Gout and colchicine

Great news!

Stopping a diuretic is good news for gout (I assume you took it for high blood pressure).

Great that you got something to calm down the gout.

Excellent that he's obviously taking the time to balance out the different drugs.

As for the tens machine - I'd give it a go. I wouldn't put it directly on the toe tho!!

Thanks, your support means a great deal to me. Yes the diuretic is for high BP (although I do sometimes suffer from oedema that it also no doubt helps with) Luckily I haven't got it at the moment and if it comes back I'm sure elevation will be enough as I certainly don't want to take diuretics again. 

  I just looked up Prednisolone and the reviews say it's excellent for gout, works to ease the pain within hours. Can't wait to start it but won't risk it today as the reason you take it in the morning is it can prevent you sleeping otherwise and I'm already lacking sleep as the pain kept me awake all night Tuesday night. 

Yes, I was impressed that the dr spent ages checking in his book for contraindications, he also made sure I understood everything he'd said about the changes. I will definitely always ask for him in future. 

  Must go search for the tens and BP machines, hope I didn't leave the batteries in them! 

Hopefully you will not need the tens machine. Prednisone will calm the attack of the immune system on your leg very quickly I'm sure. I'd guess you'll be pain free by lunch.

What is not being sorted though - at least at this stage - is longer term management of the gout.

Keep us informed on whether it works. I'd be amazed if it didn't.

Pain free by lunch would have been good but a bit optimistic! The pain has decreased though, I've had none of those really bad ones I've come to dread and the swelling has gone down a bit too. My cosyfeet shoes are still the only ones I can get on but I was able to tighten the Velcro slightly. 

   I found my tens machine but just as you said I've not needed to use it. Also found my BP machine but I'd left the batteries in and they'd leaked so I had to buy a new one from the chemist this afternoon (at more than double the price that I could have got from eBay but what's money compared to health). The Dr told me my BP needs to be around 140/less than 90 but he didn't tell me (and I didn't think to ask!) what I should do if it's higher! And it is higher, did several readings when I got home and the first one wasn't too bad at 143/93 but then I got 142/105 and 133/104! I'll try again later and tomorrow and hope it's lower but even if it's not there's nothing I can do with it being weekend. 

 As for long term management, am I being too optimistic in saying I hope I never get this again? Do people ever just get it once? The thought of having continuous attack in the future fills me with horror and is enough to make sure I continue monitoring my diet although I'm not finding it easy to find substitutes to replace both the high purine foods and the bread I now realise I ate far too much of before. I'm now eating more veg, potatoes and eggs and yesterday I discovered sweet potatoes which I loved. My favourite dinner was porcini mushroom soup with two slices of buttered toast and corn on the cob and it's been hard giving this up but I'm going to try it with carrots and potatoes instead of the bread. Another favourite was beans or spaghetti (with reduced sugar and salt) on toast (I absolutely hate cooking and these were an easy meal) but I've yet to come up with a replacement for the toast! 

Hi Kay

I'm sure that by the time you get this your foot will be much better. As for another attack...a high % go on to have more attacks. But it's not unusual not to. So keep up drinking plenty of water.

As for your BP - those results are perfectly ok. BP increases just by the stress of taking it! So take it a couple of times and sit and relax a bit after you put the cuff on -just relax before measuring. You should find it is lowest early in the morning when rested. Losing weight will long term help your gout and your BP.

I am getting the flashing heart every time I take my BP, says in the booklet this means the monitor has detected an irregular heartbeat caused by common arrhythmias and will result in inaccurate readings so I should check with my dr for an accurate reading. No one has ever mentioned this when I've had my BP checked before and the dr took my BP Thursday so I don't know if it's a cause for worry or not? BP was lower this morning as you said it would be, 155/94 and then 124/94. 

Heart arrhythmia is pretty common once you're into middle age, and most are of no consequence unless you want to play for Manchester United. I'd mention it to the doc though.

As for the BP itself - you need to follow it over a period of weeks, but 124/94 might not be classically perfect, but it's certainly not going to worry your doc. It may gradually reduce too as you just get used to the habit of doing it (and thus find it less stressful). You certainly want to do it before the first coffee/tea/(coke?) of the day, as that will jerk up your BP in a matter of minutes.

How's the pain?

No pain - it's wonderful 👍. Swelling going down too even though I've been on my feet more today YAY. 

