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Hi Leon.
You have my sympathy- I always feel bad to see someone relatively young getting a whacking from Bro G. It's not unknown , though- even in young, female non- drinkers!
Firstly, you will get good specific advice here ,over time, but these a early anwsers to some of your ??…
Stop the smokes as planned- it will otherwise give you Hi BP/ artery disease and other problems that will make gout worse over time and affect your health badly.
If you worry now- don't wait for an attack. You're right to get in early.
You have found medics lacking on the subject of gout- that is common.
You have done good testing already and will need to get the measure of those results as to liver/ kidney function etc. This could effect your medication in the future.
Don't despair- if you read the posts here there is good advice on diet, meds and drinking but the most important thing at present is get a grip on your serum UA and tread extremely carefully till then.
If you are permanently in Kuwait, hydration will be, even more, top of your list for coping right now.
Drink plenty of good clean water with a break 1/2 hour before and 2 hours after meals.
Gout tendency is Genetic- you probably have an older relative or two with arthritis.
If you don't want long term gout meds- then it is a much harder path to control gout- but some are trying still, after many painful 'full attacks' & I'm one of 'em!
I've tried Cherry juices and found them pretty expensive and can't say they worked for me.
At the price , I probably didn't persist long enough- to be fair!
However, as this is a well documented strain in gout cure writings- I now buy only the Cherry version of those well known Muller Fruit Corners- it has 20+ gms of rather high quality cherry compote and is thus a very small 'on cost' to what would be a healthy addition to anyones normal diet.
I've often wondered why it's such a popular flavour and pleased my local Express store always stocks it.
Maybe there are more secret gouties about?
Yes. water is a great cure- I bought the Dr.Batmanghelidj book 'You're not Sick,you're Thirsty' a while back.
He states that after early adulthood one loses the sense of thirst progressively over the years , masking the feeling -by that for hunger.
By about retirement, we are almost bound to be dehydrated permanently, unless this tendency is fought off.
I don't think there is an easy solution- apart from 'gaining the habit' as described in GPs' note here.
Dr.B was in the Iraq/Iran war decades ago and had nothing to treat his fellow prisoners with and found that most illnesses [Gastric in this instance, but far from solely ] were cured by taking water .
He had apparently complained that all he had was water, and was tiold to get on with it! So he did.
A lot of gout cures are a herbal pill and instructions to drink a load of water! Nice earners..
On a similar topic for health,I recently found online ,instructions to drink water first thing am. and not eat for 45 minutes and to not drink for 2 hours after meals.
I can't find the page. I copied the text , however.
This article was based on research in Japan and covered joint pain ,but not Gout as such -and had quite outlandish claims about cures.
However, this is common online -and doesn't mean there's not a lot in there worth considering in lifestyle choices.
If anyone would like the text ,PM me.
Good to hear a good management story. There's no doubt that, whatever the worry and risk of long term medications, chronic damage to joints is the last thing anyone wants to grow old with.
In my mind, the issue of diet and UA needle growth & dispersal keep twanging something.
Both are long term events and hard to monitor.
I think diet is a large element but obscured from gout reactions by time and complexity.
Likewise the needles are very clever and can form again very easily after being 'digested'. The chemicals are still in the blood untill presumably eliminated by the liver -if the conditions are right!
Are they really eaten? I looked again at the sequence GP kindly put on site [linked above] and enhanced the last pic a bit and, on the last shot, the needle is still very much in evidence.
This is not to question the use of sequenced pics- I find them fascinating but this area of fundamental gout triggers and dispersals seems central to how the whole issue is managed, by the medical world using drug therapy, into an all too easy solution.
I have spoken to people on drugs therapy for gout and many still drink quite heavily and overeat despite the risks of masking a severe metabolic disorder.
It has already been acknowledged that UA levels are heavily involved positively in immune response capability and simply driving into a apparent safe zone [for gout prophylaxis ] is not enough, holistically speaking, for me.
I agree, it is a better place to be- for the chronic sufferer, so I am hoping for further research being done to really get this intrusive condition 'nailed', once and for all in a way that protects good health more fully.
I was puzzled by the second post also!
Two things struck me on Bobs' experience-
One, I've recently taken Colc +Statins together and I felt that the Coch effect was enhanced rather than diminished- but anyway , similarly, stopped the Simvastatin after a few doses as it made me feel groggy and I had enough on already!
Secondly, with such high SUA I wonder if Soda BiCarb would help here? [1/2 tsp/ bi-daily in water]
I have 'hard to control' High BP -so can never consider the use of this common medicine cupboard drug remedy, though have been tempted greatly.
