Thanks for the heads up on no-repeat for Krystexxa treatment. It makes sense, as we humans produce antibodies against the treatment.
I strongly suspect the pain you are experiencing is due to old crystals dissolving. Even with the fast dissolving at very low uric acid levels, there is a point in time where crystals are just starting to dissolve. At that point, our immune system springs into action. There’s evidence to suggest that prior gout attacks make us more sensitive to the gout pain process. If a large number of old crystals become exposed to our immune system, then gout flares are expected. It’s impossible to predict this, because we never know where old crystals are lurking. I know your doctor said all old crystals have gone. I suspect this might not be entirely true. Some old crystals might be partially shielded by old scar tissue. But, huge changes are taking place within the structure of your tophi. I believe there is a strong chance that some crystals are still being activated as your body recovers. Without an appropriate CAT scan (actually DECT), we might never know. I’m very hopeful that these will stop.
You’re in a rare situation John. As you’ve explained, very few people have completed Krystexxa treatment. Therefore, reports about patient’s recovery are almost unknown. Logically, all pain should resolve soon. Do you have anti-inflammatories to help, or do these also cause digestion problems?