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Sup guys…
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This is my first post here on the forums. I am 31 and have been a gout sufferer for about 6 years. My grandfather was a gout sufferer and I am overweight so there you go. I have high liver enzymes and have for years and the docs just don't know why. The only reason that I have been given is my weight. I have had attacks on and off for years but mostly in my foot and occasionally in my ankles. I was on allpuronol for about 6 months a few years ago but quit taking it because I wasn't having any gout attacks… smart I know!
Ouch!
I have had some pretty bad attacks in the past. The types that basically put you down and make you crawl to the bathroom. Those are bad. However, I have never experienced gout in my knee until a few days ago. Wednesday/Thursday I started getting that “feeling”. I went to bed Thursday with a sore knee and I woke up 2 hours later and was up all night. I have been in severe pain since Thursday. The first couple days I could just sit and my leg throbbed… It went down my leg and up to my lower back. Today my knee is still swollen however I am not taking ibuprofen or colchicine as much. I am still on crutches and for the most part the throbbing is gone unless I start moving my knee. I say for the most part because it seems to get worse at night and I just had to take 800mg ibuprofen to stop the pain.I guess I wanted to post to try to relate with some of you and maybe to get some others peoples experiences with gout in the knee… How long should I expect this? I have read it takes longer to get rid of when it makes it to your knee joint.
My first gout attack was on my left knee. First day I went to ER and doctor diagnosed me with gout and told me not to go to again to ER (just because a gout attack was not enough to be considered an emergency). Next day I was in such pain that I returned to the ER where another doctor saw my knee and ordered an MRI and blood tests. After all results came out he decided to drain liquid from the knee and inject some anesthetics and gave me a lot of medicines. Attack started on December 7, first day I could stand (with crutches) was December 22 and the attack resolved completely by December 29; 10 days of high intense pain and another 10 of medium to low pain.
Following attacks were equally painful but lasted longer (in all of them I had to go to visit the doctor for “draining” my knee). Last one before knee surgery and allopurinol lasted from March to May, almost three months. After that, about three weeks ago, I had a new attack but it lasted only 4 days and only one day with intense pain. I think that five months of Allopurinol have dissolved almost all crystals and attacks are less aggressive.
For me, knees are the worst.
I am 51, and got my first gout attack about 8 years ago. It was always ankles or feet. I never sought medical attention till this past summer when it hit my feet, ankles, wrists, and worst of all.. knees.
Everything else rebounded quickly, but my knees have taken months. It's been 5 months, and my knees are still not 100%. I can walk, and (finally) go up and down stairs normally, but still cannot run or jump well.
Am on allop 300mg per day and testing uric acid frequently. I'd advise any goutie to know their uric acid level.
Lose weight if you can. It really helps.
Knees are the worst.
Burgess, you know what you have to do.
You can take AlloP OK, and you can lose some weight and with diet care you can get rid of the scourge readily -unless your system says otherwise for some reason. [Maybe you should push Dr for more annswers?]
You just have to try it- as you are WAY too young to suffer all the knock on effects of high SUA possible.
If you can read reports on here, you can do the walk too- and no-one else will do the hard work needed.
The meds will certainly help, and I don't mean painkillers- they are not good long term and you have long term to do at your age, if you get on the case to make it more comfortable too.
Colchicine is not a cure for gout.
Hey guys!!! Thanks so much for all of your help. I really appreciated it because the lack of knowledge by most of the doctors I have spoken with is scary.
Here is the update on my situation. Last Monday I went to the doctor and he gave me ketaprofen, a steroid shot, and 300mg Allpurinol. It has been 11 days total and over the weekend I was down to 1 crutch and feeling okay. I couldn't put all of my weight on my left knee but I could walk with a limp and a crutch. The last 2 days have been horrible and I am back on 2 crutches again. I went to urgent care today and the doc did xray and blood test. My UA level was only 6.7 – which is normal correct? He told me that I am probably not in the acute phase right now so I can start my Allpurinol. He gave me steroids and Tylenol with Codine.
The xrays looked okay except for all of the fluid in front, behind, and underneath my knee cap. I am wondering if 6.7 is too high and why my knee could possibly still be swelling. Meds seem to be helping tonight and I can actually sit without being in excruciating pain.
trev said:
Burgess, you know what you have to do.
You can take AlloP OK, and you can lose some weight and with diet care you can get rid of the scourge readily -unless your system says otherwise for some reason. [Maybe you should push Dr for more annswers?]
You just have to try it- as you are WAY too young to suffer all the knock on effects of high SUA possible.
If you can read reports on here, you can do the walk too- and no-one else will do the hard work needed.
The meds will certainly help, and I don't mean painkillers- they are not good long term and you have long term to do at your age, if you get on the case to make it more comfortable too.
