1. Community
  2. Bones, joints and muscles
  3. Gout and Pseudogout

Doctor thinks I have gout but I'm not so sure - what does everyone here think?

Posted , 12 users are following.

Donkeyfumbler
Donkeyfumbler

Hi,

Hope people might be offer some advice as I’m really not sure what I should be doing.

I’m currently sitting here with a stiff and swollen big toe/foot that I agree, when you look at it, looks like classic gout. This is probably the third or fourth time it has hurt like this in the last four years (though the first time for at least two years), and each time it follows the same pattern.

1. I play hockey (field not ice) and either put too much pressure on the ball joint of my left foot by twisting and turning too much during the course of the match, or there is one moment when I can feel something actually go ‘sproing’.

2. The big toe is usually a bit stiff after the game, particulary when I raise it up but not too painful. I can walk on it OK and it either gets gradually better over the next two to three days or at least stays the same.

3. On day three, my toe quickly starts to get more painful, the ball joint goes red and starts to swell and when I press on the side of the joint it hurts a lot (but is ok when I press anywhere else on the foot or the joint). It gradually gets worse over night and by morning I struggle to be able to put shoes or even socks on without wincing.

4. This carries on for at least the next few days. More painful early in the morning, especially as I get up, even though it looks less swollen, is better after I have been up on it for 30 minutes or so, and then gradually gets more swollen throughout the day. I also get very painful twinges if I twitch or just move it at the wrong angle.

5. After a couple of weeks, it is usually back to normal, though the toe feels stiff and if I go back to doing excercise too soon I know there is a good chance it will recur.

I saw the doctor first time it happened in 2010, they took a blood test and told me my uric acid level was 'not high'. I am due to get the results of a second blood test next week. Both doctors I have seen think it is gout (despite the uric acid test) but this is based on a two 30 second examinations and not much else. It’s the easiest diagnosis for them to make and get’s me out of their surgery nice and quickly (even if it is actually gout, I’ve received no advice on what I should do other than take some ibuprofen or diclofenac and wait for it to go better).

Despite the symptoms, there are several things about this that make it hard for me to believe this is gout:

A. It only even happens after I’ve done something playing sport (but bizarrely, always 3-4 days after). I have never had a spontaneous attack.

B. My uric acid test last time was not high.

C. I have no family history of gout, I drink 7 units of beer and 7 of red wine a week, don’t overdo the seafood or other foods supposedly rich in purines, and am in the middle of my healthy BMI range.

What do you think though? Does my experience chime with any other gout sufferers or do you think it more likely to be something else (tendinitis, sesamoiditis maybe). What should I be doing or saying to my doctor? I have had problems with my kidneys in the distant past and have next to no function in one and slight damage to the other so worry that if this is gout I will start causing problems, but at the same time I don’t want to start treating gout if I don’t actually have it!

Thanks for listening – sorry it’s so long. This is all the stuff I wanted to say to the doctor that he didn’t have time or inclination to listen to.

1 like, 34 replies

34 Replies

Next
  • akegolfrman
    akegolfrman Donkeyfumbler

    Posted

    Hi,

    Gout is very hit and miss it seems, and affects people in very different ways. Because of this it is often unsure whether it is gout or not.

    It sounds like you have an active life style which reduces gout risk. I personally have increased my fitness goals, and this has reduced my gout attacks.

    I was interested in your symptoms and was equally confused as yourself, until you mentioned about your kidney problem. I would think this definately is contributing towards it, hence it most likely is gout. You're ability to flush uric acid from your body must be halved by this, meaning a high risk for gout attacks. I would certainly tell your doctor about this, even though I hate going to doctors myself!

    I have posted my experience on this conversation, and the way I try to avoid and reduce the gout, and it has worked so far, and I can sitll have the food and drink I like (in the main).

    Hope you manage to get to the bottom of this, it's a nasty illness, I'm sympathetic!'

    lol wink

  • james86315
    james86315 Donkeyfumbler

    Posted

    Hi,

    my first attack happened after a morning's tennis, it was very hot, I became dehydrated.

    A day or so later my left big toe became swollen, my doctor sent me for a blood test which showed a slightly raised level.

    Nothing more for a year or two, now I definitely have gout, my present attack in it's fifth week .

    I have found that alcohol and gout are not good for me.

    I hope that you don't suffer too much.

