Re: Saline suppression scheduled

[Guest guest]

With that high of a blood pressure we're just one weak blood vessel away from having no blood pressure!

We'll pray that all goes well for you.

-- On Sun, 6/24/12, catherinekerth1 <catherinekerth@...> wrote:

From: catherinekerth1 <catherinekerth@...>Subject: Saline suppression scheduledhyperaldosteronism Date: Sunday, June 24, 2012, 2:12 PM

Very anxious about my saline suppression on Wednesday!After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.It will be nice to have BP in the "not so scary" range. Cross fingers. 38Aldo 30 (?-28) highRatio 78.9 (.9-28.9) highrenin. 38 (.25-5.89) low normalCT Scan normalsaline suppression 6/27/12

[Guest guest]

With that high of a blood pressure we're just one weak blood vessel away from having no blood pressure!

We'll pray that all goes well for you.

-- On Sun, 6/24/12, catherinekerth1 <catherinekerth@...> wrote:

From: catherinekerth1 <catherinekerth@...>Subject: Saline suppression scheduledhyperaldosteronism Date: Sunday, June 24, 2012, 2:12 PM

Very anxious about my saline suppression on Wednesday!After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.It will be nice to have BP in the "not so scary" range. Cross fingers. 38Aldo 30 (?-28) highRatio 78.9 (.9-28.9) highrenin. 38 (.25-5.89) low normalCT Scan normalsaline suppression 6/27/12

[Guest guest]

of course is right and no doctor should risk your health like this. There

are drugs that can be used during testing. It's late for you but you should

inform him so he will know for the next case. Here is the table:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057029/table/tab4/

and I lifted it from here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057029/pdf/IJHT2011-624691.pdf

You will be doing him a favor!

Let us know, we'll be watching for your results!

>

>

> From: catherinekerth1 <catherinekerth@...>

> Subject: Saline suppression scheduled

> hyperaldosteronism

> Date: Sunday, June 24, 2012, 2:12 PM

>

>

>

>  

>

>

>

> Very anxious about my saline suppression on Wednesday!

> After CT scans. MRI's. Lots of blood tests.... I am confident this is the end

of my PA journey. Phew! After saline suppression confirms PA he will put me on

Spiro and hopefully I will respond to it.

> I am not sure how many patients my nephrologist has like me b/c he arranged

and called me himself about my suppression test.

> Just got back from vacation and my BP was 195/113 the entire trip! I was very

bloated too.

> It will be nice to have BP in the " not so scary " range. Cross fingers.

>

>

> 38

> Aldo 30 (?-28) high

> Ratio 78.9 (.9-28.9) high

> renin. 38 (.25-5.89) low normal

> CT Scan normal

> saline suppression 6/27/12

>

[Guest guest]

And DASH I trust. Like you life depended on it. Have them record how much urine u pass during the saline infusion. The grim pee part of the saline test. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 24, 2012, at 12:12, catherinekerth1 <catherinekerth@...> wrote:

Very anxious about my saline suppression on Wednesday!

After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.

I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.

Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.

It will be nice to have BP in the "not so scary" range. Cross fingers.

38

Aldo 30 (?-28) high

Ratio 78.9 (.9-28.9) high

renin. 38 (.25-5.89) low normal

CT Scan normal

saline suppression 6/27/12

[Guest guest]

Hi and john.Yes. This concerned my husband a great deal on the trip. Now that I am back home I am back down to 155/101 at worst. 139/89 at best. This is the 3rd Med I have been on in 9 weeks.And it worked great as all the others the first few weeks but now its creeping back up.The vacation was a little stressful. But really fun :)We no strokes!Just gotta hang on a little longer.38To: hyperaldosteronism From: jclark24p@...Date: Sun, 24 Jun 2012 23:45:48 +0000Subject: Re: Saline suppression scheduled

of course is right and no doctor should risk your health like this. There are drugs that can be used during testing. It's late for you but you should inform him so he will know for the next case. Here is the table: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057029/table/tab4/

and I lifted it from here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057029/pdf/IJHT2011-624691.pdf

You will be doing him a favor!

Let us know, we'll be watching for your results!

--- In hyperaldosteronism , Bingham <jlkbbk2003@...> wrote:

>

>

>

> With that high of a blood pressure we're just one weak blood vessel away from having no blood pressure!

