Hi Fabian ( @fabian-israelstam ),
d_q has already asked the most pertinent questions: “How long have you been on Uloric and what are your current UA levels?”. Because the only reason for taking Uloric, or any other uric acid lowering therapy, is to make uric acid too low to get gout attacks. If your dose is not high enough to get uric acid safe, it is a complete waste of money. Also, you are extending the time you are at risk of serious health problems.
On your particular question, I think your doctor is confusing gout diagnosis and gout management. Because painful swelling without notice is a diagnostic indicator for gout. But that’s only because new gout sufferers have no experience of gout. So, they disregard those early signs. However, once you’ve had a few attacks, it’s often easy to spot the first signs. In fact, your symptoms are very familiar to me.
But, you should not be having any gout attacks. So please post a bit more relevant history as soon as you can. Then we can save you from continuing gout, save you from fatal consequences of badly managed excess uric acid, and save you from a doctor who loves to spend your money with no real purpose.