First instance of Gout

This topic contains 5 replies, has 3 voices, and was last updated by  Keith Taylor 1 year, 2 months ago.

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  • #3620

    Goch ddraig
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    Hi all,

    I’ve been suffering from my first ever gout attack for almost 2 weeks. Initial pain was quite severe, which I tried controlling with over the counter ibuprofen. It took me a week or so to get a gp appointment, so I spent time reading up on what I suspected was gout.

    After finally seeing the gp,my suspicions were proven correct. I was prescribed colchicine (12 tablets) and was advised that once symptoms were completely gone, I need to return for a blood test.

    I’ve completed the course of colchicine this evening, and although the pain is much more bearable, it has not completely gone. My toe is still quite tender and it is still causing discomfort when I walk. Don’t get me wrong, it is a million times better than what it was, however my concern now is whether the remaining pain is likely to ease over time, or whether I potentially need additional medication until all symptoms has gone completely prior to going to have the blood test.
    In regards to my own health and circumstances which I believe have contributed to this gout attack…
    I am overweight, and could definitely do with improving my diet. I have not been keeping myself hydrated enough and quite often find that my urine is very dark yellow in colour. Since suspecting this was gout, I’ve made considerable effort to increase my water intake, which is going really well. I’m hoping to continue this as it can only help prevent further attacks.

    Any advice you can share with me would be greatly appreciated.

  • #3623

    nobody
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    Hi,

    Ideally you’d have had your blood tested for uric acid before you had any symptoms. Maybe there is such a test in your medical record (no matter how old, the result would be informative).
    But no single blood test is going to tell the whole story anyway. So if there’s any way you could get several blood tests in the next few months, you might as well get your first right away. Sure, the result might be a little off because you recently went through an attack but results can sometimes also be off even though you aren’t experiencing any symptoms. Simply drinking more water could affect the test result and I certainly wouldn’t recommend you drink less on that account! The bottom line is that having somewhat questionable data is better than remaining totally in the dark.
    If on the other hand for some reason you can only get a single blood test done, maybe waiting a little while makes sense. There’s no telling when the symptoms might come back however and you don’t want to keep delaying that test.

    Colchicine ought to get rid of all gout-related inflammation after a few days if the dose is sufficient. Would you mind telling how many tablets you took per day and how much colchicine there is in each of your tablets?
    Possibly your lingering symptoms aren’t inflammation but rather the damage it caused (which need time to heal same as any injury).

  • #3625

    Keith Taylor
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    I think colchicine is very good as a preventative during the early days/weeks of uric acid lowering treatment. But, once a gout flare has taken hold, that really needs anti-inflammatory treatment, alone or in conjunction with colchicine. Sometimes, you also benefit from additional compatible pain relief. Because that helps you stay mobile. Which, in my experience, helps gout pain resolve faster.


    How Gout Medications Work media

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  • #3647

    Goch ddraig
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    Thanks both for taking the time to reply. The pain is definitely more manageable, and I’m walking much better. I’ve noticed that the joint is still puffy though which makes it more uncomfortable than painful.

    Regarding the colchicine,from memory it was 12 tablets which I believe were 500’s. Advice was to take 2-4 daily. I decided to take 3 a day for 4 days. I did have side effects on day 2 with an upset stomach, but that eased.

    I have continued taking in more fluids than usual (water not 🍻 Haha).

    Regarding the puffy / swollen foot, do I just continue taking over the counter ibuprofen or do I need to go back to the gp?

    Appreciate any advice you can give.

    • #3672

      Keith Taylor
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      Personally, I’ve rarely managed to recover quickly from a gout attack with OTC dose of ibuprofen. Usually, I recommend maximum dose, which is only available by prescription. Also, I used paracetamol, in between ibuprofen doses, for severe attacks. Then, my aim was always to stay mobile as much as I could. Because, I found gentles exercise helped resolve my gout attacks quicker.

      So, that’s part of my 3-pronged fight back on gout pain. With colchicine being the first line of defence. But, effective gout pain control is only a small part of effective gout treatment. What you really need is uric acid control, to prevent your gout getting worse.

      There are lots of options for lowering uric acid. But, they all depend on uric acid blood test results. So, if you got a test when you last saw your GP, it would be great if you posted the result. If not, arrange a test when you can. However, it’s usually a good idea to wait 2 weeks after a gout attack before you get your next result. The delay is not mandatory if your blood tests are free of charge. Because, the sooner you create a history of uric acid test results, the better. Then, we can look at different options for controlling your uric acid, and stopping gout attacks permanently.

  • #3654

    nobody
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    If you need to see your GP once more before getting your blood tested then yes, by all means go back to the GP.
    If not and assuming the symptoms do not come back with a vengeance, maybe you could see your GP after the test and see what they make of the results.

    Some people take a bit more colchicine than you did but I’m not sure that’s necessary.
    What I’m pretty sure about is that dropping the dose progressively rather than brutally after the fourth day as you did would diminish the risk of seeing the attack coming back. It might also help with lingering symptoms.
    I’d rather discontinue ibuprofen than colchicine seeing that I could restart ibuprofen at any time and get relief quickly while colchicine is most effective as a prophylactic. But your symptoms may behave differently than mine. Also, colchicine is dirt cheap here but it’s expensive in some parts which would of course affect your decision.

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