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Uric acid levels often fall during an attack. Your Dr should have known this. There is no such thing as a 'normal' level. It makes about as much sense as saying a 'nice' level – meaningless. Get acurate figures; it needs to be below 6.00mg/dL to be safe, preferably around 5.00. See the conversion chart on the right column for other scales of measurement.
Pain where?
1. You need a blood test to measure the uric acid level in your blood. This is crucial. However, readings can be lower during an attack.
2. You may be more susceptible to the corrosive effects of NSAIDs because of your alcoholism (it sounds like you are already aware of this). The only other effective medication for gout? pain relief is colchicine, which would probably be just as bad.
3. If you can get a confirmed diagnosis of gout, you need to start taking Allopurinol or a similar gout med to lower your uric acid level as soon as possible.
Yeah, sounds like someone doesn't know what they're talking about over there or a disingenuous marketing strategy. I'll bet the latter.
nealjking said:
I have had occasional attacks of gout over the last 10 years, and have just now been prescribed allopurinol. But I have never before had my toe “wrapped” in white like that.
Also, what is odd is that there is a long-standing lump on that knuckle, that appears to be a tophus: white shows through when you apply a little pressure. But there is no damage to the bones, as confirmed by X-rays: the lump deflects the toe but not by intruding into it. Two doctors separately remarked on that.
Good, you're taking Allo. Make sure it's enough to get your SUA down to ~ 5.00mg/dL (check the info on the side bar to convert to the other values used by test labs: ?mol, mmol). 300mg per day works for most people. Drs like to start off with 100mg as a precaution against allergic reaction, but this is not necessary for more than a couple of weeks/ 1 month at most (if indeed at all). The important thing is regular blood testing to determine correct dosage. A few people have their own meters which, once you've mastered the technique of getting consistent results, give a good enough/rough guide to your SUA to keep tabs on your progress at the beginning of urate lowering therapy. I hardly ever use mine these days, but I'm glad I have it available.
Your lump tophus is the chronic type which the body walls off by laying down proteins, effectively sealing it. There is a theory that these deposits will never go away, because they are out of reach of the systemic blood supply which carries away toxins & dead cell debris.
The other was the acute version.
Tophi are a bit like volcanoes: some rumble & grumble away for years slowly adding deposits to the surrounding landscape; others are violent eruptions that devastate the local area in one go. What the Dr syringed out will undoubtedly be confirmed as monosodium urate – good riddance! and this act may have minimised further joint damage.
But you don't mention blood tests, diagnosis of gout,?urate lowering therapy etc. and?without these steps in hand you're not much better off than before the cataclysm.
People experience different initial side effects with Allo on a very broad scale: from zero to allergic rash. I vaguely remember feeling a bit tired and spacey for a couple of days, then nothing since. My guess is your metabolism is just taking a bit longer to adjust. Most people who experience s/e are OK after a month or so. By taking it less often than you should, you are probably prolonging this adjustment phase & certainly lessening the effectiveness of the drug, which may make you more prone to flares (especially if you're on a low initial dose e.g.100 mg).
My advice would be to bite the bullet & stick with it, making any necessary allowances to your activities such as less driving, having a nap if you feel tired etc. Maybe more coffee to speed up your metabolism? I'm sure it will soon pass. If not, (after a couple of months, say) have a word with your Dr and maybe think about tests for a different condition: aenemia, diabetes…but unlikely I reckon.
Keith (Gout Admin) said:
I can see your point odo, but this topic doesn't really address people like yourself who take responsibility for their own lives.
Whereas you might see a problem with your health, look for relevant information, sift out the rubbish, and ask pertinent questions, others take a completely different approach.
They assume that people who contribute here, especially myself, are going to give them a recipe for a gout-free life without any effort on their part.
Personally, I like Fry. I like his humour (definitely with a u), and I like much of what he says. Occasionally he goes over the top and occasionally he is just plain wrong. However, I believe his ubiquity is as much to do with his talents as it is to do with his drive to cash in on his celebrity status. Fortunately, unless you are physically in his company, he comes with an off button.
The most pertinent point of this video was telling the whiners and whingers to shut up. I'd just like to tell them to stop posting here, but I would much rather they turn the whinging into constructive criticism so we can all make our gout resources better.
Quite so, Keith, and apologies for the off topic rant; it's just that SF is one of my pet peeves at the moment & I couldn't resist the opportunity to vent (can't even claim the excuse of being in flare up-o delicto)
I secretly watch QI as well, I'm afraid
Oh yeah, just what we all need: Steven Fry talking down to us like little children on how to live our lives. I can't believe people are so impressed by this self appointed font of all knowledge. He is quiz show host who went to Cambridge,? now cashing in on the celebrity circuit of interchangeble front men for general interest programming: SF goes to America, SF does various nature programmes, SF explains Science to all of us thick people etc. If he was really as bright as he would have us believe, he would be a Nobel prize winning something or a captain of industry – not a media whore endlessly recycling his therapy sessions online as inate wisdom.
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He was quite good in Blackadder though.
