Mike,

Welcome, I have been battling the gout coming on almost 18 years now. Yes it is a pain and will make a gown man cry. Indomethacin in my opinion is a step in the right direction. Vicodin for the pain just won't cut it. Talk to your doc about trying to get one of the two most popular preventitive meds (alopurinol or probenicid) I take both. Also ask for some colchinne ( this drug will upset your stomach but does provide some pain relief).

I'm about 8 pounds overweight according to the Navy (just recently retired)and have been hospitalized twice with the gout. Morphine did deaden the pain (vicodin,tylox and all the other codeine derivitives did not work and the gout just laughed at it).

How much suds did you have with your BBQ binge??

Good luck and see a rhuematologist to get this stuff under control.

V/R
Jeff

Hi Jeff,

May I ask for more info about the conditions and the treatments of gout when you were hospitalized with it? Tks.

Best of your health to you all.

JYY2,

Not a problem. Can either answer here or we can take it off line. Your call.

V/R
Jeff

Hi Jeff,

Thanks for the reply. Could you do it here. It can be very useful to others too.

Please give me an idea what you are looking for and I will strart responding. Are you looking at any of the following?

What joints?

What meds?

How long held captive?

Follow on treatment?

V/R
Jeff

Basically, I am very interested in the symptoms, the tests done to diagnose gout, the treatments, and any other info that will be educational to us. Thanks again.

Symptoms: With me it usually starts with a warm tingling sensation in the affected joint, accompanied by a low grade fever and headache. I normally feel lethargic also. Affected joint is warm to the touch and is has a reddish pink color to it. Once the joint gets completely inflamed it is red or yellowish purple in color.

Tests: At least at Portsmouth Naval Hospital (PNH) they do blood work to test your uric acid level. My Doctor in the past has always wanted mine below 7. Mine usually is around 10.8 to 12. Doctor has stated in the past anything over 7 and you will start to feel pain, don’t know if this is true or not.
Additionally I have had my knee or elbow drained and the doctor then looks at the fluid removed. Fluid normally is yellow in color (kind of like Country Time Lemonade). Check this fluid for the presence of tophi crystal. The doctor has let me look at these crystals before and to me they looked like little arrows with barbs on the end. After seeing this I know why we feel the pain that we do.

Treatment: Since 1990 I have been on alopurinol anywhere between 300mg to 800 mg; Indomethacin 75 mg; and Colchinne. None of this has stopped the attacks all together. Up until recently I would say it has mad the attack less frequent.

Hospitalizations: First hospitalization was in March 07 and second one May 07. Leading up to the be being in the hospital in late December 06 I started to get a flare up in my right ring finger. Went to PNH and rheumatologist put me on a Medryl Dose Pack (6 day steroid taper) thinking this would knock out the attack. Never fully knocking out the attack I went back to PNH approx 2 weeks later complaining about the right index finger and my left knee. Doc took fluid off the knee confirmed tophi and injected knee with steroids. Less than 5 days later I had pain and swelling in the following joints left/right knees; left/right ankles; right big toe, left/right Achilles area and left elbow. Doc took one look at me and admitted me.
Once admitted they started an IV think for dehydration. In addition to this twice a day they injected heavy duty steroids via an additional IV. Still was taking Alopurinol, Colchinne and Indomethacin. Doc’s also gave morphine for breakthrough pain (now this stuff does work for pain. Vicodin, Tylox etc in my opinion is worthless. I stayed in the hospital this time for 6 days and then was released. Only new med at this time that I started taking was prednisone taper 80 mg for 2 weeks then 60 for 2 weeks then 50 for 2 weeks etc.
Second admission (never really recovered fully) called the doctor told her knees and feet were all swollen. She told me to come in and she took one look at me and it was do not pass go do not collect 100 dollars your going back to the ward. This time for 5 days, with pretty much the same regimen as above. Only new drug that was introduce was Probenicid. Finally released with same prednisone taper as above.

Presetnly: Take the following meds Alopurinol 400mg a day; Probenicid 2000 (not a typo)mg a day; Indomethacin 75 mg a day; 3 Colchinne tabs .6mg a day. Still on the Prednisone taper at 20mg a day. Docs have attempted to take me off the prednisone twice and each time the gout flares back up.

Other stuff: Diet help in controlling gout but I’m noticing more and more things trigger attacks the longer I have had gout. Course I do not drink but I did find out coffee triggers and attack for me so luckily I have never developed a taste for it.
One of the posters on this forum swears that if you get your sleep apnea under control your gout will be fine. Not to snipe at the guy but I don’t buy into that (however I’m happy for him that it works in his case). I have been using a CPAP machine for 6 years and it does do wonders for my sleep but zilch for the gout.
I also prefer ice on the affected joint vice heat. Heat to me seems to up the crescendo in pain.
I also like to keep the joint straight vice letting it bend I find this to be less painful.

