Uric acid crystal dispersment - where can they go?

First Gout Attack

This topic contains 18 replies, has 9 voices, and was last updated by  nobody 5 months, 3 weeks ago.

  • Author
    Posts
  • #2970

    John Harding
    Participant
    Ŧallars: Ŧ 3.52


    I am 50 years old, exercise regularly, my diet is not too bad, plenty of fruit and fish. I do like a bottle of wine or two at the weekend and maybe some beer.

    Anyway, I started a episode of gout 2 days after a ‘social’ weekend involving lots of wine. Swelling in my big toe joint and I have had to take a day off work. I have been prescribed Colchicine from my doctor.

    What’s the ratio between people who have recurrent attacks and people who only have one?

    I am clutching at straws here, I do a fairly physical job which I won’t be able to do if I get a lot of gout attacks.


    Uric acid crystals in toe cause first gout attack

    Will gouty swelling in big toe come back?

  • #2074

    GoutPal Victim
    Participant
    Ŧallars: Ŧ 1.84

    I am 86. I have had gout for 38 years. I am having a particularly bad attack right now of three weeks duration. Am considering Prednisone or Probenecid. Please help me, I’m in extreme pain.
    Regards,
    John

    • #2075

      Keith Taylor
      Keymaster
      Ŧallars: Ŧ 1173.53

      Hi John,

      I’m sorry to read that you are in pain. But, I’m shocked to see you’ve had gout for 38 years! I would normally tell you to get to the doctor right now, and discuss safe gout treatment.

      But, what doctor allows gout to last 38 years without getting it under control?!?

      I’m really struggling to know what to suggest, John. There’s obviously a lot more to your story than you are telling me. I want to help you. I just don’t have enough information to tell you the best way to get the right treatment. Do you have any uric acid blood test results?

      I’m especially struggling to understand why you are considering prednisone or probenecid. Both of these drugs can play a part in gout treatment. But, they are not the obvious options. Both have very different roles in gout treatment. And, both of these would only be the first choice if you had some specialist tests done.

      I’d love to help you better, John. But, I need more information. As well as uric acid test result history, I need to know:
      – What has your doctor suggested?
      – Why consider prednisone?
      – Why consider probenecid?
      – Have you used either of those drugs before?
      – Have you used any other forms of gout treatment in the past?

      Sorry about all the questions John. Gout is very easy to manage in most cases. But, it depends absolutely on applying the right treatment for personal circumstances. If gout treatment isn’t matched to your personal situation, it’s a waste of time.

  • #2972

    nobody
    Participant
    Ŧallars: Ŧ 502.46


    I hope your swelling and pain have improved but colchicine works best when taken when the symptoms start. So if you get other attacks, you can reasonably hope they won’t be so bad now that you have colchicine on hand.
    If colchicine is taken later, much patience and possibly a higher dose may be required for symptoms to subside. Possibly your doctor wants to know what colchicine alone does and doesn’t do for you but if you can’t bear it anymore, be aware that you could probably get faster relief from other drugs.
    If you manage to beat this attack with colchicine alone, I’m no doctor but I recommend tapering off slowly rather than quitting it as soon as you feel better.

  • #2974

    d q
    Participant
    Ŧallars: Ŧ 363.41

    Sorry about your swelling. One day attack? You are one lucky chap. My attacks before allopurinol were a minimum of two weeks, I’ve been on allopurinol for 3 months now and am enduring another horrible attack that has lasted about 10 days and still ongoing.

    My advice would be to check your UA levels first before starting any treatment and work from there but I am no doctor.

  • #2975

    Lance
    Participant
    Ŧallars: Ŧ 15.85

    Hi John. Sorry to hear about the flare up. I’m of similar age and experienced my first flare up several weeks ago. Ibuprofen took the sting out of a three day attack for me, 600mg every 6 hours. After doctors visits and much research it seems like the first year is light on flare ups but not to be taken lightly. Too many unknowns to know whether I’m in the lucky minority that can call this a one-off. I’m treating my diagnosis like a warning shot across the bow. Not a matter of if but when. Not to mention worse health conditions down the road.

