Re: Medical Opinions vs Facts

[Guest guest]

Eplere is not approved for PA. It is approved for high Blood pressure. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I can not afford insurance. Right now my only choice for health care is the VA. Since my PRA ratio was less then 20 by there standards I don't have I PA. So no need for eplerenone.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > > women. They will also never mention that the estrogenic properties

> > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > > comes here down the line.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > > past 40, was not supported by any of the "facts" in the research

> > > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > > the guidance I got via the *facts* presented in research articles.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > --- In

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

So we see your wife believed them and treated that depression and stress "the way God Intended"! How's that little one doing? ;>)

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > women. They will also never mention that the estrogenic properties

> > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > comes here down the line.

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > past 40, was not supported by any of the "facts" in the research

> > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > the guidance I got via the *facts* presented in research articles.

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > --- In

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Most start on spiro and if they a problem with side effects then switch to

Inspra. Most Drug co. have a program that will pay for drugs if you can not pay

for them.

> >> >

> >>

>

[Guest guest]

I took Spiro for about 3 years and switched to inspra a few months ago because it was causing me alot of gyno and pain. I can focus more mentally with Inspra and have alot less gyno pain. It doenst seem to work as well for keeping K level up. However, since it is only about 50-60% as effective at that as Spiro, I am basically taking like 25mg of spiro, instead of the 100mg I was on before i switched. I have to watch the salt even more, as my endo wont increase the dose at this point. Over the last week, i upped my K from 40 to 60Meq and am feeling better. Inspra is ALOT more expensive. If i had to pay for it in cash, I probably would stick with Spiro and deal with the side effects. It was my endo that suggested I switched because I was getting alot of breast growth. Not just fat accumulation, but

actual glands and stuff showing up on a 3rd mammogram. Anyway, that is all from a guy perspective who doesnt really want to grow boobs if it is possible to avoid it.I also worry a little about how there isnt any longterm studies for using Inspra for say 40 years. Long term use of spiro is better known. That concern alone makes we question my decision to change. Afterall, man boobs are embarassing, but they are not generally deadly. Who knows about inspra over the long haul. Maybe it will make a hand grow out of the side of my head to slap me for switching. ============================================================================45-Male-Caucasian, 5'9"- 242lbs, PA Diagnosed 2007 Suspected Hyperplasia-No tumors on CT - No AVS.Meds: 50mg Inspra, 40meq Potassium, 2400mg Calcium, 1000mg Magnesium, 100,000UI Vit D (weekly), 20mg OmeprazoleSide effects:

Gynecomastia, stomach inflammation (from potassium citrate)Other Diags: GERD, Hiatal Hernia, Metabolic Syndrome - PreDiabetic, Secondary Hyperparathyroidism caused by Renal calcium leak, Bone Cyct in left Femoral Head and Pelvis. Benign Lung Nodules, Fibromyalgia, Scarring on Right Kidney Lower Pole, Right Flank PainDASH: Started "sort of" DASHing 5/3/2011Status: Last Urine K/Na ratio was 1.1. But total of Na high alsoInitial Presenting Symptom: Muscle twitching all over body with low normal K, Mg, Ca, Low Ionized Ca, High PTH, low Vitamin DTo: hyperaldosteronism Sent: Thursday, October 20, 2011 9:21 AMSubject: Re: Re: Medical Opinions vs Facts

Which is better Inspra or Spiro? One is 150.00 and one is 4.00 per

month.

I dont have insurance.

Phyllis

Eplere is not approved for PA. It is approved for high

Blood pressure.

Tiped sad Send form mi

iPhone ;-)

May your pressure be low!

CE Grim MD

Specializing in Difficult

Hypertension

On Oct 20, 2011, at 14:55, Francis Bill SUSPECTED PA

wrote:

I can not afford insurance. Right now my only

choice for health care is the VA. Since my PRA ratio

was less then 20 by there standards I don't have I

PA. So no need for eplerenone.

>

[Guest guest]

I used to always wonder why I got sick after eating. I though it was

the sugar. So I went low carb- and I still would get sick.

It was the sodium! Of course my favorite food was pizza and let's

face it.  Low salt pizza is not cool .  I now try to avoid all

restaurant food.

I once had a Subway Tuna sandwich. I thought I would die after

eating it. When I checked their nutritional info- I was shocked!

Phyllis

 

It's so true! Even now, when I know everything

(almost :-) and when I complain to my friends that I

cannot eat in Panera Bread since I feel terrible

immediately after eating, all of them say : " No, it's

not salt, it's  pscyh problems."

