall of the

Berlin Wall) and it reminded me of that. After the dogs, the half dozen police

guards, etc had cleared the van and my ID, we were given our badges and went to

the South gate again. We were allowed through and he dropped me and my luggage

off at the Clinical Research Center. There was no one in sight. I saw a sign at

the information desk that directed me to admissions. It was quite a walk, but I

found it. There was a lady there (not another soul anywhere) and she asked if

she could help me? I told her my name and said I was here for admission and she

found me in her system, had me sign stuff, gave me an armband and took me

upstairs. Upstairs looks like a hospital. We went to the nurses station and the

nurse took me to my room. He said, first order your dinner and handed me a menu

and a phone. I quickly read the menu, called the number on the menu and was put

on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you

can put whatever you want on it and get whatever dressing you want too. I also

ordered a baked potato and steamed brocolli. The salad was great. The baked

potato must've been microwaved, it was weird and the brocolli was too steamed

and hospital tasting. I ordered the same salad for lunch today with a grilled

cheese (low fat, low sodium) sandwich and decided I might live on spinach salads

while I'm here. After the dinner stuff, I got checked in by nursing staff; they

went over my meds etc. and told me about the 24 hour urine testing. The whole

time you are here (7-10 days), you do the urine testing...pee in a hat, transfer

it to a jug, put jug in the specimin fridge in your room. After that, it was

vitals and uneventful.

> > > >

> > > > I was awakened today at 5:30 or so; they took my vitals and told me to

pee to start the urine testing. Then, I saw 3 doctors all whom were various

levels of fellows and they all had consents to sign and histories to take;

questions about various aspects of my health and records. I was seen by a social

worker and screened for mental health issues. I was seen by a bio ethics person

who wanted to make sure I knew what I was consenting to, and understood the

living will documents. I am currently waiting on someone who is going to do an

EKG. I had to apply for a IT security screen to get a password for the internet

and it took all day today to process, but alas, I have it! I spent most of the

day today with all of that and had a lot of time to get some work done that I

brought with me. So, it was a pretty relaxing day and very informative.

> > > >

> > > > If I can, I will post how tomorrow goes, etc. I won't get any results

until Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests,

tons of bloodwork ( they are putting two lines in tomorrow am), saline

supression test, ct scan (with contrast), ekg, supine/upright renin/aldo,

cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test,

dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff

too based on something they are worried about from today as well, but not

everyone would have that. Then, I will know quite a bit of results and have a

pow wow. Then we decide what to do from there based on what they have. If

necessary, I would have the AVS on Friday. Then it would take a week to get

those results, so I could go home on Saturday or Sunday, then they call with the

AVS results and we go from there as far as surgery or whatever. I signed a thing

today that I understood that they would like me to come back in a year and

repeat all of this too, if I have something to follow. I don't have too, but

they'd like it.

> > > >

> > > > So, there you have it...my NIH experience thus far!

> > > >

> > >

> > >

> >

>

[Guest guest]

He goes to signs up and the sends a request to join with a brief note as to why. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 12, 2012, at 11:29, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

What link were you trying to find?

> > > >

> > > > I flew standby to Baltimore and was put in first class. I had a glass of Pinot Grigio and before I knew it we were landing. Got off the plane and made my way to the Super Shuttle which I had reserved since the NIH airport shuttle doesn't run on Saturday's. I was the last drop off and then the NIH experience really began. The Super Shuttle driver went to the Main Entrance which was locked. (The whole place is locked, secured, gated, manned with it's own police staff, very visibly). There was a sign to proceed to the South Entrance, so we did. The guy at the gate (armed guard) said we had to go back out to get badges and he had to get cleared through commercial vehicle inspection. I went through Checkpoint Charlie (between East and West Germany prior to the fall of the Berlin Wall) and it reminded me of that. After the dogs, the half dozen police guards, etc had cleared the van and my ID, we were given our badges and went to the South gate again. We were allowed

through and he dropped me and my luggage off at the Clinical Research Center. There was no one in sight. I saw a sign at the information desk that directed me to admissions. It was quite a walk, but I found it. There was a lady there (not another soul anywhere) and she asked if she could help me? I told her my name and said I was here for admission and she found me in her system, had me sign stuff, gave me an armband and took me upstairs. Upstairs looks like a hospital. We went to the nurses station and the nurse took me to my room. He said, first order your dinner and handed me a menu and a phone. I quickly read the menu, called the number on the menu and was put on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you can put whatever you want on it and get whatever dressing you want too. I also ordered a baked potato and steamed brocolli. The salad was great. The baked potato must've been microwaved, it was weird and the brocolli was too steamed and

hospital tasting. I ordered the same salad for lunch today with a grilled cheese (low fat, low sodium) sandwich and decided I might live on spinach salads while I'm here. After the dinner stuff, I got checked in by nursing staff; they went over my meds etc. and told me about the 24 hour urine testing. The whole time you are here (7-10 days), you do the urine testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in your room. After that, it was vitals and uneventful.

> > > >

> > > > I was awakened today at 5:30 or so; they took my vitals and told me to pee to start the urine testing. Then, I saw 3 doctors all whom were various levels of fellows and they all had consents to sign and histories to take; questions about various aspects of my health and records. I was seen by a social worker and screened for mental health issues. I was seen by a bio ethics person who wanted to make sure I knew what I was consenting to, and understood the living will documents. I am currently waiting on someone who is going to do an EKG. I had to apply for a IT security screen to get a password for the internet and it took all day today to process, but alas, I have it! I spent most of the day today with all of that and had a lot of time to get some work done that I brought with me. So, it was a pretty relaxing day and very informative.

> > > >

> > > > If I can, I will post how tomorrow goes, etc. I won't get any results until Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons of bloodwork ( they are putting two lines in tomorrow am), saline supression test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff too based on something they are worried about from today as well, but not everyone would have that. Then, I will know quite a bit of results and have a pow wow. Then we decide what to do from there based on what they have. If necessary, I would have the AVS on Friday. Then it would take a week to get those results, so I could go home on Saturday or Sunday, then they call with the AVS results and we go from there as far as surgery or whatever. I signed a thing today that I understood that they would like me to come back in a

year and repeat all of this too, if I have something to follow. I don't have too, but they'd like it.

> > > >

> > > > So, there you have it...my NIH experience thus far!

> > > >

> > >

> > >

> >

>

[Guest guest]

Thanks . We even had one here who had been told they would need a heart transplant until PA was discovered after remarkable lowering of BP with spiro. I think she had hypokalemic cardiomyopathy.CE Grim MDOn Mar 12, 2012, at 9:32 AM, Bingham wrote: AMEN. LVH first echo, DASH and control with spiro and second echo was fine. I thought of your "liquid gold" metaphor today while collecting it...it is a lot easier to do as an inpatient than it was as an outpatient and I'm confident they won't lose it like my docs at home did. I apparently get details about each test as it comes up, but I appreciate the heads up. I asked about the 2 catheters and they routinely do what you said to do. They just did my EKG...showed left ventricle hypertrophy. Normal otherwise....according to the tech who did it.> > > I flew standby to Baltimore and was put in first class. I had a glass of Pinot Grigio and before I knew it we were landing. Got off the plane and made my way to the Super Shuttle which I had reserved since the NIH airport shuttle doesn't run on Saturday's. I was the last drop off and then the NIH experience really began. The Super Shuttle driver went to the Main Entrance which was locked. (The whole place is locked, secured, gated, manned with it's own police staff, very visibly). There was a sign to proceed to the South Entrance, so we did. The guy at the gate (armed guard) said we had to go back out to get badges and he had to get cleared through commercial vehicle inspection. I went through Checkpoint Charlie (between East and West Germany prior to the fall of the Berlin Wall) and it reminded me of that. After the dogs, the half dozen police guards, etc had cleared the van and my ID, we were given our badges and went to the South gate again. We were allowed through and he dropped me and my luggage off at the Clinical Research Center. There was no one in sight. I saw a sign at the information desk that directed me to admissions. It was quite a walk, but I found it. There was a lady there (not another soul anywhere) and she asked if she could help me? I told her my name and said I was here for admission and she found me in her system, had me sign stuff, gave me an armband and took me upstairs. Upstairs looks like a hospital. We went to the nurses station and the nurse took me to my room. He said, first order your dinner and handed me a menu and a phone. I quickly read the menu, called the number on the menu and was put on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you can put whatever you want on it and get whatever dressing you want too. I also ordered a baked potato and steamed brocolli. The salad was great. The baked potato must've been microwaved, it was weird and the brocolli was too steamed and hospital tasting. I ordered the same salad for lunch today with a grilled cheese (low fat, low sodium) sandwich and decided I might live on spinach salads while I'm here. After the dinner stuff, I got checked in by nursing staff; they went over my meds etc. and told me about the 24 hour urine testing. The whole time you are here (7-10 days), you do the urine testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in your room. After that, it was vitals and uneventful. > > > > I was awakened today at 5:30 or so; they took my vitals and told me to pee to start the urine testing. Then, I saw 3 doctors all whom were various levels of fellows and they all had consents to sign and histories to take; questions about various aspects of my health and records. I was seen by a social worker and screened for mental health issues. I was seen by a bio ethics person who wanted to make sure I knew what I was consenting to, and understood the living will documents. I am currently waiting on someone who is going to do an EKG. I had to apply for a IT security screen to get a password for the internet and it took all day today to process, but alas, I have it! I spent most of the day today with all of that and had a lot of time to get some work done that I brought with me. So, it was a pretty relaxing day and very informative. > > > > If I can, I will post how tomorrow goes, etc. I won't get any results until Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons of bloodwork ( they are putting two lines in tomorrow am), saline supression test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff too based on something they are worried about from today as well, but not everyone would have that. Then, I will know quite a bit of results and have a pow wow. Then we decide what to do from there based on what they have. If necessary, I would have the AVS on Friday. Then it would take a week to get those results, so I could go home on Saturday or Sunday, then they call with the AVS results and we go from there as far as surgery or whatever. I signed a thing today that I understood that they would like me to come back in a year and repeat all of this too, if I have something to follow. I don't have too, but they'd like it.> > > > So, there you have it...my NIH experience thus far!> > > >>

