Gout attack in April, but would like to avoid drugs due to possible side-effcts.

I initially had painful fingers, which swelled up after doing some manual work. I have been diagnosed with Raynaud's syndrome, and often have cold hands, but this was the first time they actually properly hurt. The swelling went away after a week or so, but the pain (often at the joints, and different ones at different times) remained. I play a lot of guitar, so they do get regular work outs.

The day before I was seeing a spcialist, I woke up with a painful (to the touch) knee - swollen, warm to touch - classic gout symptoms in other words. The specialist said as much, and as my father has gout, it seems a done deal. It took about a month for everything to get back to normal, and my hands did eventually get better (coinciding with summer, so they didn't get cold as much).

So here's my dilemma. The specialist was very keen to put me on Allopurinal (100mg for two weeks, 200mg for next two weeks, then 300mg from then on). I was also prescribed Colchicine (2x500mcg tabs a day). I have checked up on possible side-effects of these drugs and it has given me quite large doubts about taking them. My job means I am away from home a fair bit, and side-effects like stomach upsets,drowsiness and so on would be a major problem for me when away with work. It's tough enough without these added problems! So, I feel I can't risk it. I was hoping to find a two-month gap in work where I could do the course given to me, but it just hasn't happened yet. I was supposed to go back to the specialist after two months for further tests, but I keep putting back the appointment in the hope of getting a two month window to try the drugs, though even then, I'm really not sure about taking everything. I haven't had any further attacks, though have felt a couple of twinges in my big toes from time to time. I have increased my water intake, cut down my beer and alcohol (though far from cut it out completely) and haven't eaten meat/fish in 25 years. I used to eat a lot of spinach and asparagus, which I have more or less cut out after reading they can cause problems. Also got into taking a tablespoon of apple cider vinegar daily, and eating lots of cherries when they were in season.

So at the moment there may be a possible two month window in being away with work, so I may be able to try the drugs route. As stated though, I am not at all keen on them, so am not sure if should go back and see the specialist and see if my lifestyle changes have helped my uric acid level, or put back the appointment again and try for the two months on Allopurinol and Colchicine.

My initial urate level was stated as 0.42mmols/l in April, during the attack. I think that equals 7.0 on the scale used here. I am 47 years old, with a BMI of 22. I had another blood test taken in June when I was prescribed the drugs, but since I haven't been back yet, I don't know the results of that. During that visit, he did x-rays of my hands, which were normal. Ultrasound of my knees revealed "bursal thickening and a mild amount of fluid in the deep infrapatellar bursa" with "the main abnormality is a hyperechoic deposit in the distal patellar tendon insertion consistent with a tophaceous deposit". If that means anything to you!

So after writing that epic, I am hoping to get some advice on what course of action I should take. From my reading of posts, I realise some people favour the drugs, some people favour the diet control. I'm quite simply not sure! All opinions would be very much appreciated. Thanking you all in advance!

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