gout

January 31, 2006

In a message dated 1/30/06 8:05:04 PM, bayabas76@... writes:

I did not have high uric acid before I was hypertensive. My diuretic

is suspected of raising my uric acid levels. The problem is that the

combination of Spiro and Furosemides have been very effective in

lowering my blood pressure for the last five months.

I am trying to search the net for the the recommended food to avoid or

prevent gout. I noticed somehow some inconsistencies of some sites. At

one site I have read that shrimps are ok, others not. Even tomatoes

are recommended in others but must be avoided on one site I have seen.

current approach is to not worry too much about the diet as it is your lasix and your genes that are doing it.

Dr. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD

Board Certified in Internal Medicine, Geriatrics and Hypertension

High Blood Pressure Consulting

Milwaukee, WI

January 31, 2006

In a message dated 1/30/06 8:37:48 PM, bayabas76@... writes:

For the gout, I was given colchicine 0.5mg tablets, 1mg every four

hours for the first 24 hours. I developed severe diarrhea on the third

dose. A call to the doc during the weekend was not returned. I went

online and found out that diarrhea with colchicine was a sign of

overdose, so I stopped it. However the pain and inflammation started

to go down and I can walk with minimal pain now.

Is mine a secondary gout?

Almost certainly due to lasix.

Have you tired backing down on Lasix now that spiro has kicked in? I would try to increase spiro and stop lasix. but dont know all the details so check with your Dr.

This is the way colchicine is to be given. If you were not given these instructions;

Take till pain is relieved or diarrhea develops you were not given good instructions. Complain to your Dr. and you pharmacist vigorusly. If you had not stopped on your own you could have gotten very ill. Good judgement on your part but not on your health care team.

Dr. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD

Board Certified in Internal Medicine, Geriatrics and Hypertension

High Blood Pressure Consulting

Milwaukee, WI

February 1, 2006

> current approach is to not worry too much about the diet as it is

your lasix

> and your genes that are doing it.

>

This week after the gout, I reduced my Lasix to 40mg once a day, and

continued with the Spiro as is. My bp went 115/72 and pulse rates in

the 70-80s. These figures seem better even.

My gout pain has gone now. I will be closely monitoring and hope

things are going better and in the future remove lasix from my meds.

By the way, on taking the diastolic reading, if I really look closely,

I could still see the mercury blobbing at 68 mm but I can hardly hear

the K-sounds thru the sthethoscope.

February 2, 2006

In a message dated 2/1/06 11:06:28 PM, bayabas76@... writes:

> current approach is to not worry too much about the diet as it is

your lasix

> and your genes that are doing it.

>

This week after the gout, I reduced my Lasix to 40mg once a day, and

continued with the Spiro as is. My bp went 115/72 and pulse rates in

the 70-80s. These figures seem better even.

My gout pain has gone now. I will be closely monitoring and hope

things are going better and in the future remove lasix from my meds.

By the way, on taking the diastolic reading, if I really look closely,

I could still see the mercury blobbing at 68 mm but I can hardly hear

the K-sounds thru the sthethoscope.

PS in general for a BP effect Lasix must be taken bid.(twice a day)

Dr. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD

Board Certified in Internal Medicine, Geriatrics and Hypertension

High Blood Pressure Consulting

Milwaukee, WI

February 2, 2006

In a message dated 2/1/06 11:06:28 PM, bayabas76@... writes:

> current approach is to not worry too much about the diet as it is

your lasix

> and your genes that are doing it.

>

This week after the gout, I reduced my Lasix to 40mg once a day, and

continued with the Spiro as is. My bp went 115/72 and pulse rates in

the 70-80s. These figures seem better even.

My gout pain has gone now. I will be closely monitoring and hope

things are going better and in the future remove lasix from my meds.

By the way, on taking the diastolic reading, if I really look closely,

I could still see the mercury blobbing at 68 mm but I can hardly hear

the K-sounds thru the sthethoscope.

The Korotkoff sounds define the systolic and diastolic BP not the bouncing. The bouncing just tells us your heart is beating which is good. This is also the reason the oscillometric method has so many problems you cant tell where the bouncing stops very easily.

Dr. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD

Board Certified in Internal Medicine, Geriatrics and Hypertension

High Blood Pressure Consulting

Milwaukee, WI

February 5, 2006

The doctor who gave me colchicine for the gout and neglected to

clearly explain the dangers which lead to my severe diarhea also

suspected that the Lasix may have aggravated my gout. This was

confirmed by Dr. Bravo in a recent email.

However, the doctor and I decided to half the lasix dose. For about

two weeks now since I took only one 40mg lasix tablet instead of two

per day, my bp seems to improve into the 115/72 range consistently.

This is however contrary to the message of Dr. Bravo in his email

wherein he advised me not to reduce the lasix dose as my bp would rise.

He mentioned my gout was probably of renal causes exacerbated by the

lasix but never caused by lasix alone. I suffered from htn for so long

there might be impairment to the kidneys function.

My gout returned this week but it disappeared within a period of 24

hours after about 6 liters of water that I drank that day. I did not

take colchicine.

Using a better stethoscope with a better dynamic range, yes, I can

hear the low frequency K-sounds as the mercury bounces at 68-70 mm

now, not just a visual indication.

Averaged after three readings taken a minute apart would be 122/80 for

two weeks now since I reduced lasix to 40mg per day. Spiro remains at

100mg per day, one 50mg tablet in the morning and one in the evening.

And the calcium blocker just 6mg once a day. These are all I am taking.

I do not know how to tell Dr. Bravo tactfully that reducing my lasix

dose made my bps better and more stable for two weeks now. (It was my

own decision to reduce lasix, which the local doc agreed, but then he

failed me regarding the colchicine. Probably I have learned a lot here

in our group, the doc just got convinced I know what I was doing. I

have no idea I am that convincing!)

February 5, 2006

In a message dated 2/5/06 3:11:00 PM, bayabas76@... writes:

My gout returned this week but it disappeared within a period of 24

hours after about 6 liters of water that I drank that day. I did not

take colchicine.

Using a better stethoscope with a better dynamic range, yes, I can

hear the low frequency K-sounds as the mercury bounces at 68-70 mm

now, not just a visual indication.

The diastolic pressure is defined as the last sound you hear not where the Hg bounces. A sound is a sound is a sound. Always listen at least 10 mm lower than the last sound you hear.