DH's elevated potassium

Personal Finances Taking Care of Parents
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So the dr figures it’s caused by losartan (his BP med) and wants to add another med to counteract (hydrochlorathiazide, which seems to be a diuretic–great, more peeing =8-0 I stopped him from peeing on the breakfront this afternoon.

I’m having enough trouble getting him to take his current pills (he sometimes forgets what to do with a pill or spits them out). NOpe, not adding another pill. So I suggested that we wean him off losartan instead. Does he really need perfect blood pressure with advanced dementia? I say No.

And have him eat a low potassium diet–GAH!! Looking over this list of potassium foods…no chicken or salmon? REALLY?!

No dried fruits–he eats these and prune juice to help constipation. He just started a fresh box of raisin bran today and a fresh bottle of prune juice a couple days ago :-/

No beans, lentils–I give him beans/lentils/tofu 2-3x/week for constipation and plant protein. And he likes them :frowning:

Spinach, broccoli–AGH! we eat leafy greens pretty much daily. Apparently only kale–my least fave green–is OK for him :frowning: And the way I like it is in kale-potato soup…no potatoes either.

Bananas, oranges–mostly use bananas to sweeten & thicken his smoothies. I could use sugar/maple syrup/something else. But I sometimes use oranges and bananas as dinner dessert. sigh.

Tomatoes–egad! No spaghetti squash with sausage-mushroom sauce? no gazpacho? no Greek salad?!

No dairy or plant milks)–what am I supposed to put on his cereal? no cereal? He eats early and I need something easy to fix before “second breakfast” when I eat (usually eggs, late morning).

No whole grains–srsly? At least I like sourdough!

No yogurt–he eats yogurt or kefir almost daily for his gut. He loves it :frowning:

No cashews, almonds–well, he can eat walnuts, sunflower and pumpkin seeds instead. No more green beans almondine, I guess.

No chicken–srsly!!!
No salmon-- "

What, we’re supposed to live on red meat, shrimp, crab cakes, green beans and eggplant? And white rice, white bread, white pasta?!

At least berries are OK…

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Quality over quantity. What happens if you don’t lower his potassium by taking away the foods he likes?

IP

3

So the dr figures it’s caused by losartan (his BP med) and wants to add another med to counteract (hydrochlorathiazide, which seems to be a diuretic–great, more peeing =8-0 I stopped him from peeing on the breakfront this afternoon.

I hope this isn’t stepping onto the slippery slope—ie, the doc prescribes a med that has unwanted side effects. And instead of trying a different dosage, or a different drug, the response is to add another drug to eliminate the side effect of the first one. And then…there’s the chance that this added drug will cause an unwanted side effect. Which means another drug added to counteract that one. And adding a diuretic when he drinks so little—how can this be anything but harmful in the long run?

I couldn’t agree more with your thought to wean him off the losartan. Given his dementia, perfect blood pressure is a less important goal than having more manageable daily lives.

If it’s of any interest, I’ve been coming across theh mention of fenugreek as helpful for blood pressure, cholesterol, etc. I’ve just begun to look into it, and if you’re interested, I’ll post anything relevant here.

=sheila

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What happens if you don’t lower his potassium by taking away the foods he likes?

High potassium interferes with heart muscle so can cause irregular heartbeats and even end beating/heart attack. His level is in the caution zone, not danger zone. IIRC 5.0-6.0 is caution, >6 is danger. He’s at 5.4

The funny thing is that irregular heartbeat happens to me when I get too little potassium. Years ago a previous dr suggested I take potassium and agnesium for my occasional irregular beats. Fixed it fast. I still take them and no longer experience irregular beats.

I’ve never given DH potassium as I know it’s counterindicated with his BP med.

I’m thinking I’ll give him LESS potassium foods, but not eliminate altogether.

5

fenugreek–let me know, I have some on hand for Indian dishes, but I’ve been fixing less Indian food since I broke my leg (no idea why). I should step it up…curried cauliflower & green beans with a wee bit of tomato, shrimp curry, lamb vindaloo–all things he can have (huh–garlic naan, white basmati…no lassi, though…)

Ugh–one of our fave emergency rations is frozen palak paneer (spinach w/paneer). Another is various frozen and vacuum packed dals.

I read somewhere that CBT oil is good for dementia. If it helps him sleep or gives him energy for outings, either would be good.

Oh, Sheila, This evening I moved the commode by the bed as y9u suggested. I don’t know if I can get him to use it at night, but we’ll see. He’s confused enough about using the toilet these days.

