### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My daughter contacted you thinking I had been off sugar and it might relate to my existing condition. Maybe you can help. I have lupus with brain involvement and am on two imuno-suppressant medications. I have a small hernia-inoperable at this time. I have multiple cuts that were very minor but have, overnight become large and enflamed infected holes. Spoke to rheumetologist about the cuts and belives they are not staff and will slowly heal. I was at rest on the couch with elevated legs. Had my meal. My heart rate jumped to 105 and my pulse dropped from approx avg of lower 140/80 to 125/60 and over the next 30 min my heart contiued to bound between 100 and 105 and my bp kept getting lower as my heart rate went up settlng at and averate of 123/60. I got up, walked 10 feet stayed there a minute and sat back down.. slowly my heart rate went in to the 90 s and my bp jumped to the low 130 s over the hi 80 s. Been sick for a long time so these symptoms are alarming but i DONT want to tie up emergency room unless really anemergency. would like to avoid calling my doc late a nite for the second night in a row when I never call him. Ikow I am talking and yopu may not be able to give me any assurances at all.

### output:

Hello, This heart rate and blood pressure fluctuations could be related to an infection or electrolyte imbalance. Painkillers can also lead to blood pressure fluctuations.  Coming to this point, I would recommend consulting with your attending physician for a physical exam, a resting ECG and some blood lab tests (complete blood count, fasting glucose, kidney and liver function tests, blood electrolytes).  An ambulatory 24-48 hours ECG monitoring may be needed in order to investigate for possible cardiac arrhythmia.  Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. 