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Please check your SUA numbers, if they are above 6 they are prone to promote a never ending attack. Check with your doctor for the correct Uloric dose and be sure that your numbers are below 5, also ask for a Rx for colchicine (my Dr. gave me colchicine for the first year, 2 pills daily).
It is normal to have gout attacks when starting on Uloric or Alopurinol (eventually any uricosuric agent), my Dr. put me on colchicine (2 pills daily) for several months as a prophylactic and told me not to stop Alopurinol if I had an attack.
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Losartan helps to control BP and also is an uricosuric agent.?
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I would adivise not to drink a lot of water if you suffer from BP, high fluid intake increases BP.
Colchicine may reduce white blood cells that can increase the risk of infection. You may need a CBC to determine if the number of white cells is normal.
Brian,
My first gout attak was on my left knee.?
A brief chronology of events:
Friday: low swelling, numbness, 1/10 pain
Saturday: big swelling, 2/10 pain, went to ER, diagnosed with gout, they gave me NSAID
Sunday: pain 10/10, huge swelling, new visit to ER, complete exams, knee MRI, fluid drain, pain killers + colchicine + NSAID + corticosteroid (still pain nor swelling was reduced), SUA was over 11 and UA on knee fluid over 9
Next 7 days: pain 10/10, 100% of time on bed
Next 5 days: pain 8/10, could walk small distances with aid of cruches
Next 5 days: pain 4-2/10, horrible pain when pressing the car's clutch
Next month: small pain, knee would not flex completely?
Total time from start to full recovery: 2 1/2 months
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Although ER doctor was sure it was gout, rheumatologist was not sure due that no crystals were found on the fluid. Years later an arthroscopy of that knee showed UA crystals, finally I was 100% diagnosed with gout.
Allopurinol?is converted to oxipurinol (oxypurinol) that has a half-life of around 15 hours?[FDA], 18-30 hours on other studies and 24 hours is taken as a typical value.?So a single dose will work ok for 24 hours; serum levels may continue up for 48?hours, so if you miss one dose it is not critical.
I take 300mg on a single dose at any time on the day,?basically when I remember (14 months for now and never missed one).?
Drinking alkaline water does not affect blood ph, blood is regulated to stay within the range 7.35 – 7.45.?
1. Normally is not a good idea to start on Allopurinol during an attack (Zyloric), this may worsten or take more time to resolve.
2. Diclofenec (Caflam) is good for pain and swelling, a little strong for the stomach.
3. You are missing maybe the best medicine Colchicine.
These points are from my point of view and you should follow your doctor indications.
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In my case I have had
attacks that lasted from 3 days up to 3 months (acute pain). After the acute
phase normally it takes up to two weeks to be free of pain and swelling.1. Best way to determine gout is by detecting UA crystals in the fluid.
2. But on very rare cases crystals are not present or detected and still it is gout. This was my case.
3. I think I have had three aspirations on my left knee and two on my right. No problem in any of them.
4. I had a knee arthroscopy ?and surgeon found all my joint was full with UA crystals; was the final diagnose that I really had gout. He cleaned and removed damaged tissue and for now, one year later, I am perfect thanks to surgery and alopurinol.?
5. Surgeon told me if UA level could not be control then I must return every 5 years to “clean” my knee.
The best moment for aspirating is during an attack.?
1. Click on Insert/edit image (tree icon).
2. On the pop window click on the image after Image URL line.
3. New window must appear with Upload Tab.
4. Click on Browse.
5. A new Window would appear (OS window), browse your computer and select your file.
6. Click Upload. Progress line appears for a second and window would return to blank, this a little weird.
7. Click on Browse Tab.
8. There is a page selection. The images are presented in alphabetical order, change page until your image appears.
9. Click on your image, new window (really is the first would appear), click Insert.
10. Done.
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hope it helps.
From what I know there is no drug to get rid of the calcium pyrophosphate crystals.
The only treatments for pseudogout are intended to reduce the pain: NSAIDs, Colchicine, corticosteroids (oral and injected into the joint).?
