John,
Thanks again! Will do!

My Dr did mention Indocin for pain, during the flare-up, but I'm sure my liver doc would not allow that. It would probably also make me sick....

Indocin seems to work better than other NSAIDs for gout, but it is also one of the harsher ones available.

How did you do with Probenicid?(uricosuric drug, enhances excretion by kidneys)

I never tried Probenecid, just Allopurinol and Colchicine. Allopurinol dropped my SUA from 6.5 to 4.3, but I still have the same signs and symptoms... Maybe the specialist will recommend that? Thanks, I'll look that drug up...

Art,
I just reread this thread and the thought occurred to me that you could be suffering from bouts of severe and acute localized arthritis that is being masked by the gout and the focus of treatment on gout.
How did the Tramadol work? Do you still take it? Did you have any side effects? I ask, because this is my situation. The anti-gout meds are doing their job and the Tramadol seems to take care of the rest of the pain, with no side effects for me.

Tom,
The Tramadol was OK, not quite as effective as the steroid I used to get (but can't take any more). I just took an Aleve 220mg, 8 hours after the Dr gave me the shot. The pain this week was exactly the same as my typical gout pain, very "classic" for gout.

My complication is my liver condition, which prevents me from taking most medications, since we're trying to avoid elevated liver enzymes. The Tramadol injection made me sleepy and gave me a headache, dry mouth but compared to the gout pain, not too bad! It's 8 hours later and I'm just now starting to feel "normal" again...

When I have attacks, it helps to soak in a hot bath - having the ankle weightless in water is a lot of it - but it seems to help me get to sleep too. It's your ankle? I forget if you've said.

jyl,
Nothing really helps my gout except for the Aleve every 12 hours. The pain is in my large toe on my left foot. I'm trying not to take the prescription pain killers because of my liver.

The Tramadol (Ultram) works on the gout pain but makes me very drowsy, so I can't take it before I drive or at work. The Aleve works, but not as well or as long as I would have hoped.

I have checked my "gout history" notes and have noticed that although my weight ranges from 185lbs -200lbs, the gout attacks seem to occur more often at the heavier weight (during the cold MI winters) than at my lighter "summer" weight when I'm also getting more physical exercise. So, I'm making an effort to get back to 185 (or 180) and I'm at 190 right now. My long-term goal is to stay at this weight and stop the fluctuation and see if this helps. It also seems that my gout may have started when I was 40 (ten years ago), so that the damage done may be more significant that I thought. Of course, my gout may also be related to the activity level or ambient seasonal temperatures here in MI, but I think it's more directly related to my weight.

Has anyone else noticed a relationship between their body weight and frequency/severity of acute gout attacks?

BTW, the shot the Dr gave me on Friday was Toradol (Ketorolac) and it took the pain down several notches but made me very drowsy. Seems like the pain meds all make me very drowsy...I'm hoping that from this evening on, I can take Aleve 220mg every 12 hours and get relief. I drank a big glass of tart cherry juice and I'll do that every day form here on out...

Yes.. My weight also fluctuates between 180-200 also when I am at the high end a attack is guaranteed..

I am at about 192 now and working on getting back to 180..

Tim,
Wow, same weight range as me! I'm at 190 now, but I need to get to 180, I think. I'm 6'1" tall with a thin frame, so the "extra" weight tends to go to my waist, which is unhealthy, to say the least. Let's see who can get to the weight goal 1st! What do you say?

This site is the "Pelican Parts of gout" and has a lot of good info...

Gout Facts Explained

I am 6'00" and "thin" all extra weight goes right to the belly and spare tire...One problem for me is that I have no dietary restrictions, except that of a middle age man, low salt low fat etc.. However I love to enjoy some foods that do not meet 'middle aged man' diet. I feel my weight creeping up, and know there is a gout attack looming.

Haven't trained myself to adhere to a healthy diet....every attack swings me closer to being able to do the right thing diet wise...

