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I just happened to stumble upon this forum while researching gout. I had my first case of gout (doctor diagonsis) on July 4th. It went away in two days with just taking tylenol as needed. Four weeks later I fell and broke a bone in my right leg. Naturally all the strain of moving around has been on my left leg & foot. About 5 days after the break my big toe on the left foot went beserk. I couldn't sleep one night because of the pain. Went to a foot and ankle specialist & he determened it to be gout. Blood work showed uric acid level of 8.9.
Since I am being treated for a bad kidney due to a large kidney stone my kidney doctor will only allow one (1) colchicine tablet a day for now. Today is the 4th day – 4th tablet. Most of the extreme pain is gone. It seems all I have left is the joint damage pain & some soft tissue damage pain. Does this sound right? As of yesterday I was able to walk and actually bend my toes on the foot that had gout. I'll be in a cast for another 4-5 weeks and need to keep the gout away so I can walk.
My doctor wants me to wait a few more days before doing additional bloodwork because of the low dosage of colchicine I'm taking.
After doing a few days of research I plan to start the apple cider vinegar treatment and I have been eating cherries. Any other suggestions. Would like to remain on home remedies if they work. What a nasty illness.
Hi headusher. I've moved this to a separate topic (was lingering symptom question) as you have some special requirements.
I think it is important, whenever gout is complicated by another disease, to seek the advice of a gout specialist. This would usually be a rheumatologist. In your case, it is important to find one who has good experience with gout in kidney patients.
I do not think colchicine can be effective at such low doses, so I would think an alternative would be more use. 2 to 4 days is the usual period for most gout attacks. Yes, they can last longer, especially some residual pain and swelling, but it sounds to me like the worst is over, for now.
I wonder if the nature of the kidney stone has been identified. If it is a uric acid stone, then allopurinol is the thing to get rid of it. And that is what you need to get uric acid down to manage your gout. You need a 4mg/dL reduction in your uric acid and home remedies just won't cut it.
You need to start treating the hyperuricemia which is the cause of gout (and also urate kidney stones.)
Having a kidney stone is no reason not to take appropriate amounts of colchicine, nor a reason to avoid allopurinol, which you are likely to need on a daily basis.
(If you PASS that stone, be sure to save it for analysis…that's VALUABLE information.)
With a stone the only thing you might want to avoid is probenecid…a drug that causes extra excretion of urate.
I agree with gout pal, a single colchicne a day is not likely to have much effect on an attack in progress.
When to take Tylenol (acetomenophen, paracetamol) for a gout attack: NEVER. It is useless and damaging to the liver.
(Send me a PM and tell me where you usher…
)I may have mislead a little ablout my kidney stone. I had a kidney stone that had to be blasted away using ultrasonic shock waves a while back. My kidney doctor says the affected kidney is not functioning 100% which is a result of several kidney stone episodes and untreated high BP for many years. So he is very cautious at this point in time regarding anything that will affect kidney function. I have an appointment with him this week to review what happened. After new blood tests and unine tests I'll see what he suggests.
My gout foot is doing very well. I was finally able to get a dress shoe on it this weekend and venture out. The only sore spots are the bottom/side of the big toe and the pad under the front of the foot. These are the areas that take my weight when I hobble around. Every now & then the area that was very sore gets itchy so I think the healing process has begone. Even with the low doses of colchine it seemed to have worked fairly fast. I've backed off many of the suspect foods for now and stated some of the home remedy treatments (applle cider vinegar, cherries, elation) etc. It never hurts try and it definitely hurts not to!!!
I'll keep you updated.
headusher
Too bad if they didn't analyze any of the residue from those stones. Maybe we can PRESUME they were urate?
Why no allopurinol?
zip2play said:
Too bad if they didn't analyze any of the residue from those stones. Maybe we can PRESUME they were urate?
Why no allopurinol?
Heh, heh.
This reminds me of a Siemens presentation that I watched online recently. A technical presentation / sales pitch of the DECT technology we have spoken of here before, that allows visual imagery of uric acid crystals in the body. This particular pitch was for an earlier version that could use a non-invasive scan to differentiate between urate stones and others. The pitch was the cost and time savings that could be made by identifying urate stones (reliably dissolved with allopurinol, water, and maybe a pinch of bicarb.) from others that might need surgery.
Imagine the audience looking askance: “What is he on about? We just blast the buggers and hope for the best.”
Saw my kidney specialist yesterday. He wasn't very happy with me since my follow-up was supposed to be last October!!! He doesn't want me to take anything for gout except Tylenol until he sees my bloodwork results, uric acid level and urine analysis. He said as long as my gout symptoms have gone away I should stop the colchicine and only use it as needed. He also told me that Allopurinol shouldn't be used until all the gout symptoms are gone for 2-3 weeks otherwise Allopurinol can start a new attack. Right now I'm pain free except for the strain put on my left foot because of the walking cast on the right leg. Should have my bloodwork done tomorrow and then we'll see what he says. In the meantime I'm on the cherry and apple cider vinegar regimen and my gout appears to be gone for now.
