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That sounds good, Johnson.
There’s a couple of other things that might help:
1) Follow the ice treatment with a warm (not hot) “dressing”. By which I mean a warm towel, or the type of bean/rice bag that you microwave for a few seconds to generate. Or, you could go “old school” like a friend of mine. He loves his traditional rubber hot water bottle on his swollen knee, as he watches TV.
2) Keep the arm raised above your heart when relaxing.I had a couple of episodes of this elbow bursitis. Before allopurinol, I tried to keep my elbows (and all other joints) away from prolonged cold.
I hope it gets better soon.
Hey, thanks again James. Your closing comments are very welcome indeed. In fact, all your posts are always welcome.
On point 3: yes, uric acid is produced from cell breakdown. So, when we eat animal flesh, we normally produce some uric acid. But, allopurinol will stop that process. For some reason that I don’t quite understand, allopurinol seems less effective when inhibiting uric acid production from cell breakdown from our own bodies. I only mention it as a general point. In practical terms, it means that allopurinol takers do not need to worry about special diet restrictions for gout. But, we should always remember that being overweight will increase uric acid production. That’s usually easily managed with increased allopurinol dose.
So, my main concern, personally, is: I don’t want to have gout under control, but suffer other health problems by being overweight. Or, other health problems from having too much animal flesh in my diet. The answer, for me is I do “enjoy most foods in moderation”. And, I don’t “count life by the minute and avoid[ing] all sorts.” I try to count life by the week, and adjust my grocery shopping to my healthy requirements. Nothing to do with gout really – just my EFSEP project to:
– Eat Food.
– Sufficient.
– Especially Plants.I’m glad you are being advised that long term risks of allopurinol are not worth worrying about. I’ve never seen any research that raises concern. But, I’ve seen lots of horror from not taking allopurinol (or not finding another way to make uric acid safe).
I’m also glad that you’ve got the knack of spotting gout attacks early, and stopping them. Without a current blood test result, I can’t say if it’s uric acid crystal dissolving from your allopurinol dose increase. If you’re down to 300 or lower, it’s almost certainly uric acid crystals dissolving. If you’re still over 400, it’s almost certainly new uric acid crystals forming. Anything in between is a risk assessment that depends on secondary factors, such as weather, temperature, and inflammation factors in meals (very complicated).
Take care James. And, look forward to Gout Freedom in 2017! ๐
Allopurinol doesn’t last very long in the body. It gets converted to oxypurinol. That stays in the body for around 2 weeks.
The symptoms you describe are most likely to be uric acid deposits. But, you should get this checked by a doctor.
Hi Lee,
I can’t see a need to stop allopurinol immediately, as you don’t know if your itchy bumps are due to allopurinol, colchicine, or something else. And, as you say, it’s annoying, but not severe. But, I think it’s wise to call your doctor, for a blood test. You can get:
A) Liver and kidney function tests that will help your doctor take a view on itchy bumps. Important for checking the severity of your skin reaction.
B) Uric acid test to see if your allopurinol dose should be increased.
c) A proper medical opinion, and hopefully peace of mind, about the skin breakout.Get to hospital today. Your butcher has left you at risk of infection. It needs to be properly cleaned and dressed immediately.
Then get proper uric acid control, which prevents this type of disaster.
Improving your GoutPal
My vision for GoutPal is where 80% of visitors follow my guidelines. Then, with their health adviser, they control their gout. Clearly, I’ve a lot of work to do. And, the eagle-eyed reader might have spotted that I’m progressing with GoutPal and You. But currently, only a small percentage of gout sufferers can apply my gout research to their personal situation. And general gout guidelines can never cover each unique gout sufferer.
So, there will always be 20% of gout sufferers who need the gout help forum. Together, we add the personal touch that gout sufferers need to control their gout effectively. And, I can use our discussions to improve my future advice. When several people have similar needs, I improve guidelines on GoutPal.com. Then, future gout sufferers get faster help.
Now, because it’s your GoutPal, this Suggestion Box forum lets you improve gout guidelines in a more direct way. I use it to identify pages that need improving. And, I occasionally add new gout subjects that need explaining. So, it’s available to all gout sufferers to learn more. I believe you learn more about gout when you get involved with improving guidelines.
That involvement can be:
– Saying you don’t understand something on a page.
– Spotting spelling, or grammar errors.
– Suggesting better wording.
– Sharing your experiences that relate to gout subjects covered on a page.
– Sharing your opinions about the page.
– Explaining how a page has helped your gout.
– Anything else you care to share.Now, I’ve made real progress with identifying different types of gout sufferers. I’ve called those gout groups. They help gout sufferers focus on gout information that is most relevant to their situation. And, I believe I should apply that principle to this Suggestion Box forum.