No guys, it's not, it's physical problem, it's called

electrolyte imbalance!

 

Natalia Kamneva 67 Russian F with 2 cm left adrenal

adenoma, recently diagnosed with PA; diabetic; on 100 mg

eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg

Dexilant and 2 mg Lorazepam; Dashing; still have some

occasional problems with BP, K and Na; on private

consultation with Dr Grim.

[Guest guest]

What do you prescribe instead for insomnia and occasional BP spikes with anxiety? Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.To: hyperaldosteronism Sent: Thursday, October 20, 2011 3:10 AMSubject: Re: Re: Medical Opinions vs Facts

I rarely give lorazapam for BP problems.CE Grim MDTo: hyperaldosteronism Sent: Tuesday, October 18, 2011 6:34 PMSubject: Re: Medical Opinions vs Facts Hang on are you saying you don't have psych problems or you don't have PA? I have been told I *may* have a range of pscyh problems inc anxiety, panic attacks, asperger's syndrome, psychogenic polydipsia based on various psychologist opinions when previous drs gave up, I rejected all these and yet when I pursued PA they wanted to give me another psych diagnosis - Munchausen's! But then PA turned out to be right! But I had to really push them to get this far and I am not even there yet so that makes me think that there may be others out there who are too ill or weak or just too fed up to push their drs anymore so they accept a pscyh diagnosis of anxiety etc and go undiagnosed. Interestingly there is research which is showing that

various types of 'anxiety' have physcial causes that push the body into imbalance and cause it to secrete adrenaline, noradrenaline etc which makes you feel anxious e.g. mitral valve prolapse, POTS, diabetes, dehydration etc and so is physical not emotional. But if you don't have it diagnosed and some one is telling you it's in your head and to calm down all the time then maybe you will start to believe you have an anxiety disorder. Point I'm making is: what if spiro doesn't help in psych problems - what if those 'psych problems' ARE undiagnosed PA?? > > > > > > > > > > > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value. > > > > > > > > > > > > > > > > > > > > > > > > > > > > For example - the research articles will probably > > > > > never, ever mention that spiro's estrogenic properties can > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > women. They will also never mention that the estrogenic properties > > > > > may cause weight gain

(plenty of anecdotal evidence of that if you > > > > > look hard enough), yet in the three weeks I was on it, my weight > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > comes here down the line. > > > > > > > > > > > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > past 40, was not supported by any of the "facts" in the research > > > > > articles. So I was able to choose to ignore his opinion, and

follow > > > > > the guidance I got via the *facts* presented in research articles. > > > > > > > > > > > > > > > > > > > > > > > > > > > > --- In > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

It's so true! Even now, when I know everything (almost :-) and when I complain to my friends that I cannot eat in Panera Bread since I feel terrible immediately after eating, all of them say : " No, it's not salt, it's pscyh problems." No guys, it's not, it's physical problem, it's called electrolyte imbalance! Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.To: hyperaldosteronism Sent: Thursday, October 20, 2011 9:49 AMSubject: Re: Re: Medical Opinions vs Facts

The coments are classic undiagnosed PA pathway in most of our histories. I heard everything from "stress" "depression' "lazy" and who knows what else over about 5 years.. We moved to AZ in '09 when I never wanted to leave Texas, but I was too tired and sick to argue. My "colleagues" I now understand would not stop whispering to wife that I was "stressed" and so she thought the change of scenery and moving closer to home (Cali) would help "cure" me of my stress and depression (because it always causes a BP of 170/130 daily and drops my potassium - sarcasm...) - which only got worse and worse and worse in AZ until 11/2010 when I finally started spiro.

I have told the story though that I walked out on a doc once in Texas who couldn't drop the depression tag. I told him over and over I wasn't depressed, but he didn't give a damn. The label was more important than the patient.

Subject: Re: Re: Medical Opinions vs FactsTo: "hyperaldosteronism " <hyperaldosteronism >Date: Thursday, October 20, 2011, 1:44 AM

What I am saying, I do have PA but I don't have psych problems and even didn't have them before being on eplerenone. I was prescribed lorazepam but I took it only when I had a terrible spikes in BP and now take it only at night time since I have insomnia. And BTW, in addition my cortisol is high and I am diabetic. I agree that a range of psych problems may be caused by underlying physical problems. Natalia

To: hyperaldosteronism Sent: Tuesday, October 18, 2011 6:34 PMSubject: Re: Medical Opinions vs Facts

