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My request to begin allopurinol was denied due to my being in the midst of an acute attack….. yes I provided the American Journal of Medicine article. Both the GP and the Rheumotologist she consulted agreed that their clinical experience pointed to exacerbation of flares. She offered a referral to a specialist, but I presume that would be to the rheumotologist she consulted. Not sure what to do now… I believe she is suggesting that the allopurinol would start 6-8 weeks after this current flare because my UA is “not that bad” at 7.2 and my flares are infrequent. I could push to get on the allopurinol but that would be a couple months from now – is that a “big deal”, Kieth?
It’s very disappointing Luke.
I’m not sure if it’s a big deal, but it shows a typical “stuck in the mud” attitude of many doctors, including some rheumatologists.
If her only concern is exacerbation of flares, then it shows a degree of incompetence to ignore the wishes of you, the patient. There is no evidence to show that flares increase if you are already taking pain control. If you are prepared to take the risk, you should be allowed the choice, now.
Medically, the dangers to health come from continuing exposure to uric acid crystals, not from acute flares. I hate this attitude that says, “This is how we’ve always done it, and bugger the new evidence.” I hate it so much, it stops me moderating my language!
Saying uric acid is “not that bad” at 7.2 is like saying, after a few weeks, “you’re only a little bit pregnant so carry on with bad habits for a few more weeks.” Outdated claptrap!
Sorry for the rant, Luke. I know I should be helping you better by reassuring you about being patient. It probably isn’t a big deal. Like getting slapped in the face isn’t a big deal compared with getting stabbed. Annoying and unnecessary.
Let me try to put it another way. If you said you wanted to wait 2 months, I would say it is not the end of the world. However, if you get over this flare, then leave it 6 months, I’ll never reply to you again.
Hi @lhaymond I hope you’re making progress.
Did what I wrote make sense? Let me know if I can clarify anything, or help more in any way.
It sure did, Keith.
I am happy to say I am in my 5th day of pain free living! I really pu it to the test, Friday gym, Saturday golf, Sunday tennis and – except for the expected muscle soreness and tightness – I was in perfect shape – and smiling from ear to ear!
I am currently on .6 mg of cholcrys for another week and then I am going to revisit the allopurinol with my MD. I am anxious to get to the allopurinol/testing phase.
I’ve learned a great deal from this site and am greatly appreciative of you guidance and support.
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