Another Gout Question :(
Posted , 7 users are following.
New here and tried to read through as much as I could first so sorry if I missed this asked before. First I must say, OWWWWWWWWWEEEEEEEEEEEEEEEEEE!!!!! Yes, going through an attack right now so I had to let out a little scream.
My question is: This is only my 5th attack, but the previous 4 have always been the same in one foot or the other. What happened this time is two nights ago I saw the red tenderness forming next to my big toe on my left foot. I knew exactly what it was and what was going to happen. At least I thought.
Yesterday I still saw the red flare up on the left, no real pain, but my right foot started to feel a little stiff. Sure enough, woke up in the middle of the night screaming with the pain, however it was in my right foot and now the toe on my right foot (and other parts of the foot) have that oh so wonderful red, puffy glow.
Is that normal? To have it start on one foot but never really develop, yet get full blown on the other foot that initially showed no signs? Strange to me, but again, just my 5th attack.
Thanks and just curious
0 likes, 34 replies
philip_53291 studmuffin
Posted
I'm lucky I suppose Colchisine works for me (the 30%) so I know I can get rid of it within a fortnight, they won't give me allopurinol because I don't get gout often enough because I mostly guard against it and limit the danger foods and alcohol.
rustygecko philip_53291
Posted
philip_53291 rustygecko
Posted
I've never had a blood urate test.
rustygecko philip_53291
Posted
Gout is not a disease, it is a symptom of an underlying metabolic issue: hyperuricemia (too much blood urate). Hyperuricemia causes a host of problems in the body, which lead to - well death. If you suffer from gout and don't get blood urate under control your chances of premature death from a host of illnesses increase substantially- the most obvious being heart attack. If a patient is not having blood urate tested from time to time (couple of times a year), there is no attempt to manage the hyperuricemia - it's just winging it.
philip_53291 rustygecko
Posted
Well this is my first attack since May 2014 as I've managed it fairly well until recently. My first attack was in 2011 I think and then 3 more in quick succession. The question of urate tests has never been mentioned before now, I didn't know there was such a thing. I'm 62 so perhaps they figure it's not worth the bother?
rustygecko philip_53291
Posted
It's not worth the bother if you don't care about the health of the patient. But unless you are a native of Chad or Swaziland (in which case you're on borrowed time), you have a life expectancy of 20 years plus. It is not possible to manage gout or hyperuricemea without blood urate tests. Without it, the doctor is trying the "suck it and see" method of medicine, rather than science.
nancy6459 studmuffin
Posted
Owwwwwwwweeeeee is right!!! I also for the past year get gout flare ups in both my feet. I have never had both feet affected at the same time although I admit sometimes it feels like it's going to start. I am under the care of a rheumatologist and I take 3 Allopurinol every morning. The idea is to get the Uric acid below 6. If a flareup happens, I take Indomethacin as soon as I feel pain. Works great but I retain a lot of water with it. I've been pain free for 2 months. I keep drinking a lot of fluids each day to flush out the kidneys. I pray that it lasts.
rustygecko nancy6459
Posted
I assume the three tabs are 3x100 mg of allopurinol. The target of under 6 is the norm for a healthy person, but for a gout sufferer you need to be much lower. Lower for a couple of reasons - if you're at 5.7 you can easily bobble up to 6 and get an attack, but the point of the allopurinol is to flush all the stores of urate crystals in the body (a process that can take a year to several years). During that time you will get gout attacks as the urate is flushed into the blood. Only once that is done can you go to a maintenance dose. During the flushing the level of urate needs to be as low as possible as it will flush quicker. Getting to an ideal body weight helps substantially too.
You are doing the right thing by drinking planty of •water• - juices beer etc don't count. As to why you get water retention... allopurinol doesn't effect me like that at all, but it has that effect most with people in their 60s and 70s, and higher rates among women (I'm in neither group, you may well be in at least one group Nancy).
nancy6459 rustygecko
Posted
My last bloodwork was 5.8. I go every three months. My next bloodwork is next week. I don't like water so I drink seltzer with fresh lemons. The doctor said the seltzer was fine. I stay away from fruit juices and alcohol. The Indomethacin is the drug that I retain water from. They started me on Prednisone but it affected my breathing.
rustygecko nancy6459
Posted
My opinion based on extensive reading of research papers and conversation with 2 rheumatologists is that to get rid of the stores of urate in the joints and tissues, one needs to be well below 6. I take 300 mg allopurinol and nowadays I don't need anything else and eat what I like (I rarely drink alcohol). My level is about 4-4.5. Once I have been a well over a year with no attacks or symptoms of any kind I ll probably drop to 100mg. FYI I used to have tophi on my hands (and god only knows where else in my body) which have now all gone.
PS Selzer is just carbonated water isn't it?
nancy6459 rustygecko
Posted
I take 300mg of Allopurinol also. Yes, seltzer is carbonated water. I like the bubbles. Lol I also eat what I want in moderation. I eat a lot of broccoli and a lot of fruit. I tend to shy away from beef unless it's something I really like. I still need to lose some weight but it's all a slow as we go process. I'm hoping for a good Uric acid number next week. What is the normal Uric acid number?
nancy6459 rustygecko
Posted
rustygecko nancy6459
Posted
I prefer bubbly water too.
"Normal" for a healthy woman is 2.4-5.9
If you are getting symptoms at all though you need it to be lower than the 5.9 to allow the crystals in your body to be slowly dissolved.
rustygecko nancy6459
Posted
Tophi/tophus means "stone" - they are growths of the crystals - on the bones. In the worst cases the growth even burst through the skin. They grow incredibly quickly - in a matter of weeks not months. To get rid of them takes months to years.
nancy6459 rustygecko
Posted
Omg!! Thank Gid you don't have that anymore!