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Old 25-08-2008, 13:49   #46
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See your doctor, have the blood tests and urine tests. He will probably prescribe allopurinol for daily use, and indomethacin for when the episodes of gout come up. Be careful about spinach and other greens that have high folic acid. Lots of protein also seems to overload your body's capacity to completely metabolize the stuff, pumping up the uric acid in your system. Also, high levels of alcohol and stress can trigger episodes in some folks. I know. The drugs are great and can stop an attack within as little as an hour. See your doctor, lose some weight, and go sailing more.
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Old 25-08-2008, 14:21   #47
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Interesting about the spinach. That fits the timeline of my most recent episode. Among the many things that are recommended for gout are to take folic acid supplements. I tried that for awhile, and had an outbreak of it durring that time, so I stopped taking it. I dod not have another outbreak for over a year, but recently, I have been eating more spinach than usaal. I do not drink very often, and have already ruled that, red meat, and red sauces, as well as tomatoes, out.
I will also say that I woke up this morning as bad off as I have been for the past week, and took two teaspoons of the apple cider vinegar. The pain is about 25% of where it was the past few days. I will give this a chance for a few days, and if no results, I will give the doctors another chance. The last time I tried that, they put me on indomethacin. The gout lasted longer than it had before, and it came back within about a month. I did nothing, and it only lasted about 2 days. That was normal for outbreaks prior to seeing the doctor.
This is the longest I have had it hold on, but I seem to be at the end of it. I will avoid spinach for awhile, and see what happens. Like I said, if it comes back again like it did this time, I will give the doctor a shot again.
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Old 25-08-2008, 14:36   #48
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Believe me brother, I feel your pain!

I've had gout for 25 years and the bouts do get more frequent as you age. Between the first and second attack was over 4 years. I resisted going to daily allopurinol until I started having several instances a year.

The only thing I know that will stop a gout attack after it has started is colchicine. You can knock it down in 12 hrs. Cochicine does give you a nasty case of the runs about 24 hrs later, but the gout is gone.

The recommended dosage of colchicine is 2 tablets at the onset and one every hour until the pain is gone. It's a harsh drug, but I'd bet it's better than letting gout ravage your joints for a week or more.

You can mitigate the diarreha by reducing the dosage. When I need it I take one or 2 pills immediately, one an hour later, one 2 hrs after that, and another 3 hrs later. That dosage, for me, relieves 80-90% of the pain, stops the attack after about a day, and doesn't cause much gastrointestinal distress. You have to find the dose that works for you.

As for diet and exercise, the only corelation beween gout and lifestyle for me is that it always occurs when I'm breathing. It's more genetics than anything else.

I started using allopurinol daily about a year ago and haven't had a recurrence so far.

Good luck,
Norm
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Old 25-08-2008, 14:55   #49
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One of the reasons I tend to post when I have flare ups is that gout is one of those diseases that has as many theories on the cause and cure, as there are people with it. I have, at the very least, been able to rule out several causes, and cures from the posts here, and, as those who have it know, it is nice to be able to communicate with people who have actually experienced it. Not having experienced child birth, I tell my wife all the time that I would never pretend to know how much that hurts, as long as she takes me at my word, how much gout hurts
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Old 25-08-2008, 15:16   #50
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Just another point to consider Kai, but do you thing perhaps your blood pressure levels might be related to your vulnerability to attacks of Gout?

I had a severe attack about 7 years ago and like you did not want to go on the gout meds. The doctor explained that my blood pressure was high which was a contributing factor. I worked on the BP and have not had another attack of gout since
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Old 25-08-2008, 15:21   #51
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You have my advice, after 30+ years experience.

Many studies have found NO LINK to diet.

If you take proper medication -- which is not costly and not a big deal -- you can eat and drink what you like without worrying.

Why subject yourself to these painful episodes?

As Roy said, see your physician -- and you better find another one if you haven't had luck so far -- and spend more time sailing :-)

Bill

BTW, the proximate cause of gout is very well known: it's hyperurecemia, i.e., elevated levels of uric acid in your blood.

The impact of gout on arthritic conditions is also very well known: it's dangerous, when untreated.

And, best of all, the treatment and, especially, the prevention of gout is very well known and documented.

IMHO, to pretend otherwise is just sticking one's head in the sand.

B.
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Old 25-08-2008, 16:03   #52
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I have recurring gout. Have been a sufferer for several years. I generally get 3-6 attacks per year of varying intensity. There are various courses of action to manage this condition.

