anyone ever have Gout?

[NICKG]

ok, before we hear the good living crap..know it can be brought on by bad kidneys and stress. I think I have it, my big toe hurts at the base, pain on an unbearable level. No, it is not broken, it has done it before. 5 tylenol are not helping...

[trader220]

I have gout. It’s by far the most painful thing I have ever experienced and I have had some very bad sports injuries. I assume you’re now on alopuronol and you watch the kinds of food you eat. I have had 3 attacks in my life and none is 3 years since I started on the alopuronol. You know it’s caused by uric acid problems in your blood, the crystals lodge themselves in the joint of your toe usually.

At 43 I have been playing hockey for 35 years and my doctor says they trauma caused by the pounding my feet have taken probably added to the issue. I have always opted to wear skates smaller then normal.

By far the most painful experience of my life.

[dhoward]

Used to get it off an on when I was laid off for a time. Golf, beer, greasy burgers, inactivity...
Oops, sorry. Good living.
Uric acid crystals lodge in extremities joints. Really painful.
Not as painful as a kidney stone...

[NICKG]

i have not gone to a Dr's yet, i was trying to regulate it with avoiding certin foods . I am going see the Dr on Monday. I have had like 2 flare ups, but this one is real bad, I can hardly stand. it is much worse in the morning than it is in the afternoon. I also notice that my urine is extremely yellow(golden)...
I am hoping that this does not create permanant damage, or spread..my knees and thighs have been hurting, but i just thought it due to walking funny

[dhoward]

I was told to stay as hydrated as possible. More activity. Doc didn't give me an Rx as he said it's probably temporary. It cleared up in a week or so.

[Noah930]

I have gout. Traditionally, it's been thought of as a lifestyle disease: too much good living. Like others have commented, it comes from a build-up of uric acid crystals in joints. Most commonly the pain occurs in the big toe--called podogra; however, it can happen in any joint, really. The uric acid crystals come as metabolites of purine amino acids--most commonly found in things like alcohol, red meat and fatty foods/cheeses. Personally, my diet has nothing to do with my attacks, IMO. Add in some dehydration, and the uric acid tends to precipitate out of solution and form crystals which accumulate in the joints, causing irritation/inflammation and pain. If your urine is yellow/dark, you're not hydrated well enough. In med school, you're taught that it's so painful that even a sheet on the toe at nighttime is intolerable. It might not be the MOST painful thing I've ever experienced, but I can attest to the bedsheet part being true.

In reality, it's more of an inborn error of metabolism. It tends to run in families, for instance (for me: father/grandmother/some cousins on that side of the family). For some reason, the purines don't get effectively eliminated from the bloodstream, and tend to form crystals.

In the past, I'd just stay really well hydrated whenever I felt an attack coming on. That usually limited the pain to just a day or two. Motrin was my friend. Not the measly 200mg over-the-counter dose, but either 600 or 800 mg (every 6 or 8 hours, respectively) for its anti-inflammatory effects. That worked best for me. NSAIDS, in general, are an important part of symptomatic treatment.

Gouty attacks are only supposed to last a couple days. At least that's what the literature says. A couple years ago, I dropped my motorcycle on my foot and broke a metatarsal. The pain from the fracture was tolerable within 24 hours. However, it set off an attack of gout that lasted 7 weeks for me. I took 800 mg of Motrin every 8 hours for 7 weeks straight. Definitely not recommended, but that's what got me through that miserable experience. Heck, I was ready to amputate the friggin' toe by then.

Other options for medication are colchicine for acute attacks, and allopurinol for maintenance in between. Problem with colchicine is that the main side effect is diarrhea. Essentially, you keep taking it every two hours until either the pain goes away, or diarrhea hits. For me, it was the latter. Allopurinol is something to take in between the attacks, to try to prevent them. However, in an acute attack, allopurinol may actually prolong the pain.

There are a couple more nuances to diagnosing and treating gout, as well as managing the meds with their potentially serious side effects, so definitely go see your PCP (or a rheumatologist, if you can swing an appointment with them).

[TimT]

Ive had a few gout attacks over the years.... so painful reduces a grown man to tears sometimes.

If your a drinker.. stop your alcohol intake immediately when your having an attack, avoid aspirin, don't drink diet sodas

try to stay off the foot, elevate when possible.

eat cherries..or get cherry extract from a health food store. to any naysayers.. cherries are and elixir for me.. when I feel a gout attack coming on, or am suffering from an attack I start eating cherries, and feel relief in hours.

I wont/cant take motrin due to other issues, and the cherry regimen works for me

[on2wheels52]

On of the cardplayers at my shop had it, he said it helped to drink all the water you could stand.
Jim

[trader220]

On the occasions I had attacks I would see my doc and he's shoot my toe with Cortisone. It would take about an hour or 2 for the pain to go away.

[Tobra]

Gout is caused by sodium urate crystals. Product of protein metabolism, hence the rich man's disease moniker. Rich guys drink wine, eat steak and lobster, high protein stuff. They are negatively birefringent(appearance changes with polarity of light) and look curiously like ground glass in a microscope. In an acute case, the man(or post-menopausal woman, estrogen is somehow protective) wakes up in the middle of the night with his foot on fire, big toe joint hurts more if you even look at it wrong, let alone touch it. If you do touch it, it is red, warm and plenty sore.