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Dehydration is one of the causes of high potassium. I wonder if you could get him to drink more water, that could be helpful. Of course, he’d also be peeing more! Do you have any idea what his BP would be without any medication? Instead of weaning him off his antihypertensive, I wonder about lowering his dose, if that would bring his potassium down and still have an effect—although a smaller one—on his BP.

=sheila

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Did the Dr. check for his kidney function? The first link I found looking for the problems caused by high potassium https://www.kidneyfund.org/kidney-disease/chronic-kidney-dis… mentions that kidney disease is the most common cause of high potassium in the blood.

It also mentions potassium binders, which are generally a powder and can be mixed into various foods.

–Peter

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Did the Dr. check for his kidney function?

If I recall…kidney function was either included then, or done recently—and was normal.

=sheila

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The blood draw was for kidney function–I complained about his peeing so often (he had a urinalysis before the blood tests).

Kidneys OK on the whole:

egfr = 84, very good for his age

BUN = 23, barely OK for his age (could be explained by dehydration)

creatinine = 1.1 good

He’s likely slightly dehydrated much of the time. Most of what he likes to drink is now on the verboten list (oj, prune juice, hot chocolate, banana-chocolate smoothie). But he never drinks more than a cup at a time, and never drinks much water, even less than a year ago. He likes cranberry juice and I will give him some tomorrow (I got a cran-pomegranate blend).

Typical day for him:

8 oz coffee and 8 oz juice with breakfast.
During the whole day he drinks 1/2-1 cup water (usually a couple of sips after lunch & dinner pills).
In the afternoon 8 oz smoothie, kefir, kombucha, or tea, or 4 oz yogurt.

That’s it–a quart at most. Except if I give him soda with lunch or dinner–he’ll drink 8 oz. He never wants anything to drink after he takes a sip of water with dinner pills.

There’s some liquid in his foods, of course…if cold cereal, there’s milk. If hot cereal, there’s water and cream. Eggs are kind of liquidy. Sometimes we have soup or stew.

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Most of what he likes to drink is now on the verboten list (oj, prune juice, hot chocolate, banana-chocolate smoothie). But he never drinks more than a cup at a time, and never drinks much water, even less than a year ago.

Are they verboten because they’re high in potassium? I don’t know offhand, and am tired—don’t feel like looking it up right now. :wink: Do you think you could bring him water once an hour for him to take a few sips? And/or is there anything you could add to water to tempt his tastebuds? How about syrups? In France, syrup-flavored water (flat or carbonated) is a common enjoyment. The rest of my family loves menthe à l’eau—water with mint syrup. I can’t stand the mint, and enjoy grénadine à l’eau. Yeah, the carb content isn’t the greatest, but it’s a question of priorities.

Fingers crossed that the commode is helpful tonight, and not just the focal point of poor targeting!

=sheila

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Are they verboten because they’re high in potassium?

Yes.

Do you think you could bring him water once an hour for him to take a few sips?

I don’t time it. Mostly I offer him a drink when I take one myself, which is often. I drink twice as much as he does and maybe 4 times as often and almost all water–usually with potassium chloride in it(!).

syrup-flavored water

I could buy a couple of torani flavors at Target. Or try diluted juice in sparkling water. But even when we eat something salty, he doesn’t seem to get thristy.

Fingers crossed that the commode is helpful tonight, and not just the focal point of poor targeting!

oy =8-0

So at 10:40 (10 minutes after I shut my computer and was just falling asleep-), he got up to pee. I brought him to the commode right next to his bedside in hopes he’d sit on it like he did when it was in the living room. No dice. He peed toward it, but mostly in front of it and to the side. Maybe 1/3-1/2 got into it. Some ran under his dresser. Some got on the commode strucutre. He got right back into bed and fell asleep while I cleaned up.

Maybe 15 minutes later, he’s up again. Surely he couldn;t need to pee again so soon! But I took him to the toilet and he tried and tried. Finally he sat and after what seemed like a long time had a constipated poo. Which clogged the toilet. Luckily no overflow and most of the water went down fairly quickly, but the clog was visible. We both went back to sleep.

About 4:45 I hear the sound of water hitting the floor, which wakes me (his getting up didn’t–I was very sound asleep). He peed in the hallway. Big cleanup as all was on the floor. I couldn;t quite see the extent and stepped in it. Anyhow, finally done with that. The bathroom wastebasket is stuffed with pissy paper towels and a few Windexy ones (I windex after soaking up the pee. Base to counteract acid? scent to kill scent?).