Colchicine is not a cure for gout.
Trev – thanks for the support. I am seriously considering losing weight. It's easier said than done I know first hand. I am going to stay on my Alp now and hopefully I can manage my ua level
burgeszz said:
I am seriously considering losing weight. It's easier said than done I know first hand. I am going to stay on my Alp now and hopefully I can manage my ua level
This is exactly the best way to go, Burgess.
I sympathize with the weight loss. Very difficult, but well worth it. In the unlikely event that weight loss does not lower your uric acid, you will still gain massive benefits, as the strain on gouty knees and ankles is reduced. However, it is most likely that gradual weight loss will allow you to reduce your allopurinol dosage. For now, it gives you your best chance to get rid of the uric acid buildup whilst you find ways to lose weight.
Find a way to convince yourself that weight loss is more important to you than the next calorie. Then take it slow. Gradual weight loss is always the best way for gout sufferers, as fast weight loss generates excess uric acid. Slow and steady reductions in calorie intake coupled with slow and steady increases in gentle exercise such as walking or swimming will change your life for the better.
As a fat, lazy, beer monster, I know how hard it can be. I also know how much better you feel when there is 30 pounds less of you. Yes, it is hard to change habits of a lifetime, but changing your mindset is the start to improving your quality of life. And there are lots of very nice people round here to encourage and help you.
I just drove thinking all was well …about 1400 miles. I went to sleep woke up with major pain in my knee. Drank only water and ate yogurt on the trip to avoid problems? I am new to this I had blood tests last month after similar flair from a long drive? all normal? I had been taking alliprinol and indomecin. The pain was so bad kept me in bed for 5 days? Any ideas? 53 and not drinking booze 20 lbs overweight? High stress lately from last flair.
Newman- driving is not helpful for gout ! The pressure on the legs when pinched off behind the knee can reduce circulation a lot.
One days diet is not going to undo years of urate build up.
Unfortunately, the drug based treatment regimes current now are a long way from holistic health that some oldie Docs would have learnt over years of community care. Health is a lifestyle choice , not in a bottle.
'Instant shots for all' doesn't apply to gout- it has a payback time in getting back to healthier ways. Flares are normal under initial treatment with gout meds.
Can you post your figures? The 'normal' bit doesn't apply to gouties- anything over 6 is danger territory and 3 is what you need for urate clearance- That is the lowest 'normal' figure for a male, btw!
Colchicine should help your attacks times, but you will have to titrate the dose to suit the results gained- and have a break after 3 days on it, if at more than 2 a day. Get Drs advice on this if prescribed.
newman said:
I just drove thinking all was well …about 1400 miles. I went to sleep woke up with major pain in my knee. Drank only water and ate yogurt on the trip to avoid problems? I am new to this I had blood tests last month after similar flair from a long drive? all normal?
There is no such thing as a normal uric acid level (except in the minds of lazy incompetent medics). During early allopurinol treatment you need a target uric acid level – more below.
I had been taking alliprinol and indomecin. The pain was so bad kept me in bed for 5 days? Any ideas? 53 and not drinking booze 20 lbs overweight? High stress lately from last flair.
A water and yoghurt diet leaves you malnourished, which might cause a high enough cell turnover to raise uric acid.
Driving 1400 miles, without regular breaks to stretch the legs puts the knees and ankles at high risk of uric acid collecting and crystals forming (if uric acid is raised).
You are going to hate me for the next point (and it is something of a personal experience rather than something I've learned from gout research). Lying in bed, with affected joints immobile often extends the normal 2 to 3 days of an acute attack.
The most likely explanation however is that your attack is a perfectly normal reaction to lowering uric acid with allopurinol or other urate lowering therapies. As old urate deposits dissolve, they can cause a gout flare if partially dissolved crystals linger long enough.
The good news is that allopurinol will eventually get rid of the old crystals and gout flares will cease forever. But only if you get uric acid tested every 2 to 4 weeks for a few months to make sure your dose keeps uric acid well below 6mg/dL. Stay on that dose until you go for 6 months without a flare, then carefully relax dose to keep around 5 to 6 mg/dL.
After that, long drives should not be an issue. In the meantime, consider the following:
A well balanced, calorie controlled diet is the best thing for gout. When driving long distances, your calorie intake might need lowering slightly to reflect the lack of exercise. Do not make huge changes in diet, as these invariably cause uric acid to change suddenly. Sudden changes up or down are what usually causes a gout attack. Take a large bottle of water and drink regularly. This should induce frequent pee stops, where you must park as far away from the rest room as you can safely. Walk to the rest room, deliberately forgetting your water bottle. Walk back for your water bottle and refill it. OK, I'm rambling here, but just think of ways that suit you to incorporate as much fluid and exercise as you can.