[Guest guest]

One of my very first patient visits when I started as a PA in that little Texas County (I'd been out about 1 1/2 years from school) was a well-known member of the community. I sent him from first visit - chest pain and DOE - to hospital, weeks later he was literally on the heart transplant list and pretty despondent (he was in his 50's with a large beautiful family) . He came back we made friends, got him to lose some weight he was over 300lbs and about 6'5" , but most importantly I siuggested we get a sleep study and suggested it very hard. They came up with the money - it worked, he was taken off the transplant list, and today is doing fine. Just a gut feeling I had, and this isn't about me though, but that we neglect that heart of ours and sometimes there is a very simple answer. In his case Oxygen,

I thought of your "liquid gold" metaphor today while collecting it...it is a lot easier to do as an inpatient than it was as an outpatient and I'm confident they won't lose it like my docs at home did. I apparently get details about each test as it comes up, but I appreciate the heads up. I asked about the 2 catheters and they routinely do what you said to do. They just did my EKG...showed left ventricle hypertrophy. Normal otherwise....according to the tech who did it.> > > I flew standby to Baltimore and was put in first class. I had a glass of Pinot Grigio and before I knew it we were landing. Got off the plane and made my way to the Super Shuttle which I had reserved since the NIH airport shuttle doesn't run on Saturday's. I was the last drop off and then the NIH experience really began. The Super Shuttle driver went to the Main Entrance which was locked. (The whole place is locked, secured, gated, manned with it's own police staff, very visibly). There was a sign to proceed to the South Entrance, so we did. The guy at the gate (armed guard) said we had to go back out

to get badges and he had to get cleared through commercial vehicle inspection. I went through Checkpoint Charlie (between East and West Germany prior to the fall of the Berlin Wall) and it reminded me of that. After the dogs, the half dozen police guards, etc had cleared the van and my ID, we were given our badges and went to the South gate again. We were allowed through and he dropped me and my luggage off at the Clinical Research Center. There was no one in sight. I saw a sign at the information desk that directed me to admissions. It was quite a walk, but I found it. There was a lady there (not another soul anywhere) and she asked if she could help me? I told her my name and said I was here for admission and she found me in her system, had me sign stuff, gave me an armband and took me upstairs. Upstairs looks like a hospital. We went to the nurses station and the nurse took me to my room. He said, first order your dinner and handed me a menu and a

phone. I quickly read the menu, called the number on the menu and was put on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you can put whatever you want on it and get whatever dressing you want too. I also ordered a baked potato and steamed brocolli. The salad was great. The baked potato must've been microwaved, it was weird and the brocolli was too steamed and hospital tasting. I ordered the same salad for lunch today with a grilled cheese (low fat, low sodium) sandwich and decided I might live on spinach salads while I'm here. After the dinner stuff, I got checked in by nursing staff; they went over my meds etc. and told me about the 24 hour urine testing. The whole time you are here (7-10 days), you do the urine testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in your room. After that, it was vitals and uneventful. > > > > I was awakened today at 5:30 or so; they took my

vitals and told me to pee to start the urine testing. Then, I saw 3 doctors all whom were various levels of fellows and they all had consents to sign and histories to take; questions about various aspects of my health and records. I was seen by a social worker and screened for mental health issues. I was seen by a bio ethics person who wanted to make sure I knew what I was consenting to, and understood the living will documents. I am currently waiting on someone who is going to do an EKG. I had to apply for a IT security screen to get a password for the internet and it took all day today to process, but alas, I have it! I spent most of the day today with all of that and had a lot of time to get some work done that I brought with me. So, it was a pretty relaxing day and very informative. > > > > If I can, I will post how tomorrow goes, etc. I won't get any results until Thursday. Prior to Thurs, I will have done 4 days of 24 hour

urine tests, tons of bloodwork ( they are putting two lines in tomorrow am), saline supression test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff too based on something they are worried about from today as well, but not everyone would have that. Then, I will know quite a bit of results and have a pow wow. Then we decide what to do from there based on what they have. If necessary, I would have the AVS on Friday. Then it would take a week to get those results, so I could go home on Saturday or Sunday, then they call with the AVS results and we go from there as far as surgery or whatever. I signed a thing today that I understood that they would like me to come back in a year and repeat all of this too, if I have something to follow. I don't have too, but they'd like it.> > >

> So, there you have it...my NIH experience thus far!> > > >>

[Guest guest]

sounds a bit like our here.CE Grim MDOn Mar 12, 2012, at 1:08 PM, Bingham wrote: One of my very first patient visits when I started as a PA in that little Texas County (I'd been out about 1 1/2 years from school) was a well-known member of the community. I sent him from first visit - chest pain and DOE - to hospital, weeks later he was literally on the heart transplant list and pretty despondent (he was in his 50's with a large beautiful family) . He came back we made friends, got him to lose some weight he was over 300lbs and about 6'5" , but most importantly I siuggested we get a sleep study and suggested it very hard. They came up with the money - it worked, he was taken off the transplant list, and today is doing fine. Just a gut feeling I had, and this isn't about me though, but that we neglect that heart of ours and sometimes there is a very simple answer. In his case Oxygen, I thought of your "liquid gold" metaphor today while collecting it...it is a lot easier to do as an inpatient than it was as an outpatient and I'm confident they won't lose it like my docs at home did. I apparently get details about each test as it comes up, but I appreciate the heads up. I asked about the 2 catheters and they routinely do what you said to do. They just did my EKG...showed left ventricle hypertrophy. Normal otherwise....according to the tech who did it.> > > I flew standby to Baltimore and was put in first class. I had a glass of Pinot Grigio and before I knew it we were landing. Got off the plane and made my way to the Super Shuttle which I had reserved since the NIH airport shuttle doesn't run on Saturday's. I was the last drop off and then the NIH experience really began. The Super Shuttle driver went to the Main Entrance which was locked. (The whole place is locked, secured, gated, manned with it's own police staff, very visibly). There was a sign to proceed to the South Entrance, so we did. The guy at the gate (armed guard) said we had to go back out to get badges and he had to get cleared through commercial vehicle inspection. I went through Checkpoint Charlie (between East and West Germany prior to the fall of the Berlin Wall) and it reminded me of that. After the dogs, the half dozen police guards, etc had cleared the van and my ID, we were given our badges and went to the South gate again. We were allowed through and he dropped me and my luggage off at the Clinical Research Center. There was no one in sight. I saw a sign at the information desk that directed me to admissions. It was quite a walk, but I found it. There was a lady there (not another soul anywhere) and she asked if she could help me? I told her my name and said I was here for admission and she found me in her system, had me sign stuff, gave me an armband and took me upstairs. Upstairs looks like a hospital. We went to the nurses station and the nurse took me to my room. He said, first order your dinner and handed me a menu and a phone. I quickly read the menu, called the number on the menu and was put on hold for 13 minutes. (Order your meals early). I ordered a spinach salad, you can put whatever you want on it and get whatever dressing you want too. I also ordered a baked potato and steamed brocolli. The salad was great. The baked potato must've been microwaved, it was weird and the brocolli was too steamed and hospital tasting. I ordered the same salad for lunch today with a grilled cheese (low fat, low sodium) sandwich and decided I might live on spinach salads while I'm here. After the dinner stuff, I got checked in by nursing staff; they went over my meds etc. and told me about the 24 hour urine testing. The whole time you are here (7-10 days), you do the urine testing...pee in a hat, transfer it to a jug, put jug in the specimin fridge in your room. After that, it was vitals and uneventful. > > > > I was awakened today at 5:30 or so; they took my vitals and told me to pee to start the urine testing. Then, I saw 3 doctors all whom were various levels of fellows and they all had consents to sign and histories to take; questions about various aspects of my health and records. I was seen by a social worker and screened for mental health issues. I was seen by a bio ethics person who wanted to make sure I knew what I was consenting to, and understood the living will documents. I am currently waiting on someone who is going to do an EKG. I had to apply for a IT security screen to get a password for the internet and it took all day today to process, but alas, I have it! I spent most of the day today with all of that and had a lot of time to get some work done that I brought with me. So, it was a pretty relaxing day and very informative. > > > > If I can, I will post how tomorrow goes, etc. I won't get any results until Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests, tons of bloodwork ( they are putting two lines in tomorrow am), saline supression test, ct scan (with contrast), ekg, supine/upright renin/aldo, cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test, dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff too based on something they are worried about from today as well, but not everyone would have that. Then, I will know quite a bit of results and have a pow wow. Then we decide what to do from there based on what they have. If necessary, I would have the AVS on Friday. Then it would take a week to get those results, so I could go home on Saturday or Sunday, then they call with the AVS results and we go from there as far as surgery or whatever. I signed a thing today that I understood that they would like me to come back in a year and repeat all of this too, if I have something to follow. I don't have too, but they'd like it.> > > > So, there you have it...my NIH experience thus far!> > > >>

