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Guys,
Very interesting reading and I've learned some useful things, but my experience of colchecine is that it doesn't realy cut the mustard (doesn't seem to work on me)!
The pain of this awful desease is horrenous and I sit currently typing with heel pain, which started first in the ankle … i went to A&E because I thouhgt I'd broken something somehow, but soon made the link to my enemy “gout”! which has now progressed into the bunion as usual since yesterday. Damn it!
I am not on allupurinol but I am ready to wave the white flag after a year or so of on and off pain (some very severe that usually keeps me off work) so, I am going to make an appointment with the docs v.soon!
I love my beer but I guess those days might be are over now! Does anyone find this is manageable on allupurinol?
Thanks for the read all?
Rgds … Muzz
Hi Muzz. Hope you don't mind me moving your post hear, but the “Lingering Gout Symptoms” thread is getting rather long, and your post adds issues worthy of their own discussion.
I'll waffle on a bit until zip2play comes in with some succinct one-liners.
On the colchicine, what sort of dose did you take?) It seems to work well – to the point that if it doesn't, there is a suspicion that something other than gout is at work.
Have you had a gout diagnosis confirmed by analysis of the joint fluid? Goutlike symptoms can be caused by other crystals, e.g. calcium crystals in pseudo gout, and by other invaders as in septic arthritis.
If it's definitely gout, then uric acid control is the only answer. Allopurinol should allow a few beers, though there is strong evidence that a switch to wine is better for gout.
Colchicine worked for me.
You have to take it untill you feel very sick and nauseous. Took about 5 days but I cant remember the dose I took I think it was 4 a day
That finaly made me well enough to start taking alopurinol.
I can drink some beer now but only at weekends and in moderation.
You soon know when you have had too much you can feel it .
I can now tell my uric acid level is high without a test
Muzz,
Like GP implied and pagey stated flat out, IF you are well into an attack you MUST take enough colchicine to stop it. Two or 4 a day will have little effect on an attack that has been allowed to go on for several days.
I wish everyone wasn't so afraid of getting on allopurinol once they got a firm diagnosis of gout, especially with THE TOE FROM HELL. It's not “waving the white flag” or “throwing in the towel,” but rather beginning treatment with a cheap and extremely effective LIFE SAVING drug with almost no untoward side effects. I doubt if 2% of the pharmacopeia can make those claim. But then I guess nobody knows the horrific pain of PODAGRA until he experiences it first hand and only then does it seem obvious that taking a harmless pill once a day is a small price to pay NEVER to experience it again.
A parallel might be a person who resists taking daily aspirin or a statin drug UNTIL he has his first heart attack…how much better off he would have been had he instead PREVENTED that attack.
Muzz, you should be able to drink beer in moderation with allopurinol but beware any amounts like a 6 pack a day for an extended period of time…that can overwhelm allopurinol. But if it gives you a problem, I find that the “hard stuff” is easier on gout. Aim for a blood uric acid level below 6.0…or even 5.0.
Allopurinol can cause kidney failure. It is very reasonable to find other solutions. Gout is extremely painful but the pain goes away. Its not immediately life threatening. There is time to loose weight, exercise, and change ones diet. For me, I see it 180 degrees opposite from you. Why would I risk kidney failure just to avoid a couple attacks in the next 12 months while I adjust my diet and exercise?
On the contrary, allopurinol can significantly improve kidney disease.
There is time to loose weight, exercise, and change ones diet.
I see three weakness to this approach:
1. Taking allopurinol does not make it impossible to lose weight, exercise and change one's diet…if it works then one can cut the allopurinol back gradulally, even to zero if possible.
2. Losing weight, exercising, and changing one's diet usually does NOT prevent further attacks. In fact, losing weight often PRECIPITATES attacks, as does exercise. MANY people have found that all their good works are futile in the face of a genetic mishandling of uric acid. Your only prayer is a VERY restrictive diet…FOREVER!
3. Once you have had a gout attack or two, your chances of getting rid of crystals is close to zero without higher doses of drugs than any of us take. Once those crystals are present your ability ot carry a supersaturated serum is completely gone and thus somebody who has NEVER had an attack may stroll aroung pain free with a UA of 8.0 but any gouty WILL have another attack.
Excellent points, zip2play, and ones which strike at the heart of what I see as a chance to improve the management of gout.
At the moment, most gout sufferers are offered 2 choices – go on a restrictive diet and lose weight, or face a daily pill for the rest of your life.
The psychology makes the gout patient:
- Think his gout is avoidable by diet (which it often isn't).
- Think medication is poor second choice to lifestyle changes, and it's all his fault (when in many cases it is simply genetics).
I am not suggesting that better diet and more excercise is a bad thing, just that they might not work, and even if they do, it is much better to offer a third choice – support the lifestyle improvement with uric acid reducing treatment for as long as necessary.
As you say, it might be possible to reduce medication to zero. If not, the patient has a much lower exposure to the dangers of uric acid. Lifestyle improvements supported by uric acid reducing drugs is a win-win strategy that should be the first choice for managing gout. We now have to convince the world.
By the way, if anyone has seen this strategy proposed or supported by any health authority, please post details here.
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