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Hello- Thanks for all the great information. I’ve been pouring over this site the last week and I’ve learned a lot, although I must say I’m a little overwhelmed and down about the whole situation. I still have a ton of questions but I figured I better start by introducing myself.
My history…About 4 years ago I had a minor flair up for the first time. It was the classic, big toe situation. I did some very cursory research to figure out it sounded like gout and it pretty much went away, although my toe joints would still feel a little achy or tingly on occasion.
About two years ago I had a mysterious right knee “injury”. The Dr. examined it and sent me to physical therapy. The pain went away by the 3rd week. Now the past 2 weeks I’ve had a similar swollen, VERY painful left knee. From everything I’ve read it sounds like gout. I have a Dr. appointment for a full physical with blood tests on Wednesday. I did the lab visit last week and I’m not sure if Uric Acid levels were included in the tests, but if not I’ll request they be done.
Just wondering, anything else I should ask or suggest to my Dr. during a first conversation about gout? I doubt he’ll prescribe anything until he sees at least the U.A. test results. Also, I’m on Lotrel for BP and Lipitor for cholesterol. My insurance should cover any medication he might want to prescribe. Should I be making suggestions?
Thanks for any help you can give !
PS baking soda and apple cider vinegar have been getting me through this. None of the other “cures” seemed to have much effect.
snoopy,
Unless your serum uric acid levels are very high, you are going to be in never-never land for a while. While one might easily diagnose gout from a big red bunion joint and a screaming patient, such is not the case with a sore knee…the joint is too complicated and there are a vast array of injuries that it can sustain.
If your doctor is amenable, perhaps he can prescribe some colchicine for you. If something like 2 or 4 pills per day result in dramatic relief, that is some evidence for the pro column on the gout diagnosis. If it doesn't help, there is some evidence for NOT gout.
A lot depends on your uric acid. If it's not ragingly high, you will probably have to wail til a recurrence of the classic toe, instep or ankle pain. You don't want to rush into a life of treatment until you are completely sure you have gout.
In general though, most knee pain is NOT gout.
Thanks for the response. Yep, the fact that it’s my knee joints makes it less certain. If it wasn’t for the fact that I had a textbook toe flare up I would say I was stretching a bit thinking it’s gout. For what it’s worth, I recently had a chiropractor friend examine me and he told me if the uric acid reading was high he would say it was gout. The Dr. Appointment is tomorrow so hopefully I’ll make some progress. The non-stop pain, sleepless nights and lack of mobility are depressing me. I’m certainly not hoping for a confirmed diagnosis of gout but I need to get better! If the Dr. is just scratching his head I’ll push for colchicine to see if it helps. I won't leave the office without an Uric Acid test result or an order for the lab test.
Anybody out there have a similar experience? …or have gout flares that are or were primarily in the knee joints?
Snoopy- I just had a knee problem brought on by a insect bite reaction that was as bad as gout which I had many attacks over 5 years [till last year] in the ankles and toes.
This cleared with anti bios in 2 days and I was mobile quickly. It then re-ocurred in the same side knee cap due to over use, too quickly- that lasted a week but no inflammation, just puffy swelling quite pronounced though.
I think the gout lends a tendency to secondary problems, on this personal evidence.
From the sound of it you have gout building and the knees could be caused by something else , but worsened by immune flares related to the gouty condition. Just a thought, the Doc will hopefully pin this down- but the treatment of these co related conditions is not easy- the only certain thing is arthritic pain is pretty bad all round. Sympathy is no cure, of course- but at least you have company here!
I don't take meds for gout now- and can manage on the lower stress lifestyle of retirement ,and not using diuretics, so far.
Fluid intake kept up and the right diet also helps a lot.
Just got back from the Doctor and he ordered blood tests including uric acid and other indicators. He can't refer me to a specialist until these are back and he won't see me again until August. He said the only thing Insurance would let him do at this point is physical therapy.
I can do the blood test any time. Should I wait until the knee joint feels better to get an accurate UA level?
In the meantime I need to get better! This is terrible! I'm on vacation and sitting in the house on the computer. Bah! Can't even have a drink.
snoopy said:
Just got back from the Doctor and he ordered blood tests including uric acid and other indicators. He can’t refer me to a specialist until these are back and he won’t see me again until August
What kind of insurance is this where doctor decides when he would see you? If you have problem, it should be your choice to see the doctor as and when you want( subject to scheduling permitted). This sounds very unprofessional.
My insurance allows me to see any doctor of my choice as and when I need them. Am I missing something here on your insurance front?
Basically, I am finding it hard to accept that doctor would not see you before August.
Basically, I am finding it hard to accept that doctor would not see you before August.
Accept what you want. He's going on vacation and appointments are scarce this summer. That's the first available and to be honest, I didn't really push it. I guess I could have been more demanding but I'm sometimes a pushover that way.
My current plan is to get through this flare-up the old fashioned way and then push for a diagnosis and not sweep it under the rug like I did last time.
My insurance allows me to see any doctor of my choice as and when I need them. Am I missing something here on your insurance front?
Sounds like you have good Medical Insurance. Mine is very inflexible about things like referrals or seeing anyone but your primary care physician. Any special requests have to go through the system and then you get a notice in the mail accepting or denying it. Considering there's this thing constantly in the news called THE HEALTH CARE CRISIS i figure I'm better off than most, but obviously not as lucky as you.
I'm thinking of switching to Kaiser Permanente. I hear it's easier to see specialists because they have alot of their staff all in one building with one billing system etc. I like my doctor though, and he's rare in that he's a cardiology specialist that works as a primary care physician.
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