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Hans, If Concord was still flying you could nip half way round the world and be nipping ankles in no time ! π
I though my last post a great one <g>?? – I just hope the OP had time to absorb it π
George- there's no rule of thumb on urate clearance. Some people get twinges ,others attacks for at least 6 months it seems. You're not up to the year?on AP yet- and furthermore don't know your average working level of SUA [nice to know this figure].
Swings in SUA can go up or down so if you had a test at the min. and drift to a max. near 6.5 mg/dl you probably won't be shifting much in the way of urate in your body, as very much wished.
Do what is?always advised and get your real SUA figure every test- this alone will flag you up as 'onto the case' and hopefully stop the fudging that goes on with SUA figures with our friendly medicos! 300 mg AP is not always enough , but the normal dose for most it seems. Can be increased , if necessary.
?I reckon unless your figures? go above 5 much you are on track for less pain- till then keep off alcohol, aspirin and drink plenty of?H2O- you know the rules by now π
See how 1 or 2 Colchicine a day sounds to you HCP for your away trip -rather than the heavy doses used in attacks, which?don't suit you?
If you really don't like pain or meds? -then an SUA meter will be a good buy.
Learn to use it over some weeks or [more likely] months and keep records. If you learn wnat your body is telling/asking you -it will pay off.?????
5.2 SUA is too near danger for a gouty, post attack…
Likewise, 12 hours? SUA variation?doesn't compare with the 12 years gout probably took to come calling by!
Keep clear of your known gout?triggers and keep up 'non joint stress' exercise , water [!!] and stuff like anthocyanin rich Blueberries, Black Bean broth etc.? ie Alkalise? to the max, lose weight slowly and control BP-avoiding diuretics if at all?possible.[Sometimes unavoidable]
Your Dr is right to be passing the buck back?to you- if you can't handle it alone the meds are an adequate answer for long term management. The more you can get ahead now- the better your chances of long term success. Failure is painful and risky, if you don't want torture or near death experiences- as Stevie tellingly puts it!
Some people come here for a dabble, others to really learn, so it really is up to your best efforts to knock this curse back into the box. Good luck!
Yes Storm, that persitence is something that gets many. When one thinks of torture- it's the slow dripping on the forehead that's apparently the worst to bear!? [This is no drip, either]
On the urates being detected- I don't think they show up well, if at all , on X Rays. Damage to joints is more likely to show-?and?have been identified as due to gout. Hopefully you don't have this.
The Dect Scans on here are worth a look, but rarely ,if ever available to most here. [?Gout Neglect again!]
On the hip pain, we had a poster here who got gout much higher than feet due to perching on her boat navigators chair permanently. Quite a catch π , but it shows exceptions are always lurking.
Do you sit with your feet up a hell of a lot? Maybe if you walk a lot and have good circulation this will start intial gout elsewhere. If you get treatnment for the gout [hopefully] then this will improve the hip too -and that will resolve any doubts.
Our old faithful Colchicine will do the same job till then , if you can get some to try [at start ideally] of any?next attack.
On the? pain understanding bit- Gout is reported as being the most painful of all arthritic diseases- so you can claim 'prior dispensatiion' from Hubby on that!? π For him , also see first comment this post re: long term pain.
Around the ?120 and then about?mark initially? then $15 for replacement stock lancet and strips/swabs every few weeks/months depending on testing rate.
On the routine testing, not a bad thought , but asymptomatic hyperuracemia is the rule rather than the exception unfortunately. This means that repeat tests would be needed and some diet/lifestyle info taken? and really a dual energy? scan in early joints pain issues.
it's never going to happen, let's be realistic- that'ws why we're in this state with the 'devil illness' now!
Easier to blame overconsumption and bad lifestyles etc- as gets done, but this is just showing the holes in what passes for health care in the modern age.
Now , a prescription- that's easy, Sir!
[Side effects un-answerable for- that's for big pharma and a yard long list of 'get outs'!]
So, Yes ? It would make sense to test? SUA -but you couldn't even get one easily, once gout was triggered- so NO practical chance of the scourge being nailed soon [like ever?]. Notice I said 'supposed' to be dealing with in my post above.