Hang on are you saying you don't have psych problems or you don't have PA?I have been told I *may* have a range of pscyh problems inc anxiety, panic attacks, asperger's syndrome, psychogenic polydipsia based on various psychologist opinions when previous drs gave up, I rejected all these and yet when I pursued PA they wanted to give me another psych diagnosis - Munchausen's! But then PA turned out to be right!But I had to really push them to get this far and I am not even there yet so that makes me think that there may be others out there who are too ill or weak or just too fed up to push their drs anymore so they accept a pscyh diagnosis of anxiety etc and go undiagnosed.Interestingly there is research which is showing that various types of 'anxiety' have physcial causes that push the body into imbalance and cause it to secrete adrenaline, noradrenaline etc which makes you feel anxious e.g. mitral valve prolapse, POTS,

diabetes, dehydration etc and so is physical not emotional. But if you don't have it diagnosed and some one is telling you it's in your head and to calm down all the time then maybe you will start to believe you have an anxiety disorder.Point I'm making is: what if spiro doesn't help in psych problems - what if those 'psych problems' ARE undiagnosed PA??> > > > > > > > > > > > > >> > > > > > > > > > > > > > I find both opinions, and facts to be of value.> > > > > > > > > > > > > >> > > > > > > > > > > > > > For example - the research articles will probably > > > > > never, ever mention that spiro's estrogenic properties can > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > women. They will also never mention that the estrogenic properties > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > >

> look hard enough), yet in the three weeks I was on it, my weight > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > comes here down the line.> > > > > > > > > > > > > >> > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > past 40, was not supported by any of the "facts" in the research > > > > > articles. So I was able to choose to ignore his opinion, and follow > > > > > the guidance I got via the *facts*

presented in research articles.> > > > > > > > > > > > > >> > > > > > > > > > > > > > --- In> > > > > >> > > > >> > > > >> > > >> > >> >>

[Guest guest]

Oh, my goodness! How difficult to be an American, especially a veteran, especially an honest man! Could you somehow to change a doctor inside VA? Could you afford to make one visit to one doctor outside VA and ask him for a prescription for a year? Could you buy it through Canadian Pharmacy? Could you search your network for a doctor who can proscribe it for somebody who definitely has hypertension? Ask Russians how to do it :-) I usually don't lie when it's possible to tell truth and I definitely don't teach anybody to lie. But if it's an alternative to lie or to die, I would not die for nothing. BTW, if yo start to take spiro or eplerenone, probably, your aldo will go up and then VA will be

finally ABLE to diagnose you. It happened to me. Good luck!Natalia To: hyperaldosteronism Sent: Thursday, October 20, 2011 4:55 PMSubject: Re: Medical Opinions vs Facts

I can not afford insurance. Right now my only choice for health care is the VA. Since my PRA ratio was less then 20 by there standards I don't have I PA. So no need for eplerenone.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > > women. They will also never mention that the estrogenic properties

> > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > > comes here down the line.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > > past 40, was not supported by any of the "facts" in the research

> > > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > > the guidance I got via the *facts* presented in research articles.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > --- In

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

I start with a new Dr this week. This will make my fourth one since Aug of 2005.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > I find both opinions, and facts to be of

value.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > For example - the research articles will

probably

> > > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia

in

> > > > > > > > women. They will also never mention that the estrogenic

properties

> > > > > > > > may cause weight gain (plenty of anecdotal evidence of that if

you

> > > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > > (which under normal circumstances only fluctuates by a pound

either

> > > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > > effects outweigh it's benefits *may* be of value to some newbie

who

> > > > > > > > comes here down the line.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I

could

> > > > > > > > have skipped AVS and gone straight to surgery, even though I'm a

bit

> > > > > > > > past 40, was not supported by any of the " facts " in the research

> > > > > > > > articles. So I was able to choose to ignore his opinion, and

follow

> > > > > > > > the guidance I got via the *facts* presented in research

articles.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > --- In

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Natalia,

I take melatonin for occaisional insomnia, or I listen to Belleruth Naprosek's

Insomnia recording, which calms my anxious (at times) mind & helps me to sleep.

I was addicted to valium, which is a benzo similar to lorazapam when I was

younger. It is nasty stuff when used long-term.

~Lucy

Lucy Sage

Sent from my Verizon Wireless Phoneza

Natalia Kamneva wrote:

>What do you prescribe instead for insomnia and occasional  BP spikes with

anxiety?

>

> 

>Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed

with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60

mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems

with BP, K and Na; on private consultation with Dr Grim.

>

>

>________________________________

>

>To: hyperaldosteronism

>Sent: Thursday, October 20, 2011 3:10 AM

>Subject: Re: Re: Medical Opinions vs Facts

>

>

> 

>I rarely give lorazapam for BP problems.