The method I use to manage the condition is to take large doses of anti-infammatory drugs at the onset of an attack. I have found that if you get the anti-infammatory pills in when you feel the first pangs of gout, you can usually "knock it on the head" before it gets to the agonising stage. My medication of choice is Voltaren Rapid 25. I have tried various diffenent anti-inflammatories, and this one works well for me (your mileage may, of course, vary). It is also available over the counter, without a perscription from a doctor. The main problem with this approach is that strong anti-inflammatories are, in general, not good for your guts. IF you have any history of stomach ulcers or gastro-intestinal issues, you should certainly seek medical advice before following this path. These drugs also, I am told, increase your chance of stroke.

There is also a medicine that you can take, one pill per day, that will render you gout-proof. I have not tried it, but I know people who have, with complete success. I have not gone down this path because I am not very good at organising myself to take medication regularly.

Certainly diet can make a difference. Cherries and raw celery are, as far as I know, the only foods that help to cure gout, but apart from that, you can pay more attention to your diet and try to identify what it is that sets you off. It seems to be different things for different people. For some, tomatoes or capsicum / peppers. For some shellfish, for others, offal or even pulses and peas. For many people, excessive alcohol, particularly red wine can be a trigger. I have found (sadly) that staying away from large amounts of rum, bourbon or whisky helps. Indeed, avoiding booze benders has certainly reduced the frequency and intensity of attacks for me.

My doctor tells me that less cigarettes and more exercise will help. I'm not entirely convinced that this is gout-specific, good advice though it is.

Caveat: I'm not any sort of quack or saw-bones, so all of the above is worth slightly less than two cents. Seek medical advice if you want proper advice!
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Old 25-08-2008, 17:19   #53
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I have gout for the past 4 years. I tried it all. Allopurinol only made it worst. On the second week of my last attack I started taking Uricinex a dietary supplement.Within two days it started going away. I think I was taking 3 to 4 a day for 90 days. If I have a flair up now I take a couple & I'm fine. I eat & drink what ever I want. Google this,it works!http://www.micronutra.com/uricinex.html
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Old 25-08-2008, 18:02   #54
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Kai,

You have actually been getting some pretty good advice here.

Concerning gout:

The diagnosis is best made by taking a sample of the joint fluid. This rules out "pseudogout" which is caused by a different kind of crystal and is treated differently. Also, a bit of steroid can be injected into the joint at the same time which may stop an attack in it's tracks.

Serum uric acid levels are not very reliable. You can have elevated levels and not have gout, you can have gout and not have elevated levels. Also, some of the medications used to treat gout, such as allopurinol, can precipitate an attack because any change in uric acid, up or down, can cause precipitation of crystals. This is why doctors drink.

There are two ways to get gout, overproduction (10%) or underexcretion (90%). It is worth finding out which you are because underexcreters may best be treated with Probenecid, rather than Allopurinol. This can be done via a 24 hour urine test.

Diet really doesn't make much difference but alcohol, particularly beer, can.

Any NSAID (indomethacin, ibuprofen, naproxyn etc.) can be used for an acute attack but use the full dose (800mg every 6 hours for ibuprofen, 500mg every 12 hours for naproxyn) and start at first hint of trouble, then continue for 2 days after you are pain free. Colchicine can also be used, but it's effectiveness declines after about 24 hours and will usually give you diarrhea as mentioned in another post. If you can't take NSAIDS or colchicine you can try oral steroids.

It is best to get yourself on a preventative because, as pointed out in another post, recurrent attacks can damage the joint. Most rheumatologists recommend starting preventatives after the second attack. It is a pain to take a pill every day and even more painfull to admit to yourself that you have a medical condition but it's the price we pay for living past puberty.

Finally, don't listen to me. The internet is a great place to learn about boats but a crappy place for medical advice. See a Rheumatologist if you can as these folks specialize in this sort of thing and your local sawbones may be a bit rusty.

Best of luck,
Mike
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Old 25-08-2008, 18:51   #55
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Wow, Lots of great advice/experience. I have had an issue with my feet for a few years and have been tested neg for gout and diabeties. They feel like "Clay" and tingle most of the time. This tingling gets worse when I go to bed, (Horizontal) even preventing sleeping for several hours. Getting in and out of the Vberth is a major pain in the .. well foot.