[Guest guest]

What is the difference between LVH and cardiomegaly. I was told I

had both. My cardiologist said I had LVH from the echo

and a chest xray I saw said impression was cardiomegaly. I have them

both from hypertension.

Phyllis

On 3/12/2012 2:08 PM, Bingham wrote:

One of my

very first patient visits when I started as a PA

in that little Texas County (I'd been out about 1

1/2 years from school) was a well-known member of

the community. I sent him from first visit - chest

pain and DOE - to hospital, weeks later he was

literally on the heart transplant list and pretty

despondent (he was in his 50's with a large

beautiful family) . He came back we made friends,

got him to lose some weight he was over 300lbs and

about 6'5" , but most importantly I siuggested we

get a sleep study and suggested it very hard. They

came up with the money - it worked, he was taken

off the transplant list, and today is doing fine.

Just a gut feeling I had, and this isn't about me

though, but that we neglect that heart of ours and

sometimes there is a very simple answer. In his

case Oxygen,

I thought

of your

"liquid gold"

metaphor today

while

collecting

it...it is a

lot easier to

do as an

inpatient than

it was as an

outpatient and

I'm confident

they won't

lose it like

my docs at

home did. I

apparently get

details about

each test as

it comes up,

but I

appreciate the

heads up. I

asked about

the 2

catheters and

they routinely

do what you

said to do.

They just did

my

EKG...showed

left ventricle

hypertrophy.

Normal

otherwise....according

to the tech

who did it.

>

> > I

flew standby

to Baltimore

and was put in

first class. I

had a glass of

Pinot Grigio

and before I

knew it we

were landing.

Got off the

plane and made

my way to the

Super Shuttle

which I had

reserved since

the NIH

airport

shuttle

doesn't run on

Saturday's. I

was the last

drop off and

then the NIH

experience

really began.

The Super

Shuttle driver

went to the

Main Entrance

which was

locked. (The

whole place is

locked,

secured,

gated, manned

with it's own

police staff,

very visibly).

There was a

sign to

proceed to the

South

Entrance, so

we did. The

guy at the

gate (armed

guard) said we

had to go back

out to get

badges and he

had to get

cleared

through

commercial

vehicle

inspection. I

went through

Checkpoint

Charlie

(between East

and West

Germany prior

to the fall of

the Berlin

Wall) and it

reminded me of

that. After

the dogs, the

half dozen

police guards,

etc had

cleared the

van and my ID,

we were given

our badges and

went to the

South gate

again. We were

allowed

through and he

dropped me and

my luggage off

at the

Clinical

Research

Center. There

was no one in

sight. I saw a

sign at the

information

desk that

directed me to

admissions. It

was quite a

walk, but I

found it.

There was a

lady there

(not another

soul anywhere)

and she asked

if she could

help me? I

told her my

name and said

I was here for

admission and

she found me

in her system,

had me sign

stuff, gave me

an armband and

took me

upstairs.

Upstairs looks

like a

hospital. We

went to the

nurses station

and the nurse

took me to my

room. He said,

first order

your dinner

and handed me

a menu and a

phone. I

quickly read

the menu,

called the

number on the

menu and was

put on hold

for 13

minutes.

(Order your

meals early).

I ordered a

spinach salad,

you can put

whatever you

want on it and

get whatever

dressing you

want too. I

also ordered a

baked potato

and steamed

brocolli. The

salad was

great. The

baked potato

must've been

microwaved, it

was weird and

the brocolli

was too

steamed and

hospital

tasting. I

ordered the

same salad for

lunch today

with a grilled

cheese (low

fat, low

sodium)

sandwich and

decided I

might live on

spinach salads

while I'm

here. After

the dinner

stuff, I got

checked in by

nursing staff;

they went over

my meds etc.

and told me

about the 24

hour urine

testing. The

whole time you

are here (7-10

days), you do

the urine

testing...pee

in a hat,

transfer it to

a jug, put jug

in the

specimin

fridge in your

room. After

that, it was

vitals and

uneventful.

> >

> > I

was awakened

today at 5:30

or so; they

took my vitals

and told me to

pee to start

the urine

testing. Then,

I saw 3

doctors all

whom were

various levels

of fellows and

they all had

consents to

sign and

histories to

take;

questions

about various

aspects of my

health and

records. I was

seen by a

social worker

and screened

for mental

health issues.

I was seen by

a bio ethics

person who

wanted to make

sure I knew

what I was

consenting to,

and understood

the living

will

documents. I

am currently

waiting on

someone who is

going to do an

EKG. I had to

apply for a IT

security

screen to get

a password for

the internet

and it took

all day today

to process,

but alas, I

have it! I

spent most of

the day today

with all of

that and had a

lot of time to

get some work

done that I

brought with

me. So, it was

a pretty

relaxing day

and very

informative.

> >

> > If I

can, I will

post how

tomorrow goes,

etc. I won't

get any

results until

Thursday.

Prior to

Thurs, I will

have done 4

days of 24

hour urine

tests, tons of

bloodwork (

they are

putting two

lines in

tomorrow am),

saline

supression

test, ct scan

(with

contrast),

ekg,

supine/upright

renin/aldo,

cardiac echo,

US of the

kidneys,

dopper

carotids,

glucose

tolerance

test, dirunal

cortisol and

acth and an

acth stim

test. I am

having more

cardiac stuff

too based on

something they

are worried

about from

today as well,

but not

everyone would

have that.

Then, I will

know quite a

bit of results

and have a pow

wow. Then we

decide what to

do from there

based on what

they have. If

necessary, I

would have the

AVS on Friday.

Then it would

take a week to

get those

results, so I

could go home

on Saturday or

Sunday, then

they call with

the AVS

results and we

go from there

as far as

surgery or

whatever. I

signed a thing

today that I

understood

that they

would like me

to come back

in a year and

repeat all of

this too, if I

have something

to follow. I

don't have

too, but

they'd like

it.

> >

> > So,

there you have

it...my NIH

experience

thus far!

> >

> >

>

[Guest guest]

In my case I guess it was just HTN that caused LVH bad enough to require me to

be on f/t oxygen. I say this because I didn't know I was supposed to be

watching urine NA and blood NA was always low/normal. LVH resolved enough so I

no longer needed supplemental oxygen 12 weeks after getting HTN under control

using 25mg Spironolctone. (I already had been on a bipap machine for 10 years

but a second sleep study identified the oxygen problem.) Sleep studies are

expensive but they just might save your life, IMHO! Maybe even twice in my

case!

BTW, when I had my A-O registery exam a couple weeks ago the doctor said he

could see a little residual effect on the EKG but I really doubt he would have

mentioned it if I hadn't given him the HX!