>

>CE Grim MD

>

>To: hyperaldosteronism

>>Sent: Tuesday, October 18, 2011 6:34 PM

>>Subject: Re: Medical Opinions vs Facts

>>

>>

>> 

>>Hang on are you saying you don't have psych problems or you don't have PA?

>>

>>I have been told I *may* have a range of pscyh problems inc anxiety, panic

attacks, asperger's syndrome, psychogenic polydipsia based on various

psychologist opinions when previous drs gave up, I rejected all these and yet

when I pursued PA they wanted to give me another psych diagnosis - Munchausen's!

But then PA turned out to be right!

>>

>>But I had to really push them to get this far and I am not even there yet so

that makes me think that there may be others out there who are too ill or weak

or just too fed up to push their drs anymore so they accept a pscyh diagnosis of

anxiety etc and go undiagnosed.

>>

>>Interestingly there is research which is showing that various types of

'anxiety' have physcial causes that push the body into imbalance and cause it to

secrete adrenaline, noradrenaline etc which makes you feel anxious e.g. mitral

valve prolapse, POTS, diabetes, dehydration etc and so is physical not

emotional. But if you don't have it diagnosed and some one is telling you it's

in your head and to calm down all the time then maybe you will start to believe

you have an anxiety disorder.

>>

>>Point I'm making is: what if spiro doesn't help in psych problems - what if

those 'psych problems' ARE undiagnosed PA??

>>

>>

>>> > > > > > > > > > > > > >

>>> > > > > > > > > > > > > > I find both opinions, and facts to be of value.

>>> > > > > > > > > > > > > >

>>> > > > > > > > > > > > > > For example - the research articles will probably

>>> > > > > never, ever mention that spiro's estrogenic properties can

>>> > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

>>> > > > > women. They will also never mention that the estrogenic properties

>>> > > > > may cause weight gain (plenty of anecdotal evidence of that if you

>>> > > > > look hard enough), yet in the three weeks I was on it, my weight

>>> > > > > (which under normal circumstances only fluctuates by a pound either

>>> > > > > way) went up five pounds. So my *opinion* that this drug's side

>>> > > > > effects outweigh it's benefits *may* be of value to some newbie who

>>> > > > > comes here down the line.

>>> > > > > > > > > > > > > >

>>> > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

>>> > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

>>> > > > > past 40, was not supported by any of the " facts " in the research

>>> > > > > articles. So I was able to choose to ignore his opinion, and follow

>>> > > > > the guidance I got via the *facts* presented in research articles.

>>> > > > > > > > > > > > > >

>>> > > > > > > > > > > > > > --- In

>>> > > > > >

>>> > > > >

>>> > > > >

>>> > > >

>>> > >

>>> >

>>>

>>

>>

>>

>>

>>

>>

>

>

[Guest guest]

Yes, that was they suggested ACE and ARB don't work sufficiently but work much better in a combination with spiro. You suggest that spiro works better alone, then in combination with them, don't you? I will try, but I am still scared to taper Micardis. I am not afraid of steadily higher BP, I am afraid of spikes that I occasionally have. Natalia To:

"hyperaldosteronism " <hyperaldosteronism >Sent: Thursday, October 20, 2011 6:21 PMSubject: Re: Re: Medical Opinions vs Facts

In that study the pts were already on ace and were still HTN. SUGGESTS ACE WAS not working well but we dont know pre ace BP Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I know, I know. I tried to taper Micardis for many times and always had a spike in BP. Dr. Grim recommends to do it again and I will try again. BTW, my BP is very steady about 125/75 on this combination:-) I read the article here sometime ago "Efficacy of low-dose spironolactone in subjects with resistant hypertension". For subjects with and without PA they added 12.5 to 25 mg/d of spiro to ACE or ARB. That's why I added eplerenone to Micardis a year ago. Note, I never was officially diagnosed with PA. My aldo is not high enough. What convinced me, that ACE and ARB are the only two groups of medications (before eplerenon) that definitely worked for me. All other groups just killed me. Thank you.Natalia To: hyperaldosteronism Sent: Tuesday, October 18, 2011 11:06 PMSubject: RE: Re: Medical Opinions vs Facts

Natalia,Dr Grim so many times mentioned that A2RBs would be useless in PA…how come you are still on Micardis? I suspect it might reduce effectiveness of Epler. Have you tried to quit it for 6-8 weeks to see if Epler works better in normalizing your BP keeping it steady? Max.62M L adenoma by NP59 scan. High aldos not low renin. med combo #76={Spiro=100, Amlo=10, Indap=2.5, Ramip=5,

Metf=1000, Crestor=20, Feno=67, K.Cl=120 mEq}{K=4.7}{not DASHing but low-salt diet, heat intolerance} Natalia KamnevaNo, they were never checked. But Dr Grim now suggests that I have early stage of PA, although I have very high uncontrolled BP for 30 years and nocturia for 18 years. Nevertheless I didn't have any other symptoms until

last year. Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.

