Forum Replies Created
-
Posts
-
Hi aaron,
I got my first gout attack 11 years back and was gout free for 10 years after that attack. I led total normal life and have acutally even forgotten about gout, until I fractured my toe a year back, which triggered another gout attack.
I was able to live gout free for 10 years without any medication. So, my guess, you can live normal life though it is very subjective and can vary from person to person.
Uric acid reduction is very critical part of gout management and makes a lot of sense to reduce SUA under control. Borderline high is too high for those who suffer from gout.
The SUA control can be brought in by SUA reducing medicines like Allopurinol and proper diet control. You can start with diet control and if that fails, jump onto the wagon of medications. Other approach could be to start with medication and also try to do diet control at the same time. After you have adjusted to diet control, you can reduce the medication and rely more on diet if that would work for you.
NateA,
I got Gout( that's what is suspected though not cofirmed and lot of conflicting reports) 11 months back. Started with a big direct hit of the toe against the bedpost. Took 3 days for the pain and swelling to set in and got it 3 times in 2 months. The docs finally detected a fracture coupled with gout.
I started Allop 150 mg 9 months back, then slowly moved to 300 mg and am still on 300 mg for more than 7 months. I have been doing exercise, mostly walking and light jogging. Also wearing tighter leather shoes for 12-14 hrs Monday through Friday. Walking /jogging generally 45 minutes to an hour, 3-4 times a week.
In my case, i did not see any impact of exercise on my toe. I actually feel much better in the evening after I have been wearing somewhat tighter dress shoes for more than 8-9 hrs in the day.
And luckily, I did not get any gout flare up once I started Allop 9 months back. My SUA has been below 4 for last 7 months without any flareup.
So, my experience, no negative effect of activities on Gout…though I never did very heavy exercise…
Goutgal,
I think there is no medicine heavy or light for everyone….it depends on what works for YOU the BEST. Same is with food. I feel no value in going over board with diet control unless one has to do Absolutely like Sugar for Diabetics ..
Even within the food, many people have reported a food is good for them while others have got gout from it. So, if the food can cause it, why we cry on the medicines.
I found low dose Colchicine one of the best thing I did to my foot swelling and pain. When I was stopping it after 1-2 weeks, I used to get the swelling back. Then I continued it for 4 months plus and then the stoppage did not cause any issue.
For me, Iboprofen prescription dose caused me more damage than the Colchicine( I have none to report with Colchicine).
So, take your own decision after talking to the doc. Do not go into diet or medication or this and that…continue on what has worked for you and is still working for you…and get tested for kidney and liver from time to time…last thing you want is stopping it half way and get the pain back….there is no experimenting on the severe pain I guess.
qas said:
My first attack was 1 year ago and since then have been on a bit of a rollercoaster. I began with Allopurinol 2months ago and after some initial flare ups things have settled down. The cheat sheet from the pharmacy said avoid coffee so I have cut it out entirely. Now that I have “stabilized” I am anxious to get back to my coffee habit. I asked the pharmacist and he reiterated that the coffee inhibits the efficacy of the medication. On this site I see that coffee may even be beneficial.
Any opinions on whether coffee interferes with Allopurinol?
Thanks
q
The cheatsheet I got pharmacy does not talk about Coffee…it does talk about alcohol….My doctor did not say to avoid coffee. In fact, as I was feeling lethargic when I started Allopurinol, I used to take more coffee to wean off the drowsiness and lethargy caused by Allopurinol. I did not feel or notice any negative effects though my coffee is generally my favourite drink – Starbucks Double Shot Tall Non Fat Latte….twice a day..that is 4 shots a day…
zip2play said:
There's a lot of gimmiicks out there to separate you from your pain. Most just separate you from your money.
You are right on the spot. When I was having swelling and pain last year June /July, I tried all possible food cures I can – Bing Cherry, Tart Cherry juice( I used to have 50-60 pcs of cherry a day as it was peak season in California), strawberry, Devlil's claw, Many famous Goutcure medications /vitamins from Goutcure website( they are all lying waste)…You name it and I had tried it( except BBB broth)….NONE worked….it was just frustrating and I must have spent few hundred dollars easily on all such stuff….the pain always remained attached while the money separated….
The only thing which caused very little money but huge separation of pain and swelling was Allopurinol and Colchicine combo.
