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Hey Hans,?thanks for your advice there re the naproxen, I have my liver and kidneys tested regularly, in fact normally when I get urate test I also the the Liver Function test and get it done myself, my numbers are way under 6 0.23 equals 4.14 so for 2 months since starting allopurinol i havent gone higher than 4.14, the drug is definitely working, and im sure shifting crystals around is causing the flare ups, I do have alot of tattoo work and did have a 7 hour session a week ago which MAY have promoted my gout to rear its head anyway, so I am not really doing myself any favours.?
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ZIPPY my favourite gout forum poster 🙂 im like a zip groupie with the amount of your stuff i read lol, totally agree re the colchcine regime and to be honest was umming and arring about going above 2mg as i was doing indomethacin, however, for future reference I will keep doing a pill an hour till the bowels open, as in the past when I got gout 8 years ago, 4mg of Colchicne would knock my attack clean out, so now taking only 2mg and hoping for the best isnt exactly smart on my part, and I dont mind running to the toilet, its preferred to hobbling to the toilet in pain.?
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Hey DrMarc, thank you for your advice too, i will definitely be staying on allopurinol and fingers crossed in 6 months to a year ill be clear of the majority of flares, I do totally agree that minus the allopurinol I would be on the same flares, and whilst having a flare I am keeping an eye on my blood levels and they remain at 4.14ish so I know the urate must be clearing and not reforming. Again my advantage being I work on a health centre and can request lab tests on myself at the drop of a hat, so monitoring for me is easy. Also I have tried colchine in low doses and it does tend to work for me, the last flare happened after I took 7 days of my usual 1mg of colchcine a day routine, that was because I had a tattoo done and wanted it to give it max healing time off any meds.?
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Guys, thank you for the advice, I have to say it makes me feel a lot better to hear peoples opinions and advice, sometimes the pain of an oncoming attack is actually worse for me than the attack if that makes sense, because from the oncoming pain i know whats about to happen and most times fail in killing the attack fast, though I am going to try the colchcine in high doses next time.?
Hey Hans?
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I might give that a try I got Naproxen here, I just found that Indomethacin was more potent but I think my main problem was I let the attack settle in, I refused to believe I was having a serious attack because I was on allopurinol and since starting ive not had a major attack, I thought it was going to pass through the night, and started the colchcine/indomethacin when the attack was fully instigated, the result was just having to ride the pain out.?
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I may try Naproxen next time along with a small dosage of colchcine, that might be the way to go as with Naproxen you can keep using it for weeks in a row, the problem with Indomethacin is you are suppose to cut it down as soon as possible.?
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thank you for your comment by the way :)?
hey Limpy?
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thanks for your comments, yeah I jumped straight to 300mg because I know ultimately its where ill end up, and last nights mid level attack blew up into a full on attack dispite 2mgs of colchcine and 50mg of indomethacin, its subsided now and just swollen but didnt sleep much last night, I think im going to go back to colchicine twice a day again, and just ride out a good 4-5 months on allopurinol and see if that helps settle me down.?
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the thought of having to do all this again when im older is whats keeping me firmly on allopurinol to be honest.?
also attacks all in my big toe joint, first 6 years only right foot but recently right and left big toes only
hey deltatoes
when I was first diagnosed I had the worst first attack lasted about a month and in total I think I was off work for 6 weeks, from changing my diet and getting my weight down to a normal range I managed to keep the attacks away for a few years, ver 7 years my frequency of attacks were a couple every few years and they were very mild, recently in the last 3 months it came back and didn’t go, giving me on and off attacks for 3 months, so started allopurinol at 300mg and accepted at least probably another 6months of possible attacks, would rather get settled on medication while I’m 34 then later when my body won’t tolerate NSAIDs or other meds, allopurinol is going well have had a few minor flares and general soreness but no night time flare ups so I can at least sleep, with regards to medication I would say go on your gps advice but for me I do 1.5mg of colchcine 1mg then .5mg an hour later and if that doesn’t knock the attack out I switch to indomethacin and do 150mg over 24 hours, I stay on that for a max of three days, but also keep doing 1.5mg of colchine throughout the day, after three days I normally lower e indomethacin down to 75mg a day IF the pain is okay enough I can make it to work I stay on 1.5mg of colchcine till the pain has fully gone, I also take lansoprazole with the indomethacin to stop it tearing my stomach up.
