Re: Going to the endo tomorrow for follow up and had have a quick question

[Guest guest]

If your home BP is less than 135/85 on your current RX(which is?) and you feel normal and do not get up at night and your ARR was done on no meds and a 24h urine for Na K and creatinine was available to interpret the ARR WAS done the. You are OK. And I would recommend u DASH. however without your complete story we and I suspect your ENDO. have hands tied behind back. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 4, 2012, at 22:01, danielle_cairns <danielle_cairns@...> wrote:

Dear All,

Hi - I am going for a follow up appt. tomorrow with my endo to discuss next steps for treatment/surgery. The problem is, she seems to minimize my illness because I have normal BP and K levels. My aldosterone (121) and ARR (51.2) are high and they think it is due to a unilateral adrenal adenoma I have had for the past 5 years. Should I push the Dr. to be more concerned or is she right to have a laid back attitude since I do not have the 2 major symptoms? Any thoughts/encouragement would really help.

Thanks,

le

[Guest guest]

Hi Dr.,

First to answer your questions, my BP today at the Dr office was normal

(92/65)and I am on no meds at this time. I do however get up at night to urinate

1-3 times a night. The doc has not ordered a urine Na or K test (I assume bc my

blood levels are normal) for me although she did order the creatinine today. A

CT scan did confirm that I have a right adrenal mass (I have known about the

mass for 5 years):

" The right adrenal gland is prominent. Measures 2.25 cm in greatest oblique

transverse diameter and 1.05 in greatest oblique anterior-posterior dimension

with a central area of low density. The appearance of the right adrenal is the

same on both the venous phase and arterial phase images. Finding: small right

adrenal mass "

The endo said that she feels there are others better suited to handle my case

and is referring me to someone at USC as I am located in Los Angeles. I am a

medical science writer and have connections there so I believe I will be in good

hands.Does anyone have any tips/thoughts? Many physicians I work with seem to

think them will just remove the gland due to my age? What do you think? Please

let me know.

Thanks!!

le

>

> > Dear All,

> >

> > Hi - I am going for a follow up appt. tomorrow with my endo to discuss next

steps for treatment/surgery. The problem is, she seems to minimize my illness

because I have normal BP and K levels. My aldosterone (121) and ARR (51.2) are

high and they think it is due to a unilateral adrenal adenoma I have had for the

past 5 years. Should I push the Dr. to be more concerned or is she right to have

a laid back attitude since I do not have the 2 major symptoms? Any

thoughts/encouragement would really help.

> >

> > Thanks,

> > le

> >

> >

>

[Guest guest]

Were you taking any meds or herbs when Aldo Renin test were done?

If my math is right based on ARR your renin was 2.36. This would seem high if

aldo is 121. But would need to know sodium intake to know affect on renin.

I would ask what changes based on age 40. Is there good data to show if you are

less then 40 you are only going have excess Aldo on one side. Once you are over

40 you now can have chance that both sides make to much Aldo

> >

> > > Dear All,

> > >

> > > Hi - I am going for a follow up appt. tomorrow with my endo to discuss

next steps for treatment/surgery. The problem is, she seems to minimize my

illness because I have normal BP and K levels. My aldosterone (121) and ARR

(51.2) are high and they think it is due to a unilateral adrenal adenoma I have

had for the past 5 years. Should I push the Dr. to be more concerned or is she

right to have a laid back attitude since I do not have the 2 major symptoms? Any

thoughts/encouragement would really help.

> > >

> > > Thanks,

> > > le

> > >

> > >

> >

>

[Guest guest]

So my approach is that if BP and Ks are normal and you are are feeling well then not to worry about the adrenal bump.However if you are DASHing to keep BP to goal etc then the purpose of the spot urine check is to see how well you are DASHing. Blood electrolytes tell very little about what you are eating.If you are DASHing then your urine Na/K should be less than 1, Urine Na less tha 1500 mg a day and K greater than 4700 a day.What other meds are you on and tell us anything else you take OTC.Why does Dr. think you get up at night to pee 3 x. CE Grim MDOn Apr 6, 2012, at 9:08 AM, Francis Bill SUSPECTED PA wrote: Were you taking any meds or herbs when Aldo Renin test were done? If my math is right based on ARR your renin was 2.36. This would seem high if aldo is 121. But would need to know sodium intake to know affect on renin. I would ask what changes based on age 40. Is there good data to show if you are less then 40 you are only going have excess Aldo on one side. Once you are over 40 you now can have chance that both sides make to much Aldo > > > > > Dear All, > > > > > > Hi - I am going for a follow up appt. tomorrow with my endo to discuss next steps for treatment/surgery. The problem is, she seems to minimize my illness because I have normal BP and K levels. My aldosterone (121) and ARR (51.2) are high and they think it is due to a unilateral adrenal adenoma I have had for the past 5 years. Should I push the Dr. to be more concerned or is she right to have a laid back attitude since I do not have the 2 major symptoms? Any thoughts/encouragement would really help. > > > > > > Thanks, > > > le > > > > > > > > >