On a final note. I know that indomethacin, or other pain relief, is quite rightly prescribed for the first few months of allopurinol. Some doctors prescribe daily use in the hope that it will prevent gout flares from old crystals dissolving. Others prefer a 'use as required' policy. Personally, I believe the second approach is best because doses that are high enough to kill gout pain in 1 or 2 days are not desirable for everyday use over several months. Discuss the dosage (and alternatives if indomethacin is not working) with your doctor to ensure that you are getting the best solution for you.
More details of numbers will allow contributors to give you better advice. In particular, I'm thinking:
- Uric acid number
- Exact weight and height
- Allopurinol dose
- Indomethacin dose
After a few weeks here, you'll wonder what all the fuss was about (and hopefully help some other gouties with your experience of how you won the gout war)
P.S. trev posted as I was writing this. Sorry for some duplication, but I guess it emphasizes the importance of numbers.
Well…
My gout attack continues…
Day 16 on crutches
history
-Steroid Shot
-ketoprofen
-colchicine
-ibuprofen
-tylenol with cod
-methylprednisolone pack
So I had my attack. Doc gave me meds and shot – I was feeling better and thought I was getting better until steroid wore off and boom. I ended up in urgent care. Doc gave me steroid pack and painkillers – the pack about killed me – side effects terrible and I had to discontinue use. It seems like the steroids have worn off now because I am hurting again and my knee AND foot AND ankle are hurting and getting inflammation. I did start 300mg allopurinol after 2 different docs told me I was okay to take it. My UA was 6.7 so they said I was over the acute phase of my attack.
I need some expert advice. The quacks around here are going to have me in a wheelchair before Christmas. I am desperate as I have 3 kids and 1 that is 5 months old. I can't help my wife carry her or tend to her. I can't play with my son. I didn't get to help put up the tree and I can't put up the lights.
So right now I started taking the last of my Colchicine – 4 pills that I started taking earlier this morning. I have 1 pill left. I am going to finish it and go buy 2lbs of cherries. I am going to eat nothing but cherries and water today.
I have 1/2 a steroid pack/ketoprofen/ibuprofen/tylenol with cod/allp – little time and a lot of frustration.
B -You're sure suffering right now- There's a whole lot going on here.
Amongst all this, one thing stands out to me- that of the assessment that 6.7 says you are clear for ongoing problems.
This is 'finger in the wind' territory to me- unless they have analysed weeks of figures and assessed accordingly, which I somehow doubt.
All the same, it adds up to the same thing- keep on going with the AP- it is obviously going to be a long haul for you by current reports from you.
It does seem never ending and we have others who have finally broken through the ceiling on attacks like this.
Have you really hit on the Colchicine? Zip here goes for the 16 burn [spaced out of course]- which I think a bit' iffy', but you might manage a more aggressive regime [than you are ,maybe on] with it.
I reckon 12, in a course, is enough, but if you are getting the real squits- that is probably a good indication that it's working.
I mean liquidized at the business end!
If so, you you need a 3 day break from this med- in between courses, but unless you get a good 'purge' you are tottering on the edge like with the AP [albeit, unavoidably]. Get a grip, with your Docs help, on the Colchicine routine.
You've had a lot of intervention to deal with in a difficult case. Don't make it worse by beating up on yourself- you will get through and Xmas will be just great, OK?
PS: I nearly forgot- check out the Black Bean broth here. It's FOOD after all , and can help.
What were the side effects from methylprednisolone?
I had a real bad attack in both knees, feet, and elsewhere, last summer. After 12 days in bed I was able to hobble to a car and see a doc. I got a Medrol pack – 24 mg. prednisone the 1st day, 20 mg. the 2nd, etc. That helped a lot, but when it was done the gout came back almost as bad as ever.
I then got prednisone 40 mg. per day tapering over a couple of weeks. By the end of that I was pretty much OK, though it took maybe 4 months before my knees were recovered enough to go up and down stairs normally.
16 days is not all that long for a severe knee attack. It sounds like you quit the cortisteroids too quickly. If the side effects prevent you from taking oral cortisteroids, then get another shot.
Cherries and Black bean broth may help a little. Never tried colchicine during an acute attack. They say it works, if you don't mind sitting on the toilet all day.. but if you're down to one pilll, it's a moot point.
If you've already started allopurinol then stay on it. Talk with your doc about the cortisteroid side effects and figure out a way to take them orallly or get another shot. Get a load of colchicine in case you want to go that route.
The good news is that this will pass. And if allopurinol keeps your uric acid in check (it has worked great for me), you will never suffer from gout like this again.
