September 19, 2010 at 12:33 pm #3408caveman38Participant
I suffered with gout in July (I assume) and had a blood test which showed 480 after a 2 week recovery. I was prescibed with Colchine at the time which only alleviated the pain after the full 12 tablets and 2 days from that max. dose. I was prescribed nothing else but told to have a blood test in 2 months and revisit the GP.
In the meantime I have had no recurrence of the gout although my affected joint (L Foot big toe joint has had twinges which never developed to anything worse.
Yesterday I was helping my son relay a carpet and with trainers on I did the stretching of the carpet with my feet, stamping and pushing my feet forward. Today I have got a repeat of what looks like the gout.
My first bout was triggered by dehydration and/or running on the spot with carpet slippers on as part of an exercise routine. I therefor wonder if I have not just got an artritic big toe joint which reacts to heavy movements, bending a lot and such like.
My last blood test again was 480 and on hearing that I had no recurrence of the gout (before today) my GP was happy that the level was not anything to worry about.
PS. I should add that the GP at the time (he's moved on) was more concerned with high liver readings on my blood test. The GP told me last week that they are still high by within limits he is happy with. Would that sway their thinking away from Allopurial.
How can I find out if it is gout or arthritis or can gout be triggered by exercise or joint abuse. Should I take Colchine or my anti-inflammitory pills?September 19, 2010 at 3:38 pm #10014trevParticipant
Interesting that you actually open by assuming you have gout Caveman!- so you're nearly there 🙂 It IS triggered by trauma and overuse, as well as diet, stress and body mass index & BP being high. The crystals can be extracted and seen under a polarized microscope, if you can get this test.
With the high SUA and the effectiveness of Colchicine- you're well on the way. Docs are loathe to start a lifetime treatment regime on less than 3 attacks- and you are well on target. It doesn't sound like you've been driven to using a walking stick yet, though.
I take Sulfinpyrazone for gout which I think is harder on the kidneys than the , but at a lowish dose, this seems OK and is monitored.AlloP
I suppose with something like gout one thing at a time is hard- but use Colchicine for the attack aleviation, with a 3 day break after a big course like 12 [that's my max, anyway] and see of your SUA goes higher , as it may.
If so, your Doc, who sounds reasonable, will take good note- and.. remind him that for gouties 350 umol SUA is the max!
The SUA goal posts move, once you are diagnosed
Finally, taking meds is not great, but better than the alternative- if you are on course for some later years urate knocking back. It won't go on it's own, 8mg/dl [your approx reading] and higher, is where I decided diet and minor meds had to give way to a more rigorous approach.
This is also, if not solely, to see if my BP is actually worsened by high SUA- I suspect so.
It sounds like gout to me- but your Doc can decide ;~) they get excellent money these days- but here you can get a personal slant and get his undivided attention 🙂September 20, 2010 at 4:46 am #10016Keith Taylor (GoutPal Admin)Participant
Yes, caveman38, you (almost certainly*) have gout.
Yes, an acute attack can stem from heavy exercise or trauma. Also cold is another common trigger.
Colchicine is an inflammatory that is fairly specific to gout and some other autoimmune inflammatory diseases. NSAIDs like ibuprofen & naproxen are also commonly used. There is no 'best' choice other than what works best for you. The inflammation will pass by itself within a few days, but new gout attacks in the meantime can prolong this.
* 'almost certainly' means you should get this confirmed by a joint fluid examination by a rheumatologist with plenty of experience. It's painless, but don't be a guineau pig for a doctor who hasn't been doing this every month for a few years. Many doctors skip this test if the diagnosis is pretty obvious, which I suspect from your description is your situation.
You should also arrange for a 24 hour urine test to measure your uric acid excretion rate. That will determine which treatment is best for you, and your doctor may consider liver test results when setting your dosage. Ideally, you aim for a few months with very low uric acid levels to flush out all the old uric acid crystals, but liver or kidney issues might regulate the speed you can do this. As long as you keep on the right side of 350, all will be well.
The real doubts begin when it comes to treatment options. Some doctors consider that you should just treat the pain, and wait until you've had years of crippling misery before prescribing uric acid lowering treatment. They are best avoided, or better still, culled.September 20, 2010 at 9:17 am #10020zip2playParticipant
I agree with the others that you have gout based on your high serum uric acid and the thorough response to colchicine. I can imagine the bunion stress of laying wall to wall carpeting because the big toe is not only flexed the whole time it is used to push off on the metal knee-kicker that pulls the carpet tight onto the “tackless.” I'd like to give a shot at laying wall to wall carpeting but it is getting passe these days in favor of clean shiny hardwood floors.
Very few doctors will prescribe allopurinol aftter the first attack because they assume that SOME people will have only one or two attacks in a lifetime. (Yep, and I've got a bridge to sell that connects Manhattan with Brooklyn.)
If you have only one attack a year that can be managed with colchine, low purines, cherries, black bean broth, or a trip to Lourdes you might be able to do without the “forever” drugs. But if you have 2 or 3, the drug route will probably be your answer. If you are criplled on a monthly basis then your path is quite clear, 300 mg. allourinol/day.
Personally, I think when one has his first gout attack lifelong medication becomes an inevitability. The only reason I suffered though 5 attacks before starting allopurinol was ignorance (pain was atypically in instep and ankles) and RELATIVE mildness during the first 4 that ONLY required crutches….so you can imagine what #5 was like.
Think back, can you recall any unexplained foot pain that lasted about 3 days.
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