> Â

> We'll pray that all goes well for you.

> Â

> -- On Sun, 6/24/12, catherinekerth1 <catherinekerth@...> wrote:

>

>

> From: catherinekerth1 <catherinekerth@...>

> Subject: Saline suppression scheduled

> To: hyperaldosteronism

> Date: Sunday, June 24, 2012, 2:12 PM

>

>

>

> Â

>

>

>

> Very anxious about my saline suppression on Wednesday!

> After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.

> I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.

> Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.

> It will be nice to have BP in the " not so scary " range. Cross fingers.

>

>

> 38

> Aldo 30 (?-28) high

> Ratio 78.9 (.9-28.9) high

> renin. 38 (.25-5.89) low normal

> CT Scan normal

> saline suppression 6/27/12

>

[Guest guest]

We call it the Berry Aneurysm tolerance test. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 24, 2012, at 14:47, Bingham <jlkbbk2003@...> wrote:

With that high of a blood pressure we're just one weak blood vessel away from having no blood pressure!

We'll pray that all goes well for you.

-- On Sun, 6/24/12, catherinekerth1 <catherinekerth@...> wrote:

From: catherinekerth1 <catherinekerth@...>Subject: Saline suppression scheduledhyperaldosteronism Date: Sunday, June 24, 2012, 2:12 PM

Very anxious about my saline suppression on Wednesday!After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.It will be nice to have BP in the "not so scary" range. Cross fingers. 38Aldo 30 (?-28) highRatio 78.9 (.9-28.9) highrenin. 38 (.25-5.89) low normalCT Scan normalsaline suppression 6/27/12

[Guest guest]

Assuming it is being taken correcMy May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 24, 2012, at 14:47, Bingham <jlkbbk2003@...> wrote:

With that high of a blood pressure we're just one weak blood vessel away from having no blood pressure!

We'll pray that all goes well for you.

-- On Sun, 6/24/12, catherinekerth1 <catherinekerth@...> wrote:

From: catherinekerth1 <catherinekerth@...>Subject: Saline suppression scheduledhyperaldosteronism Date: Sunday, June 24, 2012, 2:12 PM

Very anxious about my saline suppression on Wednesday!After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.It will be nice to have BP in the "not so scary" range. Cross fingers. 38Aldo 30 (?-28) highRatio 78.9 (.9-28.9) highrenin. 38 (.25-5.89) low normalCT Scan normalsaline suppression 6/27/12

[Guest guest]

Remind us how and with what you are taking ur BP. WHAT SIZE CUFF do u have and do u need?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 24, 2012, at 12:12, catherinekerth1 <catherinekerth@...> wrote:

Very anxious about my saline suppression on Wednesday!

After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.

I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.

Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.

It will be nice to have BP in the "not so scary" range. Cross fingers.

38

Aldo 30 (?-28) high

Ratio 78.9 (.9-28.9) high

renin. 38 (.25-5.89) low normal

CT Scan normal

saline suppression 6/27/12

[Guest guest]

Hi. I am now on nifedipine 30mg and Bystolic 5mg. For almost 5done weeks now.I have a very average sized arm and an averaged sized cuff.That was the reading I got at the docs office on Wednesday as well. The dicfirst and hisI nurses werethought very uneasty that myI BP getsis that high. Somedays my medicine works. Somedays not so much.I hate to be so non chalant about it. But I haven't found a medicine that can keep it a a consistent level. :(38Aldo 30( ?-28)Renin. .38 (.25-5.89)Ratio 78.9 (.9-28.9)CT scan normalsaline suppression the June 27rhNifedipine 30mg and Bystolic 5mgTo: hyperaldosteronism From: lowerbp2@...Date: Sun, 24 Jun 2012 17:42:29 -0700Subject: Re: Saline suppression scheduled

Remind us how and with what you are taking ur BP. WHAT SIZE CUFF do u have and do u need?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 24, 2012, at 12:12, catherinekerth1 <catherinekerth@...> wrote:

Very anxious about my saline suppression on Wednesday!

After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.

I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.

Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.

It will be nice to have BP in the " not so scary " range. Cross fingers.