Since that time, I do not care about any other gout care product…I think it is more taxing on mind than helping. I actually have been testing myself by eating whatever is Gout prohibited – dried beans, pulses, spinach, mushrooms, cauliflower, asparagus, oatmeal…and I have been eating them a lot for last 6 weeks, every meal generally has one of these prohibited items…and also lamb on few occasions in addition to these items….so far it has been good, no flareups or twinges…let's hope it stays same way. I am taking 300 mg Allopurinol a day and I think it is helping to keep gout away…
Yes, Yes and Yes.
I have suffered a lot due to gout induced by the toe injury. I bumped my toe very hard against the bedpost, got lot of bleeding and 2 days after the injury, started getting pain, which kept on increasing and by day 3/4, got full swollen foot and burning in toe joint. It was GOUT.
Later on, it was found that there was a fracture also.
Have suffered a lot as fracture and gout were both feeding each other.
It is now 10 months to the injury and I am on Allopurinol 300 mg for more than 6 months. Things have improved a lot but not fully out of it yet.
So, to summarize, YES, injury can trigger gout and is considered one of the common factors that can cause gout.
Recommendation is to continue on Allopurinol and get the SUA tested and adjust the dosage of Allop to make sure it is below 6. That way, even if you suffer injury, the possibility of urate crystal forming is less and so is the Gout.
cjeezy said:
Post edited 12:40 pm – April 15, 2010 by cjeezy
GoutPal said:
Isn't jogging for gouties in the same class as rock climbing for vertigo sufferers?
I'm starting to think it depends on the person. Everyone's body is different and it probably depends how much urate is already laid down. I CAN run a full sprint right now if I wanted with no problems/pain but instead I jog with extreme caution at a mild pace (6mph). If my joints ever start to feel uncomfortable I'll stop. Also, while it damn near lasted 2 months, I've only had 1 major gout attack in my life thus far <again, knocking on wood>. Thank God for AP! Last test on Tuesday was 3.6!
I fully agree with you. I have always found jogging as less painful. I talked to the podiatrist and was told that it is very common thing after the joint injury as jogging for many needs less bending near toe area than the walking while the load is more on the knees and hips.
It is funny that I always felt my joint more mobile and less painful most days after jogging as I reported in one of my earlier post reply sometime back.
I am doing less currently due to never ending rain in bay area and I am not using treadmill for some time now. The weather is getting beter and I look forward to more jogging days ahead…..the only issue is that I have to be careful not to hurt the injury site…I am given a sleeve which I wear before jog and that protects it from shocks and uneven surfaces…
After the gout attack, I do not do treadmill amymore yet. Currently it is on a walking /joggin track next to a hill on the backside of my home. It is very nice at this time with green hills on one side and a lot of almond trees on other side. They were all pink(flowering season) couple of weeks back and now they are full of thousands of Almonds on them.
One fun of outdoor walking is that I can pick fresh almonds in the months of Mid May to June /July. That's my favourite time as I pick them fresh everyday after jog. I could do it only few weeks last year due to gout attack. I hope, this year I can do better in picking them
nokka,
I can speak from my experience. I started with 150 mg and moved to 300 mg in increments of 50 mg over a period of 2 months. And with every increment, the SUA levels changed as shown below –
1. Started with 150 mg on 7/31/2009, SUA levels 9.2 before starting Allop
2. Tested Aug 21, SUA levels 6.6
3. Moved to 200 mg Aug 25
4. Tested Sept 1st week, SUA 5.5
5. Moved to 250 mg Sept 7
6. Tested around Sept 15, SUA 5.0
7. Moved to 300 mg Sept last week
8. Tested Sept end, SUA 4.3
Since then on 300 mg, SUA in the range of 3.5 to 4.5, average of just under 4.
I agree. It is bad for knees.
Before my Gout attack, I used to do a lot of jogging….My average jogging was 5 miles in a stretch 4-5 time a week and at variable speed of 5 mph to 10 mph on treadmill….Somedays, I use to even go 7 miles at a stretch.
I had that routine for many years and for me if there was no jogging, I did not feel if I have done any exercise.
But then later I started getting knee pain and pain in the hips. I had to reduce the jogging and switch to brisk walking. Though I do not feel satisfied with brisk walking, at this time that is what I can do with my foot situation. Jogging is very much reduced…generally 1 mile or so occasionally..
At the same time, the painful knee has improved a lot with walking….
davidk said:
Thanks all. I appreciate the help and am finding gradual improvement. I went to a massage therapist for low back pain related to the limping from gout and she said that 4 months on a cane can cause the muscles and tendons to atrophy some.
That's possible. I was not able to wear tennis / dress shoes or walk without post op shoes for few months. when I started walking, I used to put my weight on the other side of the foot. This probably is one of the reason I got muscle and tendon atrophy in the MRI I got done last month. My doctor said that wrong loading on foot can cause this atrophy.
