k8

[k8]

Miy heart is breaking as I watch my son suffer with this problem..   He is 36 and had gastric bypass surgery in December 2009 did well and has lost over 100 lbs. in 5 months.NOW doctors say this is caused from rapid weight loss.  First attach came 4 weeks after surgery and resolved with Cholchesine and Prednisone only to return.  Prednisone worked once but now nothing works probably 4 attacks in 6 months each on worse then the last, for the last 5 weeks constant pain stiffness and tingling involving right foot both knees both hips back, both shoulders and across chest.  E.R. visit found no heart problems but he had been using crutches I guess that is a no no for gout.  UA levels are NORMAL I here this is to be expected during a flare.  He has an appt. with Rheumatologist but can't get in until the 18th. of June being treated with ibuprofen 800 mg. three times a day and percocet allupurinol   with very little relief.  I hear now not to start Allupuriol during an attack but also cannot be stopped during attack or attack will be worse.  He can't sleep and to watch seems to be becoming paralized by this disease.  Will the Rheumatologist be able to reverse any of this.  Has anybody else had this type of attack.  NOTHING HELPS.  How do you cope.

[rdavisiii]

Kate,

I can tell you this, I started Allopurinol during an attack.  Had no choice really, that attack had not let up for a month and as your son is seeing there appeared to be no relief in sight.  My experience is limited but since late Jan 2010  when I started Appopurinol I have improved but have still had attacks.  Two things will have to happen, the Uric Acid levels will have to get stabilized an this will happen via meds(Allopurinol, Uloric) and/or diet.  This is a long term commitment that will have to be for life.  It is true that during an attack you will not recieve reliable results regarding Uric Acid levels.  The second part is addressing the acute attacks, this will doing nothing for the UA levels, only address the swelling and pain of the attack.  Prednisone so far has worked well for me treating acute attacks.  I did use indomethacin as well but it would randomly give me digestive fits, not fun.   If the culprit is Hyperuricemia then over time the meds will stabilize the UA levels but he will have to be taking a proper dose, too little and things will just teeter along with no real sign of progress.  I started at 300mg Allopurinol and am now at 600mg.  

This whole thing is a process and I found that understanding the difference between treating the UA level and treating the acute attack has made a big difference in how I approach dealing with it.   Those two items are very different and should be addressed individually.  Formulating a plan with your doctors that you have confidence in is crucial.  The attacks can persist for months after starting Allopurinol but stick with your plan, stopping will do nothing but prolong this process.  One other thing to mention, I have gone through a half dozen doctors during my process.  Shaking up the staff may help as well, most of my docs had me on a course of suffering vs. resolving and this was very frustrating.  It was only through information I have gathered on my own that I was able to begin to challenge my docs and understand how this really needed to be treated.  Once I was armed with the enough knowledge to be dangerous I found a doc that I could have confidence in.

[Richard Bell]

Wow! Your son is in a rough position, k8. You didn’t mention your son’s dosage level of allopurinol but if it’s below 300mg perhaps it needs to be raised. Also, he needs to drink water on a steady basis to help his body purge excess serum uric acid which is being released by the loss of weight and the disolving of crystals in his joints. Stick with the allopurinol or this will just drag on and on. I went through a rough time in the beginning and literally had to crawl to the bathroom, suffered constant pain, experienced chills, developed tophi and even had a hole open up in the tophi of my big toe which drained and oozed for a couple of months. I stayed on the medication (Uloric in my case.) and now almost a year later am doing very well.

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