38

Aldo 30 (?-28) high

Ratio 78.9 (.9-28.9) high

renin. 38 (.25-5.89) low normal

CT Scan normal

saline suppression 6/27/12

[Guest guest]

, I hear ya. For 20 years my BP ranged from

170/100-220/120. I went to doctor after doctor. I know I have

spent/insurance company hundreds of thousands of dollars treating my

bp/hospital visits/diagnostic tests to no avail. The doctors would

cover themselves by saying I was overweight or I was non-complaint

with meds. They would actually write those things in my chart. I

was on 7 bp pills at one time and the doctor wanted to add a eighth

one. I refused.

I was reading a magazine in my area and a saw an article about a

revolutionary doctor that could get ppl BP down when all else fails.

I called and made an appt , it took 8 weeks.

The doc was Dr. Elijah Saunders. I owe him my life.

I am now on a 4 dollar pill per month from Walmart - Spiro-and

dashing and BP is finally under control.

At some times my BP was so high I could see my hair pulsate. As a

result I have had a stroke, lvh, cardiomyapthy, and chf. I am so

surprised I am still alive. Maybe God has a purpose.

Phyllis

45yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn,

chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis-

no residual except I can't recall words at times,

current meds Spiro 25mg, Benicar 20mg bid, dashing

On 6/24/2012 9:24 PM, Kerth wrote:

Hi. I am now on nifedipine 30mg and Bystolic

5mg. For almost 5done weeks now.

I have a very average sized arm and an averaged sized

cuff.

That was the reading I got at the docs office on Wednesday

as well. The dicfirst and hisI nurses werethought very

uneasty that myI BP getsis that high. Somedays my medicine

works. Somedays not so much.

I hate to be so non chalant about it. But I haven't found

a medicine that can keep it a a consistent level.

38

Aldo 30( ?-28)

Renin. .38 (.25-5.89)

Ratio 78.9 (.9-28.9)

CT scan normal

saline suppression the June 27rh

Nifedipine 30mg and Bystolic 5mg

hyperaldosteronism

From: lowerbp2@...

Date: Sun, 24 Jun 2012 17:42:29 -0700

Subject: Re: Saline suppression

scheduled

Remind us how and with what you are taking ur

BP. WHAT SIZE CUFF do u have and do u need?

May your pressure be low!

CE Grim MS, MD

Specializing in Difficult

Hypertension

On Jun 24, 2012, at 12:12, catherinekerth1 <catherinekerth@...>

wrote:

Very anxious about my saline suppression on

Wednesday!

After CT scans. MRI's. Lots of blood

tests.... I am confident this is the end of

my PA journey. Phew! After saline

suppression confirms PA he will put me on

Spiro and hopefully I will respond to it.

I am not sure how many patients my

nephrologist has like me b/c he arranged and

called me himself about my suppression test.

Just got back from vacation and my BP was

195/113 the entire trip! I was very bloated

too.

It will be nice to have BP in the "not so

scary" range. Cross fingers.

38

Aldo 30 (?-28) high

Ratio 78.9 (.9-28.9) high

renin. 38 (.25-5.89) low normal

CT Scan normal

saline suppression 6/27/12

[Guest guest]

You will find one, Spironolactone (or Eplerenone) which I am surprised he

doesn't already have you on since your CT was negative!

>

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>

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>

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>

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> Very anxious about my saline suppression on Wednesday!

>

> After CT scans. MRI's. Lots of blood tests.... I am confident this is the end

of my PA journey. Phew! After saline suppression confirms PA he will put me on

Spiro and hopefully I will respond to it.

>

> I am not sure how many patients my nephrologist has like me b/c he arranged

and called me himself about my suppression test.

>

> Just got back from vacation and my BP was 195/113 the entire trip! I was very

bloated too.

>

> It will be nice to have BP in the " not so scary " range. Cross fingers.

>

>

>

>

>

> 38

>

> Aldo 30 (?-28) high

>

> Ratio 78.9 (.9-28.9) high

>

> renin. 38 (.25-5.89) low normal

>

> CT Scan normal

>

> saline suppression 6/27/12

>

[Guest guest]

Wow Phyllis, you're my age. Scary. When my hyperthryoidism (which was misdiangnosed over and over so I didn't know what it was or that it was there, just that I was very sick) reared it's head after I got that H1N1 flu I had developed an eyelid lag, which to the untrained eye - or the nervous one like I was - looks like facial droop, plus the incredible memory loss and headaches, so I thought/felt for certain I had stroked. Either way there is a sense of doom with hyperthyroidism that is well known and I had it to a T, and that contributed. I thought I was going to die. II didn't die and I didn't have a stroke thank God, but

And even if your docs back then wouldn't do the tests, if some could just be trained in the least little but to TRY spiro in their regimen of the 500 other pills they will try and add on (I know nothing works perfectly in all of us, but if it's just side effects at least we can change it later). I have told the story of the 2 NP's I was working with who had a young resistant HTN male, nothing worked, he's on multiple meds, and they would NOT try spiro. They did a serum aldo, I explained nicely AND gave them Dr G's paper(s) and they still would not.