> >

> > > I flew standby to Baltimore and was put in first class. I had a glass of

Pinot Grigio and before I knew it we were landing. Got off the plane and made my

way to the Super Shuttle which I had reserved since the NIH airport shuttle

doesn't run on Saturday's. I was the last drop off and then the NIH experience

really began. The Super Shuttle driver went to the Main Entrance which was

locked. (The whole place is locked, secured, gated, manned with it's own police

staff, very visibly). There was a sign to proceed to the South Entrance, so we

did. The guy at the gate (armed guard) said we had to go back out to get badges

and he had to get cleared through commercial vehicle inspection. I went through

Checkpoint Charlie (between East and West Germany prior to the fall of the

Berlin Wall) and it reminded me of that. After the dogs, the half dozen police

guards, etc had cleared the van and my ID, we were given our badges and went to

the South gate again. We

> were allowed through and he dropped me and my luggage off at the Clinical

Research Center. There was no one in sight. I saw a sign at the information desk

that directed me to admissions. It was quite a walk, but I found it. There was a

lady there (not another soul anywhere) and she asked if she could help me? I

told her my name and said I was here for admission and she found me in her

system, had me sign stuff, gave me an armband and took me upstairs. Upstairs

looks like a hospital. We went to the nurses station and the nurse took me to my

room. He said, first order your dinner and handed me a menu and a phone. I

quickly read the menu, called the number on the menu and was put on hold for 13

minutes. (Order your meals early). I ordered a spinach salad, you can put

whatever you want on it and get whatever dressing you want too. I also ordered a

baked potato and steamed brocolli. The salad was great. The baked potato must've

been microwaved, it was weird

> and the brocolli was too steamed and hospital tasting. I ordered the same

salad for lunch today with a grilled cheese (low fat, low sodium) sandwich and

decided I might live on spinach salads while I'm here. After the dinner stuff, I

got checked in by nursing staff; they went over my meds etc. and told me about

the 24 hour urine testing. The whole time you are here (7-10 days), you do the

urine testing...pee in a hat, transfer it to a jug, put jug in the specimin

fridge in your room. After that, it was vitals and uneventful.

> > >

> > > I was awakened today at 5:30 or so; they took my vitals and told me to pee

to start the urine testing. Then, I saw 3 doctors all whom were various levels

of fellows and they all had consents to sign and histories to take; questions

about various aspects of my health and records. I was seen by a social worker

and screened for mental health issues. I was seen by a bio ethics person who

wanted to make sure I knew what I was consenting to, and understood the living

will documents. I am currently waiting on someone who is going to do an EKG. I

had to apply for a IT security screen to get a password for the internet and it

took all day today to process, but alas, I have it! I spent most of the day

today with all of that and had a lot of time to get some work done that I

brought with me. So, it was a pretty relaxing day and very informative.

> > >

> > > If I can, I will post how tomorrow goes, etc. I won't get any results

until Thursday. Prior to Thurs, I will have done 4 days of 24 hour urine tests,

tons of bloodwork ( they are putting two lines in tomorrow am), saline

supression test, ct scan (with contrast), ekg, supine/upright renin/aldo,

cardiac echo, US of the kidneys, dopper carotids, glucose tolerance test,

dirunal cortisol and acth and an acth stim test. I am having more cardiac stuff

too based on something they are worried about from today as well, but not

everyone would have that. Then, I will know quite a bit of results and have a

pow wow. Then we decide what to do from there based on what they have. If

necessary, I would have the AVS on Friday. Then it would take a week to get

those results, so I could go home on Saturday or Sunday, then they call with the

AVS results and we go from there as far as surgery or whatever. I signed a thing

today that I understood that they would like me to

> come back in a year and repeat all of this too, if I have something to

follow. I don't have too, but they'd like it.

> > >

> > > So, there you have it...my NIH experience thus far!

> > >

> > >

> >

>

[Guest guest]

"Cardiomegay is simply a medical term that is used by medical practitioners to describe the condition of heart enlargement". LVH is thickening of the Left Ventricle because it has to work harder due to HTN. Since this is the pump that causes blood flow throughout your body it often reduces your blood flow.

With that said I would question exactly what the meant with the Crdiomegay DX since I presume LVH could cause the heart to get larger but after looking I at the info I would make sure they meaning the same thing. Suggest you look at: http://cardiomegaly.org/cardiomegaly/ to see what MAY be going on, You re not pregnant are you? > >>> >> >>> > > I flew standby to Baltimore and was put in first class.> >>> I had a glass of Pinot Grigio and before I knew it we were> >>> landing. Got off the plane and made my way to the Super> >>> Shuttle which I had reserved since the NIH airport shuttle> >>> doesn't run on Saturday's. I was the last drop off and then> >>> the NIH experience really began. The Super Shuttle driver> >>> went to the Main Entrance which was locked. (The whole place> >>> is locked, secured, gated, manned with it's own police> >>> staff, very visibly). There was a sign to proceed to the> >>> South Entrance, so we did. The guy at the gate (armed guard)> >>> said we had to go back out to get badges and he had to get> >>> cleared through commercial vehicle inspection. I went> >>> through Checkpoint Charlie (between East and West Germany> >>> prior to the fall of the Berlin Wall) and it reminded me of> >>> that. After the dogs, the half dozen police guards, etc had> >>> cleared the van and my ID, we were given our badges and went> >>> to the South gate again. We were allowed through and he> >>> dropped me and my luggage off at the Clinical Research> >>> Center. There was no one in sight. I saw a sign at the> >>> information desk that directed me to admissions. It was> >>> quite a walk, but I found it. There was a lady there (not> >>> another soul anywhere) and she asked if she could help me? I> >>> told her my name and said I was here for admission and she> >>> found me in her system, had me sign stuff, gave me an> >>> armband and took me upstairs. Upstairs looks like a> >>> hospital. We went to the nurses station and the nurse took> >>> me to my room. He said, first order your dinner and handed> >>> me a menu and a phone. I quickly read the menu, called the> >>> number on the menu and was put on hold for 13 minutes.> >>> (Order your meals early). I ordered a spinach salad, you can> >>> put whatever you want on it and get whatever dressing you> >>> want too. I also ordered a baked potato and steamed> >>> brocolli. The salad was great. The baked potato must've been> >>> microwaved, it was weird and the brocolli was too steamed> >>> and hospital tasting. I ordered the same salad for lunch> >>> today with a grilled cheese (low fat, low sodium) sandwich> >>> and decided I might live on spinach salads while I'm here.> >>> After the dinner stuff, I got checked in by nursing staff;> >>> they went over my meds etc. and told me about the 24 hour> >>> urine testing. The whole time you are here (7-10 days), you> >>> do the urine testing...pee in a hat, transfer it to a jug,> >>> put jug in the specimin fridge in your room. After that, it> >>> was vitals and uneventful.> >>> > >> >>> > > I was awakened today at 5:30 or so; they took my vitals> >>> and told me to pee to start the urine testing. Then, I saw 3> >>> doctors all whom were various levels of fellows and they all> >>> had consents to sign and histories to take; questions about> >>> various aspects of my health and records. I was seen by a> >>> social worker and screened for mental health issues. I was> >>> seen by a bio ethics person who wanted to make sure I knew> >>> what I was consenting to, and understood the living will> >>> documents. I am currently waiting on someone who is going to> >>> do an EKG. I had to apply for a IT security screen to get a> >>> password for the internet and it took all day today to> >>> process, but alas, I have it! I spent most of the day today> >>> with all of that and had a lot of time to get some work done> >>> that I brought with me. So, it was a pretty relaxing day and> >>> very informative.> >>> > >> >>> > > If I can, I will post how tomorrow goes, etc. I won't> >>> get any results until Thursday. Prior to Thurs, I will have> >>> done 4 days of 24 hour urine tests, tons of bloodwork ( they> >>> are putting two lines in tomorrow am), saline supression> >>> test, ct scan (with contrast), ekg, supine/upright> >>> renin/aldo, cardiac echo, US of the kidneys, dopper> >>> carotids, glucose tolerance test, dirunal cortisol and acth> >>> and an acth stim test. I am having more cardiac stuff too> >>> based on something they are worried about from today as> >>> well, but not everyone would have that. Then, I will know> >>> quite a bit of results and have a pow wow. Then we decide> >>> what to do from there based on what they have. If necessary,> >>> I would have the AVS on Friday. Then it would take a week to> >>> get those results, so I could go home on Saturday or Sunday,> >>> then they call with the AVS results and we go from there as> >>> far as surgery or whatever. I signed a thing today that I> >>> understood that they would like me to come back in a year> >>> and repeat all of this too, if I have something to follow. I> >>> don't have too, but they'd like it.> >>> > >> >>> > > So, there you have it...my NIH experience thus far!> >>> > >> >>> > >> >>> >> >>>> >>> >> >>

[Guest guest]

I'm not that tall! My PCP was upset because she had sent me to all the specialists that should have done it right but no one but my wife and I were insisting on the answer to why! (I was barely under the threshold to DX COPD so they took the easy way out and said I had COPD!) After the whole story was out my PCP pointed out that I was close to a MI and had my wife to thank for dodging tht one! (She insisted on the study and they refused at first "because I hd one 10 years earlier" She got nasty, 1st time in 42 years , and we got it approved! When they had to stop the first one because I ran out of oxygen they didn't want to schedule a second one until I got another approval! I told them it would get paid even if I had to send it to OBama (I was on "fee basis" at Dartmouth). Do you think the VA should have a Card./HTN specialist? I know, any GP can treat this!

