I have kids. A healthcare provider may suspect a diagnosis of pheochromocytoma after reviewing the following factors: Your healthcare provider may use the following tests and procedures to diagnose pheochromocytoma: After your provider has diagnosed pheochromocytoma, theyll likely perform additional tests to see if the tumor is benign or malignant and if it has spread to other parts of your body. Neuroendocrine (carcinoid) tumors (adult). Instead, its described as the following: You have two adrenal glands, one on top of each kidney in the back of your upper abdomen. Pheochromocytoma and functional paraganglioma (PPGL) are catecholamine-producing tumors, arising from adrenal medulla or sympathetic nervous system-associated chromaffin cells. May I ask, did your endocrinologist order the 24 hour urine collection lab test (for catecholamines and metanephrines)? While most pheochromocytoma cases have an unknown cause, theres a significant link to certain inherited conditions. Theres another misguided approach that resonates with me called the Black Swan Theory. Hansen JT. The symptoms of pheochromocytoma may be constant, or they may occur, or get stronger, occasionally. My diagnosis came on Friday the 13th. Chromaffin cell tumors located outside of the adrenal glands are called paragangliomas. Vaccinated patients do not need a COVID test prior to surgery. Where A was when you felt as close to normal as anyone could . Advancing age, sedentary lifestyle, sleep and hot temperature, and risk factors all affect night-time BPs. 2014; doi:10.1210/jc.2014-1498. These periods usually start first thing in the morning after a treatment-free night. A pheochromocytoma is a rare, usually benign, tumor that can cause life-threatening high blood pressure (hypertension).The tumors produce too much catecholamine hormone [such as norepinephrine (noradrenaline), epinephrine (adrenaline), and dopamine] which can cause episodes of high blood pressure.In about 10% of cases, pheochromocytomas are malignant (cancerous) but they can be cured if they . If I cant get them to order MRI, I will pay for it myself and worry about how to pay it off later but no one should have to beg for care. We all have continued healing and good things to look ahead to! Night terrors in adults are a type of sleep disorder where a child or adult suddenly wakes up screaming, flailing their arms, and sweating in crippling fear. About 80-85% of pheochromocytomas grow in the inner layer of . Rhabdomyolysis (break down of your muscles) and ischemic colitis (your large bowel may not get enough blood and in worst case die) are rare complications of pheochromocytomas and paragangliomas secondary to intense vasoconstriction in the skeletal muscle and colon, respectively. Get me through another day. Please feel free to keep me updated I would love to know how things are going. Also, pheochromocytomas have been called the great mimicker because the symptoms of pheochromocytomas can mimic those of many other diseases. Off you go with a prescription for anti-anxiety and high blood pressure meds. Pheochromocytomas are rare tumors. Treatment of pheochromocytoma in adults. Symptoms of Pheochromocytomas. These foods include: Certain medications that can make symptoms worse include: Although high blood pressure is a primary sign of a pheochromocytoma, most people who have high blood pressure don't have an adrenal tumor. I eat well. Multiple endocrine neoplasia type 2. In January of 2011 a surgeon performed rotator cuff surgery on my left shoulder. Nausea and/or vomiting. Only the most meaningful messages will land in your inbox! Your adrenal medullae make hormones called catecholamines that help regulate the following important bodily functions and aspects: Sometimes a pheochromocytoma can release extra adrenaline and noradrenaline into your blood, causing certain symptoms. Accessed Dec. 15, 2021. 5th ed. Cancer It wasnt until a pheochromocytoma diagnosis was suspected that I had ever given thought to the purpose or location of my adrenal glands (unless I was about to speak in public or fly!). Im so thankful that your pheo was found. We have an adrenal gland above each of our two kidneys. If the tumor has been diagnosed for the first time or has come back (recurred). To Own every thought in my head meant I had to stay in the present and resilient. Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings. Conn's Syndrome: Primary Hyperaldosteronism, Cushing Syndrome: Primary Hypercortisolism, Learn about our new home at the Hospital for Endocrine Surgerya dedicated endocrine surgery hospital with no COVID patients, Primary Hyperaldosteronism (Conn Syndrome Tumors), Very high BP (frequently with tachycardia). Unlike nightmares where a child is fully awake from a bad dream, night . Cleveland Clinics Endocrinology & Metabolism Institute is committed to providing the highest quality healthcare for patients with diabetes, endocrine and metabolic disorders, and obesity. Signs and symptoms of pheochromocytomas often include: Less common signs or symptoms may include: The symptoms of pheochromocytoma may be constant, or they may occur, or get stronger, occasionally. Thank God they caught yours as a result of this! It showed a massive tumor growing on my right adrenal gland, down my kidney and liver and entangled in blood vessels. Your email address will not be published. hard to take it all in. My chiropractor who I have seen for 30 years is who suggested get test for pheo. Surprise, we use cookies! Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. . A part of me was comforted when he guaranteed that my doctor wouldnt find it. We are so blessed to have our new Hospital for Endocrine Surgery--it could not open at a better time! We report a 49-year-old woman with pheochromocytoma whose blood pressure (BP) was elevated regularly only at night. Modern prophet, Eckhart Tolle says, Surrender comes when you no longer ask, Why is this happening to me?'. An adrenal pheochromocytoma may be sporadic (occurring for the first time in a family). More doctors. 2. They do have to go through a process and it feels like an eternal amount of time but hang in there and keep advocating for yourself as loud as you can! The word I was told not to Google. Oh Tracy, sounds like youve been going through so much. My best wishes, Get me through work. Accessed Jan. 12, 2020. I am so ready to get this thing out of me and I am so grateful to finally have answers! Pheochromocytoma and Paraganglioma Treatment (PDQ)Patient Version. The true number of pheochromocytoma cases is unknown since many people with pheochromocytomas dont have symptoms and go undiagnosed. I settled on this random and junior doctor at a practice she was available. Approximately 90% of pheochromocytomas are successfully removed by surgery. You are not added to any lists and your information is never sold nor shared. The new Hospital for Endocrine Surgery took 3 years to build, and we moved all our surgery to this beautiful new hospital in January, 2022. All my best xo Pheochromocytoma symptoms although they come and go, and are brief (a relative word of course), are also debilitating. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Approximately 90% of pheochromocytomas are successfully removed by surgery. This is the group that masquerades as essential hypertension. They may cause the same effects on the body as a pheochromocytoma. It is associated with abdominal pain, frequently shock, but sometimes with People with MEN 2B have tumors of nerves in the lips, mouth, eyes and digestive tract. Interestingly my surgery was also on April the 2nd although it was in 2015. The adrenal glands are part of the body's hormone-producing (endocrine) system. OwnYourBest.com uses cookies so that we can provide you with the best user experience possible. Why did your dr. keep searching for the pheochromoyctoma? Get useful, helpful and relevant health + wellness information. [8] The classic triad includes headaches (likely related to elevated blood pressure, or hypertension ), tachycardia /elevated heart rate, and diaphoresis (excessive sweating, particularly at night, also known as hyperhidrosis ). Pheochromocytoma Symptoms Some people with these tumors have high blood pressure all the time. OwnYourBest.com uses Google Analytics to collect anonymous information such as the number of visitors to the site and the most popular pages. This List Summarizes a Typical Paroxysm Spell of Symptoms From a Pheochromocytoma. Uncovering diagnostic clues She heard me. Theyre there to help you. People commonly report feeling a sudden "adrenaline rush" for no apparent reason, and this can happen up to several times per day. Signs and symptoms of pheochromocytoma happen when the tumor releases too much adrenaline (epinephrine) or noradrenaline (norepinephrine) into your blood. No hypertension 10% (Discovered incidentally or through screening). An extreme drop in blood pressure upon standing suddenly (. It also sounds like you are a strong and resilient person. The graph shows a nine-day period of short, irregular bursts in blood pressure due to a pheochromocytoma. I hope you (and your doctors) are getting close to making a diagnosis so that you can resolve everything and move forward with your life. . The tumor is made of a certain type of cell called a chromaffin cell, which produce and release the hormones that cause the fight or flight response. Although lying down certainly brought symptoms on as well. The tumor develops in specialized cells, called chromaffin cells, located in the center of an adrenal gland. These resources may also be able to point you in a direction where lack of insurance wont prevent you from getting the tests you need to find answers. Talk to your health care provider if any of these factors apply to