Anyone else afflicted with this shit?
I am having an attack right now. Have popped two colchicines and an indomethacin, now waiting for some relief.
This is my third attack in the past six years; twice in my ankle and once in my big toe. The first time I was very alarmed because I didn't know what it was. Came from out of the blue and hurt LIKE HELL.
If you have it, what foods do you think are your triggers?
I had my very first (and so far only) gout attack about this time last year. It was awful. I wonder if the changing weather (cold to warm) has anything to do with it?
Does Medicare cover treatment, or do you have supplemental insurance such as AARP?
Thanks, OP/R2. I also agree with the sunlight/Vitamin D connection.
My dad used to suffer from bouts of gout, and even though folks tend to associate it with hearty food and drink, He was very slender and ate like a monk. Every so often it would just kick in and he would take the meds prescribed.
The one food that seemed to be a factor was liver, which sadly was his Achilles Heel. He gave up his pate' and then died 2 years later of prostate cancer.
Good luck....and have the pate'.... because you never know.
It's the worst. Feels like you're walking around on a broken toe and even the slightest touch hurts like a mother. I once told someone that the weight of a sheet on my toe felt like someone stabbed me with an ice pick. They thought I was exaggerating, I wasnt.
I broke my big toe yesterday, and I know exactly what you mean about the sheet. Owwweee
My medical dictionary describes gout as resulting from deposits of sodium uric acid crystals because of high blood levels of uric acid. Treatment usually involves removing fluid from the affected joints, while drugs counter the inflammation and pain.
There are, however, a fairly large number of risk factors that seem to increase the likelihood of gout, including alcohol consumption, low dairy intake, certain drugs and foods (among them, anchovies!), hypothyroidism, obesity, radiation therapy, kidney disease, and starvation. Change in the weather is not a factor.
[quote]If you have it, what foods do you think are your triggers?
I have read that eating foods containing high fructose corn syrup will lead to gout over a long period. In fact I think that is part of big pharmacy's grand plan to get as much of the population on anti-gout medication making it their new Viagra drug as gout medication counteracts the negative effects of HFCS on the liver and kidneys.
Genetics account for 60% of all gout cases.
What's interesting is that the incidence rate has been increasing in recent years.
They even advertise gout treatments on television and you never used to see such advertising.
Most cases are in men but post-menopausal women are prone to gout too.
Drink red wine
My brother had Cystic Fibrosis and had really bad gout since he was probably 12 or so. I am sure it was caused by his meds but I also heard fish was a factor. I don't recall if it helped or exacerbated it.
You need to ramp up your PH levels.
Get off those meats. Get back to nature - organic greens, raw food, the whole thing. Maybe not forever, but you're in need of a detox
Peanuts, shrimp, spinach, and liver are my triggers.
I like to have at least 24 hour separation between ingesting any of these purine-rich foods.
OP here –
The pills worked their magic overnight, and I can barely tell that I had a gout attack yesterday.
It is truly amazing how fast a gout attack can onset, and how fast the pills work especially if you take them overnight.
Go to bed with excruciating joint pain, then wake up pain-free.
On another note, did any other gout sufferers detect the huge price increase for the colchicine pills in the last couple of years? They went from like three cents apiece to over a dollar apiece.
I hate pharmaceutical companies. I really do.
Their predatory pricing is really shameless and disgusting.
I read that spinach was a "superfood" or "wonderfood" or some such bullshit, so I ate it at every meal for about a week and a half, and woke up one morning and couldn't walk because my big right toe hurt so bad I couldn't even put a sheet on top of it.
And of course, it turned out to be gout.
Spinach is one of my trigger foods as well. High in purines.
Shrimp, liver, legumes, and other stuff I typically have in my diet do not cause a problem if eaten separately.
But, about every year and a half or so, I eat the right combination of high-purine foods and I have an attack.
Couldn't agree more, R16. Do you really think they're going to come up for a cure for cancer when they can make so much more money *managing* it?
Hou will continue to have attacks until you lower your uric acid.
Woke up one morning with a pain and swelling in one of my ankles, and went to my doc who did an x-ray and told me there was no break.. even though I twisted may ankle a couple of days earlier.
After the xray showed nothing, she told me - gout... When I told her I had twisted it, she told met that was just a coincindence...
