Re: Post Surgery BP adjustment

[Guest guest]

I think I recently posted about my K & BP. If not, let me know & I'll provide

more details. My BP fluctuated after surgery. I stayed on one of the 2 BP

pills I was taking for a week or so & then reduced the dosage in half & stopped

taking it a week our do later. My BP still fluctates now (six months after my

Adx) but overall it seems to be declining. I keep track of it but haven't

tabulated, averaged or charted it since December. It usually goes around

140/75 when I eat out, & otherwise is around 125/70. Like Dr. Grim says we PAs

are salt-sensitive. I may have other underlying BP issues. I am 59 yrs old, so

that may be part of it. It seems like the BP of younger people who have Adx's

quickly becomes normal after the surgery.

Lucy Sage

Please forgive brevity & typos

Sent from my droid

cateroman <cate.roman@...> wrote:

>My husband is currently experiencing hypertensive BP following adrenalectomy 7

days ago.

>I am curious to know if other people have experienced post adrenalectomy

fluctuations in BP before settling down into the normal range.

>If so, how long did it take to correct?

>Thank you,

>Cate

>

[Guest guest]

Need more information to be able to help.CE Grim MDOn Mar 15, 2012, at 3:47 PM, cateroman wrote: My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago. I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range. If so, how long did it take to correct? Thank you, Cate

[Guest guest]

Hello Dr Grim,Here are some details:My husband is a 57 year old, 12-year colon cancer survivor with a permanent ileostomy and a post-cancer Ironman triathlete.Armenian decent. Born in Los Angeles CA.

Normal and healthy renal function.Pre-surgery CT scan indicated a 13mm nodule on left adrenal. However, AVS determined high aldosterone levels ONLY on the right adrenal. Docs concluded left adrenal nodule was

none functioning as all levels where in the normal range.

Laproscopic right adrenalectomy with minor blood loss. Pathology confirmed a microscopic aldostronoma.BP cuff is accurate to +/- 3 points.BP varies less than 5 points between arms.He is currently on no medications, but prior to surgery was taking 5 mg Bystolic per day.

He took his final Bystolic the day before surgery and medication was not restarted.While on Bystolic pre-surgery BP range between 150-160/90-100.

For

two days, immediately post surgery BP was around 120/65.Then it suddenly (within a few hours) went to 160/100. The nurses began to monitor it every two hours where it consistently stayed above 150/90 until discharge later that evening.

Surgery was March 7th. He came home on March 9th. We take his BP in the afternoon, resting, left arm, same cuff. Here's are the readings:March 10th 154/95March 11th 148/90March 12th 133/92March 13th 137/87

March 14th 148/91Low-salt diet had been observed for 4 months prior. He is a healthy weight.We don't have K values.His pain is now low and he manages it with 400 mg Advil 2 x a day.We saw the surgeon today for first post-op who suggested the fluctuation and high ranges could be influenced by fluid retention from surgery and post-op pain.

Would love to hear your thoughts about whether this could be an adjustment period or ?On Thu, Mar 15, 2012 at 4:55 PM, Clarence Grim <lowerbp2@...> wrote:

 

Need more information to be able to help.CE Grim MDOn Mar 15, 2012, at 3:47 PM, cateroman wrote:  

My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago. I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range.

If so, how long did it take to correct? Thank you, Cate

-- Cate Roman, MFAArtistwww.cateroman.com“It's not what you look at that matters, it's what you see.”

                                                                                Henry Thoreau

[Guest guest]

You mentioned that he's taking Advil for pain. My nephrologist told me that

Advil/ibuprofen can raise BP in some people.

I think I mentioned that my post-adrenalectomy BP was high for about a week

after the surgery - I was also taking ibuprofen for pain, and now that I think

about it, the drop in my BP to normal probably happened right around the time I

stopped the ibuprofen.

Your husband's numbers look to be in about the same ballpark as mine were the

first week after the surgery - don't give up hope yet

-msmith1928

Successful left laparoscopic adrenalectomy 10/13/11

> >

> >

> >

> > My husband is currently experiencing hypertensive BP following

> > adrenalectomy 7 days ago.

> > I am curious to know if other people have experienced post adrenalectomy

> > fluctuations in BP before settling down into the normal range.

> > If so, how long did it take to correct?

