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.

The Gout Sufferers Cheat Sheet: The New York Times Gout Report

Are you looking for comprehensive gout info?  Look no further than this in-depth report from the New York Times.  All of the scientific research on gout here is 10 years old or less.  No matter your political opinion on the New York Times, the information contained on this page comes from medical professionals whose jobs are assisting people like myself and some of you who are only seeking to improve your quality of life.  In the future on this site, I will be referencing this page quite a bit.

For today, I want to highlight a couple of interesting things I found reading this page my first time.  I'll come back to this page in the future, but for today:

Dietary Considerations

"While meat and certain types of seafood and shellfish do produce high levels of purines in the blood, research has suggested that not all purine-rich foods are associated with gout. Eating a moderate amount of purine-rich vegetables (spinach, cauliflower, mushrooms, legumes) does not appear to increase the risk of gout." [1]

Some people use a chart to determine their diet to avoid gout.  I am going to tackle diet at sometime or another on this blog, but for right now, allow me to turn off my serious gout blogger mode and say this:

(joke over)...As I chat with other gout sufferers I find more and more that the foods that trigger gout for some people don't trigger it for others.  Science seems to strongly suggest that the intake of purine-rich vegetables is okay.  I'd go as far to suggest to you that it's great to consume any vegetable you enjoy because promoting a healthy lifestyle could help you to:

Maintain a Healthy Weight

"A supervised weight-loss program may be a very effective way to reduce uric acid levels in overweight patients. Crash dieting, on the other hand, is counterproductive because it can increase uric acid levels and may cause an acute attack."[1]

Another reference to how gout is a tricky condition.  Do try to lose weight if you are a sufferer, but don't do it by going crazy with the weight loss-cause you could just trigger another attack.  So if the veggies aren't making your toe, ankle, knee, etc etc etc hurt eat 'em up!  Develop a healthier lifestyle to avoid the pain.

Finally...

I hope you'll take time to read through the report for yourself.  Educating yourself about the horribleness that is gout is one of the best ways to take preventative measures against that awful pain, and that report is a VERY good place to start.  

Do you have a helpful resource concerning gout?  Let me know in the comments section! 

**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: 1-http://www.nytimes.com/health/guides/disease/gout-chronic/print.html]

Medicine for Gout Series, Entry 1: Allopurinol

Today I'll begin a blog series on the medicines people take for gout.  Some of them will be treatment when you have flareups and others will be preventative.  For medicines I've taken, I will include my feelings on the medicine and other concerns I've heard from others and found on the internet.  For medicines I haven't taken I hope to inquire with fellow sufferers for input on how the medicine works, side effects, and dosing information.

Why did I choose to discuss Allopurinol first over other medications?

It wasn't difficult for me to choose Allopurinol to be featured first.  This medicine has had a very positive effect in my life and many other gout sufferers. I can remember a year ago from the day I'm writing this, I was not doing well.  Around this time the attacks were coming 3-4 times a month and rather blurring together not giving me any opportunity to feel good between attacks, walking for anything other than necessity was out of the question, and effects on my mental health that I didn't recognize or acknowledge were having their toll on me.

Now on February 21, 2014, I'm proud to report that I've been able to make walking for fun and exercise a near daily thing.  The last week I've made walking 10k (about 5 miles per day) a personal goal, and I've accomplished that goal every day (some days beating it by more than 3000 steps!)  The reason for this, as best I can tell, is my daily dosage of 100 mg of allopurinol.

What does/doesn't Allopurinol do?

Some reading this will be surprised to learn that Allopurinol does NOTHING to stop a gout attack.  From everyone and everything I've heard including this succinct website from Arthritis Research UK you should start taking allopurinol when you're clear of your gout attack.  I'll discuss why shortly.

