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Gout Pal , thank you.
I'm sure I have understood what the consultants are trying to do, I am aware that I cannot just come off the allupurinol. I would not be surprised if gout and a broken sesamoid are playing their part.
“Fractures usually heal eventually” I've been told that mine won't heal as it has atrophy. The injury is years old and has been overlooked because of the earlier gout diagnosis. I was given indomec/dicoflex and other drugs to mask its pain. None worked. Since returning from Shaolin in May i have persevered with trying to tell consultants that I am not having a gout attack and that something else is wrong and has been wrong for years.Eventually MRI showed the fracture. It has caused me an incredible amount of pain.
I'll keep you posted of developments that might help others in a similar situation. Gout Pal's input on the correct course of treatment can be used to guide your consultants.
Believe it was depo-mendrone . We are trying to eliminate the gout as causing the severe reaction in the sesamoid;what's the problem with doing the 6 week allupurinol and reviewing the blood urate? If I still get the symptoms if the urate is lowered it would point to the problem being something other than gout? I may have to stay on the allupurinol and keep reviewing the urate. It is a trial period to try and eliminate the gout from the equation o the reaction to my foot swelling up when the broken sesamoid is overused.
Hi all, bit of an update. I've been having bouts of pain brought on by activity, walking , coaching rugby (no real sports activity). Been backwards and forwards to consuultant podiatrist. I begged for an air cast to help me walk when I had pain. That caused more problems because it made me mobile and I over did it causing ankle and achilies problem. Had full bone scan, sesamoid injury shows up like a bright star. Podiatrist concerened at the clour of my injured foot , it looks purple and swollen compared to the good foot. He also said the injury is years old and the sesamoid has atrophy. I am beside myself with the stress of this. I was told years ago that my pain was gout , but I had a broken bone that has now died! The payyern of pain seems to follow any prolonged walking/standing or ballistic movement involving my forefoot. By the end of a working week my toe is sore, add the weekend gentle activities and by the following Monday evening/Tuesday agony.The less active I am on my feet, the less pain. Swimming seems to be the only activity to keep my sanity , (must watch the push offs though!).
I have been referred back to rheumatologist as the podiatrist thinks there might be Chronic Regional Pain Syndrome . Rheumotologist thinks no CRPS and we agreed to try and eliminate gout as best as possible by going on allupurinol 100, 200, 300 mg increase fortnightly for 6 weeks, get urates to 300. If I still get the pain and symptoms then hes says it should rule out the gout. Podiatrist says he will inject the toe to help fix the pain. I won't take the injection until the Allupurionol trial is complete. Rheumatologist is not convinced of gout either, as he reminded me that when he saw me when I had an episode he injected me in the rear (with ?) and it didn't sort it out.
There, that's got it off my chest and I feel better for it!
