Q: My husband has various medical issues that make creating a menu almost impossible. Help is needed for recommendations of what to do and not to do.

He only has one kidney, controls his diabetes with diet (so far), has high blood pressure, gout, plantar fasciitis, and a bad knee and back that make walking/running difficult. What is good for one thing is bad for another. HELP. He is the love of my life and I want him around for decades to come.

A: The kidneys clean waste and extra fluids from the body, help control blood pressure, make red blood cells, maintain a proper balance of minerals in the blood, and even help keep bones healthy. They are located just below the rib cage on each side of the spine and partially protected by the rib cage at the back. You don’t indicate why your husband has only one kidney, but essentially there are three main reasons: he was born that way, one was removed because of injury or disease, or he chose to donate one to someone whose kidney(s) had failed. The body is a truly amazing thing; if only one kidney is present, the body adjusts accordingly and that one kidney functions as two normally would. So, whatever the reason, he can live with only one but must, as you are clearly aware, take some precautions.

Dietary choices should be healthy ones. He should eat fruits, vegetables, grains, and low-fat dairy products. His alcohol and caffeine intake should be rather limited, and his sodium (salt) intake should be 2,000 mg or less daily if he already has a diagnosis of hypertension. Consuming a moderate amount of protein is important for proper nutrition but he should avoid a high-protein diet because of the increased stress placed on the one kidney he has.

While he should avoid contact sports such as boxing, wrestling and football, he can exercise in other ways. For example, he might consider aerobic swimming at a local community center, walking, riding a stationary bicycle in your home, and more. In fact, some health centers offer exercise programs done from a chair and sitting position.

I can understand your husband’s diagnosis of gout because his one kidney may not successfully clear uric acid from his body and gout attacks can precipitate kidney stones that can lead to kidney disease. Generally speaking, however, gout can be controlled with oral medication – specific drugs to prevent attacks, and other meds to reduce the pain and discomfort once an attack has begun.

Plantar fasciitis is inflammation of the tissue on the bottom of the foot. It occurs when this already thick band of tissue is over-used or stretched to excess. It is most common in men between the ages of 40 and 70. Common causes for the condition include being a long-distance runner, obesity, sudden weight gain, having either high arches or flat feet and wearing shoes with poor or no arch supports, and having a tight Achilles tendon. Treatment commonly begins with over-the-counter ibuprofen or acetaminophen, stretching exercises, rest, the application of ice, and more. A splint worn while sleeping might be an option. Unfortunately, treatment can take several months before real progress is seen.

Back and knee pain can have causes too numerous to mention, but I would venture a guess that his immobility might contribute to both issues. Before even making any recommendations, I would feel better if your husband had an examination and possibly X-rays either through his primary care physician or an orthopedic specialist to rule out unknown causes. If no condition or abnormality is found, appropriate suggestions for a reduction of pain can be made.

You’ve got a lot on your plate. Begin with an appointment with your husband’s nephrologist and PCP. Request a recommendation to a top dietitian and physical therapist, both of which will have numerous issues to cover. You should accompany him since you’re the menu planner. With strict adherence, your husband just might be able to keep his sugar levels within control, lower his hypertension, control his gout, reduce his level of pain, and remain in your life for decades to come.

Readers who would like related information can order Dr. Gott’s Health Reports “Hypertension”, Gout,” and “Diabetes” by sending a self-addressed, stamped number 10 envelope and a $2 (for each report) US check or money order to Dr. Gott’s Health Reports, PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) or print an order form from www.AskDrGottMD.com.