Oh, And I Forgot This

OK, there is yet one more thing.  My lithium causes sodium depletion, which causes blood acidosis because of excess potassium.  That’s the short version, anyway.  So, my shrink does my lithium and lytes every 3 mos, cuz if my lithium level changes, then so does the potassium.  I only see the nephrologist once a year, but he gets cc’d on all the labs every three months.

So, I am supposed to see my kidney guy in February, but for the last week, my ankles have been swelling so they are quite huge, and so that it hurts to sit and move my feet around in any direction.  So, I thought maybe they would make an exception and let me come in in January.  Well, after about 4 calls to them, I finally got an appointment for the 7th.  With my luck, they will stop swelling by then.  In the 5 years I’ve dealt with this, they have only one other time swollen this large and by the time I got in, they were fine that day, so the doctor did nothing.

So, for 5 years, I have only had mild, infrequent swelling.  But this week, they are just huge.  Not pitting, tho,  just normal swelling.  So, the doctors’ office calls and now because he cannot give me diuretcs (contraindicated in people with hyperkalemia), he wants me to follow this diet called ‘The Dash Diet’.  Ok, so I looked it up just before writing this, and I found the information on the Nat’l Inst. of Health site.  So, should be reliable.

Problems with this diet and what the heck was my doc thinking when he recommended it!!!  First, the DASH diet is intended for those with heart problems or high blood pressure.  No where does it mention people with electrolyte imbalances caused by other medication.  I do not have hear disease or high blood pressure.  The second goal of this diet is weight loss.  Well, ok, I am fat.  And I could stand to lose another person’s worth of weight.  But I still have no heart problems or high blood pressure.  And I don’t see how being on a weight loss plan for 10 days is going to fix my swelling caused by excess potassium and no sodium.  And here’s the real kicker about this DASH diet—it is extremely low in sodium (less than 1500mg), and very high (over 45oomg) of potassium.  Um, hello?  Anybody paying attention out there, like maybe mr doc???  My problem is that I release all my sodium because my body thinks the lithium I take is sodium.  So, I have very low sodium counts, and because of that, the potassium has very little sodium to bond with to be excreted through the kidneys.  So, in short, because of my lithium, I have little sodium and because of that, I have really high potassium.  And now my ankles are swelling, and he wants me to do the DASH diet which is low in sodium and high in potassium, to fix my swollen ankles!

Is it just me, or is that just wrong????  So, I should lower my sodium EVEN more than it is, and allow my potassium to get even higher??  which could kill me by an asymptomatic heart attack from the electrical impulses being disrupted??  Which is the reason I see this doc in the first place!!

I am NOT going to even attempt this DASH diet.  The whole idea makes no sense in context of my conditions.  I had faith in this doc, but now that faith is being severely strained.  Why would he make such an obviously contraindicated recommendation???