Cherry juice, pomegranate juice will help, you want to be drinking plenty of other fluids(water, not gatorade.) Way I figure it, the juice alters the pH of your urine and helps you excrete it more effectively in yoiur urine. Water helps you make more urine, unless your kidneys are bad. In that case you go into congestive heart failure and feel like you are drowning if you lay flat, sort of like water boarding, only the water is leaking out of you instead of in from the fluid overload.

Tylenol will not do much. Indomethacin(indocin) is probably best NSAID for this. Aspirin at high doses will make it worse, at low doses make it better. Allopurinol for chronic treatment(kinda harsh drug) colchicine for acute attack. Colchicine has an interesting dosing protocol, give until you vomit, then back off a little, seriously, you could look it up. Best way to treat is not to get. Mostly is diet related, stay away from organ meats in particular, drink plenty of water. Some people who have metabolic or renal(kidney) disease are prone to it. For some, it is the initial event on the way to dialysis(not to be melodramatic, this is very rare)

There is also chronic tophaceous gout, which is nasty. Imagine if you were sweating out blobs of toothpaste, vary in size from grain of rice to pit of a cherry. Looks like a little pimple on a cool part of body, toe, ear, even saw it on the tip of a guy's nose once. Like a blister full of uric acid crystals, which is pretty irritating to the tissue, from the looks of it.

That reply was not quick at all.

[Stutzdriver]

I had an bout with gout once. Dr put me on indocin (sp) and in about 24 hours all was well. VERY PAINFULL though even compared to my heart attack.

[Seahawk]

Originally Posted by Stutzdriver

I had an bout with gout once. Dr put me on indocin (sp) and in about 24 hours all was well. VERY PAINFULL though even compared to my heart attack.

Wow...looks like a twofer

I've got some issue with grout...

[VaSteve]

My dad used to have it a lot. I had it once. I had something the day before that had me on the throne and I guess I got dehydrated. The pain started coming on the next evening or so (I attributed it to sitting my legs while working on the computer). By go home time the next day after work, it was so painful I was going to die. I could barely walk. I could barely drive my automatic Jeep home. It hurt to step on the gas. It was excruciating. I though I broke my toe. We went to the hospital, they looked at me for 5 min and gave me some 800mg Advils. 2 days later, back to normal.

[morganb]

Originally Posted by Tobra

Indomethacin(indocin) is probably best NSAID for this.

In most cases Indocin is the go. Gout runs in my family, Dad is on and off tablets, brother on them full time. I try to control with out drugs. If you feel gouty (hard to explain but after you have had a few attacks you can feel it forming in the joints) then no grog, eat lots of food (no items that help cause gout like intestines/meats) and drink as much water as possible. If I get an attack in my foot/toe I will normally try and play squash/tennis/racquetball or go for a run. Seems to get the circulation going and help stop the crystal formation in the joint.
If really bad then take the drugs. I once had an injection, relief in about 2 hours. The drugs are normally about 8 hours to have a good effect. Very Important is to attack the issue as soon as you feel an attack coming on.

Good Luck and I feel your pain.

[azasadny]

I'm a vegetarian, drink no alcohol of any kind, eat tart cherries or drink tart cherry juice every day and my gout still flares up every year. I avoid foods that are high in purines (salmon, asparagus, lentils, etc...). I took Aleve the past 2 weeks to control the gout pain and it was effective. I drink 1 gallon of water a day and do everything else I'm supposed to do. I sure wish they would come up with a cure for gout!

[trader220]

Until 3 weeks ago I had not had an attack in 5 years. As soon as I have an attack and the pain gets so bad I cant walk I get in the car and drive to the Doc and have it shot with cortizone and its gone in a few hours.

[azasadny]

I'm taking 100mg of Allopurinol once a day and I'm experiencing "twinges" and discomfort, which is normal while the Allopurinol flushes the uric acid out. I'm drinking 1 gallon of water a day and taking Aleve as needed. I'm removing high fructose corn syrup from my diet, which isn't easy and I hope to see an improvement...

[Hugh R]

My brother has had it, I don't, he's four years younger, he limits alcohol, no red meat, no scallops, no asparagus. I consume all those things, no gout.

[azasadny]

Hugh,
My younger brother also has gout but I had a few "attacks" before he did but I didn't know what they were. He's had one attack and no more, that's common to 20% of people, one acute attack and no more. I've had at least three minor and 1 major attack this year. I'm a vegetarian, no alcohol of any kind for over 3 years, not overweight (6'1" and 180-185lbs).

I hope you never develop gout, it's truly a terrible thing. The pain is almost unbearable...I've hardly driven the 911 this summer because the clutch pedal is hard for me to depress.

[Racerbvd]

Originally Posted by azasadny

Hugh,
My younger brother also has gout but I had a few "attacks" before he did but I didn't know what they were. He's had one attack and no more, that's common to 20% of people, one acute attack and no more. I've had at least three minor and 1 major attack this year. I'm a vegetarian, no alcohol of any kind for over 3 years, not overweight (6'1" and 180-185lbs).

I hope you never develop gout, it's truly a terrible thing. The pain is almost unbearable...I've hardly driven the 911 this summer because the clutch pedal is hard for me to depress.

You got that correct, only staph hurts more..