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Ravenwood said:
So in layman's terms, I would be accurate in telling the doctor, “6.8 might be fine for someone who does not already have gout, but since I do, it's still high enough a concentration for me to be developing urate crystals.? Therefore, write me the bloody script, damn yer eyes.? Please and thank you.” ??
Ravenwood, you have basically two options:
?1) You accept your doctor as your MASTER and GOD and say:YES MASTER, YES GOD, I am your obedient, dumb, ignorant slave and do as YOU say and even pay you for that privilege. ? ?Or
2) You can say: Dr. So-and-so, I am here not to argue with you but to request a prescription for Such and such medication of such and such strength. (Remember: S/HE is there to help/serve you, NOT YOU to serve HER/HIM. Even, though that is the attitude many doctors take today.)
You'll encounter three possibilities:
1) S/he is an arrogant asshole and won't give in. Ask for an immediate bill and leave. Don't waste your time arguing, pleading, begging. You can't win if s/he is a real asshole, unless you are a bigger one.
2) S/he gives you a logical, sound reason for not wanting to give you what you want.
3) S/he will give you what you want, but will also make you aware of the possibilities you may encounter. That puts the ball in your courtyard and it is YOUR responsibility to accept the future consequences. Remember, it is YOU, not HIM/HER who suffers the negative or enjoys the positive results.
?
To illustrate with one of my own experiences with my doctor (a rheumatologist, a woman from India):
1) In July 2010, when I saw her the first time, she prescribed 40mg Uloric, since I was allergic to Allopurinol. (She would not even consider trying Allo again since 15 years had gone by.) My SUA level was 6.5/5.8 (Home kit vs. SED lab test. I have explained in earlier posts the difference between home and lab test results.) ?I told her that there is no way I could pay $5 a pill/day. She gave me referral to one of the doctors who has a contract with the health organization who provides me with a 0$ health plan. This doctor gave me 40mg Uloric for ~12 weeks, (till next appointment with my rheumatologist.)
2) In mid-September, after 10 weeks on 40 mg, my SUA was 7.5/5.8mg/dl. Since no real change in y SUA had taken place, I requested an 80mg Uloric prescription. And here my #2 possibility from above occurred: She said that I should stay at least another two months on 40 and have another lab test to confirm that my liver and kidney vitals were all in the normal range. That made sense, since we do know that, particularly, healthy kidneys are important for combating gout. In the meantime, I had been accepted by Takeda for their free medication program and had received the first 3-month supply of 40mg Uloric.
?3) In late-November, after, now, 4+ months on 40 mg, my SUA was still at 7.0/5.2mg/dl. This showed that 40mg Uloric did not have the expected results of lowering my SUA to 4-5, as Takeda had predicted/promised. She, consequently, wrote a prescription for 80mg Uloric and faxed that to Takeda. So, now, I have been on 80 mg Uloric since mid-December.
4) Unfortunately, my SUA level has not significantly dropped, yet. Last home/lab test (mid-February) was: 6.1/4.2mg/dl. The home test trend line is even going up slightly, approaching 6.8mg/dl. HOWEVER, I have not had any gout attacks (worth its salt) since last September. Oh, I had a few twinges, here and there; on a pain level from 0-10, not more than 1-3, and that is in my book acceptable. Let's not forget, I have been nibbling on the wine bottle (3-4x a week, and once or twice a month on the gin bottle since Oct/Nov. However, I have not yet opened one of my home brews. That has to wait till I am constantly under 4-5mg/dl. And, what is more important, all, and I mean all, my COMPREHENSIVE METABOLIC PANEL TESTS RESULTS ARE NORMAL.
(Keith, why can't I insert an image/table???)?
Ravenwood, I hope this lengthy, detailed explanation is of help to you.?
limpy said:
Your both lucky to find doctors like you have.
You are right. And here is some advice to you and whoever wants to take it. Go to:
http://www.healthgrades.com/directory_search/physician/profiles
This URL will take you where you'll find out who is a good doctor and who is not. You can also find one who is in your neighborhood.
toofast said:
Guys, remember not all Doc's are bad…find a good one and you will be in good hands.
?
EXAMPLE:? My doc just wrote me a script for Colchicine…told me HE BETS if I took this and went to a pharmacy in Canada I might be surprised!
?
NOW this is an example of a Doc working with you!
