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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

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  • timothy12884
    timothy12884 Donkeyfumbler

    Posted

    I think you have gout. But I hope you don't. If you do or think you might, don't drink alcohol, especially beer ( yeast are in it ). If you are on meds. don't drink alcohol.

    Keep going back to your doctor, I hate to go but I'd rather go to the doc. than ruin my kidneys. Dialisis (3X/ week) will take up way more time than you believe. I had problems with the Allopurinol med. for gout which made it worse. We are all different the Allopurinol helps most people. The gout can damage your joints and kidneys over time so take it seriously. The doctor didn't tell me much about the diet for gout so look it up on google ( like Web MD ) and gout diet, foods to avoid.

      Myself I was is such pain that I looked up everything about it and stuck to the diet.

    The first 2 weeks I had 6oz. of chicken in a salad every 1/3 day and no other meat.

    I cut out alcohol, soda, fruit drinks ( they are full of HFCS ), shell fish, ate lots of fruits and Vegtables. Drink tart cherry juice otherwise it's too sweet. and drink plenty of water a gal./day. The second 2 weeks I had a little pepparoni with pizza added in to the mix of meat and 1 chicken sandwiches every 1/3 day or so. Was hard to do at first but then it got easier. Now I'm eating lots of vegs. & fruits, try for an apple / day. Good luck.

  • Donkeyfumbler
    Donkeyfumbler

    Posted

    Thanks for all the replies. I'm waiting for my blood test results to come back (should be by Wednesday) before then deciding how to proceed.

    Doesn't seem to be getting much better at the moment (a week in to it). Still taking Diclofenac, trying to drink more water than normal, tried the morello cherry juice and Voltarol (diclofenac) gel to no real effect that I could see.

    My foot is permanently moderately swollen, though only red around the ball joint of the big toe. The pain is fairly much limited to when I walk, apart from the early hours of the morning when it can wake me up with the throbbing. Worst thing is still the shooting twinges that cause me to gasp when they happen (usually when I sit down or stand up).

    Very depressing. Just wish I knew for sure what it was or was not.

  • Please_Cancel
    Please_Cancel Donkeyfumbler

    Posted

    Have you tried bicarbonate of soda in a glass of water? A big immediate help for some.
  • Please_Cancel
    Please_Cancel Donkeyfumbler

    Posted

    Have you tried bicarbonate of soda in a glass of water? A big immediate help for some.
  • Please_Cancel
    Please_Cancel Donkeyfumbler

    Posted

    Something I don't think I've mentioned before is my growing belief that bottled water may have content that is bad for gout? Another non scientific personal opinion that I seem to be able to draw some correlation between.
    • alsie
      alsie Please_Cancel

      Posted

      That's interesting.. I wonder if it's minerals? I tried the bicarb & water but I have prostate cancer and it seemed to irritate my bladder. I do have honeygar twice a day, don't know if it actually does anything but I enjoy it anyway!
    • Donkeyfumbler
      Donkeyfumbler Please_Cancel

      Posted

      Not something I drink a lot of to be honest. I've never seen the point of drinking bottled water when I already pay for tap water that's perfectly good!

      I'll give the bicarbonate of soda a go though when I get the chance to go out and get some.

    • timothy12884
      timothy12884 Donkeyfumbler

      Posted

      I don't know how long your gout has been with you this time but It usually takes a week or so to change your body chemistry from acidic to alkaline, depending on your weight, and how strict you stick with the alkaline diet. Plus sometimes meds. may contribute to your condition. I also took some bacon soda and water 1 teaspoon to 10 - 12 oz of water. But this will raise your blood pressure, so be careful you don't need to cause more problems. The max I did it was 4 days and the BP went up quite a bit, but the gout lessened somewhat, then the BP came back down to normal.
  • Donkeyfumbler
    Donkeyfumbler

    Posted

    Results of the blood test are back and I have been told they are on the high end of normal (0.37) and the previous test I had back in 2010 was 0.40. From what I have read and been told elsewhere though, anything over 0.35 means that, with my other symptoms, this is very likely to be gout.

