So. After a blissful week on Oahu, it’s back to reality. For my next act, I will be having an aldosterone suppression test, also referred to as oral salt loading test. Apparently there are no infusion centers affiliated with UCLA that will do the quicker, less scary in-office saline suppression test, so lucky me, I’m on my own for this one. Here’s how it’s supposed to go.
- Day one (this coming Monday, for those of you who are keeping track): go to the lab to get a BMP drawn, take 2 1-gram NaCl pills every three hours. If my potassium comes back too low when the BMP results are in, the whole thing has to stop until another time when my potassium is higher.
- Day two: Take 2 1-gram NaCl pills every three hours. This should be the easy day, but chances are by now, I will be feeling pretty crappy from all that NaCl.
- Day three: Blood draw for BMP, PRA, and plasma aldosterone. Take 2 1-gram NaCl pills every three hours. And – here’s the fun part – after that blood draw, I pretty much can’t leave my house all day because I have to pee in a gallon jug for 24 hours! And keep it in my refrigerator! Actually, I have THREE gallon jugs, just in case. Yeah, you read that right – I just told the interwebs that I’m a frequent pisser. It turns out that it’s part of the condition – people with PA have to pee all the time. And here I just thought I had a teensy bladder.
- Day 4: Pee into the gallon jug one last time, then drop it off at the lab.
This whole routine is mostly being done to please my insurance company. In a normal person, the labs that are run after this will come back with incredibly low aldosterone levels. In a person with PA, those levels will be incredibly high. (Duh – they are already incredibly high!) For this reason, I’m especially resentful of the fact that I have to do this, but whatever – I’m sure I will be in for far more unpleasant stuff in the near future.
Some people can do this and feel just fine. Others will retain water, which will lead to all sorts of icky things like headaches, bloating, nausea, elevated blood pressure, heart palpitations, and so forth. I already know that I’ll fall into that latter group – I can barely eat restaurant food without getting those symptoms thanks to all the salt most restaurants use. Sometimes blood pressure will rise high enough to warrant a trip to the ER. Here’s hoping that won’t be me.
While all of this is going on, I’ll be off work for three days. I intend to use that time productively to write three letters to my past general practitioners who missed all of the symptoms of PA that I presented with. I’m looking at you, Dr. Christine Oman of Arcadia, CA; Dr. Karen Kim of Good Samaritan, Los Angeles, CA; and Dr. Brent Michael of Santa Monica, CA.