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Keith, I have changed my mind. I'll take on the moderator job and and save you time and energy so that you can keep the forum and me straight and I'll deal with the scam artists. Mother Nature has given me lately so many adrenaline shots on the lake, I've got to get rid of some of that energy.
Keith (Gout Admin) said:
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@hansinnm – Do you want moderator rights so you can correct my posts? (Thank you for clarification)?…
Hell NO,?Keith !!!
I can hardly moderate my own life
, let alone YOU and your website.I thought you might appreciate not having incorrect statements of yours tainting your otherwise excellent gout forum.
This is only for your eyes, Keith: I would have PM'd you instead of exposing it to the general public if we still had that feature.
laerley said:
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Since, this last episode (again, for lack of a better term), the doctor is talking about switching me from allopurinol, to uloric?
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Don't let a pill pusher switch you to a $5 pill. The only sane reason to go from Allopurinol to Uloric is severe allergy to Allo. NOTHING ELSE! There is a 40-50 year proven history that Allo WILL control your gout, IF YOU HAVE GOUT.
Keith (Gout Admin) said:
Yes, alyboy, that is a good approach.
(1) I find colchicine supported by an anti-inflammatory is the quickest answer, as colchicine slows the increase in inflammation but does not provide pain-relief.
(2) ?stop the anti-inflammatory, but continue with colchicine for around two weeks. If you have a change in allopurinol dose, it is good to go back on one or two colchicine for one or two weeks which will reduce the chance and severity of more attacks.
(3) If you do get an attack, return to the colchicine plus anti-inflammatory to fix it?.
Keith, I think you are confusing the facts and the guy.
?(1) Colchicine IS the anti-inflammatory. You said yourself: ?”???
as colchicine slows the increase in inflammation but does not provide pain-relief?.” and you probably meant to say: “??
supported by a pain-relief medication. like Naproxen or Aleve is the quickest answer
?”
(2) I think you meant to say: ” ?stop the pain relief med, but continue with colchicine for around two weeks?.”
(3) Don't you want to say: “If you do get an attack, return to the colchicine plus a pain-relief medication to fix it?.” ?
drknow said:?
Hans if it's not too personal or ominous just list what you wanted to say here.? I'm grateful for this forum, PM ability or not!? It's been VERY helpful to me and many many others who probably never joined and just read.
Ok Dave. The reason I was going to tell per PM was that the matter of my discussion is neither ominous nor personal, but doesn't have anything to do with gout, just plain health. So here we go:
?“I want to add that fairly early on in my 300mg dose my mouth did have an outbreak of canker sores that was very frightening and painful. I posted about it here as well. Imagine a canker sore in the back of your throat!! Awful! I was horrified that they were related to the allopurinol but I am thinking it was just a case of bad luck and perhaps stress from other life issues (including gout concerns). I have always got canker sores over the years since childhood but nothing like this.” ?(Your comment on Sept.24,.)
I have had good results with Calcium Bentonite (Montmorillonite, a special type of bentonite clay. Google Montmorillonite and get all the details on that clay.) I have been using it for close to two years now and I am drinking it every day. To deal with any kind of sores, canker, heat blisters on the lips, herpes blisters at the base of the nose and/or lips, even small cuts and bruises, I spread a tiny amount of the clay paste on the area affected and in most cases they are healed/gone in 1-2 days. Good example: Lips crack/blister from too much sun exposure. I spread a little of the clay paste on the cracks and my lips are fine the next day. I haven't had any sores in my mouth or gum bleeding, for that matter, for almost two years. Most people get sores in their mouth every-so-often, for what ever reason. After I have brushed my teeth with “regular” tooth paste, I do a second brushing with just the clay on the brush and keep the clay in my mouth. It “coats” the gums and kills the germs and bacteria. (Just read up on Montmorillonite or Living Clay. If you should get into it, DON'T pay any one $20+ for one lb; there cheaper ways to get it. Just FYI.)?
drknow said:
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I want to add that fairly early on in my 300mg dose my mouth did have an outbreak of canker sores that was very frightening and painful.? I posted about it here as well.? Imagine a canker sore in the back of your throat!! Awful! I was horrified that they were related to the allopurinol but I am thinking it was just a case of bad luck and perhaps stress from other life issues (including gout concerns).? I have always got canker sores over the years since childhood but nothing like this.? I decided to stick to the allopurinol and so far so good.? I have not felt any side effects that are noteworthy either.