I say it again, if it was very harmful or addicting, more caution would be warranted, but big freakin deal. Use it to help diagnose those hard cases.

-- On Sun, 6/24/12, Phyllis <phylisrn@...> wrote:

From: Phyllis <phylisrn@...>Subject: Re: Saline suppression scheduledhyperaldosteronism Date: Sunday, June 24, 2012, 8:57 PM

, I hear ya. For 20 years my BP ranged from 170/100-220/120. I went to doctor after doctor. I know I have spent/insurance company hundreds of thousands of dollars treating my bp/hospital visits/diagnostic tests to no avail. The doctors would cover themselves by saying I was overweight or I was non-complaint with meds. They would actually write those things in my chart. I was on 7 bp pills at one time and the doctor wanted to add a eighth one. I refused. I was reading a magazine in my area and a saw an article about a revolutionary doctor that could get ppl BP down when all else fails. I called and made an appt , it took 8 weeks. The doc was Dr. Elijah Saunders. I owe him my life.I am now on a 4 dollar pill per month from Walmart - Spiro-and dashing and BP is finally under control.At some times my BP was so high I could see my hair pulsate. As a result I have had a stroke, lvh, cardiomyapthy, and chf. I

am so surprised I am still alive. Maybe God has a purpose.Phyllis45yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except I can't recall words at times, current meds Spiro 25mg, Benicar 20mg bid, dashingOn 6/24/2012 9:24 PM, Kerth wrote:

Hi. I am now on nifedipine 30mg and Bystolic 5mg. For almost 5done weeks now.I have a very average sized arm and an averaged sized cuff.That was the reading I got at the docs office on Wednesday as well. The dicfirst and hisI nurses werethought very uneasty that myI BP getsis that high. Somedays my medicine works. Somedays not so much.I hate to be so non chalant about it. But I haven't found a medicine that can keep it a a consistent level. :(38Aldo 30( ?-28)Renin. .38 (.25-5.89)Ratio 78.9 (.9-28.9)CT scan normalsaline suppression the June 27rhNifedipine 30mg and Bystolic 5mg

hyperaldosteronism From: lowerbp2@...Date: Sun, 24 Jun 2012 17:42:29 -0700Subject: Re: Saline suppression scheduled

Remind us how and with what you are taking ur BP. WHAT SIZE CUFF do u have and do u need?

May your pressure be low!

CE Grim MS, MD

Specializing in Difficult

Hypertension

On Jun 24, 2012, at 12:12, catherinekerth1 <catherinekerth@...> wrote:

Very anxious about my saline suppression on Wednesday!After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.It will be nice to have BP in the "not so scary" range. Cross fingers. 38Aldo 30 (?-28) highRatio 78.9 (.9-28.9) highrenin. 38 (.25-5.89) low normalCT Scan normalsaline suppression 6/27/12

[Guest guest]

Honestly, , from reading your posts I would put money on the idea that your medicine doesn't work at all, in relation to your blood pressure. When you say some days it works some it doesn't does not fit what medicine does. Something else is factoring in.

I'd bet that there is a quirkiness related to your diet and some days maybe you get less sodium and other days more just by chance or one day appetite is down (so you just get less sodium in your diet, and so on - same for your potassiums. The BP rises in a direct relationship to your salt intake (to a point of course). High to higher salt = higher pressures. Lower salt low pressure, making you or them think it is the medicine "sometimes" working. I bet the medicine is perfectly consistent every time you take it. Consistently not the right medicine.