My friend who had a real bad gout attack last year was telling me for the last week that he swore that the cherry diet worked since he hadn't had another gout attack since he started eating cherries. Last night I ran into him & he got a gout attack in the morning. As he hobbled away I could see that he wasn't a very happy fellow.
Yep, the cherry diet works very well…until it doesn't. Probably half the people now on allopurinol had some success with cherries…til they didn't.
(Even I tried them but the diet costs a FORTUNE compared to allopurinol)
Were I in your shoes, I would continure taking a colchicine a day, until I got on allopurinol and then for a couple weeks more. Your doctor is showing a failure of logic when he says you cannot start allopurinol becasue the risk of relapse is too great and then denying you the regimine that is likely to prevent an attack in the next two weeks. I'm not saying you shouldn't listen to your doctor…but…
Besides that obliterated kidney stone, do you have any other kidney issues.
Let us know your bloodwork numbers when you get them.
headusher said:
He also told me that Allopurinol shouldn't be used until all the gout symptoms are gone for 2-3 weeks otherwise Allopurinol can start a new attack.
This is against everything I've ever read about allopurinol. There are many accounts of allopurinol triggering a gout attack, as with any uric acid lowering therapy. This can happen in 2 days, 2 weeks, 2 months, or (if you really don't get your uric acid numbers right) 2 years.
It is not the medication that does it, it is the fact that uric acid is lower, therefore old crystals start to dissolve, therefore they shed the coating that the immune system tried to kill them with, therefore the immune system sees them again, therefore you may get a gout flare.
You need to refer your doctor to Allopurinol Medication: Why It Hurts To Get Rid Of Gout.
The only explanation that I have ever seen for delaying allopurinol is that the patient is unlikely to continue with it if it does not improve their gout pain. A good explanation and some appropriate pain relief would forestall such a patient reaction.
Got my bloodwork results but do not see anything that says Uric Acid. It looks like it only has to do with kidney function. Are there any other indicators besides uric acid that has anything to do with gout? I'll need to ask my doctor what happened to the uric acid testing.
No, there is nothing related to goutl except SERUM URIC ACID. When I see the doctor I tell him SPECIFICALLY what to add to “the basic bloodtest” and uric acid is always one of these (Lp(a) is another good one to add…a good measure of heart risk. CPK and homocysteine also wise, ANA if lots of joint pains, etc.)
Uric Acid was commonly done on a “Chemscreen 25″ but I notice it must be asked for separately. Maybe your doctor isn't aware of the change.
Best go back in and have another blood draw…at HIS expense! Anyone with kidney issues should be concerned about hyperuricemia.
How is your kidney function? What kidney issues have you had besides that stone?
Same issue that were discovered over a year ago, high Creatinine –1.66. Should be a max of 1.46. My doctor doesn't think the creatinine level is too serious because the BUN/Creatinine Ratio is well within the good range of 15.7. He says my kidney damage is due to uncontrolled BP for 30 years & kidney stone damage. Once he was able to get my BP under control he was happy. He thinks my kidney numbers should remain pretty constant as long as my diastolic # is 80 or under which it has been for almost a year now. That's why I need to go every 2 months for bloodwork.
And there was something new. It was Urea Nitrogen @ 26. This was 1 point out of the range on the high end. Not sure if this means anything. All the other numbers were well within the nomal range.
I have a strange hunch he's diddling you to keep you coming back with more checks. He did his work and demolished the stone and that should probably be the end of it. I am not an expert but your kidney issues seem trivial and the stone was probably caused by high uric acid. Your kidneys seem to be filtering just fine and high creatine is often the bailiwick of muscular men.
My theory: if you hit your finger with a hammer and go to nephrologist, he'll tell you the pain is caused by your kidneys. If you see a chiropractor he'll say scoliosis.
Any GP can treat blood pressure. And if gout is your issue and you want a specialist, see a rheumatologist.
What meds are you taking for your BP. If a thiazide, STOP!
Just taking Altace, HCTZ and Labetalol. All in the most lowest dose possible. Been on HCTZ and Labetalol for 20+ years. Just started Altace about a year ago. Altace is what brought my BP down to where my kidney doctor wanted it.
I like your suggestion about seeing a rheumatologist.
Just got off the phone with my kidney doctor's office. He is calling in a prescription for Allopurinol this afternoon. He will check my uric acid level when I go back in October. Since I just had my uric acid level checked 2 weeks ago he said a re-check could wait. It was 8.9 two weeks ago.
Any suggections on taking Allopurinol? This will be my first time for this medicine.
Stop the HCTZ it is a potent cause of gout…it caused mine.
If you need a diuretic, and many of us do, furosemide (Lasix), a loop diuretic works very well and has less proclivity tio retain uric acid. It took me 10 years on 50 mg HCTZ to develop gout, but develop it I did.
Lasix works very well to lower BP.
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