?…
Dave, email me. I have something to discuss with you concerning your canker sores.
Keith (Gout Admin) said:
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Now I'm a happy bunny. Urates down to 0.18mmol/L (3mg/dL) and prescription for 50.4g allopurinol.
If that don't shrink the tophi, nothing will.
Keith, don't get your hopes up too high, and for Pete's sake don't expect anything.
While it is not too difficult for our bodies to attach a sodium atom to the uric acid and deposit it as MSU=tophi on our toes and joints and what-not, I don't believe that the reverse is as simple. It's not like throwing a few specks of MSU in a test tube, and a little bit of H2O, add a few drops of this liquid, and a few grains of that powder, and bingo here comes our uric acid, all nice and clean.
Just ONE question: How come that one cannot find anything, anywhere how MSU is changed into UA or how and what will scrape the tophi off your bones, except a scalpel?
Keith (Gout Admin) said:
Wow, I've seen stuff before about fructose and gout, but some of the research was very questionable, so I put it aside. I'll take more notice in future.
Your fructose resource states:
fructose may be described? as ?alcohol without the ?buzz??.
Now that is serious!
Haven't you noticed that people, youngsters as well as adults, have become addicted to “soft drinks” ?
He also describes the chemical re/actions in the body/brain which HFCS undergoes. According to that process, HFCS? does affect the brain cells, similar to alcohol.
No matter what we think/believe about HFCS, one thing is an undeniable fact: There are more diabetics, and most recently so-called type 2 diabetics than ever before. I don't recall that any body ever mentioned the term “Type 2 diabetes” 20, 30 years ago.
Keith (Gout Admin) said:
zip2play said:
It is absolutely appalling and those outside the United States can never grasp how unreasonable, capricious, and cruel the system can be unless you are a multimillionaire or lucky enough to have made it to Medicare.
The last thing I would like to do is appal you, but it is due, at least in my case, to a total lack of experience and information.
?i have written elsewhere about the horrendous tax burden that we face in the UK. The rich can avoid poor quality National Health “Service” by taking out private health insurance, or just pay for private treatment, but anyone on average pay cannot afford it after all the tax we pay. We have to endure bug-ridden, cold hospitals, long waiting lists, and a host of other problems. But, they did save my life, and I'm now getting my gout treated for about $10 per month, so I shouldn't moan too much.
?
Does the cruelty lie in a situation where you can only get affordable health insurance if you are too healthy to need it? If that is the case, then I am truly appalled.
A warning to all potential and/or presently medicare-insured gouties: Once you are on Medicare A and B, NEVER drop B, if you “think” you are too healthy to pay for B. (Now about $110/month) ?If you do, you'll be punished with a 10% {extortion}”Surcharge” for each year you did not pay for Medicare.?
?
On the other hand, I was surprised recently to read that someone was refusing to apply for free or discounted Colcrys because they required copy payslips. In a country that demands profitable companies, did she really expect discounts without proof of income?
?
For gout sufferers, there may be something we can do to research cost-saving options. E.g. we could approach suppliers of relevant products and services to arrange discounts for referrals from here. I would be more than happy to donate all advertising revenue and commissions from GoutPal Interactive if I was certain that the money goes to those who need it.
I have posted a link on this forum in the past, (YOU need to find it!) by which gouties can get FREE Uloric for one year, provided your yearly income is less than $32,490/1person. I am now on my 2. year of free Uloric.
Does anyone have any ideas about how we might get something going, or have links with a relevant charity that I could approach?
Keith (Gout Admin) said:
Excellent news, Bhart.
It's a shame about the nausea with febuxostat. It's also listed as a side-effect of allopurinol, which I take. My prescription instructions included the advice to take with a full glass of water and with food. I have experienced very slight nausea at times, but never when I have obeyed those instructions.
(1) Uloric, according to the manufacturers, can be taken with or without food. You might like to do a little self-experimenting to see if this makes any difference to you.
(2) Monthly testing for uric acid is fine. It is wise to have liver function tested at the same time. I'm not certain about kidney function tests, but your doctor will advise.
(1)?I have taken Uloric 40mg for 5 months and Uloric 80mg for 9 months, always with a cup of strong coffee (and a few other so-called vitamins), and have never had any side affects what-so-ever. But that's me, only.