Very anxious about my saline suppression on Wednesday!After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.It will be nice to have BP in the "not so scary" range. Cross fingers. 38Aldo 30 (?-28) highRatio 78.9 (.9-28.9) highrenin. 38 (.25-5.89) low normalCT Scan normalsaline suppression 6/27/12

[Guest guest]

Hmm. Guess you don't believe (understand) that most with PA do not have bumps large enough to be seen with today's imaging?

If you imagine the red columns representing increasing amounts of aldosterone production by a gradually growing adneoma(s) as an iceberg of all the PAs in the population then those with classic PA with only the tip of the iceberg about a U aldo of 20. CE Grim MDOn Jun 24, 2012, at 7:37 PM, wrote: You will find one, Spironolactone (or Eplerenone) which I am surprised he doesn't already have you on since your CT was negative! > > > > > > > > > > > > > > > > > > > > > > > > Very anxious about my saline suppression on Wednesday! > > After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it. > > I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test. > > Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too. > > It will be nice to have BP in the "not so scary" range. Cross fingers. > > > > > > 38 > > Aldo 30 (?-28) high > > Ratio 78.9 (.9-28.9) high > > renin. 38 (.25-5.89) low normal > > CT Scan normal > > saline suppression 6/27/12 >

1 of 1 File(s)

pastedGraphic.pdf

[Guest guest]

I know Dr. Saunders about as well as any other colleague. Tell him I said hello. I suspect some of his expertise in PA (and mine) and difficult HTN comes from our joint discussions and presentations at many meetings on difficult HTN. I am sure the our success of use of the DASH in PA was shared with him some time based on the data collected from our group here.I co-wrote a chap in his first book: SEE: Luft

FC, Grim CE, and Weinberger MH. Electrolyte and volume homeostasis in blacks.

In hypertension in blacks: Epidemiology, Pathophysiology and Treatment. Eds. WD

Hall, E Saunders, NB Shulman. Year Book Medical Publishers. pg. 115-131, 1985CE Grim MD

On Jun 24, 2012, at 6:57 PM, Phyllis wrote: , I hear ya. For 20 years my BP ranged from 170/100-220/120. I went to doctor after doctor. I know I have spent/insurance company hundreds of thousands of dollars treating my bp/hospital visits/diagnostic tests to no avail. The doctors would cover themselves by saying I was overweight or I was non-complaint with meds. They would actually write those things in my chart. I was on 7 bp pills at one time and the doctor wanted to add a eighth one. I refused. I was reading a magazine in my area and a saw an article about a revolutionary doctor that could get ppl BP down when all else fails. I called and made an appt , it took 8 weeks. The doc was Dr. Elijah Saunders. I owe him my life. I am now on a 4 dollar pill per month from Walmart - Spiro-and dashing and BP is finally under control. At some times my BP was so high I could see my hair pulsate. As a result I have had a stroke, lvh, cardiomyapthy, and chf. I am so surprised I am still alive. Maybe God has a purpose. Phyllis 45yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn, chf previous EF 20% now 50%, cardiomyapathy, lvh, cva, sarcoidosis- no residual except I can't recall words at times, current meds Spiro 25mg, Benicar 20mg bid, dashing On 6/24/2012 9:24 PM, Kerth wrote: Hi. I am now on nifedipine 30mg and Bystolic 5mg. For almost 5done weeks now. I have a very average sized arm and an averaged sized cuff. That was the reading I got at the docs office on Wednesday as well. The dicfirst and hisI nurses werethought very uneasty that myI BP getsis that high. Somedays my medicine works. Somedays not so much. I hate to be so non chalant about it. But I haven't found a medicine that can keep it a a consistent level. 38 Aldo 30( ?-28) Renin. .38 (.25-5.89) Ratio 78.9 (.9-28.9) CT scan normal saline suppression the June 27rh Nifedipine 30mg and Bystolic 5mg hyperaldosteronism From: lowerbp2@... Date: Sun, 24 Jun 2012 17:42:29 -0700 Subject: Re: Saline suppression scheduled Remind us how and with what you are taking ur BP. WHAT SIZE CUFF do u have and do u need? May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension On Jun 24, 2012, at 12:12, catherinekerth1 <catherinekerth@...> wrote: Very anxious about my saline suppression on Wednesday! After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it. I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test. Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too. It will be nice to have BP in the "not so scary" range. Cross fingers. 38 Aldo 30 (?-28) high Ratio 78.9 (.9-28.9) high renin. 38 (.25-5.89) low normal CT Scan normal saline suppression 6/27/12

[Guest guest]

If they never check urine for Aldo they how would this chart relate?