generally I don’t stay on indomethacin for more than 3 days, but My attacks when I use to get them use to subside in a few days, I use indomethacin for the pain and swelling and colchine to stop the attack, hope that helps if you take indomethacin ask your gp for a stomach blocker like lansoprazole
and more questions feel free to ask 🙂
imi
totally agree about the mole measurements, that’s just how some labs do it in the uk for some reason, as long as I can convert it I don’t care, the colchcine script cost me 15 pounds to cash in so a total of 30 dollars, love the uk for its script system, no script is ever over ?7.40 the government picks up the rest 🙂
zip if you want some colchine let me know I’ll mail you a hundred tabs
hey Zip
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as always thank you for your prompt and informative response, I think the actual conversion is right, its definitely?3.7 ( i normally?do x18, so 0.22×18=3.96) , I knew allopurinol would cut my levels low as I wasnt riding too high in the first place, I will keep on 300mg because you are right in saying I have only recently had pain and even the transition to allopurinol has caused a few flare ups in the last 8 days, so yes a 6 month minimum sounds like a good idea to me.
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I actually have no visible Tophi, my reasoning for getting on allopurinol is that when I am older and wiser I dont want to look back and say, “damn wish i listened to everyone's advice and controlled my urate when I was younger” I would rather bear the flare ups on adjustment now, rather than when my body wont tolerate it.
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I didnt actually expect to see the level drop that low and funny enough I went to my GP yesterday and he looked at my previous test which were 0.39 and said, well I dont think 300mg will do much to lower it but if you get it to 0.33 thats good enough, shows you how much experience he has with allopurinol, but I am one of the lucky ones because I work for the health sector and have 3 separate GPs who I see, so if I generally tend to see them and tell them what I want, in yesterdays case?a blood test and 200 colchine tabs.
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will get more bloods done in 2 weeks and see what my level stablises at.
okay another update, I hope someone can respond to this as I am seeking a bit of advice here, I got my blood test results back, 9 days on Allopurinol and the reading is 0.22 which is bloody low I think, I know that 300mg would lower my urate quite a bit as I was only at about 0.40 so it has indeed halved it. My questions are listed below.
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1) has my urate level dropped to low ? and does this now mean I can finally eat normally again
2) will there be problems if my urate drops below the level of 0.18 the minimum level listed
3) should I keep this low is it safer ? I am guessing the answer to that is yes, but I am going to ask anyway.
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As always thank you for replies in advanced
Hi Bill,?
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I have been on Allopurinol for exactly 7 days today, taking the 300mg dose, im 34 and so far initially i ?noticed some tiredness but put that down to system adjusting, I thought i had some weird eye discomfort but that resolved after 2 days and was probably the fact i was up late playing modern warfare 3 and not the allopurinol.?
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only bad side effect so far, which of course is debatable is that its given me a minor flare up of gout, but this is expected to a certain degree so I can safely say that no side effects felt so far, will get my bloods done later this week hopefully and get checked for my liver function to make sure nothing is getting messed up there, but no so far nothing major, when I got the weird thing in my eye i did consider stopping it but glad i didnt now as it was just paranoia more than anything.?
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hope that helps, allopurinol hasnt yet cured me, but i know it will given time to work.?
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imi
hey Hans,?
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any response in my opinion is a supportive and positive response, so thank you for your advice and also yes I agree im sure it is the crystals just falling away and not a new fresh attack, I didnt do the 16 pills route but took the day off work and just rested my foot, I can walk but not very comfortable to get a shoe on so stayed in and cleaned the flat and cooked for the wife to be…..?
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hey again Zip?
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as you will see already skipped work, i figured if i do 16 tabs, normally my threshold is about 4.5mgs before bum from hell develops I wouldnt be able to get into the office anyway so stayed home and just riding it out, I think it is the lowering of my urate through the allopurinol, my level before allopurinol riding around .39 – .42 so i am guessing with 300mg I will get a decent reduction, soon as I can walk and get into work ill get the vampire (phlebotomist) to bleed me and ill report the levels after a week of allopurinol. oOoOoOo got the Rhumie appointment today, 3 weeks, not sure why its worth seeing him anyway since ive already started allopurinol but might as well since ive waited about 3 weeks to get the appointment in the first place!!!!!!!!!!!
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thanks for the post guys….?
Hi Keith,?
