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@BigA – no worries mate. But generally do you still have any minor inflammation present in your affected joint..?

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@Keith – Hello mate, thanks for getting back to me.

1. I’ll fire up a separate thread for this point as I feel it would provide us both with greater granularity.

2. Just so I understand your answer about the colchicine a little better. So you don’t or didn’t really use strong NSAIDs like naproxen or diclofenac and instead used ibuprofen and paracetamol with colchicine for accute attacks?

The reason I ask is on the arthritis research UK website (http://www.arthritisresearchuk.org/arthritis-information/conditions/gout/treatments.aspx) it says NSAIDs with colchicine shouldn’t be taken? Unless I’m understanding your previous post (#4401) incorrectly and ibuprofen isn’t really considered a strong NSAID?

P.s. Would two colchicine tablets you take when you used to get an accute flare be an hour apart or would they be 12 hours apart (morning / evening)?

3. Would that be the same approach as naproxen? Continue to use for two days after symptoms have subsided?

Thanks Keith 🙂

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@BigA – I was wondering what your latest update is. I too have swelling and a slightly puffy joint. Basically some inflammation and it’s been about 2 and a half months. I was told to take the colchicine which I haven’t but I was told that permanent damage may have occurred.

@nobody – “And it’s possible a gout attack did some damage”. This is indeed what my new rhumatologist said about my swelling however I am seeing a professor rhumatologist soon to discuss this with him. I also have a few updates for you and Keith in which I will add to the originally started thread 🙂

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@Keith

Hi mate, just a little bump on this thread 🙂

I’m just a little curios / concerned about using colchicine (should I need to – and hopefully not)

Cheers.

[d q]

Or you can always ask here too 🙂

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@Keith – hello mate, you know me.. Always trying to educate myself and others where possible 🙂

Fantastic comprehensive response. Thanks 🙂

You raise interesting points particularly with;
1. immobility and it extending the duration of the gout flare – Whilst this may be true I do feel it may delay the healing time. Since my last flare I’ve kept as mobile as possible but I notice after a long days movement my gout flare foot starts to hurt and the pain increases further as I exert further mobility. Not exercise just walking. That was certainly not the case with my previous two attacks. But that could all be down to this attack being invoked by allopurinol.

2. You mention one Colchicine at night and one in the morning (two a day)? I’m not too sure I understand as further down you mention two tablets and one an hour later (3 a day). Is the first option what you generally would take if you got an attack and the second a general dose?

3. Finally during an accute flare how many days do you generally take the Colchicine for?

Thanks mate.

[d q]

I am no doctor so it always best you consult a specialist first but from my experience;

1. It is not gout until it is diagnosed as gout by a qualified rheumatologist. Even then a high uric acid reading is not a ‘confirmation’ it is an ‘indicator’. The only true way to confirm gout is by conducting Joint Fluid Aspiration from the effected joint and checking to see if monosodium urate crystals exist under polarised light or finding a tophus. However; that said, treatment can begin in general to lower uric acid levels in your case as they are very high and that in itself is not healthy for you.

2. IF they are uric acid crystals then one third of your problem is solved. Diet alone probably wont help in dissolving crystals in your case but it can certainly help in reducing the overall dose of allopurinol (or similar) you may need.

3. Allopurinol, Febuxostat. Other medicines also exist which work in different ways.

4. Healthy Diet. The list is exhaustive but increasing intake of vegetables, low fat dairy, cherries and many other foods and techniques. Refer to this as a starting point: http://www.goutpal.com/gout-diet/

5. How long is a piece of string? This depends on your body and what medications (if any) you decide to take.

6. Exercise is generally advised. It is imperative to get your doctors advice on how much (or if any) is right first.

7. I’m not too sure I understand this question, but you will likely feel pain before you feel the gain.

Two gallons of water a day? That is over 7 litres and even more if you are measuring in Imperial Gallons + your usual food intake. I am no doctor but that definitely seems too much. You should really check your blood sodium levels with your doctor before continuing down that path.

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A few side notes to add to this thread:

Gout Pain Gone But Still Swollen

@BigA – I hear you mate. I had attack followed by another a year later and finally started allopurinol. As I increased the dose of allopurinol I got a severe attack and boy did that put me out for a good month. For that matter, my situation is exactly that of yours. I had to stop allopurinol for a few reasons but I might be starting febuxostat a little later. In any case the main pain is gone but I still get pain from the slight remaining swelling 2 months later! I haven’t been able to do my usual long walks as after a while the swelling starts to hurt a little and I need to put my feet up for a while. So can lingering pain and swelling last a month or two later? In my case definitely yes, in fact it is still slightly swollen and the pain is still lingering. I’ve been given Colchicine to try and speed the healing process but for the time being I am staying away from all drugs until another medical condition I have is checked.

