Submitted to taking another dosage of predisone to clear up the gout attack. Doctor tell me to stay on the allipuronal with the predisone. I can walk again and feeling better but do not want to get false hope since i am on the steriod. Have joint soreness. When will I be able to play my sports again

Make sure that you don't have sleep apnea. If you do, it is probably the root cause of your gout. Overcoming your sleep apnea will probably cure your gout, as well as greatly reducing your risk for the development of many life-threatening diseases. Overcoming your sleep apnea will extend your life expectancy and quality so that you can enjoy your family and your sports activities with full vigor for many years.

I got my big toe of right foot injured by hitting hard on the bed post 8 days back. A lot of blood but every thing seemed OK next day with NO swelling. However after 2 days, When I got up in the morning the big toe was swollen with excruciating pain. Took Advil for a day and in the night tied up the foot with a footstrap. Next day, toe was terrible which made me visit the hospital. They took Xrays and found no injury. I told them that 10 years back, I had similar symptoms and was suspected of Gout but that was never proved. So, the doctor said it was Gout attack again. Gave me Indomethacin 75 mg twice a day last Tuesday. I took first dose Tuesday night, pain was very brutal and it took 4-5 hrs before I can sleep(around 3 pm). Wednesday morning, pain was 60% improved. However, I have seen a strange cycle after that. Every day, in the late evening around 8 pm, it starts paining again, not very brutal but painful enough. I could sleep by 2 pm and in the morning, the pain is gone. I am at home, not able to put my foot on the ground most of the day but no throbbing pains during the day. I was hoping to recover in couple of days but yesterday night, after 4 days of taking this medicine, I again got very acute pain in the evening which was coming from all over the foot and migrating to leg. I was able to sleep around 3 pm but in the morning, the foot pain was gone and the toe pain was still there as every day. At this time, it is night and I have toe pain only.

I am going to show to doctor again tomorrow. Not sure what is going on. I am not able to put my shoe on or walk around much. The pain has not improved much( max 20%) though it is 5 days that I am taking Indomethacin. I have started Cherry juice also today evening.

I am an active jogger but am no longer able to walk since last one week. Obviously, my jogging is on hold, I am on medical leave and right now concerned about when I would be able to walk without pain. At this time, it is horrible to put the foot down.

By the way, I do not have much swelling, it is there but minor. Pain is major.

Any suggestions?

To "Painfree", what in the world does sleep apnea have to do with gout? Please describe in detail what it has to do with the excess uric acid in your system and how it relates to gout.

Sleep apnea is the condition in which the muscles lining the airway relax enough during sleep that the airway closes and prevents breathing for many seconds at a time, until the brain jolts them to reopen. This process continues repeatedly during sleep, usually without awakening the sleeper.

The frequent periods when breathing has stopped result in the reduction of oxygen in the blood, which causes two effects that lead to a gout attack. Effect #1 is that the reduced level of oxygen causes the cells to begin to disintegrate (catabolism), a process which results in their generation of excess uric acid fed into the blood. Effect #2 is that the increased ratio of carbon dioxide to oxygen in the blood makes the blood more acidic, so that it can hold less uric acid in solution. So sleep apnea feeds more uric acid into the blood and makes the blood less capable of holding it. The result is that the uric acid precipitates out of the blood in the form of monosodium urate crystals. When these crystals lodge in a joint, they initiate the immune system response known as gout.

These two effects from sleep apnea were published in pulmonology journal literature over 20 years ago. No gout experts have picked it up to quantify how many gout sufferers are affected by it. I suspect it is a large majority. I am one who was affected, having noted the complete cessation of my frequent gout attacks immediately after overcoming my sleep apnea six years ago. What gout researchers have noted recently is the strong association of gout and hyperuricemia with cardiovascular disease and diabetes, but they haven't recognized yet that these diseases are already known to have a strong association with sleep apnea.

My primary care physician has been screening all his gout patients for sleep apnea. He has found it to be present in a large majority of them when neither he nor they had any other reason to suspect it. In fact, about 20% of the US adult population is estimated to have sleep apnea, and it is undiagnosed in 90% of them. Most doctors don't screen for its presence, even though its prevalence is in epidemic proportions and its consequences can be life threatening.

This information is important for preventing further overnight gout attacks. It is even more important for using gout as an early warning of sleep apnea to allow for sleep apnea diagnosis and treatment before its known long term cardiovascular, metabolic, and neurologic consequences cause irreparable damage. Gout is the early warning!

TO Painfree; Thank you very much for your explanation. That helps a lot. The reason I questioned you in the first place was because I do have sleep apnea. However, I only have a gout attack once a year and approx always a year apart. If the apnea was the cause they I'm curious as to why I don't have the gout attacks more often? Guess I'll research some more. By the way what is the cure for sleep apnea?

Sleep apnea leads to a gout attack only when the oxygen reduction is severe enough the cause the cells to generate excess uric acid faster that the kidneys can dispose of it. The oxygen deprivation may vary significantly from night to night. My own experience was that initially my gout attacks occurred about once a year. As time went on they became more frequent, so that at the end of my fifteen years of gout suffering, my attacks occurred every few weeks with varying degrees of severity.

There are several methods for treating sleep apnea. The least intrusive is called position therapy - make sure that you never sleep on your back because in that position the tongue muscle can drop into the throat and obstruct your airway. Position therapy is effective for only a minority of people with sleep apnea - usually those who are not overweight. Another method is to use a mouth guard while sleeping to keep the jaw or tongue positioned forward. In some people throat surgery is effective. The most generally effective method is to sleep wearing a slightly pressurized mask during sleep covering your nose and mouth (CPAP- continuous positive airway pressure) to use the elevated pressure to keep your airway open. The diagnosis and treatment of sleep apnea is handled by sleep medicine specialists.

A study conducted in Australia over a 14 year period concluded that people with sleep apnea who refused treatment had a life expectancy that was 18 years shorter than those who complied with their treatment. Leaving sleep apnea untreated is courting disaster! Those who suffer from gout are fortunate in the sense that they have an early warning of sleep apnea, but only if they or their doctors know of the connection.