you: The endocrine system includes the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas, ovaries and testicles. The rapid heart rate, high blood pressure, the shaking, shortness of breath, what I also call episodes that are worse at night with just rolling over in bed or the slightest movement. That is what will warrant your doctor to send you for whatever type of scans (CAT, MIBG, MRI, PET) they feel are best to try to locate the pheo (if he/she still suspects it). In the days leading up to my adrenalectomy surgery, I was prescribed phenoxybenzamine to control my blood pressure and prevent intraoperative hypertensive crises. Was told it was malignant hypertension and given medication. A detailed medical history, including previous pheochromocytoma cases in your family. AskMayoExpert. Having zero COVID patients is great for us, and great for you. What Are Night Terrors. Pheochromocytoma is a tumor that forms in the center of your adrenal gland (adrenal medulla), and paragangliomas form outside your adrenal gland. The attacks have slowly become more frequent and more dibilitating. Tyrosine kinase inhibitor therapy is a type of targeted therapy that prevents tumors from growing. When I looked that up I saw a main cause Is the type of tumor you described here. Hypertension, either sustained or paroxysmal, is the clinical hallmark of pheochromocytoma and is commonly attributed to catecholamine excess. High blood pressure is the most common clinical feature of pheochromocytoma. Now you are on the other side of this horrific ordeal, and I wish you continued healing both physically and emotionally. A pheochromocytoma produces frightening and confusing symptoms.Despite how much our family has come to loathe this diagnosis, if one can be objective, it is a fascinating medical marvel, an out-of . Black swan is often a metaphor which describes an event that comes as a surprise, has a major effect, and is often inappropriately rationalized after the fact with the benefit of hindsight. Sounds like you are being as proactive as possible having just seen your third doctor. In brief, your brainstem contains a series of processing centres collectively known as the "reticulation formation" (which includes the periaqueductual grey mater, rostral ventral medial nucleus, and median "raphe" nucleus). Thus this avoids arriving at exotic medical conclusions and running unnecessary tests. There are two types of radiation therapy: The type of radiation therapy your provider may recommend depends on whether your cancer is localized, regional, metastatic or recurrent. Mayo Clinic; 2020. A scan of my abdomen was ordered to get a better view of the tumor. Please dont give up, keep pressing. While theres a substantial physical recovery time, the emotional and psychological recovery takes ample time as well. Where Can I Find Clinical Care Recommendations and Practice Guidelines? After testing it was determined to be a pheocromocytoma. In between. My mother had pheo and you would think that would be enough for them to continue but it is not. Ive been thinking a lot about that time. These spells can happen because of activities or conditions, foods high in a substance that affects blood pressure (tyramine), and medications. Pheochromocytoma is a type of neuroendocrine tumor that grows from cells called chromaffin cells. If the tumor is in one area only or has spread to other places in your body (metastasized). Talk to your healthcare provider if you have any first-degree relatives (siblings and parents) that have been diagnosed with pheochromocytoma and/or any of the following genetic conditions: The prognosis (outlook) for pheochromocytoma is usually good if its treated. And Im so much more aware of and humbled by the silent struggles of others and that I may never even be privy them, even by those of whom I am closest. Going through the process of this currently. People living with. Endo thought it was pheo but quit when bloodwork came back negative. Sustained 60% I valuefriendships and family. Regards Pheochromocytoma and paraganglioma. I wish you a swift recovery. Often these patients will have recurring episodes of sweating, headache, and a feeling of high anxiety. The classic symptoms of pheochromocytomas (or pheos) are those symptoms that are caused by the excess adrenaline being produced within the adrenal gland tumor. Pheochromocytoma is a rare chromaffin cell neoplasm that secretes catecholamines and is usually found in the adrenal medulla. McGraw-Hill Education; 2017. https://accessmedicine.mhmedical.com. Bilateral biochemically silent pheochromocytoma, not silent after all. A pheochromocytoma is a rare but treatable tumor that forms in the middle of your adrenal gland. A4 . Let us know your question(s) and we will forward it to Dr. Carling, Acute respiratory distress syndrome (ARDS) or shock lung is a rare but serious I am scheduled for surgery day after tomorrow. A pheochromocytoma (pronounced FEE-oh-KROH-moh-sy-TOH-muh) is a rare tumor that forms in the center of one or both of your adrenal glands (adrenal medulla). They are part of your endocrine system. Symptoms usually come on suddenly and can include: blurred or hazy vision head and eye pain red eyes nausea and vomiting sudden. Pheochromocytoma. 