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Utubelite said:
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…I have not taken Uloric but somehow there seem to be many people with better success story with Uloric than Allopurinol.
Utubelite, you got to take the “success stories” with a grain of salt. It depends who reports them. I feel that a nearly 50 years record of success (partial as it may be) is hard to beat within a couple of years with figures which do not even come close to the numbers of people who have sussessfully used Allopurinol, and I am NOT even one of them since I was allergic to it.
zip2play said:
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monaco,
If you decide to wait for the big one, make sure you have a bottle of colchicine handy so you can abort the attack when you cannot stand any more pain. Have a couple more blood tests while you wait. Who knows, you might see an 8 or a 9 pop up?
Besides all the good advice from Zip, you may also want to have a bottle of Naproxen=Aleve handy (Read up on earlier/other forum post concerning Naproxen=Aleve.
odo said:
… Bunions generally occur on both feet with one worse than the other. The telltale sign of bunions is the big toe deviated at an angle towards the other toes and corrective surgery usually involves bone realignment i.e. breaking it and setting it back straight . …
Do these feet qualify for BUNIONS and GOUT, Odo???
As you know, I have had gout for >25 years. 15 years ago I had the bunions removed surgically on both feet. I was walking WITHOUT crutches ( a blessing in disguise [the crutches, that is] 10/12/15 years later) two weeks later. No corrective surgery with bone realignment i.e. breaking it and setting it back straight, either. Neither did the podiatrist who performed the operation say one single word about gout/Uric Acid/MSU deposits.
I bet every penny I got left (and there aren't too many to lose) that there were deposits after 11 years of gout history with “official” UA level readings in the 9-11 mg/dl range. As you can see the “bunion” on right foot grew back again and I'd bet whatever pennies I got left that that “bunion” is 80-90% Uric Acid and/or MSU. Those craters, sure as hell, weren't spewing bunion lava and bunion boulders over the last 5 months.
Btw, the volcano on my left toe is presently dormant, the crater is closed and the hot lava flow contained, temporarily. 2 or 3 of the 6 craters (difficult to judge because of the closeness of the craters) on my right foot/toe are still active, but no hot lava flow, just some boulders (tophi) are daily being extracted with the help of my Manuka Honey.
zip2play said:
Hans,
Have you considered adding Uloric to your probenecid regimen.
Yes, I have, but NO.
Alas, I realize that you, like may of us, have an issue with high pricing for these new patent meds. I could not afford a lifetime of Ulroric (at an average price of $168 a month.
)That's for damn sure.
Have you ever rechallenged yourself with allopurinol, in the hope that your first failed attempt was a fluke?
No. However, I have an appointment with a rheumatologist 7/1/10 and I'll see where we go from there.
Does a Canadian pharmacy beat Wallmart or Target pricing at $10 for a 3 month supply of probenecid?
By a mile. More than 50% less. Besides, all US pharmas, including Walmart, charge >$125 plus tax for 200 pills. I got 400 for $129, including S/H.
NateA said:
… I'll just make sure to stock up on some TP before instigating the trial run
All kidding aside: Save your TP and follow Zip's remark/suggestion and use the shower, instead. The one who won the battle “Who is the boss here?” will thank you for it. Trust me, Nate. 29,200 days experience speaking.
zip2play said:
Water is particulary troubling.
Here's the common scenario…hans you can back me up since we both did our bout with Atkins to our regret.
…
Zip, fortunately, (and here, just once in my life, did my arrogance do me some good) I refused my doctor's advice/recommendation, to go on the Atkins diet. I have friends here who are on that diet, so every-so-often I do get to eat an Atkins dinner which I don't mind, since it is only once or twice a month. While I, most certainly, would not mind to eat a juicy porterhouse steak or gobble down a 1/2 lb of shrimp or a crabb leg or a big slice of liver with bacon and onions once a week (is anybody's mouth starting to Water?, I am only dreaming about that now.
trev said:
Hans- Try running it in a pop out player and listen while browsing.
…
Thank you, Trev. I just DID listen to the water tape. Yes, it was well worth it.