2010 was my worst gout year.An attack started after the SUA spike on March 16 which lasted up to May 25, it involved both knees and index finger. ?First I tried blueberries and then cherries, the graph shows there was a lowering effect in both cases but the SUA raised again after some days, still I had the SUA too high. On June 16 I had a knee surgery, the graph shows a high spike after it.The same day of surgery I started with Alo. 300 and two days later the level was under 7. The last 10 days I also started taking Losartan.[
Please note: original images lost – please see Will Cherry Juice Gout Treatment Work For You?.]My first gout attack was on my left knee. First day I went to ER and doctor diagnosed me with gout and told me not to go to again to ER (just because a gout attack was not enough to be considered an emergency). Next day I was in such pain that I returned to the ER where another doctor saw my knee and ordered an MRI and blood tests. After all results came out he decided to drain liquid from the knee and inject some anesthetics and gave me a lot of medicines. Attack started on December 7, first day I could stand (with crutches) was December 22 and the attack resolved completely by December 29; 10 days of high intense pain and another 10 of medium to low pain.
Following attacks were equally painful but lasted longer (in all of them I had to go to visit the doctor for “draining” my knee). Last one before knee surgery and allopurinol lasted from March to May, almost three months. After that, about three weeks ago, I had a new attack but it lasted only 4 days and only one day with intense pain. I think that five months of Allopurinol have dissolved almost all crystals and attacks are less aggressive.
March this year was my worst gout moment, left knee, right index finger, right foot. First time I had an attack involving several joints at the same time. Doctor put me on: diclofenac, colchicine, deflazacort (similar to prednisone), 4 weeks passed by and the attacks did not resolved. My SUA level at the time was 12.6. I started to drink a lot of water, went on a low protein (purine) diet, cherries and vitamin C a month later my SUA levels were around 10.4 and the attack continued. Initial conclusion is that diet, water and cherries may reduce SUA levels put not enough when you have very high uric acid levels.
To end the story, doctor took fluid from my knee and injected anesthetic and corticosteroid into my knee, also gave me nimesulide, a very powerful NSAID. Two weeks later the attack subsided but the knee continue swelled, so doctor send me to have a knee MRI. MRI results were that the synovial membrane was too thick, possible caused by crystal deposits, and overproducing synovial fluid. I went to surgery, a synovectomy. During the surgery the surgeon found crystal all around the joint (tendons, meniscus, cartilage) . The surgeon in agreement with the rheumatologist put me on 300 allop and colchine (2 pills), the later for at least one year and allop for life.
After starting Allop I went on a normal diet but continued with cherries. A month later my SUA levels were down to 6.4, not enough but a good start.
Suggestion: do not try to substitute Allop with diet, cherries or vinegar. These may help reduce the gout flare but not SUA.
Normally is NOT a good idea to start Alopurinol during an acute attack, it make take longer to stop.
My rheumatologist put me on AP after several weeks after the attack subsided, also gave me colchicine 2pills/day as a prophylactic and told me that I should take it for at least 1 year. You may know that when starting AP there could be several initial gout flares.
In your case there is a two step solution:
- Control the actual gout attack. Predinisone + colchicine + NSAID, RX by a Dr.
- After the attack is controlled then AP + colchicine to control hyperuricemia. Or any other med. your Dr. prescribes.
Water, cherries, vitamin C, diet, others, may help but a real solution is AP. After some months taking AP you can go back to a normal life, normal diet.
I suggest to go with a rheumatologist.
I really understand you. Since 2003 I've suffered gout on my left knee (other joints also but the worst is my knee), so using the clutch is just impossible during a gout attack. This year I had an attack that started on March and progress all the way up to June, my rheumathologist forwarded me to a knee orthopedist. The orthopedist suggested an arthroscopy to check the knee and do a clean up of crystals.
I couldn't use my car for these period and decided to buy an automatic. It's been 3 months since the synovectomy and clean up of my knee, also my doctor put me on 300 allopurinol, and now I can drive again my stick car.
Normally when starting Allopurinol colchicine 0.5 or 0.6 bid is also prescribe as a prophilactic to avoid new flares due to “de-crystallization”. Colchicine normally should be taken at least 2 months, my MD prescibe it for 6 months.
Higher doses of allo may speed the process but also may trigger more flares.
Its not a direct chemical reaction, it comes from the organisms metabolism of fructose.
“Because ATP (adenosine triphosphate) is used in the phosphorylation of fructose to fructose-1-phosphate, adenosine monophosphate (AMP) accumulates (see Figure from Woods et al. 1970). AMP is then dephosphorylated to adenosine or deaminated to inosine monophosphate, both of which are intermediates in purine catabolic pathways that produce uric acid”
