Gout, Redux
 

Great, my first gout flare in two years, and it had to start on Christmas Eve when I was cooking for 15. I got through dinner and most of cleanup before my foot became too painful to stand on. Then it got worse. Fortunately I have a stash of pain meds. Aleve < Tramadol < Oxycodone, is how it goes. I used an Oxycodone to get to sleep, then some Tramadol to get through cooking tonight's dinner. The flare is easing and I hope to be okay by tomorrow. I was given new cycling shoes by Santa, and couldn't even manage to pull them on this morning. My swollen foot wasn't going to tolerate being crammed into a tight shoe.

Oh man - John! I always though of gout as being for mid-aged guys that drink too much wine and eat too much pork. It would not be possible you triggered it through holiday behavior?

I know it hearts like a MOFO - some of my mid-aged friends have it ...

Get well soon - drink plenty (of water!)

G

I've been really restrained this holiday. Drank maybe three glasses of wine on Christmas eve, just one beer a day for the week before that. Eating the occasional Christmas cookie but really small portions at dinner. I'm cooking most of the dinners, which means I'm not too interested in eating them (funny how that works for me). Dinner last night was crab, and shellfish is supposed to be a gout flare trigger food for some, but mine started before Mr. Crab went into the pot. Just a mystery, I'm not too upset, figure one significant flare every couple years isn't bad. An inconvenient time for it, though.

One or two beers will set mine off every time. My doc set me up with an emergency kit of Colchicine and prednisone. If I feel a flair up starting I take a colchicine and prednisone "AS Directed" and things settle down pretty quickly. Don't drink beer anymore.

I have been a lot more aware since the kidney transplant.

I have a stash of colchicine. Usually I will take one on the first twinge. This time I was slow to recognize the flare, so I didn't get to the colchicine in time. I should try the steroid too.

are you on a daily allupurinol?

"I should try the steroid too."
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What absolutely slams my gout in its tracks is 5 mg of Prednisone taken as per what's on the packaging (below):
(I never get in to the 5th day...relieve is so quick for me on Pred.)
BTW, I'm presently on the downside of a left foot flare up that has lasted 2 weeks...no more heavy pain but still some swelling.
I'm finally convinced that I'll have to be on Allupurinol forever...just got a new supply.
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Boys, if you've never had a bout of gout, you're missing the thrill of a lifetime!!!!
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1st day,,,
2 tablets before breakfast, 1 after lunch and then supper, 2 at bedtime.
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2nd day...
1 before b/f, 1 after lunch and then supper, 2 at bedtime.
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3rd day...
1 before b/f, 1 after lunch and then after supper, 1 at bedtime.
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4th day...
1 before b/f, 1 after lunch and 1 at bedtime.
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5th day...
1 before b/f and 1 at bedtime.
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6th day...
1 before b/f.

Cherries are your friend if you get gout flare ups as well. :^)

I take 600 mg allopurinol.

Mine is 300 mg.
'Wonder why one is double the dosage...?

My rheum and I pushed the dose up until I got almost no flares. I tolerate the higher dosage fine.

i did a lot of research on this, after a bunch of flares. what has worked for me: 1000 mg citric acid daily, high dose b-vitamin complex, and hibiscus tea. i didn't change any of my other dietary habits, which i should, and continue to drink beer, which i shouldn't. no flares in almost a year.

John.

i'm sorry about this. i've been under the impression that the Allupurinol dose was the silver bullet for all of this. i take 300mg everyday. asked about dropping to 100mg, but they suggested i stay the course.

gout sufferers; i was told to keep the uric levels under 5 (forget the units). normal folks can run as high as 9.

I think allopurinol does indeed work well for me. This is, after all, the first significant flare in 2 years.

Drink more fluids

Medrol dose packs kick ass

John

You have my sympathy. Foot pain of any type is just awful.

Have you had your thyroid function tested? If you haven't you should just in case.

Never considered this.
My gout issues began a few years prior to my Thyroid being cancerous.
Removed in '13 and now on Levothyroxine 150 mg.
I'll have to chat w/my Endo about the med dosage.
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Hypothyroidism | University of Maryland Medical Center
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"Gout.
Hypothyroidism and gout often coexist and may have biologic mechanisms in common."

I've never considered thyroid either. Thanks for the idea.

Top 10 Home Remedies to Reduce Uric Acid Level
This won't embed, so...

https://www.youtube.com/watch?v=SH_ceFaKLA8
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Another...
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<iframe width="560" height="315" src="https://www.youtube.com/embed/RB7qm5ck5k4" frameborder="0" allowfullscreen></iframe>
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Tons of positive Amazon reviews...
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Urixtep Natural Gout Supplement Super Food
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Amazon.com: Urixtep Natural Gout Supplement Super Food, 1 pack (60 Ct): Health & Personal Care

all those home remedies..sheesh.

your foot is exploding in pain. you dont want tea or cherry juice. my rheumatologist said one patient asked about a foot amputation. wow.

i take 300mg allupurinol and i have been flare free for 4 years now. my doc said diet plays second fiddle to med with gout. unless i go full vegan it wont solve anything. he also said studies show that veggies that raise uric levels do not typically trigger flare ups like animal products that raise uric levels.

and the damn flare up is a symptom of gout. just because you are flare free doesnt mean you dont have gout. he said you have gout for years before the first attack.

the dude retired, and i havent seen another gout doc..but i would start there. i'm not convinced all docs understand it.

"i'm not convinced all docs understand it."
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After showing my PCP my swollen and nasty red foot and asked him for Pred...he said, "OK".
He prescribed Indomethacin, a pain killer.
I called the office in a pissed off state, saying, "I don't want pain relief, I want the gout to be gone!"
Got my Pred in a couple of hours.
What was he thinking?

same story everywhere.

even the pred didnt rid you of gout. just the flareup..i think

I also feel that gout is poorly treated. It takes a long time to get into to see a rhuematologist. They then treat gout very conservatively, starting drugs at very low doses and taking many months to consider raising those doses. They fail to warn patients that starting allopurinol often triggers flares, and often fail to prescribe prophylactic colchicine, with the result that many patients don't stay on the drug that will help them. They are also very slow to try new gout drugs, Uloric was on the market for a year and my rheum said she would wait a couple more years before trying out on a patient or two. They don't push dosages high enough. My feeling is that for a rheumatologist, gout is one of the less serious diseases they treat, the patient is often asymptomatic when they are seen, since the flare ended before an appointment was available, so the rheumatologists I've seen don't seem to take the condition all that seriously. Last complaint, they seem to do so much testing to confirm gout, before starting to treat it. It is possible to have gout and flares without uric acid crystals in the joint fluid and even without high serum uric acid (sUA) levels. I told my GP doc friend about the 8 months of testing (and pain, and walking with a cane or crutch) I went through before anyone decided to treat me with gout drugs, and he laughed out loud. "I'd have given you colchicine, if it helped, start treating you for gout".

john. is it better now?

Oh yeah, all over.

" I told my GP doc friend about the 8 months of testing (and pain, and walking with a cane or crutch) I went through before anyone decided to treat me with gout drugs,..."
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Oh man!!!
That's not right...that's dehumanizing!!!
WTF is wrong with some?
That would put me into 'kill mode'.
Glad to hear you're better, John.