Another page on Arthritis Research UK has this to say about how it does work:

Allopurinol targets an enzyme called xanthine oxidase which is involved in producing uric acid. By reducing the amount of uric acid produced in the body, allopurinol helps keep the urate in the blood at the correct level. - See more at: http://www.arthritisresearchuk.org/arthritis-information/drugs/allopurinol/what-it-is.aspx#sthash.MbiR2ury.dpuf

By targeting an enzyme which helps produce uric acid (the source of gout), allopurinol can put a stop on chronic gout attacks.

One note though:  if you begin taking allopurinol lookout!  It can bring on acute gout attacks in the first few months of use.  I was no exception to this rule.  I remember my first 2-3 months of taking allopurinol I had gout appear in my big right toe (a place it had never really affected me).  Because of this many doctors will also prescribe you an NSAID like colchicine, arcoxia, or instruct you to take ibuprofen for these attacks.

Dosage

Most gout sufferers will start on 100 mg of allopurinol.  For many this will not be enough to solve your problems, but you will need to get used to the effects of allopurinol at the beginning.  In follow-up doctors visits, the doctor can up your dosage; you should always be careful with taking allopurinol because there can be considerable side effects.

Side-Effects

Unfortunately, this great medication does have some difficult side-effects.  One that many people will experience is a dermatological issues. In many people allopurinol will cause some slight rashes, and in others it can cause a fatal issues (I'll quote wikipedia here):

Allopurinol is one of the drugs commonly known to cause Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TENS), two life-threatening dermatological conditions.^[21]

Because of these issues when going on allopurinol it's a good idea to get checked by the doctors.  If you find any issues with your skin you should let your doctor know as soon as possible so life-threatening conditions can be ruled out.  Other than these issues, wikipedia's gout side-effect entry has a few other very rare conditions.  If you're worried about these side effects speak to your doctor.

Complications with Allopurinol?  There's still hope!

If you happen to be one of those who does have problems with taking allopurinol, you can still get good preventative medicine.  I will be highlighting these other medicines in the future: especially feboxostat.  

In closing:

If you have been considering allopurinol to curb your gout, I highly recommend it.  It has made a major difference in my quality of life.  

Do you have any other questions about allopurinol?  Do you take allopurinol-if so what is your dosage and story?  Leave a comment and I'll do my best to address it.

Other Posts in the Medicine for Gout Series:
Colchicine

**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: 1- http://www.arthritisresearchuk.org/arthritis-information/drugs/allopurinol/what-it-is.aspx

2- http://en.wikipedia.org/wiki/Allopurinol]

Positive Web Communities for Gout

You might be asking yourself: Why is this guy making a gout blog?  The answer is for you!  You, the gout sufferer or friend/family member want more information.  Even though this disease has been around for a long time

When I was diagnosed with gout, the doctor suggested to me to look online for the "diet for gout sufferers".  The unfortunate thing is that if you've looked around longer than a few minutes you will find that one persons recommended diet differs from another's.  The same goes for successful medicines, and other preventative measures such as the usefulness of things like cherries/cherry juice and baking soda.  

At this point on of the best ways to troubleshoot your gout problems, other than this blog, are to find communities of people who have the same concerns.  So below you will find some communities for people with gout that I have found useful:

Reddit /r/ Gout: http://www.reddit.com/r/gout/  When I was diagnosed with gout, I had already been a lurking redditor for almost a year.  This community is full of great advice and other people who have been through many of the things you might be going through.  Reddit is a useful service to sign up for with many boards that are relevant to your interests, and the community encouragement and support is strong.

Gout Pal: http://www.gout-pal.com/gout-news/ I have used gout pal before just through googling my own specific problem and finding a topic from it. The advantage to gout pal is that unlike reddit, it is a forum just dedicated to just gout suffering, the drawback is that it doesn't have the organization of Reddit and has very poorly placed ads that occupy too much space.  Otherwise I have found the people there friendly and helpful to people's inquiries.

Topix Gout Forum: http://www.topix.com/forum/health/goutTopix Gout Forum is a little more of what I would consider to be drive-by message boarding.  Many people come there to post one question about their problem and then don't stay around after their inquiry is answered.  The ads can also grate on you a little bit.However there are some topics that are frequented and have stayed active for a few years now. Even a quick glance can show that there are community members there who are dedicated to helping others through their difficult time.  

