i am so thankful that this forum exists. The postings are informative.
My fiance had his first gout attack about 5 weeks ago. He just turned 29 years old. The doctor prescribed him colchicine and indomethacin. The colchicine made him sick so he stopped taking that. The doctor also prescribed him celebrex but the medicine was not effective for him. He found that indomethacin works for him so he took it until the pain is gone.
My question is although his pain is gone, his toe is still swelling after 5 weeks. Is this normal? The doctor told him to take allopurinol for that. I have to be honest, we do not yet have a family doctor and we have been looking for a doctor that we can work comfortably with.
In the mean time, we would appreciate any insights and advise on this matter. Would the swelling ever gone for a gout patient?
Thank you very much.
Im having pretty much the same problem as your fiance. Went to emergency room about 4 weeks ago thinking I had a stress fracture
and they informed me it was gout. Im just 36. I have no insurance and
out of work so I cant see a rheumatologist. They gave me antibiotics and
indocin at the emergency room. My life is like on hold, till this crap goes away. Still after a month there is a red knot on my left toe joint. It just wont go away. Cut out red meat and beer, but still the swelling wont completely go away. This seems to be a common problem from what im reading on this forum. I just dont see the baking soda working, been trying it for a week. I hate the er but guess I need to go back for more
medication or something. Im a regular walker and jogger so this is most
disturbing for me not to be doing these activities.
--not to mention I enjoy my fricken beer!
Im assuming this wont stay in my joint forever, im just not sure if there's not some kind of permanent damage.
A bad gout attack can destroy a lot of tissues and body fluids -- that's why it's so painful. Depending on how bad was the attack, it may take weeks or months to clear these fallen heroes out of the battle fields. Here are a few things that can help:
1) use the attacked joints as little as possible.
2) soak the swollen joints in warm/hot water for 10~20 minutes at a time and gently rub the playdough-like substance to break it off. Do this a few times a day.
3) raise the attack sites high above the heart level as long and as often as possible to help drain the fluids, especially after the soaking.
After the gout attacks, the mono-sodium urate (msu) crystals which cause gout attacks are coated by certain proteins and will stay in the joint forever, unless you lower your blood uric acid level to 6 mg/dl or lower. Allopurinol doesn't help reduce the swelling. But it can reduce the blood uric acid level and slowly dissolve the msu crystals (tophi). Initial gout attacks along are unlikely to cause permanent damages. But if left untreated, the build-up of tophi over years or decades can erode the bones. Avoid heavy drinking, especially beer. It is a very potent trigger of gout attacks. Learn more about gout and have war plans ready. Most likely it will be back. More gout info can be found at http://www.Icuredmygout.Org . Good luck.
The reason allopurinol triggers a gout attack is because you CANNOT use it while you are having a gout attack. When you are in the throes of a gout attack, you need an anti inflammatory. Colchicine is the best in my opinion. Take a Prilosec to coat your tummy 1x daily. Colchicine bothers some people hours later.
At the first sign of an attack take 2 .6 mg tablets. I hour later take one more. Then take one daily and no more than one, every day until the inflammation subsides. Then discontinue. One week after your attack is gone, begin 300 mg of allopurinol daily. Allopurinol will bring your Uric acid down under 6 where attacks cannot occur.
If you ever get another attack and I doubt it, discontinue the allopurinol and revert back to the colchicine routine above.
I have found that 1/2 lemon in a glass of bottled water helps as well. So does about 4-6 grams ( 4,000-6,000 mg) of flaxseed oil along with .7-1.5g ( 700 to 1500mg)of Omega 3
Also get yourself a hydroxyl D3 test. If it is way under 50, like a 10, take 2000mg of D3 daily and re check in 3 months.
If you drink, stay away from Beer and Red Wine, White Wine is is the least harmful.
Purines are everywhere:
organ meats ( liver, tongue) real bad
shell fish ( for me lobster and shrimp ok, clams, oysters, scallops kill me immediately within 24 hours)
Experiment. Remove all of these from your diet and replace one by one.
I hope you all read this... it will really help
If you are heavy lose weight obesity leads to gout and other things.
If you have psoriasis get it under control. Over multiplication of skin cells creates crystals.
I am a 42 year old white male who was diagnosed with gout in 1999. I suspect I had been suffering since 1994. My lifestyle in the 90s had a lot of rich foods and alcohol. My weight has varied between 180 and 225.
I used to be on various gout drugs and grew weary of the complications. The final straw was when the damn doctor made me get emergency mris over thanksgiving weekend. Nothing was damaged but I quit seeing him.
I took matters in my own hands and as I am an engineer began a long road of discovery and experimentation. I'll rate each step 1 to 10 with 1 being worst and 10 being gout free.