[Guest guest]

Yes, Francis, it's true. Do you have a high BP? Then insist! Eplerenone has nothing to do with renin/aldo!Natalia To: "hyperaldosteronism " <hyperaldosteronism >Sent: Thursday, October 20, 2011 6:49 PMSubject: Re: Re: Medical

Opinions vs Facts

Eplere is not approved for PA. It is approved for high Blood pressure. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I can not afford insurance. Right now my only choice for health care is the VA. Since my PRA ratio was less then 20 by there standards I don't have I PA. So no need for eplerenone.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > > women. They will also never mention that the estrogenic properties

> > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > > comes here down the line.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > > past 40, was not supported by any of the "facts" in the research

> > > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > > the guidance I got via the *facts* presented in research articles.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > --- In

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Also remember the medical authorities warning in 2009 to doctors to stop ACE+A2RB combo that can cause heart attack or some medical term that meant something like “dead meatâ€! Max. Yes, that was they suggested ACE and ARB don't work sufficiently but work much better in a combination with spiro. You suggest that spiro works better alone, then in combination with them, don't you? I will try, but I am still scared to taper Micardis. I am not afraid of steadily higher BP, I am afraid of spikes that I occasionally have. Natalia

[Guest guest]

Natalia, I can't leave you with a wrong impression. Francis and I go to the

same VA and I have quite a different experience! Did they miss PA? Yes, just

like all the other doctors for 63 years! Did they have a specialist come in and

DX my PA, Yes. (I'm probably one of the few here that didn't self DX! I didn't

meet Dr. Grim until 8 months later!)

I feel I have an excellent team serving my needs. (2 doctors, 1 NP, 2 nurses

and a technician that all know my case.) I can access all my labs for the last

2 years online. I have a copy of all the notes back to the first day I was

treated there. They have always done necessary lab test, Francis and I disagree

as to whether they do an accurate K blood draw!

Because I have T2DM I have my eyes and feet checked by specialists quarterly. I

get new glasses every 2 years or sooner if necessary.

Now, does my PCP know how treat PA? She's learning real fast! My last appt. I

spoke for 25 minutes showing at home BP, BS and HR charts and explaining why I

no longer needed oxygen. I never tell her anything that I have not verified,

NEVER! I spent time making sure she knew Dr. Grim and his background! We trust

each other!

Please don't missunderstand, I am not trying to belittle Francis's

problems/issues. He is still trying to find the right combination!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > I find both opinions, and facts to be of

value.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > For example - the research articles will

probably

> > > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia

in

> > > > > > > > women. They will also never mention that the estrogenic

properties

> > > > > > > > may cause weight gain (plenty of anecdotal evidence of that if

you

> > > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > > (which under normal circumstances only fluctuates by a pound

either

> > > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > > effects outweigh it's benefits *may* be of value to some newbie

who

> > > > > > > > comes here down the line.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I

could

> > > > > > > > have skipped AVS and gone straight to surgery, even though I'm a

bit

> > > > > > > > past 40, was not supported by any of the " facts " in the research

> > > > > > > > articles. So I was able to choose to ignore his opinion, and

follow

> > > > > > > > the guidance I got via the *facts* presented in research

articles.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > --- In

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

You mentioned your aldo, what was your renin? Here is what I told my son the

other day:

An ACE inhibitor won't work if you have PA because it works on Angiotensin (the

A) which comes from renin and PA Patients don't have any!) BTW, ARBs won't work

either for the same reason.

I would presume if you have renin they would work but there could be more going

on. Trust your consultant! In my case I was on both and nothing changed when I

stopped them but my renin was 0.1.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

>

>

>  

> >I know, I know.  I tried to taper Micardis for many times and always had a

spike in BP. Dr. Grim recommends to do it again and I will try again. BTW, my BP

is very steady about 125/75 on this combination:-)

> >

> >

> >

> >I read the article here sometime ago " Efficacy of low-dose spironolactone in

> subjects with resistant hypertension " . For  subjects with and without PA they

added 12.5 to 25 mg/d of spiro to ACE or ARB. 