The comments/advice given, confirmed that I had done pretty good in the past with avoiding dehydration or hyponatremia. However, it also told me that my “replenishing” of salty fluids during my 45 minute sauna relaxation periods, by swigging 3-4 bottles of my 5-7% “Hans in New Mexico Stout” and 1-3 glasses of wine with dinner right afterwards, wasn't the schmartest way to go. I am not going to talk about other details of my life style.
(I have mentioned someplace else that Mother Nature did what no one else was able to do: Pay me back for my arrogance by telling my doctor that I will not give up my homebrews and wine, beside a few other things. She, just quietly, increased my uric acid/MSU with only a few 3-5 days gout attacks over some 20 years till She had it and then used a sledge hammer and it has been pounding me for the last 8 months.)
trev said:
Thanks for raising this Hans! I fail to see how a BBC audio on very good info about how water balance works in the body and a link to general advice on water intake from a medical source can be dis-info....
Further, I wasn't aware the BBC put blocks on foreign listeners- but in any case I gave a round up of the main points as I saw them of interest to people trying get water intake right. This is very much a gouty thing!
I hope discussion can proceed under our usual gentlemanly rules..
I hope so, too.
I could listen to the broadcast, but no sexy pictures, so I gave up after 10 minutes.
However, your summary kept me in the loop and interested. And Zip's additional info got me even more interested since WATER, SODIUM, (POTASSIUM SUBSTITUTE), SAUNA, and GOUT are closely intertwined in my life. I, for one, would most definitely like to know more about this issue, if anybody else has any thing to contribute.
GoutPal said:
.. Great observations, Hans.
Thanks too to zip2play for observations on the urate pool …
vegetarianGuy [who] answered this much more eloquently in the first response
…[and there is poor] Nate, psychologically, at a loss to wonder why flares are still occuring…
Here we are, some of the most “informed” (at least more than most of the “medical profession”) and yet still almost as much staggering in the dark as before.
GoutPal said:
… but I've finished (for now) my review of the length of time for uric acid crystals to dissolve….
Thank you GP; most interesting.
However, I have some difficulty accepting the figures. How can any one set up a time schedule for dissolving of UA/MSU without knowing how much of that “schtuff” is in a person's body?
e.g. Let's say one person has 1,000 mg (I don't have the foggiest idea how much a person really has) and another one has 10,000 mg of UA/MSU in his/her blood and tophi combined, and the first one has a UA level of 5.2 mg/dl and the second one 8.5mg/dl, how can one predict how long it will take to lower the level where it is acceptable and no more tophi are present?
I am sure that the 18 guinea pigs did not have the same SUA level and the same length of time over which the SUA/MSU accumulated, nor the same “other” body “misgivings”, like high blood pressure, or diabetes, or arthritis, or liver/kidney irregularities, or whatever else is bugging us.
Besides, wouldn't the UA level be different for a person with little or no tophi and only SUA in the body vs. one who has egg-size amounts of tophi located at strategic points?
While I recognize that a low UA level will help reducing the existing amount of uric acid, I can’t help thinking that it will take a hell lot longer to get rid of tophi vs. serum uric acid in your blood.
I am looking at four different uric acid crystal configurations: 1) SUA/MSU in dissolved form in the blood; 2) uric acid crystals in some whitish “liquid” (referred to as: “schtuff”) right under my skin (not yet solidified to a tophus); 3) solid uric acid crystals in form of tophi, throughout my body, and 4) a solid blob of UA/MSU right on top of my toes and/or fingers.
I can't see, for life of me, how one can throw all that in one pot and come up with a good tasting dish to swallow.
cjeezy said:
Hi Nate,
… but are you taking Colchicine now? and are you taking 2 Colchicine’s daily as a preventative measure (when you’re not having attacks)? If not I would recommend talking to your Dr about getting a RX. That stuff works GREAT!
Nate, this is just a confirmation of cjeezy's remark: For me (and that is strictly for ME) two Colchicines and two Naproxens (Aleve will do) a day have done the trick for the last 25 years, up to this very day, when I had an attack or a swollen knee with excruciating pain. I generally stop the Naproxen as soon as the pain has stopped or is tolerable (in most cases after two days), however, I do continue the Colchicines for at least one or two more weeks.
zip2play said:
Post edited 5:59 pm – May 24, 2010 by zip2play
Hans,
The pictures inspire me to only two words: JESUS CHRIST!