(2) Definitely kidney tests, since kidney stones from uric acid can be formed?
and healthy kidneys are essential for getting rid of excess uric acid.
Keith (Gout Admin) said:
?
Look no further than? my recent 300mg allopurinol myth article. ??
Now, THAT IS the most sensible thing you wrote about Allopurinol all year.
?I am glad to see you are calling the 300mg Allo dose a MYTH.
No Gout God and no doctor SLOULD tell anyone what the right dose for you, a gouty, is. Only YOUR BODY and YOUR BRAIN, provided it hasn't been “washed”, SHOULD tell you what is right and what is wrong. All a doctor should do is helping you and your body to find the RIGHT dose.
It's too goddamn bad that most people have been submissive to the notion that they must be told, or must do as they are told, how to live their lives!!!
Keith (Gout Admin) said:
Oh, is that what you were trying to do?
I thought you were asking “Why, all of a sudden, has gout increased by ~50% in the last 20 years?”
I believe it is due to the rise in obesity and iron consumption. It is the job of pharmas to exploit that. It is the job of the FDA to protect pharmas. It is our job to tell the truth and help gout sufferers. If we can add in a little humor, it makes the day brighter, but with “tophaceous Rumplestiltskin” I think I'm getting a laughter overload. I hope I'm laughing WITH you. I'd never laugh AT you.
Keith, you got it.
1. I do know that you don't laugh AT me.
2. “~50% in the last 20 years” was merely the quote from the article and my question was rather an academic one since I, you, and a few others already know the answers. (You confirmed my statement.)
I have never cited iron because I don't know about that, however, diabetes has always been on my list as I have pointed out in the past the presentation of a physician, (specialist for diabetic children at a San Francisco hospital) who in particular is pointing out the poisonous/addictive characteristics of HFCS (High Fructose Corn Syrup.) If you have the time, please, watch this: http://www.youtube.com/watch?v=277MKP7uV5g
3. I have particularly pointed the finger at the American food industry because it is almost impossible to get/find any “natural” food in our stores anymore. Even the so-called “organic” food items are a joke (not their prices, they are extortions). Since all grown food items must be watered with “rain from heaven”, saturated with acids and other poisonous gases and particles (Like jet fuels), how can they be called”organically grown”?
Keith (Gout Admin) said:
This is like having a cat.
Spends hours playing where it shouldn't, then brings home a mutilated corpse, or revolting, half-dead animal.
Decorating it blue and red don't make it interesting, or wanted.
Use your miraculous charting skills to plot gout against obesity and iron intake. Or just read my gout diet pages.
What's gotten into you, Keith?
Why would or should I “use my miraculous charting skills to plot gout against obesity and iron intake. Or just read your gout diet pages”?
All I tried was to point out another gimmick of the big pharmas in kahootz with the FDA and the food giants, poisoning the American public.
Keith (Gout Admin) said:
Penny,
1) I do not want to disagree with zip2play, who knows more about gout, and most other things, than the rest of us put together, but I have an issue with 300mg allopurinol.
It is certainly better than 100mg, but the determining factor must be your uric acid level.
Set a target – 5mg/dL is best, but I prefer to go lower for a few months to speed up getting rid of the old crystals. This also cuts the time you need to depend on pain relief.
2) Take enough allopurinol to reach your target, up to a maximum of 900mg.
3) Get tested at least once per year, but every 4 weeks when you change dose until you reach stability.
In a few months you can contact me to see if I can change your username to usedtohaveouchiefeet.
Ad 1): I am glad to see that I am not the only one who dares to disagree with Zip. However, I now must disagree with you, Keith. Between you and me, we two know just as much as Zip does, if not more, and “the rest of us put together” certainly know more than Zip by himself. Please, don't forget, there are several gouties (without ?mentioning all their names) around this globe who also have contributed invaluable knowledge and help to other gouties.
Ad 2): I also question your 900 mg figure. Who has established with certainty that 900mg is good or could be bad(too much)? I, personally, think that the maximum figure aught to be established by the patient, with the help of a knowledgeable representative of the medical industry.
Ad 3): Lab tests should be done before and at the end of the experimenting stage of lowering the SUA, with regular weekly home testing, till stability and desired SUA level is reached.