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Andrew said:
Eczema and alopecia are both considered autoimmune disorders.
Also, both can be triggered by stress. Repeated gout attacks are very stressful & you mention another very stressful situation in your life which, in addition to its primary stress effects, may also be preventing you from having your own health issues acknowledged, as they are perceived as minor in comparison – adding to your stress levels.
While a link between gout & other auto immune diseases may be interesting (and a no-brainer imo), I think the stress factors in your life are a more important consideration, which needs adressing urgently. Easier said than done, no doubt, but sometimes you have to let the world know that you need to get your own sh*t together before you can be of any use to anyone else.
I was going to say 8 months isn't that long to be so confident, but you didn't mention you were on Allo in your original post. It's good to eliminate fructose, but the Allo has to take the majority of the credit for your success.
ctrlkeys said:
I do have another quick question guys, is it normal for a gout attack to hit around the same time every day for some unknown reason my attack which has been running for 2 weeks now seems to come to me at 2-4am is that normal for an attack to always pop up around the same time ? last nights lasted an hour with 50mg of indomethacin knocking it out but any particular reason why the timings are so constant ?
Could have something to do with the fact that this is the body's lowest time of metabolic activity i.e. your defences are down, blood pressure & temperature drops. Very common time for sickly/old people to pass away.
In Chinese medicine, 3am marks the end/beginning of the human 24 hr cycle. All transition periods being considered when we are more susceptible to disease (e.g. Spring/Autumn).
Just thought I'd slip that in to annoy all the scientists
Tattooing obviously kicks off your inflammatory resonse – not surprising
really, as even a stubbed toe can bring on an attack. Urate levels are
often lower during an attack; any Dr worthy of the title should know
this, and anyway, .37 is not low enough to prevent attacks for a goutie.
Stick to your guns & get the Allo. Insist on a maximum of 1 month
on 100mg then increase to 300mg & re-test after 1-2 months. Agree on
a target level of .3 SUA (~5.00mg/dL) or less with your Dr; if he disagrees, change Drs.hansinnm said:
?
And you may RIP that I will/shall NOT tamper with any gouties' posts/comments.
Good to hear Hans. If I was coming to this forum for the first time (in pain) I don't think I'd be too impressed with threats of censorship and editing if my enquiry or spelling & punctuation wasn't up to scratch.
Aaaaaah, that's better.? Better go & take a smileypurinol now, just in case
Keith (Gout Admin) said:
?No way would I wait 3 months.
[edit]I just remembered. One joker tried to increment from 100mg to 200mg. The 100mg made very little difference, and I suggested 300. He stuck to his guns, and gave me a prescription for 8 weeks. After 4 weeks on 400mg I returned claiming mis-hearing. He got the message.
[/edit]
Neither did I. Stuck it out at 100mg for a month then took 200mg for a month & went back and got a scrip for 300mg thereafter. Still too long imo.
Keith, do you know if there are any rules regarding regular UK prescriptions? I currently only get 2 months and was wonderiing if I could get 3. Last time I enquired about long term scrips, I was given a leaflet about a scheme, which was only economically viable for multiple medications.
There's an acupressure point for nausea approx 2″ up from the inner wrist crease (in between the 2 tendons that are tensed when you press tips of thumb & little finger together – don't have to do this while massaging the point, it's just for location). Massage firmly with your thumb (both sides, small anti clockwise circles) for approx 5 mins or till symptoms subside. You can buy sea sickness wrist bands which do much the same thing, but this is free & stronger treatment.
Keith (Gout Admin) said:
?death at 300mg was enough to convince me that the slow but sure approach is effective and safe.
Me too.
?Now we can turn our attention to trying to convince Drs that only a couple of weeks (1 month at the most ) is necessary before an effective dose can be prescribed. 3 months, which seems to be the default here in the UK, is waaay too long and, as Zip says, likely to cause unneccessary suffering.
No point setting an arbitrary length of time before you start Allo either. A lot can happpen in a month when you're at the tipping point of gout attacks. As soon as you feel you're over the flare, start taking it and then don't stop no matter what.
No I think you're probably right, I noticed the same thing with tofu and chickpeas. But before you're on UA reducing meds there are so many ways of triggering an attack, many of them related to certain foods, but it could just as easily be walking a bit too far one day or stubbing your toe, wrong shoes etc. I think of it like a cup filled to the brim with water with only surface tension holding back a spill, all it takes is a couple of drops to make it overflow by considerably more than the drops that caused it (cascade effect of inflammatory process). No wonder people believe gout is entirely due something they ate last night when in reality it's just a small (but important) part of a much bigger picture.
The other day someone offered me a SPAM sandwich and said it would cure my gout. Imagine my surprise when I took a bite and found it was filled with BULLSH*T
Do not discontinue taking Allo. Your throat symptoms are caused by something else, most likely bacterial/viral infection.
Don't delay any longer. Read as much as you can on this forum & you'll understand why. There is noting to fear from taking Allo, quite the opposite in fact.
Not sure explaining that brassic means skint is going to help much Keith LOL (where are them damn emoticons?)