     

  • triron
    triron Donkeyfumbler

    Posted

    Hello, I am a long time gout sufferer and while the symptoms you quote are applicable to gout perhaps it is just a mild attack. Examine your way of life i.e., do you eat high protein food before a game or just after, there are many healthy foods we eat that can bring on an attack, such as sardines and other oily fish, rare beef, my favourite but which I indulge just twice a year and many more. If you search the Internet for 'gout causing foods' you may find the answer. I have found that keeping the affected limb above heart level will quickly reduce the discomfort, not always possible when in regular employment. Oh yes, I found also that anything citrus should be avoided during the attack.

    Hope this is of some value to you. Good luck.

  • alsie
    alsie Donkeyfumbler

    Posted

    I think take the meds the doctor offers and see if it works. I got ferocious gout attacks yet my uric levels are only a bit high. This went on for 10 years until I finally met a doctor who understood how to manage the gout. red wine, beer, prawns etc had no impact on my gout, what brought about attacks with me could be a simple change of diet - such as stopping beer for example. A knock on my left foot could bring on a gout attack in my right knee, there seems to no rhyme or reason to it!
  • Kersey
    Kersey Donkeyfumbler

    Posted

    You need to insist on a proper diagnosis - I have pseudogout which is different from gout and does not have a high uric acid.  It is diagnosed by fluid drawn out from the joint - I had this done at the Nuffield Orthopaedic hospital in Oxford.  Dont let the gP assume gout as they have different causes and different treatment.  What you drink or eat has little to do with it.  Over time you will learn what triggers it - mine is overextension of the joint mostly .  I treat with ice packs, elevation, rest, dont try to weight bear on it while it is inflamed use crutches.  pain relief is what you can take - personally not much works.  I have had injections into the joint which help. Drink lots when you have an attack whether it is gout or pseudogout to flush the body.  I have had it for over 30 years but rarely get an acute attack these days - mostly chronic stiffness and soreness and the odd painful twinge.
  • philip_53291
    philip_53291 Donkeyfumbler

    Posted

    My gout is usually preceded by a physical injury like stubbing a toe but the main way I know it is gout is the sheer pain of it. It is often said to be the most painful affliction that affects mankind and I would concur with this. The fact that you describe it as painful to even put socks on makes me think that it is gout as I have the same problem.
    • akegolfrman
      akegolfrman philip_53291

      Posted

      This is so true philip, it really is a nasty illness. However, it is not clear what constitutes an 'attack', because I think there are many sufferers that get mild attacks, like myself. I have had 2 attacks which I would describe as VERY painful, even though very little swelling and no redness. However, more recently, now I think I can ward it off It is a bearable pain, or sometimes just a warm, stiff toe, so long as you fight it early with liters and liters of water, plenty concentrated cherry juice, cider apple vinegar, bicarbonate of soda, colchicum herb, barley grass tablets and SAIDs. That said, we're all in it together....nasty illness.
  • Donkeyfumbler
    Donkeyfumbler

    Posted

    Thanks very much for all of the responses so far. It's really good to get some real-world information and experiences, especially given how little information the Doctor gave me.

    Particularly interesting to hear from those whose attacks are mainly triggered by some sort of injury. I guess it must be even more annoying to fall into this category as it's not something you can avoid, unlike food or drink triggers. As someone plays a fair amount of sport, it would be depressing to be told that a bit of knock could trigger days or weeks of pain.

    How would you all describe your pain and is it always in the same place or does it move around and change during attacks?

    For instance mine at the moment is more of an intense throbbing pressure at the moment but it's not as tender to press on the side of the ball of the foot as it was (and the tender spot has moved from directly on the side to more like on the bottom). Do you get the painful shooting twinges when getting up or sitting down as I seem to be getting (that really take my breathe away at times)?

    Thanks.

    • akegolfrman
      akegolfrman Donkeyfumbler

      Posted

      I agree, it sounds like you're the person that shouldn't be getting these attacks, because of your active lifestyle. Good on you. However, I think that kidney problem IS a contibuting factor this time.

      How you describe the feelings is EXACTLY as I have had. I would say gout, so sorry to say. Nasty illness. I have limped for 3 weeks after stubbing my toe, brought on a mild gout attack, and had a sharp feeling thereafter for 3 weeks.

      Gout is caused (I think you would know) by the uric acid crystals being too big and going through the very small veins in the foot/toe, where are the smallest veins in the body. Now if you were to injure your toe slightly, this would cause swelling, and of course but pressure on the veins in that region. This would cause an attack in my view.