Hey, I got almost 6 hrs of sleep–better than average! And my back is getting stronger every day from all the bending–DS & GF noticed how much more fluidly I move and how much less creaky I am when bending down to the floor. So there’s that!

1 Like
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Do you have any idea what his BP would be without any medication?

130s-140s/70s IIRC. He’s taken BP meds for 5, 6, 7 years?

He used to get these episodes where he’d spike very high once or twice a year. Once reached 188/100 and I almost took him to the ER, but usually in the 150s-160s/80s. I gave him an extra BP pill and the dr sent him for imaging and labs the first time. Nothing apparent. After that, just gave him an extra BP pill and green tea. He hasn’t had one of those episodes for a long time. 1-2 years as a guess. We’ll see what happens as I cut down losartan. I hope I don’t have a fight with our dr about this.

Last few times I tried to take his BP he was uncooperative. We’ll see tomorrow.

Also, dr wants him to get another blood test for potassium in 3-4 weeks. ugh.

13

Forgot to note he’s been wearing Depends since yesterday afternoon. Won’t pee in them. But when he wasn;t wearing them in the morning, he wet himself. Go figure!

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An hour later needed to pee again. Did much better with the commode. Didn’t sit on it but I moved him and the commode to be in synch. Just a few drops to clean up besides the commode pail. Score!

Ah, he needs to poo again. Luckily I “dissolved” the clog with his pee and my own a few minutes ago.

Note to self: he needs extra fiber today.

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Note to self: he needs extra fiber today.

Luckily there are a few options on a low-potassium diet:

berries (I made a fruit salad yesterday of strawberries, blueberries, raspberries and blackberries)
grapes
apples
cranberries (inc. juice and dried–yay, a dried fruit he can have! And I just bought a fresh bag of craisins a few days ago)
pineapple

lettuce (no more than 1 c)
arugula
celery (1 small stalk)
radishes
watercress
cabbage
kale
cauliflower
green beans
zucchini & summer squash
spaghetti squash (under a cup)
eggplant
asparagus
snow peas
sugar snap peas (not too many)
bok choy
corn

Apparently up to 1 oz nuts is OK.

Whole grains with lower potassium:

Barley
Buckwheat (kasha)
Bulgur
Popcorn
Wild rice

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Yeah, the carb content isn’t the greatest, but it’s a question of priorities.

There are all sorts of low carb syrups if this is a desired approach.

IP

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He doesn’t need to avoid carbs to the extent of using artificial sweetener, keto bread, etc. He eats a moderate-carb diet (although now he needs to avoud potatoes, non0white rice/bread/pasta–what a change). He’s skinny and has normal fasting BG (it was 90 an hour or two after lunch when he got his blood test a couple of days ago).

OT–washing up

He’s getting a bit more cooperative allowing me to wash his face and armpits with a warm, wet wash cloth. And changing his clothes. So he smells better. In fact, he smells good :slight_smile:

AND! While I was googling for my fave lip balm no longer carried at Target (Burts Bee’s ultra-conditioning) and replacement blades for his Norelco shaver, I left him putting on his jeans over fresh Depends (which are over a freshly washed bum :slight_smile: and socks. When I suddenly heard, over NPR’s The Takeaway, the sound of liquid hitting liquid. Yup, he found his way to the toilet, undid his pants and pulled down his Depends, and peed in the toilet. Almost every drop getting on target. A 2-paper-towel cleanup (one to absorb, one to spread Windex-), which I regard as trivial nowadays. (Peeps–buy stock in paper towels and Windex for our aging population-)

But wait, there’s more…(TMI)

When I saw that our pee partly dissolved his constipated, unflushable poop, making it flushable, I used white vinegar for the larger, er, log. Left for maybe 20 minutes. Flushed all away like normal. Let’s hear it for acid!

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Have you tried making it…ummm…sexual? I won’t be explicit, but you can use your imagination. “Distract” him while you wash him? Distract him while you get his clothes off. Etc.

I recall you said he didn’t initiate anymore, but can you? Sexual-ness is very basic in all animals, so maybe that reptilian brain is still functioning.

1poorguy

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His testosterone plummeted a few years ago. AFAIK he hasn’t had an erection in a long time.
:frowning:

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His testosterone plummeted…
In addition, or maybe related: prostate meds Tamsulosin HCL (Flomax) and Finasteride (Proscar) cause ED.

My understanding is that interest isn’t predicated on ability (just guessing based on the popularity of Viagra, Cialis, etc). However:

  • this is not my area of expertise, and
  • personally, regarding 1poorguy’s suggestion, I wouldn’t. Ew. Of course, whatever works for you, have at it.