HELP! Husband suffering with gout!

ok, my husband is 45 years old.

His first atack was 10 years and he has a family history of gout.

He is 6 foot and weighs 235 lbs.

Its crazy bc the gout moves through out his foot day to day.

I can actually see it.  Some days its in one foot and somedays its in both feet.  Its in his big toe, his instep, ankle, top of his foot near the toes, and his ackilis.  (no clue how to spell that word)  This current attack has been going on for the past month +.  Hes had 2 steroid shots, and is on alpurinol and indo.  We went to the doc last week and his blood test came back with a 3.8... which i dont understand.  But like i said, hes been on meds the past month so maybe that would affect his UA level???   

He does drink crown royal on the weekends sometimes.  

Im worried about whats next... Hes had it for such a long time and it wont clear up.  He goes through stages where he can walk but then quickly ends up in severe pain and in bed.  Im worried its going to affect his kidneys.  What are the warning signs of that?  We are currently shopping around for health insurance so at the moment everything is out of pocket.  Please let me know if yall have any input or ideas about what to do.  He is truly suffering.  Hes the bread winner and ive got 3 kids under the age of 8.  One is a newborn.  We rely on him for our income but he is about to lose his job bc of so much missed work.  I feel like NO ONE understands the struggle unless theyve had it.  Thank you for your help in advance.  bonnie 

Bonnie if he wants to continue working being the breadwinner, and diminishing the effects of gout he needs to cut out booze immediately! No alcohol of any kind period. Also, cut out any type of wheat, like wheat bread, wheat cereal, wheat beer, remove it from his diet. Try cherry juice and stay away from crab, shrimp and mussels. There's a purine chart online I suggest you google it to see what purine foods are still causing his pain. Also, get rid of sodas and anything weight fructose and sugar. Hope this helps.

I'm sure rusty will add more to the my list.

Hi Bonnie

Firstly he is obese and it would probably help to lose 40 or 50 pounds slowly.

The result (3.8) I'd guess was taken during an attack and therefore means nothing.

He needs to drink more water. Pretty much a gout sufferer must drink as much water as they can.

Giving up alcohol is probably a good idea as is all soda and sugary drinks. Cut down on wheat. Cut down on meat.

Exercising - something like swimming or cycling would probably help.

He needs to get his level of allopurinol probably up to 300mg and maybe higher. Be aware allopurinol itself will create gout attacks at first as it clears out the urates stored through his body.

Being concerned about his kidneys is a legitimate concern, but providing he drinks *plenty of water*, gradually reduces his weight and takes the allopurinol it will get sorted out. Water will protect his kidneys.

***Don't worry - gout can be fixed. It just takes a bit of time and patience***

Is he taking any painkiller? Ibufren is quite good I found.

He might want to try colchesine.

How long has he been on allopurinol and what dose?

I am sure others can also give further excellent advice.

Read Sochimas advice Bonnie. It is very sensible. Hopefully others will chip in, but with what you have here you have the basic outline of what needs to be done.

I wonder why you are here and not your husband (who is after all the patient). Is he resistant to making these life style changes? You want to tell him that gout is not just a problem of your toes - it's the symptom of an underlying metabolic issue, which if left unresolved will lead to severe health complications.

Of course the urate level was low - the test was done during an attack. Gout 101: blood tests done during an attack will show a low urate level. Also he is taking allopurinol and has the symptoms one would expect when first taking it.

Finally pseudogout tends to impact the knees, and larger joints, gout is primarily the feet. Pseudogout is primarily a problem of much older people (60+) this guy is in his 40s.

As for your foolish suggestion not to drink water - drinking extra water is the primary action one should take for both gout and pseudogout; as it reduces attacks in both, but also helps to protect the organs.

Thank you for your contribution.

Aaahhh, I didn't realise that the test was taken during an attack. Any doctor should know that a test shouldn't be taken during this period, so I took this for granted. Of course water is good for the condition, but the only time I ever drink water is with the allupirinol, and that's because the instructions say so. I would have expected hime to be given Colchesine when he was first given the Allupirinol. My advice would be to change doctors. I still stick with the advice to carry on with life, and don't let the get rule it for him

Gout / pseudo-gout are metabolic syndromes in which monosodium urate / calcium pyrophosphate dihydrate are not removed by the kidneys. The more water we drink, the less concentrated are these chemicals in the blood and the easier it is for the kidneys to remove them. Furthermore the more water consumed the greater the chance that they won't form crystals in our bodies. Finally simply dehydration itself can cause gout (and some drugs causing dehydration will cause gout). It is therefore good advice for anyone with gout / pseudogout to drink more water than a totally healthy person. It may not be easy advice to always follow, but it is good advice nonetheless.

As for your suggestion of changing doctor - that seems like pretty sound advice. Find a doctor that understands gout and takes it more seriously. Somebody suggested doctors who are fellow gout sufferers are good gout-doctors - good advice if you can find one, as they will certainly become experts!

Thank you everyone for all of your sound advice and for sharing your personal experiences. They have all helped in different ways. As I said before my husband Chris has struggled on and off for 10 years with gout. Over the years he has learned what he can't eat and drink. No turkey, no ham, no shrimp, no chocolate, NO ICECREAM, no cheese, no Frickin almonds???, wierd but true, and so on and so on. He does drink TONS of water. He has agreed to cut out alcohol. And he started weight training this week. It has FINALLY calmed down. He's atleast able to walk around with a cane. The only pain med he takes is Aleve. I believe you hit the nail on the head when you explained the alpurinol and how it works. He was on a very heavy does for nearly 6 weeks. It sounds like according to your info that the gout wouldn't go away bc his system was clearing out all the crap. Yes we HAVE TO FIND NEW DOC! He was a moron. He told us they don't make colchesine anymore and the new substitute for that doesn't work. So as of this moment things are looking up. Someone asked why my I am on here and not my husband. Simply put, bc I Love that man and I hate to see him suffer. He does for me as I do for him. Plus, I know i will get more info on here than he would. 😉 Thanks again everyone. Will keep y'all updated

Bonnie are you in the USA? In the USA colchesine has been bought by a company and to some fiddle it is largely banned and they've increased the price by about 10. If you live near Canada sneak over and get some. If not go on holiday abroad or find a friend abroad to send you some. (Its illegal of course)

It's not illegal if you buy it in Mexico. They sell it in pharmacies including penicillin.

Good point Sochi! I totally forgot about Mexico! You'd think it impossible with all the wall talk.

What I meant was illegal is I suspect having posted across the border. Chances of getting caught? Not high I'd guess.

Hey rusty,  yes we are in US, east coast.  I pray that we won't have to get to that point BUT Thank you for input.  So, is alpurinol something you take everyday for long periods of time or is it like a rescue medicine?

Allopurinol is the long-term solution to gout. It not only stops attacks but it flushes out the monosodium urate crystals stored in patient's bodies.

You will hear a load of rot about allopurinol. For Chinese-Korean-Thais it is dangerous. For the vast majority of the rest it isn't. NB if your husband has to use it during the first 15 days just take a small dose - and stop if there's a skin rash (1:50,000 chance). Apart from that it can upset the stomach - I found dissolving in my mouth in water stopped that. And, like everything to do with gout: drink loads of water. Beware though - as the crystal stores are released by the body it causes random attacks of gout so at the first sign take the pain killers etc - don't stop the allopurinol. After a time the gout attacks will stop. In my case that was just over a year (touch wood).

Allopurinol is also very cheap. I buy it at the correct market price in the UK and its something like $8 for 300mg per day for 6 months (4 cents a tab). I reckon the packaging costs as much as the drug.