Any of you gout sufferers get any symptoms like this? It is not local to a toe or other joint. It seems to be slowly going further up my leg. I thought it was gout but I am puzzled and frustrated.
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Old 25-08-2008, 20:15   #56
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Hi Will,

Sounds more like a peripheral neuropathy than gout. There are several causes for this but way up at the top is diabetes. Even though you have tested negative in the past it must be kept in mind that you can have insulin resistance for many years prior to development of frank diabetes. Talk to your doc about this so he can rule out other causes like vit. b12 deficiency. A glucose tolerance test may be in order to help better screen for "prediabetes". On the bright side there are some good treatments for peripheral neuropathy like Pregabalin (Lyrica) available nowadays.

Mike
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Old 26-08-2008, 01:36   #57
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Quote:
Originally Posted by mikereed100 View Post

Any NSAID (indomethacin, ibuprofen, naproxyn etc.) can be used for an acute attack but use the full dose (800mg every 6 hours for ibuprofen,<snip>
Wow - this is interesting.

(disclaimer)
1/ I am not a doctor
2/ Go see a doctor

I get periodic joint swelling. Sometimes ankle, sometimes knee. In the past it has been cause for being bedridden. I was always reluctant to go to a doc. My wife nagged and nagged. 6 years ago. I finally went. At the time both my knee and my ankle were swollen and painful such that I was on crutches sometimes for a week at a time.

Previously I played soccer at very competitive levels for 9 years.

The doctor said I probably have gout. I told him I never had problems in my digits only the main joints. He said it didn't matter.

He drew samples from my knee and ankle with a huge, scary and painful syringe. Negative for high uric acid levels. He x-rayed the joints. My ankle (unbeknownst to me) had been broken at least 3 times in the past.

He gave me bed rest. 4 years ago i had a bad attack and went to a doctor here. Almost the same drill.

I had taken tylenol for the pain in the past but was out so I popped 600mg of ibuprofen. I felt better in a couple of hours. I took 600mg more 6 hours later. I googled ibuprofen on Wiki and Web MD to make sure I wasn't going to OD or something.

Long story short ibuprofen is my friend. I don't know if I have gout. I suspect I will have increasing problems as I grow older but for now as soon as I feel any joint pain I do 24 hours of ibuprofen at 600mg every 6 hours. If the pain isn't completely gone is 24 hours it always has been in 48 hours. And now it's not even pain. It is more a little discomfort and has never put me on crutches or on my butt.

I didn't post my experience before because I know 600mg is a big dose.

I saw my doctor (2 different doctors) and they are clueless as to what causes it. My treatment works for me. haven't been to a doc in 4 years and I have about 4-6 attacks per year.
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Old 26-08-2008, 06:04   #58
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I read recently that lots of fructose exacerbates the problem, so it may be worth avoiding fruit juice and concentrating on good old hydrating water. I also found that avocados, spinach and asparagus exacerbate my condition as well as beer. I found that other greens are not a problem and lots of parsley and stinging nettles seem to improve things. I do not think folic acid is a problem. I also suffer from pseudo gout which I found was triggered by preserved meats. I have not had a case in a four years since following the diet guidelines
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Old 26-08-2008, 10:13   #59
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Hi, guys, haven't posted in awhile - but this one got my attention. Might as well throw in my $.02.
I've had exactly one episode of gout. Most painful and baffling thing I ever experienced. I did not understand what was happening to me. My right foot felt like someone had crushed it with a sledgehammer. I had taken my young daughter to a movie, starting with no pain. In the course of an hour, it developed alarmingly to a point where we had to leave. I was in tears just walking to the car. Had to drive home using my left foot - lucky it was an auto trans. Took 2 ibuprofen and drank a quart of water, and it began to subside. By morning, it was gone. Went to see the doc anyway (that was the earliest appt I could get), and he said, "You've experienced your first case of gout. Reduce your intake of protein, especially red meat, and alcohol, and increase your water intake. View moderate or dark yellow urine as a warning sign of insufficient hydration. You need to make a change in habits or this will come back, and it will be worse next time."
I was dealing with the stress of a divorce, learning to be a full time single dad with a pre-school daughter, and trying to restructure my finances to avoid losing our home. I was drinking too much and eating too poorly, although the doc called it the "rich man's disease" because that meant I was eating too much meat. But I took the doc's advice, and I have not had a second episode - now over ten years on. And I think I'll go refill my water bottle.
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Old 26-08-2008, 12:23   #60
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Thanks for the info Mike. I did have a Glucose test (I called it liquid lolypop) and it did not show anything. I drink so much water that I was concerned. Funny that this started a few years ago when I started taking Norvasc and Triamterene-HCTZ (Min dosage) for slightly elevated BP. Think I will continue sailing, drop some weight and dump the Meds. This is getting tiresome.
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