Lesson learned: Keep the spouse around, it might save your life or in my case, after 44 years, mess around and it will end my life! (I probably could have done the same thing with a tape recorder but what fun would that be!) Hey, that's an idea, record your night and take that to your doctor if they don't think you need sleep study!

> >>> >> >>> > > I flew standby to Baltimore and was put in first class. I had > >>> a glass of Pinot Grigio and before I knew it we were landing. Got > >>> off the plane and made my way to the Super Shuttle which I had > >>> reserved since the NIH airport shuttle doesn't run on Saturday's. > >>> I was the last drop off and then the NIH experience really began. > >>> The Super Shuttle driver went to the Main Entrance which was > >>> locked. (The whole place is locked, secured, gated, manned with > >>> it's own police staff, very visibly). There was a sign to proceed > >>> to the South Entrance, so we did. The guy at the gate (armed > >>> guard) said we had to go back out to get badges and he had to get > >>> cleared through commercial vehicle inspection. I went through > >>> Checkpoint Charlie (between East and West Germany prior to the > >>> fall of the Berlin Wall) and it reminded me of that. After the > >>> dogs, the half dozen police guards, etc had cleared the van and my > >>> ID, we were given our badges and went to the South gate again. We > >>> were allowed through and he dropped me and my luggage off at the > >>> Clinical Research Center. There was no one in sight. I saw a sign > >>> at the information desk that directed me to admissions. It was > >>> quite a walk, but I found it. There was a lady there (not another > >>> soul anywhere) and she asked if she could help me? I told her my > >>> name and said I was here for admission and she found me in her > >>> system, had me sign stuff, gave me an armband and took me > >>> upstairs. Upstairs looks like a hospital. We went to the nurses > >>> station and the nurse took me to my room. He said, first order > >>> your dinner and handed me a menu and a phone. I quickly read the > >>> menu, called the number on the menu and was put on hold for 13 > >>> minutes. (Order your meals early). I ordered a spinach salad, you > >>> can put whatever you want on it and get whatever dressing you want > >>> too. I also ordered a baked potato and steamed brocolli. The salad > >>> was great. The baked potato must've been microwaved, it was weird > >>> and the brocolli was too steamed and hospital tasting. I ordered > >>> the same salad for lunch today with a grilled cheese (low fat, low > >>> sodium) sandwich and decided I might live on spinach salads while > >>> I'm here. After the dinner stuff, I got checked in by nursing > >>> staff; they went over my meds etc. and told me about the 24 hour > >>> urine testing. The whole time you are here (7-10 days), you do the > >>> urine testing...pee in a hat, transfer it to a jug, put jug in the > >>> specimin fridge in your room. After that, it was vitals and > >>> uneventful.> >>> > >> >>> > > I was awakened today at 5:30 or so; they took my vitals and > >>> told me to pee to start the urine testing. Then, I saw 3 doctors > >>> all whom were various levels of fellows and they all had consents > >>> to sign and histories to take; questions about various aspects of > >>> my health and records. I was seen by a social worker and screened > >>> for mental health issues. I was seen by a bio ethics person who > >>> wanted to make sure I knew what I was consenting to, and > >>> understood the living will documents. I am currently waiting on > >>> someone who is going to do an EKG. I had to apply for a IT > >>> security screen to get a password for the internet and it took all > >>> day today to process, but alas, I have it! I spent most of the day > >>> today with all of that and had a lot of time to get some work done > >>> that I brought with me. So, it was a pretty relaxing day and very > >>> informative.> >>> > >> >>> > > If I can, I will post how tomorrow goes, etc. I won't get any > >>> results until Thursday. Prior to Thurs, I will have done 4 days of > >>> 24 hour urine tests, tons of bloodwork ( they are putting two > >>> lines in tomorrow am), saline supression test, ct scan (with > >>> contrast), ekg, supine/upright renin/aldo, cardiac echo, US of the > >>> kidneys, dopper carotids, glucose tolerance test, dirunal cortisol > >>> and acth and an acth stim test. I am having more cardiac stuff too > >>> based on something they are worried about from today as well, but > >>> not everyone would have that. Then, I will know quite a bit of > >>> results and have a pow wow. Then we decide what to do from there > >>> based on what they have. If necessary, I would have the AVS on > >>> Friday. Then it would take a week to get those results, so I could > >>> go home on Saturday or Sunday, then they call with the AVS results > >>> and we go from there as far as surgery or whatever. I signed a > >>> thing today that I understood that they would like me to come back > >>> in a year and repeat all of this too, if I have something to > >>> follow. I don't have too, but they'd like it.> >>> > >> >>> > > So, there you have it...my NIH experience thus far!> >>> > >> >>> > >> >>> >> >>>> >>> >> >>

[Guest guest]

No not pregnant, I thought it meant what you said. SO Cardiomagaly

is general heart enlargement and LVH is a kind of cardiomegaly?

Hopefully my heart will decrease with then dash and mcb's.

On 3/12/2012 4:08 PM, wrote:

"Cardiomegay

is simply a medical term that is used by

medical practitioners to describe the condition of heart

enlargement". LVH is

thickening of the Left Ventricle because it has to work

harder due to HTN. Since this is the pump that causes

blood flow throughout your body it often reduces your

blood flow.

With that said I would question exactly what the meant

with the Crdiomegay DX since I presume LVH could cause the

heart to get larger but after looking I at the info I

would make sure they meaning the same thing. Suggest you

look at: http://cardiomegaly.org/cardiomegaly/

to see what MAY be going on, You re

not pregnant are you?

> >>> >

> >>> > > I flew standby to Baltimore and

was put in first class.

> >>> I had a glass of Pinot Grigio and before I

knew it we were

> >>> landing. Got off the plane and made my way

to the Super

> >>> Shuttle which I had reserved since the NIH

airport shuttle

> >>> doesn't run on Saturday's. I was the last

drop off and then

> >>> the NIH experience really began. The Super

Shuttle driver

> >>> went to the Main Entrance which was

locked. (The whole place

> >>> is locked, secured, gated, manned with

it's own police

> >>> staff, very visibly). There was a sign to

proceed to the

> >>> South Entrance, so we did. The guy at the

gate (armed guard)

> >>> said we had to go back out to get badges

and he had to get

> >>> cleared through commercial vehicle

inspection. I went

> >>> through Checkpoint Charlie (between East

and West Germany

> >>> prior to the fall of the Berlin Wall) and

it reminded me of

> >>> that. After the dogs, the half dozen

police guards, etc had

> >>> cleared the van and my ID, we were given

our badges and went

> >>> to the South gate again. We were allowed

through and he

> >>> dropped me and my luggage off at the

Clinical Research

> >>> Center. There was no one in sight. I saw a

sign at the

> >>> information desk that directed me to

admissions. It was

> >>> quite a walk, but I found it. There was a

lady there (not

> >>> another soul anywhere) and she asked if

she could help me? I

> >>> told her my name and said I was here for

admission and she

> >>> found me in her system, had me sign stuff,

gave me an

> >>> armband and took me upstairs. Upstairs

looks like a

> >>> hospital. We went to the nurses station

and the nurse took

> >>> me to my room. He said, first order your

dinner and handed

> >>> me a menu and a phone. I quickly read the

menu, called the

> >>> number on the menu and was put on hold for

13 minutes.

> >>> (Order your meals early). I ordered a

spinach salad, you can

> >>> put whatever you want on it and get

whatever dressing you

> >>> want too. I also ordered a baked potato

and steamed

> >>> brocolli. The salad was great. The baked

potato must've been

> >>> microwaved, it was weird and the brocolli

was too steamed

> >>> and hospital tasting. I ordered the same

salad for lunch

> >>> today with a grilled cheese (low fat, low

sodium) sandwich

> >>> and decided I might live on spinach salads

while I'm here.

> >>> After the dinner stuff, I got checked in

by nursing staff;

> >>> they went over my meds etc. and told me

about the 24 hour

> >>> urine testing. The whole time you are here

(7-10 days), you

> >>> do the urine testing...pee in a hat,

transfer it to a jug,

> >>> put jug in the specimin fridge in your

room. After that, it

> >>> was vitals and uneventful.

