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Hello everyone, I had my first gout attack about two years ago in my left big toe.
I had a lump on the side which my doctor told me was a bunion. Treated that attack with colchicine and Indomethicin. That cleared it up pretty quickly and I really didn't do anything to address the gout after that.
The bunion started bothering me more and more so my foot doctor agreed to bunion surgery. When I was in recovery the doctor told me he was shocked to find a lot of uric acid crystals in my foot. He told me he removed as much as he could. Two days into recovery my big toe pain got worse and felt like gout so I took some of the old colchicine pills I had and that seemed to relieve the pain somewhat. Then two days ago, a week and a day after surgery, my ankle just got so painful I feared that was gout also.
I called my foot doctor and he prescribed me indomethacin after taking that for a day my ankle pain lessened and went away. I am continuing the indomethacin for a few more days. I am going to have to change my diet, slow down on beer,[which I haven't drank since surgery] and get on allopurinol.
Does anyone think my toe and ankle could have been gout attacks after surgery?
Yes, very likely; trauma is a major cause of gout attacks either through injury or overuse of the joint, so surgery would certainly fit the bill. The question is: did you actually have a bunion or was it a gout tophus? Bunions generally occur on both feet with one worse than the other. The telltale sign of bunions is the big toe deviated at an angle towards the other toes and corrective surgery usually involves bone realignment i.e. breaking it and setting it back straight . Recovery is 4-6 weeks on crutches and considerably longer to be walking 100% again. If your toe was relatively straight with just a big lump on the side, you probably didn't have a bunion.
The doctor said it was a bunion but there were a lot of crystals in area also. My concern was the fact that I had all the crystals in my toe area but my ankle pain went through the roof a week fter surgery. I didn't know gout could affect different areas at almost the same time.
Does anyone think my toe and ankle could have been gout attacks after surgery?
ABSOLUTELY, Mark.
You went to a BUNION DOCTOR, who would see a bunion as the cause of pain for a man just run over by a BUS.
He was wrong, you had no “bunion” but rather a gouty tophus.
Digging out the monosodium urate is all well and good EVENTUALLY but it has repercussions. Your foot doctor cut into walled off deposits (that's how the body deals with excess urate in gouties) freeing up a LOT of urate that needs to find someplace else to hide, like ankles, inteps, fingers and knees.
Alas, while it is floating around it is likely to casue no end of attacks.
I think for you, a wise maneuver would be to take allopurinol to stop more formation AND probenecid to increase the amount dumped by the kidneys. The probenecid wouold likely be temporary until all attacks stopped but the allopurinol would be forever, the normal routine treatment for gout.
How high is your serum uric acid? That number is the most important one in gout and its treatment.
odo said:
… Bunions generally occur on both feet with one worse than the other. The telltale sign of bunions is the big toe deviated at an angle towards the other toes and corrective surgery usually involves bone realignment i.e. breaking it and setting it back straight . …
Do these feet qualify for BUNIONS and GOUT, Odo???
As you know, I have had gout for >25 years. 15 years ago I had the bunions removed surgically on both feet. I was walking WITHOUT crutches ( a blessing in disguise [the crutches, that is] 10/12/15 years later) two weeks later. No corrective surgery with bone realignment i.e. breaking it and setting it back straight, either. Neither did the podiatrist who performed the operation say one single word about gout/Uric Acid/MSU deposits.
I bet every penny I got left (and there aren't too many to lose) that there were deposits after 11 years of gout history with “official” UA level readings in the 9-11 mg/dl range. As you can see the “bunion” on right foot grew back again and I'd bet whatever pennies I got left that that “bunion” is 80-90% Uric Acid and/or MSU. Those craters, sure as hell, weren't spewing bunion lava and bunion boulders over the last 5 months.
Btw, the volcano on my left toe is presently dormant, the crater is closed and the hot lava flow contained, temporarily. 2 or 3 of the 6 craters (difficult to judge because of the closeness of the craters) on my right foot/toe are still active, but no hot lava flow, just some boulders (tophi) are daily being extracted with the help of my Manuka Honey.
zip2play said:
Post edited 2:10 pm – May 30, 2010 by zip2play
Does anyone think my toe and ankle could have been gout attacks after surgery?
ABSOLUTELY, Mark.
You went to a BUNION DOCTOR, who would see a bunion as the cause of pain for a man just run over by a BUS.
He was wrong, you had no “bunion” but rather a gouty tophus.
Digging out the monosodium urate is all well and good EVENTUALLY but it has repercussions. Your foot doctor cut into walled off deposits (that's how the body deals with excess urate in gouties) freeing up a LOT of urate that needs to find someplace else to hide, like ankles, inteps, fingers and knees.
Alas, while it is floating around it is likely to casue no end of attacks.
I think for you, a wise maneuver would be to take allopurinol to stop more formation AND probenecid to increase the amount dumped by the kidneys. The probenecid wouold likely be temporary until all attacks stopped but the allopurinol would be forever, the normal routine treatment for gout.
How high is your serum uric acid? That number is the most important one in gout and its treatment.
I am going back to my regulay doctor to get my levels checked and am going to develop a plan which I am sure will include Allopurinal.
Mark,
Suggest to your doctor allopurinol + probenecid until your attacks subside. Explain to him that while allopurinol causes our bodies to MAKE LESS urate, probenecid will allow a lot of extra urate that might have been liberated by that surgery to be excreted quickly.
Make it sound like it was HIS idea…they like that, the little dears.
hansinnm said:
Post edited 7:52 pm ? June 1, 2010 by hansinnm
odo said:
? Bunions generally occur on both feet with one worse than the other. The telltale sign of bunions is the big toe deviated at an angle towards the other toes and corrective surgery usually involves bone realignment i.e. breaking it and setting it back straight . ?
Do these feet qualify for BUNIONS and GOUT, Odo???
As you know, I have had gout for >25 years. 15 years ago I had the bunions removed surgically on both feet. I was walking WITHOUT crutches ( a blessing in disguise [the crutches, that is] 10/12/15 years later) two weeks later. No corrective surgery with bone realignment i.e. breaking it and setting it back straight, either. Neither did the podiatrist who performed the operation say one single word about gout/Uric Acid/MSU deposits.
I bet every penny I got left (and there aren?t too many to lose) that there were deposits after 11 years of gout history with ?official? UA level readings in the 9-11 mg/dl range. As you can see the ?bunion? on right foot grew back again and I?d bet whatever pennies I got left that that ?bunion? is 80-90% Uric Acid and/or MSU. Those craters, sure as hell, weren?t spewing bunion lava and bunion boulders over the last 5 months. Btw, the volcano on my left toe is presently dormant, the crater is closed and the hot lava flow contained, temporarily. 2 or 3 of the 6 craters (difficult to judge because of the closeness of the craters) on my right foot/toe are still active, but no hot lava flow, just some boulders (tophi) are daily being extracted with the help of my Manuka Honey.
OMG! The horror!!! That should be an ad for UA therapy! I could have the caption “Got Allopurinol?!”
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Gout or Bunion?
People are often unsure if their problem is gout or a different form of arthritis. In which case, I recommend you start a GoutPal Plan for Arthritis Sufferers.