[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.