> >

> >

> >That's why I added eplerenone to Micardis a year ago. Note, I never was

officially diagnosed with PA. My aldo is not high enough. What convinced me,

that ACE and ARB are the only two groups of medications (before eplerenon) that

definitely worked for me. All other groups just killed me. 

> >

> >

> >Thank you.

> >

> >

> >Natalia

> >

> > 

> >

> >

> >

> >________________________________

> >

> >To: hyperaldosteronism

> >Sent: Tuesday, October 18, 2011 11:06 PM

> >Subject: RE: Re: Medical Opinions vs Facts

> >

> >

> > 

> >Natalia,

> >Dr Grim so many times mentioned that A2RBs would be useless in PA…how come

you are still on Micardis? I suspect it might reduce effectiveness of Epler.

Have you tried to quit it for 6-8 weeks to see if Epler works better in

normalizing your BP keeping it steady?

> > 

> >Max.

> >62M L adenoma by NP59 scan. High aldos not low renin.  med combo

#76={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Crestor=20, Feno=67,

K.Cl=120 mEq}{K=4.7}{not DASHing but low-salt diet, heat intolerance}

> > 

> > 

> >Natalia Kamneva

> >

> >

> >No, they were never checked. But Dr Grim now suggests that I have early stage

of PA, although I have very high uncontrolled BP for 30 years and nocturia for

18 years. Nevertheless I didn't have any other symptoms until last year.

> > 

> >Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently

diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg

metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some

occasional problems with BP, K and Na; on private consultation with Dr Grim.

> >

> >

>

[Guest guest]

, was this an opinion or fact?

I just turned 65 so I lost my retirement ins. benifit. Premium was going to go

from $138/quarter to $557/month! For just my wife since I use the VA (I had to

sign up as the former employee.) We said " no thank-you " and Put " the old girl "

on Medicare Advantage!

I've seen both sides and vote VA all the way but sounds like I need to try AZ!

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > I find both opinions, and facts to be of

value.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > For example - the research articles will

probably

> > > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia

in

> > > > > > > > women. They will also never mention that the estrogenic

properties

> > > > > > > > may cause weight gain (plenty of anecdotal evidence of that if

you

> > > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > > (which under normal circumstances only fluctuates by a pound

either

> > > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > > effects outweigh it's benefits *may* be of value to some newbie

who

> > > > > > > > comes here down the line.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I

could

> > > > > > > > have skipped AVS and gone straight to surgery, even though I'm a

bit

> > > > > > > > past 40, was not supported by any of the " facts " in the research

> > > > > > > > articles. So I was able to choose to ignore his opinion, and

follow

> > > > > > > > the guidance I got via the *facts* presented in research

articles.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > --- In

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Very rational I would think.CE Grim MD Since you mentioned it I have to share. When I saw my psychiatrist a week or so ago I thought she was going to get me off the psyco drugs. When I mentioned it she stopped and asked me exactly what I wanted. When I responded, "I want to get off all drugs!" she panicked and I thought we were going to have to get the mop! She finally agreed to let my cut the mirtazapine in half! I told her I "would humor" her for a week or so and ended it last night. I told her I would discuss the Cymbalta with my PCP next Monday since it is used dual purpose for diabetic neuropathy (there may be better drugs for that)! I couldn't believe she was so shocked, am I headed the wrong way or just weird? - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > For example - the research articles will probably > > > > > > never, ever mention that spiro's estrogenic properties can > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > > women. They will also never mention that the estrogenic properties > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you > > > > > > look hard enough), yet in the three weeks I was on it, my weight > > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > > comes here down the line. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > > past 40, was not supported by any of the "facts" in the research > > > > > > articles. So I was able to choose to ignore his opinion, and follow > > > > > > the guidance I got via the *facts* presented in research articles. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > --- In > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

But I don't take ACE+ARB. I take ARB + MCB. Did they say anything about that combination?Thank you,Natalia To: hyperaldosteronism Sent: Saturday, October 22, 2011 7:15 PMSubject: RE: Re: Medical

Opinions vs Facts

Also remember the medical authorities warning in 2009 to doctors to stop ACE+A2RB combo that can cause heart attack or some medical term that meant something like “dead meatâ€! Max. Yes, that was they suggested ACE and ARB don't work sufficiently but work much better in a combination with spiro. You suggest that spiro works better alone,

then in combination with them, don't you? I will try, but I am still scared to taper Micardis. I am not afraid of steadily higher BP, I am afraid of spikes that I occasionally have. Natalia

[Guest guest]

Okay, . Then it's up to him. We all are making our own decisions, not always correct, but hopefully we are moving in a right direction at least :-) I also take ARB in addition to eplerenone, and Dr. Grim still cannot convince me that it doesn't work for me. Natalia To: hyperaldosteronism Sent: Saturday, October 22, 2011 7:26 PMSubject: Re: Medical Opinions vs Facts

Natalia, I can't leave you with a wrong impression. Francis and I go to the same VA and I have quite a different experience! Did they miss PA? Yes, just like all the other doctors for 63 years! Did they have a specialist come in and DX my PA, Yes. (I'm probably one of the few here that didn't self DX! I didn't meet Dr. Grim until 8 months later!)