Started me on indomethicin and allopurinol and the pain slowly lessened - but not completely...
The pain starts out dull and continues all day long, getting worse and as the day goes on.... it's pretty much swollen all the time, but the pain isn't the kind people usually mention from gout and friends keep asking why I'm limping... Hell, every time I'm walking in an airport, the guys driving the carts stop and offer me a ride because of my limp!
After about 6 months on the two kinds of pills, I went to a foot doctor who told me after checking things out that it wasn't gout and told me to stop the pills... So I did, and the pain came back... But considering indomethicin is an anti-inflammatory, it would help for things other than gout too...
From what everyone says, the pills work instantly... that definitely isn't my case....
Anybody ever have a break that can't be seen on an xray? Not even sure what to do next... I guess go to a rheumatologist?
In addition to the rheumatologist, I'd also pay a visit to a podiatrist.
Actually, it was a podiatrist who told me it wasn't gout, and to get off the pills....
Soryr, I'm still drinking my morning coffee.
Gout is so ovah. It is all about the ague these days.
Triggers are for MichFest.
Actually, MichFest triggers my gout, so that's kind of ironic.
A friend who suffers from gout says that his main triggers are beer and wine. But he can drink hard liquor without triggering an attack.
Op the attacks will be more and more frequent as you age unless you do something about your uric acid levels, which take time to resolve themselves if you want long run results.
I inherited my gout from my grandfather, who started having attacks at age 30. I started at age 44. So ours was not necessarily due to long-term lifestyle habits (though those don't help) but just bad genes.
Fighting gout on my own, with the occasional colchicine and/or anti-inflammatory prescription, was a losing battle - until I got real professional help. Find yourself a good rheumatologist.
a)a particular episode that sent me to the emergency room (my body reacted to the allopurinol I was taking - a prescription I had requested and was easily given - by exposing all the deposits of uric acid crystals that it had previously sealed - AT THE SAME TIME - sending every joint where it happened, into reactionary swelling and pain: that was two ankles, a shoulder, an elbow and a bit of a knee, the worst pain I've ever felt in my life) and
b)subsequent unrelated surgery (gall bladder) which resulted in a gout flair as I recovered from hospital medication and anesthesia (fairly common occurrence),
I decided it was time to fuck the diets and consult with the experts.
My rheumatologist changed my life! I've been on an Uloric treatment (medicine that slowly dissolves pockets of uric acid deposits), properly combined with colchicine (colcrys now - used to avoid reactionary flares that are common when your body is trying to dissolve and dispose of the crystalline deposits) - for a year now.
I haven't had any flairs since April 2012 (was having an average of 3 a year going on 4 before , and I'm only 52!). My uric acid went from 11 to 4.9 in less than two months (under 6 is normal). Even some ugly elbow and toe swellings left over from previous attacks, that I thought would never go away, have receded and all I have left to work on (and the reason I'm still on Uloric) is a small elbow swelling, the result of a particular attack that was accompanied by bursitis ("old lady elbow"). I'm still doing this because of vanity as I don't like looking at myself working out in the gym mirror and seeing that little elbow ball.
In a nutshell, get a rheumatologist. Oh, and stay off GHB - a lot of fun when you do it but a sure way to start getting gout symptoms after a weekend bender.
r28, my plan did not cover the cost of colcrys (the "new" colchicine, same thing with a different name and exclusive rights because no one else secured them) and you can imagine my reaction when I got the bill for 300.00 for 60 pills.
Luckily, the makers of colcrys do have a plan. Their rip-off is for people that take the medication only once. But after, my first prescription, I was issued a card with which every subsequent prescription costs me only 15.00 (there is a cap per prescription, but I'm good for a whole month). Now, 15 dollars a month is a whole lot more manageable than 300 dollars every two months (and I don't even use it that much so it usually lasts me longer).
Also there are pharmacies that are still pretty stocked up on colchicine and it's price of 11 dollars for 30 pills. Though they were supposed to stop selling those (that's how much big pharma tries to control distribution - and this has nothing to do with controlled substances and everything to do with money), most of them are happy to continue dispensing them until they run out.
Thanks for the info, r30 & r31.
If young with gout, you're likely a drunk.