You are right. There are a few decent doctors left, however, they are far and in between. My doctor, a rheumatologist, a woman from India, I must add, has been very cooperative and good to me.
limpy said:
Hansinnm,?i know your right it just ticks me off that a person can buy the same drug just accross the boarder for 1/10 the price. And the doctors we hire to keep us healthly stand by and won't say a word against it. LIMPY
50 years ago, doctors did try to keep or make us healthy. Not today. Now, they are trying their damnedest to keep us alive but not healthy. Dead, they could not make any money, but alive and sick they and the pharma boys get rich beyond dreams. The only thing that puts the brakes on the doctors are mal-practice suits or threats thereof.
limpy said:
I've come to the conclusion that most doctor are hypocrites.?I talked to my Rhumatoloigist on the phone yesterday.?I told him?I found colchicine? from Canada for a lot better price he basically said he couldn't or wouldn't?write me a?prescription but he wouldn't turn me in if i was able to get it. Man?I was hot when?I got off the phone. Turn me in !? ?For trying to find a cheaper way to deal with pain. After all the money he's made from me and my insurance company.?They need to drop their phony oath to help patients and be truthful and swear their allegiance to the drug companies. I don't know how many times I've been waiting to get in to see a doctor and have a drug rep walk in and get hustled right in to see the doctor. That kind of tell you right away where you stand. Sorry about the rant guys?I just had to let off a little steam. LIMPY
?
Limpy, don't let the pharma and medical industrial extortionists let your blood pressure get up too high. It ain't worth it. All it does, it will only cost you more money (what they want) for BP meds. Just accept those facts, since YOU and NOBODY else is going to win against them. They got the money and the power to squash you. The pharma extortionists got the medical and government extortion terrorists in their pocket to do the dirty work for them.Talking about terrorists: No foreign terrorists have harmed the American people more than our own government, like e.g. the FDA siding with the pharmas, and the Obama Administration giving hundreds of billions of Dollars of American tax payers' money to the industrial crooks (and CEO's) of the banking, insurance, and Wall Street industries.?
limpy said:
Hansinnm, Thanks for the help why didn't I think of that. Oh wait I did one site says low chance of doing any harm another says very risky. So I thought this being a great place to get peoples opinions I'd ask here. For me Google isn't always the best place to get answers. LIMPY
You are right Limpy. It takes experience and quite a bit of knowledge to pick out the right crumbs what you see on the Internet.
?I have used Naproxen for nearly 27 years with always good results. I have never taken more than two pills per day and only as long as the major pain would last. Generally 2-3 days. Never more than 5 or six days. This was always in addition to 2 Colchicine per day which I generally continued to take for 3-7 days after I stopped taking the Naproxen, depending on the severity of the attack..
However, don't for get, what is good for the goose is not necessarily good for the gander, despite popular acclaim. As has been said many times on this forum: Each individual has to make up his/her mind which way to turn and to go. You know what I mean.
limpy said:
…. The same doctor that gave me the Naproxen said it was heart healthy anyone heard of this? If I remember the first warnings on this drug were stroke and heart attack. Any input on this will be greatly appreciated thanks. LIMPY
Why don't you google naproxen and see for yourself.
odo said:
sdgfrofg said:
?Any brands of SUA self testers you or indeed anyone else can recommend it would be appreciated. I think it might be? wise purchase.
This is a good one that many people have:
uric acid test meterGet an extra box of strips, you tend to get through them pretty quick at first.
I second Odo's recommendation. I have used that kit since Dec. 2009 with good results. In order to avoid using/misusing too many strips w/o proper results, make sure that you get a large enough drop of blood. 1/8″ drop always works for me.
toofast said:
I tried searching, but could not find any reference to this subject.
?
Sorry if I missed it….but what is the BEST way to safely store a large supply (100 pills) of colchicine.? I got this filled RIGHT before the price increase and since my gout is pretty well under control…I won't be needing all of these in the next few months.
?
The bottle says to discard after 1 year…but there HAS to be a way to prolong the life of this life saving drug?? Please let me know your thoughts on the best method…and also how long MIGHT i expect the stored product to last.
?
Thanks!
