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I just got over a 4-week gout attack and am about to begin taking the allopurinol. Never took it before and don’t know what to expect, but I must admit that I am Skeeeerd!
We’ll see what happens…….
I was also apprehensive about starting on allopurinol but took the plunge 4 months ago – Doc started me on 100mg which is the correct way to go about it to see if my body took it OK – turns out I had zero problems – acid levels down a fair amount after but still not in “safe” zone so I am now on 200mg (a week so far) and still no side-effects – so all good so far!
A mate was started on 300mg and has been for ages – his Doc I think is a bit clueless and hasn’t made a point of checking his blood acid levels at all – he reckons the allopurinol has done the trick as he rarely gets gout these days – also zero side-effects for him.
So – I am hopefull all will be fine for you too Dennis.This is turning into a great discussion about the psychology of allopurinol. First, I should warn I’m about to have a rant here. It is definitely not aimed at Dennis or Barry. It’s a general rant about misplaced fears of allopurinol. Those fears are fueled by ignorance spread by certain sections of the medical community. Aye, ’twas Barry’s mate’s doctor what set me off!
Scared of allopurinol – I take that to mean scared of another gout attack. But, you are *not* bound to get more attacks with allopurinol. You *are* bound to get more gout attacks if you don’t control uric acid. The resulting uric acid crystals will bring much, much worse.
I’m not sure if Barry’s apprehension was pain-related. My apprehension about starting allopurinol was the fear of turning into an old man who’s only raison d’etre was to discuss his daily lifelong meds. Fears of allopurinol = fears of old age.
Barry’s mate’s doctor epitomizes the strange attitude to allopurinol that it is meant to stop immediate gout attacks. Is attitude part of psychology, or is it philosophy? No matter – this attitude is bloody stupid, and from a doctor too!
Allopurinol exists to lower uric acid. It has a reputation for scary side-effects. But now we know that these are largely genetic-based, and can be screened for. Healthy fear of dangerous side-effects is one thing, but what’s with the fear of pain? You’re gonna get the pain anyway when the next attack comes from untreated gout. Then you’re gonna get more pain, as uric acid crystals cause crippling joint destruction. Then you’re gonna get more pain as uric acid stones rip through your kidneys. Then you’re gonna die when tophi block your heart valves.
That’s how important safe uric acid is. Gout patients might not understand that, so I’ve made it one of my life’s missions to spread the word. But when doctors and other healthcare workers start putting gout attack treatment before uric acid control, my hackles rise. Are they stupid, or they just trying to make money from gout misery?
[rant over]
Sorry Dennis, for hijacking your first post. I can assure you, I’m not always like that. I’m sure I speak for all GoutPal members in wishing you well, as you take control of your gout. It’s a great feeling when you realize you’ve done it.
Despite my rant, it’s natural to be apprehensive. As Barry has so brilliantly shown, we’re all rooting for you. Any time you have any concerns, just post a message here. Also, be sure to tell us when it’s going well.
My fears about allopurinol were the possible side-effects. I was resigned to the pain anyway and was prepared to go through this for the ultimate aim of not getting the pain eventually!
I have a history of reacting badly to medication – in fact I am allergic to anti-inflammatories! So when I get a gout attack it is only colchicine (and painkillers) for me – and like most people colchicine makes me very woozy and diarrhea starts on the second day. A few years ago I had minor brain surgery which involved a 50p size hole being cut in my skull – try to imagine NOT being able to take anti-inflammatories after that operation – it was HELL.
So far I have not reacted badly to allopurinol – been on 200mg a day for a week now (after starting on 100mg for 4 months). I am confident the allopurinol is the right way to go. In fact I even have the odd lager (about 3 a week) now and so far so good. Hopefully once the drugs have reduced my acid levels more I can indulge a bit more!Barry! Is there ever anything minor about brain surgery? After that, gout should be a walk in the park. You seem to be coping well with uric acid lowering.
I’m sure, with our encouragement, @dennis will have great success. A 4 week gout attack is extreme. It just shows, you can never really give a general answer to the “how long does a gout attack last” question. Gout is very personal.
Hi Keith
it was certainly a “mind-opener” as it were!! Soon after the op I retired early and bought a boat! We just love sitting on deck in the warmer months sipping wine with snacks etc, not even taking said boat out of the marina much.
Anyway – point I am making is this: now that I am not working I want to enjoy all aspects but this ***n gout has certainly spoiled things big time recently! I suppose looking on the positive: I don’t swill back the booze like before and now plan my intake very carefully and every Stella I do have is like I would expect nectar to taste – appreciate every single drop!
If I think of anything else that might be helpful I will certainly post here.
Thanks again
regards
BarryMate, don’t take this the wrong way but…
I’d rather deal with gout on a yacht with Stella, than in a Bradford Council death-trap with a wife that hates me! #JustSaying 😉
Subject: Doctor says…….
Description:
I just had my Uric Acid checked and it is at 6.6 mg/dl. Also just barely getting over a gout attack. Is this a good time to begin taking Allopurinol? Doctor says do it and that it should not cause another attack.Any recommendations from the group?
