Q: My 90-year-old dad suffered with gout for many years. He has walking problems but other than his skin cancer which is under a doctor’s care, he is sharp and in good shape for his age.
I begged him to talk with his doctor about his blood pressure medication possibly causing his gout. He refused, saying his doctor has him on the best medication for his gout and he wants to stay on the drug. About six months ago I came on my regular rotation day to help my parents. My dad was in extreme pain due to his gout. He wanted me to call his doctor which I told him I would, but I indicated I wanted to speak to the doctor about his gout and his blood pressure medication being the cause of his horrible outbreaks which were then weekly. His doctor apologized and said he never thought of his blood pressure medication being the cause, but possibly it was.
He told my dad to stop taking the medication (which he did) and within several days, he was out of pain and able to put pressure on his foot which was where the gout had been for years. His doctor told us to buy a blood pressure monitor and to monitor his readings. His numbers were low – 122/60. Do I need to say he likely didn’t need the medication at all?
I have learned so much from your column and want to maybe help other people who might be suffering as my dad did for so many years.
As an aside, we love my parent’s doctor. My folks trust him as I and my family do, but sometimes we need help with a medical column. Thank you for your great service.
A: Thank you and now you can indicate you have received help via a medical column.
One thing we often forget is that physicians are human and sometimes err without really meaning to. That doesn’t imply we will make a rapid switch to another physician but that we can tactfully (or more forcefully if necessary) suggest that he or she may be overlooking something that should be investigated. You did and thankfully, his physician perhaps reluctantly but did ultimately make the connection that made all the difference in the world in your dad’s care.
I know of one physician who put a patient on medication that had a potential side effect of diabetes. Sure enough, when blood was drawn the patient was found to have elevated readings that the physician demanded required injectable medication nightly. The medication was expensive, the self-administered shots were painful, and the bottom line was that they weren’t ever needed in the first place. It was only after the patient was admitted to a nursing home for rehabilitation and his readings were more closely monitored, that the personnel there discontinued the drug responsible for the elevated readings and the injections, as well. To this day his readings are normal but it was literally like pulling teeth to get the prescribing physician to admit to the connection.
Those medications known to aggravate gout may include diuretics such as hydrochlorothiazide, and others like the popular Lasix (furosemide). And as we can all appreciate, some people may be able to take almost anything without experiencing unwanted side effects. Then there are others, such as your father, that may be experiencing devastating effects that take extended periods of time to sort through before a connection can be made.
I commend you for sticking to your guns and contacting his physician. Perhaps we can all sit up and take notice. We’re not perfect. We make mistakes and may not always have the right answer. And, with luck, we are never too old to learn.