If you're a readhead, apparently red hair involves chemical changes that help people eliminate excess uric acid. I read it in Harper's so I know it must be true.
Who hates gingers now, OP?
[quote]I once told someone that the weight of a sheet on my toe felt like someone stabbed me with an ice pick.
Absolutely! As a gout sufferer for 7 years (see r30), I TOTALLY BELIEVE YOU. The affected area is very tender to touch, and the funny thing is that light material/fabric feels worse than say, someone's hand making contact!
Here are some common occurrences experience and reading have taught me.
1) Fuck excessive dieting. Almost every food group has something that can trigger gout. Excess is the thing to avoid - both in consumption as well as prevention. If you went to three X-mas parties in a row where you ate ham with lots of beer and red wine, you may be asking for trouble. If you just eat cherries and vinegar, you're asking for other kinds of trouble.
2) Just when you decide to blame drinking, don't then substitute with drugs. If you meet a hot guy and go on an alcohol-free crystal meth (a pain repellant that can give you false hopes) and GHB binge for three days, you may get a huge attack on the fifth, once you crash from the meth/coke/speed.
3) As you gout sufferers all probably know, night time is your enemy when on a flair. The pain is relentless, to the point where you watch someone dancing, hell, WALKING, on TV and you wonder how is he not in pain and if you'll ever be able to do it again. Also, it's been my experience that cold, dry weather is more conducive to an attack than warm/humid (though my worst episode was in a tropical setting!).
4) Weight gain/obesity is your enemy (more likely to trigger attacks, but so is exercise! - especially high impact cardio stuff. You need to find the right balance of eating and working out that's best for you. Throw away your p90X tapes and don't eat fried pork and beer three days in a row. Slight symptoms of an upcoming flair start appearing when you upset that balance, which brings me to
5)GET TO KNOW THE SYMPTOMS of an upcoming flair, and immediately follow your rheumatologist's directions (pills, call, whatever).
6) Own at least one pair of croc-like easy-slip-on shoes. I know they're ugly, but they might be the only footwear you'll fit into at times. Also handy: ace bandages. Amazing what a little support can do to pain. They are the difference between not being able to walk and at least limping to work for a few days.
7) Rolling office chairs are better than crutches (kneeling or sitting on them, depending on where it hurts). Always have one on every floor of the house. They are refrigerator friendly and let you take the weight off the affected area better than crutches. Wheelchairs are too cumbersome. You can navigate stairs on your ass (that's how I once got to the paramedics, one step at a time or sliding..
5)Always have anti-inflammatories at hand (Prednisone, for instance, to be taken only during flairs, bad as a lifetime habit - it is a corticosteroid after all).
6) Always have colchicine/colcrys available. But use only when NOT taking allopurinol, as taken together, they can make matters worse (google why, it's too long to explain). And the sad part about colchicine is that during an attack you are supposed to take two every four hours until you literally shit your pants. Not pretty.
7)Rheumatologists are very nice people. They understand your pain. Get one and befriend him. Get the kind who has his personnel trained to take an unannounced visit from you - if you can crawl there - for an emergency shot. Mine does, and though I've never had to do that (I'm pain and attack-free since I've been seeing him), it's nice to know I can go there and the pain will stop immediately. An emergency room will leave you waiting in a steel cold bed writhing in pain until they do proper blood work, and the lab technician comes back from lunch, etc. They won't take your word that it's a gout attack. My only ER experience left me waiting in please-cut-my-foot-off pain for over six hours.
8) Finally, no one will believe your pain. Unless they are sufferers themselves. When in doubt, show your boss your swollen elephant feet.
Flair = flare, as in "flare up"
Oops - sorry. Screwed up the word flare everywhere. Also noticed a few unclosed parentheses and its vs. it's. Typed too much too fast. Just sue me if you can't understand :)
Pa got the gout occasionally when he was a heavy beer drinker and smoker. I don't know if they were related. Probably.
When I was about 30, I got a tremendous pain in my right hip. Like Pa, I was a heavy drinker and smoker. I had never had a pain like it before and got myself to a doctor when it showed no sign of going away. After testing, the doc said what I had was basically "gout" in my hip. I had a very high uric acid count and changing my diet and some medication finally cleared it up. I guess quitting smoking and easing up on the drinking helped too.