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> > > Very anxious about my saline suppression on Wednesday!

> > >

> > > After CT scans. MRI's. Lots of blood tests.... I am confident this

> > is the end of my PA journey. Phew! After saline suppression confirms

> > PA he will put me on Spiro and hopefully I will respond to it.

> > >

> > > I am not sure how many patients my nephrologist has like me b/c he

> > arranged and called me himself about my suppression test.

> > >

> > > Just got back from vacation and my BP was 195/113 the entire trip!

> > I was very bloated too.

> > >

> > > It will be nice to have BP in the " not so scary " range. Cross

> > fingers.

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> > > 38

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> > > Aldo 30 (?-28) high

> > >

> > > Ratio 78.9 (.9-28.9) high

> > >

> > > renin. 38 (.25-5.89) low normal

> > >

> > > CT Scan normal

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> > > saline suppression 6/27/12

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[Guest guest]

Phyllis, I could almost have written much of your story myself. My BP was 224/114 and all the BP clinic at Kaiser would do is double-down on my meds, some of which caused my K to tank further. My NP would tell me to "lose 10 pounds" and "relax", and I was spending a fortune on BP pills and Kaiser visits. My medical chart had me listed as a "non-compliant" patient, because I refused medications for borderline "diabetes" and borderline high cholesterol, which was 2 points over there recommendation for diabetics. Why I didn't have a stroke is a mystery to me.I had to diagnose myself, via the Internet. When I demanded the urine aldosterone test my NP actually screamed at me over the phone that I "was a non-compliant patient and now I wanted a test for what?" I didn't know then that I really needed an ARR test, but my

Aldosterone test came back with a reading of 300.1 (0 -29 being normal).To me the really sad thing in your letter is that in the article you read, Dr. Saunders was listed as a "revolutionary" doctor. Not to take anything away from him, but his approach to treating HBP should be common to all doctors and not revolutionary at all., hang in there. As you can see you have people in this group who have been in your position. You are young and may have caught your illness early enough to escape some of the damages that can occur with long term, undiagnosed, PA.

Dianne

69, bi-lateral adenomas 1.2cm rt, 1cm left

25yr hx of HBP and low K.

Previously on 5 BP meds & 80MEQ K with

ever increasing BP

Diagnosed myself via Internet July 2010

Had to demand tests to confirm PA, from

scoffing NP

CKD. Kidney function fell after use of

contrast dye during CT scan 8/2010.

Now on 50mg Spiro, 12.5mg Atenolol

BP avg. 130/70

Dashing with very low Na (aim for 1,000mg)

and high enough K to keep me in range, but not so high as to further damage

kidneys.

Very anxious about my saline suppression on

Wednesday!

After CT scans. MRI's. Lots of blood

tests.... I am confident this is the end of

my PA journey. Phew! After saline

suppression confirms PA he will put me on

Spiro and hopefully I will respond to it.

I am not sure how many patients my

nephrologist has like me b/c he arranged and

called me himself about my suppression test.

Just got back from vacation and my BP was

195/113 the entire trip! I was very bloated

too.

It will be nice to have BP in the "not so

scary" range. Cross fingers.

38

Aldo 30 (?-28) high

Ratio 78.9 (.9-28.9) high

renin. 38 (.25-5.89) low normal

CT Scan normal

saline suppression 6/27/12

[Guest guest]

