Doctor's Visit, Tests, and Results

Friday two weeks ago, I had to go to the hospital to help a friend.  While I was there I was able to schedule an appointment for myself.  The reason for my appointment:  recent morning pain in my feet, and a gout attack in the same week.

The doctor was able to get me in this last Thursday for a morning blood test (the fun one where you can't eat in the morning).  Later on Thursday the doctor called me with results.  

Thankfully my liver and kidney function in relation to allopurinol was fine.  Cholesterol and Triglycerides were okay (though the Tri's were a tick too high).  My uric acid level was high enough that the doctor agreed I should up my allopurinol dose 50 mg a day.

So since Thursday I've been taking 100 mg in the morning and 50 mg in the evening.  Hopefully it will knock this recent bout. (which I believe to be seasonal). 

Tell me how your doctor's visits and blood test have gone! Leave a comment.

Seasonal Gout

Oh Spring!  Everyone loves mentioning how spring is the time for birds chirping and flowers blooming, but for me Spring is gout season.

Since the weather has been breaking from lower than 50°F (10°C) to weeks with 60s and 70s F(15-20 C) I've been waking up with stiff joints in my left foot.  If not for my allopurinol this spring might be like last year where I had near daily attacks.

I do have last spring's near-disaster to thank for helping me to seek out the proper help to get my gout diagnosed, but I am not looking to relive it.  So here's some ways I'm going to try to beat my seasonal gout stiffness:

1. If I feel really stiff I will take a colchicine before bed.
I've done this a couple of times and have avoided what I think were incoming attacks.

2. Increased water consumption.
I usually drink 3 liters of water a day, though recently since I've been waking up with stiffness I've been going closer to 4.  It's a lot, but the bathroom trips are increasing and hopefully getting the uric acid out.

3. Scheduling a doctor's visit.
I want to check out the effects of allopurinol on my body and checking to make sure 100mgs is going to continue to do it for me.  I also want to be careful not to overdo the allopurinol, but making sure it's not hurting me and is getting the uric acid level to a proper level.

4. Occasional foot soaking.
A salt soak for gout can be helpful for most forms of arthritis and joint pain. I think this is a worth-while attempt that used with the other methods could help.

What are your solutions for seasonal gout?  I'm interested in sharing solutions with fellow suffers.  Leave me a comment!

App Store Apps for Gout Recommendation: Argus

Howdy friends!  Today I wanted to let you in on an Apple store app that I have been using for about a month and a half now, and feel comfortable enough recommending it as a great app for gout sufferers.  May I introduce: Argus

Argus is meant to be a lifestyle tracker, an interactive daily diary that can be very helpful for the gout sufferer.  After downloading the app you'll be prompted to enter some personal information such as your name, email, weight, height, and gender as shown below.  

After you've done that you'll get to a few different settings.  The main setting I recommend turning on is "Show Steps on App Icon":

The step tracker has been a great tool for my personal life and battle with gout.  The steps tracker lets me see how far I go in a day.  As long as my bluetooth is on the tracker is fairly accurate.  It's amazing to see how far I can go on clean and clear days and how difficult it is on days that I don't.  

It should be pretty obvious the days where I was hitting the colchicine and ibuprofen.  

Another tracker which you control yourself that can be extremely helpful is the water tracker.  

Most days I go well over the "8 glasses a day" requirement, which my 8 glasses is actually right about 3 liters, this helps me ward off the horrid gout.

One feature that I make less use of, but could if I wanted is the food photo tracker.  This can definitely help you remember how much meat and vegetables you've consumed, making gout prevention easier.

The app is free, and you can add friends.  If you do add the app, be sure to add me: james l goode.  Hope to see you there!

Do you use applications or technology to prevent or track your gout?  Leave me a comment!

History of Gout Series: Ancient History

Being the holder of a Bachelors of Arts in History, I dig learning the history of things around me, so I have decided to do a series on the history of gout in our world.  My intention is to give a better idea of where the human race has come from with gout and possibly reach into research and look to another series for the future.  I thought I'd begin with some very old accounts of gout.

One of the World's First Known Sufferers: Poor Sue!

As previously noted in my post on research, Sue is one of the earliest known sufferers of gout.   She also has the distinction of being the largest and best preserved T-Rex skeleton ever found.[Sue] Being such a large creature, I imagine her ordeal was prbably not very fun.

Gout's Earliest Acknowledgement: Egypt

Historians generally agree that ancient Egyptians were the first known culture to report the occurrence of gout, the earliest texts being from 2600 B.C..[1] Some sources look at evidence in mummies that point as evidence of gout.[2] While I did find one source that disputed this, the writer of this source has looked at scholarly reports from translated papyrus as evidence that ancient Egyptian doctors acknowledge a condition that caused swelling in the toe and prescribed a cure of applying nar-catfish from the Nile River and honey to the afflicted area.[3]

According to medscape, both the Edward Smith and Ebers papyri (other early Egyptian medical documents) acknowledge the existence of gout in Ancient Egypt.