…
(How can you resist slicing through the thin skin of your finger to let those harsh white tophi right under the skin out? I;d be at work with a sterile razor blade in minutes.)
Are you in continuous pain with only degrees of difference?
…
The pictures inspire me to only two words: JESUS CHRIST!
There is no JESUS CHRIST here today to perform the miraculous healing of the GOUTIES.
(How can you resist slicing through the thin skin of your finger to let those harsh white tophi right under the skin out? I’d be at work with a sterile razor blade in minutes.)
I have lanced two fingers a couple of times, but I have not yet reached the stage of self-mutilation.
Are you in continuous pain with only degrees of difference?
No, I have mostly passed the painful stages.
vegetarianGuy said:
Post edited 9:53 am – May 24, 2010 by vegetarianGuy
…So you are in your 80s? Those injuries must hurt a lot? Can anything be done to fix it? What are the Docs saying now?
…So you are in your 80s?
VG, I'll be 80 in November.
…Those injuries must hurt a lot?
At times, in the beginning, or when an attack was going on, the pain was sometimes hard to discribe. I have been living for the last, almost 8 months, between my bed, the chair plus chair (for my legs) in front of my computer, and St. John, (not to forget my invaluable crutches.)
… Can anything be done to fix it?
Yes! I have done it, w ith the help of a few friends.
First, I got myself a prescription for Probenecid and got the med from Canada for less than half of USA prices. My SUA levels have been fluctuating between 3.3 and 8.4 mg/dl since 2/19/2010, averaging: 5.9 mg/dl.
Second, while I have been able to avoid any infections over the last ~5 months, by using an antibiotic cream with iodine (Povidone-Iodine Ointment 10%) till the middle of April. After that, I have been putting pads with Manuka Honey (+15 Activity factor; the higher, the more potent) from New Zealand on all of my open wounds/UA oozing openings with an astonishing (so promised) results. Two nights ago was the first time that I did not “chain” any of the “culprits”, however, I have found out that every-so-often, closed wounds, holes, tophi can open up again to ooze out some of the stuff (I feel more like saying: some of the SHIT.) The honey fights germs, staph, inflammations as well as heeling the skin by producing hydrogen peroxide(H2O2.)
Third, I am in the process of establing a contact with new hospital/insurance group and a rheumatologist associated with that group.
…What are the Docs saying now?
Nothing.
The first one (a Podiatrist), one week after the Dec.30, photo said 3 things: a) I don't have much time to talk to you, b) I can't prescribe that med (Probenecid), c) get Medicaire insurance. He did give me a 30 day prescription for Colchicine, though, and squeezed the living daylight out of my toes and put a bandage with antibiotic cream on them.
The second one (an Internal Med.) talked to me for 10 minutes, never looked at any of my tophi/wounds, but did give me the requested prescription for Probenecid with 3 refills (all of which the Canadian pharmacy sold/sent me in ONE shipment.)
GoutPal said:
If you cannot trust a med school prof, what hope is there?
GoutPal, I cannot put all the blame on him. You do know how many medical professionals do not know about gout or how to treat it. As we know, now, rheumatologists are our best bet, and even they are not 100% on target.
The first doctor (a nephrologist) diagnosed me right off the bet with gout in 1984, however, not until 1995 did he put me on Allopurinol, only to find out that I was very much allergic to it.
The med professor, who was a geriatrist, did put me on Probenecid in 2000 and told me to lay off red meats and beer, but MY ARROGANCE laughed at him and told him that I never would do that (and DO NOT EVER SAY NEVER. Have not had any of my home brews and hard liquors, except ONCE, in 5 months now.) However, he only kept me on Probenecid for 12 months and then stopped.
I saw a total of 6 doctors between 1984 and 2010 (not to mention the army of 8-10 when I was in the emergency/hospital with my open wound infected left big toe) and NONE of them put me on a gout-management plan or explained the seriousness of UA/MSU crystal build-up in my body.vegetarianGuy said:
Post edited 9:58 pm – May 23, 2010 by vegetarianGuy
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Hansinnm are those foot photos Tophy/Gout induced only or do you have Diabetes too?
