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Nope, no instruments, but I just read your other post about your tophi and it made me think…… probably overuse of a mouse for a computer. That's the only thing it could be. I drained mine over a year ago but still have the bump on my thumb. No return of the white fluid, though.
Tramadol actually seemed to work best for my back and as I said, just took the edge off of the gout pain. It's something, at least.
With as much Aleve as I've taken in the past 3 or 4 years, I wished I owned stock! It is the best non-prescription NSAID, but I have to take 800mg+ at a time to derive even the slightest benefit for gout. For headaches and other minor things it does a decent job. No other NSAID helps me at all.
I hate Vicodin. But, it was me stating that hydrocodone really, really does help with an attack when put with oral prednisone. I held off on seeking any out for this last attack because of my experience with a real prick of a doc who has red-flagged me because I had received percocet twice in the previous six months. It really, really works for me in that combination and knocks an attack back quicker than anything I have ever tried. God-forbid I'd want something that makes a bad attack go away in 2 or 3 days. Instead, I'll just suffer with an attack and be absolutely miserable for two weeks or more……
Sorry, meant to type 18 speed.
I'm taking 75-150mg of diclofenac per day, but it does nothing, really. Well, except upset my stomach. I may go in and get my prescription of Tramadol refilled tomorrow. It seems to take the edge off at least.
The only tophi I have is on the end of my right thumb. Can be annoying at times but not too bad.
aaron,
it's good you're getting on top of this now! Stay with it – or you'll end up like me! It took 14 years for me to receive a positive diagnosis regarding my gout. There were many reasons for this that would take way too long to explain. Right now, I'm tyring my best to treat my gout so that I can eventually begin leading an active lifestyle again.
A short anecdote regarding surfing. When I lived in Japan, my gout was getting severe. I still surfed whenever I could, often through excruciating pain. The cold salt water did seem to help the pain quite a bit while sitting on the board, but when popping up, I'd just have to grit my teeth and ignore the pain in my big toes. Now, I used to never have a problem dragging my toes when popping up. However, as my gout became worse and the state of big toe joints deteriorated, I did start to drag my back foot when getting up. It was just too painful to pop and directly plant, so I kind of had to ease my way up and dragging my foot helped. After a few months of this, I started getting a nice crater in the top of my right big toe (I surf regular foot). It was from constantly dragging my big toe across the top of the board and from all of the small rocks and sand stuck in the wax. I started taping and bandaging the hole up, but I'm sure as you know, the tape didn't last long while out in the water. Anyway, I still have a nice scar where that hole was, approximately 1/2 the circumfrence of a dime.
I'm keeping a blog of my effort to get back on the slopes, out in the water and on my bike. I'm in too bad of shape right now, from gout, to do much beyond sitting on the couch. Hopefully I'll be able to regain somewhat of my old ways again soon. Just keep on top of your emerging gout and hopefully you will never have to go through what I, and many others on this site, have.
Thanks odo. Unfortunately, even biking is going to be too rough for me right now. I have a very nice 19 speed mountain bike and actually took it for a spin not too long ago. I came home quickly as the pedaling was aggravating my achilles and feet way too much. I think I just need to completely rest for a while and not attempt doing much of anything. I'm still keeping my fingers crossed that I'll be able to ski next season at some point.
Exercise never used to spur on attacks in the past. This is a new thing for me. Perhaps since I've been dealing with gout for 15 years and there is enough built-up UA in my system, this is now another way that an attack is initiated in my body. Either way, it's definitely something I need to be wary of now as I can say with almost certainty that there is a correlation – for me.
I'm just happy to see that you found this site so early in your battle with gout! if GoutPal would have been around 10 years ago, maybe things wouldn't be so bad for me now.
It sounds like you're doing everything right. You can never be sure about this, but I'm wondering if you didn't always have hyperucemia and then some type of trigger or something in your body turned that overload of UA in to the attacks you are now experiencing. Getting three full-blown attacks in just three months to start your gout odyssey, although I'm sure not unheard of, seems kind of rare to me. Mine started of slowly, maybe one every four months or so, and then it became almost a constant thing jumping from joint to joint.
I definitely must state that this new norm I'm experiencing is not pain-free like before I had gout. There is always some pain going on in my joints, be it due to joint destruction or just the UA crystals having a strong hold in certain joints. I can deal with that compared to full-blown attacks, though!