I do not think it really matters. If you are out of the main painful episode, you can start. Many people wait for many weeks and still get the gout attacks triggered with Allopurinol. I satrted it when I was in middle of it and it helped a lot. I did not get any gout attack triggered by Allopurinol though I started it in the middle of the pain and swelling.
So, in my opinion, wait is just wasting time. Let's see what others feel and say and then you can decide.
Trev,
I will try you suggestions and see where it gets me in terms of posting the images.
zip2play,
When I said “suspected fracture”, it was initial 6 -8 weeks. In the first Xray taken 3-4 days after injury, it did not showup. When I was getting repeatdly painful and swollen foot, they did Xray again and it showed up second time. But it was always suspected that fracture and torn/overstretched ligament was causing a lot of problems. The one thing different in my case from general gout prospective was that even at the peak of the pain and swelling, I was able to fully bend my toe downward without any pain almost like a normal toe; it was upward movement that was painful. Besides, my pain was only when I was puting my foot down, there was no pain when I was resting and when there was no load on the foot….except for first 2-3 days when I felt severe burning sensations inside the bunion joint….didn't have them after that.
And that's what caused all this confusion of gout or no gout. The only reason gout was suspected as I told doctor about my history of a possible gout 10 years back ……and later on I thought and still believe it was gout as because SUA was high(9.2 measured after 8 weeks of injury), Colchicine helped me a lot though it was very low dosage, and Allopurinol made a lot of difference….though it could have been a healing process in itself over a period of time…..
May be I started Allopurinol a bit earlier but it is better than being late as otherwise high SUA could cause joint damage forever….I wish I could have started it within first week of the attack( like I did 10 years back and was back to normal in less than a week time), and it could have made recovery faster…who knows????
….I believe it is the doctors who failed in correctly finding the cause and treating me correctly in the early stages that has made it linger on for such a long time and still continuing though at much lower magnitude….I will post my Xrays in 1-2 days though I donot know how to post MRI as there are more than 100 images in the CD I got for the MRI.
Trev, I will also post a latest picture of my foot.
I agree with zip2play and would like to share my experience. I got gout attack 10 months back. I was almost immobile for couple of months and then on post op shoes for few weeks. Though my swelling went away when I started taking Allopurinol but there was pain at the end of the step. I was not able to wear dress shoes because of this pain. It lasted for about 6-7 months and then it started going away. I do not have any pain now at the end of the step for last 2 months. I got MRI done and it showed no bone or joint damage. So, watch and wait, it should go away. Best of luck!
vegetarianGuy said:
Post edited 6:51 am – March 31, 2010 by vegetarianGuy
Isn't that normal for lot of people with Gout who are on AlloP that they don't get any attacks? Isn't that the whole point of being on AlloP?
There are 2 types – ones who get Gout attacks when they start Allop due to fall in SUA levels which results into crystal dissolving and the attack…then there are those who do not get the gout attack though their SUA levels fall dramatically like in my case it fell from 9.2 to below 4. There are other factors that play role while we take Allop and SUA levels fall….that's why few get attacks while few do not…over a period of time, most are supposed to get rid of the painful gout attacks…
Though clinically my Gout is not proved, I am convinced as when in doubt, I believe in taking route of what can prevent the adversaries than wait for them to happen and conclude….
vegetarianGuy said:
Post edited 3:27 am – March 31, 2010 by vegetarianGuy
I think Gout can take as much as 20+ years before fully unleashing it's fury
Get off AlloP but get back on if your numbers start climbing specially as you are a confirmed Gouty (1999).The other thing could be that you never had Gout now or in 1999 🙂
So it means what I got last year was unleashing half way only
but that was painful enough and lingered on for long…I know that my SUA numbers will go up if I stop Allop as I always had high SUA levels( I have 4 or 5 records of SUA in last 1o years and they are all 7.8 to 8.2….
If I talk of the docs that have treated me, they believe I never had gout either before or now.
Personally, I am convinced I had gout as both times, Allop worked very well….Gout as we all know is very complex to understand….I may be of Type that may not be getting that many attacks or trigger an attack on Allop….it is like many people get Flu every year while many do not for years…..though Gout is different than flu but probably similar theory can be applied to it as well….some people can look North when they encounter virus from Southern Nigeria
Looks like 36 is magical number. I got my first Gout attack about 10 years back, when I was 36 plus but less than 37.
