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One more question for everybody, this is regarding the block of sugar theory. I get it that the “warmer the water gets, the sweeter the concentration,” and the more dissolving of the “sugar block”. Ok i get it until that point.
what i still don’t get is, why is it that it cause another flare at the pain spot on foot? because logically speaking, isn’t the “sugar block” concentration got decrease? got smaller? if it got smaller size why i still got painful flare that become obstacle for me to walk normal?
Thanks DQ for answering my questions. That’s a relief to hear that the sugar block theory of yours. Actually, i’ve been thinking about that possibility for a long time, i wasn’t sure of my hypothesis but now your answer just strengthen my thought about that, so that i’m confident it’s not just me that have a hypothesis like that.
Hello everybody that read this thread, i want to update my condition. I wrote this thread 2 weeks ago. Since then, i haven’t got any flares up until May 28th 2017 (at this point, i thought “what is this? i’m on 300mg of allopurinol/day since March 27th 2017, not one day without 300mg of allopurinol, so logically speaking, my crystal should already be dissolving and i was confident that at this point my SUA will be lower than 5.0 because last time i checked on May 20th 2017, my SUA is 5.2).
So, at May 28th 2017 i got another flare on the same spot i told everybody above (left foot – subtalar joint between the heel’s calcaneus and talus bones). I took emergency helpers like 90mg of Arcoxia(Etoricoxib) and 0.5mg of Colchicine. And then, i went to hospital to get MRI scan. The result was: my foot bone was intact, normal as new, but the doctor said something about the pad/cushion between that area of achiless tendon and calcaneus bursa being inflamed/swollen (right now, the information is still partial and i have to get to that hospital again to clarify the scan result).
And then, on June 3rd 2017 i went to a lab to check my SUA (at this rate, i’m still on flare but subsiding slowly). The result was shocking, my SUA is 5.9, and that means my SUA rising again despite the fact that i’m taking 300mg of allopurinol daily since March 27th 2017 (3 months).
Okay, enough of the backstory. Now, i want to get to the main point. Please anybody, especially Mr. Keith Taylor, to help me answer these questions:
1). So is it possible that SUA fluctuates during Urate Lowering Theraphy? even if i’m taking allopurinol daily in order to achieve lower SUA level?
2). I want to raise my dosage of allopurinol from 300mg/day to 400mg/day until June 18th 2017, which is 2 weeks, starting today, June 4th 2017 to observe whether my SUA level fluctuates again or not. Is this a good plan?
3). How to prevent future SUA level rising again? because i’m on healthy diet, i’m not eating any high purine food or anything.
Thank you for reading this, your answer might be a big help for me.
Well, thanks again for the answer. This clear things up. I finally get the big picture of what I should do now and next.
Thanks for the clarity of the issue, actually I feel better now. What you said is true, my actual target SUA before the initiation of ULT is below 4, and my schedule for another lab test is this Saturday, hopefully the result shows me that I got lower than the last result (below 6, or better below 5).
another question:
1). If I take one 0.5mg Colchicine/day for, say 1-2 months, is it advisable? just for prophylaxis. It’s just I want to prevent another attack coming while i’m on ULT2). I read somewhere and base on my last doctor told me before, that while i’m on 300mg of allopurinol, lab test should be at least once per 30 days (1 month) to really know whether the 300mg dose works or not. Can anyone elaborate?
3). And lastly, this is just another personal hypothesis, if I got the next lab test a much lower SUA than before, and if I got another flare not long after that, than can I assume that this is the real application of the “old crystal dissolving” theory?
Gout Flares during Urate Lowering Therapy
I’m 22 years old. I’m from Indonesia. I read the article in this site about why it’s painful during gout lowering treatment. I’ve been having gout since 2011, it’s been going on for 5 years I left my gout untreated. Until march 2017 I decided to fully treat my gout. I lowered my SUA level from 9.5 to 6. Last time I check, april 18th 2017, my SUA is 6. By the time i’m writing this, the date is May 14th 2017. So, my ULT been going on approximately 2 and a half months.
I understand that during lowering treatment, we might have caught another flares-up, sometimes in places that never been attacked before. In just 2 months since I took 300mg of allopurinol continuously until today, I got series of flares, 4-5 times. For 2 months I haven’t been able to walk like a normal person (the only near-normal-condition is half limping). Every time I got flares, I took NSAID (90mg of Arcoxia – Etoricoxib) and 0.5 mg of Colchicine. I took Colchicine daily for prophylaxis. What I’ve been meaning to ask is: is this really normal? if so, why? Mr. Keith Taylor said if it hurts, then it’s working (old crystal dissolving)….but now I have a lot of doubt whether it is feasible or not, because whenever I nearly recover, the next week I got another flare, so that I can’t enjoy days like a normal person would.
I haven’t seen a rheumatologist before. Please anyone help me, i need some answers. This is another useful information i wanna share to help diagnose what’s best for my condition:
Flare location is in my left foot, the tophi (pain spot) is in my subtalar joint between my calcanaeus heel and talus bones. In my right foot, the spot is rather on top of my foot, and inner side. Neither big toe’s are harm (i never experienced pain in that area). Is gout relatable with muscle trauma? because once before i have gout, i did running, karate, and other exercise that uses both of my pain spot.