  I'll mention the heart arrhythmia when I see him on 31st oct then. I sometimes have a very weak (I hate strong tea) cup of tea after my breakfast but drink mainly water. With the 4 litres plain water I'm now drinking daily I'm no longer drinking the sparkling flavoured water I used to drink loads of. Probably a good thing eh! 

  The Prednisolone is causing sleep disturbances, I'm waking up frequently all night and that's as well as the 4/6 times I get up to use the loo! But it's a small price to pay to be rid of the gout and its only a 7 day course so hopefully my sleep will go back to normal when it's finished. Also once it's finished I won't need to constantly check my BP although it won't hurt to do it occasionally. I've just ordered a tart cherry supplement that has excellent reviews on Amazon for gout and also to help with sleeping. I checked out some uric acid monitors but they're very expensive as are the strips you need with them so I'm going to wait to see if I'm lucky enough for this to be a one off attack. If it's not then I'll reconsider. 

Great news!

You never know - you may be lucky and maybe you'll have no more attacks.

I took my last Prednisolone tablets this morning and while I'm very grateful for the help they've given with the gout I'm glad the course is finished as they've disturbed my sleep and cause strong hunger pangs that are impossible to ignore. The swelling has yet to go down 100% but it is slowly decreasing and I'm hoping this will continue now the tablets have finished. I'm still working on my diet, still avoiding all high purine foods and still drinking around 4 litres plain water daily and I was feeling really pleased with myself as I felt I had greatly improved my diet by introducing new foods, rye bread, cauliflower and whole wheat couscous, sweet potatoes, whole wheat packet spaghetti and noodles, whole grain crispbreads with added seeds, whole earth peanut butter with sunflower, pumpkin and flax seeds with absolutely no added sugar etc. I also now eat more eggs which I found are delicious scrambled with small pieces of walnuts or mixed seeds added and I've been adding nuts and seeds to salads as well as eating them instead of crisps. But then today I came across a video on YouTube about phosphorus in food and drink and how you should avoid it with kidney disease! I was shocked as the first item on their list to avoid was flavoured water! For years I have drunk nothing but flavoured water totally unaware it contains phosphorus that is very bad for kidneys and dread to think what this has done to my solitary kidney. But there are no legal requirements to add the phosphorus content on the label! And GPs are obviously unaware too as one GP asked me once what was in my drink bottle and I pointed to the bottle of flavoured water she had on her desk telling her I drank gallons of it! 

  Next I discovered certain nuts and seeds I've added to my diet are high in phosphorus, almonds and Brazil nuts especially and flax, sunflower and pumpkin seeds too! I value my kidney too much to ignore this vital information so no more flavoured water and very limited nuts and seeds in the future. I'm sure the benefits of eating nuts and seeds instead of junk food must outweigh the disadvantages of the phosphorus in them so don't want to eliminate them completely again. 

  I'm also now drinking apple cider vinegar daily to help reduce the uric acid (I use it when I have heartburn caused by my hiatus hernia too) and have started a tart cherry supplement. Also read celery seed is good for gout so may try that next. I also bought a smoothie maker which arrived today and using this will greatly improve my diet as I'll be adding fruits and veg I wouldn't normally eat. 

The hardest thing I've found is giving up much of the bread I was eating as the craving is so strong, easily as bad as the craving for nicotine when I gave up smoking 19 months ago after 44 years. And with the bread there is no substitute where I use an e cig for the nicotine which I actually prefer to cigarettes. 

Would be interested in your thoughts on the food and phosphorus as you sound very aware of what's healthy and what's not? 

Well, it's good you mentioned the flavored soda waters, they never make me feel good, in fact, I end up getting sick after drinking them so I've completely stopped.  I was on a diet of almonds, sunflowers, and pumpkin seeds, that didn't make me sick, in fact I loss a good extra 10pds. eating moslty nuts, but with so much phosphorus, I will limit how much I eat.

You mention eating wheat, this for me causes gout to flare up, so I stay away from any form of unprocessed wheat or wheat bread, rye bread, pumpernickel, and couscous. I eat white french sourdough bread with no gout issues to speak of. Wondering how is it that you can wheat and I can't? I guess it's one of the many intricate phenomenons of life.

I can't say for sure that wheat products are ok for me as I am still experimenting and have yet to come across a substitute for the bread I'm craving so I'm just limiting myself to a small amount and choosing a variety of different sorts the Internet told me are healthiest. I also tried gluten free crumpets and the brand I tried are to die for, they are really soft and fluffy on the inside but I have just one a day with mashed banana. I can't name the brand but it wouldn't take a genius to discover this 😉. 