      You mention food or drink triggers. This is not a big issue. Because many of us like our food and drink, and many of us like our sports. Everyone to his taste. Main thing is to try and solve our own personal gout symptoms.

      As in my other posts, I believe there are mild sufferers; usually can fit off a warm, stiff feeling in the big toe. And then there are acute sufferers; who cannot fight it off at all, and don't seem the persons where it is self inflicted. Those persons, it seems to me, are those that get it in many other parts of the body where the veins are bigger. This is a worry. And when you talk about getting shooting twinges when getting up or down then, sorry to say, I would keep in touch with the doctor, and even get a second opion. I would say you may be an acute sufferer, and I am SO sorry for you. I hope that I am wrong. 

      Keep us posted, it's an aweful illness!

      lol

  • alsie
    alsie Donkeyfumbler

    Posted

    Hi, my gout can move about.. well maybe not so much move about but flare up in another area too. The pain is very intense - to say the least, if I get it in the toe region (which isn't very often these days, it seems to attack larger joints) even the weight of my quilt on it is debilitating! I've learned to recognize the incoming of an attack and I have an emergency kit (thanks to my doctor who is fantasticly understanding), the first thing I do is anti-inflammatory (needs to be Naproxen or indomethacin in my case) then a double dose of colchicine and a paracetamol. If the pain intensifies then codiene or even tramadol, usually though if I catch it right I don't need the codeine etc. You'll get the hang of it!! Most importantly - and most people won't talk about this - is water. A couple of glasses an hour is a must!

    Good luck and I hope you pick some stuff up rfom all of these great comments people are leaving!

    Alwyn

    • akegolfrman
      akegolfrman alsie

      Posted

      Alsie, good post.

      Fully agree with the water bit. Liters and liters ASAP. We then spend a lot of time on the throne though, but it is worth it to ward off an acute attack.

      I would also say another thing, and that is during or before an attack, rub in some sport injury blue gel. Excellent stuff, chills the toe down. It is available from sports shops.

      i don't have an emergency kit as you have, I don't do doctors. But I do have my own emergency kit that works so far...thankfully. Just the usual if you see my other posts if you're interested.

      lol

    • alsie
      alsie akegolfrman

      Posted

      Good call with the blue gel but..... You can buy diclofenac gel! That's awesome because it doesn't heat up or cool down the skin but goes in to relieve pain (diclofenac is part of everybody's gout cupbiard!!)
    • akegolfrman
      akegolfrman alsie

      Posted

      I like that!

      I tried the equivalent gel, but it didn't work on my acute attack at all.

      The slight problem with that is that I moved to communist country, where such things are forbidden!

      Beat that then. So I have to cope with gout in restricted circumstances.

      Still, such is life. And it works so far.....

      lol

  • philip_53291
    philip_53291 Donkeyfumbler

    Posted

    The shooting pains that take your breath away seems consistent with gout also, I've been known to swear suddenly in places where you shouldn't swear when I get a sudden sharp pain.And I agree with 'alsie' about the water, I check the colour of my wee all the time these days and if it gets too dark I make a point of drinking more water. They also say that each consecutive attack is always as bad or worse than the last and mine attacks all my toes after starting at the big toe now so it's definitely worth trying to avoid if possible.
    • akegolfrman
      akegolfrman philip_53291

      Posted

      Interesting you say all your toes.....

      Do you ever get a sore feeling along the front base of your foot where all your toe joints are?

      (Feels like walking on a hard ball in the middle front of your foot)

    • chris11143
      chris11143 akegolfrman

      Posted

      I have this one right now and its the worse one to have in my opinion. I have suffered with Gout for 12 years and have tried everything, recently it started off in the knee, having always been in the foot, and I have had 3 attacks in the last 2 weeks. This morning I surrendered, went to the doctor and now have a prescription for allopurinol. I am not happy but I am fed up with gout and the way it can disable you from normal life like taking the dog for a walk etc.
    • akegolfrman
      akegolfrman chris11143

      Posted

      Sorry to hear of your suffering. My  gout must be mild, and I am treating it with the usuals. If it gets worse I may ask for Allopurinal. Just make sure you take Colchicine with it at the start or it may bring on even worse attacks.

      When you are free, as I am at the moment, YES it is lovely to be able to walk without limping!

Back to top
Next

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.