So, I will start new ideas that apply to specific gout groups. I strongly recommend that you get involved with these ideas. I listed different ways you can get involved above. I firmly believe that writing about gout helps you understand it better. When you understand it better, you control gout faster. If you are not convinced, ask me to summarize some of the science that supports my belief.
If you are convinced, please share your thoughts in the gout help forum. In many ways, writing is its own reward. Would other rewards convince you to write more?
I hope you’ll enjoy writing about aspects of gout that benefit other gout sufferers. Why not start by adding your comments here?
Thanks for your uric acid number, Ryan.
You already have the perfect response from Patrick. I’m posting this to prompt you to read every word of Patrick’s response again.
Then, after your appointment, please post your doctor’s response to your need for uric acid control. The sooner you get below 300 μmol/L, the happier your life will be.
Hi Bob,
743 μmol/L is way too high. Because it’s over twice the upper limit of 350 for gout patients with kidney disease. But kidney problems make gout management too complicated for an online forum. So, you really must seek professional help today.
If you don’t know what to ask, we can help you formulate good questions for your medical team. Similarly, we can help you understand what your doctor tells you about gout. But we can’t give general help about gout with kidney disease. Except to say there are too many complex issues. So you need individual professional help
Hi Amanda,
I’ve known females of your age with gout. It can’t be ruled out. But, I don’t have enough information to rule it in. This is really a job for a rheumatologist. I say that because differential diagnosis is a specialist subject. It’s beyond what can be accomplished with an Internet chat. But, I’ll give you some partial explanations, based on what I know so far.
Gout symptoms
“Each flare-up brings fairly standard gout symptoms,”
There are no such things as standard gout symptoms. My first doctor I consulted thought gout had standard symptoms. He failed to diagnose my gout.
Can you describe your gout symptoms in detail? โGout triggers
” and the triggers are fairly standard gout triggers.”
There are no such things as standard gout triggers. Every gout sufferer is different.
Can you describe your gout triggers in detail? โGout tests
” My doctor ran blood tests and my uric acid levels were not high,”
‘Not high’ is meaningless.
Can you get your full numeric result? โ” so he drew fluid from the affected joint
There were no uric acid crystals in the fluid. (There also were no calcium crystals to indicate pseudogout, which was the other possibility.)”
Were tests done immediately with polarizing microscopy? โ
Was fluid also tested for bugs? โ
Any other tests for diseases that display gout-like symptoms? โGout
“non-uric acid gout, which I had never heard of.”
And neither has anyone else because there is no such thing. By definition!As I say, you really need diagnosing by a specialist. But, the most essential thing, is uric acid numbers. Please find and post the results of every uric acid test you can get. Dates, and exact numbers (with scale) are important.
You’re taking me right back to my testing days! ๐
It takes a little getting used to. But, once you get into a routine, it’s easy. The trick is to reduce the number of variables as much as you can. It might seem petty to always sit in the same chair. And, always place your equipment in the same place. But, that attention to detail reaps rewards.
It’s sensitive kit, so all efforts to get consistent drop size are worth it. I also used to focus on cleanliness, as skin contaminants can affect results. I’m not saying medical cleaning swabs are necessary. But commonsense avoidance of skin contaminants is good.
I’m excited about seeing more results. And, I’m impressed by the way you’ve made this personal forum your own. You might also think about recording those gout symptoms.
I agree. The UAsure uric acid meter seems best. UK based, but they ship and support worldwide. Or, at least they did when I got mine.
It would be great if you could get uric acid test result history from your GP. In this day and age, we can expect accurate results to be emailed to us. If you can copy and paste exact results, with dates, that would be best. If you have to rely on the phone, be careful to get exact numbers and dates. Numbers should always have a scale (mg/dL, mmol/L, or μmol/L depending on country).
Personally, I would never wait until getting a uric acid blood test. Sometimes they are artificially low during an attack. If that happens, just get another test after 2 weeks. Repeat until you get stable results. That way, you have more information to support a diagnosis. If there is any logic in waiting, I can’t see it. I’d love to see arguments supporting delaying a blood test.
Cherry juice is tasty, so I see no reason to avoid it. When concentrated, it provides a big hit of anthocyanins (as do other red/blue/purple fruits). These help inflammation for most people. Personally, I prefer gout pain relief at max strength pharmaceutical dose. It’s much cheaper, and much faster. But, every gout sufferer should choose what’s best for them.