No, VG. I never had any kind of diabetis. I had tophi on both feet and both hands over the past 10 years. The first time I had an open wound with UA/SMU oozing out was my left foot middle toe and when my doctor saw it he called all the other doctors in to show me/it off. However, he never started me on any management plan because a UA level of 9mg/dl was THEN not considered serious. And he was a professor teaching at the university med school. The only thing he wanted me to do, go on an Atkins diet which as we know today isn't all that gout friendly, because it allows steaks, chrimp and other high meat proteins/UA producings foods.
ppkul said:
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What do you suggest?
DON'T EVER let it get this far!!!Dec. 30, 2009: Uric acid oozing out on big, right toe
Aug. 22, 2009: Tophi with serum, skin still unbroken. (I finally lanced it, myself.)
UA/MSU has been coming out ever since with, interruptantly, solid tophi on the
outside of finger (See above photo)
May 4, 2006: Tophi in right index finger (Skin never broken,yet)
I have posted those photos , ONLY, for all the gouties who may live to my age (~80 years) and hope they won't let GOUT get the better/best of them (as it has of me in the last 7 months after 26 years of on/off gout attacks and an unknown amount of UA/MSU crystal built-up in my joints.)
Here is my advice, including other members' advice given in the past:
1) Take control of your life/gout and start to manage it!
2) Check your SUA (Serum Uric Acid) level regularly and keep it under 6.8 mg/dL = 405µmol/L (the magic number), preferably 3-4 mg/dL!
3) Get a COMPETANT RHEUMATOLOGIST to assist, advise, and monitor you!
4) Don't let your own arrogance dictate to you how to live your life, as I did.
ppkul said:
….
Can I start Colchicine right now without prescription or doctor's advice?
… and for how long?
ppkul, not knowing where you live, I can only tell you what one must do in the USA. Here, you have to have a doctor's prescription for Colchicine and Naproxen. However, Aleve is the same as Naproxen and is available over the counter. If you are in the USA, get a prescription for Colchicine ASAP and try Wal-Mart ($4/bottle=90pills). (A greedy Pharma [URL Pharma Inc.] has gotten a new patent and is selling it under the name of Colcrys(TM) for $5/pill. (Read up on it: https://gout-pal.com/colchi…../2009/09/)
I can only give you MY experience: I take 2 colchicines (.6mg) a day and if/when I have excruciating pain I take two Naproxen a day in addition. I suggest that you get a COMPETENT RHEUMATOLOGIST to advise and monitor you.
I have had gout for >25 years now and during the first 10-15 years I experienced a similar condition like yours: A gout attack every 17-18 months. Almost like clockwork. I took my colchicines and Naproxens till the attack was over and quit till next time. What I did not know, until I found GoutPal, what was happening in my body. And I assure you, my body is telling me NOW what DOCTORS, including professors, who were teaching med students/future doctors did NOT tell me: Uric acid, the culprit for gout was accumulating at unknown rates. I got the visible proof today.
As far as starting right now, I would suggest you have a rheumatologist get basics of your body (blood tests for all essentials of your system) and go from there. Some medications have side effects on liver and kidney, some of the prime organs you need to control your uric acid manufacturing and elimination processes.
Both, Odo and GoutPal already gave you advice what else do.
odo said:
Probably the other main consideration is to make sure you don't get sunburnt (feet especially).
Along that line: If you are out in the middle of the day, under intense sunshine, COVER your body, rather than splash sunscreen all over yourself. Check out what the world is saying about the affects of sunscreen.
cjeezy said:
…I was wondering if gouties can enjoy hot weather like the 100+ temps it gets where I'm at. …
Cjeezy, I have had gout for 25+ years, and I never stopped canoeing and/or sailing. I have lived for ~15 years in New Mexico with 300+ days of sun shine, often in the 90's and 100's. I don't believe that I ever had a gout attack because of sun shine. However, as VG points out, you need to drink a lot of water, not like me, who drank a lot of beer and mead, which my gouty ghosts loved and I have been paying for it dearly.
DarkRain said:
Post edited 10:49 am – May 1, 2010 by DarkRain
You are welcome to share your experience.
Thanks, DarkRain, for your time and effort to post the URL's of the comments regarding coffee.
I have consumed ONE cup of coffee in the morning (strong, along the line of espresso) for more than 40 years and I have had gout for >25 years. Until recently, (~7 months ago) I only had attacks about once, sometimes twice a year. And I am not on Allopurinol because of allergy to it.
