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I thought I would share what I've been going through regarding the current state of my gout and my attempts at trying to remain somewhat 'in shape' through the allopurinol cleansing stage. For the past six months, I have been on 600mg/day of Allopurinol in an effort to rid my body of old uric acid deposits while at the same time maintaining a UA level below 6mg/dl. For all intents and purposes, my body has reacted well to the cleansing so far. My monthly UA tests have shown that the Allopurinol has worked, lowering my UA levels from pre-Allo levels of 8-10 down to 3.9-5.9. I did experience some horrific attacks the first month during this regime, but the severity and frequency of the attacks did subside soon after.
At times during the past couple of months, I've actually felt pretty good with little joint pain. During these times is when I'd attempt to do little light workouts. This involved going for short hikes with my dog in the woods or doing 25 minutes on the elliptical machine along with some very light weights or even just walking around some of the nearby cities. Each and every time, these activities resulted in an attack popping up, usually in my feet or ankles or achilles. Although these attacks were nowhere near as severe as the attacks I experienced before starting Allo, they still sidelined me for at least two weeks each time.
Last weekend, my wife and I spent four days in Vienna. I knew I would have to take it easy with the walking since sometimes, we can go for hours exploring some of the places off the beaten path. Instead, we utilized the tram system, subways and even took a horse carriage ride to see the most famous sites We took a lot of rests when we were walking, me mainly resting while my wife went in to stores to shop. I really didn't think I was overdoing things, but my body was telling me otherwise. Each night when we'd return to our room, I could barely move. I hurt. The pain wasn't from gout but was definitely gout related. All of my joints just….hurt.
On the day of our drive back from Austria to Germany, a bad attack began springing up in my achilles and foot making it difficult to even drive. The attack only got worse and worse as the week wore on. Finally, today (Sunday), the attack is subsiding somewhat but still quite painful.
I know that this is different for all gout sufferers, but it seems for me, even the lightest activity is sparking new attacks. I'm sure the activity is just aggravatiing old attack locations where uric acid still exists. This is a new thing for me, though. I guess in the past, the pain was just so ubiquitous and so common that I just powered through it when I could. Now, even with a light to moderate attack, I'm noticing the pain much more easily. I have a new 'normal' state to compare it to where I don't have pain so the attacks just stick out to me more. Kind of like in the beginning of my battle with gout when an attack would come out of nowhere and just knock you for a loop.
I'm trying to look at this as a good thing. I see it as being on the downward slide towards recovery. The attacks are less frequent and less severe and I can now compare an almost pain-free state to a gout induced state in a joint once again. It's been years since I've been able to do that. I just wish I knew how much longer this 'cleansing' process was going to take! I've suffered through, I don't know, hundreds of attacks over a 15 year period, so I'm thinking I've still got some time to go.
My plan now is to keep doing what I've been doing but to now stay away from my attempts at exercise – at least until my body tells me I'm ready. This could be months away – or longer. I'll also have to be extremely careful when I travel and just will have to learn to love the cafe culture in Europe and sitting on my ass! Perhaps, when possible, I can rent a Segway to get around for a few hours to snap pictures, but the hours of walking will have to end for now.
(thanks, Hans)
Which Activities are Best for Gout? NateA sorry to hear about your pain. I think as you have way too many deposits it might take a while for you to be in the clear. My uneducated guess would be another year (minimum). I would say things will gradually improve over a period of 3 years maybe.
I was a normal physically active person one year ago completely unaware of Gout. Then low level pain started on my toe for no reason and finally the dam burst 3 months ago. I have never been pain free like I was 1 year ago. My new normal = low-medium level pain.
In last three months I have had 3 full blown attacks (1 before starting AlloP and 2 after being on AlloP). Anyway 3 months of AlloP and I still get flare ups. I am thinking it will take me another 6 months to year of AlloP to clear the deposits and hopefully get back to the real normal no pain level of 1 year ago.
I go gym when I have low-medium pain. I am not seeing any direct relation in my case between going gym and getting flare ups but I am not sure as proper gout attack are all new for me so not enough data to come to any solid conclusion yet.
I'm just happy to see that you found this site so early in your battle with gout! if GoutPal would have been around 10 years ago, maybe things wouldn't be so bad for me now.
It sounds like you're doing everything right. You can never be sure about this, but I'm wondering if you didn't always have hyperucemia and then some type of trigger or something in your body turned that overload of UA in to the attacks you are now experiencing. Getting three full-blown attacks in just three months to start your gout odyssey, although I'm sure not unheard of, seems kind of rare to me. Mine started of slowly, maybe one every four months or so, and then it became almost a constant thing jumping from joint to joint.