I have stored Colchicine in the freezer for 15 years and it never lost its potency.
sdgfrofg said:
I am curious to know if I have gout?…
Based on, ?Janssens clinical prediction rule? (see below) I score 6. Gout is highly unlikely with a total score of? less than 4 and is >80% likely with a total score of? greater than 8:
* Male sex?2.0 points (I score 2)
* Previous arthritis attack reported by the patient?2.0 points (I score 0)
* Onset in <1 day?0.5 point (I score 0.5)
* Joint redness?1.0 point (I score 1)
* Involvement of first metatarsophalangeal joint?2.5 points (I score 2.5)
* Hypertension or one or more cardiovascular diseases?1.5 points (I score 0)
* Serum uric acid concentration >350 ?mol/l?3.5 points (I score 0)
So I would like to know the following?
1. Based on the clinical diagnosis of the symptoms I presented with, have I gout?
2. Is it worthwhile get a synovial fluid analysis to check for the presence of CPPD crystals, to confirm the diagnosis?
3. GP suggested that he would put me onto other medication when I had a return visit which
incidentally is now overdue as I reduced the dose of Colchimax, which I am still
taking. I guess the new medication might be NSAIDs but I have no idea.
4. Is it advisable to try to manage the condition without taking medication in the long term?
Ad Janssen Rule: Your 6 out of 8 may not be correct. Unless your doctor gives you the EXACT number of your SUA you (and nobody) will know where you are. So before you do anything else get that SUA value. Then we'll talk again.
Ad 1.: Possible, but not for sure.
Ad 2.: Not yet. Again, until you know your SUA value.
Ad 3.: Before you enrich the pharma crooks, you need to know what medication he is trying to push.
Ad 4.: It's unlikely that you will/can manage TRUE GOUT without meds in the long term.
Thanks again, Keith.
“Who are you going to believe, me or your own eyes?”
I believe you and my own eyes. Lucky for me, I had a thorough eye examination this last Thursday, including two special eye tests(forgot the names) and I am pretty sure that I don't have any gouty eyes. Another reason to get solid 8-9 hours a night sleep.?
zip2play said:
?… This would be hilarious but for all the pain it is causing.
Thank you Mr. Obama.
Zip, this country deserves him, since greed, money and the dumb asses who voted for him put him there. Wait till they have to pay for insurance they can't afford and then been forced to pay penalty because they can't afford or don't want to line the pockets of the insurance extortionist with their hard earned money.
zip2play said:
?… Colchicine does things that no other drug does….
Thanks, Zip, for shedding more light on the inflammation issue.
I second your Colchicine comments. It has terminated attacks/flares/twinges/inflammations in 1-4/5 days for me. Half of the time without having to take any additional pain killers, like Naproxen/Aleve.
toofast said:
Be very careful with a rheumatologist
That holds true of any physician these days.
I was told I HAD to go to one…after thousands of dollars of BS tests, wrong drugs, him telling me I DON'T have gout, I found a good Family Physician who UNDERSTANDS what gout really is and how to treat.
I agree. If you can find an old-fashion family physician (that is if you really can find one these days) I'd had more confidence in him than the new, young , pharma-instructed, so-called medical industry employee (my definition.)
?
I am not on my way to solid gout mgmt.
If you have gout, you better do or you wind up with what I have documented here on this forum in words and pictures.
?
Honestly if you go see a rheumatologist – YOU MUST ask for references of people he treated for GOUT.? Most try to say you don't have gout.
good luck!
simonbrooke said:
Hansinn,
??During attacks, my GP used to have me on Ibuprofen (1200mg per day) but I went back to him in the early stages of this attack because I thought it was not really helping much. So he put me on what he described as maximum dosage Naproxen (1000mg per day). This too didn't seem to be doing much and I concluded that I had become NSAID tolerant. I have since read that NSAIDs do not deteriorate in efficacy with extended use, so I must have been be wrong. Given that I was no further forward, I asked if there was anything else I could take to complement the Naproxen, giving me more cover throughout the day and hopefully more powerfully at night. He reeled off a list of possibilities (paracetamol among them) but they all seemed too weak. As I said in an earlier post, he didn't want to give me Colchicine (I think it may have been to do with stomach/bowel upsets). We settled on Codeine (which I've since found, also gives digestive problems). It beats the hell out of me!
??Surely though, this must be a common problem; no matter what NSAID you take during an attack, you can only cover 12-16 hours of the day? Most likely this leaves you overnight, without any relief. How do people deal with this? I'm hoping that I can use the Codeine just before I go to bed and then once more during the night, should I need to get up for a pee (which is very likely, as I'm drinking water and tea like a mad thing)
?
