Re: Re: Effects on Renin after surgery

[Guest guest]

Well- atenolol will lower renin and Aldo tri Na lasix will raise it, and you need a 24 hr urine at the same time to be able to interpret it. If you were my pt I would either stop all meds for 2 weeks and repeat test or add spironolactone to see if BP and your Sx got better and check a spot urine Na and K and cr to see how well u are DASHING. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 3, 2012, at 17:11, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

Guess I should have asked this a bit different. I had an appendectomy and two weeks later had PRA test done. Becides the meds I was on for the PRA ratio test. ATENOLOL25MG TRIAMTERENE50MG POTASSIUM CHLORIDE 20MEQ FUROSEMIDE 60MG TAB. Would this change the outcome of the tests?

Evaluation for RENIN: 1.8 ng/mL/hr

Current Range:

Non-hypertensive adults:

RENIN: (upright/sitting) 0.65-5.0 ng/mL/hr

SERUM ALDOS: 16 ng/dL adult reference range:

Upright 8:00-10:00 am < or = 28 ng/dL

Upright 4:00-6:00 pm < or = 21 ng/dL

Supine 8:00-10:00 am 3-16 ng/dL

I am told the meds wouldn't effect test much by my now PCP.

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> > Do you know of any data that gives affects on Renin long term after

> > surgery? Other then removal of adrenal gland would two weeks give

> > enough to have renin return to pre surgey levels?

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[Guest guest]

If your BP is at goal and you are feeling well then no reason to try spiro I would think. You may have done well with DASH and current meds and not need sprio or eplere. If either of these is a problem then a trial of spiro or eplerenone is appropriate as both are approved for use in high blood pressure of almost any kind.CE Grim MDOn Apr 4, 2012, at 10:42 AM, Francis Bill SUSPECTED PA wrote: The problem is I can not get the VA to retest me. And since they don't think I have PA then no need to treat it. > > > > > > > Do you know of any data that gives affects on Renin long term after > > > > surgery? Other then removal of adrenal gland would two weeks give > > > > enough to have renin return to pre surgey levels? > > > > > > > > > > > > > > > >

[Guest guest]

How about a trip to NIH? Once you get there it is free. C can give you details.CE Grim MDOn Apr 6, 2012, at 3:04 PM, Francis Bill SUSPECTED PA wrote: I am a long way from doing good. B/P and fluid may be better due to less salt still have brain fog all the time. Also shortness of breath is a big problem. I still need to work on DASH. > > > > > > > > > > > Do you know of any data that gives affects on Renin long > > term after > > > > > > surgery? Other then removal of adrenal gland would two weeks > > give > > > > > > enough to have renin return to pre surgey levels? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

With an adrenal bump I am certain they will want to talk to you.May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 15:30, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

I am thinking about doing this. Most likey would have to stop meds so would have to have VA Dr that will do this. When I asked my PCP retesting because how the Meds affect Aldo Renin tests was told he would not stop meds. He then lood at test results that were done and told me meds didn't change meds enough to retest off them.

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[Guest guest]

Well I thought the first thing was an adrenal bump and HTN. ASK specifMay your pressure be low!Calmly who one our group should apply?CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 20:35, <jclark24p@...> wrote:

I can give info on how to apply and he would have to have a doctor willing to refer him and symptoms to justify the protocol he is applying for. "I think I have PA would not work" First he/they would have to show SX, like BP, ARR and other items that indicate he is a fit for what they are currently researching. Asking about a 40 y/o cutoff is not what they are studying, that is a done deal. Is is the result of many studies, done with controls and that is not a medical decision, it is an actuarial decision IMHO. Insurance and government make the final decision unless you can convince them otherwise or want to pay for it yourself, IMHO!