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yep I use low dose as well and then top up with NSAID, sometimes it works, sometimes it doesn't, today it seems to not have, have taken 1.5mgs of colchine through the day and 1000mg of naproxen and right now looking at the clock thinking I might not be going to work tomorrow as my foot has started to throb again, unless I go back to colchine and just resorted to one an hour ill be up playing MW3 all night I guess….?
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Hey Zip?
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I totally agree about the 5am time clock, I have to be honest I actually dread going to sleep now, and this is really starting to depress me, trying to keep positive now im on day 6 of allopurinol but arguments with GF and family are starting to get worse, and I am starting to hate my life, but I will put my head down and just try and get through it, though my GF who is soon to be my wife in 6 months I am debating if I want her to live a life with someone who has to deal with this so frequently, but again *crosses fingers* allopurinol will come through for me, worst thing is I have to be at work tomorrow, in fact I cant really take the time off, at all, and I cant see how it can happen right now.?
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Anyway, sorry guys just deflated and a bit defeated right now, 9.30pm and I doubt ill sleep properly if at all tonight, ?hope you all have a good night and the support here is fantastic, just being able to read posts helps :)?
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Imi?
hey Hans
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when the attack actually started yeasterday I took x2 0.5mg colchchines and another an hour later, it held of the throbbing for about 2 hours and then it started again, so I switched to naproxen, my attacks arent all in one hit I tend to get waves of attacks, it comes and goes, I dont want to take colchine at a high dose only to have an attack come back a day later and not be able to take it, so I generally dose with x3 colchine tabs a day and then naproxen to tie me over, but that is because the attacks I get do not hit all at once, generally because they are mild, however I do know what a major flare feels like and if I feel that coming on I do change from naproxen to colchine 1 per hour till ive reached around 4-5mgs
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but I agree with you regarding colchine stopping attacks, problem is when you are getting 3-4 mild waves of attack in a day you cant keep taking 2 tabs each time, would quickly reach the limit, hence why I use naproxen and save colchine for larger flares.?
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hope that makes sense.?
quick update guys, 5 day on 300mg allopurinol and yes last night at 5am i was awoken with the usual pain of gout, left foot 2nd joint, it wasnt extreme with meds managed to fall back asleep, still today its tingling on and off, like it wants to break out into a full on attack but taming it with 1000mg of naproxen and praying thats enough to keep it at bay, colchcine at hand if it really goes mental on me.?
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just thought id give you all an update, took me to day 5 of being totally clear to get what i would call a minor flare right now, will see how it goes by the morning…?
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🙁 *sigh*
Hi Keith,
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got your email and replied. I called the GP and got a prompt within 10 mins call back, she checked her BNF and said she cant find itchy eye, lol, I checked my OWN BNF and yeah its not specific, plus the actual side effect says, irritiated eyes, yeah not specific at all… but no its the same today on day two, but I am guessing that its not a hyper sensitvity reaction as no swelling, no pain,? no discharge, no discolouring, just being a bastard and itching now and then…
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she did give my initial blood results on the day I started allopurinol and they were .39 so 6.6 or 393, I have learnt to convert on the fly now lol…. the xrays she had taken show no joint damage so thats a plus sign too..
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will continue the allopurinol unless I get a serious reaction while causes me to have to stop, I think once my body ajusts and stop being paraniod ill be just fine!
hey Keith,?
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sounds good to me, and funny enough I do work in IT for the NHS and have access to web design tools and drs and nurses and all kinds of NHS type material, so in theory I am sure we could work something out, am happy to discuss that when we both have time, I generally do have free time during the weeks and would be happy whenever you have time to meet up and have a chat.?
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a last quick question, took my first dose of allopurinol last night and no side effects but a damn itchy left eye, i noticed the serious side effects said irritated eye – contact hospital/gp, though I am not sure to what degree they mean irritated, its irritated like its annoying but its not swollen or red or painful, just annoying, could be nothing to do with the allopurinol just coincidence it decided to happen, years ago when I had a 100mg dose for a month I dont recall having an itchy eye lol… am I just being paranoid ?
Hey Keith?
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thank you again, have just popped my first allopurinol 300mg pill and breathed a sigh of relief, will keep a diary and document my progress, side effects, levels and such.?