> > Thank you,

> > Cate

> >

> >

> >

> >

>

>

>

> --

> Cate Roman, MFA

> Artist

>

> www.cateroman.com

>

> �It's not what you look at that matters, it's what you see.�

> Henry Thoreau

>

[Guest guest]

I think I sent a request for more info a day or so ago. Maybe not.Your current team may be clarivoyant but I am not.On Mar 15, 2012, at 3:47 PM, cateroman wrote: My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago. I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range. If so, how long did it take to correct? Thank you, Cate

[Guest guest]

Dr Grim,I have posted this twice already. Here it is for a third time and I hope you get it this time. Thanks in advance.The details:My husband is a 57 year old, 12-year colon cancer survivor with a permanent ileostomy and a post-cancer Ironman triathlete.

Armenian decent. Born in Los Angeles CA.

Normal and healthy renal function.Pre-surgery CT scan indicated a 13mm nodule on left adrenal. However, AVS determined high aldosterone levels ONLY on the right adrenal. Docs concluded left adrenal nodule was

none functioning as all levels where in the normal range.

Laproscopic right adrenalectomy with minor blood loss. Pathology confirmed a microscopic aldostronoma.BP cuff is accurate to +/- 3 points.BP varies less than 5 points between arms.He is currently on no medications, but prior to surgery was taking 5 mg Bystolic per day.

He took his final Bystolic the day before surgery and medication was not restarted.While on Bystolic pre-surgery BP range between 150-160/90-100.

For

two days, immediately post surgery BP was around 120/65.Then it suddenly (within a few hours) went to 160/100. The nurses began to monitor it every two hours where it consistently stayed above 150/90 until discharge later that evening.

Surgery was March 7th. He came home on March 9th. We take his BP in the afternoon, resting, left arm, same cuff. Here's are the readings:March 10th 154/95March 11th 148/90March 12th 133/92March 13th 137/87

March 14th 148/91March 15th 143/91Low-salt diet had been observed for 4 months prior. He is a healthy weight.We don't have K values.His pain is now low and he manages it with 400 mg Advil 2 x a day.

We

saw the surgeon yesterday for first post-op who suggested the fluctuation and high ranges could be influenced by fluid retention from surgery and post-op pain.

Would love to hear your thoughts about whether this could be an adjustment period or ?On Fri, Mar 16, 2012 at 8:38 AM, Clarence Grim <lowerbp2@...> wrote:

 

I think I sent a request for more info a day or so ago. Maybe not.Your current team may be clarivoyant but I am not.On Mar 15, 2012, at 3:47 PM, cateroman wrote:

  My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago. I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range.

If so, how long did it take to correct? Thank you, Cate

-- Cate Roman, MFAArtistwww.cateroman.com“It's not what you look at that matters, it's what you see.”

                                                                                Henry Thoreau

[Guest guest]

There is always an issue of does a pt with Conn's also have "essential hypertension" whatever that is, in the background and this is the reason for the failure of BP to return completely to normal.In the old days some did a kidney biopsy at the time or surgery to help the prediction of cure but we now know that a lot of renal fibrosis is due to excess aldo/salt and will likely go away when the Conn's is unilateral and cured.My hunch is that in most who have had this explanation used as a failure for BP cure is that: 1. They have bilateral disease and the other side is still producing come excess aldo. This would be tested by following PRA and aldo after surgery. Maybe once a year with a 24 hr urine for Na and K at the same time. Would expect renin to go slowly down and aldo slowly up. DASHing should help counter act this.If it is essential HTN then would expect the following to be present:BP should return only to what it was before Conn's developed. There should be a strong family Hx of HTN that is not due to Conn's or its variants.The BP should respond nicely to the use of diuretics without lowering K.There should be no other reasons for BP to be up: such as low eGFR, BCPs, eating licorice or being a salt glutton. CE Grim MDOn Mar 15, 2012, at 4:27 PM, Lucy Sage wrote: I think I recently posted about my K & BP. If not, let me know & I'll provide more details. My BP fluctuated after surgery. I stayed on one of the 2 BP pills I was taking for a week or so & then reduced the dosage in half & stopped taking it a week our do later. My BP still fluctates now (six months after my Adx) but overall it seems to be declining. I keep track of it but haven't tabulated, averaged or charted it since December. It usually goes around 140/75 when I eat out, & otherwise is around 125/70. Like Dr. Grim says we PAs are salt-sensitive. I may have other underlying BP issues. I am 59 yrs old, so that may be part of it. It seems like the BP of younger people who have Adx's quickly becomes normal after the surgery. Lucy Sage Please forgive brevity & typos Sent from my droid cateroman <cate.roman@...> wrote: >My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago. >I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range. >If so, how long did it take to correct? >Thank you, >Cate >

