Gout

[Verdinut]

Hey thanks for that. This is absolutely horrible, and I’ve had some decent injuries before too. It’s just relentless!!!! Like I wanna jump into traffic!!!!!
I’ll try to calm down a little to share some info. But yeah, some foods make it worse. Imaging kidney stones in one of your joints. You know, really sharp and spikey!

Sorry to hear about your problem. Here is a good list of food and drinks to avoid which I found. Hope this will help::

10 Foods that trigger gout - CK Health

A balanced diet is the number one recommendation for avoiding gout! Here are 10 foods and drinks to avoid to reduce risk of a gout attack.

ckhealth.com.au

 

[William Lemmerhirt]

What is it you want to know about gout? Gout is the deposition of uric acid crystals in the joints. Normally these crystals are encapsulated and cause no problem However, if the capsule is damaged by injury or any other reasons, then the crystals set up an intense inflammatory reaction in the joint, and you get an intensely inflamed hot, and painful red joint. This eventually subsides spontaneously. However two drugs are helpful, the ancient drug colchicine and a sub class of anti inflammatory NSAID drugs. The two representatives of this class are tolmetin sodium and indomethacin. However they have significant side effects. In addition the high uric acid levels can result in uric acid kidney stones.

For acute gout I found that using two IV infusions of colchicine spaced 24 hours apart resulted in quick resolution of the problem.

If recurrence is frequent, then long term treatment with allopurinol is indicated. This reduces uric acid production, and the uric acid crystals in the joints will slowly dissolve. However the dissolution of the the uric acid crystals disrupts the protective capsules, and often precipitates acute gout. So in initial therapy cover with an anti inflammatory drug is indicated. Then maintenance therapy with allopurinol can be continued. It does require ongoing monitoring for side effects, of allopurinol.

Lastly gout does need to be managed properly, as there are significant renal and cardiovascular consequences. If your doctor is not familiar with appropriate protocols for the treatment of gout, then ask for referral to an experienced rheumatologist. Gout is not a trivial disease, but too often approached as if it is. It is in fact a disease with life limiting consequences. It should not be treated as a joke, which it far too often is.

Wow mark. Thanks for that information. I thought you might drop in.
I’ve learned some of what you mentioned in just the last couple days, mainly the part about uric acid crystals. Never knew anything about that before.
I do have a question.
I’m retrospect, I have realized that my water intake has been very, very low. Possibly for a few months. Is it possible at all, that my low water consumption was not allowing my body to process the uric acid properly? And once I return to normal(100oz) daily water consumption my body will properly process through the kidneys as it’s supposed to? Or have I just discovered that I could suffer this for the rest of my life?

 

[William Lemmerhirt]

Heya,

You typically handle your gout flare ups with ibuprofen, take it every 6 hours (max dose yourself at first) until you break through the initial flare up. If you want to reduce it, there's a lot of diet influence involved. Hopefully its enough to handle it. If it's not, there are further measures but ideally avoiding anything more than that is good.

Gout sucks. Sorry you're experiencing it. It's common enough. Lots of info out there.

We give very basic anti-inflammatory treatment to patients when they show up and don't know they have gout, nothing fancy or extra stuff, except for extreme cases that cannot be handled simply that require more. Hopefully you're not in that second category.

Very best,

Thank you. I hope I’m not in the extreme group either. I haven’t noticed any markers before, except possibly that I have had kidney stones in the past. I basically stopped getting those by quitting soda, save for the occasional one. That was 14 years ago.
I was prescribed prednisone and have been using an ice gel pack a lot. Also gimping around with crutches to keep pressure off of it.
I was once told that ibuprofens anti inflammatory characteristics take up to a few weeks to work. Ever heard that? Didn’t seem to ring true to me. Don’t know…

 

[MalVeauX]

Thank you. I hope I’m not in the extreme group either. I haven’t noticed any markers before, except possibly that I have had kidney stones in the past. I basically stopped getting those by quitting soda, save for the occasional one. That was 14 years ago.
I was prescribed prednisone and have been using an ice gel pack a lot. Also gimping around with crutches to keep pressure off of it.
I was once told that ibuprofens anti inflammatory characteristics take up to a few weeks to work. Ever heard that? Didn’t seem to ring true to me. Don’t know…

Drink plenty of water.