Keith (Gout Admin) said:
Sorry for editing your post, Hans. Just removed the salesman's link copied from the original post ? now deleted.
That's OK, Keith. I only took the trouble to respond to prevent others from doing what he wanted.
?By the way, do you know that there are three “asses” in the States? I won't mention the first two of the alphabet, but the third one is a “Texas(s)”, and as we all know we got lots of them.
Keith (Gout Admin) said:
…. OK, it's from 1905, only 106 years ago, but that is when Hans was in his prime.
[ducks for cover]
I'll wait until I'm sober before I respond properly
Yeah, you better sober up, because those critters in 1905 are still doing their tricks!? in 2011, just like they did more than 4000 plus years ago!!! Welcome to reality.:snile:
zip2play said:
I think it is not necessary to differentiate the particular attachments the urate ion has made, whether with an H+ or any number of Na+. Both forms are present and the quantity of one versus the other depends on the concentration of H+, i.e. acidity.
I think it IS “necessary to differentiate the particular attachments the urate ion has made”. The acid and/or urate in the blood and in the synovial fluids may (and probably) are in an ionized state, however, I strongly doubt that the tophi are in an ionized state. If they were, they would come and go as they pleased.?AND THEY ARE NOT! That's where my disagreement with Keith comes in.
I am certain that what is flowing in the bloodstream and what is settled out in old tophi contain both the acid and the monosodium urate, and even the disodium salt. All are equillibrium solutions.?Only the relative quantities of? components?change. I think all we might say is that at normal body temperature, MOST urate in the bloodstream is the weak acid and MOST urate in tophi exists as the monosodium salt.
I tend to agree with you here, Zip.
They cannot be sure even when testing how much of each exists because the mere action of chemical reagants is exttremely likely to change the mix and any testing solution used is going to be vastly different from plasma.?Thus the only thing they can be really sure of is the total urate content.
This is where I have great doubts. What are they testing? Are they testing all three, the acid, the mono and the disodium or only the acid? That number: mg/dL, what does it cover?
What is so difficult for an experienced bio-chemist to determine the % of UA, MSU, and DSU in a solution, be it blood serum, synovial fluid or what ever liquid medium??? This has been my gripe. NOWHERE can I find/get the answer.?
?
There's a long old discussion of solubilities of the various forms of urate but, alas it is a Springer Link and thus $$$$ to read. As I vaguely recall the solubilities of urate forms do not differ much between UA and MSU.
Read this: http://www.jbc.org/content/1/2/177.full.pdf ?ON THE SOLUBILITY OF URIC ACID IN BLOOD SERUM.
I have? taken to referring to serum urate and urate deposits?and I think that is as good a term as any other. It's about as clear as the subject will allow.
Keith (Gout Admin) said:
In a discussion on organic chemistry, the best you can come up with is sodium chloride and hydrochloric acid
??!!Just being facetious to show the difference between a salt and an acid where a sodium ion was replaced by a hydrogen ion (just like in UA and SMU.)
Don't be thinking of training to be a teacher
.Not in ?million years, if I still got that many left!?
I remembered the missing factor regarding the stability of the bond. Vital but forgotten. It holds all the answers, yet you are adamant that “Those bonds are so strong that it can and will ?stay for years or ever attached like a barnacle to your bones“
So come on, Hans. Earn your smilies and explain that one. Proper references this time please.
Reference is ME. Those tophi have attached themselves like barnacles to my feet and are still there after many years and 6 months of Probenecid and 14 months of Uloric.
Keith Gout Advisor said:
hansinnm said:
?
You “thought you knew the difference between ionized and non-ionized”. Please, tell me what it is,
Hans, the posts I made on 22nd are exactly what I think the difference is. Do you think I just conjured it up to annoy you? “Hell, NO”
??I guess I'd better explain why I think what I think, cos it don't look like I'm gonna get any help unless I crawl [You don't have to crawl. Mother Nature does a hell lot better job on you than I ever could!] (before you blow, remember the humor that NEVER comes across properly in the written word, (yeah, I know, but you and I are trying our best, don't we?).