Lots of people make lots of money out of Apple Cider Vinegar (ACV). There’s nothing wrong with that, unless you’re exploited. Also, the placebo effect is generally measured around 30 to 35%. That is much higher than the number of doctors who understand uric acid. So, again, you pays your money, and makes your choice.
Baking soda is dangerous. It might be acceptable under medical supervision. But very much an edge case. As far as I’m aware, all situations that warrant this type of chemical intervention have a safer alternative.
The safest form of non-pharmaceutical pain control seems to be distraction. Just write about your gout symptoms here, and you’ll soon feel better!
Of those 2 sentences, the first has most medical validity. ๐Gout symptoms and diagnosis
Your symptoms are consistent with gout. But, could be something else. As you say: “UA reading (I need to find out what it was)”Dads are good at hiding symptoms.
Fake gout treatments
“Wouldnโt be able to say if any of these has had a positive effect.”
Your current Internet gout treatment combination, as described, is tasty/pointless/dangerous.“get this under control”
In the right sidebar of each page here (displays below on mobiles), there’s a section: “STOP GOUT WITH SAFE URIC ACID LEVELS” Below that is a table that describes different possible uric acid ranges. If your result is “Safe”, you probably don’t have gout, and your GP should refer you to a rheumatologist.If your uric acid test results show any other range, you probably do have gout. And, there’s no need for a rheumatologist for simple uric acid lowering. But, assuming you heard correctly, you need to change your doctor. Or, train the one you’ve got. There is never a situation where it is right to delay treatment because, “itโs a lifelong thing”. If you don’t start uric acid lowering treatment when you need it:
A) Your life will be shorter.
B) Your quality of life will be less.What next
I’ve focused on the important points. If you want me to elaborate, please ask.To give you better advice, I really need your uric acid test result numbers.
Ooops! It turns out that the lead I had is for a completely different product that uses “Urit” in it’s product description. From everything I’ve seen so far, I think this is a dead brand.
I’m still not convinced that there is any merit in home testing. Unless you are trying to develop your own bespoke gout treatment plan. If that was the case, I’d use a UASure uric acid meter. They have the technical support to answer queries properly. And a track record long enough to instil commercial confidence.
Nobody has taken me up on my free offer of my old UASure meter, if you pay for shipping from UK. I wonder if anyone will convince me they deserve it before my next clearout?
Hi Deanna,
I’ve got lots of facts about gout and iron on my Gout Facts website. The most prominent is Gout and Iron Revisited. As well as that, you can follow links from that page, or use the search box at the top of each page.
You will see plenty of general information. It’s a subject that fascinates me. But, it’s very difficult to suggest general treatments for gout that is caused, or made worse, by excess iron. There are so many variables.
There’s also a lack of specific guidelines about acceptable iron intake. And, blood test results are hard to understand.
Having said all that, I’m very interested in researching more about gout and iron. Like most aspects of gout, it needs individual assessment. And, a personal treatment plan.
As far as I know, the only treatment that has been proved to be effective is blood donation. But, some types of iron overload have other treatments.
Last year, I started Improving Gout & Iron Guidelines. But, there’s not a lot of interest in that. Perhaps you can change that, Deanna.
Tell us more about your experiences with iron and gout. Perhaps it will encourage more people to share their thoughts. Then, we might be able to suggest the best gout treatment for different types of iron overload.
Hi Irma,
Personally, I would keep going, as long as symptoms are bearable.
It’s almost certainly colchicine causing gastric problems. But Coxflam (AKA Mobic) can also cause issues for some people. It’s an anti-inflammatory, meloxicam. In the UK, anti-inflammatories are often prescribed with other drugs that help reduce gastric problems. There are lots of options, but no alternatives to colchicine. If you really can’t tolerate the colchicine, many gout patients manage without it. That’s especially true when anti-inflammatory is supported with a pain-blocker such as paracetamol.
Finally, some people are affected by when they take medicines in relation to meals. Medication before, during, or after meals can make a difference. Your doctor or pharmacist should have advice on which might produce best results for different drugs.
I never got a response from the Urit manufacturer. But, I might have a lead on a distributer. I think they are in the UK. Is that any good? Do you (or any other Urit-10 owners) want me to ask about shipping rates to USA or other countries?
While I’m waiting, Chris, I have a question I should have asked before.
Why are you bothering with a home test meter when you are taking febuxostat (Uloric)? Is your doctor not doing this for you? I always recommend that gout sufferers get a blood test at least once a year. The test should include uric acid, kidney function, and liver function. The function tests are particularly important for anyone who takes gout medicines, including herbal medicines. In rare cases, uric acid medicines can interfere with kidney or liver function.
This is especially important in the case of febuxostat. See Uloric Liver Warnings for more.