Worst in over 10 year

Posted , 5 users are following.

Well here I am, Steve 43 uk, feeling sorry for myself lol.

I have had gout on and off for over ten years and even went 7 months without a hint once though don't know how as done nothing different and have never managed it since.

I am currently suffering the worst ever with the whole of my left foot twice the size of my right (I get gout in either foot just picked the left this time)

I can usually still walk with a limp even offshore on the rig I can get by. It I am on a 10 score pain and left to crawl around the house as can't weight bare (apparently I can still reprint all the skirting boards lol)

I have ordered crutches and knee pads as think it's a long job this time and due back offshore in 11 days but to be fair have seen gout come and go as quick.

One thing I have done is totally cut out alcohol started drinking green tea and also Cider Apple Viniger since Monday and the pain drops through the day and managed to sleep in my bed upstairs last night, the three nights before..... I never slept and was on the verge of calling an ambulance lol. Well I will let you know how I get on but fingers crossed

Steve

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18 Replies

  • Posted

    Are you on any urate reducing therapy?

    Have you seen the doctor?

    Are you taking colchecine or similar?

    You should try to drink as much water as possible. To reduce an attack you need to *urinate* at least 2 litres per day, and ideally 3! That involves drinking drinking a lot of water.

    If you are overweight - reduce it.

    Good luck Steve!

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  • Posted

    I'm on allopurinol twice a day and 400mg Ibuprofen 4 times a day with blood tests tomorrow to check Uric acid level and will ask them to check for bacterial infection too

    Drinking plenty of water but the swelling is not changing at all

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  • Posted

    When did you begin allopurinol? How many mg?

    Are you on any other medication? I assume you are otherwise in good health?

    Having a blood urate test done during an attack is pointless as levels fall during an attack. (Do doctors fall asleep during gout 101 and do they not read the guidelines from NICE?) Blood urate levels are taken at least 15 days after last symptoms, and ideally 40 days after.

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  • Posted

    Steve. You didn't say what drugs you are on. Diet is secondry if you get your drugs sorted. I take Allupirinol and eat and drink what I want without getting attacks. Of course, some days my foot aches more than others, but nothing I can't handle

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    • Posted

      Steve

      You are on allopurinol twice per day. But what dose of allopurinol i.e. How many mg each time (the tabs are 100mg or 300 mg). Secondly when did you first begin taking allopurinol?

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    • Posted

      Ok. Now it's clear what is happening. You have had hypereuricemia (excess uric acid) in your blood for years. The tissues absorb this, and from time to time it precipitates into the joints (causing pain), and other places not causing pain. Because you took no treatment at the time, these deposits are not removed but are covered with a layer of protein to protect them from the immune system. When you take the allopurinol blood urate drops, and that allows monosodium urate crystals to dissolve. But the body then begins to "dig out" the buried monosodium urate crystals by dissolving the layer of protection. As that happens the crystals are exposed and are attacked by the immune system, which is what we call gout. These crystals will be dissolved by the allopurinol. However that takes time, which is why it is normal to be given colchecine to calm down these white cells attacks during the gout flare. 100 mg is the normal maintenance dose once your system is cleaned out. However in the cleaning phase the most common dosage is 300mg. It could be an idea to be on 300 mg.

      This cleaning out phase causes gout attacks but they will gradually reduce. If you'd been given colchecine as per NICE recommendations you almost wouldn't have had such a severe attack.

      The down side of this is that you are going to get some gout attacks in the short term. Medium term the attacks will stop. The upside is that allopurinol reduces the level of LDL "bad cholesterol." If left untreated the high blood urate causes damage to the walls of the arteries which leads to plaque build up and eventually heart attack stroke and kidney disease. Blood urate lowering therapy puts this into reverse.

      In the meantime the best things you can do is reduce your weight to a BMI of say 24, reduce alcohol and drink loads of water.

      Good luck. Gets some colchecine to sort this attack, and stick with it and you will get rid of gout.

