[jonpayson]

One more thing,

?

I just had an appointment with the Rheumatoligist. I told him that the ortho aspirated some fluid to see if he could detect gout in my knee. ?The Rheumatologist said that since my UA is at 4 while on 300 of ap, that crystals will never show upon aspiration.?

?

Does that make sense to anyone??

I was under the impression that a gout attack will show crystals, regardless of what your ua is. ?IE someone on 300 of ap who has a gout attack will still show crystals.?

?

JP

[jonpayson]

Thanks for the help/advice.  

I have a prednisone patch (6 day supply) that i could have used…but since im trying to ween of the daily dose, i thought it would be counter productive to take it.  With that said, if it happens again ill probably use it.  I got my range of motion back today, and there is just a little bit of tightness.  Hopefully it wont come back again..at least not at the same severity.  I can handle the little ones, but this big one freaked me out a bit.  I hadnt experienced that level of pain from gout in about 2 months, and it brought me back to my 3 month series of attacks, and 4 dr's, 3 mri's, and 3 months of not being able to go to work hell that i went through prior to being diagnosed with gout (again, minimal compared to many on this post, but scary just the same….especially when the financial well being of your family is tide to your ability to work)

JP

[jonpayson]

As always thanks for the help:

Trev:  As far as pseudogout, from what i can see the treatment is prednizone and/or NSAID's (just to fix the symptoms, not the cause), are you aware of a different treamtment?

Zip:

As far as the ortho problem for the knee:  I have got an mri reviewed by a specialist, nothing significant, but he is willing to do a surgery to determine if possible there is a miniscus tear he can fix (exploratory).  My rheumatologist says its gout, and no need for surgery.  Here is my thoughts on it:  Before the allip, i had a limp for 3 months which finally subsided.  I would get rapid uneven swelling (ie first the left side of knee, then the right side of knee, rarely the whole knee), which would come on without a physical reason for it. a few times, the swelling did come on right after i ate one of my gout triggers (determined by diet restrictions and introduction of things i suspected triggered my gout)

As far as the prednisone, i agree i should have never taken it, but i have issues with nsaid's that forced me into it.  I was on 20 mg for 2 months, now im on 10, and weening myself off.  when i went from 20-15 i had pains in my wrist for a few weeks, which eventually went away, but no increase in knee pain at that time.  could it be withdrawels from the prednosone that is causing the flare?  Ive been on 10 now for 2 weeks,

Thanks,

JP

[jonpayson]

Thanks trev,

I should be happy that i am finally back at work after 3 months….but i guess im just a little impatient.  Im still pretty far from having the physical confindence i had prior to the start of this mess (may 5th).  Im pretty lucky to be treating it with allip, but until its completely under control, ill always doubt the effectiveness of my therapy.

……I have started eating protien again (in moderation), so the re-introduction could also be a factor

[jonpayson]

Ok, so im approaching the 2 month mark on 300 allip.  My limp is VERY deminished.  Still a little pain in my left knee, and weakness, but the obvious limp has not been around for over 2 weeks.  Sometimes ill get a little reminder, but it has not lasted more then an afternoon or so.

One thing that has not gone away is the swelling in the Right knee.  Not a lot of pain, and never a limp.  Just a small amount of swelling that is there 90% of the time.  squishy when touched (as opposed to tight and hard like it was before the allip).  

Anyone else have sustained swelling in a joint without much pain that just seems to linger on??

JP

[jonpayson]

well i understand the dehydration correlation, and i think i am more than hydrated (ive been peeing clear since my diagnosis due to the amount of water intake), but you never know.

Thanks, Ill keep the fluid intake in mind

JP

[jonpayson]

im on 75mcg of levothroxan (not sure on spelling).  I never had any affects of hypothyroidism, just tested low about 6 months ago, and have family hx of it.  my levels are normal now, but the gout started 3 months after I started treatment for it,

JP

[jonpayson]

Nothing else except .6 of colch 1 a day.

After i posted this, i came across the “Twinges” post, if anything it sort of resembles those discriptions.  Or more specifically, it feels like my bakers cyst felt when it ruptured, and fluid seemed to trickle down to the calf area from the inside of my leg,

JP

[jonpayson]

Thanks for the help

[jonpayson]

Thanks for the education.  I really do appreciate it. 