Tim,
I hear you... I switched to a very healthy diet over 4 years ago after I was diagnosed with a liver disease (NASH) that can't be cured, only treated and is related to gout, metabolic syndrome and diabetes. The diet/lifestyle change worked for me and another benefit of the "healthy liver diet" is that it's very similar to the "lower your uric acid" diet. No red meat, only chicken or fish once a week, no alcohol of any kind, no high fructose corn syrup (HFCS), very low fat, low sugar diet is hard for many people to maintain, but I've done it for 4 years, but it doesn't appear to have any positive effect on my gout, which is extremely frustrating.

I'll get my weight down to 180 (or a little lower) ASAP and keep it there and see if that helps prevent gout attacks. good luck with yours! I'll post as soon as I'm at 180lbs.

art. i have not read all three pages.

your doc, verified it is gout? he took a fluid sample from your joint?

i ask because i had some serious pain too. i emailed my doc, and she asked me to circle the joint that hurt..i poked around and it was the first joint. i circled it with a sharpie and emailed her the pic. she said that joint can hurt from a myriad of reasons and sent me to a podiatrist. he immediately felt that it wasnt gout, and took some scans. there was evidence that i had fractured my foot, (probably from my fatarse jogging and hiking), and told me to lay off the running shoes. he then proceded to inject my joint with a cortisone shot, which to this day..is the MOST PAINFUL thing i have ever endured. he told me to look away because (his words), "nothing good can come from looking". the white hot pain was unreal. i came into the office with a tiny gimp, and left almost needing crutches. i sat in the waiting room waiting for the pain to go away..i managed to get home. 3 days later, the pain was a dull ache, and it has gone away totally. i have been painfree for almost a year.

i have some heel pain, and i am paranoid about jogging anymore. the pain was gout-like. i now cycle. no more pounding on my joints.

Cliff,
Thanks for the info! I never let the Dr take a fluid sample, but my SUA was high, and all of the other signs/symptoms matched. The Allopurinol dropped the SUA, but I still have gout pain in my great toe on each foot. I did have the steroid injection in my hip and it helped, but I had a reaction to it and I cannot take it again.

My brother's gout came on before mine did and he didn't have another attack for a few years, but the last time I talked to him, his gout was flaring up more frequently, which is a common pattern for gout to follow.

If you have high SUA (above 6ml/dL), you may develop chronic gout, as I did, or you may not. It's an inherited defect in the body's ability to process uric acid and we have gout sufferers in our family.

I'm sincerely hoping you never have another gout attack, if in fact you had one to begin with. Maybe yours was something else? My gout is complicated by my liver condition and the Dr and I believe that the two conditions are linked, but I don't know that we'll be able to prove it, as if that matters... Thanks again!

Several people have asked about my gout so here's a brief update...

I've been taking 600mg of Allopurinol for a few months and my serum uric acid is down to 2.2 ( from 6.5 ) and my liver enzymes are still normal.
Unfortunately, i still have severe pain in both feet (1st metatarsals), especially after activity that involves my feet, like playing the drums or using the clutch pedal. My Dr thinks that i have something else in addition to gout going on. I have an appt with a rheumatologist in the middle of August as that was the 1st available appt when i called in April.

I take OTC Aleve (220mg) every 12 hours for the pain and it helps but the pain never goes completely away... Very discouraging and has negatively affected my life...

Sorry the news isn't any better that this...

Sorry to hear that, Art. At a certain age, say 70-75, one gets to accept pain, some pain, as an unavoidable consequence of remaining alive, and learns to accept it, or treat it, or deal with it (better living through chemistry) in some manner, but Art, you are way too young for that! Let's hope that the Rheumatologist finds something specific and readily/easily curable and "fixes" it.

Gutes Besserung!

Tom

Tom, thanks! This chrpnic pain has definitely changed my life (for the worse). I'm hoping the Rheumatologist can help me with it. I've done everything I can do, to no avail...