Reply To: Lingering pain & weakness 6 weeks after gout flare

Stopping Gout Together Forums Help My Gout! The Gout Forum Lingering pain & weakness 6 weeks after gout flare Reply To: Lingering pain & weakness 6 weeks after gout flare

#2231
Keith Taylor
Participant


I understand why people suggest waiting until gout flare has gone before starting treatment. I know why I would not wait ( http://www.goutpal.com/4853/start-allopurinol-quickly-but-carefully/ ). What really matters is the view of your mentor.

I believe all gout sufferers need a mentor, who will support them during the planning and therapy stages of uric acid lowering. I can improve my explanation of the importance of mentoring. But, for now, my best effort is my first Gout Mentor article. I believe your gout mentor should be your doctor. But, I’m happy to share that role.

Leaving aside the question of starting allopurinol now, or waiting a week or 3, let’s focus on what is more important.

To successfully manage uric acid lowering, I believe you have to be confident with your gout pain therapy. This is because most gout sufferers will experience gout flares, until allopurinol has worked it’s magic. That is why early start of allopurinol works in the study I mentioned. Because, gout patients who take preventative pain relief can start allopurinol without problem. It is logically and practically correct. But, it won’t work if your mentor doesn’t understand it.

In theory, this is simple logic based on established medical facts. In practice, gaps in knowledge cause problems. That’s why I offer diaries for personal gout facts. And structured help for personal gout therapies. My services should support doctor’s medical history, and doctor’s scheduled consultations. Ideally, you don’t need my help. Especially if, your doctor provides the right treatment, with the right pre-treatment guidance and support.

Pain control should address:
1. Limiting inflammation spread
2. Reducing inflammation
3. Blocking residual pain.
Country mainly affects the first of those 3. Limiting inflammation is usually a job for colchicine. I’m not getting any feedback on the latest situation on the Colcrys price problem. Officially, cheaper generic colchicine should now be available. Anyway, I’m visiting the States in January 2017. So, I can check it out for myself.

Sorry, Chris, this has got a bit long-winded. Detailed timing and dosing must be personal. Also, there are individual choices about specific meds. A general guide for effective gout pain control during urate debulking is:
1) 1 preventative colchicine at bedtime for 2 to 6 months. Additional 1 colchicine in morning, as required if gout symptoms justify.
2) As required, gout strength ibuprofen, naproxen or other NSAID.
3) As required, gout strength acetaminophen/paracetamol between NSAID doses.

I hope it goes without saying that this must be doctor/pharmacist approved. It’s a starting point for discussion. Some doctors advocate steroids for gout pain control. To me, that’s a last resort.

As with all things gouty, there are alternative points of view. So long as the final choice suits the patient best, we cannot ask for more.