I feel I have an excellent team serving my needs. (2 doctors, 1 NP, 2 nurses and a technician that all know my case.) I can access all my labs for the last 2 years online. I have a copy of all the notes back to the first day I was treated there. They have always done necessary lab test, Francis and I disagree as to whether they do an accurate K blood draw!

Because I have T2DM I have my eyes and feet checked by specialists quarterly. I get new glasses every 2 years or sooner if necessary.

Now, does my PCP know how treat PA? She's learning real fast! My last appt. I spoke for 25 minutes showing at home BP, BS and HR charts and explaining why I no longer needed oxygen. I never tell her anything that I have not verified, NEVER! I spent time making sure she knew Dr. Grim and his background! We trust each other!

Please don't missunderstand, I am not trying to belittle Francis's problems/issues. He is still trying to find the right combination!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > > > women. They will also never mention that the estrogenic properties

> > > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > > > comes here down the line.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > > > past 40, was not supported by any of the "facts" in the research

> > > > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > > > the guidance I got via the *facts* presented in research articles.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > --- In

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Yes, my renin was low. But ACE and ARB always lowered my BP, although not enough to the normal range. And now when I have spikes of BP around 200/100, the combinaton of Micardis+ eplerenon lower it much faster that only eplerenone. Thank you, . Natalia To:

hyperaldosteronism Sent: Saturday, October 22, 2011 7:55 PMSubject: Re: Medical Opinions vs Facts

You mentioned your aldo, what was your renin? Here is what I told my son the other day:

An ACE inhibitor won't work if you have PA because it works on Angiotensin (the A) which comes from renin and PA Patients don't have any!) BTW, ARBs won't work either for the same reason.

I would presume if you have renin they would work but there could be more going on. Trust your consultant! In my case I was on both and nothing changed when I stopped them but my renin was 0.1.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

>

>

> Â

> >I know, I know. I tried to taper Micardis for many times and always had a spike in BP. Dr. Grim recommends to do it again and I will try again. BTW, my BP is very steady about 125/75 on this combination:-)

> >

> >

> >

> >I read the article here sometime ago "Efficacy of low-dose spironolactone in

> subjects with resistant hypertension". For subjects with and without PA they added 12.5 to 25 mg/d of spiro to ACE or ARB.Â

> >

> >

> >That's why I added eplerenone to Micardis a year ago. Note, I never was officially diagnosed with PA. My aldo is not high enough. What convinced me, that ACE and ARB are the only two groups of medications (before eplerenon) that definitely worked for me. All other groups just killed me.Â

> >

> >

> >Thank you.

> >

> >

> >Natalia

> >

> >Â

> >

> >

> >

> >________________________________

> >

> >To: hyperaldosteronism

> >Sent: Tuesday, October 18, 2011 11:06 PM

> >Subject: RE: Re: Medical Opinions vs Facts

> >

> >

> >Â

> >Natalia,

> >Dr Grim so many times mentioned that A2RBs would be useless in PA…how come you are still on Micardis? I suspect it might reduce effectiveness of Epler. Have you tried to quit it for 6-8 weeks to see if Epler works better in normalizing your BP keeping it steady?

> >Â

> >Max.

> >62M L adenoma by NP59 scan. High aldos not low renin.  med combo #76={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Crestor=20, Feno=67, K.Cl=120 mEq}{K=4.7}{not DASHing but low-salt diet, heat intolerance}

> >Â

> >Â

> >Natalia Kamneva

> >

> >

> >No, they were never checked. But Dr Grim now suggests that I have early stage of PA, although I have very high uncontrolled BP for 30 years and nocturia for 18 years. Nevertheless I didn't have any other symptoms until last year.

> >Â

> >Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.

