Help with possible gout?

I hope you were not born simple, b/c I don't quite understand what you mean?

Sure as eggs is eggs... welcome to the club. You have gout. 8.4 and a pain in a joint, for sure.

Beer is one of the most common triggers of gout.

What treatment did your doc give you?

Do you have any comorbidities (other illnesses)? Do you take any medicines at all (inc aspirin)?

What is your height / weight / age?

Best basic advice - start drinking more water than you do now. Add a glass of water whenever you can (without going crazy)....and stop drinking beer.

The thing is, can you get gout in the back of your heal. And No 2, my Uric acid level is only 7.0 and I am in the middle of a painfull episode of what ever is happening. 

I am 40 years olds and 230 lbs but not overweight. My doctor says it could possible related to the psoriasis I have, as that can cause similar reactions to gout.

As I said , my doctor gave anti inflamitry meds withs painkillers. And I take no other medications.

My understanding is that gout comes and goes within 3 to 4 days, not 2 months???

"Only" 7 in the middle of an attack!

Ok. The blood gets full of uric acid. At some point it precipitates (condenses) into crystals in the joint, causing uric acid concentrate in the blood •to fall• (hence why uric acid measurements are not made during an attack, but your doctor was asleep in that lecture). If it's 7 now it's much higher in reality.

Which anti inflammatory meds? (Obviously not the right ones).

As for you not being overweight - at 230 llbs either you are either overweight or you are 6 foot 9 inches tall.

It is possible for a gout attack to go on for 2 months (but not common) especially if you aren't in the correct meds and even more so if you carry on drinking beer during the attack. Attacks at the back of the heal are also not unknown.

You need to be drinking lots of water (especially if you are 230 llbs and 6'9).

Dave

Excuse my facetious tone, when you are in such pain, but I thought humour might help. You are in pain but don't worry, by tomorrow we will tell you which meds you need and you should be out of pain in 24 hours.

OK, but what alludes me is the fact that this is the first time and that it is not in the big foe joint. Not to mention that not even cronic people do not have attacks for more than a few weeks and this is my first time for this.

You say it is much higher, but I have had a blood test in the middle of what waht was my most pain and that was a 7.0. I don't see how that would be be actually higher as you say????

I explained before why it is lower during an attack. It is the same as rain. The air gets to say 96% humidity and something triggers rain. As soon as the rain begin some of the water leaves the air and the humid immediately falls. Gout occurs when the blood level of uric acid goes above 6.7 at which point the crystals form. (The maximum normal level is 5.9 because above 6 precipation of crystals can occur in the big toe or cool parts of the body).

You are not the first person to come on this forum with a first gout in the foot or ankle. My observation is the gout you have is even more painful and longer lasting than classic gout. *** However the very high blood urate reading shows you have gout ***

"Remember that gout is not just a disease of the joints – its crystals can be deposited in many body areas. In the heels there are four places where gout can flare up and three are not joints.

Where gout attacks the heel There is an attackable joint – the subtalar joint between the heel's calcaneus and talus bones. But also gout can, and as usual, inflame the bursa(e), the cushioning sac(s) beside the Achilles tendon. Deposits of its crystals elsewhere in the heel's tissues can set off an attack too, and eventually grow into a tophus (if one) or tophi (if more than one), if treatment is not successful. Fourthly tophi can deposit on the Achilles tendon, and in rare cases break it."

Treatment: the front line treatment is colchesine. This will slightly depress the part of the immune system which is attacking your foot. *** Do not take more than the recommended dose *** some people get diarrhea with this drug - the vast majority don't.

Once you get it, pain will reduce in hours.

The long term treatment is allopurinol. This could be a problem for you if you have existing skin issues.

What is sure though: your beer drinking days are done.

Unless you are 6'9 you need to lose weight - slowly, as fast weight loss will trigger gout.

OK, I see what you are saying with Uric acid levels.

I should also say what the pain is like. It does not hurt to touch the back of my heal, I can rub it it and press the affected area with virtually no pain. Also it only hurts when I wake up in the morning after no using the foot and after walking around on it for a while the pain goes right away, only to have it come back during the day if I have not used it for a long time, ie sitting down at my desk for hours. If I am up and about the pain does not return.

Also, the affected area is not red and has no swelling at all.

I am not overweight, I am rather muscular so I can't really lose much more weight. 

 

Ok. The pain is not the usual pain, but your uric acid levels are higher than the maximum normal level, indicating gout. If you can get hold of colchesine and it helps - that would also indicate gout.

Have a look at this:

http://www.nhs.uk/conditions/foot-pain/pages/introduction.aspx

The thing is that high uric acid levels don't neccesaly indicate gout. Whihc is why I cam to the forum. Everything about this pain dose not point to gout except that I am having some sort of pain in my foot.

Is there anyone whos gout get better throughout the day as you use the place that is in pain? 

Can anyone with gout, touch and massage the spot with very little pain? 

Does anyone with gout not have swelling and no redness at the spot of their gout?

I have been to the Doctor twice now and twice they said I don't have gout. But, I have higher levels og uric acid hense the question here. BTW, No one in my family has gout either and all are big beer drinkers.

Gout is a symptom of high levels of uric acid.

Go to see a specialist. He will give you a very long list of damage high levels of uric acid give you; it's slowly effecting your organs. It won't kill you now, but it will contribute to a host of metabolic diseases over the next decade.

If your doctor reckons you haven't got gout - what is the geniuses explanation for your foot pain? If it's not gout he should be investigating what it is. Giving medication when you don't know what illness a patient has is unethical.

He thinks I have Psoriatic arthritis. I tend to agree with how the pain is and where I have it. 

But, I wanted to hear what other people with gout have to say about gout pain.

It's very possible.

But you also have hyperuricemia. One will eventually kill you, one won't. I'd keep my eye on the one which will.

I don't really understand that statement. As some people can have very high uric acid levels all their life and go through life with no symptoms or detrimental effects on their health.

According to my mother, my grandfather lived to 94 and he had very high uric acid levels and never had a bout of gout all his life.

Dave, I don't know what country you're in but anything above 5.9 for uric acid is indicative of having some type of arthritis, whether it be gout or something else. In your case it sounds as if it's arthritis. But to some degree your uric acid levels are too high to ignore.