We need a Gout Pressure group really- Keith for life president. Hoorah- a new dawn?. and a Royal Wedding to distract us from the pain and cost of keeping ourselves fit [for taxpaying purposes]
Hi there SJ- welcome to the fold- sounds like you did the beer now you talk the talk like us lot π
Firstly , thanks for the heads up on the pain of gout versus childbirth. As it's mostly men who get gout,at least till later years, we get it bundled up with 'Man Flu' jokes. No one dares make this claim against childbirth- which doesn't usually bring on suicidal thoughts- not unknown with long term untreated gout!
Well, you need a proper diagnosis to get the treatment needed. It could be something else and lifetime meds are not started without a clear indication. That said, you're early in to the problem and already looking for your own solutions. Medics can be quite clueless over gout even when the meds they prescribe state it as a side effect it [as been denied to me ! [See?above]
I've had not [very]?itchy white spots crop up all over a gout attack area and they subside later after dryibg out a bit. I've not seen much [if anything] on the rate of surface symptoms versus deep joint laydown of urates -but hopefully your joint depositions?are still not too well established with '3 day' attacks. Mine have been over a week normally when I had it untreated.
Stopping beer won't have an immediate?cure effect now, but some here will say do what you like with diet once you find your level- when on the proper meds for you. Wine is best from my exp. but I did meet one guy last year in a pub who switched back the other way to beer [strange..] to improve matters.research supports wine 2:1 less likely to trigger gout. [US study]
While you search for medical remedy, watching the diet now will pay immensely, esp if you invest in a SUA meter- as you don't like relying on Docs.?Like me on BP meds, have enough to do already with pill taking- and the side effects, probably.
I don't think you will have a problem convincing the Doc after a few posts on here- but of course?Drs. vary -and you do need a proper diagnosis. [Possibly a fluid draw from joint by specialist]
The pain can get worse than the early attacks- so stay vigilant!
I agree Zip. very few people [a few % ?] are likely to get away with SUA figures staying the same in life.
If they did, than diet and lifestyle would have a better chance. SUA will go up slowly- it's not a self reversing condition unless caused by external issues like radiation?treatment or??longterm ?meds etc. and then -only before an actual attack has occurred.
On top of the actual level of SUA building up over time -there's the day to day swings that cover up the results of personal trials to manage the 'threat'. I have tried this myself- and it's not easy to get 1 or 2 mg/dl lower.
So , with the impossible task of predicting how a varying amount of urates will stay around for too long,? deposit &?then trigger immune system to finally flare and?probably cause eventual?attack- it's no wonder Medics and sufferers alike get lost in the process, often enough.
Essentially, sufferers?have to establish- [not an?exhaustive list]
1.?Their SUA 'profile'? ie: blood figures and variations due to diet,exercise etc. plus flare/attack profile.
2. How much they are prepared to do?to?manage these figures without medication for urates reduction and at the risk of some severe?pain &? [probable] long term damage.
3. What finally,if out of time on the above factors,? what medical approach they are going to do to?manage the 'SUA critical' level back to acceptable. [ say 6mg/dl MAX]
With the practical working knowledge gained here and elsewhere, this approach seems capable of success for the general case. Some cases will be a lot more complicated- or risk more, but that's what medics are supposed to be dealing with?anyway.
The sufferer HAS to take an enlightened interest in this condition, to win well.??? My 2cents !
That's good news Baz- now we get to the interesting stage when the dose should be upped and you pass through the 6.5mg 'barrier'.?
If you're on the same diet and lifestyle as previously, I would think your Dr would up the dose to 200 or 300 mg/day as you seem happy on the med. and 7.5 SUA?is still in urate laying down country , as you know!
Keep us posted -and be prepared for some ups and downs so common with this illness.
That mucky water is a serious risk for causing infection, Gerry.
Have you thought/tried to put some strong [and hopefully?stretchy] plastic bags over yout feet when near a water soaking- even taping up round ankles?