Hi B.P. is not an issue here and others have found it effective in lowering blood acid quickly.
I have used it however as a soak[up to 1/2 cup] ,along with Epsom Salts[up to 1/2 cup] in the bath- and understand, as well as detoxing, this combinatiion used equally, can balance out re-absorptions.
Large packs can be found if you shop.
With such a painful situation anything would help extensive gout like this case.
Thanks Keith-
I gave it a try and uploaded to your site OK .
Saves messing with 3rd party sites!This was the last attack in June 09 -comparing bad L foot with almost normal R.
Did I miss that box at the end before- or is it a new add on?
I may have been put off by the url tag , which is still on there.
It's a shame that feet aren't pretty to start with- but you do need samples on here and people need something to compare to, as well.
A picture is worth a thousand words, or in gouts' case- 100
[ We like to share 
]
Docs? I doubt you will have a penpusher- they have to be a bit more engaged that that in a hospital setting.
If he's really young he will have an 'old fox' lurking behind and will disapear that way if the going gets tough- At least he will be fresh on training but as Gout is still recovering from Henry VIIIs' bad image- that isn't saying much
My last visit to a hospital consultant drew the comment that treatment (for High BP) was a bit hit and miss- & I appreciated his honesty. I would say Gout is a better bet for a result on that score.
I was only there because another [and younger, non GP] Dr. liistened to me and booked me in for serious tests- it didn't go down well with the lead man!
Taking an interest in your condition is a good thing, there is occasional arrogance in the medical profession and not quite enough compassion or humility – though I don't envy their position between the Gov't and Pharma. The pay must help a bit!
Hi Amy- Sounds like you have had a nasty time with this.
Whenever I hear 'knees' – I think 'Psuedo-gout' , due to Calcium deposits rather than Uric Acid.
Has this been mentioned at all, in your diagnosis ?
The nail got stamped on years ago in a scrap.
It sometimes gets stressed on a walk (right where the boots bend) when the nail discolours at the quick a bit and then it comes off!.The new nail will look & be OK for a while then it will probably happen again. Not sure what the weakness is, I just think wherever the nail grows from is vulnerable in some way.The nail still carries striations on the outer side from being crushed- as it has trouble forming well, but otherwise is no real problem.
Makes a change from Gout!
When life gets tedious – it's good to look at an old Gout pic- very nice not to have one going on!
The nail is an old injury which walking boots tends to kick in and maker the nail come off.
Thanks for your concern. I don't think there is any infection.
My foot is almost back to normal now- going on a 6 miler today- so if the boots play up ( can't get away with sandals with recent rain)- I'll chop the distance.
Onwards and sideways 🙂
Yes, It's quite strange when you look at what your own body has done with itself!
I suppose it was about 5 years ago [my early 60's] whenthe first twinges started, and it was a while before I got an attack proper. Always brought on by beer drinking- naturally enough.
I love real ale- a prerequisite for suffering in the Gout game 🙂
Yeah, I knew you meant water- but on holiday you need a few naughties so I was giving tacit permission- especially now you corrected me and you're nothing like as Baaad as presumed 😉
I sincerely hope you have a better run this time anyway- enough frights already!
I've finally got round to adding a pic of that last attack on Flikr for reference and some notes if they show up.
I know feet aren't pretty but the info is hopefully useful !
Don't knock your forbears VG- it wasn't their bad eating habits but your mutual genes.
Arthritis in the family is a dead giveaway- and as Gout is of that ilk- the old adage of keeping things moving but NOT ,in Gouts case, over stressed.
If your walking involves more than a few miles a day you will be taking a risk of course- but keeping to a regular daily routine and keeping the walks circular, if at all possible, gives you some 'get out' it the 'tweeks' start.
Try a hiking pole ,too. Collapsed- if you don't need it.
From what you've said previously- I bet you're planning 10+ miles a day though!
I have a 6+ mile walk coming up on Sunday- I want to do it but still wary after my recent attack- but I did a shorter 4m one last week, on the flat, in soft sandals +socks, on a quite hot evening too- without problems. Heavy boots haven't helped in the past btw.
It's all a lottery, but the getting out will be good for your angry soul right now! 😉
Keep to one or two SMALL glasses of wine MAX,no beer/spirits -with food and keep the fluids up- and I reckon you'll squeak through- if you avoid the worst food triggers.
Further ,I would like to add that your blood lipids being high will add to your risk of the cursed added dimension to gout- Hypertension, an added risk factor which I struggle with now.
As your age is young for high levels of risk for both these- the genetic, inherited factor is a big one.
