Gout and Lupus

It has been an emotion-filled past 2 weeks for me on both the work front and health status.  

Recent results on potassium level showed that the level is back to normal range.  I asked whether I should continue with Micardis since my blood pressure during the period I stopped the medication is perfectly normal. I somewhat suspect that diagnosis of hypertension way before the diagnosis of SLE could be lupus related.  And since I have my lupus under-control now, whether it would be mean that I can stop the hypertension medication. The answer from doc is to continue to take the Micardis (even though it may elevate potassium level). His reason - I have evidence of renal inflammation (in medical term - it is called nephritis) in the initial stage of my SLE and mild protein in the urine.  Micardis is useful to help control renal disease and therefore I should continue to take 40mg daily. I suppose that means I also need to watch my diet and not to take too much high potassium foods. 

Just recently, I wake up with pain on the big toe joint.  I thought it was a sprained joint from walking too much the day before. Didn't think too much about and thought it would heal after a day or so with some massage.  The next day, the pain became worse and I noticed the foot has become swollen.  It then daunted on me that it might be gout - though I has never had it before.  I read up about gout on the internet and learned that gout is due to uric acid accumulating at joints and cause it to be inflamed (commonly occurred at the big toe - a condition called podagra).  A diet of too much protein may cause too much uric acid for the kidney to excrete it, especially if the kidney function is not efficient - perhaps like mine. while I waited for the next day to see a doc, I also decided to self-medicate with Naproxen Sodium (Synflex) - a NSAID that I used sparingly for margarine or severe menses cramps.  While this medicine is effective for pain and inflammation and also can be used for gout, it is harsh on kidney thus I used it only when necessary or in low dose.  I had one tablet in the night and by next morning - the pain and the swell have both subsided. The doc visit was abandoned since I reckoned that the doc would prescribe the same medicine or if not, give me prednisolone that I would be reluctant to start.          

On reflection, I wonder why my health is being hit by one thing by another recently.  Stress could be a trigger since I have dealing with difficult work matters in recent weeks and some involve personnel issues which is emotional straining for me.  Diet could be another factor - but now I am in a fix - I actually do not know how to eat anymore since I need to exclude potassium rich food and also protein rich food... I really do not know how have a balance diet then.  Think I am giving up on this front and just continue to eat everything in moderation and don't care about their potassium or protein level.   Maybe that will make it happier and also help in my health!          
     

Lupus, Kidney Function and Potassium

Living with lupus is like living with a time bomb that you never know when it will explode. Regular doc follow up, blood and urine tests are essential routines that I adhere to so that I will have some early warning signs to prevent the time bomb from going off.  For people with SLE like me, it is always a worry that lupus flares might cause organs damage to kidney, liver, heart, etc, no matter how responsible I am towards health.   

Recent blood test shows that my potassium level is high - a sign that my kidney function may not be functioning properly (since it cannot eliminate excess potassium effectively), although most other indications like ds-DNA are stable. Doc has asked that I stopped my high blood pressure medicine (Micardis) temporary and also avoid food with high potassium like bananas. I will repeat the test in a week time. I read up information on the Internet and realize that high blood pressure medicines might cause high potassium level (apparently potassium helps to lower blood pressure).  Found that some food/drinks like potatoes and orange juices have high potassium level.  High potassium level can be dangerous as it might affect the heart condition and stop heart beating. Since I stopped Micardis, I also have been diligently measuring my blood pressure.  It has been at the healthy range so far.  Some time I also wonder that my high blood pressure is caused by lupus and now that I have my lupus under control, I also have blood pressure under control, then I should not need to take medicine for high blood pressure.  But medicine reference always says once you are diagnosed with high blood pressure, it is something that cannot be cured.... but what happened if the diagnosis is wrong in the first place? Anyone can shed light on this area? 

Though I remain quietly confident that my potassium level will go down during my repeated test next week, I wonder how to achieve the dedicate balance in controlling the different medical conditions and the side effects of medications.  Micardis helps to control high blood pressure but yet it can be harmful to the kidney.  Plaquenil controls lupus but yet it can be harmful to the eyes.  Doc will say it depends on whether the beneficial effects of the medicine exceed the cons at the time of treatment.

Anyway, no point worrying too much and I will just take one thing at a time.  I strive to live each day fully since I do not know what will happen next. Good luck to the my next test results.