Thank you!
[Posted via GoutPal’s Gout Helpdesk]
Subject: Well wishes….
Description:
It is nice to know so many folks can relate to the gout battle I am fighting. Although I am (almost) over my recent 4-week gout-bout, there is still some residual pain in my tumb joints and big toes. Therefore, I am holding off on beginning the Allopurinal at 100 mg until I can spend some “normal” time again painfree.My doctor told me my Uric Acid at 6.6 was not too high and suggested that I may have “Pseudo-gout”? or Rumatoid Arthritis. A follow-up test for the Arthritis was normal, so he gave me a prescription for Cochin? Not the correct name, but it was a drug that was generic – then not generic – and now generic again. It cost $174 (generic) for 30 day supply. Too rich for my blood, so I had to pass. It was supposed to determine if I have gout or pseuto-gout.
The Allopurinol I can handle at $10 for 90 day supply, so I will begin that as stated, shortly. Any thoughts on this shared information?
Thank you!
[Posted via GoutPal?s Gout Helpdesk]
Subject: Generic Drug Update
Description:
Hello Keith,In my earlier post, I referenced a generic drug that would determine if my attacks were really Gout, or Pseudo-gout. Here is the correct name of the drug I was supposed to get, but couldn’t due to $$$. It’s called Colchine.
Don’t know if this is short for something else or not, but that’s what the doctor wrote down for me.
Thank you,
Dennis
[Received at GoutPal’s Gout Helpdesk Thu, 18 Jun at 2:29 PM]
Subject: Allopurinol….. the rest of the story.
Description:
You all may recall that I was somewhat “skeeerd” about beginning the Allopurinol. I had decided to wait until all signs of my 3-4 wek gout-bout were gone.In the meantime, my doctor told me not to take the the Allo and instead he wanted me to start taking what turned out to be, Colchicine. OK – fine. He told me that it was now available as a generic, knowing my $$$ situation. It turned out that even the Generic was $174 for 30 pills. No way Doc! Can’t do it.
Anyway, and this is for all who are reading this, he suggested that I contact Canada Drugs – so I did. They offer the Colchicine for $79 for (90) pills! (you do the math). So, I am going to sign up. Perhaps I am the only one who didn’t know about this – maybe not. If you call them, please mention my name (Dennis Roucek) and I will get some kind of referral credit, which will help me out too.
One other thing. On June 1st my Uric Acid tested out at 6.6 mg. On june 12th, I retested at 5.0 mg. This was after basically two-weeks of slamming water and taking ground Flax Seed. Things are looking up, but I still have residual pain in my thumb joints. I am still going to begin taking the Colchicine and then transition to the Allo to start knocking down the crytals that exist (your thoughts Keith?).
I hope this information helps someone else and any feedback would be more than welcome – thank you!
Dennis
[Received at GoutPal?s Gout Helpdesk Sun, 21 Jun at 10:37 PM]
Hello DEnnis
I started on 100mg allopurinol eventually after also being scared and also waiting to being attack free – so far no problems from allopurinal (now on 200mg).
Colchicine was also prescribed but I really don’t like it and only take it when I get an attack – am learning to spot the signs so take it for 2 days max at a time (total of about 7 or 8 pills) and stop just before the diarrhea sets in. That seems to work.
Good luck!Barry, I’m pleased the allopurinol is progressing nicely. When are you scheduled for another uric acid test?
Dennis, I’m going to cover your points in sequence, now, then I’ll try to summarize where I think you’re at. I’ve got to leave for an appointment soon, so I’ll do what I can, then catch up later.
I agree with your doctor. Start allopurinol as soon as you can. 6.6mg/dL is too high for safety, but should be easy to control. Though gout attacks on allopurinol are not mandatory, it is good to have a good pain prevention and relief plan, just in case.
I’ll come back on the colchicine and your most recent post next time. Sorry for the delay.
Hi Keith – haven’t scheduled the next blood test but am seeing my doc in about 10 days time – see what he says. Haven’t had an attack since 04th June! so have been slowly testing my alcohol intake – gin and tonic one night, cider the next, no booze the next and then a Stella or two once a week. I have so far avoided any wine recently – I have been keeping a diary of everything I eat or drink and so far it has been when I have had wine over the previous week that I have had twinges.
Good luck all
BarryBarry, that’s great news. It’s great when you can begin to feel you’re controlling the gout beast.
Dennis, I’m glad the Canada source for colchicine works for you. I find it disgusting to see that Prasco appear to be continuing the profiteering that Colcrys started. Anyway, for anyone wanting cheaper colchicine, ring 1-800-CAN-DRUG (226-3784) and tell ’em Dennis Roucek sent you.
It’s good to see that your uric acid levels have fallen, but I think your plan to start the allopurinol is wise. Rheumatologists recommend getting uric acid below 5 where there are any visible signs of tophi. If you can get down to 3, or even lower, for a year, it gives your gouty joints the best chance for recovery.
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