[Guest guest]

There are several here who live in LA and have had good results. USC or UCLA would both be good. Most recent experience is UCLA as I recall.CE Grim MDOn Apr 6, 2012, at 12:35 AM, danielle_cairns wrote: Hi Dr., First to answer your questions, my BP today at the Dr office was normal (92/65)and I am on no meds at this time. I do however get up at night to urinate 1-3 times a night. The doc has not ordered a urine Na or K test (I assume bc my blood levels are normal) for me although she did order the creatinine today. A CT scan did confirm that I have a right adrenal mass (I have known about the mass for 5 years): "The right adrenal gland is prominent. Measures 2.25 cm in greatest oblique transverse diameter and 1.05 in greatest oblique anterior-posterior dimension with a central area of low density. The appearance of the right adrenal is the same on both the venous phase and arterial phase images. Finding: small right adrenal mass" The endo said that she feels there are others better suited to handle my case and is referring me to someone at USC as I am located in Los Angeles. I am a medical science writer and have connections there so I believe I will be in good hands.Does anyone have any tips/thoughts? Many physicians I work with seem to think them will just remove the gland due to my age? What do you think? Please let me know. Thanks!! le > > > Dear All, > > > > Hi - I am going for a follow up appt. tomorrow with my endo to discuss next steps for treatment/surgery. The problem is, she seems to minimize my illness because I have normal BP and K levels. My aldosterone (121) and ARR (51.2) are high and they think it is due to a unilateral adrenal adenoma I have had for the past 5 years. Should I push the Dr. to be more concerned or is she right to have a laid back attitude since I do not have the 2 major symptoms? Any thoughts/encouragement would really help. > > > > Thanks, > > le > > > > >

[Guest guest]

At the time of test, I was taking:

Depakote: 1000mg/day

Lexapro: 30 mg/day

Loryna:(birth control): 1 pill/day

Valium (5mg) as need for flying (I travel for work)

BTW, your math is right. I don't measure my sodium intake but if I had to guess

it's high because I have craved salt for years. I am not sure about the whole

" age 40 " thing -I am new to the board and have just heard the idea tossed

around. I am open to suggestions, thoughts, etc.

> > >

> > > > Dear All,

> > > >

> > > > Hi - I am going for a follow up appt. tomorrow with my endo to discuss

next steps for treatment/surgery. The problem is, she seems to minimize my

illness because I have normal BP and K levels. My aldosterone (121) and ARR

(51.2) are high and they think it is due to a unilateral adrenal adenoma I have

had for the past 5 years. Should I push the Dr. to be more concerned or is she

right to have a laid back attitude since I do not have the 2 major symptoms? Any

thoughts/encouragement would really help.

> > > >

> > > > Thanks,

> > > > le

> > > >

> > > >

> > >

> >

>

[Guest guest]

BCPS affect renin and aldo and BP May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 13:35, danielle_cairns <danielle_cairns@...> wrote:

At the time of test, I was taking:

Depakote: 1000mg/day

Lexapro: 30 mg/day

Loryna:(birth control): 1 pill/day

Valium (5mg) as need for flying (I travel for work)

BTW, your math is right. I don't measure my sodium intake but if I had to guess it's high because I have craved salt for years. I am not sure about the whole "age 40" thing -I am new to the board and have just heard the idea tossed around. I am open to suggestions, thoughts, etc.

> > >

> > > > Dear All,

> > > >

> > > > Hi - I am going for a follow up appt. tomorrow with my endo to discuss next steps for treatment/surgery. The problem is, she seems to minimize my illness because I have normal BP and K levels. My aldosterone (121) and ARR (51.2) are high and they think it is due to a unilateral adrenal adenoma I have had for the past 5 years. Should I push the Dr. to be more concerned or is she right to have a laid back attitude since I do not have the 2 major symptoms? Any thoughts/encouragement would really help.

> > > >

> > > > Thanks,

> > > > le

> > > >

> > > >

> > >

> >

>

[Guest guest]

Thanks for responding. The problem is that I don't feel well. I went to the Dr.

for extreme fatigue and rapid weight gain and Blood sugar probs. My thyroid is

normal and she thinks the blood sugar is a separate issue. I am not DASHing bc

my BP is normal as is (92/65. They don't know why I urinate so much at night. I

have not had urine NA, K or aldo tests done. My fear is that " not worrying "

about my tumor has led me to this point (it has grown and they suspect it is

functional since the time of diagnosis 5 years ago). I am only 33 and I don't

want to have serious problems down the line - isn't better just to deal with

this head on? Please let me know your thoughts.

Thanks-D

> > > >

> > > > > Dear All,

> > > > >

> > > > > Hi - I am going for a follow up appt. tomorrow with my endo to

> > discuss next steps for treatment/surgery. The problem is, she seems

> > to minimize my illness because I have normal BP and K levels. My

> > aldosterone (121) and ARR (51.2) are high and they think it is due

> > to a unilateral adrenal adenoma I have had for the past 5 years.