I think an ion is a charge due to an imbalance of electrons and protons.?Kind of but not quite. Per Webster: ion 1: an atom or group of atoms (molecule) that carries a positive or negative electric charge as a result of having lost or gained one or more electrons. 2: a free electron or other charged subatomic particle. I also think that is what determines if something is classed as an acid or base (alkaline). I believe that when salts are formed, a bond is made between the acid and the base which balances out the negative and positive charges. It's not that simple. You could take a 50 lb bag of uric acid and a 50 lb containre of sodium hydroxide and dump them together and nothing would happen, unless you dumped that bag of uric acid into water and also dumped that bag of NaOH in another drum of water and put them together (and you have to do a few ?more abracadabras to get Monosodium urate.) ?I assume that this state is what is meant by non-ionized, i.e. protons and electrons in the salts are equal.?so are protons and electrons in acids and bases when they are not ionized.
Now, if those memories of high school science and assumptions are wrong, I would love an explanation of why they are wrong. I hope I explained it enough, if not, then I permit you (am I not nice?:smile:) ?to consult Professesor Google. I know I can spend time searching for the answers, but I would expect members of this forum to save me some time. I have no doubt that Internet is full of the same crap about basic chemistry as it is about basic gout. In my defence for being too lazy to research it, I was not the one who raised the subject in the first place ? if I had done, I would have created a separate topic. 🙂
OK, back to my knowledge and my explanation of why I wrote what I wrote about ionized and non-ionized states. As I'm not allowed to use Google, I cannot remember if acids are positive and bases negative or the other way round. I'm sure if I go for a walk I will remember, but I don't have time as my wife is finishing work soon and she needs me more than you do.
When I apply my limited knowledge of chemistry, to uric acid I see that in it's pure form it has a proton/electron imbalance. NO,NO. ?Uric acid, in it's pure form, has NO? proton/electron imbalance.
?I call this ionized UA. It is NOT ionized in its pure form. When it combines with what? to become monosodium urate, I see that as the non-ionized SUA.
Monosodium Urate is NOT non-ionized SUA. MSU is one of the salts of Uric acid. I recall from my studies of organic chemistry that, unlike inorganic chemistry, the bonds are far from permanent. Not when it comes to MSU. Those bonds are so strong that it can and will ?stay for years or ever attached like a barnacle to your bones. (That's why I agreed with Zip on his statement concerning ? tophi.) I also recall that heat and pH are primary factors in the stability of the bond. I have an inkling that there may be other factors, but your Google ban prevents me from looking (I hope your ban is only temporary, Hans ? I can't live without my Google 🙁 ). Please, don't cry. It tears my heart out. I DID lift the ban on Google, as you know.
That is why I refer to uric acids in the way that I did. That is why I think of UA and MSU as two states of the same thing. NO, THEY AIN'T, as, I think/hope, I have sufficiently explained. That is why I thought I knew the difference between ionized and non-ionized. Would you say that NaCl (regular cooking salt) and HCl (hydrochloric acid) are “two states of the same thing”??? If you need convincing, just lick some salt out of your hand and some hydrochloric acid (if your hand will cooperate with you)? and YOU tell ?me!!! (Let me know before you do and I'll make sure you won't find me when you or your henchmen cross the ocean to come after me.)
There is no point in discussing the rest if that is wrong, but you can be sure that, once you have pointed out the error of my ways, I shall tackle your original questions and subsequent comments. Have fun!!!
Please be gentle with me ? I've had a particularly hard day following a particularly hard few months.
Sorry, Keith, that I got you tangled up in one of my character faults: stickler for accuracy. But it is ALL YOUR fault. I never thought you could/might be wrong! (And you can paint the emoticon yourself, since you robbed us of them.)
?
I shall try my damnedest to be “gentle with you”. I hope I was.
Keith Gout Advisor said:
I thought I knew the difference between ionized and non-ionized – otherwise I would not have written what I did. I'm not looking for a lecture, just an explanation if I got it wrong. Or are you saying only Google can give me an explanation?
No, I am not saying only Google can give you an explanation? Google is the easiest and fastest way of getting an explanation without going back to college and taking a course in basic chemistry.
You “thought you knew the difference between ionized and non-ionized”. Please, tell me what it is, without consulting Google and I'll give you an explanation why/where you are wrong (in your previous comment on Aug.22,)?
Keith Gout Advisor said:
hansinnm said:
Keith Gout Advisor said:
?but from all I've read, for gout control the difference between MSU and UA is not significant?.