If you suffer from gout and aren't a member of a gout support community, I recommend finding one.  The ones mentioned here are a great place to start and will be able to quickly address your issues.  Good luck to you all!

Do you participate in an online gout forum or have a comment about one of the aforementioned one?  Let us know here!

Gout Medical Treatment Research

Another post and another topic:  the future of gout prevention and treatment.  We will again look at at the National Institute of Arthritis Musculoskeletal and Skin Diseases website, a very useful resource for learning about gout.  

As I've stated before, gout is a tricky condition, for example, if you are overweight you are more susceptible to developing gout and after you've developed it if you lose that weight you can often get a flare up then. What a horrid place to be in!  Fortunately in my mind the future of gout treatment is looking up!  Let me tell you why:

In my readings, I've learned that gout is rare in animals.  Scientists do believe, however; that poor Sue the Tyrannosaurus  did suffer from gout. Gout is rare in most animals because they have an enzyme that breaks down the purines in their body.  New medicines like Krystexxa help humans to do the same, though this treatment has just hit the market and is very expensive though I am personally hopeful that in the future we will see cheaper versions of this medicine that will be easier to take.  

Let's look at the NIAMS websites discussion on the future of gout treatment:

What Research Is Being Done on Gout?

Scientists are studying:

• Which NSAIDs are the most effective treatments for gout
• Optimal dosages of medications for gout
• New medicines that safely lower uric acid in the blood and reduce symptoms
• New therapies that block a chemical called tumor necrosis factor
• Enzymes that break down purines in the body
• The role of foods and certain vitamins
• The role of genetics and environmental factors
• The interactions of cells involved in acute gout attacks.

Scientists are also studying the role of genetics and environmental factors in hyperuricemia and gout. [1]

 Gout sufferers and friends and family, I believe there is hope. Have you heard any news concerning gout research or treatment?  Leave your comments here!

**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.

[Source: http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp]

Preventive Measures Against Gout

For gout sufferers, preventative measures are among the most important bits of information you could ever have as they will stop you from future pain.  However; You may be suffering from an attack now and wanting information about how to stop your current attack, I would recommend starting here though there might be other posts on this blog in the future that talk about treatment.  

Let's again return to the National Institute of Arthritis Musculoskeletal and Skin Diseases website and learn what they say about preventative measures:  

What Can People With Gout Do to Stay Healthy?

Some things that you can do to stay healthy are:

• Take the medicines your doctor prescribes as directed.
• Tell your doctor about all the medicines and vitamins you take.
• Plan followup visits with your doctor.
• Maintain a healthy, balanced diet. Avoid foods that are high in purines, and drink plenty of water.
• Exercise regularly and maintain a healthy body weight. Ask your doctor about how to lose weight safely. Fast or extreme weight loss can increase uric acid levels in the blood. [1]

Most experienced gout sufferers can attest that preventative measure #1 is the drink water.  Some doctors agree with this as well as can be seen here.  I personally make a goal to drink 3 liters of water a day which is more than half a gallon (1 gallon = 3.785 liters source: google).  I have personally seen my gout attacks go down.

Many of the gout sufferers that swear by water drinking would also suggest preventative medicine that can be prescribed by your doctor.  I take allopurinol, which reduces uric acid.  Some of the main side effects of allopurinol that I have experienced include: some skin rashes and initial gout flare ups in the first 2-3 months of use.

This second side effect shows just how much of a tricky condition gout can be, i.e. taking a medicine to prevent it makes you get it.  

Other side effects are more rare but fatal.  So scheduling follow-ups with the doctor would be advisable.  If patients show adverse effect to allopurinol there are other preventative medicines they can take like febuxostat.

One final note:  future discussion on this blog will include avoiding purine high foods, though this subject is another example of just how tricky a condition gout is. Until then: what are your preventative measures against gout?  Let 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.
[Source: http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp]

How is Gout Treated?