Simon
Simon, as I have said in my earlier post, as long as you don't deal with the cause you are just doing what the majority of so-call doctors do: Treat the symptoms, don't eliminate the cause, or we will lose our jobs and a very nice, easy income. (Besides, the pharmas would go broke, too, and they put a good chunk of $ in our pockets.)
You can take all the pain killers in the world, if you don't eliminate your cause: INFLAMMATION you are out of luck or out o' brains. (Sorry! I, really don't mean to offend you, it's the medical profession who has lost its brains and substituted it with greed and ignorance.)By the way, “stomach/bowel upsets”=diarrhea=shits is a common occurrence with a lot of meds. It's your call how far/fast/long you want to go/run!!!
zip2play said:
??I think the only real competitor to colchicine for pain relief are steroids like prednisone?or the really hard drugs like opiates. But ONLY colchicine will actually work to STOP an attack.
?? I cannot afford daily cherry juice (can anyone?) 🙂
Zip, I have a slightly different point of view on your Colchicine/steroids/opiates.gout attack issue:
?
A gout attack is accompanied by an inflammation which generally is accompanied by pain. Inflammation and pain are two different issues. They are both symptoms, not causes of the attack. The real issue is the cause: An increase of uric acid in your system (of course, there is are reasons for that to begin with) which generally trigger the deposition of those nasty critters, called uric acid/mono sodium urate crystals, which cause the inflammation, which causes the the pain.
Now, if you want to first deal with the inflammation (the symptom of the attack and the cause for the pain)i, you take the Colchine which ?is one, if not the best med for gout inflammation. (Colchicine does not reduce the pain, but the inflammation, which is the cause of the pain.) If you are in excruciating pain, you SHOULD take Naproxen or better Aleve (cheaper and just as effective.) Forget opiates, unless you are looking for some expensive highs. (There are cheaper ones than opiates.)
?
Yes, I can afford cherry juice.
Montmorency (black, tart) concentrated cherry juice. 8×1/2 gallons, including S&H $169. That is ~$21 for 2 months of a daily cherry juice drink (1oz concentrate/day), that is 35 cents a day. ?How much do you pay for a glass of orange juice?skyhigh said:
Follow doctor's advice. that's the best way to solve I mean to cure your condition.
What kind of a doctor (Podiatrist Melbourne) are you? If he has gout, you should not tell him that there is a cure for his condition. Gout CANNOT be cured, only managed/controlled, as all gouties will tell YOU.
Gerry said:
?56 what I dont know, but I will mention this to my doc at next visit.
Gerry, as I mentioned before, make sure your doctor orders a “complete metabolic panel test”.
?
Get all the figures (numbers) of the various tests. Watch the BUN (Blood Urea Nitrogen) and Creatinine numbers carefully, since they tell the story about you kidneys and the ?Albumin, Alkaline Phosphatase, ALT, and AST numbers tell the liver story.
Here is a URL which gives you detailed info about any medical test for almost anything a doctor wants to know about or keep an eye on:
http://www.labtestsonline.org/understanding/analytes/liver_panel/test.html
Here is e.g. what you get when you put the word : Creatinine in the Search field:
Creatinine
Also known as: Creat; Cre; Blood creatinine; Serum creatinine; Urine creatinine
Formal name: CreatinineRelated tests: BUN; BUN/creatinine ratio; eGFR; Creatinine clearance; CMP; BMP; Urinalysis; Urine protein to creatinine ratio; Microalbumin
The Test
How is it used?
When is it ordered?
What does the test result mean?
Is there anything else I should know?
Your number 56 refers to the so-called eGFR CLASSIFICATION which has to do with your kidneys filtering Creatinine. The higher the number the better the filtering process. <15: Kidney Failure or receiving dialysis. Just one example.
They give easy to understand explanations and descriptions.
burgeszz said:
??My doc didn't prescribe me anything at all to take along with it and I don't want to go back to the doc?. ?any suggestions?
What kind of a doc do you have? The pharma boys must not have paid him too much under the table. With your gout attacks and pains he should have rubbed his hands and said: You are the perfect candidate for MORE meds, like Colchicine, or better yet Colcrys (the true scientifically produced and monitored medication of the modern man), and Naproxen (don't get that over-the-counter stuff:Aleve, that is not as good as the prescription drug. Remember the saying: You get the quality what you are paying for.)