“? is not significant…”
That's where I very much disagree. It's MSU that make up the tophi, not UA. And my tophi are still there. It's UA that goes through your blood, not MSU.
?1) I do not think your final sentence is right, but I could be suffering from mumbo jumbo overload.
2) Surely the serum uric acid test includes both uric acids – the non-ionized UA and the ionized MSU???
3) From this, the reason that there is little or no non-ionized UA in tophi is to do with the pH of the fluids in which tophi are found, or originate. Studies of kidney stones – the equivalent of tophi in urine – seem to dwell on the non-ionized UA form, as this is predominant when pH is less than 5.75 (from Walter G Barr, Uric Acid, on PubMed). pH can't get that low in blood or synovial fluid, so the prevalent sodium ion attaches readily. I can''t find any data on how long it takes for UA to ionize to MSU, but does it really matter?
4) Allopurinol gets rid of tophi. Who cares about anything else?
?
By the way, the Barr reference contains some hideous nonsense about normal uric acid levels, which is the main reason it does not get a link. And the answer to who cares is (among others) me.
Keith, you are walking on very thin ice. Get off before you break through and drown.
Ad 1) Prove it to me. I have spent hours to find out, but no such luck.
Ad 2) First, if UA and MSU were both part of the mg/dL number then we'd be in deep doo-doo. To my knowledge, the reagents used in the tests to check a specific item in the blood are specific for that particular item.
And let me tell you again: URIC ACID (ACID) in not the same as MONOSODIUM URATE ([acidic]SALT) which is not the same as SODIUM URATE ([non-acidic]SALT). I am not going into Sodium urate since we ain't gotten any of that in our system (at least, I don't think so.)
Second, what are you talking about: “non-ionized UA and the ionized MSU”?? Do you know the difference between non-ionized and ionized? I am not going to give a chemistry lecture here. (Any one interested, Google it!)
Ad 3) UA does not ionize to MSU. It just exchanges one or two Sodium atoms for one or two Hydrogen atoms (while in an ionized state for which they have to be in the proper medium.)
Ad 4) Allopurinol DOES NOT get rid of tophi (not as such) .
?All it does, is preventing our metabolism to turn purines into uric acid and thus helps our metabolism to deal with the effects of too much UA in our system.Keith Gout Advisor said:
?but from all I've read, for gout control the difference between MSU and UA is not significant?.
?
“? is not significant…”That's where I very much disagree. It's MSU that make up the tophi, not UA. And my tophi are still there. It's UA that goes through your blood, not MSU.
zip2play said:
?I feel pretty strongly that tophi will persist even with a serum urate of zero. ?
As I said in an earlier comment to your post, I agree with you. Please, put on your thinking cap and help me out!
?
As I woke up this morning it hit me: There is quite bit of “good stuff” written about gout and uric acid and monosodium urate and a hell of lot more “mumbo jumbo stuff”. While it seems quite natural and easy to me (having been a chemist in one of my past lives) to see uric acid turned into MSU which make up those tophi, (Mother Nature is a hell lot better bio-chemist than we are), I can't see for the life of me how MSU is turned back into UA. I haven't seen/found any body yet to “mumbo jumbo” about THAT. It got to be UA (not MSU) to get transported by the blood to the kidneys for them to get rid of it. ?Right???
Sooo, how do we get rid of tophi??? I know, I got rid of some it by having a doc scraping the living daylight of the bones of my index finger, but my big toes still look like a disaster area. (I can/could provide pictures if no one believes me.)
I spent hours today, reading about MSU and UA. You almost got to have a PHD to understand their “mumbo jumbo stuff”.
?
So, Zip, if you still got any time left between your six packs, can YOU tell me????
zip2play said:
…
Lesson learned: rich dark beer in quantity?CAN set off a gout attack, even when it's on sale for $5.99/ 6-pack! and even after all these years.
You should drink “HansinNewMexico Stout” and only a bottle at a time then you wouldn't have to learn lessons at YOUR age.
Wrave said:
My parents nor grandparents vote.
Sorry, forgot to say: All those parents and grandparents.
?I am seriously thinking of moving to Canada for that very reason. ?Free health care (government run or not) is a good thing.
The sooner the better for you. That big US of A warship is taking on water and about to go where it has sent others to in the last 100 years.?
Any tips on how to get rid of the redness and swelling?