I used to never connect working out or going skiing or surfing or biking with gout flare-ups. This seems to be a newer thing for me and I'll just have to be patient with it. It just happens so fast nowdays. Workout Monday evening, gout flare Tuesday morning. Never has it happened so quickly!
I'm willing to do what it takes and if that means taking it super easy, as much as I HATE sitting around, it's what I'm going to have to do. Time to invest in a PlayStation 3, perhaps?
Best of luck!
I'm a seasonal coffee drinker. I have a friend back in the US who runs a coffee roasting business and I get some great stuff from him. In the warmer months, I drink diet soda, now mostly Pepsi Max (no sugar, no calories, but around 200mg caffeine per liter). I know I shouldn't, I know it's probably not great for me, but I'm addicted to the stuff. I should note, that I drink a minimum of 4.5 liters of water a day and usually more.
About a month ago, I decided to try to kick the pepsi max habit. I stopped entirely and just drank water for a week. I had my worst gout attack in five months two days after I gave up the pepsi! Coincidence? Probably. But, it was the only thing at that moment that I had changed in my dietary ways and lifestyle. Once I was over that attack, I had another bad attack, still while remaining off of the pepsi.
About two weeks ago, I started back up on the pepsi max. No bad attacks since, just the normal middling attacks that plague me while my body cleanses itself of old deposits (I'm on 600mg/day of Allo – six months now).
I don't think the Pepsi is hurting me (except for the chemicals on my internal organs, perhaps!). I can't correlate any effects from drinking the Pepsi and my gout, though.
Just got my latest test results back today:
UA 4.9 (yay!)
Liver and Kidney functions good
Blood Pressure continuing to lower
Everything else checked out fine too
Dr. Bernarr – wow, I hope English isn't his first language! It does come across as some 'As Seen on TV!' article.
I just saw my GP today. Good visit. He said that he got back from a workshop and that Vitamin D was a big converstation topic. He said that the benefits of getting your RDA+ (he did mention 1,000 iu) of Vitamin D 'may' have some benefit for gout but nothing is solid as of now. He said I should at least try it, mainly as a mood booster, since I'm dealing with not only gout but some other problems that have me constantly living in pain. It's worth a shot. He also did say I should get D3 as it is better.
I probably do need a little more Vitamin D in my diet anyway. Because I have been so hobbled the past year, I don't get out nearly as much as I used to. Also, when I do get out, well, I'm in Germany. Not exactly a place known for sunbathing and nice weather!
zip – don't think I'll be doing that. I'm staying on the Allopurinol and that's that! I haven't missed a dose for six months and I'm not going to chance messing with my UA levels for a test such as this if it's completely unnecessary. I'll be seeing my regular doc Thursday morning and will be discussing this with him. I think he will agree. Besides, he already knows that I know more about gout than anyone in that clinic, including him. Kind of scary, eh?
After speaking with my wife this morning, I have decided not to do the pee test today. I'm going to wait and talk this over with my regular doctor before wasting this sunny day (somewhat rare in Germany!) carrying around a piss jug. Plus, I'm not going to incur the cost of the test if there is no need for it. I may do it later if my regular doc still wants me too, but I want more info first. I don't want to put anyone off at the clinic due to it being one of only two choices I have for doc support in my local area, but I think being armed with a bit more knowledge and hearing the reasoning behind why they want this (unnecessary) test would be prudent.
Enjoy your Sunday!
zip – thankfully, if I ever do need it, I do live in Germany and can get it quite cheap. I should start a black market for this stuff……. 😉
I HATE where the entire medical industry is right now (who doesn't?). Keep us sick so they make more money. I could go on and on about greed in this world and my thoughts on this, but I'll keep quiet for now. I did read about this on goutpal a few months ago and was taken aback. Now to see this hit the mainstream media just got my hackles up again.
THANK YOU for that goutpal! Yes, this guy is a tosser. I've come to this conclusion after only seeing him twice. He also has an odd habit of snorting loudly and rubbing his nose every 20 seconds or so. Seems that maybe he is the one that should be taking a pee test 😉
Maybe I'll just fill the jugs with a mixture of lemonade, beer and jellied head cheese at the fest! Nah, I'll do this for him to prove I'm not some Tramadol/Percocet/Vicodin crazed drug addict.