This would help your chances of staying infection free in the lesion area
-?but remove the cover as soon as possible after to stop sweating up. An antiseptic swab, or cool antiseptic salt/BS soak after, might be a good idea, too.Worth looking like a refugee occasionally -?to save problems developing ..
While the 'Ice Jury' is out, maybe my suggestion of cold water soak for 20 mins or so is the best halfway house?
Even cool water feels great to a gouty foot!????
Ice ???? ? in the 'pain mindset' camp, possibly.
My?way, the? nearer to surface tissue gets a 'cold shrink' for a while helping ease discomfort?and the deeper joint deposits don't get the chance to start getting too?lucky and crystallising?even more with a 'payback' load!
PS: Where's Zip? He's missing all the fun? π
I was puzzled by that comment too- as all the previous advice here?is?NOT ignore long term UA build up, so at best, only a temporary solution.? Valid, maybe- for an individual choice, but not ideal for most with knowledge of Gout.
Maybe we're being tested π
Maybe, it's just a case of enduring more initial pain in order to speed up the healing process? [ie:?No Ice]
The long term pain of an attack is what wears me and many others down more than anything else!
I have used Soda Bicarb in?cool water as a soak with some success in the past – but never ice.
Quick answer is- that if you have gout diagnosed ,that's 'it's for life'? – at least in the background, if lucky!?
It's been building for ages- you just haven't triggered your immune reaction till now. When /where is rather acedemic, tbh.
You'll have to watch your step on diet as you well know- but when [& if] you then get a 'full blown' attack, you'll know it, alright π
Best thing to do is get?an?SUA taken?and a subsequent diagnosis. Then have some Colchicine on standby to deal with any flares and decide a management stategy then- with your medics.
By then you'll know whether they're on top of the issue or not from your own searches/treatment gained?etc,?and be even more aware yourself.
Pain is a great teacher, as we all know here π , but?gout can be handled OK- with the right approach.
Ben Franklin-Excellent link -so true of gouts' ass whipping tendencies… there's a cartoon to go with it somewhere.
Bloodletting ,Odo? In the old days it may have saved a few cases by default …
Anaemia -a lot easier to treat than gout. Or,maybe have the iron & UA?taken out -and your own blood back?
I see?blood re-oxygenating out of the patients body?is?being used for?treating bad cases of swine flu now, btw.
Haemachromiasis is apparently the most common undiagnosed [genetic] disease in europe.
I read it up last year, after getting?a lot of gout and fatigue etc but was told that untill you see copper flecks in the eye iris colour it's not a problem. This sounds a bit late in the day for me, but?I was surprised at the newspaper report on its prevalence.
There is indeed, relatively, a 'lot of it about' as is often said by Docs. Whatever, ?:)
High iron is?on the bad to have list for gout- one reason why younger women?stay clear of gout, too.
Hopefully, you will get some test figures on SUA and also fill us in more on the progress of the iron excess -as for gouties, this has to be an interesting connection.
Uriscorics may be one answer?
Ron- Given the amount of confusion over Gout with the average Doc , it's no surprise that secondary issues under such effective management get scant attention.
The relief at not having a gout attack makes us, maybe, rather easily fobbed off- as this is a different league to the worst gout can do.
However, the shock of intense pain can be very alarming- and being a bit older than you ,have learned to accept a few aches and pains as normal, especailly if they go away after a while.
I think, whilst under gout settling regime, it's best to take things a bit easier- it's no crime! Keep up the walking trips and avoid 'shock' loadings for a few months.
Hans has commented before on Docs- Surgeons like to chop and GPs like to prescribe- apart from that, little sympathy for the frustrated active type!
I've noticed a tendency [ no pun] to tendonitis or similar, these last few months.
Mainly noticeable in ankle and to the rear of it towards the heel on one foot.
I got stuck on the stairs a few weeks back after turning sharply on my heel and hobbled about after gingerly levering myself back to the GF. This was intensly sharp pain.
Occasionally I get a twinge of it to remind me. The knees also can suddenly give sharp twinges, at one point I could barely walk for a few hours, later on that week,?I was back to doing 6 miles in the country- though i was pleasantly surprised at this.