I am now 70 and I never had another attack. Lucky.
Fibromyalgia, Gout, and plaque psoriasis. It's a wonder I get to MichFest, let alone enjoy it. Reminds me--need to get an extra battery and the off road tires put on my Hovaround.
I wish I had read a post like this prior to my first gout attack.
I was so ignorant that when I woke up with such horrible unexplained pain from my first attack, I thought that I had been bitten by spider while I slept.
My ankle was red as a beet and fiery hot but when I went to bed, it was not like that. I was pain-free.
I was CONVINCED I had been bitten by a recluse spider -- had to have been!
I tore all the bed linens off my bed looking for that damn spider … I guess so I could take it with me to the emergency room.
Funny now, but if you've never felt such horrible pain for no reason at all, it's very confusing the first time.
So DLer's reading this, take heed.
Albert, lay off the smack.
Thanks for the suggestions... Guess I'll be making an appointment with a rheumatologist ASAP....
Funny thing is, when the doc checked my uric acid level, I think it was 4.8 or 5....
And even though my ankle hurts and is swollen, it isn't red or hot or sensitive to the touch...
What a pain! In more ways than one....
r21. I'm no doctor but there can be many explanations for why you're already showing symptoms of gout with a normal uric acid reading. The best one could be things are just starting out for you and your body just reacted to its first exposed crystalline deposit.
In other words, you had somewhat high uric acid before that your kidneys couldn't get rid of fast enough (either because your liver was producing too much or your kidneys were falling short of their duty), your body found a way to "get rid of it" by slowly collecting it and storing it in your ankle in crystalline form (at this point your uric acid reading would level off), then one day the crystal was large enough for your body to "detect" the foreign object and react to it with swelling and pain. Any storage from this point on changes locations, and the process starts on another joint.
Caught early, your doctor can help you ensure the storing of more crystals throughout your body doesn't happen. And that seems to be your case. Again, I'm no doctor, so I'm disclaiming, but urging you to see one.
The worst explanation is that it's something else, not gout. Though I can't imagine what else - other than a sprain - would produce so much non-bleeding pain in your ankle (and trust me, a sprain is less painful). That's why you need to see a rheumatologist.
I should add, gout is one of those diseases that general MD's know very little about. You need to talk, extensively, with an expert and understanding rheumatologist. Each person's disease progression is different and communication is important. Dosage and treatment has to be custom-made.
The first doctor I had looking at my swollen toe was a generalist who gave me a wrong diagnosis. The rheumatologist I saw months later didn't even have to wait for me to remove my entire sock to know what it was. However, THAT one just blindly prescribed colchicine without observing my specific case.
The surgeon to whom I came complaining about gout symptoms after the gall bladder surgery he performed (I just wanted anti-inflammatories) showed very little sympathy (typical butcher surgeon), wanted to wash his hands off any of it, and recommended I visit his hospital's ER. I had already gone through a bad gout ER experience and my symptoms at that time were controllable enough that I just opted to see a friend of mine who is a doctor to just get the medicine.
It wasn't until I landed a rheumatologist who was willing to put the time, dedication, and communication to address my specific case (what we determined was a "gout out of control") that I started getting the right treatment and dosage. Finding a good rheumatologist is the most important step.
Here's advice about gout I've had it for some time:
Eat cherries or drink cherry juice. It acts like ibuprofen but in a natural way.It also lowers uric acid levels.
Drink skim milk. It also lowers the uric acid levels.Or low fat diary has the same effect.Water helps flush uric acid out of the body as well.
Extra virgin olive oil is good for gout.Tumeric and Cayenne pepper help stave off the inflammation as well.
As for the posts about spinach, I've never had an attack after eating vegetables that are high in purines. Research show that eating "anything with a face"(beef, seafood,pork,liver etc so on) is more likely to trigger an attack. There's something about the purines in animals that is different than the purines in vegetables and legumes.
One glass of red wine isn't bad for you, it is supposed to be good for gout because of a healthy element(one of many also found in the berry family) in red wine. Beer is murder. avoid that at all costs. Oh hard liquor too.If you must stay away from all liquor.
If you are fat, lose weight. I've known people that have lost weight and the uric acid is not the problem it once was.