Thanks, I am learning a lot from this forum. I was put on 300 AP twice a day for a month and indo 50 3 times a day…for a week, at the same time. This was a 1 month plan. After long drive (1000 miles) one month after I started….. my first knee flair…. Wow. I went to urgent care…. she dropped the Ap to 1 pill 100 mg once a day had me wait until I finished the indo 50 2 times a day. (10 days) Then I drove to FL. …. 1400 miles… and all was fine until I hit the hotel….worst pain ever in the same knee. I am 53 6' 2 225 lbs. I first had an attack in 2006 but after it passed went back to drinking wine and beer….but playing lots of tennis and walking in golf. I have been scared straight (walk or drink?) with the beer and wine…but I need to work out to sleep. I would have made myself shuffle if I knew it would have helped. The knee pain was worse than any football game injury I ever suffered. What about baking soda? Vitamin C ? I am eating no meat, seafood, ( is tuna ok?) black beans, whole wheat toast with peanut butter and lots of water….some coffee….and yogurt (new to my diet) I read so many views on what to eat… not to eat etc….I'm confident with the useless booze calories gone I will be back to my fit weight of 200-205 lb's. How long after wrong food will an attack occur? I am starting a meal history to track it. What about cookies? I will do what ever it takes. I do take alleve… only for pain….but I take no other meds. I pay my own way at the Dr's and travel for work (self employed) so I can't just run in and out with $100 bills. Should I buy a UA self tester? I can't afford to miss a week of work if I can avoid it through knowledge. I have never been in a chat room ……after college went straight to Alaska to avoid the tech world….but I need help.
They sent my blood test results to old address but on the phone told me my three blood tests… kidney, UA level, and liver were “normal”… I will find out what normal means.
Newman- There's hold on new posts here due to revamping work – but you really need your own..
newman said:
… I can't afford to miss a week of work if I can avoid it through knowledge. I have never been in a chat room ……after college went straight to Alaska to avoid the tech world….but I need help.
Newman, where have you been for the last 53 years? Still hiding in Alaska to avoid facing life and its challenges?
Let me tell you as to “can afford” or ” can't afford”: When your health is impaired, and having GOUT, your health is impaired, Mother Nature does not give a damn what YOU can or cannot afford. You are at the beginning of the end, meaning, you have started now with gout and you'll end with gout. (Once you have gout, you have it for the rest of your life.) There is only one way to live with it: MANAGE GOUT, as GoutPal has been trying to pound in to our heads for the last 4-5 years, or so. Therefore, when you have an attack and CAN'T walk, use your time to peruse GoutPal's forum here and if you have your eyes, ears, and mind open, you'll find out what to do and then you can tell your doctors what to do (since most of them know very little about gout.) “… kidney, UA level, and liver were “normal”… don't mean doodle do. You need concrete figures.
I am sorry to talk to you in “generalities”, but GoutPal already told you above what the score is and what to do.
newman –
I pay my own way at the doctors also, and I have a uric acid test kit. The doc put me on 100 mg. allopurinol per day and had my blood tested a month later. The test showed 6.4 mg/dL. They called that normal and told me to come back in a year.
Uh.. No. I scheduled an appointment and brought in a chart of my thrice weekly uric acid tests for the last two months. It clearly showed a drop after starting allopurinol, but there was a gradual rise as I backslid on my strict diet/ alcohol abstinance. There were spikes as high as 8 even on 100 mg. per day.
I said (paraphrasing) “Doc.. I pay my own medical bills. This visit is costing me money. Here is what I want from you: a year's prescription for 300 mg. / day allopurinol, a year's prescription for colchicine 0.6 mg / day, and a course of prednisone in case of an acute attack.”
I got what I asked for, no problem.
You have to take charge of gout yourself, especially if it costs $100 every time you see a doc, like it does me.
All that diet stuff helps, and you should eat healthy, be in shape and avoid immoderate alcohol consumption regardless of gout. But the bottom line is keeping your uric acid below 6 mg/dL. Below 5 is even better. You must know your uric acid level. I'd advise investing in a test kit. You can then see if what you are doing is working. Most of us end up on 300 mg. per day allopurinol. It works for me. (3.2 mg/dL this morning).
After extensive testing, it seems the best way for me to raise my uric acid level is to drink a lot of beer and abstain from water. The way to lower it is to drink a lot of water and abstain from alcohol. The results are apparent the next morning.
This topic has got too confusing. I cannot see if there are outstanding questions, or who they might belong to.
If anyone has outstanding questions, please start a new thread. If this forum is still locked due to my upgrade efforts, use the Emergency Gout Support Forum referred to in my sig below.
Before posting, please read the forum guidelines.
Please stop using the phrase “normal uric acid”
Please stop listening to doctors who use that phrase. If you have paid them money, ask for it back.
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