> >>> > >

> >>> > > I was awakened today at 5:30 or

so; they took my vitals

> >>> and told me to pee to start the urine

testing. Then, I saw 3

> >>> doctors all whom were various levels of

fellows and they all

> >>> had consents to sign and histories to

take; questions about

> >>> various aspects of my health and records.

I was seen by a

> >>> social worker and screened for mental

health issues. I was

> >>> seen by a bio ethics person who wanted to

make sure I knew

> >>> what I was consenting to, and understood

the living will

> >>> documents. I am currently waiting on

someone who is going to

> >>> do an EKG. I had to apply for a IT

security screen to get a

> >>> password for the internet and it took all

day today to

> >>> process, but alas, I have it! I spent most

of the day today

> >>> with all of that and had a lot of time to

get some work done

> >>> that I brought with me. So, it was a

pretty relaxing day and

> >>> very informative.

> >>> > >

> >>> > > If I can, I will post how

tomorrow goes, etc. I won't

> >>> get any results until Thursday. Prior to

Thurs, I will have

> >>> done 4 days of 24 hour urine tests, tons

of bloodwork ( they

> >>> are putting two lines in tomorrow am),

saline supression

> >>> test, ct scan (with contrast), ekg,

supine/upright

> >>> renin/aldo, cardiac echo, US of the

kidneys, dopper

> >>> carotids, glucose tolerance test, dirunal

cortisol and acth

> >>> and an acth stim test. I am having more

cardiac stuff too

> >>> based on something they are worried about

from today as

> >>> well, but not everyone would have that.

Then, I will know

> >>> quite a bit of results and have a pow wow.

Then we decide

> >>> what to do from there based on what they

have. If necessary,

> >>> I would have the AVS on Friday. Then it

would take a week to

> >>> get those results, so I could go home on

Saturday or Sunday,

> >>> then they call with the AVS results and we

go from there as

> >>> far as surgery or whatever. I signed a

thing today that I

> >>> understood that they would like me to come

back in a year

> >>> and repeat all of this too, if I have

something to follow. I

> >>> don't have too, but they'd like it.

> >>> > >

> >>> > > So, there you have it...my NIH

experience thus far!

> >>> > >

> >>> > >

> >>> >

> >>>

> >>

> >

> >

>

[Guest guest]

NO, I did NOT say that! I said to ask the one who put " Cardiomagaly " in your

chart exactly what he meant. If he says " LVH " they your assumption is correct

and treat the HTN. (Dash, Dash, Dash and MCB's are a good option as long as BP

comes into control.) If he says anything else, ask him how he is going to treat

it!

> > > >>> >

> > > >>> > > I flew standby to Baltimore and was put in first class.

> > > >>> I had a glass of Pinot Grigio and before I knew it we were

> > > >>> landing. Got off the plane and made my way to the Super

> > > >>> Shuttle which I had reserved since the NIH airport shuttle

> > > >>> doesn't run on Saturday's. I was the last drop off and then

> > > >>> the NIH experience really began. The Super Shuttle driver

> > > >>> went to the Main Entrance which was locked. (The whole place

> > > >>> is locked, secured, gated, manned with it's own police

> > > >>> staff, very visibly). There was a sign to proceed to the

> > > >>> South Entrance, so we did. The guy at the gate (armed guard)

> > > >>> said we had to go back out to get badges and he had to get

> > > >>> cleared through commercial vehicle inspection. I went

> > > >>> through Checkpoint Charlie (between East and West Germany

> > > >>> prior to the fall of the Berlin Wall) and it reminded me of

> > > >>> that. After the dogs, the half dozen police guards, etc had

> > > >>> cleared the van and my ID, we were given our badges and went

> > > >>> to the South gate again. We were allowed through and he

> > > >>> dropped me and my luggage off at the Clinical Research

> > > >>> Center. There was no one in sight. I saw a sign at the

> > > >>> information desk that directed me to admissions. It was

> > > >>> quite a walk, but I found it. There was a lady there (not

> > > >>> another soul anywhere) and she asked if she could help me? I

> > > >>> told her my name and said I was here for admission and she

> > > >>> found me in her system, had me sign stuff, gave me an

> > > >>> armband and took me upstairs. Upstairs looks like a

> > > >>> hospital. We went to the nurses station and the nurse took

> > > >>> me to my room. He said, first order your dinner and handed

> > > >>> me a menu and a phone. I quickly read the menu, called the

> > > >>> number on the menu and was put on hold for 13 minutes.

> > > >>> (Order your meals early). I ordered a spinach salad, you can

> > > >>> put whatever you want on it and get whatever dressing you

> > > >>> want too. I also ordered a baked potato and steamed

> > > >>> brocolli. The salad was great. The baked potato must've been

> > > >>> microwaved, it was weird and the brocolli was too steamed

> > > >>> and hospital tasting. I ordered the same salad for lunch

> > > >>> today with a grilled cheese (low fat, low sodium) sandwich

> > > >>> and decided I might live on spinach salads while I'm here.

> > > >>> After the dinner stuff, I got checked in by nursing staff;

> > > >>> they went over my meds etc. and told me about the 24 hour

> > > >>> urine testing. The whole time you are here (7-10 days), you

> > > >>> do the urine testing...pee in a hat, transfer it to a jug,

> > > >>> put jug in the specimin fridge in your room. After that, it

> > > >>> was vitals and uneventful.

> > > >>> > >

> > > >>> > > I was awakened today at 5:30 or so; they took my vitals

> > > >>> and told me to pee to start the urine testing. Then, I saw 3

> > > >>> doctors all whom were various levels of fellows and they all

> > > >>> had consents to sign and histories to take; questions about

> > > >>> various aspects of my health and records. I was seen by a

> > > >>> social worker and screened for mental health issues. I was

> > > >>> seen by a bio ethics person who wanted to make sure I knew

> > > >>> what I was consenting to, and understood the living will

> > > >>> documents. I am currently waiting on someone who is going to

> > > >>> do an EKG. I had to apply for a IT security screen to get a

> > > >>> password for the internet and it took all day today to

> > > >>> process, but alas, I have it! I spent most of the day today

> > > >>> with all of that and had a lot of time to get some work done

> > > >>> that I brought with me. So, it was a pretty relaxing day and

> > > >>> very informative.

> > > >>> > >

> > > >>> > > If I can, I will post how tomorrow goes, etc. I won't

> > > >>> get any results until Thursday. Prior to Thurs, I will have

> > > >>> done 4 days of 24 hour urine tests, tons of bloodwork ( they

> > > >>> are putting two lines in tomorrow am), saline supression

> > > >>> test, ct scan (with contrast), ekg, supine/upright

> > > >>> renin/aldo, cardiac echo, US of the kidneys, dopper

> > > >>> carotids, glucose tolerance test, dirunal cortisol and acth

> > > >>> and an acth stim test. I am having more cardiac stuff too

> > > >>> based on something they are worried about from today as

> > > >>> well, but not everyone would have that. Then, I will know

> > > >>> quite a bit of results and have a pow wow. Then we decide

> > > >>> what to do from there based on what they have. If necessary,

> > > >>> I would have the AVS on Friday. Then it would take a week to

> > > >>> get those results, so I could go home on Saturday or Sunday,

> > > >>> then they call with the AVS results and we go from there as

> > > >>> far as surgery or whatever. I signed a thing today that I

> > > >>> understood that they would like me to come back in a year

> > > >>> and repeat all of this too, if I have something to follow. I

> > > >>> don't have too, but they'd like it.

> > > >>> > >

> > > >>> > > So, there you have it...my NIH experience thus far!

> > > >>> > >

> > > >>> > >

> > > >>> >

> > > >>>

> > > >>

> > > >

> > > >

> > >

> >

>

[Guest guest]

No this is what I read. Cardiomegaly is general and LVH is specific.

The ER chest xray said I had cardiomegaly, not my cardiologisst.

My cardiologist said I had LVH and cardiomyopathy.

Phyllis

On 3/12/2012 5:37 PM, wrote:

NO, I did NOT say that! I said to ask the one who put

"Cardiomagaly" in your chart exactly what he meant. If he

says "LVH" they your assumption is correct and treat the

HTN. (Dash, Dash, Dash and MCB's are a good option as long

as BP comes into control.) If he says anything else, ask

him how he is going to treat it!

> > > >>> >

> > > >>> > > I flew standby to

Baltimore and was put in first class.