My first experiment was to radically alter my diet to exclude alcohol and most rich foods. As you all know, hard to do for a length of time. I did this for 6 months and reduced the duration and frequency but did not eliminate it. Rated 3.
My next stab at this was to use a product called gout cure. It helped much better but I had to continue to abstain from alcohol and rich foods. The ingredients were advertised to clean out the liver and kidneys which to an engineer made sense. Clogged filters don't work well at cleaning anything. Rated 4.
The next experiement had me examine neutralizing acid via lemon juice and water. I still used gout cure. This went on for 3 months. The combination seemed to work well but occasional pain was experience. Duration and frequency was at the lowest. I noted the tophi reducing in my body. Rated 7.
The next phase had me focused more on acid reduction. I bought coral calcium powder and swilled a 12 ounce glass each morning. Maybe one teaspoon of the calcium. I ceased gout cure and saw yet another jump in quality. Rated 8.
I am now better understanding my situation. Ph is critical. On my own I tried baking soda. The results were immediate. I actually had entire weeks of zero pain. The tophi reduced. My urine ph was being measured daily and spot checked during the day. I was steadily alkaline. As a test I ceased the baking soda for several days. My urine was very acid. I did a shot of jack and saw the ph move to the max acid the ph could measure. A teaspoon of baking soda in water made the urine alkaline once again. My tophi began to reduce, soften and break up. My gf noted my elbows looked 20% reduced. I'd say 25%. Now I discover another problem.
As my blood was saturated to an extent that uric acid crystals could solidify and 'reef up' the baking soda reduced the saturation in liquid and the reduced saturation caused uric acid to come out of solid into solution. If I was not steadily on the baking soda and lapsed i'd get a severe attack. A quick bit of baking soda did radically reduce the pain in 8 hours. So, as I get better I find I need to be on top of the baking soda. Saturated blood can recrystalize. Pain ensues. Rated 9.
My next step is to do a further change and reduce soft drinks to one a day. I am allowing myself some alcohol and rich foods. I am trying to find baking soda capsules. I find that club soda alkalizes blood nicely so I keep a few bottles at work and in the car. My tophi are reducing steadily. I expect complete reduction in 6 to 9 months. Occassional pain is experienced but is bearable.
Anyways, my 2 cents. I am no doctor so I encourage everyone to see their doctor before trying this. Your results may vary.
One thing I appreciate is that tumors and various diseases both thrive in acid blood and promote acid blood. Your body works best in the alkaline range, not acid. Put another way, a sick body promotes further sickness. I find the baking soda solution to be cheap ($0.49 a box), easy to administer and for me it works. I am hoping that I can lose about 15 pounds to help matters along. If I get down to just one glass of baking soda water a day I will most likely continue this for the rest of my life and the great part is I can enjoy my old favorites again. Just in moderation.
ggoede1's response was excellent. As I was reading it, it was like he was talking about me personally - I am the same age, same symptoms. I just wish he had talked about the ratio of baking soda to water that helped him - and how he measured his acid levels at home. But I will find out.
I think it is important to drink loads of water to flush out the dissolved crystals when you get them back into the blood.
Not easy to do in the winter. I find a combo of Allopurinol and breadsoda working for me. Low Uric acid and alkaline blood looks to be whats needed. My tophi are gone.
I take half a teaspoon three or four times a day. I find my BP is high in the mornings but goes down as the day goes on.
I still have pain but its not severe and I feel it a healing pain. The MSU crystals hurt on the way out too but at least they are on the way out!!
Breadsoda is bakingsoda.
I assume the crystals are dissolving because the tophi are gone from my fingers and earlobes.
The pain is different. Not as severe as an attack. I have had gout for ninteen years so I know when its different.
My uric acid level was around 19 "Sky High" according to my doc., its now around 4.
Urine ph is around 8.5 on the BS. My acidic stomach is better too because of the BS.
I am prepared to accept the risk of high BP.
Maybe I am sounding too positive but I believe this helps too. Of course I'm getting better
I have had pain for the last seven months, since I started on allopurinol full time.
I know this would happen. It can take two years or longer to get rid of the crystals I have read. I presume its going to be a lifetime of vigilance, watching UA levels and blood ph. I like my seafood but I am cautious and only eat it occasionally for now.
I drank beer a lot when I was younger. I suppose I am paying for that now. I still drink a shot of whiskey at night but drink very little beer. I hope to be able to do that again some day haha.
I can control my gout better with nsaids now.
I feel that the BS helps the drug work better, maybe they have an easier time in a less acidic stomach. I try to take them with the BS. I use Solphadine for the pain, it has some codeine. I rarely need that now though.
I had small lumps on my knuckles and white blobs in my earlobe. These are now gone.
Hope this helps.