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[Guest guest]

But it is free only if u do not pay taxes ever. Nevertheless excellent opportunity to get detailed evaluation. And contribute to general fund of knowledge. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 20:52, maggiekat7 <ljurkovic@...> wrote:

My suggestion, as per usual, is to RUN, do not pass go, to NIH! They continue to be the best docs ever! And the nursing staff is second to none. The study is now in the "sick" people phase. Sometime, they will close it and only allow "healthy" (non symptomatic people) into the protocol. It won't be there forever, in other words. All anyone needs to do is google NIH search the studies...in the search box, put aldosterone, or hyperaldosteronism or the protocol number that has on his signature....then, fill out the contact info, send an email to Dr. Lyssikatos, he will call you and voila! You will then have the very best evaluation, treatment and care for FREE! No ins., and as a taxpayer, I am very happy to benefit from what I pay in taxes. I know it's not FREE, nothing is, but I mean you pay your transportation and then benefit from the government/tax supported National Institutes of Health research program. You pay nothing out of pocket and

they don't deal with your insurance even if you have it. They even pay for your meds. It's a no brainer folks!

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[Guest guest]

Good echo here. Have been preaching this since BB came out and a Dr. Winer showed this in the 70's as I recall. CE Grim MDOn Apr 7, 2012, at 7:44 AM, Francis Bill SUSPECTED PA wrote: Information from Endocrine Society PA Guidelines Beta-adrenergic blockers atenolol being one may lower both renin and aldo K+-wasting diuretics furosemide being one may or may not raise aldo but may raise renin K+-sparing diuretics triamterene being one may raise both renin and aldo. K status Hypokalemia may lower aldo and may or may not raise renin. Potassium loading may raise aldo and may or may not lower aldo. Yes I use my bi-pap not sure how much good it does. If they look at the many B/P readings from the VA from my many visits to the ED and clinic then would find in high. > > > > > > > > > > > > > > > > > > > Do you know of any data that gives affects on Renin long > > > > > > term after > > > > > > > > > > surgery? Other then removal of adrenal gland would two > > > > weeks > > > > > > give > > > > > > > > > > enough to have renin return to pre surgey levels? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Thats you I think?CE Grim MDOn Apr 7, 2012, at 8:49 AM, Francis Bill SUSPECTED PA wrote: For this one only thing it says is you need the adrenal bump. > > > > > > > > > > > > > > > > > > > Do you know of any data that gives affects on Renin long > > > > > > term after > > > > > > > > > > surgery? Other then removal of adrenal gland would two > > > > weeks > > > > > > give > > > > > > > > > > enough to have renin return to pre surgey levels? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

So is a Beta blocker good or bad for PA? I still didn't understand

the article.

Thanks

On 4/7/2012 12:59 PM, Clarence Grim wrote:

Good echo here. Have been preaching this since BB came

out and a Dr. Winer showed this in the 70's as I recall.

CE Grim MD

On Apr 7, 2012, at 7:44 AM, Francis Bill SUSPECTED

PA wrote:

Information from Endocrine Society PA

Guidelines

Beta-adrenergic blockers atenolol being one may

lower both renin and aldo K+-wasting diuretics

furosemide being one may or may not raise aldo

but may raise renin K+-sparing diuretics

triamterene being one may raise both renin and

aldo. K status Hypokalemia may lower aldo and

may or may not raise renin. Potassium loading

may raise aldo and may or may not lower aldo.

Yes I use my bi-pap not sure how much good it

does. If they look at the many B/P readings from

the VA from my many visits to the ED and clinic

then would find in high.

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> Do you know of any data that gives affects

on Renin long

> > > > > > term after

> > > > > > > > >

> surgery? Other then removal of adrenal

gland would two

> > > > weeks

> > > > > > give

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> enough to have renin return to pre surgey

levels?

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[Guest guest]

It does not work well and will interfere with testing. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 8, 2012, at 7:42, Phyllis <phylisrn@...> wrote:

So is a Beta blocker good or bad for PA? I still didn't understand

the article.

Thanks

On 4/7/2012 12:59 PM, Clarence Grim wrote:

Good echo here. Have been preaching this since BB came

out and a Dr. Winer showed this in the 70's as I recall.

