Barry Goldsmith went to a great extent to stay out of the doctor's office. His faith in fitness – especially running – to keep him fit and healthy had long been a piece of faith. If he did not feel good, Goldsmith would sneak up his shoes and "run it off". Maryland patent attorney routinely racked up about 30 miles per week – more when he was training for a marathon or triathlon – interspersed with swimming, cycling and weight training. For more than 30 years, his strategy worked. "Barry is incredible fit and he has always been this great athlete to avoid healing doctors," said his wife Paula, a former teacher. His aversion also continued after his sister became family medical. But several years ago, Goldsmith, now 56, experienced a series of alarming episodes that he could not run. They followed a pattern: first a rush of what felt like acid would push Goldsmith's legs. Then came 1 0 minutes of throbbing palpitations that ended with a wave of nausea. At the beginning, the episodes were sporadic. But eventually they increased in frequency and duration and left Goldsmith shrinking on the neighbor's lawn at the start of a run. The couple was shocked to find that Goldsmith's problem was potentially deadly and had spit for years, partly camouflaged by his star level of fitness. "Being in good physical health was a blessing and a curse," Goldsmith said recently. "The longer I waited, the more I risk myself." – –…
Barry Goldsmith went to a great extent to stay out of the doctor’s office.
His faith in fitness – especially running – to keep him fit and healthy had long been a piece of faith. If he did not feel good, Goldsmith would sneak up his shoes and “run it off”. Maryland patent attorney routinely racked up about 30 miles per week – more when he was training for a marathon or triathlon – interspersed with swimming, cycling and weight training.
For more than 30 years, his strategy worked.
“Barry is incredible fit and he has always been this great athlete to avoid healing doctors,” said his wife Paula, a former teacher. His aversion also continued after his sister became family medical.
But several years ago, Goldsmith, now 56, experienced a series of alarming episodes that he could not run.
They followed a pattern: first a rush of what felt like acid would push Goldsmith’s legs. Then came 1
0 minutes of throbbing palpitations that ended with a wave of nausea.
At the beginning, the episodes were sporadic. But eventually they increased in frequency and duration and left Goldsmith shrinking on the neighbor’s lawn at the start of a run.
The couple was shocked to find that Goldsmith’s problem was potentially deadly and had spit for years, partly camouflaged by his star level of fitness.
“Being in good physical health was a blessing and a curse,” Goldsmith said recently. “The longer I waited, the more I risk myself.”
– – –
Goldsmith first noticed the problem 2014 at the end of a cross-country flight. He landed in California and got up and felt the sparkling of acid, palpitations and nausea, which dropped quite quickly.
Maybe Goldsmith remembers that he had been sitting for too long. When the episodes came back every month or so he found them “about” but for months they did not mention his wife or his internist as he saw every year or so. In 2015, he developed a single morning headache.
Goldsmith consulted the cardiologist whom he had seen as a precaution for low heart rate, which may be due to severe exercise but did not mention the episodes. The doctor said that Goldsmith seemed healthy.
“He told me,” I’m fine now, I cleaned it, “Paula told,” and continued to push. “
By 2016, morning headquarters occurred more often. Sometimes Goldsmith felt tired, but assumed he grew older or not slept well.
” We both just ignored it, “Paula said.” Nothing intensified and most days he was good. “
However, during a 5K race in July 2017, Goldsmith felt so weak that he had to finish halfway and go to the finish line. Heart pains and nausea became more common.
Goldsmith called his sister who suggested he saw an endocrinologist Some of their relatives had thyroid problems, perhaps he did.
The endocrinologist he saw in September ordered blood tests, revealing a slight thyroid gland. During the visit, Goldsmith mentioned the ongoing problem that had not come back, and his morning headache. The endocrinologist suggested that he may want to attempt thyroid medication and recommended that he return in three months.  At the end of the fall, Goldsmith had more trouble completing a run; His headache had become an almost daily event.
An ophthalmologist suggested that he could experience blood pressure nails, even though his readings in medical offices were normal. It was sensible: both his parents had developed mild hypertension in the 60’s.
By his friend’s proposal, Goldsmith bought a blood pressure cuff. He immediately suspected that the device did not work: the readings were sometimes the charts – they could not be accurate enough, he thought. A registered 204/118, a reading that complies with a hypertonic crisis, which may require emergency treatment. On other occasions they were normal, about 125/85.
Goldsmith tried to use a friend’s cuff; The same thing happened.
Despite Paula’s insistence that he called his doctor, Goldsmith waited a month. He said he wanted to see if the readings were stabilized.
“I kept pushing, but he fought for everything,” she recalled. “He played everything, it was his style”, a characterization that Goldsmith agrees with.
In December, Goldsmith went to his wife’s wishes and saw one of his internist partners. His blood pressure reading at the office was worrying 170/87. Goldsmith told the doctor who prescribed medication to reduce blood pressure, switching work and under stress. Goldsmith took the medicine faithful, but the nails continued.