Being overweight is in the same territory- as an added element of risk.
The good thing is people are getting on top of these co factors early- so though you are somewhat unlucky to be looking at these issues relatively young, you have a good chance of 'getting in first' as you are doing.
By the time they threaten any chronic disposal in your life [and concommitently also,as happens so much as you age], you will be an expert in all these conditions- and hopefully have better drugs and protocols than arrived over the last 50 years.
Doctors have mentioned to me that they prefer if more people' took an interest' and discussed more fully their concerns with them.
The web has made some, if far from all, patients less overawed by medical professionals.
Passwords: BMI< 25 , Good Diet & Regular Exercise.
Oh, While we're at it- Try to be born to the right parents
Yeah- Watch the goats..the deserts' big and lonely
I find Colc. helps- but would hesitate to take more than 8 tabs/day for a few days myself.
A body can get used to painkillers after a while – so it's not a long term solution to rely on these.
I generally use Co-Codamol [Effervescent] but am aware that Codeine is habit forming long term.
Seems to me VegGuy, 5 or 10 miles a day for 5 days would be a sensible weekly 'maintainence routine' while you sort out a diagnosis and treatment plan.
I know a head on approach is admirable when the medals get handed out- but your body may hand you a few first!
Gout isn't in the least forgiving….
From my experience on this- (fwiw)
If you can ride a bike without stressing the bad joints- all to the good, it's the only way I can get around when I have an attack,[assuming you don't get knee or instep problems, that is].
It keeps the morale up and stops long days of inactivity that don't help general wellness.
17 miles though, would seem like pushing it to me, as stress in general is supposed to contribute to attacks. Tiredness certainly, in my case.
Did I read here somewhere, that lactic acid from heavy training workouts can mess up the bodies Ph balance- seems to make sense.
I do get tenderness on old sites, particularly on the big toe joints which act as monitors to impending activity-
If you have this mechanism then you may manage a work round but you know how effective your meds are in this, should you 'get it wrong'.
I noticed the RH vein also and wondered why the LH didn't so present.
Maybe there are depositions on the RH veinous system not present on the LH
In this case- it's possible that the discrimination of the scanner can't differentiate between certain of these variables.
Also of interest is the suggestion that calcium and gout tophi are intermingling – this would help understanding but first thoughts are how much more complicated gout treatment could get with extra knowledge available now- but it must be a way forward.
In course of treatment scans would be invaluable to address the re- triggering of attacks, whilst stabilising SUA.
*** Goutpal- if you can would you attach my recent 'attack' pic here as I can't do this at present!
It would illustrate a typical attack and the fairly clear other foot to compare.
This lapsed site http://www.podiatry-arena.com/…..php?t=1242
has some interesting comments about rheumatologists, but more to the point are some pointers as to the establishment mechanisms of gout in the toe- a favourite spot!
Your pic doesn't show much to identify, so I can see why you can't get a diagnosis.
Don't forget Gout is a form of arthiritis and the specialists may not be 'Gods'- but they do see a lot of cases for comparison
I have a pic of my recent attack which would put yours to shame ;-D – but I keep forgetting my sites where I can post my pics -and all old mails with links/passwords etc. gone on upgrading.
Is there a simpler way to do it here?
Since the attack the skin has peeled off like sunburn- attack as usual not a lot of fun- especially as I omitted the icecream treat at the time !
When I first got gout in my L.ankle, a few years back, I was caught out enough to get it x-rayed in casualty. It felt like it was broken- and I had actually broken this same ankle 20+ years ago.
I mentioned I suffered from gout and they brushed the comment aside.
Nothing detected , and I got pained looks as presumably an imposter would.
After a decent few days interval,' Big G' showed its hand and the ankle went through the usual.
Until we get that double energy x-ray [developed in Canada] we will never get a fair hearing (on average, anyway) – unless lucky enough to meet a fellow sufferer.
http://w1.siemens.com/press/en…..905045.htm
On the issue that I first meant to address here, your symptoms ,Veg Guy, sound just like mine, and that is indisputably gout!
Yours may not be, but I would guestimate much higher than 50/50 chance and the fact that you are here seems to indiicate your suspicions also.
Good move- the more you know the better, though everyone would wish the problem miles away- with a bent politician,say!
TBH – if you got away with 4 hours on the hoof you were lucky and I would expect you might pay the price sooner, rather than later.
This will depend on your SUA status more than anything- but without some Colchicine, as a standby treatment backup I can understand your wanting to get a diagnosis as you won't get the drug without one.
I think it's good that you at least don't have to go through the worrying business alone- as many (including me) have done in the past and at least here, people really do 'get it', for once – in more ways than one!