Many people who visit this site are probably hoping for assistance with relieving their gout.  The pain your in probably means that you're looking for a quick fix.  I'll begin with more help again from the National Institute of Arthritis Musculoskeletal  Skin diseases website, then I will give you some of my own experiences. 

If  your experiencing a gout attack the way to treat it according the site is:

How Is Gout Treated?

Doctors use medicines to treat an acute attack of gout, including:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroids, such as prednisone
• Colchicine, which works best when taken within the first 12 hours of an acute attack.

Sometimes doctors prescribe NSAIDs or colchicine in small daily doses to prevent future attacks. There are also medicines that lower the level of uric acid in the blood. [1]

 When I had my first experience with gout in China, the doctor didn't know what was wrong with me, but gave me sodium diclofenac, which did the job.  I remember in my first attack it took 2 days for the pain to clear up.  It was over the counter in China, and since I didn't know what my condition was for a long time, I would take this to clear up the pain when I would have a flare up.  I don't recommend doing this because it didn't do anything to clear the condition, rather it slowed and cleared up the symptoms until the next attack.  

This was okay at first, as the following year I still only had 3-4 attacks, the problem was that by 2013 I was having attacks every week or two.  Walking on a gout attack is horrid and something I would only wish upon my worst enemy.  

More recently I began taking colchicine for the pain.  Colchicine works most of the time, but is in general poisonous to the human body.  I will have a future blog about colchicine and will link it here.  You really must be careful with it

Another medicine I have taken for gout is Arcoxia I found this medicine to be very helpful.  The doctor who diagnosed me with gout gave me this medicine and really takes the gout away very quickly.

What medicines do you take to relieve gout?  In my next post I will talk about preventative measures and how they changed my life.

**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.

[Source: http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp]

How is Gout Diagnosed?

I'm going to start with my own story of how I came to be diagnosed with gout.  After which I will again share some material from the National Institute of Arthritis Muscluoskeletal and Skin Diseases website.

In September 2006, I moved to Fuzhou, China.  When I went I was overweight (near 300 lbs).  In my first few weeks in China, I walked everywhere and climbed the local mountain.  The day after walking up the mountain steps, I had some of the worst pain I had ever experienced in my left foot.  I was unaware at the time that I was experiencing my first gout attack. 

For 6 years I would experience similar pain.  The whole time through doctors visits in China, I thought I had a problem with my foot shape thinking my arches were too high or that I was walking incorrectly. Over time the pain appeared in different places on my left foot and sometimes even in my right foot and knee. The pain was sometimes a heated spot that was right near the surface of my skin.

Finally in May, 2013, I was introduced to a doctor that gave me the true diagnosis.  I will tell you my story, but first let's look at how gout can be diagnosed by a doctor from the aforementioned NIAMS website.: 

How Is Gout Diagnosed?
Your doctor will ask about your symptoms, medical history, and family history of gout. Signs and symptoms of gout include:

• Hyperuricemia (high level of uric acid in the blood)

• Uric acid crystals in joint fluid

• More than one attack of acute arthritis

• Arthritis that develops in 1 day, producing a swollen, red, and warm joint

• Attack of arthritis in only one joint, usually the toe, ankle, or knee. [1]

To confirm a diagnosis of gout, your doctor may draw a sample of fluid from an inflamed joint to look for crystals associated with gout.

My doctor asked me about diet, family history with arthritis and similar conditions, then had me to a blood test.  My blood test returned a high uric acid reading and he concluded that I had gout. The six year mystery had been solved, and I was ready to move on to preventative measures.

In future posts, we will discuss how gout attacks are treated, and then how to stay healthy and try to prevent it.  

Do you have gout?  What is your diagnosis story?  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.

[Source: http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp]

What Causes Gout?

Many of you searching this page might be wondering how gout is caused.  I know that in my personal experience, I had no idea until a doctor told me.  Today's post will try to explain a bit of the causes of gout.  Again we'll explore the website of the National Institute of Arthritis and Musculoskeletal and Skin Diseases website for some more information about this horrible condition.

