August 2, 2002

My wakeup call came at exactly 7:30 AM this morning. Grandson’s last morning of day camp for this week. As I have done every morning this week, I picked him up at 8:00 AM and together we picked up our breakfast at McDonald’s. This morning we had our breakfast at Papa’s office. The day camp kids were to meet at a huge vacant lot just a block south from Papa’s office. The morning activities included a giant water fight and a spectacular view of the parade route. The annual community parade took place this morning and the day camp kids watched it as a group.  The morning was a great success. When I picked Grandson up at 11:30 AM he had a backpack full of candy!

My appointment with No Name was at 9:45 this morning. I was to receive the results from my latest lab work which included my aldosterone and renin results. No Name seemed very distracted this morning and not focused on my health concerns. He spent most of my appointment fiddling on his computer trying to find the above mentioned lab results. No Name did mention to me that he had written a letter to a doctor of nepbrology. The letter included a description of my symptoms and a description of the lab work I had done at No Name’s clinic. No Name handed me a copy of the summary from the nepbrologist and this summary reads in part as follows: “On looking at the overall picture I wonder how much of what is going on here is psyschogenic related. How much of the leg weakness is real – does she have any objectively found neuropathy.” The nepbrologist then says and I quote, “The question is whether she has periodical paralysis (a very rare condition and usually the potassium is much lower than that), diuretic induced hypokalemic episodes or possibly gastrointestinal losses. The only way to sort through this is to do the following: Send off a blood sample for potassium, total C02, and osmolality as well as a spot urine for Ph, sodium, potassium, chloride and osmolality.”

I find it unbelievable that someone who has never laid eyes on me or spoken to me can presume that “much of what is going on here is psychogenic and then goes on to ask “how much of the leg weakness is real.” I think an appropriate name for this nepbrologist should be NotSoFine.

After fiddling with the computer and handing me a copy of the summary from Not SoFine, No Name stood up indicating the end to my appointment. He handed me a requisition for more blood work which included Osmolality, Urine Potassium (random), Urine Osmolality (random), Urine Sodium (random) and Total CO2. No Name then casually mentioned that he thought he remembered noting that my renin levels had been high. He went on to say that he was unable to confirm this since he could not find my lab results.

After seeing No Name I made my way to the lab to get my lab work done. The lab technician told me that I would have to come back on Tuesday. She was much to busy to do the blood tests that morning. Before I left the lab I asked the lab technician if she could please try to find my lab results. She promised to look for them.

I had to return to the clinic at 1:00 PM to be fitted with the holter monitor. At that time I asked the nurse if my lab results had been found. The nurse looked on the computer and finally had me look as well. I found them almost immediately. They had been filed under June 27th instead of July 17th which was the day they were done. The nurse printed out the results and gave me a copy.

July 17th Lab Results:

Aldosterone was 153 with the lab normals being 110 – 780. However it makes no mention whether the 110 – 780 was supine or upright. According to the lab normals on the first aldosterone test I had done, 110 – 780 is normal for supine and 340 – 1720 is normal for upright. I was sitting upright during this test; I had walked in from the parking lot, sat down and they immediately did the blood test. Makes me wonder if the 153 should have been noted as upright. If that is the case, then my aldosterone level was low. My first aldosterone test in February came back with a result of 162. It was noted as low.

My creatinine was 71 with lab normals being 40 – 115

My potassium was up at 4.3 with the lab normals being 3.6 – 5.0. I had been off my diuretic for 8 days at this point. Interesting that my potassium levels should rise this dramatically when off my diuretic.

Sodium was 143 with the lab normals being 135 – 145.

My renin came back at 7 with the lab normals being .40 to 2.30.

July 26th Lab Results:

Potassium was 4.1 with the lab normals being 3.5 – 5.1. After being back on the diuretic since July 17th, my potassium is starting to drop.

Sodium level is 146 with lab normals being 140 – 148. After being back on the diuretic since July 17th my sodium levels are slowly climbing.

At 11:30 AM, I picked up my Grandson at day camp and the two of us went to my mom and dad’s for lunch. After lunch we all headed out to the big pioneer day celebrations. After a couple of hours I realized that my holter monitor was not working so on the way home I stopped back in at the clinic. The nurse removed the holter monitor and was unable to tell me when it would be fixed. Everything seems to become a waiting game.

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