?Now, all kidding aside: First get yourself a better doctor. Get your SUA checked so that you know where you or your body is. It's hard to navigate a road/life without roadsigns (your SUA is good sign to tell where you are driving.) Then make sure that you are getting the appropriate dosis of Allopurinol for YOUR condition. When an attack/flare starts take 1 or 2 Colchicines (0.6 ?mg) per day to fight the inflammation. Some, like Zip may even suggest 10/12-12/16 pills per day. (If you do, call in “sick” because you can't get more than 10-15 feet away from St. John without being sorry later on.) If you have excruciating pain, take additionally 1 or 2 Aleve to overcome that pain. (For me, 4-5 days 2 Colchicine and 2-3 days 2 Naproxen=Aleve generally do the trick. But that's me. Remember: Every goutie is different. YOU have to find your own niche.)
Gerry said:
…
I am a great candidate for infection as I have Non-Hodgkins Lymphoma which means my immune system is faulty and bacteria has a way of finding only me in a crowd. I have had Golden Staph infection after an operation on my leg which took 6 months to heal so I am very aware of that.
I don't know anything about that subject.
I gather from what you say that the white gunk coming out of my toe is monosodium urate? which becomes tophi or at least adds to the tophi that exists.
Yes.
My dilema is do I let this MSU continue to leave my body via the toe (which seems to be a good idea to me) or do I try and seal up the toe to prevent infection and thus leave the build up of MSU in the toe hoping I will get rid of it thru my urine.
That's YOUR judgement call. You can always have an operation on your foot/toe and have the tophi removed that way. However, I would consult a knowledgeable podiatrist on that matter. (I, personally, prefer to have NO open wounds on my body.)
This might not make sense as I am trying to learn and like things to be black & white (simple) (there is NO such thing as black and white when it comes to GOUT.) and have lost confidence in one doctor who I pleaded with to help me and was not willing to treat the cause for several months, instead just giving me a pain killer which I could not continue with due to side effects.
I would get rid of a doctor who is not cooperating and willing to treat the cause.
From reading items on this site I gather it could be a long time before the tophi disappears. I accept that if I know it will eventually disappear.
There is medical proof that tophi do dissolve over time (a year, more or less), provided your SUA is on the low side, preferably 3-4 mg/dl. ?
Gerry said:
?
Was it pus or urate or uric acid (still getting used to the terms)
What does the uric acid look like when it first breaks thru the skin ??
Gerry. I am kind of an expert on this, although I am not getting paid for it nor am I proud of it. I have been dealing with this for more than ten years.
?
You are actually looking at the least three different conditions here:
1) Dissolved uric acid in your blood, generally referred to as SUA or Serum Uric Acid, is the stuff which every human being has in his/her system/body/veins.
2) Excess uric acid (>6.8mg/dl) is generally excreted/deposited on your joints which is the cause for your gout attacks. But it isn't all that easy. You can read up on it here on the forum. This excretion comes in two forms/ways:
2a) White/milky stuff, looking like puss, but has a whitish color instead of a yellowish color. Consistency is pretty much like puss. This whitish looking stuff, I call it: Shit, is MSU (Mono Sodium Urate) or the salt of the uric acid (which, by the way, is also a solid, not a liquid like lots of acids.) It first shows up as a whitish bubble directly under the skin. People, like Zip and I, who don't fear god or the devil any more take matters in our own hands and puncture the bubble with sterilized needle (generally done in a hot gas flame (that's me, I don't know about Zip.) People who are afraid of dieing generally wait till Mother Nature busts the bubble or have a doctor do it. (I used to belong to them, in one of my past lives.
Now, one of the things you must be aware of, having become a self-acclaimed doctor without that piece of paper from an accredited institution, be it from a university, college, or the internet, that is: Infection. When you puncture, cut your precious body, there is always the risk (almost certainty) of? getting an infection. (Look at the thousands of people who go into a hospital, practically half healthy, coming out as a body because of a staph or other infection, caught in there. Why do you think they say: Operation successful, but patient died!?
Anyway, you must have some kind of anti-bacterial ointment to cover the open wound/cut/puncture. I use Manuka Honey +15, from New Zealand to prevent infection and speed up the healing process.