This hasn't been diagnosed by Doc as I have enough going on at the moment therebouts, even being on anitbiotics that can cause tendonitis ,apparently.
My SUA is well down low -and from twinges in finger joints and toes this is still in the settling stages.
I'm on 200mg?Probenecid daily?-[Sulfinpyrazone here] and suspect the joints/tendons/bursa are reacting to?changes in their structures as stuff moves about,? &/or dissipates.
Tendon attachment points do?seem vulnerable.?[Your bursa may be more with the gout- as more fluidic in structure.]
These symptoms are not like gout, with its slow build up, – but quite intense pains that come and go relatively suddenly when?under tension.
Does this seem like yours, Ron?
My bad- for sloppy posting, Hans-
On point 3, what I meant to convey was -It's more important to get sequential readings, and tally these with treatment and further? periodic measurements, rather than worry overmuch about 'absolute' values.
Especially, if not principally, due to this very point in discussion. ie:?what is good/bad in each sample?instance?
They're potentially unreliable on current suggestions.
This would explain the lack of focus in tallying?absolute SUA levels to symptoms -which seems to engender a sort of helplessness in approaching the scourge of gout in?a real?scientific sense!
No doubt, there's 'a lot of it about' ?
[PS:? I heartily support the plea for more research into this 'post sample drift' question of accuracy.]
Anyone know what happens when the sample cools on way to lab?
Do crystals precipitate and reduce the UA in solution thus reducing the reading gained?
I agree with the consensus that it's not absolutely critical what a level is -when looking at attack levels and treatment effect- but there are already too many variables in gout, to start with.
I can see that this topic is even more hard to nail than the usual suspect -of when to sample and what to make of the result, by many health carers.
This Banaba is amazing stuff- I've never heard of it and thought it a mispelling of banana ! π
It seems a more usual use is blood sugar control where it is as powerful as insulin.
From the site refereral:
Balances blood sugar
Promotes healthy insulin levels
Controls appetite and food craving (especially carbohydrate cravings)
Promote weight loss
So, these would have to be considered 'side effects' to the SUA lowering discussed from the Japanese research, when used for gout.
Obviously , to be used with exreme care. This is not to deny its potential usefulness, of course, but it looks like a good candidate to be banned and then resurrected as a miracle cure at huge cost.
With huge drums costing $10+ grand a go- this wouldn't be difficult to justify.
Sometimes,I really respect out forebears with their trials of home cures- many must have 'dropped off the cart' in the event and be written off to 'experience'.
With gout being so painful, this is understandable.
Newman- There's hold on new posts here due to revamping work – but you really need your own..
B -You're sure suffering right now- There's a whole lot going on here.
Amongst all this, one thing stands out to me- that of the assessment that 6.7 says you are clear for ongoing problems.
This is 'finger in the wind' territory to me- unless they have analysed weeks of figures and assessed accordingly, which I somehow doubt.
All the same, it adds up to the same thing- keep on going with the AP- it is obviously going to be a long haul for you by current reports from you.
It does seem never ending and we have others who have finally broken through the ceiling on attacks like this.
Have you really hit on the Colchicine? Zip here goes for the 16 burn [spaced out of course]- which I think a bit' iffy', but you might manage a more aggressive regime [than you are ,maybe on] with it.
I reckon 12, in a course, is enough, but if you are getting the real squits- that is probably a good indication that it's working.
I mean liquidized at the business end!
If so, you you need a 3 day break from this med- in between courses, but unless you get a good 'purge' you are tottering on the edge like with the AP [albeit, unavoidably]. Get a grip, with your Docs help, on the Colchicine routine.
You've had a lot of intervention to deal with in a difficult case. Don't make it worse by beating up on yourself- you will get through and Xmas will be just great, OK?
PS: I nearly forgot- check out the Black Bean broth here. It's FOOD after all , and can help.
Newman- driving is not helpful for gout ! The pressure on the legs when pinched off behind the knee can reduce circulation a lot.
One days diet is not going to undo years of urate build up.