(AND, YES, I still stand behind my regimen of percocet/prednisone to stave off my worst attacks. It works for me and allows me to still go to work and get my job done without taking vacation time or sick leave. It still is very painful and sucks, but it works – again, for me.)
Trev, my regular doc knows what I've been through, what I'm going through and what I need to do to get better. Yeah, I still bitch and moan about my gout (especially on my blog), but I am still light years ahead of where I was just six months ago. Day and night, my friend. I just need to stay the course and be patient, which is not always easy for me! The patience part that is!
Also, I just hope the two jugs he gave me is enough! I may be going in with a couple of extra tupperware containers as well 🙂
Okay, back to another project. Busy, busy, busy!! Thanks guys! Always appreciate it when you all chime in. Means a lot you all taking the time. Thank you!
Hi Trev – that's good stuff to know about the kidneys. This was sprung on me with little explanation this morning. As I (and you) said, the more information, the better!
It will be interesting doing this on Sunday, though. The wife and I are supposed to be attending a spring festival in Nurnberg then. I'll have to bring along a cooler and the jugs! We'll probably have to cut things down to an hour or two as we're just going to relax and take some pictures.
thanks, Trev!
“levels usually drop during an attack, so this may not reflect your true average. Ignorant Drs may not know this”
Truth!
I was always getting my UA levels checked WHILE I was undergoing almost continuous attacks in one joint or another. I was told I didn't have gout because my UA levels were 'normal'. Be wary of this and when you're feeling better, make sure to THEN get your UA levels checked. Try to do it a couple of times to establish an average if possible, but only when you don't feel 'gouty'.
Another approach – have fluid drained from the affected joint and tested for UA crystals. This is the only sure-fire way to know if you truly have gout or not. Over the past six months, I've had my knees drained at least 6 or 7 times. One important thing if you go this route – make sure that the lab they test the samples at is on the premise or very close by. Transporting the samples can destroy the crystals very easily!
I wish you luck! Feel better!
goutgal – yep, they do get worse with time and get worse the longer the attacks go untreated. Hopefully the 100mg of Allo will be enough. It seems most people take at least 200mg/day. Currently, I'm on 600mg/day. My next UA test is this Thursday. I'm hoping it's gone down a bit from the 5.8 I registered last month.
Sometimes the prednisone works wonders. I did have quite a bit of swelling in my knee and even took some pictures. I just haven't downloaded them off of the camera yet……. Currently, I've been battling another bad attack in my right hand and wrist. The prednisone this time was able to knock the attack back in three days. In the past, before I started taking prednisone, wrist attacks would last two to three weeks easy and were very, very painful to deal with at work.
I don't know if I'm an abnormal gout sufferer or not, but for a period of a few years, I was battling horrific attacks in multiple joints almost constantly. It all started slow enough with an attack every few months, but quickly escalated about five years in to having gout. It just got worse and worse and worse….. to a point of almost being unbearable. I'm really hoping what I'm doing now will put all this behind me eventually. Just being patient and counting these last two attacks as bumps in the road to getting better!
FYI – the only joint damage I have after having all my joints x-rayed last November was in my big toes. It's not bad and the doc said he could have it cleaned up quite easily with a simple surgery. I don't know if I'm ready for that yet or not but maybe some day down the road.
Are you my long-lost brother? Tons of similarities between your case and mine. I can't type too much right now as I'm going through a very painful wrist/hand attack. Fun times, indeed. I have been keeping a blog with daily updates and a spreadsheet of pertinent information.
http://goutactiveperson.blogspot.com/
It pretty much says everything about my case. Your lifestyle will have to change drastically if you want to control your gout – (says the guy who's gone through two bad attacks in two weeks now). Prednisone can work wonders, though.
No more typing for me. Ouch!
zip – I never went off Allopurinol. We just dropped the dose from 600 to 300mg/day for one week. Trust me, I know it's a life-long committment. I'm back up to 600mg/day now and will be for at least a few more months. It's too long of a story, but I had too many doctors talking in my ear. I'm only seeing one now so that's been remedied.
