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I'm on day three of the latest, hopefully Allopurinol induced, attack in my left foot AND right ankle. Apart from the knee attaks of the past, this is the worst it's ever been. I literally can't walk.
In the past I've had great results with Advil but for this attack it's having no effect. So this morning I decided to start Zip4Play's colchicine dosage suggestion. I'm at my wits end and don't know what else to do. My one primary concern is that 1 tablet every hour seems like a lot – is it safe?
I'm in very serious pain and am willing to do through the diarrhea and nausea if I can feel comfortable it will work and is safe.
Can anyone let me know how it's worked for them?
Any help would be appreciated.
Details:
Age 46
Gour for 6 years
Started Allopurinol 6 weeks ago – Doctor started me on 300mg straight off
Well of course it worked for me remarkably well. But don't do what I did and take 22 pills; stopping at 16 is quite enough (My instructions had no top limit…not wise.)
Remember, you can also stop when the severe diarrhea starts or the pain stops.
I never got any nausea from colchicine.
Let us know how it goes.
My initial brush with Colchicine was the same as Zip's, one every hour and no cut off point mentioned with a very dramatic result after about 16 tablets. The response was so bad that it frightened me from using it again for many years.
I now take it with attacks at the rate of 3/4 per day and by the second day it usually kicks in. Even at this rate and 7 tablets I had diarrhea for 12 hours a few weeks ago.
You will have little time to be on the Computer when it does hit.
Good Luck.
al_pain said:
I'm on day three of the latest, hopefully Allopurinol induced, attack in my left foot AND right ankle. Apart from the knee attaks of the past, this is the worst it's ever been. I literally can't walk.
In the past I've had great results with Advil but for this attack it's having no effect. So this morning I decided to start Zip4Play's colchicine dosage suggestion. I'm at my wits end and don't know what else to do. My one primary concern is that 1 tablet every hour seems like a lot – is it safe?
I'm in very serious pain and am willing to do through the diarrhea and nausea if I can feel comfortable it will work and is safe.
Can anyone let me know how it's worked for them?
Any help would be appreciated.
Details:
Age 46
Gour for 6 years
Started Allopurinol 6 weeks ago – Doctor started me on 300mg straight off
I'm wondering if 300mg is enough. You really need to get uric acid level checked with some urgency to see if your dose is OK. Ideally get down to 3mg/dL for a few months for the best chance of stopping dissolving crystals reforming.
I'm pleased to see you've promoted zip2play. Long overdue, but I have to confess to schoolboy sniggering.
Colchicine – @ 1 tablet every hour seems like a lot – is it safe?
My feeling is that it's only personally safe once you proved you can do the dose , like Zip.
Two hours between the first two and then 8 a day max for me.
12 max for course and then a few days break- as prescribed.
Obviously body weight affects dosages and particularly check any co-administered meds like Statins [ don't do!] as discussed here B4.
Trev4play- not
GoutPal said:
… Zip4Play's colchicine dosage …
I'm pleased to see you've promoted zip2play. Long overdue, but I have to confess to schoolboy sniggering.
What will zip2play do for ZipafterPlay's dosage when Zip4Play's dosage runs out?
zip2play said:
Gonna have to borrow some from Zip8Play I guess.
Well, since I didn't have Zip8Play around to borrow from, I borrowed a few colchicines (~30) from my friend Terry who has oodles (he got a good NM state insurance) until I see my doctor on Friday for some Probenecids (Benuryl in Canada.)
Since I started my “Gout Management” about 2 1/2 weeks ago I have the first good and not-so-good news.
Here is what I am doing rat now:
2 colchincines a day, no beer, (only 6-8 oz half wine, half {1/2% alcohol} mead with dinner, 1 oz tart cherry juice (Montmorency cherries) a day, 3 Uric Acid Balance capsules ( a Chinese herbal concoction of Milk Thistle Extract, Radix Curcumae, Garlic, Semen Cassiae, Radix Bupleurum, & Cynara Scolymus L.-Can provide more details if requested,) reduced intake/amounts of red meat and purine-rich vegies (like mushrooms, cauliflower) and once a week (Saturdays PM after I get out of my sauna (45 minutes ea. time) SUA check with kit from England.