….but,

I was looking more specifically for how you know if the allip is working or not, if every time i try to get off the prednisone which i have been useing as a constant med at 20 mg i need to ramp back up on it when the pain starts.  In other words, is it normal to have pain while going off the pred, or do i need to stay on the allip longer?  My research shows that im probably not producing by myself anymore becuase ive been on it for weeks, so im not sure if the pain is inevitable until my body produces its own, or if i just need to stay on it until the allip has more time.

thanks,

JP

[jonpayson]

TO azasadny: I do have shoulder pain in the left shoulder that is sometimes present with the neck pain, but not also, i also have had slight tingling in the elbow and wrist at the same time as the neck pain…but not always

Gout sufferer: thank you for the description of your neck pain, it is very similar to mine.  I have not felt the pain in the last 6 weeks…probably due to the prednisone i have been taking.  i started to ween myself off the prednisone (been on allip for 4 weeks), but once started feeling the neck pain agin i ramped back up on it.  until allip does its thing for me, i wont be 100% convinced that it is the correct treatment for me.  I appreciate the success stories for it though, and have hope that it will fix the pain

Thanks,

JP

[jonpayson]

Keep in mind that i still have a LITTLE GOUT DOUBT, due to the fact that my UA has never tested above 6.3, and by the time i got a diagnosis, the large amount of swelling had gone away (so know aspiration for crystals).  All the minor flares since ive been on allip were never big enought to aspirate (and hopefully never will be.)  If it sounds like gout to you guys, Id love the input

…so heres my story:

I had pain at the base of my second toe which i noticed one afternoon, not insane or anything, but did cause a little limp, i figured i had stubbed it.  The next morning it was a lot worse, and limped a little more but was still able to walk.  I treated it with naproxen, and continued to work on the foot for the next 3 weeks…again, never too bad.  THEN IT HIT ME.  I went on a decent size bike ride, and felt a little more pain then usual that night before i went to bed, then at 5am i woke up in insane pain, my foot was bright red and swollen, there was NO WAY  i could put any wait on it, and i honestly thought i tore every tendon in the thing.  I took two naproxyn, ice, went to the hospital, they sent me home with crutches and an appointment to see a foot dr. This pain ended up lasting about a month (though not as bad after the first week).  About a week after the wake up to the red foot from hell, my left knee swelled way up..and eventually caused a bakers cyst (which i never had before) to rupture and fill my left leg with fluid.  A few days after that my right knee swelled up..but went away shortly, then my neck got real stiff, and then pretty much every joint in my right foot and toes hurt.  then the right ankle.  I was pretty misrable.  When my left big toe started hurting, i started hunting around from dr to dr until someone finaly said it was gout (although the very first Dr i went to said it looked like gout to him, i just brushed it off).

for the last 6 weeks ive been on pred, allip for the last 3 weeks at 300, and .6 colch.  Most of the pain is gone, accept for the Left knee, and a little constant swelling to the right knee.  I should be getting back to work (physical labor) in the next 2 weeks.

that it,

JP 

[jonpayson]

Thank you,

As it seems your about a month ahead of me in this gout game, maybe you can let me know if you had similar symptoms regarding prednison.

1) my Dr put me on .6 of colch and 20 mg of prednisone, he does not want me to go higher then the .6.  Im also on 300 mg allip. 

2) It seems like my knees have had a constant “light swelling” after 2 significant flare ups while going from 100-200 and 200-300 allip.  In other words, they ahve had a small amount of fluid in them constantly since on the allip.

3) I decided to drop my does of prednisone from 20-10, and I started feeling pain in the past gout areas: Left big toe, neck, R ankle.  The pain went away within an hour of increaseing the prednisone back up to a dose around 17.5.

4) my fear: the allip is not doing what its supposed to, Ive been on it for 6 weeks altogether, about 3 weeks at the 300 level.  I would think that i should be able to get off prednisone by now.

My question for you: does this sound normal to your experience?  Specifically, when you were going off pred, even though you had allip in your system, did you still get pain?  How did you know when to get of the prednisone, and did you have to go back up in dose ever after you decreased it?

Thanks for the help

[jonpayson]

In addition, to share:

There was apoint while we were figuring this whole gout thing out that i was peeing in a bottle in bed because it was so painful to get out to use the restroom,  My experience is no where near as bad as some people..and i do not want to take away from their pain and suffering, , but it was a very difficult 3 months for me as well, just not knowing why my whole body hurt, and jsut that feeling of uncontroll of my world (it went from foot, to knees, to neck, to little joints in both feet, to wrist, etc, all within a month or two, all without prior pain or injury.  and having the employment thing over my head didnt help.

Im just really curious about others success with allipurinol, and their time frame, 

…..prior to this, i would not have even taken tylenol (honestly, ive had shoulder and back surgery, without touching narcotics during the recovery period), and now id take whatever i can to not go through the pain again, I just hope Allipurinol is the right drug for what i am experienceing, and it will take it all away eventual.