[Guest guest]

Makes one wonder if near the time of surgery, the actual surgery did nothing for the HTN because they had the wrong adrenal. The only reason BP was low was fasting and no salt, not just low salt prior to surgery. Just a thought. After 2 days post surgery, when diet was getting to normal and he was eating again and they were making sure he pooped and peed, the aame problem - high aldosteronsim, just caught back up.

Taking the adrenal helped a little, but the other adenoma isn't as benign as they think. Maybe?

So why do they not just try a tiny dose of spironolactone and see if BP goes down? If it does, what a wonderful day it would be - for the BP, that is, but it means he still has PA.

My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago.I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range.If so, how long did it take to correct?Thank you,Cate

-- Cate Roman, MFAArtistwww.cateroman.com

“It's not what you look at that matters, it's what you see.†Henry Thoreau

[Guest guest]

Good on ya !Could still be an adjustment period.Also Bystolic usually does not do much for BP in BP. But did it bring his down compared to not being on it?What had been his preop response to spiro?Ah but did not read the info that they took out the adrenal that DID NOT have the big bump. I must have missed your earlier note with this in it. Sorry.When the AVS points to the side without the big bump I will not operate without repeating it and being in the AVS room to document correct labeling of tubes etc. Did you send us the Aldo and cortisol numbers from the AVS to look at? As correctly summarized I suspect they took out the wrong adrenal (the one with the major source of aldo) and the path report of microscopic aldosteronoma confirms bilateral disease. Ask how big the "mircoadenoma" was and if there were more than one. I will be happy to look at the slides or pictures of the adrenal if they can give them to you to send to me.I have probably looked at more than they have with PA. CE Grim MD On Mar 16, 2012, at 12:47 PM, Bingham wrote: Makes one wonder if near the time of surgery, the actual surgery did nothing for the HTN because they had the wrong adrenal. The only reason BP was low was fasting and no salt, not just low salt prior to surgery. Just a thought. After 2 days post surgery, when diet was getting to normal and he was eating again and they were making sure he pooped and peed, the aame problem - high aldosteronsim, just caught back up. Taking the adrenal helped a little, but the other adenoma isn't as benign as they think. Maybe? So why do they not just try a tiny dose of spironolactone and see if BP goes down? If it does, what a wonderful day it would be - for the BP, that is, but it means he still has PA. My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago.I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range.If so, how long did it take to correct?Thank you,Cate -- Cate Roman, MFAArtistwww.cateroman.com “It's not what you look at that matters, it's what you see.” Henry Thoreau

[Guest guest]

Dr G can adenoma's sputter like an old car and sometimes emit or cause the release intermittnetly?

My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago.I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range.If so, how long did it take to correct?Thank you,Cate

-- Cate Roman, MFAArtistwww.cateroman.com

“It's not what you look at that matters, it's what you see.†Henry Thoreau

[Guest guest]

Thank you for your comments. I am happy to say that he had very normal BP readings today. And all his other pre-surgery symptoms are gone.His aldo levels post-surgery returned to normal and we believe he is adjusting.

The adenoma in the other gland is NON-functioning, which was confirmed by the AVS done by Interventional Radiologist Dr Antoinette Gomes at UCLA Regan Medical Center and we are fully confident that her finding are solid.

He did stop taking the Advil. And is now medication free!It seems his experience matches with some of the other members of this group who took a week or so to adjust post-surgery.Thanks again for your support during this transition. I appreciate not feeling alone in dealing with all of this.

Warmly,CateOn Sat, Mar 17, 2012 at 4:42 PM, Clarence Grim <lowerbp2@...> wrote:

 

Good on ya !Could still be an adjustment period.Also Bystolic usually does not do much for BP in BP. But did it bring his down compared to not being on it?

What had been his preop response to spiro?Ah but did not read the info that they took out the adrenal that DID NOT have the big bump.  I must have missed your earlier note with this in it. Sorry.