And here are the results:
1) 12/26/09 SUA: 8.2 mg/dl
2) 01/02/10 ” : 7.2 ”
3) 12/6/09 to now: reduction of swelling of right foot
4) 12/29/09: Increased pain in both feet ankles
and both knees (now gone)5) 12/30/09 – 1/2/10: In bed for three days. Excruciating pain
(like tourniquets around my ankles of both feet) Only transportation on CRUTCHES (still today) Pain is manageable now (took 1 Naproxen at height of pain)I have been out of commission (NO sailing
, NO walking, NO nothing) for more than 3 months now ( I may have mentioned this b/4) Oct./Nov. right hand; Nov/Jan. right foot; Dec./Jan. left foot, too.I hope that ALL that pain and suffering is worth it
; Lowering of my SUA??? as has been pointed out here in earlier comments.I'll report later, after I had a chance to experience the effects of Probenecid.
Hans in sunny New Mexico (10-20 at night and 35 – 45 during the day) (that is Fahrenheit, not centigrade)
zip2play said:
(Boy it's a good thing I do not Unzip2Play!
)
Lucky me!
No need to Unzip2Play! My birthday suit doesn't have any zippers to zip or unzip. My house is a hot-house with temps around 80+ all day.One more morsel of info which requires a new link for detailed explanation
I have started “Sun Gazing” (now up to 12 minutes) which eventually should/will/might lead me to the point where food won't be required anymore, thus NO purine production (from food that is.)
New Mexico and shape and location of my house is the perfect place for it.
Hans
Thanks for all the replies.
I went with 2 colchicine in the morning and one every two hours for that day. Diarreha started after 6th or 7th pill but I finished off the day. 9 pills in total. Pain reduced noticibly to the point where it was still intense but a bit dull – Not as sharp and torturous as the previous 2 days only taking Advils. Diarreha lasted the the entire next day.
The pain has steadily decreased the last coupe of days just taking Advil but the nights are really bad.
Tonight is worse again and it's effecting my knee as well.
I've been two days without taking colchicine (just advil gel caps and A LOT of hot water soaks) so if I'm not feeling any better tomorrow – I'll start the colchicine regiment again Friday.
I really hope the Allopurinol does what it's supposed to do because I'm definitely going to stick it out.
GoutPal – thanks for the recommendation, I will get into the doctor to get a uric acid level check as soon as I can walk properly.
I'm sort of glad that he started me on 300mg daily as opposed to building up – Optimistically speaking I assume it means I'll get rid of the crystal menace sooner rather than later.
Keep it up Al !- many here have been through the torture and it does seem endless.
Don't forget egg cup of Soda biCarb in the foot soak bowl, even try an equal amount of Epsom Salts in the soak also but don't overdo it ,soaks or heat. Some can get absorbed through the skin.
It is interesting to see how the Colchcine is used and how it works on different people.
In my case, I never took more than 2 tabs a day, which was also limited use like for 5-10 days and then 1 tab after that. Never 2 tabs together, always am and pm dose.
I found that the swelling was gone by 50% by second tab and 75 % by day 2. The pain improved substantially by second day with no need of any other pain killer after second day.
I did not have any significant stomach problem as probably the dosage was never too high.
One good thing about Colchcine, even 1 tab a day was very helpful to keep the gout attack away.
In my opinion, continuing on a small dose of 1 to 2 tabs a day for 1-2 months helps a lot…it helped me for sure.
hansinnm said:
Post edited 6:17 pm – January 6, 2010 by hansinnm
…
Well, since I didn't have Zip8Play around to borrow from, I borrowed a few colchicines (~30) from my friend Terry who has oodles (he got a good NM state insurance) until I see my doctor on Friday for some Probenecids (Benuryl in Canada.)