4th ed. Among the 4 MRIs that I had undergone, {head, neck, chest} the one of my Abdomen revealed the 20 MM pheo on my right adrenal gland. We spent over 4 months looking for the pheochromocytoma I surely didnt have. These programs are designed to provide a means for us to earn fees by linking to their website. You know the saying there are no accidents in life? Common symptoms of pheochromocytoma include: High blood pressure (hypertension). The multiple urine collection always showed the high amounts??? The youre a busy mom and of course you are stressed out conversation. Answer (1 of 11): Get to your doctor quickly. Clinical presentation and diagnosis of pheochromocytoma. Food sources and biomolecular targets of tyramine. The outer layer of your adrenal gland is called your adrenal cortex. Even a slight, gentle movement would trigger symptoms. This puts you at risk of heart damage (heart attacks, heart arrhythmias, and sudden death). Other Typical Signs and Symptoms of Pheochrmocytoma Include: Headaches (severe) Excess sweating (generalized) Racing heart (tachycardia and palpitations) Anxiety and nervousness Nervous shaking (tremors) Pain in the lower chest or upper abdomen Nausea (with or without vomiting) Weight loss Heat intolerance Weight loss Recent onset of hypertension Dec. 20, 2021. You should contact your provider about genetic testing. Over the course of his career, Jimenez estimates that he has seen more than 1,000 patients with pheochromocytoma. Please come back and let me know how things are going when you can. Thank you:), Hi Andrea thanks so much for reaching out and sharing your situation. I just desperately needed a doctor to listen and care enough to say, lets keep digging, lets not rush to judgement, lets think outside of the box, I am not letting you walk out of here feeling unheard., As I sat in the chair of my third cardiologist, who had exhausted both of us with a multitude of exams concluding that I have a healthy heart (thankfully) she remarked, You know, you should get checked by an endocrinologist. or to our office, and get back to you as soon as we can. Pheochromocytoma results in excessive production of epinephrine and norepinephrine, leading to very high blood pressure. I know I have a benign tumor on my kidney and when I researched it it listed all the things I experience. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by killing the cells or by preventing them from dividing and multiplying. However, if youre at risk for developing a pheochromocytoma due to certain inherited syndromes and genes, genetic counseling can help screen for pheochromocytoma and potentially help you catch it in its early phases. Targeted therapy is a treatment option that uses medications or other substances to attack specific cancer cells without harming healthy cells. When I read that my assumption was the urine result were negative so to speak for what they were looking for. Some patients, sufferers and victims, never find it the adrenal pheochromocytoma nickname is the autospy tumor (for obvious reasons). AskMayoExpert. The hormones cause blood pressure to increase and the heart to beat faster. Most of the chromaffin cells are in the adrenal glands. These episodes can happen anywhere from several times a day to a couple of times a month. A pheochromocytoma is a tumor that usually originates from the adrenal glands' chromaffin cells, causing overproduction of catecholamines, powerful hormones that induce high blood pressure and other symptoms. I did this repeatedly (probably around 4 times over the course of 2 1/2 months). June 25, 2022; 1 min read; advantages and disadvantages of stem and leaf plots; wane weather 15 closings and delays; I am of average weight. Benign prostatic hyperplasia with nocturia happens because ( 1 ): The bladder is not emptying as it should: In BPH, there is a reduction in prostate urine flow, leading to incomplete voiding. Its usually an effective treatment, but it can cause side effects. she listened. Eating foods high in tyramine, like red wine, chocolate and cheese. Adrenal.com is an educational service of Carling Adrenal Center, the world's leading adrenal surgery center. So my bloodwork was generally normal but the red flags in the results in my 24-hour urine (catecholamines/metanephrine) collection results. Sometimes pheochromocytoma symptoms aren't very noticeable. Those words kept me going. Advertising revenue supports our not-for-profit mission. Read our Adrenal Blog! Stay in touch warm wishes, Acute abdominal catastrophe is