CE Grim MD

On Apr 7, 2012, at 7:44 AM, Francis Bill SUSPECTED

PA wrote:

Information from Endocrine Society PA

Guidelines

Beta-adrenergic blockers atenolol being one may

lower both renin and aldo K+-wasting diuretics

furosemide being one may or may not raise aldo

but may raise renin K+-sparing diuretics

triamterene being one may raise both renin and

aldo. K status Hypokalemia may lower aldo and

may or may not raise renin. Potassium loading

may raise aldo and may or may not lower aldo.

Yes I use my bi-pap not sure how much good it

does. If they look at the many B/P readings from

the VA from my many visits to the ED and clinic

then would find in high.

> > > > > > > > >

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> Do you know of any data that gives affects

on Renin long

> > > > > > term after

> > > > > > > > >

> surgery? Other then removal of adrenal

gland would two

> > > > weeks

> > > > > > give

> > > > > > > > >

> enough to have renin return to pre surgey

levels?

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[Guest guest]

Some will wheeze with BB. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 8, 2012, at 8:49, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

Depends on why you are taking them. Will not do much for B/P. Can help with heart rate and may help with breathing problems. Some Data shows it can help reduce stress.

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> >> would two

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[Guest guest]

Francis, does anyone give you a reason for your shortness of breath and brain fog? You have to keep bringing it up. Have you been tested for Babesiosis? Even blood banks are now asking about that before accepting blood donations. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PAI am a long way from doing good. B/P and fluid may be better due to less salt still have brain fog all the time. Also shortness of breath is a big problem. I still need to work on DASH. >> If your BP is at goal and you are feeling well then no reason to try > spiro I would think. You may have done well with DASH and current meds > and not need sprio or eplere.> > If either of these is a problem then a trial of spiro or eplerenone is > appropriate as both are approved for use in high blood pressure of > almost any kind..

[Guest guest]

Francis, you are not assertive enough about your own health. Go back every week and complain. Have you been tested for Babesiosis? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PAAll I have been told about the brain fog is they have no idea what is causing it. I am told shortness of breath is due to deconditioning. after working with PT for over a month was told they thought it was something other then deconditioning But seems Dr don't believe PT. > >> > If your BP is at goal and you are feeling well then no reason to try > > spiro I would think. You may have done well with DASH and current meds > > and not need sprio or eplere.> > > > If either of these is a problem then a trial of spiro or eplerenone is > > appropriate as both are approved for use in high blood pressure of > > almost any kind..

[Guest guest]

Francis, Please call NIH. Didn't Dr. Grim volunteer to contact your medical

team? You deserve better treatment! Kindest regards, Lucy

Please forgive brevity & typos

Sent from my droid

Valarie <val@...> wrote:

>Francis, you are not assertive enough about your own health. Go back every

>week and complain. Have you been tested for Babesiosis?

>

>Val

>

>From: hyperaldosteronism

>[mailto:hyperaldosteronism ] On Behalf Of Francis Bill

>SUSPECTED PA

>

>

>All I have been told about the brain fog is they have no idea what is

>causing it. I am told shortness of breath is due to deconditioning. after

>working with PT for over a month was told they thought it was something

>other then deconditioning But seems Dr don't believe PT.

>

>

>> >

>> > If your BP is at goal and you are feeling well then no reason to try

>> > spiro I would think. You may have done well with DASH and current meds

>> > and not need sprio or eplere.

>> >

>> > If either of these is a problem then a trial of spiro or eplerenone is

>> > appropriate as both are approved for use in high blood pressure of

>> > almost any kind.

>

>

>.

> Web Bug from

>http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=

>42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950

><http://www.mailscanner.tv/1x1spacer.gif>

>

[Guest guest]

Ah note subclincal AKA Grim stage 1 and 2. Note-I was one of the first to suggest low renin essential HTN WAS AN early stage of PA. Dr Conn labeled this the "Grim Hypothesis". Might want to show the NIH team my evolution article for them as it was in a J not often read by Endos. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 10, 2012, at 18:16, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

Study 1 of 1 for search of: 00-CH-0160

Study of Adrenal Gland Tumors

This study is currently recruiting participants.

