Where did all the K Go! (So close and yet so far!)

March 21, 2012

I did little detective work and think I have a handle on my K issues (lab range

= 3.5-5.0). When I started (8/3/05) it was 3.9 and two other readings before

7/12/06 were 3.8 and 3.7. Two weeks later, 7/12/06, it was 3.3! They must have

decided something was amiss because they took two more readings before adding K

supplements on 11/17/06, both readings = 3.2.

The lead doctor for that team got involved on 8/7/06 and ordered a 24hr urine

test for Cortisol Free, results = 35.5 (range 4.0-50.0) Guess I passed! Hmmm

wait minute, volume was 1950. Didn't I hear over 1500 was suspect for

something? PA maybe? Never mind, his Cortisol was ok!

I must have still complained because they " fixed the problem " in November by

adding the K supplements. Wait a minute, maybe that didn't fix it - PTN is back

on 2/7/07 and K = 3.5. 2 week recall it =3.6. I don't recognize the doctor,

she was probably in immediate care, but she ordered renin and aldo. Results,

renin=0.1 and aldo = 5 and a ct-scan showed a 12mmX13mm adenoma in the right

adrenal. With aldo in range she must have assumed the rest could be ignored

because that is exactly what happened for the next 3 ½ years!

Wait a minute , look at that lab report again. What does " Low-renin

sodium/volume-mediated hypertension likely: <0.65 " and " Primary aldosteronsim

possible: <0.65 " mean? Maybe they went over that the day I went skiing! What

is this PA crap, that's Conn's isn't it? It's so rare, what are the odds that I

would catch a case in my first year out of school? Guess I can just ignore it!

Well Cogbill, the odds of you hitting one was 100%. The odds of you

identifying it was 0%. The odds of me being in pain for an additional 4 years

and never being able to return to work was 100%. Yes, I ended up with LVH and

required oxygen for 1 ½ years. Yes, OSA worsened. Yes, I ended up with T2DM

and COPD. Suggest you review current info on PA and find it affects ~10% of the

people with HTN! (God, I wish I knew where she is today just to give her the

final chapter. She got closer than anyone else!) Never mind, I do know where

the supervising doctor is and maybe I will point this out to him, no reason to

waste good research!

Aren't complete electronic medical records great. Sure is easy to be a " Monday

Morning Quarterback " ! That is not my goal but I do hope to show them how close

they were and maybe they will take that last step next time! We sometimes need

to " think outside the box " !

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