    I started with a blood test to measure UA levels and committed to actively managing this on a daily basis. Wasn’t crazy about my primary care physicians approach (wait and see, manage the pain) so will be shopping around. I like Keith’s approach, treat to target and be gout free. Period.

    I get a lot out of everyones posts so thanks for sharing!

  • #2976

    Patrick
    Participant
    Ŧallars: Ŧ 106.46

    John,

    Sorry to hear the news, but welcome to the World of Gout. First off, as a 50 year old male getting his “first” gout attack, consider yourself lucky in that regard. but guess what, brother? Colchicine is NOT your answer. Certainly not your LONG term answer. You will find here on this site that the first question asked will be “what is your CURRENT Uric Acid at?” Meaning….get a blood test and find out where you are with your Uric Acid. I find it odd that your doctor gave you Colchicine sight unseen, for big toe pain. That’s a little odd, if he didn’t do any blood work.

    Colchicine is a common anti-inflammatory prescribed for Gout. It doesn’t have any pain reducing principles, so any relief you are going to get from Colchicine may take a while as it isn’t really doing anything for your Gout cause, if indeed you really have Gout. You certainly have a symptom of what CAN be Gout.

    Also, your “social weekend” most likely didn’t have much to do with you getting Gout. It may have pushed you over your Uric Acid threshhold, which in turn caused your Gout Flare, but it really had little to do with you getting Gout itself. Many of us, through the magic of genetics and DNA, inherited this condition. I beleive the percentages put it at around 75-85% of Gout sufferers inherit it.

    The only TRUE way to determine if you have Gout is to get a blood test, first and foremost. ffind out where your Uric Acid is and if it is indeed high (over 6.o mgs/dL in the US) then discuss with your doctor potential remedies. But until you know for sure where you stand, you may be subjected to future Gout attacks, and believe me, they will get more painful and last longer as they progress.

  • #2977

    nobody
    Participant
    Ŧallars: Ŧ 502.46

    Patrick,
    Much of what you wrote is I think correct but…
    There are doctors who use colchicine as a diagnosis tool in some cases. It’s much cheaper and easier than arranging an ultrasound and joint fluid test with a skilled hand.
    And there also are doctors who discount the results of tests done on blood drawn during an attack.
    I wish diagnosis was as simple as a blood test. I have had several tests coming back well under 6 without the benefit of UA reducing drugs. Do you think that means I don’t have gout?

    • #2980

      Patrick
      Participant
      Ŧallars: Ŧ 106.46

      Patrick,
      Much of what you wrote is I think correct but…
      There are doctors who use colchicine as a diagnosis tool in some cases. It’s much cheaper and easier than arranging an ultrasound and joint fluid test with a skilled hand.
      And there also are doctors who discount the results of tests done on blood drawn during an attack.
      I wish diagnosis was as simple as a blood test. I have had several tests coming back well under 6 without the benefit of UA reducing drugs. Do you think that means I don’t have gout?

      A couple things. I can only speak for my experience, but using Colchicine as a diagnosis tool because it’s much cheaper? I don’t know about that in my experience, and it may be indeed true, but where I’m from, Colchicine is NOT cheap. As a matter of fact, it’s damn expensive. My insurance is billed almost $700 for 90 tablets of 0.6 mgs. I pay a $50 copay, but if I didn’t have insurance, $700 bucks is a steep price to pay for what may, or may not be Gout. I’d rather have more convincing evidence.

      For me (again, I only speak from my experience) I had several blood tests, none were taken during an active Gout Flare. Most often, it was taken afterward, then 4 weeks afterward. The highest reading I ever had was 9.6 mg/dL. When I first started Allopurinol, my doctor had me at blood test intervals of 6 weeks for the first 6 months. My Uric Acid is currently at 4.4 mg/dL, but I never take it for granted that I won’t have a Gout Flare, so I’m careful.

      With YOUR blood work well below 6 without meds, maybe you’re one of the lucky ones. I hope you are. I could NEVER get my levels below 8 without medication, so I really had no choice. But just because your blood work comes back well below 6, I wouldn’t say you don’t have Gout. You just don’t have symptoms. Keep up whatever you’re doing and be healthy.

