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Hi…
a patient was with hot,painful,tender swelling at dorsum of left foot behind middle 3 toes..appeared suddunly & increased within 3 days ..when i went to dr ..told me this is gout & prescribed tenoxicam,allpurinol & effervescent Granules Uricosuric…was wondering to hear this as i know allpourinol is not taken during acute attack of gout ..so the 2nd day i went to another dr where he told me that this is just a localised inflammation ..prescribed antibiotic,tenoxicam & effervescent powder ..after 6 days of ttt symptoms subsided gradually & SUA after 6 days is 3mg/dl….just sligh pain is there in long walking …
my internist (as i'm hypertensive ) told me -after i told him about foot pain-what i have passed through is typically gout no matter big toe affected or not ..-proved this by SUA 3mg/dl due to urcosuria-& prescribed colichicine, Effervescent for month to me beside changing antihypertensive drug i was taken -as diurtics & aspirin increase gout incindence-so that was today ..
now i'm confused …
is it gout or not ??!!..so i can understand nature of my life from now onward in issues related to medicine & food
And is it's gout may be it's due to medicines-diurtics & aspirin-and it'll finish once i stopped using them
And..is it ok to do another SUA test after one week of treatment ?will drugs affect level so misleading will be happened
thx in advance
Wow! Seems like a good medical response for a first attack.
It may not be gout- but your attack site is difficult to take a fluid sample from for crystal analysis– so if you stop AlloP you will see from SUA level , if liikely heading for another attack.
Diuretics can take a while to clear the system, in my experience ,as far as BP building up- but if they are the cause of gout, you are in a good position to prove this more quickly.
It all seems rather fast ,otherwise. You do risk another attack stopping AlloP- but it does seem pre-emptive to come in so hard on one attack.
What was your initial SUA reading?
DIURETICS CAUSE GOUT…thiazide diuretics are the worst of the lot.
What is effervescent or effervescent uricosuric?
What country are you being treated in polaris?
Is it gout or not? Cannot tell for sure. Perhaps you will have to wait for more data. With uric acid levels of 3, it is virtually impossible to precipitate crystals.
If you DO need a diuretic I recommend a switch to furosemide if you are on thiazide…no guarantees but furosemide retains less urate. Ask for losartan also.
trev said:
Post edited 5:09 am – October 14, 2009 by trev
Wow! Seems like a good medical response for a first attack.
It may not be gout- but your attack site is difficult to take a fluid sample from for crystal analysis– so if you stop AlloP you will see from SUA level , if liikely heading for another attack.
Diuretics can take a while to clear the system, in my experience ,as far as BP building up- but if they are the cause of gout, you are in a good position to prove this more quickly.
It all seems rather fast ,otherwise. You do risk another attack stopping AlloP- but it does seem pre-emptive to come in so hard on one attack.
What was your initial SUA reading?
1stly thanks so much for rapid reply…
Sadly i didn't measure SUA b4 or even once pain & attack comes ..i waited 6 days after ttt-about 10 days after intial pain-to measure SUA to avoid misleading lower level by uricosuria…
actually i went to 3rd dr ..to confirm this -Orthopedic dr-& he confirmed that it is not gout too by seeing site of pain …said it is just a tenosynovitis..& recommended not heavy walk or use of foot & prescribed SALIX 200(Slalicin,vit C ,zinc gluconate)one tab daily beside voltaren gel twice daily ..so now no more gout medicines to be used.
foot still have mild hottness ..with time swelling decreases ..still slight pain on pressure especially with middle toe movement…
I'm thinking to measure SUA again to confirm if this level-3mg/dl-is the true one or misleading ..
what do u think ? and when to do SUA again ..waiting till pain & swelling subsides or one now & another later on ??!!
thanks very much ..i'm really appreciated.
zip2play said:
DIURETICS CAUSE GOUT…thiazide diuretics are the worst of the lot.
What is effervescent or effervescent uricosuric?
What country are you being treated in polaris?
Is it gout or not? Cannot tell for sure. Perhaps you will have to wait for more data. With uric acid levels of 3, it is virtually impossible to precipitate crystals.
If you DO need a diuretic I recommend a switch to furosemide if you are on thiazide…no guarantees but furosemide retains less urate. Ask for losartan also.
I'm really thankful for ur response..
The effervescentis called Uricol plus ( Colchicine 0.3mg , Piperazine 195mg , Khellin 183mg) but i used it 3 times only & now i stooped it..no more gout medicines to be used .
I'm Egyptian &live in Egypt too… confusion could happen anywhere 🙂 & by the way i'm an Ophthalmologist & a close relative who is in pain not me ..
its ok now as we use a new anthypertensive drug…carvid 25mg(carvediolol 25mg)..hope this falctuating BP stooped…
As i told b4 …i'm thinking to measure SUA again..to confirm as whts annoyed me the most now is pain n slight swelling is still there ..mild hottness too…i thought about synovial fluid analysis too but wanna this to be the last if pain not improved due to painful procedure ..
thx for ur time..i'm really appreciated.
Hmmm, With Khellin and carveldilol is there some issue with heart failure? THe piperizine is a pretty strong base so it makes sense with gout where you want to neutralize as much acid as possible.
(Carvedilol is an alpha AND beta blocker generally used to ease the strain on the heart without too much diminishing its pumping ability. It's not usually a first line antihypertensive but rather one of the bigger guns. Beta blockers interfere BADLY with my sleep or I would use one regularly because diuretics, while the do the job of BP control admirably, cause gout issues.)
I guess most drugs are always a give and take.
I chatted extensively a while back with one of your countrymen on another board and I was envious of his ability to walk into any pharmacy without a prescription and get anything he asked for! My DREAM is not to have to argue with doctors to get what I want!
I'm glad your friend has tendonitis rather than gout but there is often a lot of overlap between these two conditions. A couple more SUA's is a good plan just to be on the safe side.
zip2play said:
Hmmm, With Khellin and carveldilol is there some issue with heart failure? THe piperizine is a pretty strong base so it makes sense with gout where you want to neutralize as much acid as possible.
(Carvedilol is an alpha AND beta blocker generally used to ease the strain on the heart without too much diminishing its pumping ability. It's not usually a first line antihypertensive but rather one of the bigger guns. Beta blockers interfere BADLY with my sleep or I would use one regularly because diuretics, while the do the job of BP control admirably, cause gout issues.)
I guess most drugs are always a give and take.
I chatted extensively a while back with one of your countrymen on another board and I was envious of his ability to walk into any pharmacy without a prescription and get anything he asked for! My DREAM is not to have to argue with doctors to get what I want!
I'm glad your friend has tendonitis rather than gout but there is often a lot of overlap between these two conditions. A couple more SUA's is a good plan just to be on the safe side.
Thanks again for ur care..Thx God ..about hear condition..NO ,there's not matter with heart as she uses carvidolol (BB with VD effect on arteries)..it just other antihypertensive drugs(1st line ones) not worked enough recently & some causes side effects like edema…so she tries a new medicine to adjust hypertension.
Khaellin also is like atropin sulphate is other effervescents..has relaxant action..so relieve urinary tract spasm during excertion of urates..(n not use it now )
Yes we have the ability to buy most of medicines without prescription from pharmacy except antipsychotics ..need prescribtion ..as well as tranquilizers.
And i hope u dont need to go to pharmacy anymore..just to be safe & healthy
Thanks for ur care again..was nice & comfortable hearing from u ..keep ur eye on ur BP ..& hope u always be in the best state of health ..
By the way was wondering about ur job as u have good medical informations ?
u can say wanna be frnds 🙂
stay blessed.
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