Early Treatments

If applying Nile nar-catfish and honey doesn't suit your fancy, another treatment that was used starting around 1500 BC was the drug Colchicine.  

Dr. Hippocrates on the Case

The next major mention in scholarly work on gout comes from Ancient Greece and the most famous Greek physician, Hippocrates.  He called it the "unwalkable disease" also noting a demographic connection between occurrences of gout and the rich.[4]  (A personal aside: I wish I had the rich lifestyle to go with my gout!) A further demographic line was drawn in noticing that eunuchs did not suffer from the condition.[5]

In the next History of Gout Series post we'll cover gout in the AD world.

Have you heard any interesting stories of gout remedies from the past?  Leave me a comment!

**This website is for informative purposes and should not be substituted as advice of a medical professional.  If you believe you have gout, I STRONGLY recommend scheduling an appointment with a medical professional and getting the problem checked out.

Sources [- http://en.wikipedia.org/wiki/Gout#History

http://www.hellolife.net/gout/b/what-is-gout/

http://www.academia.edu/3653849/Catfish_Remedy_for_Gout_in_Ancient_Egypt
http://www.crystalinks.com/egyptmedicine.html
http://www.medscape.com/viewarticle/780895_2]

Medicine for Gout Series, Entry 2: Colchicine

Hello again! Another week, another post about the dreaded gout.  Hope all reading are getting over your attack rather than getting one, but if you're not today's choice for our medicine treatment is one that has been with us for a long time:  Colchicine.

A Longtime Medical Companion...

In the history of gout, colchicine has been a consistent help to gout sufferers against the bane of their existence since early Egyptian days.  As wikipedia states:

 The plant source of colchicine, the autumn crocus (Colchicum autumnale), was described for treatment of rheumatism and swelling in the Ebers Papyrus (ca. 1500 B.C.), an Egyptian medical papyrus.

So with over 3500 years of history treating gout, I feel it's pretty remarkable that mankind still uses this remedy for gout attacks.  It's no wonder though, if you've never used it you must know: for most people this stuff works.

How it Works:

From a well-respected English medical website:

    Colchicine works by reducing the number of white blood cells which travel into the inflamed areas. This helps break the cycle of inflammation and reduces swelling and pain. It will have been prescribed if you are unable to take anti-inflammatory painkillers, which are the medicines most often used to ease a gout attack.

 

Many people will use Non-Steroid Anti-Inflammatory Drugs (NSAIDS) to stop their gout pain, but as you can see from wikipedia, the side-effects of these medicines can be rough.   Colchicine is an FDA-approved medicine that is known for particularly working to curb gout (among a few other things).

Side-Effects:

 Through as our useful source, wikipedia, we can find a list of colchicine's side-effects:

Adverse effects[edit]Side-effects include gastrointestinal upset and neutropenia. High doses can also damage bone marrow and lead to anemia and also cause hair loss. All of these side-effects can result from hyperinhibition of mitosis.^{[citation needed]}A main side-effect associated with all mitotic inhibitors is peripheral neuropathy, which is a numbness or tingling in the hands and feet due to peripheral nerve damage that can become so severe that reduction in dosage or complete cessation of the drug may be required. Microtubules are involved in vesicular transport. Peripheral nerves are among the longest in the body. Brownian motion is not significant enough in these peripheral nerves to allow vesicles to reach their destination. Thus, they are susceptible to microtubule toxins.^{[citation needed]} 

Toxicity[edit]Colchicine poisoning has been compared to arsenic poisoning. Symptoms start 2 to 5 hours after the toxic dose has been ingested and include burning in the mouth and throat, fever, vomiting,diarrhea, abdominal pain, and kidney failure. These symptoms may set in as many as 24 hours after exposure. Onset of multiple-system organ failure may occur within 24 to 72 hours. This includes hypovolemic shock due to extreme vascular damage and fluid loss through the GI tract, which may cause death. In addition, sufferers may experience kidney damage that causes low urine output and bloody urine, low white blood cell counts (persisting for several days), anemia; muscular weakness, and respiratory failure. Recovery may begin within six to eight days.

I know many people reading this blog probably don't have time to read all of that, so I'll summarize for you. Colchicine is poisonous to the human body!  You don't want to take too much of this stuff, otherwise you'll be giving yourself something akin to arsenic poisoning.  It will kill you if your not careful, so you need to-

Be Careful about Dosing!

If and when prescribed Colchicine you should pay attention to your doctor and your box about the dosing.  You won't want to take too much of Colchicine and cause stomach problems or worse.

There are a few sources out there that will spell it out better than I can, but this Australian website does a good job of showing that low dosing will help you more and cause fewer adverse effects. Just remember what the end of all my posts say: I'm not a medical professional so you need to communicate with a medical professional about these things.

My View on Colchicine:

I have taken Colchicine before, especially in the first few months of taking Allopurinol.  It did a great job of keeping me from too much pain.  I am pretty sure there was one time in the first few months that I went harder on it than I should have and I got a stomach ache and had a bad hour with a couple of messy trips to the toilet.  You're better off pacing yourself and remember that water is also your friend.  

