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zip2play said:
?(I hated molar units in high school, I hated them in college and I hate them today.)
I am with you, Zip, all the way. Molar units don't make any sense, even to me, as a chemist in one of my past lives. ?Now 1 mg, one thousands of a gram, that makes sense. A molar unit, what the hell is that? I bet you, 99 out of a hundred doctors don't have the foggiest idea. Only nitwits can imagine a molar unit in their brains which they ain't gotten.
zip2play said:
?Hans,
While no acute attacks, I DO tend to be forming small tophi on my fingers, my feet ache after a long walk, and I have a SOMETHING (probably a Morton's neuroma but possible a tophis) in the middle of the right ball of my foot which feel llike a BB when i walk in harder shoes. And of course, I have a back from Hell. So I have some MAYBE issues. (And of course I DO get twingy when I overdo my Black and Tan?next month!)?.
Zip, something just doesn't seem right. If your SUA is around 5+ you “should” not get new tophi. If you do then all our theories and statements ?about MSU forming if the level is above 6.8mg is out the window. Besides, we also do know that there are mortals with a SUA of 10+ and NO gout.
Maybe us gouties are all decendents of Henry VIII, we just were never told.
Maybe allopurinol contains some secret ingredient to keep us hooked for life, and if we go off we go through severe withdrawal symptoms=attacks, just like a heroin druggie.zip2play said:
Hi guys,
…
Should I increase my dose of allopurinol? Should I consider adding probenecid?
Are you asking seriously or just testing the waters?
Let's assume (and you know what that means and both of us meet that criteria, I think) it is #1: My recommendation is that you continue to do what you've been doing for 10+ years, if you don't have any attacks, flare-ups or other, gout-related pains.
Having gone the Probenecid and Uloric-80mg+Probenecid route I don't see any significant improvements except a ?slightly lower SUA level. As far as dissolving tophi go, I, personally, think that the jury is still out. Not until I have a big, clear “picture” which shows that I don't have any tophi anymore, I am not buying that “fuzzy” picture of diminishing MSU by using either Allo or Uloric. I do buy that they keep SUA levels (uric acid in blood) in check, but I have yet to see concrete proof of them dissolving MSU barnacles.
odo said:
Skating on very thin ice pal
Odo, I hope he gets your message!
And as my mother once said to me: “When the donkey feels its oats it goes dancing on ice” (and boy, did I get soaked and froze my ass off. I haven't fully recovered yet from that dance, even after 40 years. Didn't have anything to do with gout,though.)
nealjking said:
…
Is this typical of how a tophus forms, or is it more usual for it to be a gradual process, according to the impression I've received from my readings?
Neil, Odo gave you already the best answer which could be given by any knowledgeable goutie. However, as he said: “you don't mention blood tests (SUA), diagnosis of gout, urate lowering therapy etc. and without these steps in hand you're not much better off than before the cataclysm”, nor age, weight, physical activities, family history, all factors influencing the creation and/or control of gout.
You may be a “god-sent” (coming from an atheist, but I don't have any qualms using expressions of non-atheists) goutie to this forum/community. Since you live in Germany and Siemens invented and of course sells the equipment, called Somatron, you might be the first goutie here to get a Somtron-DECT image. Put DECT in the upper, right-hand search field and you'll get all the info necessary to understand DECT. (There are only 2 or3 of these dual energy machines here in America, but I know they are already quite common in the UK, and they must even be more common in Germany. It's expensive here; I don't know how expensive a DECT image in Germany is and how much insurance covers that procedure.)
By the way, for your info: DECT is right now the only non-evasive procedure to assure gout=MSU/UA crystals or deposits from other non-goutie deposits and possible bone defects. While bone defects are seen by x-rays, x-ray does NOT “see” definite urate deposits.
Gilles said:
… ?Most of the time, I tend to want to blaim other factors, but I always come to realize that my stress and general condition has to improve to change my situation around.
…
You have taken the first and biggest step: Recognize the problem. Understand it. And admit it to yourself. Life will improve!
zip2play said:
?
?? try their annual BOCK BEER for a really crippling treat??
?As an aside, I never get any twinges from a regualr beer, PBR my current cheapy favorite, but often I drink a 6-pack/day? MHL, Coors regular, Heinekin, Labatt, etc. I hate light beers?like off tasting cold?water.
?
Ah Zip, you just opened a can of worms or a window to the good ole days of the past, which ever way you want to take it.
?
