Is it really gout??

With your uric acid being extremely high, you can surely bet it's gout. 

The first time I got a gout attack was a top of the toe pain. It was swollen and hurt pretty bad. I couldn't walk on it. So, you definitely have gout.

If you're a male then beer is your worst enemy when it comes to gout. Steer clear of beer, and wheat.

Yes, I forgot to add soft drinks like soda or high fructose soft drinks.

Did you mean Thalassemia? That's an inherited blood disorder if it runs in your family then yes you could have it and experience some deformity in the face, but it is not a symptom of gout.

Give somebody colchesine for gout is a good start - it will reduce swelling. However, it isn't a long-term solution - you need something like Allupirinol to reduce levels of blood urate. As for taking it for 3 months - I'd be amazed if that were necessary, it should resolve before 3 months.

As I'm sure you know Allopurinol will trigger gout, hence you need to have something like colchesine on hand. Make sure you do a couple of weeks on 100 mg to make sure you aren't allergic to it. Then after a blood urate test increase the dose till the urate it low. Once you have had no attacks for at least six months, you tissue are cleansed of urate, and you can then go to a much lower dose.

rustygecko, why do they prescribe allopurinol if it brings on gout then? or is it that it's benefits our way the negatives?

The reason for using allopurinol is that is converts purines into different chemicals which are easily excreted, instead of them being converted to urate. The result is that you will over a year or so not only reduce your blood urate, but dissolve the stores of urates in your soft tissues and joints. Those stores of toxic urates took years or decades to put in place and won't be removed over night.

While other drugs are available allupirinol is 50 years old, well researched and very cheap.

that makes complete sense. I work in healthcare, so this is easily understandable. Also, my husband has it, but he doesn't answer my questions the way I want them answered lol.

but I do have to say, today is a good day, the swelling is down tremendously and the pain is maybe a one and that is if I walk funny. Since its only in my ankle and inside there somewhere, there's no heat or soreness to the skin. I'm just glad I'm not limping along like I was. Also, makes work a lot easier since I am on my feet about 8 hours a day.

It's still gout, I had the same happen to me. I was able to walk but couldn't pull my toe up, it's because you're moving the crystals inside the joint that still haven't cleared. This is what my doctor explained to me.

Now as to why the pain is not the same - my guess it because you are taking the cochrcine, which reduces the white cells inflammatory response, and therefore the pain will be reduced.

What do others think?

So should i start allopurinol? Im european and not allergic to allopuriol

Allopurinol works for me and I do not get gout attacks.

It is VERY important to realise that allopurinol takes up to a year or more to become fully effective.  Don't expect a quick fix but long term can be great.

It's your decision and that of your doctor.

I take it. As others have said its a slow process to get rid of all the excess urates. You should have regular blood tests for urate. You need to force the urates down to well below the max

Well, if you're taking the colchicine it should work to stop any attacks. So start the allopurinol as instructed by your doctor and you should be fine.

Allopurinol will trigger an attack. Believe it or not - that is good. The reason is that as a patient suffering from gout, you have had Hyperuricemia (high blood urate) for years, possibly a couple of decades. The reason is either you don't excrete enough (kidney) or you produce too much uric acid (liver) or both. The Hyperuricemia has slowly soaked your body in monosodium urate, and it has been absorbed into all the soft tissues, When you take a drug like allopurinol, it reduces uric acid production (by converting it into a form which is easily removed). It is important that you get a dose of allopurinol which is correct to you - you'll need blood tests - to force down the level of blood urate - not to the maximum normal level (6.8) but to much lower - so that the stuff which is deposited in your tissues will come out and be flushed away - this takes times - at least a few months and possibly a year or so. (The •average• dose needed to flush the tissues is 327mg BUT there is a huge variation around the average from 100 mg up to 800 mg).

When this "stored" material is flushed out, it may (probably will) cause some attacks of gout. Once the allopurinol has flushed you out, and you've had no attack for an extended period, your doctor will reduce your allopurinol to a low maintenance dose.

This means during the "cleaning phase" you will need colchesine or similar to reduce the flair up of gout. You can probably get away with just taking the colchesine when you start to feel an attack coming on. I think it sensible while you are doing this to note in a diary when you start to get get attacks, so you'll know when you need a maintenance dose of allopurinol.

I'm sorry this is a long explanation, but 90% of people do not complete the allopurinol treatment, and I suspect it's because they don't understand it - because GPs either don't understand it, or don't have the time to explain it.

Two last comments - most of the purines (the stuff that is converted into uric acid in the liver) comes from our own body as we recycle old cells - some (30%) comes from our diet. So while we can reduce purines in our diet, we cannot stop the body making the uric acid. Diet may be a contribution to long-term maintenance but it won't solve the problem initially.

And finally the reason that you need to get rid of the monisodium urate is not just to stop the gout - the reason is that it has serious health issues over the long-term.

Good heavens! I thought this site was just for our county! If it's any consolation I found this "....Nonetheless in the UK, fewer than half were counseled on the diagnosis or urate-lowering therapy and only 18% received urate-lowering treatment."

It would appear that over here a minority of GPs understand gout.

Funny Rust, I'm in Canada.

I thought everyone was in Lincolnshire (England - the small island of the coast of Euope - just in case there's anyone from the US).

Apparently not.

But this system is very integrated into our health system here (and maybe other places?).... it gives us all our local health services, it is called "Patient UK" and leaflets from the health service here often have the same logo. Additionally I believe one can order regular medicines through our local doctor on the system. Finally it keeps local pharmacies doctors and hospital informed of local issues (eg if there's a big event in town, or outbreak of say Ebola Fever). But maybe it's doing this elsewhere too?

I don't need to make an appointment to see him if I'm suffering from something, unless it's an emergency. I just call him tell him my problem, he calls the pharmacy for a prescription all I have to do is pick it up and I'm done. This is how I got my last gout medicine over the phone medical screening. No need to go into the office.

Similar here for the state system - you just call / email / go online and if its regular meds it just happens in 24 hours. You can either go and pick up the prescription or set up with a local pharmacy, and by some form of 21 century magic, it just happens.

If you want medicinal canabis it'll be more

complex :-D.(Still illegal here, but a very active "private sector" I believe).

I also don't need to wait 24 hours, the doctor calls right after we hang up, and within an hour I have my medicine. Canabis makes me nauseous and by this I mean just the smell of it makes me vomit.

Pretty much the same as here. If it's a new doc or a new medicine by law you have to at least say hello. We call to see the doctor and you'll get an appointment on the same day if you want. You can't just roll up though, unless you are really pretty ill.

That's interesting about calling. They are just experimenting with that and also video calling to see doc. Seems sensible ... especially if the patient has been exposed to Ebola Fever!

We had more than one person walking around infected with Ebola! (I'm not suggesting that Ebola is by any means anything but rare).

That was indeed a strange case - she ended up getting the disease 2 or 3 times after being "cured", as apparently Ebola can return. Interestingly she was struck off as a nurse, for professional malfeasance - for hiding from medical staff that she was ill when she was checked out in Heathrow on her first return. A very lucky lady.