Order Up: Coffee With a Side of Diuretics to Manage My Fluid Intake

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by Mike Naple |

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What is better than the smell and taste of a freshly brewed cup of coffee? Maybe a second cup of coffee? Maybe like me, you find comfort in the simple routine of your morning coffee before work, school, taking care of a loved one, or whatever is on your to-do list.

This week, coffee lovers around the world celebrate International Coffee Day on Oct. 1.

Piping hot with two sugars, poured over ice, black, scooped on an ice cream cone, or blended together with caramel — everyone has a preferred way to get their coffee fix. I love iced coffee, and I’ll drink it long into the winter months. Coffee has become so ritualized in our daily and popular culture that I find myself ordering coffee at a restaurant, almost like a muscle reflex.

OK, maybe it’s silly to share with readers my love for coffee in a column about pulmonary hypertension. Here’s the thing: Whenever I’m drinking coffee (or any beverage, really), I’m thinking about the amount of fluid going into my body, and the importance of regulating my fluid intake as someone with PH.

Shortly after receiving my PH diagnosis, my doctors stressed the importance of monitoring my fluid intake to guard against any excessive fluid retention. Swelling, also known as edema, can be a symptom of PH, occurring in feet, legs, and the abdomen. When I’m retaining fluid, my abdomen becomes more distended than usual.

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Medication helps me manage fluid intake throughout the day. Along with my coffee each morning, I take two forms of diuretics and a third pill midway through the day. These pills don’t give me a free pass to drink all of the coffee (or any liquid) I want, but they do reduce the amount of fluid in my body and around my heart.

While diuretics do have side effects, first and foremost, I have to factor in their intended purpose — to remove fluid from the body — when I take the pills to ensure I’ll have time and access to a restroom. Let’s just say you don’t want to take a diuretic at the start of a movie. Timing is everything.

I can’t mention fluid intake and PH without saying a word about sodium, and I don’t mean putting salt in my coffee. (Yuck!) PH patients are often told by medical professionals to limit their sodium intake. Mindy Rivera, a clinical nurse specialist in pulmonary medicine at the Cleveland Clinic, described how sodium contributes to fluid retention, putting strain on the heart as it pumps blood out to other parts of the body.

“This can lead to swelling in the legs and abdomen, and worsening shortness of breath,” Rivera said.

Sometimes severe edema can cause excessive shortness of breath that requires medical attention. This was my case last year, a few days after Thanksgiving. While the holiday meal tasted incredible, I didn’t properly monitor my fluid or sodium intake, and then spent a few days in the hospital hooked up to an IV with diuretics running through my body.

Reflecting on that episode, I can’t help but feel a twinge of guilt, mostly for the hassle and worry I caused my partner and some family and friends. At the same time, I learned from that hospitalization, and our Christmas celebration didn’t include a trip to the emergency room.

Chronic illness and rare disease can make daily life feel unpredictable. Flare-ups of exhaustion, anger, and general frustration can make even the most basic tasks harder to complete. Staying mindful about fluid intake isn’t always easy. Sometimes it feels like just another thing on my list, and I catch myself questioning whether or not I took my afternoon pill.

I’m human and imperfect. Sometimes I consume too much sodium, or I drink that extra cup of coffee. Still, I do my best to monitor my fluid intake — especially when I depend on that kick from coffee to get me through the workday — and cut back when and where I can. I weigh myself to keep track of my weight, and look at the sodium content on labels.

Staying cognizant about fluid intake doesn’t mean completely swearing off coffee or losing the ritual that comes with drinking it in the morning or catching up with a good friend over a cup of French roast. This International Coffee Day, I’ll pour a strong brew into a favorite mug from my sizable collection and savor the moment.

Readers, I’m curious: What are your tips for monitoring fluid intake, and if you drink coffee, how do you take yours? Please share in the comments below. And follow me on Twitter: @mnaple.

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Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.

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