I still got 12 or so cases of Huber's annual BOCK BEER?(only the cases) which I had bought about 1983/4/5 for less than 10 bucks a case. (I used their returnable bottles, they never broke, unless I could not wait to finish the fermentation, then Mother Nature would show me the power stored in a good, cold, or even more warm dark bock beer, for my home brew. Their dark bottles are nolonger in my possession.)
Living in blissful innocence=ignorance, those were the days my friend, I thought they'd never end until I stubbed my big toe at a camping/sailing trip and three day later my GP said: “You got GOUT!”? “What? What is GOUT???” It took me more than 25 years to find out. You and the other “old” gouties know my story too well.
Anyway,back to BOCK BEER: Have you ever had DOPPLE BOCK BEER??? ?A friend of mine in Germany worked in a brewery and had access to FREE BEER. mmm, that was good, so good, after 3-4 bottles I rode my bike home (at night) free-handed, without touching the handle bar and not falling or getting caught by the police. Society didn' look too favorable on teenagers (maybe I was a little older, I forgot) riding their bikes free-handed in the middle of the street. (Fifty some years ago there were far less cars on German streets than today.)
And to top it off: How about a Sam Adam's TRIPLE BOCK BEER??? I still got one (1) bottle left (now ~15 years old), waiting for THEE DAY to be consumed. You see, after all, there is still something waiting for ME in life!!!
Oh, by the way, I have started to brew my HansinNewMexico Stout again. Should be ready to bottle in 3-4 days.
My life started to pick up/look up a hell lot more/better some three months ago, when I began finishing off my HINMStout from two years ago.
1, at the most, 2 bottles at a time. So far so good! Since I quit the additional Probenecid, my SUA has gone up to 5-6, but no flares or attacks. (Haven't had any for almost a year now.)zip2play said:
I've been tossing around some thoughts about the mechanism for controlling gout with allopurinol and Uloric. I was trying to envision a “grand scheme” but there are just too many loose ends to tie up in my head. So I thought I'd just begin typing and maybe grow some kind of logical picture EVENTUALLY. Once it's written down I don't have to rethink THAT part (if that makes any sense.)
So we know that gout originates from either an over-production or under-excretion of uruc acid/uriate. The body makes uric acid from the oxidation of purines, proteinaceous foods that contain a xanthine structure, mostly hypoxanthine (purine base), xanthine and guanine,?an unbreakable pair of rings one with 5 carbons and one with 6. I say unbreakable because they are unbreakable by humans?most animals CAN break the rings and thus only man and dalmatians form uric acid as the end product of xanthine oxidation.
In man, all the oxidation of xanthines is accomplished by the aid of a HUGE molecule usually in the liver called xanthine oxidase (XA)?quite appropriately named, say what? The XA is a catalyst which accomplishes a reaction without actually being changed by it. The xanthines in the blood are?grabbed by XA and oxidized
Enter allopurinol which is ALMOST a?hypoxanthine but with the slightest reshuffling of a couple atoms. It fools the XA into oxidizing IT into into oxipurinol ?all of which is tying up the xanthine oxidase and preventing some of the purines from being converted to uric acid. While the XA is being tied up,?the increased level of hypoxanthines and xanthines are being excreted by the kidneys.??Net result is a lowered serum uric acid. The products of allopurinol, hypoxanthine and xanthine are all more soluble than urate so the kidneys get rid of them.
?
What might we deduce:
1. That the oxidation of allopurinol and oxypurinoll must be fairly slow, otherwise the XA would not be hindered from making uric acid.
2. That the supply of XA must be relatively fixed? Otherwise the body would make enough of it to counter any allopurinol.
So now we must ask, over the long haul will the body make more XA in response to years of allopurinol probably requiring increased dosing? If so, then stopping allopurinol after a long time might be disastrous for gout patients given larger amounts of XA.
?
So now, we are taking allopurinol. It lasts only a short time before it is converted by XA to oxypurinol which lasts even longer before is is again converted by XA to oxypurinol which lasts several days, tying up XA.
Questions:
1. Since allopurinol is changed quickly by XA, is it best to administer it slowly in multiple doses for more effect?
2. Is the oxypurinol ALWAYS tied? by XA during its lifetime or is it a fleeting contact? Or both?
?
Does it seem that the amount of XA can be a constant, can the molecule be thought of as living forever? Wouldn't reducing the amount be a nice help for gouties? What ELSE does it do. If nothing, then all we would lose without it is a paltry loss of calories from the inability to oxidize purines. I think we can all do without some of the calories from the immense quantities of SWEETBREADS that we eat. :D:D
?
(Like I said, this is a work in process?any thoughts, amplifications?or?corrections are welcome.)