I had my 2nd gout attack in early April and about 3 wweks later,an attack in my ankle(same foot). The worst is over but the pain when my shoe hits the toe joint is unpleasant. Also,my ankle and top of my foot is still swollen(it is now mid-June!!)Do the Ph drops I've been adding to my water less helpful than BS? Will the swelling go away as the crystals dissipate? Thank you so much for any advice. Lisa
worried about the joint pain and the persistant swelling and the
i had pain in my 3rd metacarpophalyngeal joint of right hand about the start of september2009.the doctor diagnosed me with gout as my uric acid level was 8.5.i was put on flurboprofen200mg(nsaid) and the doctor assked me to keep taking it for a month and then he plans to add allopurinol to my treatment regimen.
although i have been taking my flurbiprofen for last three weeks and the pain has almost disappeared ,pricking pain remains alil.,but the swelling is still there.
wat iam worried is that shoulkd i keep taking the flurbiprofen till the swelling is there or should i stop it as the most of pain has gone.secondly is it right to keep taking the NSAID for two to three months with stomach protection medicine as the doctor intends to continue this NSAID even for first two months of allopurinol?
I HATE SWELLING!! Don't get me wrong,i hate the pain too. I had my first gout attack in my ankles about 2 weeks ago and the swelling is still very bad!!! I am 34 female and I never thought I would get this, that is life for ya. Sad part is, my ankles were the only skinny thing on me. lol. Does anyone know when the swelling will go down???
I get gout roughly once every year, Major Major Major pain and swelling round the ankle and more or less feels like a broken foot!!! first thing first the best thing i have which takes the swelling down near enough the same day is NAPROXEN 250mg 3 times a day accopanied by 1 LANSOPRAZOLE once a day.
After 2 days the swelling is gone pain is almost gone and i can walk pretty much pefect.
I still drink beer which i enjoy a lot about 8 pints twice a week and i do like the odd curry, before you go there, NO im not over wieght im just a guy of 38y that enjoys his life.
Every body on all the forums raves about baking soda etc... but it never helped me. Iv written this for all them people that have tried several things with no result.
These work for me with 100% success rate within 5 days.
I hope this helps somebody out there who maybe gets this as bad as i do.
I appreciate reading everyone's posts. I'll share my story....I had my first gout experience at the age of 26 or 27. I don't know what my uric acid levels were then but they have been running around 8.5-9.0 recently. The experience was textbook classic-woke up in the middle of the night with excrutiating pain in my big toe. even the weight of the sheet was too much. Felt like shards of glass in my joint. Swollen and red. The only thing I can figure that precipitated the attack was when I had started taking niacin supplements in order to reduce my cholesterol levels which were up around 300! I'm now on 80 mg. of Prevastatin.
Today, I take Indomethacin when I feel an attack coming on and alternate with ibuprofen. I also take lots of ibuprofen for frequent headaches. Sometimes I worry about possible stomach bleeding especially since I tend to borderline binge drink with friends on weekends. I have started limiting my alcohol intake to red wine (Merlot)and have eliminated beer entirely. I also suffer from frequent heartburn and take OTC Zegrid and Maalox. Probably just another sign that my system is way too acidic. I think I'm going to try the baking soda method. Do you just mix the baking soda (the kind in the box) with a glass of water and drink?? Any side effects besides possible High Blood Pressure? Currently, I have also been taking several supplements that I have read are suppose to be helpful:Vitamin C 500mg doses-taking approx. 1500mg per day (shown to reduce uric acid levels), Potassium Citrate 99mg (to help prevent kidney stones-of which I have had one back in 2002 and hope to NEVER have again as it was the worst pain of my life!), Vitamin E, Selenium, Flaxseed Oil (all for anti-inflammatory effects).
I have recently had another gout attack in the big toe of my left foot on September 9, 2010 and it lasted for nearly 7 days-the longest one ever! The swelling in my left foot still continues today and has me a little worried when it will go down. Thanks for any advice anyone on here can give me. Sometimes I start feeling like I'm a walking timebomb-try to fix one problem with my body chemistry and it causes another one.
P.S. I'm getting ready to turn 38 and I sure hope that I can make it to at least 78!
Your overnight gout flares are probably a direct result of sleep apnea, where you stop breathing frequently in your sleep for many seconds at a time. The reduction of oxygen in your blood causes the generation of excess uric acid and its formation as the crystals which cause gout. High cholesterol and frequent headaches are also known to be consequences of sleep apnea.
The best advice that I can give you is to insist that you get tested for sleep apnea, and to follow the recommended therapy if you have it. Not only will overcoming sleep apnea prevent future gout attacks, but it also will extend the quality and length of your life. This is serious stuff. Your gout is probably only a symptom of your sleep apnea.