    • #2982

      nobody
      Participant
      Ŧallars: Ŧ 502.46

      re: #2980

      20 1.0mg colchicine pills costs less than $7 here. That’s like 5 seconds worth of a doctor’s time per pill.

      These blood tests under 6 were basically flukes. I still had symptoms and my UA tests went back up after a while.
      My take away: don’t trust one test. You need a bunch of tests to build a decent picture. But in order to have a bunch, you need to start at one…

  • #2979

    Patrick
    Participant
    Ŧallars: Ŧ 106.46

    John,

    Sorry to hear the news, but welcome to the World of Gout. First off, as a 50 year old male getting his “first” gout attack, consider yourself lucky in that regard. but guess what, brother? Colchicine is NOT your answer. Certainly not your LONG term answer. You will find here on this site that the first question asked will be “what is your CURRENT Uric Acid at?” Meaning….get a blood test and find out where you are with your Uric Acid. I find it odd that your doctor gave you Colchicine sight unseen, for big toe pain. That’s a little odd, if he didn’t do any blood work.

    Colchicine is a common anti-inflammatory prescribed for Gout. It doesn’t have any pain reducing principles, so any relief you are going to get from Colchicine may take a while as it isn’t really doing anything for your Gout cause, if indeed you really have Gout. You certainly have a symptom of what CAN be Gout.

    Also, your “social weekend” most likely didn’t have much to do with you getting Gout. It may have pushed you over your Uric Acid threshhold, which in turn caused your Gout Flare, but it really had little to do with you getting Gout itself. Many of us, through the magic of genetics and DNA, inherited this condition. I beleive the percentages put it at around 75-85% of Gout sufferers inherit it.

    The only TRUE way to determine if you have Gout is to get a blood test, first and foremost. ffind out where your Uric Acid is and if it is indeed high (over 6.o mgs/dL in the US) then discuss with your doctor potential remedies. But until you know for sure where you stand, you may be subjected to future Gout attacks, and believe me, they will get more painful and last longer as they progress.

    This is by far the best site on the web for Gout information. There is a good group of people just like you who are experiencing the same things. Read, learn, and engage. Keep the group posted on your progress, John.

  • #3018

    John Harding
    Participant
    Ŧallars: Ŧ 3.52

    Thanks for all your replies, I’m in my third day now and have got some naproxcin from the doctor which is may start tomorrow. This is the most frustrating thing to suffer from as you know it will come back again isn’t it. I love to be active and have an outdoors job which I can’t do if I am having a gout attack. I was recently made redundant and was just getting my act together again. I empathise with you all and thanks for the advice. I am getting a uric acid test a few weeks after this bout dies down and see what that brings. I suppose the upside could be I will have to live a healthier life now.

    • #3122

      Keith Taylor
      Keymaster
      Ŧallars: Ŧ 1173.53

      Hi John,

      I hope you’ll return and post your uric acid test results. Your best next move would be to start a gout diary. That way, I can help you prepare pain control for any future attacks. Because, there is no way you should allow gout to interfere with your work. Then, when your happy with pain control, we can set a plan to stop gout ever returning. Also, I can help you with the healthy eating.

      Be kind to your future self 🙂

  • #6632

    Deb Kamerer
    Participant
    Ŧallars: Ŧ 0.37

    First time horrendous gout attack pain

    Naproxen didn’t help, prednisone now for 4 days not working, what next

  • #6633

    Keith Taylor
    Keymaster
    Ŧallars: Ŧ 1173.53

    Hi Deb, I’m sorry to hear that you are suffering from horrendous gout pain and I hope I can help you.

    Firstly, you must understand – gout pain is a different experience for each gout sufferer. So you need to develop your own gout pain management strategy. Then we can work out ways to control your gout pain until you can get full gout recovery. But full gout recovery can take several weeks/months/years depending on how bad your gout is and how long you had it.

    The good news is, we can help you control your gout pain very effectively. But the bad news is, you’ve given me absolutely no information to help you. Because to help you properly, I need to know:
    – More about the timing of your first gout attack.
    – What your doctor said. Especially, did your doctor escalate from naproxen to the prednisone? Or were you just taking naproxen over the counter? Most importantly, what did your doctor say about any follow-up?
    – Much more about you personally, if you want help long-term beating this for good.