I don't know if it had a positive influence on my gout or not, however, I do not believe that it had any negative influence either.
davidk said:
Hi folks. I've been on Uloric for 3 months and have my UA running below 5.0. Toes were in almost perfect shape for a few weeks, then I had a major flare up. The only thing I can think of is I ate about 10 bites of a crab based appetizer dip and a half serving of orange roughy. It was about 36 hours later when I started havign the flare up.shell fish seem to be a trigger, so I've avoided them for a year, but thought a few bites of an appetizer would be ok. I also am very confused about which fish are ok and which ones are not. I've read about seafood on this site and which ones are acidic and that you need to balance with alkaline foods, but I'm not sure I understand all that. I've avoided red meat, shell fish, alcohol for a year. I don't each much fish either mostly because I don't know which ones are okay. I'm confused.
David, you got lots of company in your boat, however, that does not help or change YOUR situation. Read, study, and examine what you see here. The one “person” you MUST listen to, is YOUR body. What works for one, does not necessarily work for the other (and mostly it doesn't). Learn from the experiences of the other gouties, but listen to YOUR body and use YOUR grey matter to decide what is best for you.
trev said:
Hans- this Vit D thing is being mentioned a lot lately.
…
I know, Trev, that's why I started this link. However, as I have said several times, the individual needs to decide him/herself on the merits of any and all information provided by what ever means.
I, mysef, don't take any vitamin D, whatsoever. My sun exposure through sungazing, sailing, and walking here in New Mexico, with 300+ days of sunshine gives me all the vitamin D I ever need.
trev said:
..The right one to have is D3…
I make sure I don't oversubscribe any of them. the only supplement that I keep to daily is Omega3, high quality -from the US.
…
It's been stressed here, many times, that good dietary balance is important and the same goes for Vitamin supplements- the best quality are far from cheap but usually worth the cost and research.
Very true. One has to look very closely at the fine print to recognize which are the real McCoys and which are filled with cheap fillers.
It's been noted that heavy doses of Vits [like C in particular] can make the body lazy and stop it synthesizing its own needs properly.
Just like feeding the birds in the summer when they should find their food in the wild instead of from human hands.
…
Trev to the rescue again!!!
There are two vitamin D's: D2 and D3, with D3 being the better one. I suggest that anyone interested in vitamin D google vitamin D2 and D3.
Goutgal said:
We all have choices. I had a skin cancer removed from my face 2 years ago, and 3 months ago had “something else” removed from my face, not skin cancer, though, just skin damage from the sun, the surgeon said. I run from the sun, and really shield myself from strong rays. So, I'm not ready to buy in to the sun's benefits to gout. But if it works for others, fine!
Trev is correct, however, there is more to it than meets the eye. One should never expose the unprotected skin to direct sunlight during the day when the UV factor is greater than 2. A lot depends on an individual's disposition to the sun. Some can tolerate direct sun exposure better than others and there is no gadget or ways (to my knowledge) that will tell a person where the limits are.
I have exposed my body to sunlight for the last 75 years and never had a problem except for sunburns which I contracted almost regularly as a kid. If one takes the time to slowly get the skin used to the sun the effects are not as serious.
I may have mentioned in another post that I am presently engaged in “sun gazing” and have passed the 26 minute direct sun-to-eyes exposure. All is being done during the first or the last hour of sunrise/sunset when the UV factor is less than 2. So far no damage encountered to my eyes or skin. My far sight has improved to the point where I don't need my glasses anymore and my near sight seems to be improving, too. I'll have my eyes checked by a doctor when the cycle is completed after 45 minutes.
However, again, what one person can do, another may not be able to do.
As I said in my first post: Each person has to draw his/her own conclusion regarding the benefits of vitamin D and sun exposure.
Richard Bell said:
I work outdoors in the sun. I got an attack last August that put me in the hospital and out of work for almost 8 months. I don’t think my problem was vitamin D, I think it was a high SUA level.
Richard, Vitamin D does NOT cause gout, it fights it.
Quote: “SICK? WELL? … SUNBATHING HELPS YOU AND EVERYONE
By Dr. Bernarr, D.C. D.D.
SUNBATHING DOES NOT CAUSE CANCER OF THE SKIN NOR WRINKLES.
