9 weeks still in pain

[Usman Nawab]

Hi guys,

i’m in my 9th week and still have not recovered from my gout pain.

I was initially prescribed naproxen for 6 weeks which reduced the pain about 35%

after this I was taken off naproxen and took Nurofen for a week which did nothing

then i was given colchicine but after 3 days I suffered the diarrhea and had to stop taking

now i am on indomethacin for the last 2 days which makes me light headed but am trying to push on.

Skin dry and red around the right toe, not as bad as before but still noticeable.

Struggle when wearing shoes and walking.

Pain if i try to point my toe upwards or bend it downwards, still stuff and not as mobile as my left toe. lots of pain when i put pressure on the ball of my right full.

What the hell do i do?!?!!

[Keith Taylor (GoutPal Admin)]

for gout pain, take no more than 2 colchicine per day. if pain persists take naproxen or other anti-inflammatory. if pain persists after that, see doctor or pharmacist for analgesic that is safe to take with naproxen. Search for ‘pain freedom’ for more info. don’t do this for a long time – you need to lower uric acid to 5 mg/dl or less to avoid permanent joint damage.

[Usman Nawab]

i was taking 1 colchicine 3 times a day as advised by my doctor and didn’t notice any difference and stopped at the first sign of diarrhea.

6 weeks of naproxen has confirmed that is is useless on me.

now on day 4 of indomethacin 3 times a day still not really noticed much.

If I try to use my right foot and put pressure on it I feel pain and its killing me 9 weeks later with nothing solving it. And I cant go on allopurinol until this attack subsides so its just lose lose right now.

i tried cherries and baking soda and celery seed extract to no avail.

I am heading abroad tomorrow for the weekend and scared about the indomethacin… at some point every day i feel unwell since taking this pill.. be it light headed or sleepy or sick

[Tavery]

I am sorry to hear the drugs are not helping. Here are some things to consider.

1. Cherries, baking soda, celery seed and so forth are all things to help lower your overall number but they are not miracle workers. They wont drop you 5 points or even necessarily 2 points. In general they are good for maybe a point and in general helping you maintain a lower number. If you stop taking them, your number will pop back up.

2. Try bigger doses of the anti-inflammatory. Yes, too much can be bad for you, but if you take it with food, you can do it for a few days at least without any sort of long term problems. I am a fan of mixing different types during the day if I am in a lot of pain. Naproxen, ibuprofen, and so forth. Just don’t do Aspirin since it is a blood thinner.

3. Drastic diet changes. You wont get better unless you change your diet for the long term. Eliminate the red meat, sausage, gravies, alcohol and shellfish (plus any others that increase uric acid). Salad is no longer a side dish…its the meal.

4. Drink more water. The more you drink the more uric acid your kidneys can flush from your system.

5. Try a hot soak. The crystals dissolve at higher temperatures. Do frequent long/hot soaks to see if you can get them to dissolve and reform in some other place. As hot as you can physically stand.

6. Buy the uric acid kit. It isn’t that expensive and monitoring your numbers is the only way to know if you are actually improving or not. Pain just isn’t a good indicator.

7. Exercise. Yes, this one sucks when you are hurting, but increasing your heart rate opens your capillaries and increases blood flow which will either dissolve the crystals or let them flow somewhere else.

8. Weight Loss – I have no idea how big you are, but 90+% of us on this forum are overweight/obese so I will assume you fit in that group. The more weight you lose, the better your gout will be. Shed the pounds and you will generally shed the pain. (with a few notable exceptions)

9. Drink more water. Yeah, I know I already said that. I cant stress it enough though. If it has anything besides H2O in it, it doesn’t count as drinking water….that’s just drinking.

Good luck! Keep us posted!

[Usman Nawab]

Thanks for all the advice!

I bought a home test kit and have been testing myself over the last few weeks… I vary massively. When first checked by my GP I was 9.8, the the home test kit testing in the morning roughly every few days I fluctuate from 9 down to 5.5 with no noticeable changes to my diet.

My diet for the last few months has been as follows: No meat, Never had alcohol and no things high in purine like chickpeas mushrooms etc just having vegetarian dishes like rice and potatoes. I also drink a minimum of 2 litres of water every day. I don’t consume any other softdrinks or tea just water.

Yes you are right I am overweight, but I started healthy eating a month before the gout attack on which I lost 1.5 stones.. Since my attack 9 weeks ago I actually have lost roughly one more stone and now weigh 16.0 stones.. im only 5.10 so still about 3-4 stones overweight i would say.

I used to hot soak in the beginning and it did help ease the pain for a couple of hours, I might start doing it again.