2b) The white stuff in the liqid “puss” generally settles out as what's called “tophi”. If you let the white, milky stuff sit on top of your finger or toe, it will turn solid into a whitish crust. That is also MSU. Generally, that will fall off after some time or get ripped off by accident with opening up the skin and bleeding. Be aware of infection!. (I got several “nice” photos of what I described here on this forum.)
I hope these explanations helped scarring the daylight out of you and every one else (except Zip.)
Gerry said:
…
As it happens my daughter's partner is a bee keeper in NZ and recently visited me and brought over 4 containers of manuka honey. I am a firm believer in the anti bacterial properties of honey so appreciate your suggestion.
Man, you are fortunate. If you check manuka honey and my comments on this forum you'll find what a literally life/foot/toe saver it was.
Keith (Gout Admin) said:
…
None of us live our lives in a perfectly logical atmosphere. Those lucky enough to reach their 80s see life much differently from people 30 or 40 years younger. …
As I have said in an earlier Post: Keith, “you come through with flying colors” ?and an excellent dissertation.
I can only say in my own defense for having been so “rough and tough” in my comments to other gouties was? because I have reached the 80's and having lived an ignorant, arrogant, stubborn, conceited life for more years than I care to admit or readily accept, I, now, want to save some of the ones in their 30's and 40's (I was there, too, once) what I have been going through in the last 12 months. Don't forget, I was approaching my 80's before Mother Nature really saw fit to let me have it. And in all honesty, it wasn't Mother Nature who let me have it, it was my ignorant, arrogant, , stubborn, conceited attitude which let me have it.
My gout problems started when I was already in my mid fifties and it was tolerable for almost 20 years, despite or because of my ignorant, arrogant, stubborn, conceited attitude, but the “finale” if it is/was the finale, is NOT anything I wish on any one.?
Keith (Gout Admin) said:
Hans, I'm only here to help and advise.
If someone wants to accept the risks of elevated uric acid, then they are perfectly within their rights to do so. Just as people have the right to smoke, partake in dangerous sports and many other aspects of the human condition, which is rarely bound by logic.
It only becomes unacceptable, to me, when the decision harms other people, or it is made in clear ignorance or through being duped.
…
Well, Keith, as usually, you come through with flying colors. I cannot but accept your expanation.
Gerry said:
…
I visit a podiatrist who scrapes the tophi from my toe. The last time she did this she noticed pus under the tophi in the cavity that remained. I then had a swab done by a doctor but that did not show infection.
…
Gerry, you seem to be doing all the right things to get or keep control.
Apropos Probenecid: How many mg/day are you taking? I was on Probenecid in one of my past lives and found out that one tablet (500mg) was not enough. I upped it to 1000mg/day and my SUA got in the 4-5 mg range. However, do not forget:That was for ME! YOUR metabolism may need more or less.?
Here is another thought you may want to consider: Living in Australia, you shouldn't have much of a problem to get your hands on Manuka Honey from NZ. +15 or ?+20 strength. Whenever you have an open wound (from tour tophi scrape or any other type) put a patch with that honey on it and change every 24 hours. It will close it w/i 3-5 days and prevent infection, too. (Google Manuka honey)
Gerry said:
…
I am now on Probenecid to lower the uric acid and a recent blood test put the uric acid level at 0.32 mmo1/L
This seems a different way of expressing it to anything I can find here.
I have had the tophi scraped off several times which was rather painful process, and as I have been unable to wear shoes (too painful)? for over 7 months, my toe keeps getting infected.
My main aim in life is for the wounded toe to repair and once again be able to put on shoes.
Gerry, you have a couple of problems here, if you don't mind me telling you that.
1) Your “main aim in life should not be for the wounded toe to repair and once again be able to put on shoes. Your main aim in life should be to manage your uric acid level in your body.
You are doing the right thing by using Probenecid. Just keep an eye on your kidneys and have a complete metabolic panel test performed. Your doctor, GP or rheumatologist will be able to tell if anything is starting to go wrong. Please, do not let my remark disturb you. It's just a precautionary remark.
Your blood test of 0.32 mmo1/L = 5.4mg/dl shows that Probenecid is doing the trick for you. (6.8 mg/dl is the critical point.)