[jonpayson]

Thank you,

As far as the prednisone: Ive been a little worried because hes had me on 20 mg for about 8 weeks, I stressed to him how important it is for me to get better (my work is physical…and i was on a prety limited time frame for alternative work).  Since ive taken it regularly, im not sure if it has much of an affect on the actual attacks, because when i have had a flare up, I have resisted increaseing it.  Im less concerened with the side affects of pred, and more concerned with the long term mgt of gout,

Thank you for your experience, It helps me.  I got hit rather quickly with multiple gout attacks as well, with no prior history of it.  Hopefully we both get it under control quickly as to not suffer long term joint damage,

JP

[jonpayson]

Thank you,

As far as the prednisone: Ive been a little worried because hes had me on 20 mg for about 8 weeks, I stressed to him how important it is for me to get better (my work is physical…and i was on a prety limited time frame for alternative work).  Since ive taken it regularly, im not sure if it has much of an affect on the actual attacks, because when i have had a flare up, I have resisted increaseing it.  Im less concerened with the side affects of pred, and more concerned with the long term mgt of gout,

Thank you for your experience, It helps me.  I got hit rather quickly with multiple gout attacks as well, with no prior history of it.  Hopefully we both get it under control quickly as to not suffer long term joint damage,

JP

[jonpayson]

thanks for all the help….I really should not have that much complaining to do, it seems like the allup is working, its just the lingering swelling between the “attacks” that have me worried.  I guess that part is hard to grasp, i just do not understand why the joints stay swollen (although at a much lower level) after the pain goes away…the same thing happened to my foot, it stayed swollen and uncomfortable for a few months (and still is), I've only been on the higher level of allip for 2 weeks or so, but i really wold like to know that i will be able to go for a jog at some point in the future.  For never having pain to the foot or knees before, then to have the worst pain ever in the foot, and the constant swelling in the knees for the last 3 months..with no trama to link it to, just really confused me.  I guess i should feel lucky that im treating it now, but to be honest, i could not have ignored it if i wanted to, it has just been too painful.

….and yes, i probably still havnt fully accepted the fact that i am probably having the correct treatment for my issues,

JP

[jonpayson]

The “ruptured Bakers Cyst” was diagnosed when my i had an echo exam on the legs after I experienced a arge amount of swelling to the knee and calf with pain (very rapid swelling).  Prior to that swelling, the only other symptoms i had ever had on either knee was an additional rapid swelling of both knees (but more on the left than the right) about a week earlier.  I was never diagnosed with a bakers cyst prior, but the dr said the echo showed a ruptured bakers cyst.

The mri of the knee show a “possible” menisis tear, but not confirmed.

As far as the limp:  it varies in severity, but general there is some pain, but the actual limp feels like it comes from not having the normal ability to fully straighten the leg while walking.  Also, when i got a cortizone injection in the knee, my limp went away for about a week.

I had thought that it was possible that i never had a bakers cyst, and the swelling was from gout alone, but the echo confirmed that it was a rupured bakers cyst, and im not sure if that is a definitive diagnosis or not.  I wil say this, during the week or so after the alleged bakers cyst ruptured, I was still recovering from my right foot which got swelled up and i was on crutches for, and the left knee/leg was excrutiating painful for about a week.  

JP

[jonpayson]

I appreciate the feedback, maybe a little more background can shed some light on why he diagnosed it based on symptoms….let me know what you think:

1) random foot swelling, which left unable to walk for 3 weeks, no trama, not able to bear any wait on it

2) a week later massive l knee swelling

3) another few days after the left knee…..R knee

4) then a series of smaller joints in the feet/toes/ankles/wrists over the next month or so.

5) since alli and pred and colch only the L and R knee remain affected, the rest of the pain all vanished. the constant limp in the L leg and slight swelling constant in the R knee are only lingering symptoms.  Sometimes all the swelling goes away, both swelling increased while going from 100-200-300 of ali.

6) no personal history of any injuries or arthritis

thanks for the help.

[jonpayson]

Thank you for your help, The Dr is convinced it is gout, and he ruled out RA, lupus, infection, with all of the blood tests.  I was originally skeptical, but after the research and the response to the allipurol I support his diagnosis.  Especially the comments about the joint “twinges” on this site.  I am still amazed at the fact that my joints (especially the knees) can just “randomly” swell without any trama within a few hours.  Im sure you all can relate, but literally within a few hours my knes will be so tight that i can barely bend them. 

2 more questions if you have time:

1) When i went from 100-200 allipo they swelled up within 2 days, and when i went from 200-300 allip they swelled up again within 2 days.  Im not a Dr, but it seems like the fact that the change in allip coencided with the swelling would support a gout diagnosis (ie sensitivity to uric acid changes)

2) The residual swelling in 3 of the joints that have been affected (both knees, and foot) have not return to 100%, they are more like 50-75% of what the joints were before the initial attack, and it has been about 3-4 months since the original attack, and i have been on meds for a month now (20 mg pred, colchocine .6, 300 allup).  Some of the other more minor affected joints (smaller foot joints, wrist,) have returned to their pre-attack level, with no apparent residual affects.  In your experience, is it common for the joint to be damaged and take a very long time to go back to “normal” based on damage caused by the swelling (ie trama caused by walking on the joint when its swollen), or is it just take a long time for the needle like uric acid deposites to stop irritating it.  The reason i ask, is if its an orthapedic issue, id like to get the surgery done now (and get back to work quicker) rather than wait the three months to see if it will get better on its own, and then get the surgery.

You all are very helpful,

Regards,

JP

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