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if you are ever in London let me know would love to meet you for a coffee or something I live very central (regents park) and yesss Squirrels watch out, so many in London cant wait to break of the steak knife and fork lol
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imi
Hi Keith,
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thank you very much for your reply and your advice, all makes perfect sense, I was umming and arrrring about 300 or 100, but tonight will take my first dose tonight will some naproxen.? Also totally agree re the holding back on food till my levels are under control, I will wait a week before I commence on meat eating, though I am a chicken eater so I think a nice Sunday roast at the end of this week is in order…. oh and a squirel eater too lol….
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I agree re Drs and levels in the UK when my Dr saw my level of .37 she didnt bat an eyelid at me starting Allopurinol, so I think I will have it easy when it comes to agreeing a level of .30 and my level a few weeks ago of .37 gives me hope that achieving .30 is very very doable.
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I know I thank you all the time Keith and I have read a few messages recently commenting on the layout of this website, I am a new user, well I have navigated this site for a few months now, and I can say, the first time I got here I had no problems locating information, the forum or unlocking all the info I needed to assist me and help me get through nasty stages of gout attacks. Infact if I am honest it was actually so much information I spent hours reading and finding stuff, I actually didnt find anything which I thought hmmm thats useless, or hmmm wish it was layed out differently.?
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I just wanted to add that as this morning I was thinking if this site ever shut down or closed, I would feel like my major source of support for me is leaving, as selfish as that sounds it is testiment to how amazing this site is.? Anyway rant over and thank you again for the advice.
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imi
hi Zip?
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thank you for that, I have already had allopurinol 100mg about 4 years ago so I know I can tolerate it, just an update too, I have rejoined my old GP who initially diagnosed me with gout some 8 years ago, had to lie about my living location but this old doctor was really on point with my condition, and she will probably slap me for leaving allopurinol all those years ago but at least ill be back with a GP who actually knows what gout is.?
hey Odo and Zip,?
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thanks for both your replies, ill try a hot water bottle in the bed an hour before i got there so it should keep the covers warm and today ive been trying a hot water bottle under my foot to keep my foot warm, i have riduclously cold feet and hands, yes i have the best circulation lol.?
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with regards to allopurinol zip, my girlfriend read your comments and is in total agreement with you, she feels i have the 3 month supply and a gp in the health centre i work at willing to keep that going indefinitely, so i should just start instead of waiting for my “official gp” to get the rhumie referral to me. I am slightly conflicted about what to do, one part of me thinks just start the allopurinol soon as I can walk another says, bo**ocks, just wait for the Rhumie to see you and give you the diagnosis, even though I know its gout.?
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so if I start the allopurinol ASAP (when im at least semi clear of this attack) it cant do any harm can it, other than lower my urate level (obviously possibly give me more attacks) if for whatever reason i dont have gout (which if i dont ill eat my shorts) it cant give me a condition, only lower my urate, however right now food triggers attacks, over activity triggers an attack, it looks like gout, it was initially diagnosed with gout 8 years ago with elevated urate levels, why am I even debating why it could be anything else, well I am because my GP wasnt sure….okay rant over again.?
hey Limpy,?
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I do wear like super thick wool socks to bed, but i do know when i first lie down my feet are freezing and the covers on my bed warm them up, so I am going to try a hot water bottle in the bed and see if the instant warm up makes a change, will try tonight and let you know if i sleep through the night tomorrow :)?
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imi
ANOTHER QUESTION?
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I do have another quick question guys, is it normal for a gout attack to hit around the same time every day for some unknown reason my attack which has been running for 2 weeks now seems to come to me at 2-4am is that normal for an attack to always pop up around the same time ? last nights lasted an hour with 50mg of indomethacin knocking it out but any particular reason why the timings are so constant ?
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could it be my dinner which is practically purine free ? or something to do with fluid or just crap luck, totally depressed with the whole gout situation right now and waiting for the Rhumie referral, looks like Monday and no work for me because walking is painful right now :(?
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imi
HAHAHHAHAHAHAHAHAHAHAHAHAH………. oh Zip that made my day which has been full of limping and pain seem not so bad lol…. thank you for that, and well if you like ill comission the study if you wanna go ahead and examine poop, infact if I get another attack tonight ill even find a bucket to give you test samples with…. okay now thats grossed me out, I retract that statement.?
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but seriously ill spank the Colchcine if tonight goes like last night, for some reason whenever I think the gout has settled it comes back again like it doesnt care it just gave me an attack the night before :(?
hey Limpy,?