Unfortunately, the drug based treatment regimes current now are a long way from holistic health that some oldie Docs would have learnt over years of community care. Health is a lifestyle choice , not in a bottle.
'Instant shots for all' doesn't apply to gout- it has a payback time in getting back to healthier ways. Flares are normal under initial treatment with gout meds.
Can you post your figures? The 'normal' bit doesn't apply to gouties- anything over 6 is danger territory and 3 is what you need for urate clearance- That is the lowest 'normal' figure for a male, btw!
Colchicine should help your attacks times, but you will have to titrate the dose to suit the results gained- and have a break after 3 days on it, if at more than 2 a day. Get Drs advice on this if prescribed.
I understand that blood donated and found unsuitable for any reason can be turned into plasma which can be used in place of blood- without the Blood type being an issue.
With the amount of care , or lack of it in Gout, I would think the cost of testing SUA would be prohibitive-but a nice idea.
A random slug of high octane gouty blood would not be noticed, unless already a sufferer getting it- and then it would take some time.
Anyone needing a transfusion would probably not mention it later, even if tieing the events together.
Hope your problems ease soon, Lynda. Stress is bad for gout. So is living with people who don't understand special diets.
I had a meat loving wife for 25 years and did the same- but on separation, I stopped meat 20 odd years ago and don't regret it.
I do eat fish, but skinless. The diet thing is good for gout, to the tune of a point on the SUA scale or two, but it all helps.
Further, the grabbing control back in your life is good for you too- and will make you more resolved to get fit again.
People who just nod and glaze over about others issues are understandable, but sometimes a gout prod jolt would be nice to deliver!” <evil>.
I have a friend who knows the gout /beer link but always offers another, and another etc- it's what men do!! Isn't it? Well- not with big 'G'
The mental strictness is hard, but needed in these areas.
Water intake really HAS to be worked on- we just lose out abilty to feel thirsty with age. I still o0nly do just over half what I should do.
It's said that , by the time we feel thirsty we are getting de- hydrated already. There was a Dr Batmangelhej [or similar, dead now] who wrote a lot on this- 'Your bodies many cries for water'! For gouties, especially true..
Burgess, you know what you have to do.
You can take AlloP OK, and you can lose some weight and with diet care you can get rid of the scourge readily -unless your system says otherwise for some reason. [Maybe you should push Dr for more annswers?]
You just have to try it- as you are WAY too young to suffer all the knock on effects of high SUA possible.
If you can read reports on here, you can do the walk too- and no-one else will do the hard work needed.
The meds will certainly help, and I don't mean painkillers- they are not good long term and you have long term to do at your age, if you get on the case to make it more comfortable too.
Colchicine is not a cure for gout.
Hi Brendan
Till you get your results due- try not to jump the gun. You need specialist advice to take these meds with kidney function loss.
There's a lot of discussion on various meds here that can apply differently to each taker- but one thing we all agree on is that alcohol is BAD for un-managed gout.
If you take this seriously by reducing your alcohol intake to minimal until your figures on SUA stay down ,and comfortably,- then the docs will think harder for you π -and be more inclined to back off the meds, if causing side effects.
You definitely don't want the pain back, do you?
Don't forget your SUA readings for here- they are a big indicator.
Glad things are improving Lynda. I know with the transplant you have to tread carefully, indeed.
For this reason it's a shame that you can't take uriscorics- as they seem to really whistle down the SUA.AlloP is best for you, though- as it cuts production.
Are you really doing enough of the right things to help? Diet [strongly adhered to] can take about 1-2 points off SUA , coupled with water intake kept up.
I'm back on Lasix/Cozaar combo again after the Doxasozin faltered somewhat- so I know what extra problems can add to Gout issues and treatment.
Mu SUA was 2.8 yesterday and that just with 200mg daily of Sulfinpyrazone on top. It was nearly 9 after stopping AlloP, a while back.
On the knees, I have to mention that calcium deposits are not impossible, along with normal gout – they usually present in the knee and take a different med to handle.
Psuedogout- just as painful, apparently as gout. Lets hope it was just MS urate a touch' long in the going'.