Verified September 2011 by National Institutes of Health Clinical Center (CC)

First Received on June 28, 2000. Last Updated on March 20, 2012 History of Changes

Sponsor: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Information provided by: National Institutes of Health Clinical Center (CC)

ClinicalTrials.gov Identifier: NCT00005927

Criteria

•INCLUSION CRITERIA:

Patients are adults or children with evidence for the existence of a tumor of the adrenal glands, as indicated by previously obtained imaging studies and/or biochemical investigation of hormonal secretion. This condition is meant to include the possibility of individuals with subclinical hormone secretion syndromes, which may be detectable at the biochemical level even in the absence of frank clinical signs/symptoms.

All eligible patients are invited to participate in this protocol, regardless of sex, race or ethnic origin. All populations appear at risk for adrenal tumors, and therefore the subject population can include Native Americans, Asian/Pacific Islanders, Caucasian, Hispanic, and Black individuals. Patients will be accepted for evaluation based on referral from clinicians, or may be self-referred, if they can provide evidence supportive of the diagnosis of hormone oversecretion. Patients must be willing to return to the NIH for follow-up evaluation.

> > >> >

> > >> > If your BP is at goal and you are feeling well then no reason to try

> > >> > spiro I would think. You may have done well with DASH and current meds

> > >> > and not need sprio or eplere.

> > >> >

> > >> > If either of these is a problem then a trial of spiro or eplerenone is

> > >> > appropriate as both are approved for use in high blood pressure of

> > >> > almost any kind.

> > >

> > >

> > >.

> > > Web Bug from

> > >http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=

> > >42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950

> > ><http://www.mailscanner.tv/1x1spacer.gif>

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[Guest guest]

Keep us posted after their meeting. And give us all the numbers which you must have lots of and their normal ranges for guys your age and ethnicity and weight if they have many normals they have studied in your age, gender, ethnicity and BMI group.Keep up the good work and reporting.CE Grim MD On Apr 10, 2012, at 9:07 PM, wrote: You are baiting me and even as punchy as I am I'm not falling. Look forward, maybe just over the horizon and tell me what you see! IMHO they are not looking for any old tumor, in fact my tumor was not what brought me here. It was something else. With that said, I encourage you to check if you are so inclined, It is certainly not my place to answer. > > > > >> > > > > > >> > If your BP is at goal and you are feeling well then no reason to try > > > > >> > spiro I would think. You may have done well with DASH and current meds > > > > >> > and not need sprio or eplere. > > > > >> > > > > > >> > If either of these is a problem then a trial of spiro or eplerenone is > > > > >> > appropriate as both are approved for use in high blood pressure of > > > > >> > almost any kind. > > > > > > > > > > > > > > >. > > > > > Web Bug from > > > > >http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > > > >42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950 > > > > ><http://www.mailscanner.tv/1x1spacer.gif> > > > > > > > > > > > > > > > > >

[Guest guest]

yes I need to add this to our welcome.Seems like most here would be candidates.CE Grim MDOn Apr 10, 2012, at 9:46 PM, Francis Bill SUSPECTED PA wrote: You can check this out by this link. http://www.clinicaltrials.gov/ct2/show/NCT00005927?term=00-CH-0160 & rank=1 > > > > > >> > > > > > > >> > If your BP is at goal and you are feeling well then no reason to try > > > > > >> > spiro I would think. You may have done well with DASH and current meds > > > > > >> > and not need sprio or eplere. > > > > > >> > > > > > > >> > If either of these is a problem then a trial of spiro or eplerenone is > > > > > >> > appropriate as both are approved for use in high blood pressure of > > > > > >> > almost any kind. > > > > > > > > > > > > > > > > > >. > > > > > > Web Bug from > > > > > >http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > > > > >42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950 > > > > > ><http://www.mailscanner.tv/1x1spacer.gif> > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Well the VA at UC DAVIS reported that PA IS very common in Vets who need 3 or more drugs for HTN. Maybe the vets are different in the EAST but suspect not.May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 11, 2012, at 10:28, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

I do believe Dr Grim has said he would contact my team. My last PCP didn't seem to have any interest in this. Since my new one seem to thing nothing he is seeing indicates PA then not likely to get very far with him. In fact other then s Dr would be hard to find any other Dr at this VA that thinks PA is some they will never see.