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thank you for your reply, I completely understand where you are coming from with the not wanting to give out dosage advice, I am 100 percent with you on not doing that, I can tolerate 4mgs of colchicine before I have to run to the toliet, so 1.5 doesnt do anything to me, indomethacin does seem to workish, last night i was confussed what to do, so i tried the colchcine and when the attack didnt stop i switched to indomethacin but in all honesty that didnt help either, it was one of those attacks where all you can do is ride it out and no amount of meds seem to touch it, right now its sore, swollen but stable, IF i get another major attack like that again ill use colchine only, when i was younger I would use only colchine and just let it knock the attack out, I should do that now really.?
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thank you again, really appriciate your replies as they are keeping me going throught his painful time?
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imi
hey Limpy
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so funny you should say that and not, last night when I got home from taking the girfrlend to watch “the help” i had the atttack from hell, it kicked in while watching the film and havent had a wink of sleep yet, I hit it with x3 .05 colchicine and X100mg of indomethacin (not all at once over 16 hours) and the pain is just about under control, was thinking should i keep on the indometh or just hit it with my colch ??
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if it were you on a day 2 attack from hell and it was still twingy but not raging, would you stick with the NSAIDS or hit hard with colch ?
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thank you in advance for your advice ?
okay just realised something, the GP isnt sure ive got gout but keeps giving me colchcine lol… and tells me the best way to take it when I have an acute flare up of gout… but not sure I have gout LMAO…. sorry I found that amusing for myself.?
okay quick update, I have seen the GP today, discussed my results, and he still isnt sure its gout because of my low urate level, inspite of the fact I was diagnosed 8 years ago from a different GP when my urate levels were sky high, however, after looking at my foot and finding out that the pain is in the classic gout joint and only been there, coupled with my test results, he thinks its PROBABLY gout, lol, so funny, but he doesnt want to prescribe allopurinol till the Rhumie has seen me and confirmed gout… ?
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so…. he gave me a script for naproxen and colchicine and said that will keep me goint till the Rhumie appointment in a few weeks, I got those and got myself a 3 month supply of allupurinol from someone I know 300mgs, I will wait till I see Rhumie but if he tries to fob me off ill start the allopurinol, im actually tempted to take it, because if I dont have gout (which I know I do) then 2 months of allopurionol isnt going to kill me, but if I DO have gout then at least im ahead of the game.?
what do you guys think ??
Hey Zip?
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I dont think the GP ment Tophi, I have no visible Tophi at present, he meant the build up crystals around the joint, I thought those mealt as your urate level in your blood drops, which is why starting Allupurinol can cause attacks once started, because the build up protien coated crystals begin in dissolve, or am I wrong in that, glad I have no visible Tophi though im sure there is probably some lodged in my joints, but again not I can feel or see.?
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imi
hey ZIP (my fav gout replier) thank you for the reply and the info I should have listened to you 3 months ago when I posted and taken the meds then when you said you thought I had chronic Gout from the frequency and intensity of my attacks, I will be taking your advice this time around and agree re the negative ANA, and also the normal ESR and all the other readings, I feel like starting a name and shame website for GPs who have no idea what they are talking about, the GP initially said to me that uric acid crystals never dissolve so I could forget about trying to get rid of them, I blinked and just said errrr okay….?
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if you can post more later, please do :)?
hi odo,?
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thank you for your reply, I thought that too, I am going to insist on 300mgs of Allopurinol on Friday, I can tolerate it as ive had 100mg years ago and just stopped as my diet and weight changed I didnt seem to need the medication, wish I had stayed on it now.?
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but ill aim for .3 as standard, I believe my levels normally ride higer than that but because I only ever get a urate test when Im having minor flare ups I think the level shows at the top end of normal, but do my symptoms seem consistent with gout, I am just worried because the attacks disappear during the day and come back at 4am, its almost like a pattern, previously an attack would rage for days and not go, but when it did it was quite safely on its way out, now it seems it goes, but comes back, could be the same attack not settling ? or just new attacks each day ? im edging on same attack not being resolved, I tend to ease of meds very quickly and dont follow through for days, soon as the attack pulsing pain goes, I stop meds, but of course there is always remaining swelling which I think brings on a new attack ?
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thank you again for your advice, I see your a fellow londoner :D?