Have you taken Colchicine for your gout?  What were your experiences?  Leave me a comment!

Other Posts in the Medicine for Gout Series:
Allopurinol

**This website is for informative purposes and should not be substituted as advice of a medical professional.  If you believe you have gout, I STRONGLY recommend scheduling an appointment with a medical professional and getting the problem checked out.

Gout: That Picture!

“The Gout” by James Gilray, 1799

Even before I had gout, I was familiar with this picture.  I probably first saw it in a history book.  It didn't make sense to me-probably because most of my pain has been in the lateral side (outside) or on the top of my foot in my arch.  Here we can see some sort of spawn of hell attached to the area near the big toe.

If you've never had gout, you don't don't really understand this picture.  If you do, you can imagine that little imp grabbing onto whichever place your affliction manifests.  The redness, the swelling, the feeling of your own personal hell-that's gout.  This picture captures the feeling perfect.

My experience...

When I was suffering from my regular gout attacks but wasn't diagnosed, It was absolutely awful.   I had gone to a few doctors and none had thought to check my uric acid levels, and to be honest I didn't go to the doctor for every attack.  I was afraid!  My major worry was that my body was weak and I was walking incorrectly.

My answer was to get online and figure out the problem for myself.  This was a major mistake!  My personal diagnosis cheated me out of countless weekends with friends and fun because I went years without getting my problem properly diagnosed.  I let this imp ride along for far too long.

If you're experiencing horrible foot or knee pain that can't really be explained: say you do your daily walking and don't majorly twist your ankle or get your big toe injured by some mishap, get it checked out.  Letting the gout imp into your life and not doing anything about can be hazardous to your health (I'll try writing about a few examples and linking them here in the future).

What to Do if You Have Gout... 

If you do have gout and you haven't been given options by your doctor, you should start by drinking lots of water everyday (at least 2 liters!).  If you're a big guy (read: overweight) like I have been a decent bit of my life, you're probably going to have to clean up your diet a bit especially right now while you figure out what foods are going to trigger the pain.

When you talk to your doctor, try to get on allopurinol and an NSAID.  The allopurinol is not going to solve your pain that same day (in fact it will probably trigger an attack or two) but in the long run you'll thank yourself for doing.

Keep your chin up!  If you take these steps and keep in contact with your doctor you'll be okay.  I walk 5 miles a day these days and enjoy a quality of life that I didn't think possible during the dark days.

If you have a question or comment please leave one!  I'll do my best to answer and assist as best I can.

**This website is for informative purposes and should not be substituted as advice of a medical professional.  If you believe you have gout, I STRONGLY recommend scheduling an appointment with a medical professional and getting the problem checked out.

The Water of a Gout Sufferers Life: WATER!

I'm going with obvious information today, but if your new to gout maybe you need to hear this.  Drinking water is one of your best ways to prevent that horrid pain.  Don't believe me, then don't take my word for it?Google: gout water.  This is what I came up with on the front page, If you're going to leave my site, don't worry I'll wait for you:

Water May Wash Away Gout Attacks

Fighting Gout with Skim Milk and Water

NYTimes-Why Do I have Gout? "Many doctors who treat patients with gout advise them to cut down on purines and drink more water."

Water and Gout

Gout: What Can I Do to Help Myself - "Drink lots of water – between 1.5 and 2.5 litres a day (six to eight glasses) to help prevent kidney stones."

Water does a marvelous job of washing away the uric acid in your body, stopping it from forming into crystals that cause the horrid pain.  It should be your first line of defense against the feelings of pain, defenselessness, and fear of walking that can plague gout sufferers.  (In my opinion, Allopurinol with a big glass of water is your second one-after you are well committed to drinking the water.)

My personal goal of water consumption everyday is 3 liters.  I feel like a 50% bump on the always quoted 8 glasses a day aka 2 liters gives an extra oomph to wash out uric acid. Oh-and I should add-coffee seems to assist in lowering uric acid levels (According to the US National Library of Medicine National Institutes of Health). If that link wasn't fun to read you can see some of the same basic information in laymen's terms from MedPage Today.  According to that link tea didn't really have any effect on your uric acid levels, though as long as it doesn't seem to affect you I use it once in awhile to substitute a few mL to get up to my 3 liters for a day.

Of course there is a study out from Medicinenet and the American College of Rheumatology that basically contradicts that other article.  If you've read some of my other entries you know: gout is tricky and seemingly different people get attacks from different triggers.

If you're looking to increase or track your water consumption, might I recommend Argus to you.

For me personally: getting the heavy dose of daily liquids is far more of a help, the only major drawback is I have 5-6 trips to the restroom everyday.  As I recall in the beginning I would wake up once or twice in the middle of the night to empty my bladder as well.

Do you find coffee helps or trigger a gout attack?  How much water do you drink in a day?  If you drink as much or more than me you must go for a leak quite a bit!  Leave me a comment!

**This website is for informative purposes and should not be substituted as advice of a medical professional.  If you believe you have gout, I STRONGLY recommend scheduling an appointment with a medical professional and getting the problem checked out.