What is needed is to have someone like Dr Grim come to the VA and teach VA care providers that PA is real and very common. I belive Dr Grim has tried to do this but since he would like to be paid for his time as he should. He hasn't done it.

My thoughts are What ever Dr Grim would charge to do this would save the VA much more then then they would pay him.

> >> >

> >> > If your BP is at goal and you are feeling well then no reason to try

> >> > spiro I would think. You may have done well with DASH and current meds

> >> > and not need sprio or eplere.

> >> >

> >> > If either of these is a problem then a trial of spiro or eplerenone is

> >> > appropriate as both are approved for use in high blood pressure of

> >> > almost any kind.

> >

> >

> >.

> > Web Bug from

> >http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=

> >42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950

> ><http://www.mailscanner.tv/1x1spacer.gif>

> >

>

[Guest guest]

As I suspect you're getting at it is in anyone on 3 or more meds for resistant HTN. At least we have the VA to get some research done.

I do believe Dr Grim has said he would contact my team. My last PCP didn't seem to have any interest in this. Since my new one seem to thing nothing he is seeing indicates PA then not likely to get very far with him. In fact other then s Dr would be hard to find any other Dr at this VA that thinks PA is some they will never see. What is needed is to have someone like Dr Grim come to the VA and teach VA care providers that PA is real and very common. I belive Dr Grim has tried to do this but since he would like to be paid for his time as he should. He hasn't done it. My thoughts are What ever Dr Grim would charge to do this would save the VA much more then then they would pay him. > >> >> >> > If your BP is at goal and you are feeling well then no reason to try > >> > spiro I would think. You may have done well with DASH and current meds > >> > and not need sprio or eplere.> >> > >

>> > If either of these is a problem then a trial of spiro or eplerenone is > >> > appropriate as both are approved for use in high blood pressure of > >> > almost any kind.> >> >> >.> > Web Bug from> >http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=> >42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950> ><http://www.mailscanner.tv/1x1spacer.gif> > >>

[Guest guest]

Francis, Isn't it left to NIH to decide if you have PA? All you should have to do is tell your doc you want to go through their research study. Your doc ought to be doing what YOU want. Trying to change the VA by bringing in Dr. Grim isn't going to do any good for those who come along later. Trying to change a public school is hard enough; trying to change a major government agency is … well … Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PA I do believe Dr Grim has said he would contact my team. My last PCP didn't seem to have any interest in this. Since my new one seem to thing nothing he is seeing indicates PA then not likely to get very far with him. In fact other then s Dr would be hard to find any other Dr at this VA that thinks PA is some they will never see. What is needed is to have someone like Dr Grim come to the VA and teach VA care providers that PA is real and very common. I belive Dr Grim has tried to do this but since he would like to be paid for his time as he should. He hasn't done it. My thoughts are What ever Dr Grim would charge to do this would save the VA much more then then they would pay him. > >> >> >> > If your BP is at goal and you are feeling well then no reason to try > >> > spiro I would think. You may have done well with DASH and current meds > >> > and not need sprio or eplere.> >> > > >> > If either of these is a problem then a trial of spiro or eplerenone is > >> > appropriate as both are approved for use in high blood pressure of > >> > almost any kind.> >> >> >.> > Web Bug from> >http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=> >42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950> ><http://www.mailscanner.tv/1x1spacer.gif> > >>

[Guest guest]