I definitely must state that this new norm I'm experiencing is not pain-free like before I had gout. There is always some pain going on in my joints, be it due to joint destruction or just the UA crystals having a strong hold in certain joints. I can deal with that compared to full-blown attacks, though!
I used to never connect working out or going skiing or surfing or biking with gout flare-ups. This seems to be a newer thing for me and I'll just have to be patient with it. It just happens so fast nowdays. Workout Monday evening, gout flare Tuesday morning. Never has it happened so quickly!
I'm willing to do what it takes and if that means taking it super easy, as much as I HATE sitting around, it's what I'm going to have to do. Time to invest in a PlayStation 3, perhaps?
Best of luck!
Nate, for mobility and a bit of exercise and freedom, think about getting a bicycle with loads of gears 20+(unless you also get knee attacks). You can keep the ankle joint fairly still with due attention (keeping the pedal just in front of the heel) and even if you take it gently you'd be surprised how many muscle groups you're working: quads, glutes, abs, arms etc. Deffo stop you going stir crazy better than a PS3
Hope you're feeling better soon.
NateA,
I got Gout( that's what is suspected though not cofirmed and lot of conflicting reports) 11 months back. Started with a big direct hit of the toe against the bedpost. Took 3 days for the pain and swelling to set in and got it 3 times in 2 months. The docs finally detected a fracture coupled with gout.
I started Allop 150 mg 9 months back, then slowly moved to 300 mg and am still on 300 mg for more than 7 months. I have been doing exercise, mostly walking and light jogging. Also wearing tighter leather shoes for 12-14 hrs Monday through Friday. Walking /jogging generally 45 minutes to an hour, 3-4 times a week.
In my case, i did not see any impact of exercise on my toe. I actually feel much better in the evening after I have been wearing somewhat tighter dress shoes for more than 8-9 hrs in the day.
And luckily, I did not get any gout flare up once I started Allop 9 months back. My SUA has been below 4 for last 7 months without any flareup.
So, my experience, no negative effect of activities on Gout…though I never did very heavy exercise…
Thanks odo. Unfortunately, even biking is going to be too rough for me right now. I have a very nice 19 speed mountain bike and actually took it for a spin not too long ago. I came home quickly as the pedaling was aggravating my achilles and feet way too much. I think I just need to completely rest for a while and not attempt doing much of anything. I'm still keeping my fingers crossed that I'll be able to ski next season at some point.
Exercise never used to spur on attacks in the past. This is a new thing for me. Perhaps since I've been dealing with gout for 15 years and there is enough built-up UA in my system, this is now another way that an attack is initiated in my body. Either way, it's definitely something I need to be wary of now as I can say with almost certainty that there is a correlation – for me.
19 speed mountain bike
How on Earth do you gear a 19 speed bike?
Do you have any analgesics to help you get through the joint pain, Nate? Do you have any visible tophi.
Sorry, meant to type 18 speed.
I'm taking 75-150mg of diclofenac per day, but it does nothing, really. Well, except upset my stomach. I may go in and get my prescription of Tramadol refilled tomorrow. It seems to take the edge off at least.
The only tophi I have is on the end of my right thumb. Can be annoying at times but not too bad.
Did you ever the CLARINET or SAX? (We share that right thumb tophus.)
Anyhoo,
I find Tramadol to be SINGULARLY useless for pain…of any sort. It doesn't even help me sleep. Friends with bad backs and knees me the same thing.
Have you tried Aleve (naproxyn-sodium?) I find that the best non-prescription (in the U.S.) NSAID.
EVERYBODY seems to get Vicodin Rx these days for EVERYTHING…they must have a good sales staff.
But I don' have any experience with oxycodone or hydrocodone. Somebody here a while ago praised them for gout.Nope, no instruments, but I just read your other post about your tophi and it made me think…… probably overuse of a mouse for a computer. That's the only thing it could be. I drained mine over a year ago but still have the bump on my thumb. No return of the white fluid, though.
Tramadol actually seemed to work best for my back and as I said, just took the edge off of the gout pain. It's something, at least.
With as much Aleve as I've taken in the past 3 or 4 years, I wished I owned stock! It is the best non-prescription NSAID, but I have to take 800mg+ at a time to derive even the slightest benefit for gout. For headaches and other minor things it does a decent job. No other NSAID helps me at all.
