The Saline Suppression Test

Taken in October 2008

This was test I had to take before the adrenal vein sampling. It seemed easy enough and I was thrilled I didn't have to do the real salt load test which is done at home. That one sounded hard core with all the drinking and salt tablets, as well as the blood pressure monitoring with no medical staff to check on you. If you can, get your endocrinologist to give you a slip for the saline suppression test. It's done in a hospital where nurses will monitor you often and see that you are ok.

This is a test where spironolactone has to be discontinued for at least 6 weeks. I also had to stop nipedifine, my high blood pressure med, but only that day. Also, if you are a big black licorice eater, you have to stop eating it because it oddly throws off the test.

I went to St. Agnes Hospital of Baltimore to have mine done. If you go to a hospital, the procedures are usually performed in the the infusion centers of the cancer department. There will be people getting blood transfusions and chemo. It can be a bit daunting if you have never seen or experienced that. It was a good experience for me, everybody (including the nurses) was polite and quite positive.

The Test and What to Expect:

1) You will go in early (7:30-9:00 a.m. at the latest) and stay for about 4 hours. You go in early because that's when your aldosterone is at it highest.

2) After you are admitted, you will sit for approx. 20-30 minutes and then a nurse will take samples of your blood. They'll be checking for renin, potassium and aldosterone levels.

3) The nurse will then take your blood pressure.

4) You will get an I.V. put into the opposite wrist or arm from where they took your blood. You will receive a catheter for the saline infusion. You will be expected to sit, not lay down, for the entire time. You can however, sit back if you are in a recliner chair.

5) A nurse will administer 1 of 2 bags of saline (.9% Liter). It will feel really cold going into your veins. The nurse said after a while I wouldn't feel it, but honestly I did the whole time. I was freezing and got some blankets- you may need to do the same. I recommend layering with a sweater and even a scarf, too.

6) You will be allowed to drink juice, water or soda during the procedure, but be careful, they are adding a lot fluid to your system and you'll start to feel like you have to go to the bathroom within a half hour. You are also allowed to eat food, they serve lunch around 11:30-12:00 p.m.

7) You will be there for 4 hours to receive all of the saline from both bags.

8) You will go to the bathroom often after the 1st bag is in your system. I went about 15 times during my visit- no lie. Make sure you have a sense of humor and try to get a seat close to the bathroom... mine was across the room and it was a real pain carrying that I.V. apparatus.

9) After you are finished, the nurse will take you blood again to compare against the earlier sample. She'll check your blood pressure too.

10) You get to go home. When you leave you'll be extremely dehydrated, so make sure to drink plenty of fluids (for as much as they put in you, you emptied out, trust me). Also, you'll have zero electrolytes, so I recommend Gatorade, and take it with your potassium pills. I felt very weak after wards, and my joints hurt. I also had a horrible headache, so I just went home and crashed for a couple of hours. Hopefully, you don't have to go back to work, you'll be very unproductive.

11) Your endo will call you within a week with the results.