By the way – yesterday I could barely walk, barely bend my knee and my elbow was horrible (I need to download the pics I took – it was bad). I needed immediate help so this attack didn't prolong itself. One day – yep, one day of prednisone and percocet and I was almost back to normal today. I'll be on the prednisone for a few more days as I taper off the drug, but I only had to take a couple of doses of the perc to deal with the pain and now it's done.
I just got back from a lovely day spent in Nurnberg. If you would have asked me yesterday, I would have told you that I'd be laid up for at least a week. My methods may not work for everyone, but they sure seem to work well for me when a bad attack comes on.
You're probably right, Trev. I've got a feeling that the reason I had so many gout attacks in my ankles early on was because of all the sprains and breaks I had from sports. Same with my wrists and now my knees. I'm still keeping my chin up, staying positive and just viewing this as another bump in the road on my way to recovery. Luckily, it's supposed to rain here in Central Bavaria all weekend, so I won't feel too bad about staying inside 🙂
The severity of this attack did surprise me, though. I'm still planning on going to another doctor to have my knee checked out in the next couple of weeks. I need to see if it's healed properly or not and if I still need to get the knee scoped. After talking to some nurse and doctor acquaintances, the answer is probably Yes. I'm not happy about that, but it may be a necessity. I'm sure I can look forward to some further moderate gout attacks after the surgery too. Seems to always happen.
Have a good friday, Trev!
Welcome to the forum! I'll be 36 in two weeks.
The three worst places (in my opinion, of course) you could live and not be able to drink beer:
Belgium
Oregon, USA
Germany
I'm from Oregon and living in Germany now. Over the past six months, I've really altered my diet and stopped drinking alcohol all together. It has made a world of difference. I just wish I was able to exercise a bit more. I just have to keep telling myself to be patient, it will take time. After 15 years of living with this disease, I'm just happy right now that I haven't had any severe attacks in about 3 months. Sure, a couple of smaller ones here and there, but none of the 'can't walk keep-me-in-bed' types of attacks.
I'm so happy I found this site when I did. I was at the end of my rope when I stumbled upon GoutPal. I'm slowly getting better thanks to the advice and knowledge I've gained from this site.
Well, I recieved my test results back today. My UA reading was 5.8 – higher than it has been in months. I really have no idea what could have caused it to go this high from the previous levels of 4.2 and 3.8. Also, my liver enzymes were a bit elevated, most likely due to the 600 mg of Allopurinol. The doc said that he wants to keep me at 600 m/g in light of this higher UA result. We will continue to monitor the levels monthly. He didn't seem too concerned about the elevated liver levels but we will be tracking that too.
some good news – my blood pressure was 128/84 which is much lower than it's been in the past when I visit the clinic. The diet and no drinking at least are paying off in those regards. This is down from the usual 145 to 155 / 85 that my BP is usually at when I visit there. At home, it's normally around 135/85. I really hope I can keep it at this level, or better yet, even lower so I don't have to complicate my gout treatment with BP meds.
Could be zip. I'll ask the doc about that tomorrow when I see him. I'm just under six foot but weigh 215 and have a fairly athletic build. I have a heck of a time finding clothes to fit me! I darn near hulked out of an XL (american) work shirt the other day when I bent over to stretch. XL sizes fit me fine – except in my shoulders! Finding pants that fit is even worse!
david – almost missed your post!
I'm at the same stage. Still cleaning out old deposits. It's been six months that I've been doing this now and I am seeing some very positive results. I spent the last 15 years suffering from gout quite badly, so I'm sure I've still got some time to go until I rid myself of everything that has built up.
The doctor that put me on 600mg of Allo basically had the same theory as your rheumotologist – get the UA level as low as possible in order to cleanse the body more quickly. However, one large difference is that he told me to expect some bad attacks while my body was going through this process. Lo and behold, he was correct. The attacks have been less and less frequent and not nearly as severe. I'm definitely on the dowhill side of the gout bell curve right now and look forward to hitting the bottom of it soon. I know there will still be some aches and pains and possibly even some bad attacks. It will all pay off eventually, though. I just need to continue being dilligent with my diet, try to get some exercise and let time do its thing.