Excellent update.And with some "benefit" from consulting with Dr. Grim as I recall?CE Grim MDOn Jun 25, 2012, at 7:03 AM, Dianne strong wrote: Phyllis, I could almost have written much of your story myself. My BP was 224/114 and all the BP clinic at Kaiser would do is double-down on my meds, some of which caused my K to tank further. My NP would tell me to "lose 10 pounds" and "relax", and I was spending a fortune on BP pills and Kaiser visits. My medical chart had me listed as a "non-compliant" patient, because I refused medications for borderline "diabetes" and borderline high cholesterol, which was 2 points over there recommendation for diabetics. Why I didn't have a stroke is a mystery to me.I had to diagnose myself, via the Internet. When I demanded the urine aldosterone test my NP actually screamed at me over the phone that I "was a non-compliant patient and now I wanted a test for what?" I didn't know then that I really needed an ARR test, but my Aldosterone test came back with a reading of 300.1 (0 -29 being normal).To me the really sad thing in your letter is that in the article you read, Dr. Saunders was listed as a "revolutionary" doctor. Not to take anything away from him, but his approach to treating HBP should be common to all doctors and not revolutionary at all., hang in there. As you can see you have people in this group who have been in your position. You are young and may have caught your illness early enough to escape some of the damages that can occur with long term, undiagnosed, PA. Dianne 69, bi-lateral adenomas 1.2cm rt, 1cm left 25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July 2010 Had to demand tests to confirm PA, from scoffing NP CKD. Kidney function fell after use of contrast dye during CT scan 8/2010. Now on 50mg Spiro, 12.5mg Atenolol BP avg. 130/70 Dashing with very low Na (aim for 1,000mg) and high enough K to keep me in range, but not so high as to further damage kidneys. Very anxious about my saline suppression on Wednesday! After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it. I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test. Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too. It will be nice to have BP in the "not so scary" range. Cross fingers. 38 Aldo 30 (?-28) high Ratio 78.9 (.9-28.9) high renin. 38 (.25-5.89) low normal CT Scan normal saline suppression 6/27/12

[Guest guest]

The chart is hypothetical of course and without urine aldo it is difficult to Dx PA.There has been considerable downward creep of the upper limit of Normal U aldo over last 40 years as well. So absolute definition of high u aldo depends on year of study, urine Na, meds and lab doing it.CE Grim MDOn Jun 25, 2012, at 4:04 AM, Francis Bill SUSPECTED PA wrote: If they never check urine for Aldo they how would this chart relate? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Very anxious about my saline suppression on Wednesday! > > > > > > After CT scans. MRI's. Lots of blood tests.... I am confident this > > is the end of my PA journey. Phew! After saline suppression confirms > > PA he will put me on Spiro and hopefully I will respond to it. > > > > > > I am not sure how many patients my nephrologist has like me b/c he > > arranged and called me himself about my suppression test. > > > > > > Just got back from vacation and my BP was 195/113 the entire trip! > > I was very bloated too. > > > > > > It will be nice to have BP in the "not so scary" range. Cross > > fingers. > > > > > > > > > > > > > > > > > > 38 > > > > > > Aldo 30 (?-28) high > > > > > > Ratio 78.9 (.9-28.9) high > > > > > > renin. 38 (.25-5.89) low normal > > > > > > CT Scan normal > > > > > > saline suppression 6/27/12 > > > > > > > >

[Guest guest]

The chart is hypothetical of course and without urine aldo it is difficult to Dx PA.There has been considerable downward creep of the upper limit of Normal U aldo over last 40 years as well. So absolute definition of high u aldo depends on year of study, urine Na, meds and lab doing it.CE Grim MDOn Jun 25, 2012, at 4:04 AM, Francis Bill SUSPECTED PA wrote: If they never check urine for Aldo they how would this chart relate? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Very anxious about my saline suppression on Wednesday! > > > > > > After CT scans. MRI's. Lots of blood tests.... I am confident this > > is the end of my PA journey. Phew! After saline suppression confirms > > PA he will put me on Spiro and hopefully I will respond to it. > > > > > > I am not sure how many patients my nephrologist has like me b/c he > > arranged and called me himself about my suppression test. > > > > > > Just got back from vacation and my BP was 195/113 the entire trip! > > I was very bloated too. > > > > > > It will be nice to have BP in the "not so scary" range. Cross > > fingers. > > > > > > > > > > > > > > > > > > 38 > > > > > > Aldo 30 (?-28) high > > > > > > Ratio 78.9 (.9-28.9) high > > > > > > renin. 38 (.25-5.89) low normal > > > > > > CT Scan normal > > > > > > saline suppression 6/27/12 > > > > > > > >

[Guest guest]

It's failing that test that's no fun

From: catherinekerth1 <catherinekerth@...>Subject: Saline suppression scheduledhyperaldosteronism Date: Sunday, June 24, 2012, 2:12 PM

Very anxious about my saline suppression on Wednesday!After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.It will be nice to have BP in the "not so scary" range. Cross fingers. 38Aldo 30 (?-28) highRatio 78.9 (.9-28.9) highrenin. 38 (.25-5.89) low normalCT Scan normalsaline suppression 6/27/12