When the AVS points to the side without the big bump I will not operate without repeating it and being in the AVS room to document correct labeling of tubes etc. Did you send us the Aldo and cortisol numbers from the AVS to look at?  

As correctly summarized I suspect they took out the wrong adrenal (the one with the major source of aldo) and the path report of microscopic aldosteronoma confirms bilateral disease.  Ask how big the " mircoadenoma " was and if there were more than one. I will be happy to look at the slides or pictures of the adrenal if they can give them to you to send to me.

I have probably looked at more than they have with PA. CE Grim MD On Mar 16, 2012, at 12:47 PM, Bingham wrote:

  Makes one wonder if near the time of surgery, the actual surgery did nothing for the HTN because they had the wrong adrenal. The only reason BP was low was fasting and no salt, not just low salt prior to surgery. Just a thought. After 2 days post surgery, when diet was getting to normal and he was eating again and they were making sure he pooped and peed, the aame problem - high aldosteronsim, just caught back up.

  Taking the adrenal helped a little, but the other adenoma isn't as benign as they think. Maybe?   So why do they not just try a tiny dose of spironolactone and see if BP goes down? If it does, what a wonderful day it would be - for the BP, that is, but it means he still has PA.

    My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago.

I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range.If so, how long did it take to correct?Thank you,Cate

-- Cate Roman, MFAArtistwww.cateroman.com

“It's not what you look at that matters, it's what you see.”                                                                                Henry Thoreau

-- Cate Roman, MFAArtistwww.cateroman.com“It's not what you look at that matters, it's what you see.”

                                                                                Henry Thoreau

[Guest guest]

Good. Let's hope it stays.

My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago.I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range.If so, how long did it take to correct?Thank you,Cate

-- Cate Roman, MFAArtistwww.cateroman.com

“It's not what you look at that matters, it's what you see.†Henry Thoreau

-- Cate Roman, MFAArtistwww.cateroman.com

“It's not what you look at that matters, it's what you see.†Henry ThoreauG

[Guest guest]

We would still like to see the AVS numbers for our files. Being from Missouri I like to see the actual numbers. You did not mention any family history as rarely these run in families. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 17, 2012, at 21:53, cate roman <cate.roman@...> wrote:

Thank you for your comments. I am happy to say that he had very normal BP readings today. And all his other pre-surgery symptoms are gone.His aldo levels post-surgery returned to normal and we believe he is adjusting.

The adenoma in the other gland is NON-functioning, which was confirmed by the AVS done by Interventional Radiologist Dr Antoinette Gomes at UCLA Regan Medical Center and we are fully confident that her finding are solid.

He did stop taking the Advil. And is now medication free!It seems his experience matches with some of the other members of this group who took a week or so to adjust post-surgery.Thanks again for your support during this transition. I appreciate not feeling alone in dealing with all of this.

Warmly,CateOn Sat, Mar 17, 2012 at 4:42 PM, Clarence Grim <lowerbp2@...> wrote:

Good on ya !Could still be an adjustment period.Also Bystolic usually does not do much for BP in BP. But did it bring his down compared to not being on it?

What had been his preop response to spiro?Ah but did not read the info that they took out the adrenal that DID NOT have the big bump. I must have missed your earlier note with this in it. Sorry.

When the AVS points to the side without the big bump I will not operate without repeating it and being in the AVS room to document correct labeling of tubes etc. Did you send us the Aldo and cortisol numbers from the AVS to look at?

As correctly summarized I suspect they took out the wrong adrenal (the one with the major source of aldo) and the path report of microscopic aldosteronoma confirms bilateral disease. Ask how big the "mircoadenoma" was and if there were more than one. I will be happy to look at the slides or pictures of the adrenal if they can give them to you to send to me.

I have probably looked at more than they have with PA. CE Grim MD On Mar 16, 2012, at 12:47 PM, Bingham wrote:

Makes one wonder if near the time of surgery, the actual surgery did nothing for the HTN because they had the wrong adrenal. The only reason BP was low was fasting and no salt, not just low salt prior to surgery. Just a thought. After 2 days post surgery, when diet was getting to normal and he was eating again and they were making sure he pooped and peed, the aame problem - high aldosteronsim, just caught back up.