another infrequent but well-recognized presentation. Accessed Dec. 15, 2021. Accessed Dec. 15, 2021. Receiving a pheochromocytoma diagnosis of course was challenging in itself, but just as significant is the mental, emotional and spiritual survival. Adrenal blog covering adrenal tumors, adrenal cancer, adrenal disease and adrenal surgery, from the expert surgeon-scientists at the Carling Adrenal Center. Just a quick question regarding your tests. Approximately 10% of cases occur in children. Researchers are currently studying sunitinib, a type of tyrosine kinase inhibitor, for the treatment of metastatic pheochromocytoma. Thus, I knew something was brewing inside. Pheochromocytoma is often associated with paroxysmal hypertension. This realization has been a blessing and a curse but mostly a blessing. We have been very busy performing adrenalectomies all year long and our protocols for safe care of our patients have been tremendously effective. So April 2 represents closure from over 2 years of progressively worse symptoms, sleepless nights, frustration beyond explanation and zero answersworse than no answers, brush offs from doctors. Certain activities or conditions can make symptoms worse, such as: Foods high in tyramine, a substance that affects blood pressure, also can make symptoms worse. Fever, sore or swollen lymph nodes, and joint pain are more common symptoms after you first get the virus and become HIV-positive, but about 1 in 10 people get night sweats. Symptoms include A fast and pounding heart rate Excessive sweating Light-headedness when standing Rapid breathing Cold and clammy skin Severe headaches Chest and stomach pain Nausea and vomiting Vision disturbances Tingling fingers Constipation Headaches like a tight band mainly on waking early hours and feeling wiped out and lethargic National Cancer Institute Center for Cancer Research. Each person's symptoms may vary. Dismiss. Cristy, My heart aches reading this. When you hear the sound of hooves, think horses, not zebras.. It was 17 days later that a pain came out of nowhere that was unbelievable. Young WF. Carney triad (paraganglioma, GIST and pulmonary chondroma). Mayo Clinic. It would be so appreciated! Please feel free to keep me updated so glad the article resonated with you if it helps with finding answers!! This can lead to high blood pressure and cause symptoms such as severe headaches, irritability, sweating, rapid heart rate, nausea, vomiting, weight loss, weakness, chest pain, and anxiety. They also may have a tumor on the adrenal gland, called pheochromocytoma, and medullary thyroid cancer. Yet what she ultimately discovered was beyond what I had imagined. Uncontrolled bleeding in your brain (cerebral hemorrhaging). I am so very thankful I will never know for sure. If you disable this cookie, we will not be able to save your preferences. Healthcare providers use targeted therapies to treat metastatic and recurrent pheochromocytoma. Most pheochromocytomas are benign (not cancerous). Sleep apnea goes hand in hand with many chronic illnesses but with MS it is more likely to result in needing a CPAP mask or a breathing machine to keep oxygen flowing during sleep. Unfortunately, you cant prevent developing a pheochromocytoma. My best wishes for good health! xperience the best Mindfulness Meditation techniques click here. Neumann HPH, et al. The way your body responds to stress (the fight or flight response). These cells produce hormones needed for the body and are found in the adrenal glands. Pheochromocytoma is typically associated with a symptom triad of headache, palpitations, and diaphoresis. Unvaccinated patients will be given a rapid COVID test when you arrive at the hospital. Researchers don't know exactly what causes a pheochromocytoma. Could my children and/or relatives develop a pheochromocytoma? It is estimated that the annualincidence ofpheochromocytoma is approximately 0.8 per 100,000 person-years. (sited from UpToDate.com). You have a personal or family history of traits linked with inherited pheochromocytoma or paraganglioma syndrome. My story is very similar to yours. Pheochromocytoma and paraganglioma: An Endocrine Society Clinical Practice Guideline. These spells can happen because of activities or conditions, foods high in a substance that affects blood pressure (tyramine), and medications. of familial pheochromocytoma and paraganglioma, those cases found by screening will likely increase. They kept me tethered from each stressful moment to the next by only a thin, fragile string of hope. These hormones help control many body functions, such as heart rate, blood pressure and blood sugar. The symptoms can be very variable, and some patients are asymptomatic. This damage can cause several critical conditions, including: Rarely, a pheochromocytoma is cancerous, and the cancerous cells spread to other parts of the body. My pheochromocytoma symptoms were