Hey zip,
I'm pretty sure it was the drastic change in dosage that caused this – or the exercise. I don't think the cold, or lack there of, in my feet had much to do with it. I'm always out in the snow and have never noticed attacks from my feet being cold. I have some really good gear, too, and rarely have a problem with cold feet. Now, my hands…………
I'm thinking it may have been overdoing it on exercise more and more now. I was feeling pretty good this weekend, but last night I decided to do a little cardio and went pretty hard. Even though it was on a low-impact eliptical, I can really feel the twinges in my right ankle and a couple of my left toes. I don't think these will manifest in to full-blown attacks, but they are bothersome.
I go to the doc Thursday for my test results. I'll report back after I get them.
Yeah, I didn't want to mention the age thing
I'm sure it will be a factor as I do get older. I'm a weather nerd so I'm acutely aware of both the weather and my attacks. I just see no correlation so far.
600m/g is rare. Boy, did I suffer the first couple of months, but it may have been worth it to get the excess and built-up UA out of my body. I didn't notice any side effects from taking such a high dosage either – not-a-one. I do realize that this would not be for everyone.
As a general comparison, a few of my posts on here from I think Nov and Dec of '09 pretty much started out with
*$#@#! this son of a ^&)(#! go& d^#% gout attack!
This latest attack is NOWHERE near that level. It still hurts like heck, but definitely not as severe as before! I just think that any big switch regarding meds, diet, weight loss, etc… is bound to be a trigger for a lot of people.
cjeezy – docs instructions. I get my SUA levels checked monthly and have been for 6 months now. They have been between 3.8-4.2 for a few months now.
trev – I was wearing my interior Alaska Sorrel -100F snow boots. Love those things! I don't know if the snow had much to do with it. I suffered through really bad attacks while living in Hawaii too. I don't think the environments I've lived in (cold, hot, wet, dry, high pressure systems, low pressure systems, etc..) have had much to do with any attacks I've ever had. The change in the Allo dosage, however….. That is the culprit I'm leaning towards. I'm curious to see my test results next week.
Nope, still drinking tons of water. 3-4.5 Liters/day depending on what I've been doing + whatever tea and coffee I drink (which isn't more than half a liter a day).
Trev – I wonder if gout is striking people at a younger age now? I have no idea if there is any medical correlation for this or not. I know, for me personally, that the thought of having gout at a young age was embarassing. For a long time I suspected gout was my problem but I wasn't getting the backing of the doctors on this. You know, inexperienced docs taking UA readings when I wasn under attack and then telling me, “hey your UA levels are fine. Must be something else….” When I'd tell friends I thought I may have gout, I was teased and jokes were pointed in my direction. I think if they realized just how much pain I was in and what I was going through this might have been different. There are a lot of misconceptions out there about gout, especially with the younger generations. I'm hoping I can change these perceptions little by little and bring the reality of the disease to light. It's not something to be ashamed of!
I'm off for a short hike in the woods with the wife and the dog in the little snow that remains. Baby steps……. 🙂 Feels great to be getting back out, though!
Mine started at the age of 21. My dad has suffered through three or four attacks in his lifetime and his half brother is stricken with mild to middling attacks every 3 or 4 years. That is it as far as my family and gout. Then, there's me. I've always been very, very active, enjoying a variety of recreational pursuits and sports. I was a pretty good athlete through high school and college, playing a bunch of different organized sports. I really got in to skiing and mountain biking and climbing (outdoors stuff) around the age of 17 and became quite proficient at these as well. I got the same response from doctors as you – my lifestyle was causing the pain and 'injuries' and so forth. Yeah, I did get injured a lot, but that didn't explain the mystery swollen foot or wrist or elbow and eventually my knees. For the last 8 years or so, the gout really has affected what I could and couldn't do, but I soldiered on until I could soldier on no more. Doctors had me thinking I had all kinds of different problems and never singled out gout as the main culprit. It wasn't until this past October, after finding GoutPal.com, that things started to turn around for me. I was f'ing miserable! I finally received a positive diagnosis and have now taken the proper action to take control of my gout. This site has been indespensible. The advice offered by the people on here is better than you will find anywhere else on the web. The site is truly a blessing.
Take control of your gout NOW! Get your uric acid monitored, get on the necessary drugs to lower your UA levels, moderate your diet, make sure you find a good doctor that will work with you and most importantly, listen to you! It took me a while to accept it, but this is something you are going to have to deal with the rest of your life. I'm slowly on my way back and look forward to many more years in the mountains, doing what I like to do. Best of luck!