Taking the adrenal helped a little, but the other adenoma isn't as benign as they think. Maybe? So why do they not just try a tiny dose of spironolactone and see if BP goes down? If it does, what a wonderful day it would be - for the BP, that is, but it means he still has PA.

My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago.

I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range.If so, how long did it take to correct?Thank you,Cate

-- Cate Roman, MFAArtistwww.cateroman.com

“It's not what you look at that matters, it's what you see.†Henry Thoreau

-- Cate Roman, MFAArtistwww.cateroman.com“It's not what you look at that matters, it's what you see.â€

Henry Thoreau

[Guest guest]

Great news Cate! I know I've posted the results of a study that said it

sometimes takes weeks for BP to resolve and the total effect may not be seen for

up to a year. They always treat the resolution of any K issue as a positive

sign.

Dr. Stowasser suggests checking renin: " Assessment of renin levels is also

helpful in guiding changes in management for patients in whom hypertension has

not yet become optimally controlled following introduction of mineralocorticoid

antagonist treatment.

If renin levels have

already become `unsuppressed', for example, persisting

hypertension is best treated by adding in or increasing the dose

of other antihypertensive medications. It must be remembered

that renin suppression can persist for long periods after `cure'

of unilateral PA by adrenalectomy, if PA was longstanding. It

may therefore also take some time for `complete' blockade

of the mineralocorticoid receptor to result in renin becoming

`unsuppressed'. "

I look forward to continued positive reports!

.....

> >

> >

> > My husband is currently experiencing hypertensive BP following

> > adrenalectomy 7 days ago.

> > I am curious to know if other people have experienced post adrenalectomy

> > fluctuations in BP before settling down into the normal range.

> > If so, how long did it take to correct?

> > Thank you,

> > Cate

> >

> >

> >

> >

> >

> > --

> > Cate Roman, MFA

> > Artist

> >

> > www.cateroman.com

> >

> > " It's not what you look at that matters, it's what you see. "

> > Henry Thoreau

> >

> >

> >

> >

>

>

>

> --

> Cate Roman, MFA

> Artist

>

> www.cateroman.com

>

> " It's not what you look at that matters, it's what you see. "

> Henry Thoreau

>

[Guest guest]

Especially if you continue to eat the notoriuolsy high Aussie salt diet.I suspect he makes the common error of measuring renin/aldo but not urine Na and K.CE Grim MDOn Mar 18, 2012, at 1:02 AM, wrote: Great news Cate! I know I've posted the results of a study that said it sometimes takes weeks for BP to resolve and the total effect may not be seen for up to a year. They always treat the resolution of any K issue as a positive sign. Dr. Stowasser suggests checking renin: "Assessment of renin levels is also helpful in guiding changes in management for patients in whom hypertension has not yet become optimally controlled following introduction of mineralocorticoid antagonist treatment. If renin levels have already become `unsuppressed', for example, persisting hypertension is best treated by adding in or increasing the dose of other antihypertensive medications. It must be remembered that renin suppression can persist for long periods after `cure' of unilateral PA by adrenalectomy, if PA was longstanding. It may therefore also take some time for `complete' blockade of the mineralocorticoid receptor to result in renin becoming `unsuppressed'." I look forward to continued positive reports! .... > > > > > > My husband is currently experiencing hypertensive BP following > > adrenalectomy 7 days ago. > > I am curious to know if other people have experienced post adrenalectomy > > fluctuations in BP before settling down into the normal range. > > If so, how long did it take to correct? > > Thank you, > > Cate > > > > > > > > > > > > -- > > Cate Roman, MFA > > Artist > > > > www.cateroman.com > > > > "It's not what you look at that matters, it's what you see." > > Henry Thoreau > > > > > > > > > > > > -- > Cate Roman, MFA > Artist > > www.cateroman.com > > "It's not what you look at that matters, it's what you see." > Henry Thoreau >

[Guest guest]

Another great BP reading today. 120/7011 days post surgery. What a blessing so far.He will see his endocrinologist next Wednesday for follow up.I think he was lucky that he was diagnosed after only 3 months of becoming symptomatic.