Ibuprofen works fast (60 minutes should start to feel an appreciable difference). When you get a flare up, take max dose ibuprofen every 8 hours.

Seriously, people show up the ED all the time with gout and have no idea what's going on, we flood them with saline and ibuprofen as the front line. After a week of no improvement, it progresses from there. But usually you can solve it with just water and an anti-inflammatory.

Very best,

 

[William Lemmerhirt]

Sorry to hear about your problem. Here is a good list of food and drinks to avoid which I found. Hope this will help::

10 Foods that trigger gout - CK Health

A balanced diet is the number one recommendation for avoiding gout! Here are 10 foods and drinks to avoid to reduce risk of a gout attack.

ckhealth.com.au

Thanks for that. That list seems to echo others I’ve seen. Unfortunately too many things on there are ones I enjoy. This will be difficult.

 

[lovinthehd]

I doubt that food would cause gout although it seems possible if you eat excess red meat or seafood. In my opinion, your business partner might have had an alcohol problem which originally caused it.

Yeah when I researched at the time I didn't put much to it but does have a history with shellfish particularly IIRC. Altho gout seems to cover a variety of things, not exactly a precise diagnosis for many it seems. As I posted he was a former (heavy) alcoholic but had been in AA (and for real) for a few years before I even met him, but no sign of it during our relationship....he had plenty of issues, but not that particularly

 

[William Lemmerhirt]

Drink plenty of water.

Ibuprofen works fast (60 minutes should start to feel an appreciable difference). When you get a flare up, take max dose ibuprofen every 8 hours.

Seriously, people show up the ED all the time with gout and have no idea what's going on, we flood them with saline and ibuprofen.

Very best,

Nice. I’ve been chugging water like a fiend!!!!!
I can see them showing up in the ED scared as hell. First kidney stone, I went to the ER afraid I had a case of torsion(no idea why I’d have that lol). I was really scared. It was funny kinda. They gave me fentanyl, and it must’ve been training day, because every single doctor, and nurse, and ultrasound tech had two other observers with them. I swear there was even a maintenance technician in one of the rooms. Lol

 

[Verdinut]

Thanks for that. That list seems to echo others I’ve seen. Unfortunately too many things on there are ones I enjoy. This will be difficult.

It's unfortunate and I understand you. With some restricted diets, experts recommend to avoid the bad things six days a week. Then, if you find it really impossible to avoid them completely, you cheat a little bit only one day a week, always the same day. That might be a solution at the beginning, and eventually you might surprise yourself at being successful to avoid them all for good.

I wish you good luck in your endeavour.

 

[jinjuku]

Wow mark. Thanks for that information. I thought you might drop in.
I’ve learned some of what you mentioned in just the last couple days, mainly the part about uric acid crystals. Never knew anything about that before.
I do have a question.
I’m retrospect, I have realized that my water intake has been very, very low. Possibly for a few months. Is it possible at all, that my low water consumption was not allowing my body to process the uric acid properly? And once I return to normal(100oz) daily water consumption my body will properly process through the kidneys as it’s supposed to? Or have I just discovered that I could suffer this for the rest of my life?

Many things can trigger a bout of gout:

Dehydration, semi to rapid weight loss, foods high in purines, injury to the affected area.

Gout is typically hereditary. So you'll most likely get it again. I have a a flare up every 3-4 years. Expect it not to stay in one place.

As already pointed out, colchicine is the backbone drug for treatment. It's part of the the arsenic family. Talk to your doctor about always keeping an unexpired 24 hour dosing in your medicine cabinet and if you suspect an attack coming on start the schedule. It's best pre-inflamation.

Surprisingly not all MD's from a general practice perspective understand the treatment options and one from the Urgent Care over prescribed colchicine but the pharmacist caught it and told me the levels and schedule would have put me in the ER.

Indomethican is something I can't take so I double dose Naproxin-Sodium for my first with a LOT of water and then maintenance dose. It helps.

Prednisone is supposed to force the uric acid out of suspension in the blood by taking it's place and allowing your kidneys to expel the uric acid. Careful with taking other pain meds with Prednisone as if I recall it was developed in WWII to extend duration of meds in the blood stream helping conserve wartime supplies of drugs.

Lastly if you ever feel that your MD is not up to snuff or your condition is going out side the standard distribution of gout attack, frequency, duration, ask for a referral to a Rheumatologist. You would want to get a kidney function test.