> > > >>> I had a glass of Pinot Grigio

and before I knew it we were

> > > >>> landing. Got off the plane and

made my way to the Super

> > > >>> Shuttle which I had reserved

since the NIH airport shuttle

> > > >>> doesn't run on Saturday's. I

was the last drop off and then

> > > >>> the NIH experience really

began. The Super Shuttle driver

> > > >>> went to the Main Entrance

which was locked. (The whole place

> > > >>> is locked, secured, gated,

manned with it's own police

> > > >>> staff, very visibly). There

was a sign to proceed to the

> > > >>> South Entrance, so we did. The

guy at the gate (armed guard)

> > > >>> said we had to go back out to

get badges and he had to get

> > > >>> cleared through commercial

vehicle inspection. I went

> > > >>> through Checkpoint Charlie

(between East and West Germany

> > > >>> prior to the fall of the

Berlin Wall) and it reminded me of

> > > >>> that. After the dogs, the half

dozen police guards, etc had

> > > >>> cleared the van and my ID, we

were given our badges and went

> > > >>> to the South gate again. We

were allowed through and he

> > > >>> dropped me and my luggage off

at the Clinical Research

> > > >>> Center. There was no one in

sight. I saw a sign at the

> > > >>> information desk that directed

me to admissions. It was

> > > >>> quite a walk, but I found it.

There was a lady there (not

> > > >>> another soul anywhere) and she

asked if she could help me? I

> > > >>> told her my name and said I

was here for admission and she

> > > >>> found me in her system, had me

sign stuff, gave me an

> > > >>> armband and took me upstairs.

Upstairs looks like a

> > > >>> hospital. We went to the

nurses station and the nurse took

> > > >>> me to my room. He said, first

order your dinner and handed

> > > >>> me a menu and a phone. I

quickly read the menu, called the

> > > >>> number on the menu and was put

on hold for 13 minutes.

> > > >>> (Order your meals early). I

ordered a spinach salad, you can

> > > >>> put whatever you want on it

and get whatever dressing you

> > > >>> want too. I also ordered a

baked potato and steamed

> > > >>> brocolli. The salad was great.

The baked potato must've been

> > > >>> microwaved, it was weird and

the brocolli was too steamed

> > > >>> and hospital tasting. I

ordered the same salad for lunch

> > > >>> today with a grilled cheese

(low fat, low sodium) sandwich

> > > >>> and decided I might live on

spinach salads while I'm here.

> > > >>> After the dinner stuff, I got

checked in by nursing staff;

> > > >>> they went over my meds etc.

and told me about the 24 hour

> > > >>> urine testing. The whole time

you are here (7-10 days), you

> > > >>> do the urine testing...pee in

a hat, transfer it to a jug,

> > > >>> put jug in the specimin fridge

in your room. After that, it

> > > >>> was vitals and uneventful.

> > > >>> > >

> > > >>> > > I was awakened today

at 5:30 or so; they took my vitals

> > > >>> and told me to pee to start

the urine testing. Then, I saw 3

> > > >>> doctors all whom were various

levels of fellows and they all

> > > >>> had consents to sign and

histories to take; questions about

> > > >>> various aspects of my health

and records. I was seen by a

> > > >>> social worker and screened for

mental health issues. I was

> > > >>> seen by a bio ethics person

who wanted to make sure I knew

> > > >>> what I was consenting to, and

understood the living will

> > > >>> documents. I am currently

waiting on someone who is going to

> > > >>> do an EKG. I had to apply for

a IT security screen to get a

> > > >>> password for the internet and

it took all day today to

> > > >>> process, but alas, I have it!

I spent most of the day today

> > > >>> with all of that and had a lot

of time to get some work done

> > > >>> that I brought with me. So, it

was a pretty relaxing day and

> > > >>> very informative.

> > > >>> > >

> > > >>> > > If I can, I will

post how tomorrow goes, etc. I won't

> > > >>> get any results until

Thursday. Prior to Thurs, I will have

> > > >>> done 4 days of 24 hour urine

tests, tons of bloodwork ( they

> > > >>> are putting two lines in

tomorrow am), saline supression

> > > >>> test, ct scan (with contrast),

ekg, supine/upright

> > > >>> renin/aldo, cardiac echo, US

of the kidneys, dopper

> > > >>> carotids, glucose tolerance

test, dirunal cortisol and acth

> > > >>> and an acth stim test. I am

having more cardiac stuff too

> > > >>> based on something they are

worried about from today as

> > > >>> well, but not everyone would

have that. Then, I will know

> > > >>> quite a bit of results and

have a pow wow. Then we decide

> > > >>> what to do from there based on

what they have. If necessary,

> > > >>> I would have the AVS on

Friday. Then it would take a week to

> > > >>> get those results, so I could

go home on Saturday or Sunday,

> > > >>> then they call with the AVS

results and we go from there as

> > > >>> far as surgery or whatever. I

signed a thing today that I

> > > >>> understood that they would

like me to come back in a year

> > > >>> and repeat all of this too, if

I have something to follow. I

> > > >>> don't have too, but they'd

like it.

> > > >>> > >

> > > >>> > > So, there you have

it...my NIH experience thus far!

> > > >>> > >

> > > >>> > >

> > > >>> >

> > > >>>

> > > >>

> > > >

> > > >

> > >

> >

>

[Guest guest]

LVH means increased thickness of the left side (wall(s)) of the heart. This can be detected by EKG but echo is more quantitative and now by MRI and CT. Everyone with HTN has LVH (for them) otherwise they would go into heart failure. Problem is we don't usually have an echo before HTN develops. So LVH prob goes thru the same evolution as PA. First one get physiologic hypertrophy (to prevent failure from an increasing BP, then individual hypertrophy (say geater than 2 SD of what the wall thickness was before HTN, then group hypertrophy in which it if above the averages set by population studies and then full blow hypertropy which can be seen on chest x-ray and detected on physical exam. Animal data shows that enlargement begins within a beat after the pressure goes up. Cardiomegaly is when the heart shadow gets bigger on the chest x-ray. When it gets really big we can see the PMI left and below the nipple and feel the impulse by placing a hand over the heart just below the nipple. If one has he pt roll go the left and exhale it is easier to feel but this skill and method seems to be lost. One can also detect this by percussion of the left borders of the heart--- another lost art.The best correlate (predictor) of heart size in the population is the diet salt intake in the population. But if we had many BPs over time done correctly my bet is that BP would be the best predictor. When salt/BP goes down cardiac enlargement goes down. This can be detected by 2-4 weeks in humans and probably earlier if one had enough baseline Echos before going on a low sodium diet. CE Grim MDOn Mar 12, 2012, at 3:08 PM, wrote: "Cardiomegay is simply a medical term that is used by medical practitioners to describe the condition of heart enlargement". LVH is thickening of the Left Ventricle because it has to work harder due to HTN. Since this is the pump that causes blood flow throughout your body it often reduces your blood flow.With that said I would question exactly what the meant with the Crdiomegay DX since I presume LVH could cause the heart to get larger but after looking I at the info I would make sure they meaning the same thing. Suggest you look at: http://cardiomegaly.org/cardiomegaly/ to see what MAY be going on, You re not pregnant are you? > >>> >> >>> > > I flew standby to Baltimore and was put in first class.> >>> I had a glass of Pinot Grigio and before I knew it we were> >>> landing. Got off the plane and made my way to the Super> >>> Shuttle which I had reserved since the NIH airport shuttle> >>> doesn't run on Saturday's. I was the last drop off and then> >>> the NIH experience really began. The Super Shuttle driver> >>> went to the Main Entrance which was locked. (The whole place> >>> is locked, secured, gated, manned with it's own police> >>> staff, very visibly). There was a sign to proceed to the> >>> South Entrance, so we did. The guy at the gate (armed guard)> >>> said we had to go back out to get badges and he had to get> >>> cleared through commercial vehicle inspection. I went> >>> through Checkpoint Charlie (between East and West Germany> >>> prior to the fall of the Berlin Wall) and it reminded me of> >>> that. After the dogs, the half dozen police guards, etc had> >>> cleared the van and my ID, we were given our badges and went> >>> to the South gate again. We were allowed through and he> >>> dropped me and my luggage off at the Clinical Research> >>> Center. There was no one in sight. I saw a sign at the> >>> information desk that directed me to admissions. It was> >>> quite a walk, but I found it. There was a lady there (not> >>> another soul anywhere) and she asked if she could help me? I> >>> told her my name and said I was here for admission and she> >>> found me in her system, had me sign stuff, gave me an> >>> armband and took me upstairs. Upstairs looks like a> >>> hospital. We went to the nurses station and the nurse took> >>> me to my room. He said, first order your dinner and handed> >>> me a menu and a phone. I quickly read the menu, called the> >>> number on the menu and was put on hold for 13 minutes.> >>> (Order your meals early). I ordered a spinach salad, you can> >>> put whatever you want on it and get whatever dressing you> >>> want too. I also ordered a baked potato and steamed> >>> brocolli. The salad was great. The baked potato must've been> >>> microwaved, it was weird and the brocolli was too steamed> >>> and hospital tasting. I ordered the same salad for lunch> >>> today with a grilled cheese (low fat, low sodium) sandwich> >>> and decided I might live on spinach salads while I'm here.> >>> After the dinner stuff, I got checked in by nursing staff;> >>> they went over my meds etc. and told me about the 24 hour> >>> urine testing. The whole time you are here (7-10 days), you> >>> do the urine testing...pee in a hat, transfer it to a jug,> >>> put jug in the specimin fridge in your room. After that, it> >>> was vitals and uneventful.> >>> > >> >>> > > I was awakened today at 5:30 or so; they took my vitals> >>> and told me to pee to start the urine testing. Then, I saw 3> >>> doctors all whom were various levels of fellows and they all> >>> had consents to sign and histories to take; questions about> >>> various aspects of my health and records. I was seen by a> >>> social worker and screened for mental health issues. I was> >>> seen by a bio ethics person who wanted to make sure I knew> >>> what I was consenting to, and understood the living will> >>> documents. I am currently waiting on someone who is going to> >>> do an EKG. I had to apply for a IT security screen to get a> >>> password for the internet and it took all day today to> >>> process, but alas, I have it! I spent most of the day today> >>> with all of that and had a lot of time to get some work done> >>> that I brought with me. So, it was a pretty relaxing day and> >>> very informative.> >>> > >> >>> > > If I can, I will post how tomorrow goes, etc. I won't> >>> get any results until Thursday. Prior to Thurs, I will have> >>> done 4 days of 24 hour urine tests, tons of bloodwork ( they> >>> are putting two lines in tomorrow am), saline supression> >>> test, ct scan (with contrast), ekg, supine/upright> >>> renin/aldo, cardiac echo, US of the kidneys, dopper> >>> carotids, glucose tolerance test, dirunal cortisol and acth> >>> and an acth stim test. I am having more cardiac stuff too> >>> based on something they are worried about from today as> >>> well, but not everyone would have that. Then, I will know> >>> quite a bit of results and have a pow wow. Then we decide> >>> what to do from there based on what they have. If necessary,> >>> I would have the AVS on Friday. Then it would take a week to> >>> get those results, so I could go home on Saturday or Sunday,> >>> then they call with the AVS results and we go from there as> >>> far as surgery or whatever. I signed a thing today that I> >>> understood that they would like me to come back in a year> >>> and repeat all of this too, if I have something to follow. I> >>> don't have too, but they'd like it.> >>> > >> >>> > > So, there you have it...my NIH experience thus far!> >>> > >> >>> > >> >>> >> >>>> >>> >> >>