2) Your more serious problem is your tophi on your toe. Don't try to scrape it off yourself. you do not want to get the inside of your toe infected. See a doctor and make sure you don't have an infection. I think I have a picture on this site to show what happens when an open gout wound gets infected. (Not nice. 4 days in hospital for surgery and $30,000 med bills.)
3) I wear Birkenstock sandals since shoes aggravate a gout -inflamed toe/foot.
toofast said:
… I personally would avoid a rheumatologist. (assuming you are in the United States)
?
they will most likely spend thousands of dollars on meaningless tests.? most rheumatologist as mentioned above do not understand gout.
…
I think you are a little too fast advising a gouty not to see a rheumatologist and that “most rheumatologist(s) as mentioned above do not understand gout.”
You are very wrong! If any doctor knows about and/or understands GOUT, that is a RHEUMATOLOGIST. It's most GP's who know little or understad less about gout.
Keith (Gout Admin) said:
…
A final thought on the pain vs uric acid issue. I was chatting with my gouty brother-in-law over the holiday. He is firmly in the gout pain camp. “What's the point of taking a pill everyday, when I only need a few pain-killers once or twice a year?”
A perfectly valid point of view, and I imagine he'd welcome the ice pack.
Keith, I hope that wasn't you who said that is: A perfectly valid point of view...
That is about the dumbest view point a rational, intelligent person can have!!! While s/he cuddles her/his pain brain, Mother Nature says: Have at it! I'll make damn sure you'll remember your stupidity down the line while I increase your uric acid in your blood.
Your gouty brother-in-law should apply for a job with the pharma industry. Since their motto is: Treat the symptoms, not the cause, he'd make an excellent salesman for them.
(Keith, I am really angry with you. I would have expected that statement from any body else, but not from YOU
, who always says: Manage your GOUT. I have NEVER heard you saying: Manage your pain.)stevieb said:
…? The only meds I've taken is 800 mg ibuprofen 3 x a day …
Ibuprofen won't do a thing for GOUT. All it does is covering your pain while Mother Nature continues behind the scene (pronounced: in your metabolism) to increase your chances of more twinges/flares/attacks by increasing your uric acid. Trev has already given you advice what to do.
Do your attacks coincide with having dark beer and shrimp, or other things
My attacks are mainly due to my overall diet.
Don't kid yourself!!!
From what I now understand, the uric acid builds up in my blood over time until saturation is maxed out and precipitation of crystals occurs ? a gout attack.? I often pull my left leg out from under the covers while sleeping, that's near a window ? left foot becomes a cool part of my body and *_boom_* there it is.
Quite true.
Beer and shrimp are not part of my normal diet. I suspect it's a coincidence that at least 2 of my attacks (#4 and #6) arrived ~36 hours after such indulgence.? It may be the case that I am especially intolerant to beer and shrimp, though I doubt it. More likely that I gorged myself on beer and shrimp a couple of times when an attack was probably imminent anyway.
To answer your question; It's other things, a combination of everything in my (previously) gout-prone diet.? Don't remember if anything special brought on the other attacks ? probably was just my “normal” diet catching up with me? lots of booze mixed with cola and other sodas, lots of meat ? all kinds, maybe some fruit and veggies for color now and then… maybe.
I've sworn off beer and shrimp just to be safe and am now making a real effort to improve my diet and fitness.? We'll see how far that gets me….?Diet and exercise don't cause your gout! They just add to or subtract from your misery which gout causes.
Keith, the founder and Administrator, and the many members (and contributors) of this forum have spent many hours to show the way: MANAGE YOUR GOUT!!! Just take the time (particularly when you are in pain and can't go anywhere) and read, read, read what has been presented to you on silver platter (the Web.)
rdavisiii said:
? I saw my doc with the Achilles incident because I thought it was or about to get very serious. ?When I brought up gout as being a contributor he shrugged it off basically saying that uric acid does not affect bursa sacks but I have read the contrary. ??
Instead of wasting time, money, and emotion on a doctor, an employee of the medical industry and a drug pusher for the pharmas, I'd spend the time to see Dr. Google who seems to be a hell lot better doctor and who even makes house calls for free:??
?Bursitis can be caused by chronic overuse, trauma, rheumatoid arthritis, gout, or infection. Sometimes the cause cannot be determined. Bursitis commonly occurs in the shoulder, knee, elbow, and hip. Other areas that may be affected include the Achilles tendon and the foot.
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