Thanks a lot for your detailed gout info. It's very educational for me. I believe it benefits many other gout sufferers, too.

As to the claim that sleep apnea causes gout, I couldn't find a thread of scientific data that support the claim. I found two cases over the years in this regard: One, a nurse reported that after her patient's sleep apnea was corrected, he began to develop gout. Two, a medical study shows that after the patients' sleep apnea was corrected with CPAP, their blood uric acid level went up, not down!

Thank you again for your long report and wish you the best of the health.

There are many medical journal references that discuss the relationship of sleep apnea to excess uric acid in the blood and to increased blood acidity. That is the connection of sleep apnea to gout. When I tried to post website information here to allow you to retrieve that information, the administrators of this site withheld my posting. If anyone would like that information, please email me privately.

Painfree

When I turned 40 and had a physical that started me on Blood Pressure medicine and Zocor. The doc also recommended that I take a baby aspirin daily.

I was not over weight and at the time was riding my bike about 100 miles per week.

When I turned 43 I woke up one morning and thought I broke my toe. Gout was the diagnosis. For the next 5 years my gout attacks became more frequent until I was getting hit 2 times a month in both my feet and knees. I tried everything, Cherry juice, herbal, and was going to get the allopurial. but I finally met to a rhumatoligist that suggested I stop the daily baby asperin.

I did and within 3 months my gout stopped! I get hit now about 2x per year and contol it with indomethisen.

If you are suffering and taking daily baby asperin, try stopping and see what happens to your gout frequency after about 90 day.

May I ask what were your blood uric acid level and the 24-hour urine uric acid excretion rate, before and after you stopped baby aspirin? Thanks.

Don't know the answer to that.

Hi JYY2,

Was wondering if you received my pm ?

Cadams,

Back in 1990 the first thing my rhuematolgist told me was stop taking any tyoe of asprin due to it will trigger an attack of gout. I haven't had an asprin since but have had numerous attacks.

Seen you are a bike rider. I was myself up until last year. You a Roadie or Mtn Biker. Myslf was a Roadie (21 yrs) and then switched to the Mtn Bike after I came back to CONUS about 4 years ago. Have not been on a bike this year. Due miss it though however have not kicked this attack I have had since Dec 06 yet.

V/R
Jeff

RE: zeth
Posted: 09-18-07 1:04a

Hi JYY2,
Was wondering if you received my pm ?
------------------------------------------ ----------

Hi zeth,

No, I have not received your pm. Please pm here. Will respond when I can.

------------------------------------------ --------------------------------
Hi JYY2,


OK, just re-sent my private message again (Also took out some http links, wonder if it was blocked because of that). Let me know. Thanks.

I don't check my email. Please post it here and will respond when I can. Thanks.

OK, private messages here seem not to work. Briefly, I had a number of questions which I was hoping you could help me with:

1) Is there a sure-fire way to trigger a gout attack?

I noticed on your website that you indicated that you had experimented with eating large portions of high purine diet in order to trigger gout attacks without success.

Recently, I tried to trigger a gout attack myself. Looking at the high purine list, I noticed tinned sardines being the most readily available with the highest purine content and had a 425 g can adult dosage of Aspirin. I skipped the accompanying tomato sauce on account of the contradictory evidence. Nothing. A week on, I tried the same with pork liver (~400 g) and Aspirin, again nothing. I might experiment with shellfish next or up the dosage of sardines.

I'm not looking for any long-term solutions, so weight gain is probably out, I need something more like a short-term fix to maybe trigger a minor attack sufficient to render me relatively immobile for say 1-2 weeks.

2) Failing that, is there a way to fake gout?

Correct me if I'm wrong, I understand there are 3 tests, the blood tests for uric acid levels (indicative of only hyperuricemia, not gout), physical examination of red swelling at joints (since it is physical, there could be other causes) and fluid extraction from joint (probably conclusive, but labourious) for X-rays.


My gout history:

My first gout attack occured at 30, initially I thought I had fractured my toe and could barely walk for the next 4-5 weeks such was the swelling on my big toe. I was prescribed the standard painkillers and Allopurinol to be taken some time later. The doctor advised me that I could skip the Allopurinol courses after the first 2 prescriptions if there was no recurrence.

My next attack took place almost 2 years later on the same right toe (lasted a day or two) and ever since then (almost 10 years since the first attack), I have been relatively gout-free (exception being one or two minor pain episodes that lasted a few hours).

The only lifestyle change I have made since the gout attack has been to lose a lot of weight, no long-term medicine involved.

I do not know any sure way to trigger gout attacks. Certain triggers can trigger attacks in some people but not others.

MRI, CT scan, and high resolution ultra sound, are also used in research to ID tophi (urate crystals) in the body. They are expensive and are rarely used for common gout patients.

Do you know what are your blood urate level and the 24-hour urine uric acid excretion rate? They can be useful to assess the seriousness of your gout.

Let us know when you find your triggers. Take care.