There you are, except for the medical/chemical terms.
Gilles said:
…
?I'm submitting the information to the forum for your comments?
Thank you.
Gilles, instead of us, since you are the one who wants to know all about fructose, especially HFCS, I suggest that you put HFCS into the search field at the upper right-hand corner. I guarantee you, that you will/can spend 24 hours or 24 days to read what has been said/written about fructose/HFCS.
Any ?experience with fructose/HFCS of a gouty member of this forum, while probably important to that person, is/may be totally irrelevant for you. Please, keep that in mind.
ctrlkeys said:
…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.
?…
You got things backwards. Naproxen isn't going to deal with your attack. COLCHICINE is THE attack blocker. Naproxen deals only with your pain, the result of your attack!
When the attack strike, take 1 or 2 Colchicine. If the pain gets unbearable add 1 or 2 500mg Naproxen or Aleve. (They are the same, except Aleve is the non-prescription drug.)
Keith, I agree with you and most of the things the guy is saying. I don't know him, however, that is not important. While you and others are more diplomatic about or with criticism, I just don't have neither the time left nor the patience to cuddle someone who is supposed have some brains left and drink when some water is handed out.
I am not trying to punish anyone. I do care, that's why I am responding.
floridatrees said:
Hello, I recently found Goutpal and was amazed by its content .? Its the absolute best source of information I have ever found on gout.
1) …? I simply cant make heads or tails of how to find information.
2) …Is it my browser?
3) … I can tell the information is there, but I cant use it.
4) …Can someone offer some advice?
-John.
Ad 1) If you don't have a head and a tail, how in hell did you find Goutpal with its amazing content and being the absolute best source of info on gout you EVER found?
Ad 2) Yes, John, it IS your browser=brain
Ad 3) The best information in the world is useless, unless you have the right browser or brain to understand and? deal with the info.
Ad 4) Get a NEW browser!
?
John, if my comments pissed you off, please, don't waste it! Have it checked to see how much uric acid was in your urine. It may be an indicator how bad your GOUT PROBLEM is. However, confidentially, there are better and more accurate methods to determine the severity of your gout, like someone sticking the needle into your arm and sucking the blood out of you or better, yet, sticking it into your knee and sucking some fluid out of it.
Keith, without trying to be critical or judgmental, please, let me say this:
Save your precious time and energy for the good “apples” in your basket and throw the one or two bad ones out before they affect the good “apples”. Remember, you got over 1500 in your basket who have successfully navigated your forums for over 5 years or so, including Gouties from all over the world who were/are not fluent in the English language.
Your time is better spent on people, like Limpy, who respect you and your efforts.
If there is/was a problem, you have generally remedied it within very reasonable time.
Keith (Gout Admin) said:
Sorry Limpy, but I felt the need to remove the link.
There are widespread reports of malware from this website, and others owned by the same person. My own check was very strange – after loading one page, I could no longer access the site, but my computer is pretty well protected, so I'm assuming the attempts to load bad software failed and caused the site to block.
?
Anyone who wants to chance it can copy the link into their browser.
Thank you, Keith, for being OUR “Guardian Angel”
. Fortunately my computer's ?”Guardian Angel” blocked the company's URL.?
Limpy, FYI: Colchicine requires a doctor's prescription.
Keith (Gout Admin) said:
…
I'll leave the rest of the 1040 results for another day.
I'll join you, Keith, in your campaign, in another day, after/when I have joined the rest of the 1040 results!
zip2play said:
…
Keith,
Coincidentally, I went into my “tophi is forever” chant on another post only a little while ago. My personal experience was the only way my few tophi went was through the skin…not the bloodstream. But I look forward to your study..and thanks for being the guinea pig.
I agree and through surgery
. (And they can't even remove all of them that way. Too many nooks and crannies for the barnacles to grab hold of the joints, etc.) (I know, Keith laughed at my example that those barnacles don't dissolve like a spoon full of salt or sugar in warm water.)
You can now purchase the UASure kits directly from a website that ships from the US. They offer free US Shipping via first class mail to. Go to uric acid test kit? This is the best deal on the internet now for gout sufferers in the US who want to use the UASure Uric Acid monitoring system.
?
Thank you, Keith J. This is one of the best, most useful recent news on our forum.
limpy said:
Hey Zip & Hans, I'm going in tomorrow to see a new doctor as I've been having more pain in my feet lately and as you guys said the numbers don't add up with that low of an acid level. Other then uric acid what other blood test should I ask for? Thanks Limpy
My rheumatologist always orders a COMPREHENSIVE METABOLIC PANEL (18 items) plus the Uric Acid test.
zip2play said:
No doctor will calll in a prescription for ANYTHING without having diagnosed you. It is part caution and part greed?.