    Day 12 now and the shooting pains seem to have gone after a couple of days (thank god). During the day I am now pain free unless I try and bend my toe upwards, which is very painful now (strangely when this attack first started I had no pain or problem bending it upwards). Last night was a different matter as I was woken by the pain at about 2am and even Diclofenac and paracetamol combined struggled to comabt it - the worst so far I would say.

    Back to the doctor tomorrow to hopefully persuade him to refer me to a rheumatologist who can hopefully confirm this is gout 100% and I can then move on from there.

    • timothy12884
      timothy12884 Donkeyfumbler

      Posted

      When I had gout the pain was worse when I got up from sitting or sitting down. What are you waiting for start eating for the gout. The sooner you get your body more alkaline the sooner your pain goes away. Usually bad when I woke up for the day. The more I moved around the better I was. Then I'd sit and get the pain back. I'm now controling my gout through the gout diet and no medicine. I've lost 6 lbs. and I starting walking again, I use to walk 3.2 miles/day. Just starting back because of a brused foot bottom from jumping on a shovel where a rock was a few inches below the surface and I was wearing sneakers. It sure takes longer to heal the older you get.
  • russ3212
    russ3212 Donkeyfumbler

    Posted

    Im not an expert nor am I a Dr. I am however a patient of 5-6 years of gout. My Uric acid levels were off the charts. At first it was redness when it flared, usualy spicy foods for me and spaghetti sauces. I was given a daily medication to take and was told to watch my diet... yeah yeah yeah...over time the flare ups were more constant and a nice size lump the size of a large golf ball start to pertrude out the inside of my foot from the cystalization build up. this went on for years the stated on my other foot and something called Tophus Gout was growing out of control on 2 of my toes.

    After this time I went to a doctor which sent me to a specialist...after cutting open both feet and toes and removing all the crystaliztion I was forced to have one toe amputated last week.

    My adviceis, take this very seriously and change your diet and the way you live or you will be forced to be put in a position as I was in

    • akegolfrman
      akegolfrman russ3212

      Posted

      Thank you for your warning and experience. It is a very nasty, serious illness. I can confirm that a change of diet and lifestyle is essential. Although I am a mild gout sufferer, I hear what you say.

      When you say Uric Acid levels 'off the charts', what level do you mean?

  • Donkeyfumbler
    Donkeyfumbler

    Posted

    So it's now been 2 1/2 weeks and it seems to have got stuck in a pattern where it is just about back to normal when I go to bed, but then if I don't take painkillers I get woken up by the pain gradually increasing after about 2-3 hours asleep.

    When I wake up in the morning, the pain has slackened off a bit but it's now swollen, stiff and painful to bend but then gradually through the day it eases off, the swelling goes down and by evening it's almost OK again.

    I have read that you should keep the joint rested and raised as much as possible, but for me resting it and raising it (as it is in bed) seems to bring back the pain. The more I move it during the day, the better it seems to get (after the initial pain). Is that normal? Should I be trying to exercise it more?

    At the moment I'm beginning to think that this is the way it's going to be from now until forever sad

    • timothy12884
      timothy12884 Donkeyfumbler

      Posted

      I had the same problem with the pain waking me up during the night and swollen in the morning. Then I changed my diet and it has been gone now that my body is more alkaline than acidic. You must be close but still acidic more than alkaline. Pay attention to your diet and fix your body chemistry. You can do it. Don't wait until you get more complications. You don't want kidney stones or other problems. Don't wait for medicine to take the place of the gout diet. Lay off the high purine foods and eat lots of vegetables and fruits, not Beef, Pork, and shellfish. I went without any meat 2 out of 3 days for a month until I got back the blood test to prove I was alkaline.
  • akegolfrman
    akegolfrman Donkeyfumbler

    Posted

    I actually feel very sorrow for you. I have had exactly the same pain in the night. It is when your body temperature rises. Do you take Colchicum herbal, drink Tart Cherry, take barley grass tablets, Cider Apple Vinegar and drink a cup o bicarbonate of soda in water before you go to bed??

    I have often had this, and true, it seems to ease throughout the day.

    i just think your gout may be more acute.

    Try these simple meds and see. They work for me, and in fact I eat beef and drink beer without the problem coming back!  smile

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