Can this be gout?

[feenix]

Hi there.

OK.  I am thirty years old and have had gout on and off for the last few years (maybe 5 years or so).  Basically, I'm wondering if this is gout – I've never heard of it affecting anyone as young as me before.  All the classic symptoms suggest that it is – swelling of the big toe, intense pain for days at a time, a redness in the toe.  Also, my doc says its gout and a few years ago put me colchicine (spelling?) which worked but didnt agree with me.  I dont like taking it because I hear its used in chemotherapy so it sounds a little extreme.  I'm taking aspirin and codeine for it which certainly seems to be working at the moment.

All of which leads me to believe that it is gout.  It also jumps from one foot to the other – had it in my right foot a few weeks ago, now its in my left.  I'd be interested to know why it jumps like that.

Anyway, I'm new here (joined today) so wanted to say hi as well!  I'd appreciate any information I can get about this topic.

Thanks, guys.

Feenix

[Keith Taylor (GoutPal Admin)]

Welcome Feenix.

With gout, you need to separate yourself from the statistics. Statistically, you are less likely to get gout before 40, but this does not make it impossible. In fact, there are references to juvenile gout, which is simply gout in a young person.

Everybody is at risk from gout, but several factors increase that risk. Statistically you are in a low risk group. But the facts point strongly towards gout.

First off, is to get a proper diagnosis to be certain it is gout. This involves a simple process called arthrocentesis (or aspiration). Some family doctors perform this, but it is usually done by a rheumatologist. Finding a good rheumatologist, with gout experience, is your best chance for proper diagnosis, treatment, and advice.

Gout often moves from joint to joint. It can affect all joints, and in my experience, it usually involves different joints. Sometimes just one elbow, sometimes a knee and a wrist. Every attack seems different after a while.

As uric acid levels rise and fall, uric acid crystals form and dissolve. Crystals will tend to form wherever temperature is lower, where blood flow is slower, or at the site of an injury or tight clothing which restricts bloodflow.

There is a natural tendency, when you have a gout attack in one joint, to forget other joints. Perhaps you limp a little (who wouldn't!) and place more stress on the unaffected foot. Gout attacks tend to clear themselves in a few days, but if your uric acid level rises again, you are at risk of crystals forming again. What better place for them than the foot that is stressed by doing all the work for a couple of days.

So now, my dear Feenix, it's time for some serious self analysis, some expert analysis, or – better still – both.

Why is the gout (assuming it is gout) happening? Do you produce too much uric acid? Do you excrete too little? Is it a mixture of both?

Is the uric acid very high all the time? Just high enough to trigger an occasional attack? Or somewhere in-between?

Can you fix it through diet and lifestyle changes? Do you need medication? Or a bit of each?

In short, do not waste years of time, money, energy and health trying to avoid some foot pain. Let's work together to find the right questions to ask, and find the answers that improve your quality of life.

We need a partner in this – your doctor. I'm neither qualified or prepared to give medical advice, but I am here to help you and interpret any advice you are given. From what you've told me so far, I get the feeling your doctor is working on some pretty out-of-date guidelines. Colchicine is a perfectly acceptable painkiller for gout in some circumstances, but I believe that the patient must be aware of those circumstances, the risks, the benefits, and the alternatives.

I'll pass the buck back to you, for now, and ask how you feel about consulting a rheumatologist. I know that circumstances vary from country to country, so I won't assume you have easy access to a rheumatologist. It's just the first important question, as we proceed differently according to whether we have a rheumy on board or not.

[JasonM]

feenix,

As GoutPal was saying, I find the statistics don't mean squat…  I am 29 about to be 30 and have gout.  Everything you describe to me certainely seems like gout.  Although I just got it myself recently and am learning more about it.  Some blood test to monitor your Uric Acid levels would defenitley go along way in verifying.

[Author]

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