Because of limited allowable time off from work, I almost have always had to go in when I'm suffering from an attack. Getting to and from work is the worst, especially if it's a knee that is going through the attack. Driving is horribly painful (and probably dangerous). Getting from the car across the parking lot to my building is also a huge hassle. Then, there is the inevitable climb up two large flights of stairs to my office. Once there, I hunker down and don't leave for the day. I try to prepare the best I can by bringing my food, drinks and any meds I may need with me. Luckily, most of my work is done from a computer, so I don't have to be that mobile. It still is miserable sitting there all day with my joints throbbing away, trying to maintain some type of positivity and joy while dealing with demanding customers.
When the attacks are too bad to go in to work, I have to take my vacation days in order to stay home or go to the doctor. For the past 8 years, my vacation time has been severly limited and even completely used up by staying home becaue of gout. These are instances when I absolutely can not walk and am in so much pain that even getting out of bed is nearly impossible. I've lived in some pretty fantastic places during this time. It kills me knowing that I can not fully take advantage of travel opportunities or take any extended time off because I've used all of my vacation to deal with gout. I've luckily had some kind enough managers every now and then that have allowed me to work extra hours so I can take a day or two here or there, but this usually ends up adding to my stress load and wears me out more than anything. Doing this for so long really put me in a funk and I'm still dealing with it right now. Things are getting better, though. Because of this site, I've learned to take control of my gout and look forward to a more pleasant future. Seriously. This site has been wonderful and has put me on the right track. Thank you for that, GoutPal!
To be a bit more specific, though, I think I tend to move a bit too much when I'm undergoing an attack, using the affected joint way more than I should. I don't condone lying in bed all day, even during the worst attacks. I think it's important to try and be somewhat mobile in order to increase blood flow, but I do have a tendency to overdo things too. In my experience, I find a balance of sufficient rest with movement that doesn't stress the gout to be the most effective. I used to go skiing with horribly swollen ankles or elbows or wrists that wouldn't bend, drinking sufficient booze to numb the pain. I caused way more damage and greatly increased the time of recovery from my attacks by being such a bloody dunderhead and a pig-headed idiot. I know better now!
The old saw is applicable here:
Patient: “Doctor, it HURTS when I do that.”
Doctor: “Well then, don't DO that!”
Exactly, zip!
Good stuff on this thread! Thanks for sharing everyone. Diet is something I'm always struggling with. I eat well, but I tend to overthink things sometimes. Should I have this when I had this and did I have too much of that and it's going to affect this……
I altered my diet recently and haven't had any red meat and only a weekly portion or two of fish for the last few months. I haven't increased grain or pasta but have instead been implementing more tofu, fruits and veggies. In the overall gout management scheme, it seems to be working well. I have some belly weight that I would like to lose and hope to start doing some light exercise beyond walking the dog and shoveling the snow from the driveway! Start out slow and easy and adjust as needed. I'm hoping to find a simple balance to take a lot of the thinking out of the equation. I really need to simplify my life, take some of the stress out of it. Live simple, live healthy, be happy!
Anyway, the tofu fajitas my wife made last night were fantastic! Seasoned with cumin, the tofu is great. I'm looking forward to my lunch today 🙂
I want to stress that I don't think this method is a cure! It's a necessary means to an end for me two to three times a year. I don't get a lot of sick leave or vacation and have to show up to work no matter what at certain times. This was one of those occasions. I HAD to be back on my feet and had to once again go down this avenue.
I don't like prednisone at all but it does work for me at times. One thing I find funny is the predispostion of German doctors to give out cortisone shots like it's candy when I'm suffering through attacks. I actually have had to turn down shots before because I knew they were going overboard. Getting the shots also masked the uric acid crystals I was having examined and prolonged me receiving a confirming diagnosis of my gout.
Anyway – this is not a cure! It got me back on my feet and I actually still feel better right now than I have in MONTHS. I'm still taking my 600mg/day of allo, getting my blood checked monthly, eating very healthy, etc….
zip – I'm doing more research in to Orthonkin. My US insurance won't cover it so I have some thinking to do over this.
sorry – my thoughts are all over the place today. Very busy but at least have more energy and more mobility than I have in a long time!