What Causes Gout?
Gout is caused by the buildup of too much uric acid in the body. Uric acid comes from the breakdown of substances called purines. Purines are found in all of your body’s tissues. They are also in many foods, such as liver, dried beans and peas, and anchovies.
Normally, uric acid dissolves in the blood. It passes through the kidneys and out of the body in urine. But uric acid can build up in the blood when:

• The body increases the amount of uric acid it makes.

• The kidneys do not get rid of enough uric acid.

• A person eats too many foods high in purines.

When uric acid levels in the blood are high, it is called hyperuricemia. Most people with hyperuricemia do not develop gout. But if excess uric acid crystals form in the body, gout can develop.
You are more likely to have gout if you:

• Have family members with the disease

• Are a man

• Are overweight

• Drink too much alcohol

• Eat too many foods rich in purines

• Have an enzyme defect that makes it hard for the body to break down purines

• Are exposed to lead in the environment

• Have had an organ transplant

• Use some medicines such as diuretics, aspirin, cyclosporine, or levodopa

• Take the vitamin niacin. [1]

To sum up: gout is caused by a buildup of uric acid in your body which is caused by a compound called purines.  Many purines occur naturally in your body, but some are found in the foods you eat.  
When your blood gets too high of a concentration of these purines, they can crystallize and lead to gout. Emphasis on can because in some people this buildup does not affect them.  If you have gout today, you've unfortunately won the worst lottery ever.

 Do you have any questions or comments?  I want to be a help and resource to your questions.  If you leave a comment I will do my best to answer your question.

In our next post I will discuss how gout is diagnosed and my own personal account of how I learned I had gout.

**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.

[Source: http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp]

Why does my foot hurt so badly? Do I Have Gout?

How I wish this post existed for me back in September 2006 when I had my first attack.  I didn't even find out I had gout until early 2013.  That was near seven years of pain popping up at the worst times and near ruining my life.

Let's start with some simple advice that will go at the end of all future blog posts:  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.

A Website for a Good Start: What is Gout

The National Institute of Arthritis and Musculoskeletal and Skin Diseases has an informative page here that gives fast facts on the symptoms of gout.  Basic gout facts found on the linked site include: 

Gout is one of the most painful forms of arthritis. It occurs when too much uric acid builds up in the body. The buildup of uric acid can lead to:

• Sharp uric acid crystal deposits in joints, often in the big toe
• Deposits of uric acid (called tophi) that look like lumps under the skin
• Kidney stones from uric acid crystals in the kidneys.

For many people, the first attack of gout occurs in the big toe. Often, the attack wakes a person from sleep. The toe is very sore, red, warm, and swollen. 

Gout can cause:

• Pain
• Swelling
• Redness
• Heat
• Stiffness in joints.

In addition to the big toe, gout can affect the:

• Insteps
• Ankles
• Heels
• Knees
• Wrists
• Fingers
• Elbows.

A gout attack can be brought on by stressful events, alcohol or drugs, or another illness. Early attacks usually get better within 3 to 10 days, even without treatment. The next attack may not occur for months or even years. [1]

My personal recollection is that my first and certain other attacks of gout felt like some of the worst pain ever.

Ever had swelling in your foot, knees, elbows, or wrists and felt like it would hurt less if you cut off that body part?  I recommend seeing your doctor as you could very well have gout!

In future posts I'll explain some of the science behind this horrible condition, how a doctor diagnoses this condition, how to treat it, and the future of treatment.  

[Source: http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp]

First post

This is a new blog site.  I would like to put a gout resource on the internet so that suffers like myself can find a place to solve their horrible problem because I find that most internet resources concerning gout are often contradictory and difficult to process.   As a gout sufferer of 6+ years, I have at least a small understanding of the pain you're going through.  I hope that the information you find here will assist in you quickly finding a solution and ending the horrid pain.