…
And here are the results:
1) 12/26/09 SUA: 8.2 mg/dl
2) 01/02/10 ” : 7.2 ”
3) 12/6/09 to now: reduction of swelling of right foot
4) 12/29/09: Increased pain in both feet ankles
and both knees (now gone)5) 12/30/09 – 1/2/10: In bed for three days. Excruciating pain
(like tourniquets around my ankles of both feet) Only transportation on CRUTCHES (still today) Pain is manageable now (took 1 Naproxen at height of pain)…
I'll report later, after I had a chance to experience the effects of Probenecid.
Hans in sunny New Mexico
Here is my first report:
Leave it to the “caring” American medical profession and the medical arm of the United States of America , called: FDA.
I saw the one and only doctor I had trust and confidence in seeing on Friday, Jan.8, 2010 with 4 questions on my mind. Guess what: He is a podiatrist who operated on my gouty/infected foot 1 1/2 years ago. He CANNOT prescribe for me PROBENECID. Only an intern medical doctor can do this, but only after he has done tests on my kidney, my urine, and my blood. (Never mind that my former doctor, a now retired university professor who had it already prescribed for me and I had taken it for a total of 12 months.)
The only advice I got over and over again was that I should get my SS Medicare, so that they can charge me more than they charge someone who pays with cash. “They” is a business group of Northern New Mexico Orthopedic Center, PC to which he, now, belongs and who sets the rates for everything.
For $150 per visit (less 25% since I paid in cash) = $112, I got the following merchandise/service:
1) Approximately 5-6 minutes of the doctor's time. (His opening statement after shaking hands: We cannot chat. I don”t have much time if any.)
2) No, I can't prescribe Probenecid. (See above) He did prescribe 90 cochicines, though.
3) No, I can't operate on your toe here. You must be an out patient in a hospital (2 choices)
4) “Get your SS Medicare.” ( I did not ask foe that advise.)
5) He DID squeeze the living daylight out my two big toes which were open and uric acid in some kind of a liquid was oozing out and put an anti-biotic ointment on them and a purple bandage on one and a blue one on the other toe/foot. That was the ONLY worthwhile service I really got.
6) He was out the door without saying good-bye after I refused to have an X-ray taken. ( I had not yet have a chance to ask all of my 4 questions.) So I waited outside the examination room to get one more question in between his other patients. Yes, he could have a blood test for SUA done (and they run about $350 -$400, but he has no trust in lab tests. Yes, the SUA value is of some importance, but there are more important matters to consider. (I never found out what they are, though.)
Now to a more positive part of my follow-up report:
1) 12/26/09 SUA: 8.2 mg/dl
2) 01/02/10 ” : 7.2 ”
3) 01/09/10 ” : 6.8 ”
While the level did not go down as much as the week before, it DID go down. I am cutting further down on alcohol and other high-purine foods.
I am also continuing doctoring my two feet and while I still have some pain (bearable) I now can walk without crutches again.
This is all for now. Hope to see/report to you again (hopefully positively) in a week again.
Hans (in New Mexico, very disappointed in my only doctor and grateful for GoutPal's existence)
$350 to $400 seems too high for SUA test. You can get it done in just $20 in any good lab (even without insurance). I have used LabCorp many times and they charge $19 per SUA test and the results are available online in a day mostly. My regular hospital will charge $20 without doctor's slip and nothing with a doctor's slip.
Hans, that SCREW YOU MEDICAL CENTER sounds like a very good reason NOT to live in NM.
I'm confused about your insurance. Are you OLD enough to get Medicare (and a citizen), if so you should immediately. If you really want to slash your costs, then get into a Medicare Advantage Plan and all you'll pay is a $10 or $15 copay no matter WHAT they do. Only wrinkle is that you must be in a populaous enough area so that there are several medical professionals to choose from who take any particular plan.
On that doctor's inability to prescribe probenecid it is not that he CANNOT it is that he WILL NOT. ANy doctor can prescribe ANY medication, thus a dermatologist can prescribe chemotherapy for brain cancer. Your doctor is what is described in very medical terms, a PRICK. He is interested only in running up charges.