Interesting thing to know is that it had classic symptoms of gout. The doctor gave me 200 mg of Allopurinol on the 3rd day of attack, when my foot was like hot baked potato and gout attack at its peak.. If I had read the forums( there were none at that time), I would not have taken it. But ignorance is bliss at times. The Allop worked like magic, 2 tabs a day and with in 2 days, the pain was gone 95% and within a week, the foot was like there was never any attack.
I took Allop for few months and then stopped it. Next 10 years, I did not follow any rules of diet, drink, exercise or wait loss….and my SUA was always 7.5 to 8.2…and against all the odds, I did not get another attack till time I injured / fractured my toe last year.
I am for sure an exception to the lifelong Allop medication committment we generally talk about….donot know how would it work in the coming days if I get away from Allop.
Hello vegguy, Trev and zip2play,
Thanks for the inputs. My podiatrist is very confident after this MRI as all the listed swelling and edema is exactly at the place where the toe fracture was suspected. So, the edema and hypertrophy confirms her theory of change in gait due to the trauma and difficult in walking and uneven distribution of load on the foot that I am experiencing.
The main point was to rule out – 1. Hallux Limitus 2. Damage to the cartilage 3. To find out if there was any fluid retention due to bursitis.
All above points have been ruled out now and at-least now I can say “Shut up ” to the other doctor who told me that I had Hallux Limitus.
Coming to point of Gout, I have no doubt that it played its role in the early days of injury though it does not mean that I may get it again and again…this only time will tell.
Remember, I had my first attack of Gout in Feb 1999. I tool Allop 200 for 3 months and rthen 100 for another 3 months and then stopped it. I did everything that is prohibited for gouties in the next 10 years without getting Gout till time I injured my toe.
Another interesting point is that though my first attack was in 1999, the MRI did not show any sign of Gout. That is surprising as I was expecting some signs of my earlier gout. Does it mean I did not have gout 10 years back and it was Virus from Southern Nigeria as suggested by zip2play
1. If everything goes fine, I may reduce Allop after few weeks and see how things go….
2. I do not want to go the route of diet control( sorry but that is ME, I would rather take medicine if my body can accept it and be free in my mind of what I eat and what not)….So, allop to continue for some time more…
3. Sea food and other organ meats do not mean anything to me as I do not eat them anyway…for me, meat is Chicken, Turkey and Lamb mostly….occasionally beef, seafood is not for me….But I am already trying few extremes and they seem to work fine…
4. I started wearing my narrow toe box shoes 4-5 weeks back( a big no for gouties), am wearing it for 15 hrs a day( 7 am till 10 pm) at-least 4 times a week to check the upper limits of torture to joint….I also drove car for 11 hrs with these narrow shoes ……And thank God, so far it did not cause any problem….And that gives me a lot of confidence…
Any suggestions on what more torture(non diet torture) I can give it to check for gout
zip2play said:
p.s. You must have a cast iron stomach if you can tolerate 800 mg. ibuprofen 3 times a day. I am gettin gastritis just TYPING this.
And also the heart that can pump the blood through every known canal in the world. I was given 800 mg ibuprofen 3-4 times a day. My stomach some how tolerated it wothout any gastric problem but the BP went roaring through the roof( 180/110 appox)….I was told prescription dosage of ibuprofen can cause it. I am still on the BP reducing medication since then( 9 months now) though I did not have BP problem before I took ibuprofen….I have reduced the dose of BP medication to half for last few months and if everything remains fine, may withdraw it altogether in the coming days.
I felt a lot of dizziness when I started taking Allop. And I did get the same feelings of dizziness when getting up( once I almost fell down but I was able to get support of a chair and balance myself) and out of balance feelings while transferring /moving. I reported it in my earlier posts.
My dizziness continued for almost 3 months and then it almost went away. I was also taking some other medications and they might have played their role as well.
Now I am on Allop for almost 8 months and the dizziness is almost gone( 98% plus cured).
I am in conflict to what most people say. In my opinion, the best investment I made in my gout treatment is the SUA meter. I have been using it for many months and now I can almost feel the sensations in my toe and guess the SUA levels. Whenever I feel unusual hot feelings in the toe area e.g. sharp pain swings, my SUA levels are on higher side of my range( 4.5 to 5.0)….after the things settle down, the SUA levels fall back to 3.5 to 4.0.
Now with almost knowing the levels based on the sensations in the foot, it gives me so much peace of mind that I do not care about these pain or burning sensations any longer. Cost wise, 200 Dollars is hardly any cost to the benefits and peace of mind it gives. I personally would not mind or think twice spending for such a device.
