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If she has a history of gout then it is quite likely gout related. If this is an isolated incident with no history of gout, then it MANY be gout but it is not likely.
Welcome Jeffros?so sad to hear that you HAD the allopurinol and didn't take it. I am sure that won't happen again.
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The gout will get better but I hope you can get a resolution of the mangled knee. I went for weeks unable to straighten mine but it was only a ripped meniscus that kept getting stuck inside the joint acting like a wedge.
some awful white chalky paste-like goo. Is this tophi?
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Yes it is?and the nice part? this is one of the few places that tophi don't HURT!
You got a pretty soild diagnosis with that burst tophus. Some of us have to play more of a guessing game.
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Don't fear allopuinol for life, it is among the most innocuous of drugs.
I think it is not necessary to differentiate the particular attachments the urate ion has made, whether with an H+ or any number of Na+. Both forms are present and the quantity of one versus the other depends on the concentration of H+, i.e. acidity.
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I am certain that what is flowing in the bloodstream and what is settled out in old tophi contain both the acid and the monosodium urate, and even the disodium salt. All are equillibrium solutions.?Only the relative quantities of? components?change. I think all we might say is that at normal body temperature, MOST urate in the bloodstream is the weak acid and MOST urate in tophi exists as the monosodium salt.
They cannot be sure even when testing how much of each exists because the mere action of chemical reagants is exttremely likely to change the mix and any testing solution used is going to be vastly different from plasma.?Thus the only thing they can be really sure of is the total urate content.
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There's a long old discussion of solubilities of the various forms of urate but, alas it is a Springer Link and thus $$$$ to read. As I vaguely recall the solubilities of urate forms do not differ much between UA and MSU.
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I have? taken to referring to serum urate and urate deposits?and I think that is as good a term as any other. It's about as clear as the subject will allow.
@ zip2play how temporary how many days? will I take alop for 600mg?
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I would think something like 3 months with a couple blood tests to ascertain effect on serum urate. Based on the final urate you can then adjust the dosage or not.
bestest said:
I'm now on my third week of taking alop. Started with 100mg a day gradually increase dose each week now I'm on 300mg a day and my index finger and palm hurts so bad this morning I took calchicine hoping the pain will lessen but up to now it still hurts so bad it gives me fever. Is this how it should feel when uric acid is desolving?
Most likely what you are feeling is an acute attack.
Why not consider bumping up the allopurinol, perhaps even to 600 mg and perhaps only temporarily. You want to get out of that 6-7 UA range as soon as possible?which will cause endless attacks. Remember that those WITHOUT gout can escape attacks in that range but once gout has occurred that?range will be forever dangerous.
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If you can lower your dosage in the future all the better but perhaps not because you?started with?the highest serum urate I have ever heard of. I'm surprised you didn't crackle while you walked. Know well that allopurinol may have saved your life.
Yeah,
After 8 years it is none too soon to start allopurinol in earnest and forever. I recommend you go right to 300 mg. If your doctor talks nonsense about 100 mg. to start, tell her you already DID that and you are not allergic to the drug so no sense screwing around with an ineffective dosing schedule.
Brian,
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A knee is very hard to call but my best guesstimate is that for a first attack, a knee is NOT a?likely place for gout to attack.
So, given equal odds, my bet would be NOT GOUT.
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Have you done anything that would have torn a meniscus (cartilege?)
ctrl,
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That sounds more like the syndrome characteristic of CHRONIC gout, frequent less severe attacks,?rather than ACUTE gout, infrequent and unabatedly?INTENSE,?but there is a whole spectrum of gout manifestation made even broader by use of several pain meds during the long bout.
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If it goes on for much longer, just take the allopurinol rather than waiting too much?longer. When you start, don't stop for anything except a serious?allergic rash. Continue to take the colchicine with the allopurinol for perhaps a month.
You might try a day with 8 or more colchicine to see if you can knock it out.
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Avoid beer for a while.
Wow Keith, 900 mg.
You will be our guinea pig.
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Suprpising, since not so long you were very quietly but very firmly resisting allopurinol. <wink>
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Now here's your task (if you choose to accept it< Mission Impossible theme playing>): prove me a liar when I say that tophi removal is a near impossibility because of the deft way that the immune system walls off urate. I feel pretty strongly that tophi will persist even with a serum urate of zero. The ball is in your court. (If it works for you, I'll up my allopurinol too.)
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Well, best of luck to you.
polecat,
Too bad about that rotten first diiagnosis. Probably the stiffness in your hand has more to do with the attempted surgery than with gout itself.