> > Should I push the Dr. to be more concerned or is she right to have a

> > laid back attitude since I do not have the 2 major symptoms? Any

> > thoughts/encouragement would really help.

> > > > >

> > > > > Thanks,

> > > > > le

> > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

There is variation between machines so better to have size estimates done on same machine and read by same team. Bp same in both arms? May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 13:40, danielle_cairns <danielle_cairns@...> wrote:

Thanks for responding. The problem is that I don't feel well. I went to the Dr. for extreme fatigue and rapid weight gain and Blood sugar probs. My thyroid is normal and she thinks the blood sugar is a separate issue. I am not DASHing bc my BP is normal as is (92/65. They don't know why I urinate so much at night. I have not had urine NA, K or aldo tests done. My fear is that "not worrying" about my tumor has led me to this point (it has grown and they suspect it is functional since the time of diagnosis 5 years ago). I am only 33 and I don't want to have serious problems down the line - isn't better just to deal with this head on? Please let me know your thoughts.

Thanks-D

> > > >

> > > > > Dear All,

> > > > >

> > > > > Hi - I am going for a follow up appt. tomorrow with my endo to

> > discuss next steps for treatment/surgery. The problem is, she seems

> > to minimize my illness because I have normal BP and K levels. My

> > aldosterone (121) and ARR (51.2) are high and they think it is due

> > to a unilateral adrenal adenoma I have had for the past 5 years.

> > Should I push the Dr. to be more concerned or is she right to have a

> > laid back attitude since I do not have the 2 major symptoms? Any

> > thoughts/encouragement would really help.

> > > > >

> > > > > Thanks,

> > > > > le

> > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Pretty sure this has already been addressed, but Loryna is a generic for Yaz,

which uses a progestin called drospirenone - which is a mineralcorticoid

blocker. Any test results for PA while on this med will not likely be accurate.

> > > >

> > > > > Dear All,

> > > > >

> > > > > Hi - I am going for a follow up appt. tomorrow with my endo to discuss

next steps for treatment/surgery. The problem is, she seems to minimize my

illness because I have normal BP and K levels. My aldosterone (121) and ARR

(51.2) are high and they think it is due to a unilateral adrenal adenoma I have

had for the past 5 years. Should I push the Dr. to be more concerned or is she

right to have a laid back attitude since I do not have the 2 major symptoms? Any

thoughts/encouragement would really help.

> > > > >

> > > > > Thanks,

> > > > > le

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

The blood sugar may not be a separate issue - until my tumor was removed I had

blood sugar problems (insulin resistance and borderline diabetic). The tumor is

gone now and these problems are gone as well, in addition to the rapid weight

gain that they caused. Sorry if this has been said before but I feel it just

can't be emphasized enough - PA is more than just HTN and low K!

> > > > >

> > > > > > Dear All,

> > > > > >

> > > > > > Hi - I am going for a follow up appt. tomorrow with my endo to

> > > discuss next steps for treatment/surgery. The problem is, she seems

> > > to minimize my illness because I have normal BP and K levels. My

> > > aldosterone (121) and ARR (51.2) are high and they think it is due

> > > to a unilateral adrenal adenoma I have had for the past 5 years.

> > > Should I push the Dr. to be more concerned or is she right to have a

> > > laid back attitude since I do not have the 2 major symptoms? Any

> > > thoughts/encouragement would really help.

> > > > > >

> > > > > > Thanks,

> > > > > > le

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

You betcha and I am off 2000mg of metformin/day and BS is usually in valid range

(I have had insulin a couple of days becausethe protocol requires strictor

controls than my doctor. Test is done before meals and at bedtime. I have seen

numbers as low as 90 and as high as 157 and I shoot for 140 or less at home.

(Remember I am post 3+ months from Spiro so I should be full blown PA and also

remember I doubled metformin when my PA was resolved by spironolactone)

What is the timeline that it has grown? And was it done at the same place on

the same equipment? Mine hasn't grown from 2005 to 2007 according to the first

report but appears irrelevent because it is still small enough to ignore if

nonfunctioning (it isn't)! The more important point is just what is going on

and there is a lot of good information sometimes if done on good equipment and

there is good clarity and the person reading it knows what s/he is doing, IMHO.

> > > > > >

> > > > > > > Dear All,

> > > > > > >

> > > > > > > Hi - I am going for a follow up appt. tomorrow with my endo to

> > > > discuss next steps for treatment/surgery. The problem is, she seems

> > > > to minimize my illness because I have normal BP and K levels. My

> > > > aldosterone (121) and ARR (51.2) are high and they think it is due

> > > > to a unilateral adrenal adenoma I have had for the past 5 years.

> > > > Should I push the Dr. to be more concerned or is she right to have a

> > > > laid back attitude since I do not have the 2 major symptoms? Any

> > > > thoughts/encouragement would really help.

> > > > > > >

> > > > > > > Thanks,

> > > > > > > le

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

>