I had gout when I was in my teens. At first, I didn't know what the hell it was. The underside of my right big toe hurt terribly and I initially blamed the hard penny loafers we were required to wear for school. Mine were new and not yet broken in. But it turned out to be gout. At the time, my family ate a ton of broiled red meats and I believe that's what caused it.
I dealt with it for several years, but then it went away on its own when I took over cooking for the family as a young adult. Very little red meat (maybe once a week at most) and a LOT of garlic were the biggest changes. But I've been gout-free for about 15 years and I actually eat a lot of food that's on the trigger list from the doctor, including plenty of seafood and asparagus.
You know, with gout and diet, it's always hit or miss.
In my case, I can never know FOR SURE which foods that I ate in the last 24 hours are the culprit(s), though peanuts and spinach are on the short, prime suspect list.
I might have a spinach salad for supper and then eat a peanut butter sandwich for lunch the following day. This type of thing.
No one's diet exclusively consists of just one high purine food source, so my theory is that it gets down to combinations and quantities over time.
But honestly, as long as I can afford the tried-and-true medications that work fairly quickly on my form of gout, I can't be bothered too much about amending my diet to avoid an attack. Not yet, anyway.
And this is going to sound weird to anyone who is not a gout sufferer, but when the attack is ramping up and later, when it is waning, there are few minutes when the pain is of the "hurts-so-good" variety. This step doesn't last long at all, but it is oddly satisfying while it lasts.
If I had to liken this phenomenon to anything, it like your mouth feels just at the moments when the oral anesthetic wears off from dental work you've had done that day.
[quote] The surgeon to whom I came complaining about gout symptoms after the gall bladder surgery he performed (I just wanted anti-inflammatories) showed very little sympathy (typical butcher surgeon), wanted to wash his hands off any of it, and recommended I visit his hospital's ER.
Surgeons don't deal with medical problems; they deal with surgical problems. You shouldn't ask a surgeon whose taken out your gallbladder to treat your gout any more than you should ask a rheumatologist to take out your gallbladder.
I'm curious about the rheumatologist visits. Is gout an autoimmune issue?
So R6, one could say you were tender to the touch?
If you have it, you should watch out for kidney disease and diabetis.
[quote]Is gout an autoimmune issue?
Get your DNA tested for methylation and detox mutations; they cause gout amongst other things and there are established vitamin etc. protocols to treat these mutations.
Just had mussels marinara. I feel an attack coming on.
I hope you dodge the gout bullet, r56. Ouch.
Im having an attack now in right toe. Started on tuesday. Took colcrys and script ibu not helping much. Giving me an excuse to couch it this weekend.
r58, NSAIDS (Aleve, Advil) and ibuprofens just don't cut it when it comes to gout. You need to have prescription anti-inflammatory corticosteroids (prednisone, for instance) at hand just for these occasions.
Three in one day will do the trick, or just one if you feel the symptoms coming but are not in pain yet.
Ask any doctor for a prescription.
For now, since you do have Colcrys, you can follow the old-school method of taking two every four hours until you get diarrhea (not a joke, they were directions given to me by rheumatologists of yore - not done as much because there are better methods nowadays. This will happen by the 4th round or so, by which time you will have alleviated the pain and some of the swelling considerably.
If you are young and already have gout, I would say that you may have a short life in front of you.
r60 is so fucking wrong, don't even listen to him. It's mostly genetics. My grandfather had gout from age 30 and lived to see 80.
i had it a few times, but not since in the last 4 years, weird. anyway, i remember waking up middle of the night and the bedsheet touching my big toe was so painful i sincerely had to crawl to bathroom and vomit from the pain lol. gout sux
I don't think anyone is truly an ex-gout sufferer.
I think you are just not currently a sufferer ... until the next time.
So i had an attack in my knee over a year ago. Been on allopurinol since september. For the last two weeks the ball of my foot has been swollen and painful, hard to walk, couldnt touch it etc. my rheumo is on vaca. Took the colchicine i had left. Today is day 14 and it feels pretty normal. Never had it in the foot before, maybe it was a sprain, i dont even know but it hurt like a MF.
I am having my worst gout flare up EVER today.
It woke me up at 3 AM -- the classic "even a sheet resting on my foot" lit me up when I rolled over. Wow!