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(Yes, I too know the difficulty of getting to the bathroom on hands and knees with one foot lifted behind so as not to bump anything. Probably worse for you with a bad hand.)
Consider taking 400 mg. allopurinol with an eye towards getting that 5.3 down a little more to give you a margin of safety. After months without an attack you can go back to 300.
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After things settle pehaps you will need some physical therapy with that hand.
How about:
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It has been shown that 35% of fatal car injuries involve alcohol,
SO in order to reduce your chance of a fatal car injury make sure you are pretty wasted when you drive?
Esprit,
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A bad back, which I also have, may or may not be gout related, which I also have.
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Ignore the back for the time being and ASSUME your toe is gout related and test your uric acid. If it is high it is more likely the toe is? gout and less likely it is sciatica.
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You CAN have both.
If you can endure 11-16 pills/day, you, probably, may get rid of the attack/inflammation in 3-4 instead of 14 days.?
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Or ONE DAY! That was my experience with the worst attack imagineable that went on for 14 days. But I took 22 pills?one an hour!
Of course, I shat my brains out for hours and hours. Each glass of water ran through me in?5 minutes. But I ran to the bathroom with a smile because I was running and not CRAWLING. (This was all before allopurinol!)
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Now I take 2 if I feel anything that I really suspect as gout?and 2 more if the pain is still there an hour later. Four gets rid of the pain and causes mild diarrhea the next day. I use about?8 colchicne a year.
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For an attack that is crippling and has gone on for a week I recommend the dosage from the PDR a couple decades ago:
2 to start + 1 every hour until pain ceases, diarrhea starts or you hit 16.
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Of course, now that the FDA has colluded with a manufacturer to repatent colchine, the oldest known drug,?the cost of 16 colchicine?is exorbitent.
When you are on allopurinol and still feel an attack, take 1 or 2 colchicnes immediately. If pain persists for an hour, do it again. As Keith said DO NOT STOP ALLOPURINOL.
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I think Naproxen is a TERRIFIC drug, but I have yet to use it for any foot pains, so I cannot give any personal anecdotal info on it re gout. For my knee and shoulder pains and even minor low back discomfort?it works very well.
(For BIG backaches it's SOMA plus my TENS unit.)
That's why I add 20 drops of KOH to my water (1 gal) before drinking it. I know, it has raised my bodily (urine and saliva) pH's by .5 to 1 point.??
What was the strength of the KOH solution?you put into the water as drops. I ask because I know that pure KOH is a solid so?to use drops it must be a water solution.
Where did you buy it?
(I know that LYE (NaOH) is easy to find but I have never seen KOH even in a big hardware store.)
Actually GLUCOSE is the body's primary antioxidant.??Fructose probably comes in second being convertible to glucose.
An antioxidant is nothing more or less than a reducing agent.
Hang in there Donna.
I have gout, I take allopurinol , I have had burning feet occasionally?but I think there's no relationship.
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Probably a month from now the allopurinol will have started working its magic.
It is important that you get some reading of Uric Acid? between this last attack and the NEXT.
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So if you have ANY reason to go to an MD, make sure a uric acid blood draw is part of the visit.
Keith (Gout Admin) said:
I'd love to say it was Zip2play's wise words that convinced me on daily allopurinol, but it actually took a large bang on the head!
I hope you don't have to fall 14 feet for your next AHA moment.
I also hope everything is healing well!
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(I was WONDERING how long you were going to avoid my advice.)
cjeezy,
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Hi again.
I would look into anything going on that might cause lean tissue breakdowm This might account for a flooding of your system with nucleic acid wastes>>>uric acid.
Heavy workouts? Fast weight loss?
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Allopurinol isn't appreciably a drug that we get accustomed to and need more and more of.
That is very tempting but alas the trip from New York is a bit of a haul, and?it is already the 28th.?
But mostly,?I'd be afraid I'd wind up in the pokey if?I really let my feeings about how the U.S. and?its FDA?has kow-towed to Big Pharma in a huge?price fixing scheme to extort money from those suffering this?lifelong diseases.
?I'm afraid that the words BRIBERY and “rigged studies” would escape my lips a bit too often for the delicate ears of? those on the take.
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I wish you well.
I lost 20 pounds in 6 weeks at the end of last year casued by tension and anorexia. I subsisted on beer, hard work, and anxiety raised to level of panic.
Up popped 2 tiny tophi on my right had. Painless but tophi nevertheless.
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So I will vote for a strong correlallation between fast weight loss and gout exacerbation.