You got to get your immune system back into order and (in my opinion) only a good doctor (preferably a rheumatologist in your case) can help you. You ain't gotten just a swelling and redness from a bee sting! Gout is is a far more malevolent beast (unless you got it tamed) than a little (generally quite peaceful) bee.?
?
?My parents do not see the big deal and I know I really need to get a hold on this. ?While i do have health care through my step dad, they don't want to take me to a rheumatologist unless the symptoms persist. ?They do not see the need to spend all this money on me for just a simple disease that they think will be a one time thing. ?I read that some glucose testers have a UA setting and I am going to look into that because I really want to be healthy.
You are between a stone and a hard rock. The stone: not having a doctor knowledgeable about gout and a hard rock: parents who know even less about it.
?However, you are 1 in a 1000 who is made aware of gout at an early age. You don't want to reach 80, if you ever will, with your joints crippled, gout attacks ?forcing you on all your fours to crawl to the bath room (and I am not kidding) and whatever else can, and quite often, will happen.
You may think that I am trying to put the fears of god or the devil in to you. Far from it. They are just figments of imagination. GOUT AIN'T! It's more REAL than the most “powerful god” or “devious devil” you can imagine.
And yes I would love that site.
Wrave said:
When I can find the cash, I am going to get a tester. ?Here in the US everyone is against free health care for some reason.
?
And the Cherry Juice is to help get rid of the swelling and redness.
Please, do yourself and your pocket book a favor: Don't spend money on cherry juice “to help get rid of the swelling and redness.” You won't.?
I have been drinking one ounce of concentrated juice for more than five years. ( Yeah, I started for the same reason as you try to do.) It is healthy, I like the taste and it has lots of antioxidants. Like other people drink OJ, I prefer CH J.Man, you got your whole life ahead of you. don't start skid-row at age 20. And I don't mean the alcoholic skid-row, but the gout skid-row. If you got genetic gout (and you seem to indicate that), you have gout for life. Get hold of NOW. ?You MUST get the exact uric acid level in your blood, regardless where it is rat now, you must get it below 5mg/dL.
I feel for you but I can't be sorry for you. 1. It wouldn't help you anyhow, and 2. you have to thank your parents and grandparents who voted during the last 30-40 years. The only advice I have: Try to find someone (friend or relative) on whom you can rely who has some knowledge of how to beat one of the, if not the crookedest health system in the world.
Keith (Gout Admin) said:
The survey, along with one for home test users is now at Uric Acid Blood Test Debate
Keith, I have to agree with Zip. There is something basically wrong with your survey. I had answered some questions before and went back today to follow up. I had answered Q. 1-3 but not 4 the first time and today I answered Q.4. I should not have been able to do that since 2 & 3 cover 4. And the number of answers don't jive with the number of total answers given. As Zip said: “The questions and answer-ability are incomprehensible.”
?I just went back and voted again the same way I did before. I am sorry I am screwing up your survey. But you better find out rather NOW than LATER that your survey has been tampered with.
To have any credibility for your survey you need (must) know who the person is who gave the info. And you got to have a built-in device to prohibit multiple times of voting.
I, for one, would not trust anyone who NEVER visited your forum and contributed some kind of comment relating to his/her experience with gout. I would accept members who don't have gout but are speaking for their mates, parents, or siblings.
zip2play said:
Dr. Buff,
Re those horrific tophaceous pix on the web (and in medical books), no they will not resolve in a couple months?maybe a couple years. Big enough tophi that are mangling the function of a joint must/should/may be removed surgically.
And even then, they , generally, can't be removed 100%. I am living proof. (My doctor, just to cover her, you know what, told me before she got started that she could not remove every bit of tophi.)?
At a SUA of 3.05 (talk about?medical personnel?not knowing what significant?figures??mean??? maybe it was 3.05127932? ROFL) I think you are doing as well as you can and should see significant tophi reduction without too much pain in several months. Keep measuring your uric acid, and to 1 decimal point is MORE than close enough.
?Yes, that is as good as medical treatment gets so try to stay there. As GP says, EXCEPTIONAL.You will not remove all your tophi with meds nor can you restore any erosion that has occurred because your doctors were incapable of diagnosing the oldest disease in time?I'm sure they were busy measuring your blood pressure, which is what they do best.