Yes I think you should just tell your VA team you want to volunteer for this project which is studying all adrenal bumps. They should be excited that they will learn in great detail if the bump is or is not having anything to do with your health.Can you communicate with the VA thru healthyevet yet? If so send your team a note giving them the info on the NIH web site etc.CE Grim MD Francis, Trying to change the VA by bringing in Dr. Grim isn't going to do any good for those who come along later. Trying to change a public school is hard enough; trying to change a major government agency is … well … Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PA I do believe Dr Grim has said he would contact my team. My last PCP didn't seem to have any interest in this. Since my new one seem to thing nothing he is seeing indicates PA then not likely to get very far with him. In fact other then s Dr would be hard to find any other Dr at this VA that thinks PA is some they will never see. What is needed is to have someone like Dr Grim come to the VA and teach VA care providers that PA is real and very common. I belive Dr Grim has tried to do this but since he would like to be paid for his time as he should. He hasn't done it. My thoughts tare What ever Dr Grim would charge to do this would save the VA much more then then they would pay him. > >> >> >> > If your BP is at goal and you are feeling well then no reason to try > >> > spiro I would think. You may have done well with DASH and current meds > >> > and not need sprio or eplere.> >> > > >> > If either of these is a problem then a trial of spiro or eplerenone is > >> > appropriate as both are approved for use in high blood pressure of > >> > almost any kind.> >> >> >.> > Web Bug from> >http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=> >42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950> ><http://www.mailscanner.tv/1x1spacer.gif> > >>

[Guest guest]

Again I would contact your team and tell them you want to do this. See what they say. If they say no we can explore further.CE Grim MDOn Apr 12, 2012, at 7:49 AM, georgewbill wrote: The problem is DR has to be on board to some extent. I would have to stop meds. Dr grim says this should only be done by Dr. > > >> > > > >> > If your BP is at goal and you are feeling well then no reason to try > > >> > spiro I would think. You may have done well with DASH and current > meds > > >> > and not need sprio or eplere. > > >> > > > >> > If either of these is a problem then a trial of spiro or eplerenone > is > > >> > appropriate as both are approved for use in high blood pressure of > > >> > almost any kind. > > > > > > > > >. > > > Web Bug from > > > >http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId > = > > >42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950 > > ><http://www.mailscanner.tv/1x1spacer.gif> > > > > > >

[Guest guest]

Francis sound like you have some type of bacterial or fungal

infection.

Phyllis

On 4/12/2012 1:40 AM, Valarie wrote:

Francis,

Isn't it left

to NIH to decide if you have PA? All you should have

to do is tell your doc you want to go through their

research study. Your doc ought to be doing what YOU

want.

Trying to

change the VA by bringing in Dr. Grim isn't going to

do any good for those who come along later. Trying to

change a public school is hard enough; trying to

change a major government agency is … well …

Val

From:

hyperaldosteronism

[mailto:hyperaldosteronism ] On

Behalf Of Francis Bill SUSPECTED PA

I do believe Dr Grim has said he would contact my

team. My last PCP didn't seem to have any interest

in this. Since my new one seem to thing nothing he

is seeing indicates PA then not likely to get very

far with him. In fact other then s Dr would be

hard to find any other Dr at this VA that thinks

PA is some they will never see.

What is needed is to have someone like Dr Grim

come to the VA and teach VA care providers that PA

is real and very common. I belive Dr Grim has

tried to do this but since he would like to be

paid for his time as he should. He hasn't done it.

My thoughts are What ever Dr Grim would charge to

do this would save the VA much more then then they

would pay him.

> >> >

> >> > If your BP is at goal and you

are feeling well then no reason to try

> >> > spiro I would think. You may

have done well with DASH and current meds

> >> > and not need sprio or eplere.

> >> >

> >> > If either of these is a problem

then a trial of spiro or eplerenone is

> >> > appropriate as both are

approved for use in high blood pressure of

> >> > almost any kind.

> >

> >

> >.

> > Web Bug from

> >http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=

>

>42201/stime=1333976864/nc1=3848643/nc2=5191951/nc3=5191950

> ><http://www.mailscanner.tv/1x1spacer.gif>

> >

>