[Guest guest]

Update:

Drs. today (NIH) confirmed diagnosis of PA. Very high aldo on saline supression

testing...and all other 24 hour urine, etc. No renin to speak of (under .1) and

k totally tanked even though supplementing. And so far, bilateral nodules. and

cardiac arythmia likely connected to very low k. More eval on that after k is

stable. Now getting k in IV. IV's keep failing...arms trashed. Tomorrow will

have AAS...very nervous about that, but looking forward to it since it is the

path to clarity.

Anyone know why they do AVS on some and AAS on others???

Any advice on how to not be so scared of this procedure????

> > > > >>> >

> > > > >>> > > I flew standby to Baltimore and was put in first class.

> > > > >>> I had a glass of Pinot Grigio and before I knew it we were

> > > > >>> landing. Got off the plane and made my way to the Super

> > > > >>> Shuttle which I had reserved since the NIH airport shuttle

> > > > >>> doesn't run on Saturday's. I was the last drop off and then

> > > > >>> the NIH experience really began. The Super Shuttle driver

> > > > >>> went to the Main Entrance which was locked. (The whole place

> > > > >>> is locked, secured, gated, manned with it's own police

> > > > >>> staff, very visibly). There was a sign to proceed to the

> > > > >>> South Entrance, so we did. The guy at the gate (armed guard)

> > > > >>> said we had to go back out to get badges and he had to get

> > > > >>> cleared through commercial vehicle inspection. I went

> > > > >>> through Checkpoint Charlie (between East and West Germany

> > > > >>> prior to the fall of the Berlin Wall) and it reminded me of

> > > > >>> that. After the dogs, the half dozen police guards, etc had

> > > > >>> cleared the van and my ID, we were given our badges and went

> > > > >>> to the South gate again. We were allowed through and he

> > > > >>> dropped me and my luggage off at the Clinical Research

> > > > >>> Center. There was no one in sight. I saw a sign at the

> > > > >>> information desk that directed me to admissions. It was

> > > > >>> quite a walk, but I found it. There was a lady there (not

> > > > >>> another soul anywhere) and she asked if she could help me? I

> > > > >>> told her my name and said I was here for admission and she

> > > > >>> found me in her system, had me sign stuff, gave me an

> > > > >>> armband and took me upstairs. Upstairs looks like a

> > > > >>> hospital. We went to the nurses station and the nurse took

> > > > >>> me to my room. He said, first order your dinner and handed

> > > > >>> me a menu and a phone. I quickly read the menu, called the

> > > > >>> number on the menu and was put on hold for 13 minutes.

> > > > >>> (Order your meals early). I ordered a spinach salad, you can

> > > > >>> put whatever you want on it and get whatever dressing you

> > > > >>> want too. I also ordered a baked potato and steamed

> > > > >>> brocolli. The salad was great. The baked potato must've been

> > > > >>> microwaved, it was weird and the brocolli was too steamed

> > > > >>> and hospital tasting. I ordered the same salad for lunch

> > > > >>> today with a grilled cheese (low fat, low sodium) sandwich

> > > > >>> and decided I might live on spinach salads while I'm here.

> > > > >>> After the dinner stuff, I got checked in by nursing staff;

> > > > >>> they went over my meds etc. and told me about the 24 hour

> > > > >>> urine testing. The whole time you are here (7-10 days), you

> > > > >>> do the urine testing...pee in a hat, transfer it to a jug,

> > > > >>> put jug in the specimin fridge in your room. After that, it

> > > > >>> was vitals and uneventful.

> > > > >>> > >

> > > > >>> > > I was awakened today at 5:30 or so; they took my vitals

> > > > >>> and told me to pee to start the urine testing. Then, I saw 3

> > > > >>> doctors all whom were various levels of fellows and they all

> > > > >>> had consents to sign and histories to take; questions about

> > > > >>> various aspects of my health and records. I was seen by a

> > > > >>> social worker and screened for mental health issues. I was

> > > > >>> seen by a bio ethics person who wanted to make sure I knew

> > > > >>> what I was consenting to, and understood the living will

> > > > >>> documents. I am currently waiting on someone who is going to

> > > > >>> do an EKG. I had to apply for a IT security screen to get a

> > > > >>> password for the internet and it took all day today to

> > > > >>> process, but alas, I have it! I spent most of the day today

> > > > >>> with all of that and had a lot of time to get some work done

> > > > >>> that I brought with me. So, it was a pretty relaxing day and

> > > > >>> very informative.

> > > > >>> > >

> > > > >>> > > If I can, I will post how tomorrow goes, etc. I won't

> > > > >>> get any results until Thursday. Prior to Thurs, I will have

> > > > >>> done 4 days of 24 hour urine tests, tons of bloodwork ( they

> > > > >>> are putting two lines in tomorrow am), saline supression

> > > > >>> test, ct scan (with contrast), ekg, supine/upright

> > > > >>> renin/aldo, cardiac echo, US of the kidneys, dopper

> > > > >>> carotids, glucose tolerance test, dirunal cortisol and acth

> > > > >>> and an acth stim test. I am having more cardiac stuff too

> > > > >>> based on something they are worried about from today as

> > > > >>> well, but not everyone would have that. Then, I will know

> > > > >>> quite a bit of results and have a pow wow. Then we decide

> > > > >>> what to do from there based on what they have. If necessary,

> > > > >>> I would have the AVS on Friday. Then it would take a week to

> > > > >>> get those results, so I could go home on Saturday or Sunday,

> > > > >>> then they call with the AVS results and we go from there as

> > > > >>> far as surgery or whatever. I signed a thing today that I

> > > > >>> understood that they would like me to come back in a year

> > > > >>> and repeat all of this too, if I have something to follow. I

> > > > >>> don't have too, but they'd like it.

> > > > >>> > >

> > > > >>> > > So, there you have it...my NIH experience thus far!

> > > > >>> > >

> > > > >>> > >

> > > > >>> >

> > > > >>>

> > > > >>

> > > > >

> > > > >

> > > >

> > >

> >

>