About the persistent swelling, there might be a few things you could try. But what you already done for that foot treatment-wise? And what tests (if any) were done on the painful location?
Some of us have had lingering symptoms for more than a month after what we assumed to be a gout attack. Insufficient treatment might be part of the reason why the symptoms lingered so long.
I’ve not experienced this problem recently. Perhaps it’s because my uric acid is lower and perhaps it’s because I’ve been taking more colchicine when dealing with worrying arthritic symptoms.
About your uric acid, my concern with your doctor’s approach is that a single blood test is insufficient as a basis for long-term treatment (you shouldn’t try to lose that weight over a few weeks). But maybe your doctor had more data than you posted here.
Also, do I understand correctly that your blood was tested during or shortly after an attack? That sometimes skews the result.
If all you have is the one blood test, I strongly recommend you get at least one more test. When you’re experiencing gout symptoms and especially when uric acid is borderline rather than very high or safely low, test results can randomly vary a lot.
It is possible to manage uric acid without allopurinol, even if the average amount of uric acid in your blood is actually a bit higher than 0.41. But it would be easier if your average was a bit below 0.41.
And I’ve got to warn you that you’re likely to experience more pain and disability over the adjustment period than if you temporarily took a drug such as allopurinol. The higher your average uric acid, the more hardship you would likely face.
The reason is that gout is mainly caused by uric acid crystals which build up in your body over the years and not by what you ate or drank yesterday or even by the amount of uric acid currently in your blood. If you eat right and start losing weight, these crystals wouldn’t go away instantly. Instead, they would slowly start to dissolve in your bloodstream which would likely cause both minor and serious gout symptoms. As a result, you risk feeling worse instead of feeling better for a while.
The same thing usually happens with allopurinol but you’d get over the bad patch quicker. You might also experience less serious symptoms while in that patch.
If you want to try lower your uric acid without drugs, there’s more you can do than drinking water and cherry juice by the way. But maybe you already know all about that…