I am not so sure about that. First, a “Nurse' or “Medical Assistant” takes the readings, and second, instead of rejoicing when you have a “low” BP, they rejoice when it is high. Because they feel justified to write you a prescription for their shitty BP meds.
Remember, we remove uric acid by a few hundred milligrams and tophi weigh in at ounces or 30 grams per ounce ?or 30,000 mg. per ounce. Add to the fact that the deposits are walled off by fatty deposits, pus and, scar tissue so drug treatment may not reach them. That's why it's so important to prevent their formation.?So the net is that some tophi you will have to live with unless you want to resort to surgery. Caution: I doubt that many surgeons are good at this anymore?too busy with brain and heart surgery that pays better.
Luckily, I found one. Even though she couldn't remove it all, she, at least, put my index finger back into operation again. And now, 10 months later, I can say that she did a fine job. (Well, if anyone is interested, I have commented in detail on that operation and ensuing consequences on this forum during the past year.)
(I am beginning to think that more of us should be on probenecid?but I have no experience with it.)
ps?If you are getting UA levels of 3 with probenecid, do not worry about under or over excretion because it is obviously the right drug for you.
Here is the reason for opening up your comment again: I had be been on Probenecid from Feb 2010 to July 2010 when I started with Uloric 40mg. After reading about some research with Allopurinol/Uloric and Probenecid combination on this forum (about 5-6 weeks ago) I decided to also do me own research and added 500mg Probenecid (5 weeks ago) to my 80 mg Uloric/day.
My SUA was 5-7 mg during the 80 mg Uloric phase and has dropped to 3-5 mg now. I'll have a COMPREHENSIVE METABOLIC PENAL TEST done in a couple of weeks, to make sure that my body approves of my “high-handed”, unapproved (I haven't asked nor told my doctor about, yet) research.
One good thing came out of “painreliefindia”'s post: It got me to read again all those comments made back in Nov/Dec of 2009. (Co-incidentally, Dec 13, 2009, the date of your post, was the day I discovered and joined GoutPal.) And, as I have said so many times, besides Keith, you generally hit bull's eye right on.
candy40 said:
… and I am very scared of the side effects. …
Candy, have you read all the info which Takeda has published on Uloric? What dosis are you taking?
“I have gout and high uric acid levels. I also have chronic renal failure (before use of meds)” .
Has your doctor ordered a COMPREHENSIVE METABOLIC PANEL TEST? It is most important (particularly with your renal history) that s/he does so since gout-fighting meds can/may have an affect on liver and/or kidneys. (Keep track of all the numbers relating to liver and kidneys to see if any changes [especially negative ones] occur while taking any kind of gout meds.)
Keith (Gout Admin) said:
?
That's a tricky one Hans, but it raises issues that strike at the heart of gout management.
?
My view is that statistical gout studies can give us pointers that suggest ways that we can understand our own gout better. However, only personal analysis can tell us as individuals what we might get? most benefit from.
Thus, if we live in a hot climate, and dehydration is a risk, it is a fairly easy self-experiment to try drinking 2 to 3 liters of water during the course of the day to see if it helps.
Going a stage further, we know that individuals react to uric acid crystal deposits differently. Some people get the intense, painful swelling at the first hint of a crystal floating around. Others can spend years growing beautiful invisible tophi, and barely notice!
I fall between the two, with (up until recently) frequent swollen joints, but nothing that a few ibuprofen couldn't handle. And going back to day one of my gout journey, I failed my inexperienced doctor's gout test because the swelling was in my ankle, not my big toe.
?
When it comes to gout, it's very much “each to his/her own.”
As usual, Keith, you almost always hit the nail right on.
While I agree about the values of statistical studies, however, if they are sporadic, and possibly money/profit/recognition motivated (which quite often is not apparent or easily visible) statical studies murky the issue more than they clarify.
Hot climate or not, our bodies “should” be properly hydrated, but our laziness (I am speaking strictly for myself) is the biggest monkey wrench in that process. Besides, we sapiens homos can always find a very reasonable, “intelligent” excuse what/how to substitute, like one six pack of suds (6x12oz= a little more than 1/2 gallon of water) will do the trick.
And, of course, the individuality of gout attacks, tophi and SUA levels responsible for gout.
Yes: ” When it comes to gout, it's very much 'each to his/her own.' ”
