Keith’s GoutPal Story 2020 Forums Please Help My Gout! Your Gout come away from doctors even more confused

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  • #3182
    ouch
    Participant

    well finally got past dragon lady at the appointment desk for my blood results. 

    I must have asked  3 times for my uric acid levels  and each time the doctor say 216.   now I thought I'd miss heard  but still same figure  3 different times?    does this make any sense to any of you here?   He did say  he watches for a reading of 700  and then starts more drastic drugs? 

    I'm so darn confused. 

    ciao  OUCH

    PS  little pin picks in my fingers today  so short type.    Frown

    #7698
    trev
    Participant

    You need to get the unit of measurement confirmed to save confusion.

    In the US it's different to the UK. 215 doesn't seem worrying.

    Converted from umol/l would be about 3.6mg/dl mid range normal for a woman.

    Top end would be 357 according to my Kernel  supplied data. 700 would seem way high, especially for a confirmed gouty.

    #7699
    ouch
    Participant

    thanks trev.   I'd sort of figured it was around 3.64  mg/dl   from an article I read on orange juice and gout.    but wasn't positive I was reading correctly.    just totally threw me off at the office I was expecting numbers like you all throw around here 4, 5 , 6 ,7     216 almost made my heart stop.    

    the doctor said it appeared not high  but he still was concerned about the swelling, redness and tenderness on my left foot.   right foot seems to have gone down.    more indomethicine (spelled incorrectly I'm sure)   and a back up refill for any other flareups until I can get past the front desk.    Also a notation in my file for same day clinic admision if he is booked solid.   

    we discussed at length diet  and he was in the opinion of following mayo clinic and john hopkins recommendations.      They pretty well fall in line with what is discussed here  so I'm on track, food wise. 

    we also discussed the factor of stress, and I figure its a combo of stress and the added exercise I'd added to my normal daily activities that put me over the threshold.    I've a step daughter from h….llll    and she was just one big headache over Christmas.  Things are settling down we've not had to deal with her since Christmas. 

    ciao 

    OUCH   

       

    #7714
    zip2play
    Participant

    The number 216 has no meaning without UNITS. Ask doctor what they are. If he doesn't know right off hand, get a new doctor. (It is most definitely not one of the common measurements except perhaps in Zaire or Kazakhstan?)

    Like buying an apartment:

    Q: How big is it?”

    A: “Eleven.”

    Makes no sense.

    #7721
    ouch
    Participant

    I'm sorry   I'm not near as knowlegable as you are.   but I came here for help.   this is all very confusing to me  and frankly I'm terrified.   i don;t really need the stress of changing doctors and starting from point one again.      point was made that there were different measurements  by first answer so now I know what to ask next visit.     I didin't need to be made to feel stupid, or were you trying to make a joke? 

    ouch.

    #7734
    zip2play
    Participant

    Call doctor. Get Units. Then we can help. Period!

    #7744
    ouch
    Participant

    actually zip2play I did check  my doctor uses  SI standard measurments.   A simple point out to the coversion chart was all that I required. 

    mg/dL           µmol/L           mmol/L
    Under 6    Under 350      Under .35 Good  This level will stop uric acid crystals forming and dissolve existing crystals

    old level  221  divided by 59.48   =  3.715 mg/dl
    latest result 216  divided by 59.48 =3.631   mg/dl

    https://gout-pal.com/refere…..cid-levels

    #7748

    Ah, nice one ouch – I was just going to write something similar, so you've saved me the trouble.

    Now, I have to ask why the uric acid level is so low. You cannot have gout at such levels unless you are on uric acid lowering drugs such as allopurinol or febuxostat.

    So that we can help you better, please can you give a bit more information on the history of your condition?

    At the moment, I can only see 2 possibilities. Either you are on uric acid lowering therapy and the pain you are experiencing is from old crystals dissolving, or you have something other than gout. This is vital to know, as what you do next is entirely different in each case.

    #7751
    zip2play
    Participant

    Okay ouch,

    Now that I know we are talking about micromoles/Liter I have to echo GP's request as to how you are getting numbers so low with gout. While brainstorming the possible units for the 216, I thought of micromoles/Liter and dismissed that guess because nobody could have a gout attack with numbers so low and probably no men could have it ever without multiple drug therapy.

    So give us the particulars of your case (again for those of us who have forgotten…I am not particulary adept at searching back posts on this board.)

    #7753
    ouch
    Participant

    my thoughts exactly    why were the tests so low?   can you now understand why I'm very confused.   Not only were the numbers throwing me off  but  finding the conversion chart to recheck my figures   absolutley had me stumped.   unless I've actually  miscalculated the coversion between umol and mg/dl  ?????      

    gout pal     no drugs.   I've had indo  for the initial swelling  which has gone down now to almost nil.       no injurys  for onset.   went to bed fine woke up in middle of night in excrutiating pain.       had xrays done to make sure no broken foot.   given indo  to releive swelling while blood tests were out to lab. 

    some small recurring tingles  that come and go, with the occasional odd jab of sharp pain in my hands around the knuckles and in my toes (big toe both feet).  for some reason two or three cups of hot water and  sliced slivers of ginger   tend to ease.  ????? 

    I'm confused.   My lifestyle hasn't ever been one of excess, and I definitly don't eat much meat or trigger foods as far as I can tell.   only issue I have is being overweight  but I've been reducing that over the past year at less than 1 lb every week.   So excess exercise isn't the culprit, and i definetly do not starve myself.  ????  I'm not a drinker,   all other tests have come back fine, even this one for uric acid levels. 

    and for the record zip   I'm a woman   

    ciao  OUCH

    #7755
    zip2play
    Participant

    IF the uric acid is a correct 216 micromoles per Liter and you are a woman and you have not been medicating to inhibit uric acid, then you most definitely do not have gout. Remember though, labs DO make mistakes. Have you ever had another Uric Acid test? Numbers?

    Alas, NOW the fun begins where you must find out which of the laundry list of joint diseases might be causing your pain.

    Tell us what your symptoms have been and I'll try to steer you.

    Have you had you ANA run recently? Results? (ANA is high in a GREAT many autoimmune joint diseases and a low ANA is a good sign.) I went through a huge pile of tests to rule out Lupus, so I am a bit familiar with the process.

    Let me try to pull your old posts.

    #7761
    hansinnm
    Participant

    ouch said:

    …    I didin't need to be made to feel stupid, or were you trying to make a joke?

    ouch.


    My dear Ouch,

    Here is a belated  pill to ease your ouch.

    The vast majority of the people on this forum are gouties. And to ease the pain (even it is only in our minds) we make jokes, some funny, some crude, some not so funny, but jokes, nevertheless. I assure you, no one, particularly the knowledgeable contributors on this forum would ever think of making another co-suffering goutie feel stupid.

    #7774

    Nice to see we are getting somewhere with this, though I am totally at a loss to know what the real problem is.

    Before I suggest a way forward, I am intrigued to know where the gout suggestion has come from. We know that blood uric acid can fall slightly during a gout attack, as uric acid leaves the blood as crystals are formed. However, this is unlikely to fall much below 350, and certainly not as low as 216.

    I feel the only way you will get satisfaction is to see a rheumatologist as soon as possible. It is not a good idea to treat with indomethacin for long periods.

    My next statement is directed to your doctor, not you. It is ridiculous to offer dietary advice, or even look for dietary solutions, when the diagnosis is not clear, just as it is ridiculous to wait for a reading of 700 before prescribing uric acid lowering medicines (an eye-watering 11.77 mg/dLSurprised).

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