My doctor just called with the results of last week’s aldosterone suppression test. I’m not going to go into numbers until I have a hard copy in front of me, but here’s the condensed version.
My aldosterone levels, both plasma and urine, were off the charts high. This is what was expected, and confirms that I have PA. The only unusual thing that turned up was that I did not excrete as much sodium as is typical, but that’s probably because I don’t eat the standard American processed food diet and avoid sodium like it’s the devil. And that probably accounts for the extra two pounds I’ve been carrying around since last week, grumble grumble.
So – there are two schools of thought as to what my next step will be: adrenal vein sampling (AVS), or surgery? My doctor thinks it would be safe for me to skip adrenal vein sampling entirely and just have the left adrenal taken out. Me, I’m not so sure; I feel like I’ve had this undiagnosed for so long that I would like to be good and certain that the problem is only unilateral before taking that step.
From what I hear, the AVS is trickier than the actual surgery, but I’ll be getting it done by the head of interventional radiology at UCLA, so I’m pretty confident that risks will be minimal. The biggest downside? Results are often inaccurate or inconclusive, as the right adrenal is difficult to catheterize. And, my tumor is on the left adrenal. Which means that even after doing AVS, there’s still a possibility that the right adrenal could also be affected. So it’s in the realm of possibility that I could have the surgery and still have problems and still get stuck on meds for the rest of my life.
But you know – and these are words that have become my motto as of lately – that’s a chance I’m willing to take. I’d rather go into this knowing that I did everything possible to confirm the diagnosis before I undergo surgery.
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For those curious about AVS – this article seems to be the place to start. It’s a bit of a how-to manual but gives a pretty clear description of what to expect.