 

[Swerd]

Still swollen to hell. The doc gave me prednisone. I guess it’s like a super ibuprofen.

Unfortunately, I've had some extensive experience with prednisone. I don't know what dose and schedule your doc prescribed. I hope it's brief, as in one week. It probably involves starting with a higher dose, and slowly tapering off the dose down to nothing. Be absolutely certain to follow that schedule as prescribed.

Prednisone is a steroid drug (a cortico-steroid), and ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). Both can work well, but unlike the NSAIDs, steroid drugs have all kinds of unwanted side effects.

One of the major side effects of prednisone is that it makes you feel hyper and sleepless. It can be like a rush of adrenaline, such as what you feel in the seconds after a near accident or a severe fright. Except with prednisone, you feel that rush all day and all night. Some people actually like that, and others (like myself) hate it.

Prednisone, when processed in the liver acts as an adrenaline substitute. High doses of prednisone (higher than roughly 20 mg/day), over longer periods of time (longer than several weeks), can cause your adrenal glands to shut down until the dose is lower. Once natural adrenaline production by these glands stops, it can take 6-8 weeks for them to return to normal activity. During that 6-8 weeks, people usually feel highly fatigued. As the adrenal glands reactivate, this fatigue slowly goes away.

Some people hate what they feel with prednisone, and quit taking it without the gradual dose reduction. I know of one person who took prednisone to treat an severe case of poison ivy. She hated the prednisone experience so much she quit taking it cold turkey, without reducing the dose gradually. She ended up being severely depressed for weeks because she quit cold turkey. This an extreme case, but it's an example of how potent prednisone can be.

The good news about prednisone is that it works fast, within 2-3 days, to significantly reduce the pain and swelling you feel from gout. I hope it's doing that for you. Just be sure to follow that dose and schedule as prescribed.

 

[GO-NAD!]

I have a couple of co-workers with gout. I know when either of them is having an attack, when they limp into the office.

 

[Pogre]

Former friend had it. Said it felt like he had ground up glass laced with acid in his joints. Double whammy was beer and red meat makes it worse. He loved beer and meat, lol.

 

[Out-Of-Phase]

I have had gout. I have had it three times. I have had attacks on both big toes. It hurts!

I took Colcrys. It worked. They gave me 3 tablets. I took the first 2 immediately then the last tablet an hour later.

By the next day, my pain and swelling was down about 90%. No stomach distress either.

 

[panteragstk]

Hopefully beer doesn't cause stones, I'm screwed if so

I'd probably be dead from the 8ft round stone they try to remove

 

[panteragstk]

Thanks for that. That list seems to echo others I’ve seen. Unfortunately too many things on there are ones I enjoy. This will be difficult.

You gonna have a hard time ditching the organ meats eh?

 

[WookieGR]

The only experience with GOUT I've ever encountered was my mother's deceased 3rd husband. He only drank beer and ate fatty deep fried foods and mexican. He also sat around and didn't have a job plus thought he was a motherf^cking genius because he watched documentaries. I suppose those things can cause gout. Seems to be the result of poor diet, lack of exercise and being a knowitall.

The only reason I came in here was I thought it had something to do with the original Star Wars trilogy. Sorry.

 

[Hetfield]

The only experience with GOUT I've ever encountered was my mother's deceased 3rd husband. He only drank beer and ate fatty deep fried foods and mexican. He also sat around and didn't have a job plus thought he was a motherf^cking genius because he watched documentaries. I suppose those things can cause gout. Seems to be the result of poor diet, lack of exercise and being a knowitall.

The only reason I came in here was I thought it had something to do with the original Star Wars trilogy. Sorry.

Well, he sounded like a real winner.

 

[WookieGR]

Well, he sounded like a real winner.

More like a real weiner.

 

[Hetfield]

More like a real weiner.

Definitely, yikes.

 

[lovinthehd]

The only experience with GOUT I've ever encountered was my mother's deceased 3rd husband. He only drank beer and ate fatty deep fried foods and mexican. He also sat around and didn't have a job plus thought he was a motherf^cking genius because he watched documentaries. I suppose those things can cause gout. Seems to be the result of poor diet, lack of exercise and being a knowitall.

The only reason I came in here was I thought it had something to do with the original Star Wars trilogy. Sorry.

I'll bite, how would gout connect to Star Wars?