worse at night usually because I was less active in the evenings. Im grateful for your website!!! Still between points A and B, I continued through a series of tests that ultimately sculpted me in to a different human being today. Feeling shaky. It is noteworthy that more than one-half of pheochromocytoma and paraganglioma, patients do not have discrete spells. Were your blood tests negative or positive? Policy. They increase the heart rate, flow of blood, and metabolism. People with pheochromocytomas may also experience paroxysmal attacks, which are chronic episodes of high blood pressure that often lead to headaches, irregular heartbeats (palpitations) and excessive sweating (diaphoresis). However, some pheochromocytoma tumors dont make extra adrenaline or noradrenaline and dont cause symptoms (are asymptomatic). I wish everyone well who has shared their story, its unreal what a Pheo does to you. My results were through the roof which was what kept my doctor digging. Usually, a pheochromocytoma develops in only one adrenal gland. Others may feel a burning or an ache. This extended my ordeal of course. We do this to give you the best experience on our website. Along with anxious thoughts, you might experience: sweating. Usually, pheochromocytoma affects only one adrenal gland, but it can affect both glands. Others are not nearly as fortunate. Each of these diseases can disrupt your sleep with pain and stiffness because they can cause your hip joints to swell or become inflamed. Family history: Hypertension, diabetes . If youre experiencing symptoms of pheochromocytoma, such as high blood pressure and headaches, talk to your provider. Pheochromocytoma and paraganglioma are both rare tumors that come from the same type of cells known as chromaffin cells. Although my pheochromocytoma symptoms would come and go, these eventsthe pounding of my heart and head, and the symptoms mentioned above occurred while I was at rest and would shift my position. Accessed Dec. 15, 2021. Exercise and reaction . a frequent need to urinate. In MEN2, PHEOs are usually benign and do not spread beyond the adrenal glands. People who have certain rare inherited disorders have an increased risk of pheochromocytoma or paraganglioma. If you do have a pheo, once they find it and address it, you will feel like a new person. So this story of symptoms, diagnosis and how I survived a pheochromocytoma is an example that I hope you find inspiration from and apply to your journey. Get me through what had seemed to everyone else an ordinary day. Experience the best Mindfulness Meditation techniques click here.. If you or one of your first-degree relatives have been diagnosed with a pheochromocytoma, its important to go through genetic testing to make sure you dont have a genetic condition that could potentially cause other medical issues. Keeping this cookie enabled helps us to improve our website. They can last anywhere from 30 eternal seconds to several minutes and will leave you with residual tremors and exhaustion. Mayo Clinic is a not-for-profit organization. But if you continue testing the 24 hour urine collection is a must! The attacks include violent shaking, blister headache, vomitting, sneezing, heart pounding out of my chest. Great news! https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/types-of-blood-pressure-medications. The surgery was a success and I was free to move forward with one less adrenal gland and a new perspective. If this is the case for you, I hope that they run these scans and zero in on it! Crawford MH, ed. American Heart Association. El-Doueihi RZ, et al. Medication that keeps your blood pressure normal, such as, Medication that keeps your heart rate normal, such as. Pheochromocytoma: An approach to diagnosis. Hello Laura, Im terribly sorry youre going through all of this physical and emotional pain. While I am saying they were worse at night, it may just be because they were more noticeable and I had more time to obsess about them as well. Andersen G, et al. You can have one family member with you at all times. These genetic conditions include: High blood pressure can damage organs, particularly tissues of the heart and blood vessel (cardiovascular) system, brain and kidneys. If youve been diagnosed with a pheochromocytoma, it may be helpful to ask your healthcare provider the following questions: Pheochromocytoma is a rare tumor. Please keep us posted too we care and want to know how you are. All our doctors and staff have been vaccinated and boosted. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). This is the safest hospital for you! If pheochromocytomas are left untreated, they can potentially cause serious, life-threatening complications, including: Some people with a pheochromocytoma may also be at risk of developing a stroke or heart attack (myocardial infarction).
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