@morgano70herbs – this is not entirely true. Refer to this: http://www.goutpal.com/1629/is-allopurinol-a-lifetime-drug/

The general advice for treatment is:
1. Find out if you actually have gout and not similar conditions.
2. If it is gout, then find the cause for your gout and treat that.
3. If there is no apparent cause, try and treat it with diet “if” possible.
4. If that cannot be achieved then go onto drugs.

Whilst it is true that gout is insidious and takes time to develop, not everyone with high uric acid will develop it.

Don’t let gout scare you, it is treatable, you just need patience and will.

[d q]

as nobody says it’s probably best if you check your levels after changing your eating habits.

On the smoked salmon side, I eat smoked salmon regularly that comes from the market and that comes from most shops and have no issues with it. In fact it is healthy for you. I’m not too sure what constitutes as ‘a lot’ of smoked salmon but again start with maybe 100grams and check your UA levels then depending on that you know to move up or down.

Smoked (or not) Salmon is delicious! 🙂

Eat everything in slightly stricter moderation to people without gout and avoid a few ‘key’ foods and you will be fine 🙂

Dont worry too much.

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@jokeco68

A little late to the party and ignorantly haven’t read the entire thread but you mention fatigue and low energy. Do you have any blood test results before starting allopurinol that include your haemoglobin, iron serum, ferritin and folate? If so, compare all those results to the ones you have done a few months after starting allopurinol to check for differences. If you could provide those vital numbers I can try and advise further.

Cheers.

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@nobody

Haha 🙂

Febuxostat is nearing buddy, so I’m sure I’ll have questions (assuming allo was the culprit). Rheumatologist appointment is coming up in just over 2 weeks and next bloods coming up in 10 days. Interesting to hear that inflammation can also cause a blood count drop so there might be a little link to note in my case as I still have slight inflammation going on…..

Well I wouldn’t be me if I didn’t ask! Besides I was and still am interested as to why you decided to stop it.. 😉

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Hey Patrick pal, I’m doing good, I know your having a difficult time, how is it all going back home?

I’m definitely going to discuss Methylprednisone option with my new rheumatologist and see if it’s safe for me to use and if he can prescribe it. Is it common to take with accute attacks?

With regards to colchicine, how many hours apart did you use to wait between each dose (it was 500micrograms right)? Did you continue the colchicine and naproxen alongside the 6 day course of Methylprednisone or stop those earlier or later?

Thanks buddy.

@Keith – what about you mate?

[d q]

Now I fully understand – thanks pal. I was given the green light for colchicine by my haematologist but as I said I’d rather wait till mid July to see if the haemoglobin bounces back before trying anymore pills. Also I have the new rheumatologist round the corner in which I’ll ask the few outstanding questions with regards to prescriptions, inflammation and dosing.

One last thing, why did you stop allo?

Thanks mate.

[d q]

nobody has answered your question spot on.

Rich, you also need to ask yourself what you want from all of this.

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nobody! don’t you know me by now? I’ve always got questions 🙂

I’m really sorry about what your going through mate, if it’s any consilience (and I know it probably isn’t) I’m going through a pretty rubbish time too. It seems another summer might be cut short for me if this inflammation and lingering pain don’t recover (haemoglobin to be tested in 2 weeks but so far so good). Got my new rheumatologist next month so maybe he’ll save the day with regards to the above.

Me aside;

4 months, wow, well a few more weeks and that’ll be me too mate and even when (if) this inflammation does subside like you it may be another few months to get total comfort in it again. Good news on you not needing colchicine for those long episodes, that’s given me a little boost of confidence in trying to avoid it 🙂

Did you not take any other ULT drugs apart from an attempt of febuxostat? Is it just diet maintenance and acute pain relief when it strikes?

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@keith

Maybe it’s just me but I can’t see any update to that page explaining the above? Maybe a mention of what centigrade uric acid crystals form at too? 🙂

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@nobody

the rheumatologist was also pretty shocked to see such a long standing attack. By the way, assuming one doesn’t take colchicine will the inflammation eventually go on its own..?

re: “hardocore”
Ah right. So what dose are you taking now then?

re: overconfident
So how long have you been on febuxostat prior to this attack. I know crystals can linger around for possibly years but when did you actually start taking febuxostat after learning you have gout?

re: my hemoglobin
Chronic inflammation is exactly my worry. Its been ages with this minor inflammation I have and I have no idea when it will go. Is your chronic inflammation a result of not treating it with colchicine or is it something that may never go away?

re: your SUA test result
Yep, you sure did and to be honest I never thought it would go up by 160ummol. I was thinking more 50 or so. Let’s hope it is just a “drug stop shock” and the body just re-adjusts. When you say fairly quickly, how long roughly after stopping? So you are no longer taking ULT?

Cheers mate.

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