I hate Vicodin. But, it was me stating that hydrocodone really, really does help with an attack when put with oral prednisone. I held off on seeking any out for this last attack because of my experience with a real prick of a doc who has red-flagged me because I had received percocet twice in the previous six months. It really, really works for me in that combination and knocks an attack back quicker than anything I have ever tried. God-forbid I'd want something that makes a bad attack go away in 2 or 3 days. Instead, I'll just suffer with an attack and be absolutely miserable for two weeks or more……
Hey NateA I am going gym today (hopefully tomorrow too) for the first time since my recent attacks. Will let you know if I notice anything in next 1-3 days as a result of going gym. I wil lalso take before and after SUA readings.
I will do weights for 40minutes but will give cardio most probably a miss as I don't want too much strees on my toe joint.
Currently I have zero visible swelling or redness. Pain is at my normal non Gout attack level ie. low-medium pain when pressure is applied to the joint.
Doctors hate ONLY drugs that work really well. They are very happy to push drugs that do their job very poorly, if, and only if the useless drug is VERY expensive.
Useless drugs with kickbacks AND horrific side effects are always a special favorite.
“No we cannot give you hydrocodone, it works so well that you might LIKE it. Take this Celebrex instead: it's useless, it's expeensive, and it MAY stop your heart…the perfect drug!”
Thanks VegeGuy – be interested to hear your report. Hopefully working out won't cause any adverse reactions for you.
So true, zip. As I've said before, what in the heck do they think I'm going to do with a three day supply of this stuff? Go hawk it on a corner in Munich?
I was actually given Celebrex when I lived in Alaksa. The doctor did a cursory examine and then gave me some sample packs he had just received. So, as I always do before taking anything, I went home and researched the drug. This was right when all of the negative press was starting regarding Celebrex and other COX-2 inhibitors. Suffice to say, I didn't take any of it after reading through some of the findings.
NateA said:
Thanks VegeGuy – be interested to hear your report. Hopefully working out won't cause any adverse reactions for you.
Well getting the Gout confirmation knocked the wind out of my gym going sail
I will definitely go tomorrow and will keep you informed how things pan out.
Ok Nate I went gym yesterday at 11am for the first time since my last attack. Did weights for 25-30minutes and was exhausted. Tank was completely empty and did not attempt cardio/steps machine. My reading was 4.1mg/dl in the morning before going gym.
So yesterday the pain was low level ie. I could walk without any pain and put weight on the ball of my foot. Today (morning) my reading is 4.7mg/dl and I have pain in my problem toe.I would class it medium level pain and putting weight on the ball of the foot is bit painful.
So looks like even 30minutes of weight training + sleep at night = some trouble
I sure hope this improves with time and more time on AlloP! Cause I sure want to go gym regularly again!!!!!Differential effects of exercise intensity on serum uric acid concentration.
Green HJ, Fraser IG.
Department of Kinesiology, University of Waterloo, Ontario, Canada.
……………..It is concluded that exercise intensity rather than total work output is a critical factor mediating increases in blood uric acid concentration. These results are consistent with the interpretation that uric acid formation may arise from purine nucleotide degradation and fast-twitch fiber utilization during conditions of high energy utilization.
PMID: 3343917 [PubMed – indexed for MEDLINE]
Good study VG. I would have expected as much. To my way of thinking it is only PEAK exercise, in this case 1 minute at 120% capacity (that's BRUTAL,) that will destroy muscle tissue and release copious nucleic acids whereas a modest couple hours at a lollygag pace wouldn't do much.
I guess heavy weightliifting would be the ULTIMATE peak exercise. Incredible output over a VERY short time. Something that has always stuck with me was the claim that a SINGLE repetition of a lift at one's ABSOLUTE maximum capacity was the ultimate muscle builder (and perforce, muscle destroyer.) That's more theoretical than practical becasuse the thought of a maximum lift right out of the starting gate sounds like the PERFECT recipe for injury…but the principle remains valid.
In contrast, in series 2, prolonged sub-maximal exercise failed to stimulate increases in uric acid concentration either between days or within days.
Zip now I need to work out what my sub-maximal exercise levels are? How the hell do I do that?
Some examples-
Ex.1 – 30 pull ups in one go with 5 minutes pause followed by 50 push ups per day. Would that be sub-maximal ie. safe?
Ex.2 – Weight training 30 minutes 4 times a week but reducing my weights by 30% or so but upping the reps?
Ex.3- Biking 50 kms at gentle pace?
Looks like I just will have to take the SUA testing kit with me to gym and check different exercise combinations to see what keeps my SUA stable and below sub-maximal.
Jeez! people go gym to work out and I will be goign to not work out too much LOL Oh! the joke nature is playing on me.
EDIT- As there is no device that does real time SUA measuring while exercising would heart rate monitor be a good general idicator for not going overboard? Although weight training does not raise heart rate too much but still can be very damaging from Gout angle. Hmm don't know what are safe exercise levels anymore.
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