    So, with so little info, all I can suggest is seeing your doctor as soon as you can. But also, you can browse and search to find more information. Perhaps you could start at How Do I Stop Gout Pain?

  • #7062

    Alex
    Participant
    Ŧallars: Ŧ 2.50

    First gout flare up! Advice please

    Hi all,

    I am told I have just had my first gout flare up this week. I haven’t had tests yet to confirm but I’m trying to get as much info and get ahead of it just in case.

    Some back story. I’m 5’11”, 220lbs(on the way down, lost 8lbs in the past month). Not very active the past few years and have been eating less healthy than I used to(more pizza, fast food, etc.). About 10 days ago I woke up with pain in the back of my heel that became worse throughout the day. By the next morning I could barely put any weight on that foot. Went to the doc and was told it was a strained Achilles Tendon. It made sense to me as that is where it was tender.

    I woke up one morning a few days later and the pain had moved to the top of my foot, I figured it was from compensating for the injury but as the day went on it moved down my foot and settled in the large joint of my big toe. I broke the bone in this joint when I was 17 and it being achy and stiff from overuse, poor shoes, or rainy weather is common. So I didn’t think too much of it. By that evening it had become extremely painful and swollen, resulting in a trip to the ER. After a physical exam (no blood tests) I was told it is most likely gout and was prescribed Colchicine and given Advil. That was 4 days ago and the meds have taken the edge off the pain but the foot is still swollen and sore.

    So I have a couple questions I’m hoping the community will be able to help me with. First is any advice to help end this flare up. and second is how to prevent the next one.

    I’ve already adjusted my diet to cut out processed foods (a good idea anyway) and will be seeing my regular doc next week. Most of the common triggers I can live with letting go but a big concern is I very much enjoy having a couple pints on the back deck with the wife or out with some friends. Everything I have read so far says those days are over if this is confirmed as gout. Is this true or are there ways to still enjoy beer without a flare?

    I am getting on this aggressively as I have a big trip in the fall and don’t want an attack to ruin our holiday.

    Apologies for the long post and appreciate any advice you all can give.

    Thank you

  • #7063

    nobody
    Participant
    Ŧallars: Ŧ 502.46

    Let’s not jump to conclusions but, assuming you really have gout…
    -colchicine plus advil should take care of a flare in less than 4 days if the dose is sufficient… how much are you taking?
    -poorly-healed fracture + gout isn’t a good combination
    -the way to enjoy beer without fear (though a little beer would probably be OK anyway) is to cure gout which typically requires a daily allopurinol pill
    -take care to drink plenty of water, especially after having consumed any kind of alcohol

  • #7067

    Alex
    Participant
    Ŧallars: Ŧ 2.50

    Thanks for the reply!

    I was given 1.2mg colchicine off the bat then 0.6mg twice a day since. Advil I think I was given 1000mg by the doc and I’ve been taking the max dose on the bottle since, 400mg every 6-8 hrs.

    Assuming this is gout it sounds like allopurinol might be a good way to go. I’ll talk to my doc about it.

    Another question I have is will gout get more painful with use of the limb? I’m using crutches but I noticed if I stand or walk on it (crutch assisted) even to the kitchen and back it gets more painful and inflamed.

  • #7069

    nobody
    Participant
    Ŧallars: Ŧ 502.46

    These doses seem to be on the weak side, especially considering you’re a large guy. But not everyone can take large doses so you should check with your doctor before doing anything rash.
    You’ve noticed what’s immediately painful. If you went by the signals your body is sending you’d lie down and even raise your leg above your body. Beyond the immediate pain though, opinions differ somewhat. But I think there’s general agreement that, however painful, standing for a little while is typically more helpful than not. Some people would recommend you even try to walk without crutches. I’d be much more careful and avoid putting your body’s weight on the painful location, especially if you’re not sure what causes the pain. Instead you could perhaps lift small weights or something to get a little exercise without stressing your foot.

You should log in to GoutPal to reply to this topic.


If you need more information, get it from Keith Taylor’s Log-in Help.