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Hi Keith, Thank you for taking the time to respond to my post. To answer your questions:
1) I don’t know how long I’ve been accumulating UA crystals. I was only officially diagnosed with Gout about 18 months ago, but, on hindsight, I believe I’ve had symptoms for several years. I’ve had accute pain in my right big toe for years which I blamed on a previous injury.
2) With respect to Gout in the forearm tendons. I have had tendonits (micro tears) in my tendons and I wonder if this didn’t exacerbate the Gout in that area? Have you heard of people getting acute pain in their tendons before?
3) I had ultrasound done on my arm (right elbow) and they saw many tears which were treated with a platelet injection.
4) My history with Allopurinol is 1 year. I take 400mg per day. My physician (who is very good) and Rhemtologist sugested Probenecid to get rid of UA that I create myself (without purine input). I started this about 2 months ago. Initially my UA went below 3 but I can’t keep it there. It gradually comes back to about 4. I don’t believe there is anything more I can do with my diet to change this.
5) Do people often take doses of Allopurinol greater than 400mg/day?
6) My dose of Probenecid is 1000mg per day (4x250mg capsules);
7) I wonder if I need to get my UA even lower to rid my body of this pest…I’d rather have a few months of intense pain that have this thing drag on indefinitely.
Thanks Keith….great website.
Hello and welcome.
I first started treating my gout about 12 months ago. I had/have tophi on the helix of my ear. I started with 200mg of Allopurinol and now am taking 400mg. When first taking the Allopurinol, I was caught off guard by the extent and severity of the flare-ups. I experienced flare-ups in my heals, elbows, fingers, toes and wrists. I don’t recall feeling pain in my back or neck. I’m 53 and it felt like i had aged 20 years in a short period. The worst pain for me was in the tendons in both my arms. It was debilitating to a point that I had a hard time lifting a cup of coffee.
Indomethicin is a Godsend. However, I was/am very conscious about the impact of longterm use on the kidneys and monitor my Creatine frequently. I also took colchicine daily during the bouts.
With respect to how long the body will take to “flush” the crystals, that’s the magic question and one your not likely to get a satisfactory answer to. After 12 months, the severity of my pain is much diminished but, I still have nagging irritations in my fingers and occasionally in my elbows. I’ve recently started taking magnesium and have gone gluton free to see if perhaps this will help. I’m very conscious of my diet (no red meat, seafood and beer)
My UA levels were never stratospheric and are currently well under 3 and have been for quite some time. I’m surprised that I still have some joint pain. Like you, I never knew I had gout and found out when i had a big pain in my toe. I’d had this pain before for many years and thought it was an old injury from the past.
So, the long and short of it is, it does get better with time but, I don’t think anybody is going to be able to give you a definitive answer as to when the pain stops. Until that time, the cure is worse than the actual disease.
You’re challenges and questions are along the lines of my own. As some background, I do have some small tophi on the outer rim or helix of my ears. These are my “canary in the wharf” and are very sensitive to change. When they get sore or sensitive (due to swelling), I’m usually in a gouty phase.
I don’t know how long I’ve had gout….I was diagnosed about 12 months ago after a flare up in my right toe. However, I’ve had the tophi on my ears for years and have had the toe flareup in the past which I mistakenly diagnosed as a consequence of a broken toe when I as young (currently 53).
About 1 year ago, I started taking Allopurinol. I monitor my UA every second day (at home) and once a month I go for some bloodwork where my UA and Kidney functions are all tested. I’ve been using Indomethacin to deal with periodic joint and tendon pain (very effective). Like you, when I first started taking Allopurinol, the Gout pain increased substantially. I do not eat read meat or seafood and my beer intake is quite low….1 or 2 pints per week.
My UA levels have dropped considerably over the past year and, with the exception of perhaps 5% of the time, my UA levels have been below 300 and averaging 250 over the past 6 months. I have not had a “severe” inflammation for quite some time.
HOWEVER, on most days (60% of the time), I do have nuisance pain in my fingers, heals, elbows and knees. Not debilitating but, irritating and restricting. I believe that the tophi on my ears shrank in size over the summer (anecdotally – hard to measure). Recently, while my UA levels have not changed, the tophi on my ears have begun to be painful and the nuisance pain has increased and become more frequent.
I would have thought that after one year of reduced UA levels and diet change my symptoms would have improved. Unfortunately, such is not the case and now, I’m wondering if this is my permanent condition. I thought (perhaps mistakenly) that once I flushed my body of UA, my nuisance pain would diminish.
At this point, I’m at a bit of a loss as to what to think. Is this my new reality or, am I still “flushing” my body?
I’d love to hear other people’s experiences just so that I can get some idea of where I’m heading and what my future looks like.