I have gout, I get treatment from the Dr. to deal with the attacks.
Colchicine – good enough but not something you'd take if you didn't have to – it's basically (like a lot of drugs) a poison.
When having a blood test recently I had to insist that SUA was added to assessement checklist for the hospital doing the analysis.
It just doesn't seem to enter the mind of medics that this figure is important to a gout sufferer.
When I queried the results to reception a week later I was told results were – OK !
Needless to say, I got caught with an attack a few weeks later, when being indiscreet with the beer glass.
My uric acid in blood was actually around 7.5,- for a sufferer, in the danger area -but discovered too late. Quoted as 445 mmol/dL just to confuse..
Your notes about Blood Uric Acid should be pinned to every GPs wall.
No wonder home testing is becoming, not just popular, but necessary.
I'm sure most, but probably not all, sufferers of Gout would like to follow a dietary cure rouite if they could.
Due to the fact that levels of UA in the blood are so variable and triggers so individualised this becomes something of an unobtainable 'Holy Grail'- and to default to the drug cure is all too easy, especially if pushed by your Doc!
I would have thought 3% was a good accuracy for home testing given the equipment spec of 6x that- so so long as you do the tests under similar time and conditions then to look for a 20% overall reduction in UA over time, would be readily attainable- if you are prepared to stick to a tough diet totally for long enough.
My 2c – no expert!
This ? has gone cold- but it's an interesting one.
The obvious and simple answer is 'It depends' …
On what?- well the SUA status of the eater for a start, hydration and stress or injury at a vulnerable joint for an extra kick- just when you don't need it.
All the same to start the ball rolling I would say that if I'm building for an attack then hours are all it takes to feel known culprits like shrimps & beer have their effect.
If it's taking days then you'll never know imo! In other words- only in the critical stages will you be able to discriminate- and then it's too late.
PS: Contrary to what's been said elsewhere Curries are supposed to be beneficial and one cure I tried years ago was simply Circumin in a capsule and lots of water to go with it ! Surprise….
I suppose our OP guest has long gone- but it would be good to know why the usefully acting Mg was stopped!
it is apparently commonly quite low in Western diets in any case.
I've got loads of old data on paleolithic diets etc. which address these deficiencies but now the web is so well informed- new searches would raise the same points.
Almonds are a good alkalising source of Mg.
Zip: I take minimum salt !
The beta blocker does not seem to have a diuretic effect as far as I can tell. I've been drinking more through this current attack.
I saw the Hospital Dr today -something of an interim stage as more tests due next week.
He took the suggestion of Lasix and Cozaar, at split times, very well -and said he hadn't heard of it.
Naturally I forget to tacke the paperwork on this… :~((
I couldn't say why I wasn't on AlloP as he seemed to feel this should have been pushed by GP earlier. My superficial answer was- what? -another long term drug to take! – but I think worries about eventual liver damage are in the back of my mind.
He stated that people are too ready to stop the use of Diuretics but the reasons weren't discussed. Maybe as Gout is random, medium/long term periodic- it gets downgraded- but the sufferers don't forget easily!
As this was a cardio clinic he looked on Gout and even pre-diabetes as a secondary concern to that of unresponsive Hypertension therapy. No doubt he is right, in a interventionist world- but these side issues seem to have uncanny links as we discuss them here.
I didn't dare mention the issue of high UA in heart disease in general – nor the recent study in the US of some teenagers, given AlloP– and finding their BP reduced!! [Another+ plus for it]
Maybe, in time, a stronger link will glue these two plagues together more constructively and equally, treatmernt can be co- supportive, rather than clashing in the backwoods of old fashioned views of treatment. Many novel uses for existing drugs seem to be appearing more and more.
Anyhow, your timely posting of this Lasix/Cozaar looks like going on a bit. I hope to get on it.
Any Magnesium reduction (by Loop diuretic action) can be dealt with by supplementation- should it possibly occur later.
Zip: Thankyou for your tip on the betaBlockers.
My aggressive 'antiBP' specialist has added them back in -and on just reading this thread realise that Thiazides are not the only culprit using diuresis.
Are BetaBlocks the cause of my latest attack -after a whole year free?
I'm getting a bit peed off to say the least at my treatment- tomorrow i see a consultant cardio who at least is one stage up the chain- and I hope to resolve a few issues.
Talk about the left hand not knowing what the right hand does….
You're quite right- HT is a RISK, if a serious one, but shovelling the problem down a dark alley with a few years grace before it resurfaces as another risk factor (Gout) is no way to treat sensitive humans [ like me!]