I'll keep you posted.CateOn Sun, Mar 18, 2012 at 8:29 PM, Clarence Grim <lowerbp2@...> wrote:

 

Especially if you continue to eat the notoriuolsy high Aussie salt diet.I suspect he makes the common error of measuring renin/aldo but not urine Na and K.CE Grim MD

On Mar 18, 2012, at 1:02 AM, wrote:   Great news Cate! I know I've posted the results of a study that said it sometimes takes weeks for BP to resolve and the total effect may not be seen for up to a year. They always treat the resolution of any K issue as a positive sign.

Dr. Stowasser suggests checking renin: " Assessment of renin levels is also helpful in guiding changes in management for patients in whom hypertension has not yet become optimally controlled following introduction of mineralocorticoid antagonist treatment.

If renin levels have already become `unsuppressed', for example, persisting hypertension is best treated by adding in or increasing the dose of other antihypertensive medications. It must be remembered

that renin suppression can persist for long periods after `cure' of unilateral PA by adrenalectomy, if PA was longstanding. It may therefore also take some time for `complete' blockade of the mineralocorticoid receptor to result in renin becoming

`unsuppressed'. " I look forward to continued positive reports! .... > > > > > > My husband is currently experiencing hypertensive BP following > > adrenalectomy 7 days ago. > > I am curious to know if other people have experienced post adrenalectomy

> > fluctuations in BP before settling down into the normal range. > > If so, how long did it take to correct? > > Thank you, > > Cate > > > > > > > >

> > > > -- > > Cate Roman, MFA > > Artist > > > > www.cateroman.com > > > > " It's not what you look at that matters, it's what you see. "

> > Henry Thoreau > > > > > > > > > > > > -- > Cate Roman, MFA > Artist > > www.cateroman.com

> > " It's not what you look at that matters, it's what you see. " > Henry Thoreau >

-- Cate Roman, MFAArtistwww.cateroman.com“It's not what you look at that matters, it's what you see.”

                                                                                Henry Thoreau

[Guest guest]

How is he doing now?CE Grim MDOn Mar 16, 2012, at 12:50 PM, cate roman wrote: Dr Grim,I have posted this twice already. Here it is for a third time and I hope you get it this time. Thanks in advance.The details:My husband is a 57 year old, 12-year colon cancer survivor with a permanent ileostomy and a post-cancer Ironman triathlete. Armenian decent. Born in Los Angeles CA. Normal and healthy renal function.Pre-surgery CT scan indicated a 13mm nodule on left adrenal. However, AVS determined high aldosterone levels ONLY on the right adrenal. Docs concluded left adrenal nodule was none functioning as all levels where in the normal range. Laproscopic right adrenalectomy with minor blood loss. Pathology confirmed a microscopic aldostronoma.BP cuff is accurate to +/- 3 points.BP varies less than 5 points between arms.He is currently on no medications, but prior to surgery was taking 5 mg Bystolic per day. He took his final Bystolic the day before surgery and medication was not restarted.While on Bystolic pre-surgery BP range between 150-160/90-100. For two days, immediately post surgery BP was around 120/65.Then it suddenly (within a few hours) went to 160/100. The nurses began to monitor it every two hours where it consistently stayed above 150/90 until discharge later that evening. Surgery was March 7th. He came home on March 9th. We take his BP in the afternoon, resting, left arm, same cuff. Here's are the readings:March 10th 154/95March 11th 148/90March 12th 133/92March 13th 137/87 March 14th 148/91March 15th 143/91Low-salt diet had been observed for 4 months prior. He is a healthy weight.We don't have K values.His pain is now low and he manages it with 400 mg Advil 2 x a day. We saw the surgeon yesterday for first post-op who suggested the fluctuation and high ranges could be influenced by fluid retention from surgery and post-op pain. Would love to hear your thoughts about whether this could be an adjustment period or ?On Fri, Mar 16, 2012 at 8:38 AM, Clarence Grim <lowerbp2@...> wrote: I think I sent a request for more info a day or so ago. Maybe not.Your current team may be clarivoyant but I am not.On Mar 15, 2012, at 3:47 PM, cateroman wrote: My husband is currently experiencing hypertensive BP following adrenalectomy 7 days ago. I am curious to know if other people have experienced post adrenalectomy fluctuations in BP before settling down into the normal range. If so, how long did it take to correct? Thank you, Cate -- Cate Roman, MFAArtistwww.cateroman.com“It's not what you look at that matters, it's what you see.” Henry Thoreau