Zip, his doctor had diagnosed him with gout. Here is his comment:
cafabrofon,posts 6
9:18 pm October 13, 2011
Thanks for responding. No I have never had fluid taken from my joint. My gout was diagnosed because the very first time I had it I went to the emergency clinic not knowing what it was and they took blood, sent it to my doctor and she told me my uric acid level was very high and I had gout. she prescribed some meds that never worked and to be honest I don't remember the name. The med I took yesterday is indometacine and it worked wonders for the first couple of hours but even though I have continued taking it, it hasn't done much else and it still hurts a little and it is still extremely swollen to my liking. I can't walk good still. It has been two weeks I lost my job because of it and now I don't think anyone wants to hire a gimpy guy hahaha. PLEASE HELP!!!
?
I think it's a great part of GREED.
limpy said:
? As far as uping my dose of Allop to 300mgs I've tried several times with three different doctors they all said no. I guess I'll see what they say after my next blood test. Limpy
Limpy, if you don't mind me telling you: Get rid of all three (not doctors) pill pushers. It's your body, not theirs and if you want 300 mg Allo they should give it to you. If they are scared of a law suit, maybe they have a good reason. An even better reason to get rid of them.
?To my knowledge, NO ONE EVER DIED OF 300 mg Allo
, but a lot of people died because of “doctors' stupidity.zip2play said:
…
You know, with gout conjfirmed by crystals, it seems improbabl that you would get a 3.9 mg./dL (not 390 in molar units right?) That seems too low.??Have you had confirmatory results? If I go to a doctor for a cold I ask for a uric acid test.
Make sure you confirm the 3.9 because it sounds suspicious?and shouldn't allow attacks. Definitely do not try to throttle down your allopurinol based on 1 reading AND a continuance of pain.
…
Limpy's 3.90 mg/dL, coming from a US of A lab or gouty is very suspicious and getting the SUA level down to 3.9 on 200 mg Allo
sounds even more suspicious (at least to me.
) Remember, Keith had to go to 900 mg to get THAT ?low. ?limpy said:
I'll be waiting.
Better get an extra supply of Allo, Colchicine and Aleve to tie you over.
zip2play said:
…
But then computer programmers may have no clue these days what the term SIGNIFICANT DIGITS means. Few people really do. And the doctor blindly reports what the printout tells him.
?
I'm 6 feet 2.000 inches tall. (If measured with a laser.
)
They only know the term SIGNIFICANT OTHERS because they cost them money.
You are sure you are not missing the 0.0001 inch???
JCabo said:
What is the price of Uloric.. before.. or without insurance.. for 30 – 60 – 90 – 365 days per year?
You figure it out for yourself. ONE PILL costs $5.
cafabrofon said:
Yes I have called my doctor and she refuses to call in a prescription for me. she wants me to come in first. I will call walmart and costco to find out what the deal is. thank you for your useful information. I don't know when but I am going to have to wait until I can afford to see the doctor
You CANNOT get Allo WITHOUT a prescription, regardless of cost.
You better find yourself another doctor who is willing to call in a prescription without putting your feet (or pocketbook) to the fire.
ltjuggernaut said:
1?months and a half ago, my UA level was 6.74 mg/dL. Which is average, but my feet and hand still have numbness and redness residing on the padding. (I apologize I dont have photos to show you)
If I were you, I'd question the number 6.74 mg/dL I have NEVER seen mg/dL expressed with two decimals. To me, the number looks very suspicious. I don't think that you have a correct SUA reading.
limpy said:
YES PLEASE BLOCK THIS JERK.
Sorry, I can't block that jerk; I can only delete his posts, which I have done, as you can tell. I would love to stick them up his rear end.
Keith (Gout Admin) said:
Hans, you saved my life – or at least my short vacation.
You now have special powers in the form of a little spanner next to the profile button on the line above the message. Edit or delete as you think fit. I'm sure you'll be kind to those who make genuine mistakes and ruthless with those who are trying to abuse us.
I am back at the weekend, but will be checking my emails daily.
Gotta go now before I start making declarations of undying love
Thank you, Keith, for your vote of confidence. Enjoy whatever is left of your vacation. You need not worry about ??
“making declarations of undying love“. You aught to know, there is NO “undying love”. It dies with you the moment you take your last breath. I'll be content and satisfied with declarations of just plain love.And you may RIP that I will/shall NOT tamper with any gouties' posts/comments.