[Guest guest]

Yes, consulting with Dr. Grim and this group has saved my life, and I don't believe I'm exaggerating in the least. I've learned quite a bit from all of you, but in those early days all I knew was that I was in a barely functioning state and a stroke had to be right around the corner.My doctors would have never taken the steps they did without Dr. Grim guiding them. Then I would have stroked-out and they would have said: "tsk, tsk, too bad she didn't take care of herself". Very anxious about my saline suppression on Wednesday! After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it. I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test. Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too. It will

be nice to have BP in the "not so scary" range. Cross fingers. 38 Aldo 30 (?-28) high Ratio 78.9 (.9-28.9) high renin. 38 (.25-5.89) low normal CT Scan normal saline suppression 6/27/12

[Guest guest]

Even if maybe I should have known better (but are any of us thinking clear when we're sick?), but until I got the diagnosis and found this list and got serious, who knows what may have been, so I echo that in saying the influence on me health-wise and personally from having this group has been immeasurable.

Very anxious about my saline suppression on Wednesday!After CT scans. MRI's. Lots of blood tests.... I am confident this is the end of my PA journey. Phew! After saline suppression confirms PA he will put me on Spiro and hopefully I will respond to it.I am not sure how many patients my nephrologist has like me b/c he arranged and called me himself about my suppression test.Just got back from vacation and my BP was 195/113 the entire trip! I was very bloated too.It will be nice to have BP in the "not so scary" range. Cross fingers. 38Aldo 30 (?-28) highRatio 78.9 (.9-28.9) highrenin. 38 (.25-5.89) low normalCT Scan normalsaline suppression

6/27/12

[Guest guest]

In the ICU when I had the stroke the

Intensivist said to me, " You didn't take those meds did you? You

are too young for this" I said well no sometimes I didn't take the

hctz which made my K+ 1.9 , and I didn't take the Beta blocker

that made my HR 33, or the ACI that gave me angioedema. Then he

said "your kidneys have taken a hit." I said to him my kidneys

were fine until you gave me that contrast dye. He just looked at

me and turned around and left. I never saw him again.

I have some horror stories about me, this blood pressure and

doctors!

45yo AAF 20yr of BP 170/100-220/120. Previous 7 BP pills, hx. htn,

chf previous EF 20% now 50%, cardiomyapathy, lvh, cva,- no

residual except I can't recall words at times, sarcoidosis

current meds Spiro 25mg, Benicar 20mg bid, dashing

Phyllis

On 6/25/2012 12:48 PM, Dianne strong wrote:

Yes,

consulting with Dr. Grim and this group has saved

my life, and I don't believe I'm exaggerating in

the least. I've learned quite a bit from all of

you, but in those early days all I knew was that I

was in a barely functioning state and a stroke had

to be right around the corner.

My doctors would have never taken the steps

they did without Dr. Grim guiding them. Then I

would have stroked-out and they would have said:

"tsk, tsk, too bad she didn't take care of

herself".

Very

anxious about

my saline

suppression on

Wednesday!

After CT

scans. MRI's.

Lots of blood

tests.... I am

confident this

is the end of

my PA journey.

Phew! After

saline

suppression

confirms PA he

will put me on

Spiro and

hopefully I

will respond

to it.

I am not sure

how many

patients my

nephrologist

has like me

b/c he

arranged and

called me

himself about

my suppression

test.

Just got back

from vacation

and my BP was

195/113 the

entire trip! I

was very

bloated too.

It will be

nice to have

BP in the "not

so scary"

range. Cross

fingers.

38

Aldo 30 (?-28)

high

Ratio 78.9

(.9-28.9) high

renin. 38

(.25-5.89) low

normal

CT Scan normal

saline

suppression

6/27/12

[Guest guest]

I would suggest drinking a couple of V8's before testing so your K will not drop

too much afterward (your doctor should measure your K before and after the test

and they should add it IV if below).

Also eat a regular salt diet as the post-suppresion ranges are never adjusted

for DASHing hence you can get a false negative.

And don't forget Dr. Grim advice: measure how much you pee'd during that test as

you can have an early result (>1.5L you have PA, 1-1.5L probable PA).

Good luck with testing and don't be anxious about it as even if the test fails

this group and Dr. Grim are still here for help!

tiu