– – –
In January 2018, Goldsmith returned to the endocrinologist, accompanied by Paula. He mentioned blood pressure sticks and headache. The specialist ordered blood tests to check Goldsmith’s hormone levels and convinced him to start taking a low dose of medication for his underactive thyroid gland.
When they left the office, Paula suggested they stopped at the laboratory for the tests ordered by the endocrinologist. Goldsmith dropped: he hated needles. His internist had recently increased the dose of his blood pressure drug and he said he wanted to see if the new treatment worked before blood tests were taken.
However, the increased dose of blood pressure medicine, later enhanced by a second drug, made him feel worse. And Goldsmith had developed a new symptom: severe sweating.
Keeping a close eye on his blood pressure, he had noticed a pattern. Immediately after he had a headache, his blood pressure was usually sky high. An hour later it returned to normal. At that time he took his blood pressure medicine, went and drove and read another reading. It was an alarming low 83/48, and the goldsmith felt typically weak and spent, afraid he could go out. But in a few hours, reading returned to normal.
Doctors told him that calibration of the correct dose of blood pressure medication can be difficult and suggested that he change the time.
In May, things fell apart.
During a drive with friends, Goldsmith stayed for less than a mile. He then shrugged and dropped on the neighbor’s lawn, too weak to stand.
Paula came a few minutes later. Then he seemed to have recovered something.
She remembers to feel furious and afraid. “I said,” This does not work! You hurt your heart. You need to find a blood pressure specialist. “
Goldsmith went online to see what he could learn about the causes of blood pressure spikes. : sudden hypertonia or blood pressure spikes, severe sweating, rapid heart rate, weakness and headache These results when the tumor releases uncontrolled outbreaks of hormones including adrenaline, especially in response to physical exertion or stress. Adrenal hormones help control many functions including heart rate, metabolism, blood pressure and response to stress.
Goldsmith mailed his internist and asked if it was possible that he had such a tumor known in medical jargon as a “pheo.”  The internist replied that it was telling him to call to the endocrinologist.
A week later he was back on them The doctor told him that one of the blood tests she had ordered six months earlier – which he had not received – could have helped answer this question. The saturated level of catecholamines – hormones secreted by the adrenal glands, they parade the organs on top of the kidneys. Elevated levels of these hormones can signal an endocrine tumor.
Goldsmith’s levels turned out to be way beyond normal.
The endocrinologist sent him to an abdominal CT scan, revealing a huge tumor, about the dimensions of a little squirrel squash, engulfing his right adrenal glands. It was probably a pheo, of which about 10 percent is malignant.
Tumors, diagnosed in about 2 per million adults annually in the United States, rarely cause high blood pressure, which corresponds to 0.2 percent of hypertension cases.
Pheos often develop for unknown reasons, but in at least 25 percent of cases, genetic factors play a role. Doctors consider the tumors a “time bomb”; They can cause stroke, kidney failure, heart attack or sudden, unexplained death. Treatment typically involves surgery to remove the tumor together with the affected adrenal gland.
Goldsmith’s endocrinologist immediately called to Washington, the endocrine surgeon Erin Felger.
– – –
Felger, Associated General Manager at MedStar Washington Hospital Center, met the couple two days later.
The size of Goldsmith’s slow-growing tumor – 10 centimeters – made laparoscopic removal a challenge that would require two surgeons, she told Goldsmiths.
“It is clear that he has had it for many years,” said Felger.
Although fearful of surgery and the risk of sudden death caused by such a tumor, Goldsmith said he was assured of Felger’s experience, her uncomplicated manner and the fact that she was also a runner.
Felts, which have performed more than 250 such operations, ticked of possible complications, which include postoperative heart problems and blood loss requiring a transfusion.  Goldstein first needed drugs to stabilize his blood pressure, which could postpone significantly during surgery.
For Paula, the two-week pre-up period was required, which was dominated by the ghost of her husband’s sudden death. Every morning she said that she woke up and wondered if he was still alive.
“I did not want to leave her side,” she recalled.
Felger said that the June 29 procedure “went perfectly”. He was scheduled to spend two days in intensive care and a total of five days at the hospital, but Goldsmith was well enough to be released the day after surgery.
Six weeks later, with Felger’s approval, Goldsmith continued to run, although at a slower pace and a reduced distance. His blood pressure remains somewhat elevated, which is common after surgery. He will require lifelong monitoring to ensure that the tumor does not return, which rarely is the case.
During the months before his diagnosis, Goldsmith said fear was an obstacle: he was increasingly afraid of what a doctor could find. 19659003] In retrospect, he wishes he had acted with a larger shipment. “I could have saved a few years,” he said.
(In addition to the title, this story has not been edited by NDTV staff and published from syndicate feed.)