  Bread is the hardest thing for me to get my head round, 100% whole grain is supposed to be the best but supermarket shelves just seem to be full of bread saying wholemeal which is not the same thing. I'm ashamed to say I've never checked the ingredients of the food I ate before and am finding it's extremely confusing knowing which foods I should be buying. I suppose it's just trial and error and will take time for me to learn which ones are best. You mention a white sourdough bread, I've yet to read up on sourdough bread, is it a better choice? Sorry, I'm really showing my ignorance here but this is such a huge subject to take on especially as I have attention deficit disorder and feel totally overwhelmed by it all. 

But I have known for a long time my diet needed improving, it's a shame it has taken an attack of gout to make me sit up and take notice! 

My suggestion is that you eat and drink what you want, and then take Allupirinol avery day. All this other stuff is nonsense

I would normally agree with that, but in this case this lady has a severely compromised renal system, relying on less than one kidney. This case has to be dealt with carefully.

Well done on steadily improving your diet Kay; I'm sure it will be beneficial for all your maladies.

I think your decision to drop flavoured water is very good. Water alone should be perfectly ok but in the worst case I'd guess that water with a slice of lemon will be healthier.

As for phosphorus - I must say I know little about it except that it's in all our foods, being an essential plant nutrient. I've had a quick look, and it seems the products which are highest in phosphorus are also high in primes (e.g. Offal, heart etc), so you can easily kill two birds with one stone!

As for bread - I note the following. Bread is high in starch which is converted to sugars. This is great for a couple of hours but after that as the high blood sugar falls it will leave you feeling starving. I think if you reduced bread intake you'll notice you feel less hungry.

Overall I'm sure these diet changes are postitive and will gradually lead to improvements in your health and psychological well-being.

From what I read, yes, sourdough is better than white sweet bread. But as with any food, moderation is key.  I don't eat bread everyday, and when I order a sandwich, I remove the top slice of the bread and eat the bottom half. I can understand about the crumpets though, I can only eat one once in a grea while. However, your craving of bread is from eating poor processed, refined foods, and bad carbs. Maybe now that you're changing your diet you can have some will power to stop craving bread. In the beginning it can be hard, but once you start then you can control yourself to stop eating what is bad for you and think that way too. That's how I stopped, thinking that it's bad for me, and sure enough the craving went away.

Also, perhaps you're not aware, but too much potassium is bad for your kidney's, also avoid eating kale. When I eat kale, I get deathly sick ending up in the ER every single time. It was a hard lesson to learn since I had no idea that it was kale that was making me sick. The high oxalates cause kidney problems and also gout.

There is very little sourdough bread available in the UK.

I would agree completely that as one moves away from processed carbs the craving for it reduces quite quickly too.

Two of my blood tests showed my potassium level to be low, the first one was a couple of years ago and the second one recently. I doubt the first one could have been very low as the GP wasn't concerned but this time he was concerned and tested again a couple of weeks later. I ate lots of high potassium foods and he said it was fine that time. So I was interested to learn too much potassium is bad for kidneys. I also just read you shouldn't use low-salt with kidney problems as this is high in potassium. And eggs and milk are high in phosphorus. I doubt the salt affects me as the only time I add salt to food is a pinch to veg during cooking although it is low-salt I use. But I have been having more eggs and milk lately as I believed they improved my diet. I think I need to see a dietitian to give me help with understanding this enormous subject. I have felt really rough the last two days and have a permanent achy pain in my side that's not letting up that I'm worried is from my kidney. I have an appointment booked with the doctor tomorrow so I'll see what he says. Also my foot swelling has still not gone down any more although thankfully there is no pain. Does the swelling sometimes take time to completely subside after a gout attack? 

I assume your drinking enough water.

It is not my personal experience of gout that it stays around for weeks. However for some people after a very bad attacks it can leave a joint swollen for weeks or even a couple of months. I found this:

" ...raise the attack sites high above the heart level as long and as often as possible to help drain the fluids, especially after soaking in warm water."

Still drinking lots of water and have now added a veg and a fruit smoothie to my diet daily. But I admit I've not been elevating my foot as often as I was before, must make a bigger effort! But I found having it above the heart level for any length of time was very uncomfortable. I'll start again but for shorter periods, see if that helps it go down. 

Yes, it can take months, what I end up doing is raising my legs up on the wall for as long as I can, usually 5 minutes, or on the sofa for 10 minutes or longer, sometimes twice a day until the swelling goes down.

A dietitian is your best option. I didn't now eggs were so high in phosphorus. Thanks for the information.