I’m going to stick with the indomethacin for another week or two and see if it kills off the pain, fingers crossed! 9 weeks just seem such a long time for this to be ongoing and I fear that my joints are being eaten away and I can’t do anything about it.

I do wonder at times if we have just abused our bodies so much that they have lost their ability to process uric acid properly, there must be a way to re-sensitise the body to it I refuse to believe there is no cure for something like this

[Tavery]

Ah. Makes sense now. Quite classic really.

You had gout (prior to the attack) but had not yet reached the uric saturation threshold to cause an attack.

Think of it this way. Uric acid crystals live in your bloodstream. If you have 6 liters of blood in your body to support your original mass. That 6 liters held a large amount of uric acid. Once your mass starts to decrease, your blood volume will drop proportionally (slightly more slowly than the weight loss), but the uric acid volume in the blood does not drop as the blood volume drops. Therefore it becomes more concentrated which leads to crystal formation which results in 9 weeks of pain.

It will come down eventually, but unless you get on some sort of uric lowering medication (aka allopurinol) it might be a while before you are back to “normal”.

I would pause your weight loss until you get your pain under control. If you keep losing, you will keep having pain. Once the pain stops and you get on the medication, you can continue losing weight. (It is very common for gouties to have an attack during a period of weight loss)

Changing your diet will be a big help. On the plus side, I think you are near the end.

One other thought, (based on my own experience) be sure to flex the joint you feel the pain in. I know you are tempted to baby it, but instead try to purposely work it. The more you use it, the looser and less painful it will get.

[Usman Nawab]

yes it did cross my mind that the weight loss might be the cause of such a lengthy and extreme attack, but the combination of cutting out the fizzy drinks and fatty food and drinking lots of water means it is coming off by itself without any exercise.

I just came back from a weekend abroad, plane flights really made my feet feel quite stiff, not the thing you want on a 7 hour flight! can only imagine this is linked to gout somehow.

Im back at work as of last week and Im walking about around client sites etc from 8am-6pm so the joints are getting worked alright 😛

[chadaaron]

Sorry to hear your troubles…as I have also experienced weird feelings on endomethicin. My first attack lasted about a month a couple years ago. It went away but came back sporadically. About a week ago I suffered again. I started buying frozen cherries and making cherry smoothies in the morning and the gout attacks have went away. I also drink plenty of water as recommended.

[Usman Nawab]

So I make that 13 – 14 weeks now and still my right foot is messed up.

So here’s what I have discovered, indomethachin is doing SOMEHTING because i didn’t take it for a day because i ran away and my pain level increased so much, and after a few days back on the indometh the pain subsided. Now let me be clear i still cant put real pressure on the ball of my right foot with being in pain, I feel it when im walking, driving any time. I get twinges all around my feet now. This is despite changing my diet to one with no meat, never had alcohol anyway.. but ive been healthy diet wise for roughly 4 months as i started one month before my attack came along.

My GP has now referred me to get another x ray, see a podiatrist and also a rheumatologist. I suspect i may be one of those hopeless case that at the age of 23 even before i could try the allopurinol i cannot rid this attack with any anti inflammatory despite it being 3.5 months.

[Cujo]

Colchicine gets you diarrhea, it’s a known fact but why stop? In my experience it’s the best solution to gout attacks.
When i attack is coming i take Colchicine in doses exactly how my doctor advised (i could share if you like) and it’s VERY effective. My last two attacks lasted three days and wasn’t so painful thanks to that drug.
Diarrhea in my humble opinion is way better option than excruciating pain that lasts for weeks.
And one advice, just like fella earlier said, take it with your meal, it should counteract diarrhea.

[Usman Nawab]

What can I say guys, it’s been 5 months I still have a slightly swollen right foot, it is also still red. Still if I put pressure on my right foot the WHOLE foot is in pain. FIVE MONTHS! Every drug under the sun has been tried the only one giving me any sort of real relief was prednisolone but you can’t use this long term i only used it for 4 days once i came off it my pain went right back to what it was before. so thats naproxen, indomethacin, colchocine, paracetamol, ibuprofen and prednisolone all been tried to get me past this one attack and all have failed. I can’t start allopurinol until this is fixed. I had an x ray and the doctor said the results came back fine i don’t have arthiritis or anything (bare in mind im 24 years of age). 5 months of my life gone… not sure what to do now

[Keith Taylor (GoutPal Admin)]

Of course you can start allopurinol now. The old advice was simply a doctor’s con trick. If you meet with resistance, ask your doctor to check the November 2012 edition of the American Journal of Medicine. http://www.goutpal.com/4853/start-allopurinol-quickly-but-carefully/

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