Everyone has got right to differ on the views but I firmly believe if you can afford, go for it. Unless you use it, you can't even imagine the benefits of it. It is like trying to tell how the meat tastes to a vegetarian person…unless you eat, you can't.
I have a different experience on itching in the last 7 months that I am taking Allopurinol.
1. Whenever I have increased the dosage e.g. 150 mg to 200, to 250 and then to 300 mg, I always got itching for couple of days. Few times, it was almost scratching on few spots on skin, which would turn red and then become normal in 2-3 hrs. This is story of my first 6 weeks of Allopurinol.
2. After I stablized on 300 mg dose almost 5 and half months back, I have seen that every 2-3 weeks, I would experience few heatup sensations in the toe and itching in the skin. I have also taken SUA readings on those days and the SUA levels were on the higher side of my range( Remember my range is 3.2 to 4.8 but on these days, I always got the readings of 4.4 and above upto 4.8)….If I do not include these high itch and sensation days, my SUA levels would be always below 4.
It has happened at-least 5-6 times, last time it was just a week back. My SUA levels shot up to 4.8….it settled down in 2-3 days. My levels today are 3.6 and 4.0 in the 2 reading I took at home.
So, I can conclude easily that whenever I have got itching every 2-3 weeks, SUA levels were high and probably reason of the itching….I have no logical reasoning behind it but it is just my personal experience.
I think asprin is not good for gout as I remember having read at many places. Aleve many take to relieve the gout pain, so that should be fine.
I generally take Advil or Mortin(Ibuprofen) as it relieves headache also and is good for gout as well.
Hi Leonard,
Great to know the progress you made with Allopurinol 300mg. And you do have a good rheumatologist otherwise most of them do not realize the importance of bringing SUA below 6 and even below 5.
I also had similar kind of reduction when I increased my dose to 300 mg, my SUA levels dropped to below 4 within a week. And I did not get any gout attack while the foot improved. There were few drowsiness related minor reactions.
So, based on my experience, I think you should be good to go without any adverse reaction in the coming days.
turkeyspurs said:
Trev, I do value a min med. approach. I have also read on this forum that diet alone can only lower SUA levels by 1 point. If my next test confirms 9+, would you recommend AP?
I think it varies from individual to individual. You would soon discover what works best for you.
I tried the diet approach for 2 months, very strict diet approach. Bing cherries, Cherry juice, Celery, Very low purine diet….you name it and I tried. ALL simply failed. My SUA was 9.2.
Started Allopurinol and it worked like magic.
I think, the best approach is to start with Alllopurinol, get the things under control while work on the diet control at the same time. Once things are under control, one can try diet only approach and see if it works.
But as I said, it varies and you will find soon what works best for you.
I would agree with z2p ( Sorry Zip, I am using your new Avatar z2p).
I had started Allop twice in my life so far. Once 10 years ago when I was in the peak of the attack( 3-4 days of gout attack and full swollen foot), and recently 6 months back while I still had pain and swelling.
Both times, I did not get any gout trigger. Allopurinol actually stopped the gout attack and reduced the swelling.
Though I have also read to wait for a clean window before taking Allopurinol, my own experience says it does not matter, rather it is better to start early rather than letting gout do more damage.
Hi cjeezy,
I stopped taking Colchicine 2 months back. I do get the pain on the top of the toe many times but it has never alarmed me to the extent of tkaing Colchicine.
Once about 3 weeks back, I did get almost alrarming pain when I got up around 3 am and found I had some pain in the right big toe. On that night, for a change, I did not wear the special sleeve that I wear before I sleep. I almost thought of taking Colchicine but then decided to test it as otherwise it would always remain a suspense if it was going to cause gout attack or not.
Next day, it disappeared when I got up…So, I guess it was something else. In my case there was no obvious reason for it.
It is difficult to decide as if it gets into full blown attack, you would curse yourself why you did not take the Colchicine at first place. And if it did not, you would not be able to say for sure if it was going to become gout attack and if Colchicine use was appropriate…though I donot think it was abuse in your case.
Hi vegetarianGuy,
My apologies as my response to earlier posts is still pending. I will write more details soon as your case is almost identical to mine. Your pictures are almost replica of my foot few months back( except that it was right foot in my case), exactly same type of swelling and almost same spots of pain.
And I also suffered the same way like you did, which made my walking impossible. I will try to locate pictures of my foot and load it for you to see and compare.
And my diagnosis was also all too much confusing( it is still) but I took treatment for Gout and mechnical problem both and things have improved.
I will write more details soon. Just going to attend an urgent meeting.