There is a logic though in testing urine for 24 hours before dosing with probenecid. If your urinary output of urate is greater than normal, probenecid won't be the drug of choice. But still there's no reason that it won't work fine, just not as well as somebody with low excretion.
But get another doctor. STAT.
(What kind of insurance do you have now?)
al_pain,
I think my one an hour colchine routine is better than your one ever 2 hours. Try mine next time and see for yourself. ANd don't delay starting; I have found that delaying a day or two doubles or triples your ultimate effective colchicine dose. Fast is Less.
zip2play said:
Post edited 3:48 pm – January 11, 2010 by zip2play
Hans, that SCREW YOU MEDICAL CENTER sounds like a very good reason NOT to live in NM.
I do agree with you, Zip, however, the 300+ days of sunshine and the pure air at ~6000 feet and, above all, my little lake, essential for my sailing and living in this godforsaken world/country, keeps me here in New Mexico.
I'm confused about your insurance. Are you OLD enough to get Medicare (and a citizen), if so you should immediately. If you really want to slash your costs, then get into a Medicare Advantage Plan and all you'll pay is a $10 or $15 copay no matter WHAT they do. Only wrinkle is that you must be in a populaous enough area so that there are several medical professionals to choose from who take any particular plan.
I ain't gotten any insurance, and I am a citizen, old enough at 79 to get Medicare and I am about 100 miles round trip away from any populous enough area.
On that doctor's inability to prescribe probenecid it is not that he CANNOT it is that he WILL NOT. ANy doctor can prescribe ANY medication, thus a dermatologist can prescribe chemotherapy for brain cancer. Your doctor is what is described in very medical terms, a PRICK. He is interested only in running up charges.
Zip, there are things here in these United States of America that you may not be aware of, like: Who can prescribe what. Example (fact) in case: A friend of mine died a year ago of skin cancer in his face (after several thousands of $'s for doctors' fees, medications, trips and hotel bills.) Between hospital radiation and chemo he went to a Texas clinic where they used a drug which was not sanctioned by the FDA for skin cancer. It was sanctioned for two other internal cancers (I forgot the names.) That clinic disregarded the FDA rules and charged 100k's $ for treatments. He did not want to pay/have that kind of money, so he and his wife came back home to NM. All the doctors here, with whom he consulted or treated him, refused to prescribe that particular medication because of that FDA rule and since they did not want to lose their license. He took his chemo and then died 3-4 months later under horrible pains. NO Medicare, NO doctors, NO treatment, NO money could save his life because of FDA.
There is a logic though in testing urine for 24 hours before dosing with probenecid. If your urinary output of urate is greater than normal, probenecid won't be the drug of choice. But still there's no reason that it won't work fine, just not as well as somebody with low excretion.
But get another doctor. STAT.
Who, what doctor??? All we got left are highly (overpaid) pill pushers of/for the pharmaceutical industry who is not interested in healing people, but to keep them alive so long/as long as there is any money to be extorted from them or their insurance companies, especially Medicare.
(What kind of insurance do you have now?) As said b/4: NONE.
…
I am confused hans. WHy not Medicare at age 79? Part A is free and Part B is $96/month. Who would say not to that, except someone determined not to get sick? What is the upside of not taking Medicare? All NOT having Medicare gets you is the $400 uric acid test and the $200 visits to Dr. Quack.
(I am a person who avoids medical care like the plague, but that seems not to matter much because fate and the universe don't bow to my wishes. So when I get medical care all is done precisily according to MY wishes, but I am lucky since I have tens of thousands of practioners withing 10 miles <NYC.> )
zip2play said:
I am confused Hans. Why not Medicare at age 79? Part A is free and Part B is $96/month. …but I am lucky since I have tens of thousands of practitioners withing 10 miles <NYC.> )
I understand your confusion, Zip. To fully explain (not to excuse myself) would go beyond the scope and purpose of this forum. Just let me tell you that the screwings I got from my medical providers (like being kicked out), including the various HMO's , Lovelace, Presbyterian, and the University of NM, especially after my doctor for ~10 years retired, prompted me to opt out.
And I don't have tens of thousands of practitioners withing 10 miles.
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