> >

> >

>

[Guest guest]

Natalia, Micardis+Epler work well for you. Check this picture to see what they do and find out if you need to block something else too:Click for details 1 Max. Yes, my renin was low. But ACE and ARB always lowered my BP, although not enough to the normal range. And now when I have spikes of BP around 200/100, the combinaton of Micardis+ eplerenon lower it much faster that only eplerenone. Thank you, . Natalia

[Guest guest]

Well it sure works better when renin is low and aldo is high. Reason to use it would be if not feeling well and or bp not at goal. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Yes, Francis, it's true. Do you have a high BP? Then insist! Eplerenone has nothing to do with renin/aldo!Natalia To: "hyperaldosteronism " <hyperaldosteronism >Sent: Thursday, October 20, 2011 6:49 PMSubject: Re: Re: Medical

Opinions vs Facts

Eplere is not approved for PA. It is approved for high Blood pressure. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I can not afford insurance. Right now my only choice for health care is the VA. Since my PRA ratio was less then 20 by there standards I don't have I PA. So no need for eplerenone.

> > > > > > > >

> > > > > > > > >

> > > > > > > > > WARNING

> > > > > > > > > Spironolactone Tablets have been shown to be a tumorigen in

> > > > > > > chronic toxicity studies in rats (see Precautions). Spironolactone

> > > > > > > Tablets should be used only in those conditions described under

> > > > > > > Indications and Usage. Unnec

[Guest guest]

I have been impressed with the VA. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

, was this an opinion or fact?

I just turned 65 so I lost my retirement ins. benifit. Premium was going to go from $138/quarter to $557/month! For just my wife since I use the VA (I had to sign up as the former employee.) We said "no thank-you" and Put "the old girl" on Medicare Advantage!

I've seen both sides and vote VA all the way but sounds like I need to try AZ!

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > > > women. They will also never mention that the estrogenic properties

> > > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > > > comes here down the line.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > > > past 40, was not supported by any of the "facts" in the research

> > > > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > > > the guidance I got via the *facts* presented in research articles.

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > --- In

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

One of the problems Natalia is having is he rBP GOES TOO low so we are trying to reduce her MEDS. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Natalia, Micardis+Epler work well for you. Check this picture to see what they do and find out if you need to block something else too:<image001.png>Click for details 1 Max. Yes, my renin was low. But ACE and ARB always lowered my BP, although not enough to the normal range. And now when I have spikes of BP around 200/100, the combinaton of Micardis+ eplerenon lower it much faster that only eplerenone. Thank you, . Natalia

[Guest guest]

Time or lean to do meditation or read and practice the Relaxation Response nTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

What do you prescribe instead for insomnia and occasional BP spikes with anxiety? Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.To: hyperaldosteronism Sent: Thursday, October 20, 2011 3:10 AMSubject: Re: Re: Medical Opinions vs Facts

I rarely give lorazapam for BP problems.CE Grim MDTo: hyperaldosteronism Sent: Tuesday, October 18, 2011 6:34 PMSubject: Re: Medical Opinions vs Facts Hang on are you saying you don't have psych problems or you don't have PA? I have been told I *may* have a range of pscyh problems inc anxiety, panic attacks, asperger's syndrome, psychogenic polydipsia based on various psychologist opinions when previous drs gave up, I rejected all these and yet when I pursued PA they wanted to give me another psych diagnosis - Munchausen's! But then PA turned out to be right! But I had to really push them to get this far and I am not even there yet so that makes me think that there may be others out there who are too ill or weak or just too fed up to push their drs anymore so they accept a pscyh diagnosis of anxiety etc and go undiagnosed. Interestingly there is research which is showing that

various types of 'anxiety' have physcial causes that push the body into imbalance and cause it to secrete adrenaline, noradrenaline etc which makes you feel anxious e.g. mitral valve prolapse, POTS, diabetes, dehydration etc and so is physical not emotional. But if you don't have it diagnosed and some one is telling you it's in your head and to calm down all the time then maybe you will start to believe you have an anxiety disorder. Point I'm making is: what if spiro doesn't help in psych problems - what if those 'psych problems' ARE undiagnosed PA?? > > > > > > > > > > > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value. > > > > > > > > > > > > > > > > > > > > > > > > > > > > For example - the research articles will probably > > > > > never, ever mention that spiro's estrogenic properties can > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > women. They will also never mention that the estrogenic properties > > > > > may cause weight gain

(plenty of anecdotal evidence of that if you > > > > > look hard enough), yet in the three weeks I was on it, my weight > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > comes here down the line. > > > > > > > > > > > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > past 40, was not supported by any of the "facts" in the research > > > > > articles. So I was able to choose to ignore his opinion, and

follow > > > > > the guidance I got via the *facts* presented in research articles. > > > > > > > > > > > > > > > > > > > > > > > > > > > > --- In > > > > > > > > > > > > > > > > > > > > > > > > > >