SUNBATHING HELPS HEAL CANCER OF THE SKIN.
…Sunbathing helps heal the following, in alphabetical order: Genitalia, Gas Gangrene, Gangrene, Gout, Goiter, Gun-Shot Wounds, Glycogen Storage Increase In Liver & Muscles
…
If you had a high SUA, (how high?), you are probably right that your gout attack was related to your uric acid level.
zip2play said:
Post edited 12:33 pm – April 8, 2010 by zip2play
…nothing will stop it faster than a proper dosing with colchicine. .…you may need 16 of them in one day. Since your attack has gone on so long, I think you need need all 16.
…God LOVES to toy with us!
Zip, I have to butt in here:
YOU are NOT his doctor, so, please, don't advise him to take 16 Colchicines a day. He may have to run to the john faster than his gouty feet will allow him and may be there longer and more often than his body would appreciate. If you do advise, tell him to start with 2 or 3 a day, or 1 every 3-4 hours, and possibly take some naproxen/aleve. However, his doctor, preferrably a rheumatoligist, should be the advising person.
God does not toy with us, since he is only the figment of our imagination. It's our life style, the chemically contaminated food, which the food giants shove down our throats, the meds/drugs the pharma and medical industries get us hooked on, and our inheritance from our parents and their ancestors which we so freely inherit, that toy with us.
zip2play said:
Post edited 12:58 pm – March 22, 2010 by zip2play
Yep,
that's very interesting.
With that pH swing of 6.5 to 8.9 I doubt that it has to be any larger…that range is a hydrogen ion content of several hundredfold.
I've mentioned it occasionally but with little emphasis as in “who knows what the temperature and pH of the affected joints are.”
Hmm,
Uric acid solubility with pH? Let's see what I can dig up without running into $$$$$Springer links$$$.
One of the problems seems to be the relationship between uric acid and monosodium urate…both of which present gout problems and each has it's own relationship to pH.
Then there is the other quirk of uric acid solutions:
As much as 220 mg./dl. of uric acid could be dissolved for 24 hours at pH 7.0. But following seven-day incubation the total dissolved urate concentration decreased to 16 mg./dl. due to NaU crystallization. The stability of NaU supersaturation depended not only on the concentration of sodium and urate anion but also on time and pH.
There is this strange TIME relationship. Might explain a bit why a high concentration or urate after exercise doesn't cause pain til the next morning.
Let me add another bugaboo to your good questions:
Is there anything we can do with diet to change the pH of our synovial fluid?
As an overview to this question, perhaps gout is a disease ultimately caused by too acidic a synovial fluid. As as adjunct, long ago I read a good long article (on paper actually) about how colchicine worked and why it was so specific to gout. THe writer said with some certainty that colchicine alkalyzed the synovial fluid. Sounds logical to me.
And appropos of nothing: I found that the SKIN is a rather acidic 5.5.
Zip, you opened up another BIG can of worms, so I'll start a new link under: Uric Acid and Mono Sodium Urate.
zip2play said:
Post edited 7:49 pm – March 8, 2010 by zip2play
Yep,
Stay away from aspirin with gout unless you can commit to taking about 16 a day…a real stomach punch.
Low doses of aspirin retain uric acid, huge doses dump it readily.
Zip,
You just made MY day!!!
My G.P. for 10 years (1996-2007), a university medical professor in Gerontology, made me take baby aspirin for 10 years (and I continued for two more.) He knew about my gout, to the point that he called other doctors to look at my uric aid coming out of my toe which none had ever seen in their careers.
My G.P. was a doctor for 35-40 years.I did quit taking it about 2-3 months ago when I read here on the forum that it wasn't good for gout, however, I did NOT know that it actually retained uric acid. No wonder, that my gouty life got goutier in the last 12 years than in the prior 15 years b/4 the ASPIRIN AGE.
Utubelite said:
I think asprin is not good for gout as I remember having read at many places. Aleve many take to relieve the gout pain, so that should be fine.
I generally take Advil or Mortin(Ibuprofen) as it relieves headache also and is good for gout as well.
Ubelite is correct, as far as I know. Naproxen (prescription), the equivalent of Aleve (over the counter), is which I have been taking for >25 years for pain and inflammation control (in my case: Gout.)
