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It's been two weeks since my flair up. My previous one to that was 18 months ago. Tried the Indocin for about 4 days and no relief. Figured it was because the meds were 2 years old. Made doctor appointment and she put me on a dose pack of prednisone 6 pills day one, 5,4,3,2,1 the following days. Only relief was taking first two days (11 pills in about an 18 hour time period). Did another prednisone pack, no help and just started back today on Indocin and I'm still in a lot of pain. Gave up the beer, no fish and cut my meat eating by over half the last week, i eat healthy to begin with, mostly chicken. Drinking a lot of cherry juice, up to a quart a day and lots of water also take a 2x fish oil pill. Nothing is working for me! My previous flair ups only lasted 2-3 days at most. I'm early 40's 5'10″ and 161lbs. Still waiting on uric acid results. Any suggestions greatly appreciate, am supposed to go on vacation to Disney this weekend and I can barely walk.
The first pain treatment for gout should be colchicine.
For most gout sufferers, you do not need anything else.
If that doesn’t work, first insist on a thorough investigation by a gout specialist (rheumatologist), because there is a strong chance that you might have something other than gout – bursitis, pseudo-gout and septic arthritis all have gout-like symptoms.
Next in line is one of the many NSAIDs such as indomethacin (Indocin) or ibuprofen. There is a lot of research going on at the moment for medication normally used for other forms of arthritis, such as rilonacept.
Prednisone should be last on the list. I do not have enough information on your case, but it is often lazy prescribing for gout that does more harm than good.
Keep on with the water, and keep the affected joints warm (though you can try an ice pack for 10 minutes – just keep warm at all other times).
I will amplify GP's first suggestion.
Call your doctor and have him call iin a pharmacy prescription for 60 colchicine tablets (tiny things that are extremely cheap.) Take 2 immediately and then one an hour until
1. the pain stops
2. Diarrhea becomes intense (a little is okay)
3. You have reached a total of 16 pills.
(Don't plan on leaving the house.)
I think this is likely to end yout attack. Since it has gone on for so long, maybe 2 more cochicine each morining for a couple days is a good idea.
Your doctor should NOT give you an argument on this.
Forget diet, uric acid etc. until you can end this acute attack.
If by this weekend you mean TOMORROW…forget Disneyland, it;s a foot torture worthy of the Inquisition.
went back do doctor, uric acid level was normal. she gave me 30 doses of cochicine .6mg. I took 2 then 1 every hour for 8 straight hours (until midnight). Read somewhere at 10 should be the max. Not much relief at all no nausea or diarrhea when I fell asleep. BUT this morning aroun 7am I came down with both, toe feels much better but still stiff. I've had the nausea and diarrhea for the last 8hrs. Does this last more than a day? Thanks all for the advise.
My experience of Cochicine is that the runs could last a couple of days.
Don't forget to replace fluid to help the gout and avoid dehydration.
It's unlikely you'll want to take more C right now, but I think 3 days delay is recommended between 'applications'. I stick to 8 tabs max, but others do more.
Quite likely, by then, esp. as your SUA is not high- you will be on the 'run down' with this attack, but that could last a week or more and you will no doubt taking good care of joints usage,
Disney or not!
My first dose of colchicine was 22 (I didn't know to stop at 16 because my doctor never mentioned it.) As SOON as the diahrrhea hit like a freight train at hour 21 my pain left my foot within 45 minutes…after 9 days of being crippled on crutches. Diahrrhea took only a couple hours to to empty me out….but that was several dozen “emptyings” with the finale being a glass of water that would run through me in a minute or two. I was lucky and felt no nausea…just cramps. THen a much needed long sleep.
Perhaps the huge dose had everything moving faster than if I had stopped at 8 or 10 colchicine.
But I find a light laxative effect the day after even 2 colchicine on a rare day when I suspect a “twinge.”
I almost think there's some bizarre but unfathomable connection between the diarrhea and the pain relief.
Stephen,
I'm glad they helped a lot with your pain. Perhaps 2 today and 2 tomorrow might be wise…but that's only a guess. (Can I presume you are postponing DisneyLand?)
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