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  • Posted

    Steve1973 sorry to hear about that, I certainly understand and have been there. I read once that it helps to elevate the foot when sitting and especially in bed at night. I have put up to 3 pillows under my foot when sleeping. It's not very comfortable but I found it helped drain some of the swelling and crystals out of the foot. I take colchicine (0.6 mg pills), when gout flares up: 2 pills at onset, then 1 an hour later on the first day. Over the next 5 days, take 1 pill twice a day. It usually takes 5-7 days, but colchicine helps me get rid of it. I have been on Allopurinol for a few months and have been advised here that it can cause flare-ups for the first couple of months. I have found this to be true in my case. But as I said in another post I now drink 16-20 ounces of water throughout the night in addition to drinking water all day long, at least 6-8 glasses daily. I have found this helpful. I have not had a flare-up in 3 weeks now. Good luck feel better

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    • Posted

      Well was at a 2/10 on the pain scale until I went to bed.... I am now back downstairs on an 8/10 😕

      I have found the pain gets worse when I elevate the foot and used to be able to ease the pain putting my foot in a bucket of really hot water but that doesn't work anymore and even ice does little, my foot can't swell anymore on the top or sides so the sole of my foot is now swelling.... won't need a football soon lol. Have done all the colchicine allowed for this attack so am on the 400mg Ibuprofen 4 times a day which does nothing I'm half expecting to be wheeled into the nurse tomorrow for my blood test (which is pointless during an attack) and be told to go A&E and end up on a drip with antibiotics, I could really get depressed with this grrrrrrrr

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    • Posted

      I don't think for one moment there's any reason to think you have an infection. Many people have gone to A&E thinking they've broken a bone to be told they have gout.

      If it's swelling it is recommended cold water. I used to use hot water on the grounds that it might help to dissolve the crystals. I've also seen alternate hot and cold water suggested.

      Speak to the doc and ask if you should be on 300 mg of allopurinol and as the other Steve says - get some colchecine!

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    • Posted

      Thanks, have had colchicine but here am only allowed to take 12 tablets in any one gout attack then must have 3 days off before taking them again, to be honest don't think my GP understands much about it

      Thanks for the info though and will check the dosage

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  • Posted

    Well visited the doctors for my blood test and was wheeled in (my crutches had not arrived yet)

    Went in to see "the nurse" and asked if there was any point doing my bloods in the middle of a flare up, she sort of said well not really but have done them on other people when they were having a flare and was up to me 🙄

    I let her take the blood asking what she was testing for and was just the Utica acid no liver function test or anything else.

    I then asked her if she minded looking at my foot and seeing what she thought as gave. It been able to walk for 5 days to which she replied " oh I'm just a Heath care professional and wouldn't know what I was looking at" good old NHS...

    She said she would make me an appointment with my GP on Tuesday (another 4 days away) despite the GP being in the next room too busy to pop her head in... at this rate won't make my next offshore trip and have had to forewarn the office

    On a good note I am relatively pain free well I call scores under 4 pain free after three days of 10s lol

    I put this down to the green tea and cider apple vintages 3 times a day

    Still only on 2 x 100mg Allopurinol a day which do nothing during a flare

    And still on the 4 x 400mg Ibuprofen a day ( which is probably slowly destroying my stomach)

    Oh the joys

    Supposed to be shopping day but even the mrs won't let me be seen with her in a wheelchair lol I'm sure the 4 yo would have loved it haha

    Steve

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    • Posted

      I wouldn't be so pessimistic about the allopurinol - it is reducing blood urate - but at the beginning it can also release uric acid into your blood. Even at 200 mg it's working but perhaps would be doing its work faster at a higher dose.

      The other thing to recall that even with no treatment every gout attack comes to an end.

      As for doing pointless tests - that probably wastes £50 each time, millions and millions every year.

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  • Posted

    Well that's the sick note in for two weeks and medications changed

    She still has me on Allopurinol 100mg twice a day but took me off Ibuprofen as not doing a thing

    She replaced them with Colchacine and co-codamol which I have had before

    Feel I have gotten no closer to getting rid of this attack as is over three weeks now, I know other people get it for much longer but for me this is a hell of a lot longer than normal 😤

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    • Posted

      Hi Steve

      Thx for the update.

      You now have the right meds although I think you should go to 300mg in a couple of weeks, assuming no side effects.

      The only good thing that every day the attack goes on is one day closer to the end - it can't go on forever.

      You have cut out alcohol, sugary drinks and are drinking plenty of water?

      Keep your pecker up! (You can tell this isn't the forum for erectile dysfunction. :-)

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    • Posted

      Lol yeah,

      Still wake up early and have to get my foot moving

      I was hoping the allopurinol would go to 300 and was tempted to do it myself but will follow what I been told

      Alcohol and sugary drinks are gone and replaced by cider apple vinegar and honey oh joy

      Have odaema pitting of the swelling and goes up to mid calf with aching up to my knee with sciatica too

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    • Posted

      "......•sugary drinks• are gone and replaced by.....honey"

      One of the main triggers of gout is sugar and especially FRUCTOSE. Honey is 50% fructose and 92% sugar.

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