I've been taking colchicine and painkillers all morning and neither medication has made much of a dent in my pain.
Ouch! Ouch! Ouch!
SHIT I AM SICK OF THIS!
If it is in your foot/ankle see a good Podiatrst and get an injection.
You'll be glad you did.
Get some of dat allopurinol. 300 mg a day and your gout is just a bad memory.
Who's gonna tell the original poster this isn't 1700?
[quote]I've been taking colchicine and painkillers all morning and neither medication has made much of a dent in my pain.
Avoid painkillers. They do nothing for gout and are yet another thing for your already busy liver to contend with. You might as well be drinking beer! (which, in case you didn't know, is not good for gout)
Op et al are tender to the touch!
It could be just gout or .... Have it treated but also get a complete blood workup and your kidneys checked because you never know...
Only in my hussy hole...
I think I have gout in my hand. On the the palm below my pinkie, just above the wrist and in the fleshy area of the base of my thumb.
I woke up yesterday and it hurt and got a little worse throughout the day. By the night time, it got worse. It was bad throughout the night and today it was bad enough for me to stay home from work. I'm about to walk to the drugstore to buy an ace bandage. It seems like support would help with the pain.
Have my annual rheumotologist appt tomorrow morning
I had a friend in nursing school who later married a rheumatologist. He was the ugliest guy I'd ever seen. He looked like Jerry Lewis as The Nutty Professor. He came from a horrendous family with the worst JAP sister in the universe (sis used to be on Oprah a lot as a therapist -- meanwhile, she couldn't keep even one friend). My friend was an absolutely gorgeous black woman who dressed to the nines and was the epitome of class. I thought, "Hmm. I guess she married for security."
But it tuned out he was one of the nicest guys I'd ever met. That's why she married him. He was a real mensch.
My uric acid is 8 and i take allopurinol daily. 300 mg.
R73 What are you eating and drinking? Are you eating dairy and cherries every day?
[quote]But it tuned out he was one of the nicest guys I'd ever met. That's why she married him.
Huh. Imagine that.
Not dairy, R73, but lots of cherries. I just read about dairy yesterday and am having some unsweetened kefir right now. It's much better today. The pain is still there, it's just much more bearable.
Milk is like cherries when it comes to gout.It really helps. I also get probiotic low fat yogurt with cherries and I have a cup a day.I also avoid beef,seafood,pork or any animal flesh.To be honest I rarely if ever get a flareup.
Make sure you are drinking enough fluids durintg the summer months.
Not being properly hydrated will increse your gout attacks.
Ow my knee. Ow my toe. It hurts.
Thanks for providing a gout sufferers support network, everyone!
Yellow curry works wonders!
If you have gout, you really need to change your lifestyle.
R84 Especially tumeric. It fights inflammation.One doesn't have to have curry and you can add add tumeric to your food instead.
Are we sure turmeric doesn't give you tumers?
I did a search on the web for gout + niacin.
I was taking two niacin supplements a day; now i take just one.
I hope this slows the frequency of my attacks.
Hydration, as some one mentioned up thread, I think is a problem for me, so I am consciously drinking more fluids per day.
Tumeric supposedly stops tumors!It's very good for cancer prevention as well.
I put turmeric on everything for awhile. I never noticed any difference except it has makes everything taste a little dusty.
[quote]If you have gout, you really need to change your lifestyle.
If you believe this, you really need to educate yourself.
After over a year of good medication and therapy, I woke up with a hurting ankle this morning, just as I ran out of Uloric and was due for a rheumatologist visit (he had to postpone due to an office emergency).
Could be that I was taking a whole bunch of other medication for not-so-serious stuff (testosterone, Lamisil, and the gout stuff) and all of a sudden all the prescriptions ran out and my body is reacting to the mild "crash."
I had a gout attack a few years ago. The sad part is I was 24 years old, and I'm female, so not even remotely in the demographic for gout. I wasn't hugely overweight, either, but was in Maryland at the time and went out for crabs and beer (two things that cause gout). My right toe swelled up BAD and I could barely walk, I thought it was a spider bite or something. Went to the ER, I didn't have insurance at the time, and they didn't give me any meds at all, just told me to take 800mg Ibuprogen. Hurt like HELL, I'll never forget the pain. Worst pain I've ever felt.