<s>[INST] I have a history of pericarditis, pericardial effusion, pleurisy, pleural effusion all of that within 3 1/2 months starting in 2007. Sed rate at it s highest was 200, wbc at it highest 24500, positive for anemia, pos protein in urine, neg ana. Never diagnosed with anything and ruled out fmf, cancers, all the usual suspects. Was told probably inflammatory process likely due to autoimmune. I am still having symptoms, severe joint pain in knees which just started 3 months ago, still difficulity breathing a couple times per week (but lungs are clear) last anywhere from 20 minutes to 4 hours, now smelly foamy urine. Any ideas? [/INST] Respected Sir, hi I evaluated your query thoroughly. This relates to the decline in inherent respiratory effort Chat Doctor. *Joint pains are different related to articular surfaces erosion or frictions or calcium and other elemental disorders.*Smelly foamy urine is directly indicating urinary tract infection. All measures you have to carry out at home are :-- maintain He level by high iron diet with Iron capsules or syrup.-- maintain your HY </s>