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Sorry this goes on a bit but I feel Its important for others new to gout who maybe looking for information
Hi all, this is my first post after reading this excellent site after my 3rd flare up!
My first was 9 months ago, I thought I had broken my big toe or something due to the pain and swelling, but I couldn’t remember stubing, banging or dropping anything on it so I was puzzled, I also have a REM type sleep disorder so thought I must have done it in my sleep. (nothing wakes me I go into a coma like state) anyway I went off to the hospitals A&E department where I was seen by a doctor, they xrayed it but no fracture or break, I explained to the doc that I had completely changed my lifestyle 4 months prior to this, I was jogging upto 2 miles a day, eating really healthy cutting out a lot of meat, and fatty foods etc and so he was puzzled as there was no obvious bruising etc.
He then advised a blood test to see if anything showed up such as infection, so I had blood taken there and then and he told me to phone my GP in around 3 days to get the results!
I phoned my GP and made an appointment, on the day I went along, explained what had happened etc and he checked my results, he told me it was gout as I had high uric acid levels and perhaps this would be my only flare due to my lifestyle change and I shouldn’t worry about it too much, then said Google the gout diet and stick to that but if I have another attack to go back, so off I went!
Then about 4 months later, my ankle swelled up and the PAIN was unbearable, I thought ok, another attack so made an appointment with my GP. I arrived at the practice in a lot of pain and barely able to walk, I saw a locum this time, I explained everything to him again and he just prescribed anti-inflammatory’s and booked me another blood test but with a liver function test and a few other things too. So I had the bloods taken the next day and was good to ring my GP in a couple of days, which I did, the receptionist told me the results were back in but there was no need for me to see the doctor as everything was ok.
Roll on to last Tuesday and bam a flare up in my left ankle and then 2 days later my right ankle, I couldn’t walk, the pain was intolerable again, like someone hitting my ankles with a hammer or something and as I write, my left ankle has eased off and the swelling has gone down and my right ankle is not so swollen and less painful and I can now walk again, I didn’t bother with the doctor this time as I thought it was a waste of time, I just took pain relief and the prescription anti inflammatory I was previously prescribed.
After reading the blogs and this forum though I will be on the phone Monday demanding to see a rhumatologist (can’t spell It sorry) and get diagnosed properly, I had no idea that my UA should be monitored how bad gout could get and what other damage it can lead too.
So sorry for going on BUT THANK YOU for this site!
woodster said:
?he told me it was gout as I had high uric acid levels and perhaps this would be my only flare due to my lifestyle change and I shouldn't worry about it too much, then said Google the gout diet
Google “medical negligence”
Seeing a rheumatologist might help, but you really need to sign on to a new GP. If anyone suggests Internet searching for medical advice they are a fool. If they purport to be a doctor, they are certifiable. Please post the nutter's name and location so that others in the land of cricket can avoid him.
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Uric acid control – the key to fixing gout – is not that difficult. Measure it regularly. Reduce it to safe levels with allopurinol. Simples.
Thank you for your reply Keith,
I shall name and shame if I don’t get a suitable response from my GP on Monday!
It’s quite a large practice and also a training centre for future GP’s, which in its self is quite worrying really!
The reason for seeing a rheumatologist is to have proper and full diagnosis through joint fluid, I take it this is done after an attack? There’s no way they’d get near me with a needle during an attack, that’s for sure.
I have also just found out that my grandfather suffered from gout so I’m 99.9% certain it is gout and is hereditary
I am 44 years of age and prior to my first attack I never had any problems, it only seemed to kick in after changing my diet and lifestyle to a more healthier one, which was the strange thing because when I did Google the gout diet I’d already been eating the right foods for the last 4 months anyway and couldn’t understand then why I had an attack!
The big problem with “gout diet,” and the reason for my scathing remarks about your GP, is that, once you understand gout, you realize there is no such thing. Especially in your case, where gout is likely to be hereditary. It's like referring to a “tallness diet” or a “blonde diet”.
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Gout diet usually refers to low purines, but dietary purines have a marginal? effect on gout. Most purines come from our own cell breakdown, so the main dietary effect is from excess weight, especially muscle mass.? Also excess iron is a considerable risk for gout.
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The professional response should be to engage the services of a qualified nutritionist who can assess current diet and make proper recommendations about improving diet in respect to gout. Unfortunately, nutritionists who understand gout are rare, but they should be able to come up with something if the risk factors are explained properly. In my view, advising a patient to Google “gout diet” is negligent, incompetent and ignorant.
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It is a good idea to consult a rheumatologist if there is doubt about the diagnosis, but best to insist on one with recent experience of gout, as some rheumatologists are simply not up-to-speed with current gout management, or may not have the necessary joint aspiration experience. The only pain from a joint aspiration (other than from incompetence) is the anxiety of expectation.
woodster…
as a quick note, I personally would avoid a rheumatologist. (assuming you are in the United States)
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they will most likely spend thousands of dollars on meaningless tests.? most rheumatologist as mentioned above do not understand gout.
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find a good GP, that is what worked for me.? my first GP was clueless, said I needed knee surgery…my second was much the same.? Then I was told find a rheumatologist, WOW that was even worse.? You have to call around, ask a ton of questions before you make the appointment though, so you don't waste your time.
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What is you UA Levels ?? This is also a very critical key area…looks like maybe no one told you yet ?
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Finally I was referred to a GP who worked with Gout and understood it.? Pretty simple, I am fixed 100%.? If you EVER want to talk to me, we can exchange phone numbers, as I am your same exact age, similar health, etc.
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DIET did not work for me, and I doubt it will work for you.
Hi toofast,
I’m in the UK my friend so visiting a rheumy won’t cost me anything, but thanks anyway mate!
Well it went sort of ok with the GP today, I say sort of because the doc I saw today was clueless, she asked me what I wanted to do, then preceded to tell me gout isn’t serious, there’s no long lasting damage that can be done. I stopped her there and said hang on a minute, I dont even know what my UA levels are cus no doctor has ever told me for a start and my bloods have never been fully monitored and your telling me that gout causes no long lasting damage, so why then have I read that it can if left unchecked damage joints and organs then?
She preceded well that’s in very severe cases with regular monthly flares!
I asked her why I haven’t been offered allopurinol?
Her respons: “well some people become uncomfortable with taking a tablet everyday when attacks such as yours are quite far apart!”
I lost the plot a bit at this point
So I’m now booked in for a blood test tomorrow with a whole host of tests AGAIN and I have been referred to a rheumy!
But I am seriously considering changing my GP after I have the appointment through for the rheumy!
toofast said:
… I personally would avoid a rheumatologist. (assuming you are in the United States)
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they will most likely spend thousands of dollars on meaningless tests.? most rheumatologist as mentioned above do not understand gout.
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I think you are a little too fast advising a gouty not to see a rheumatologist and that “most rheumatologist(s) as mentioned above do not understand gout.”
You are very wrong! If any doctor knows about and/or understands GOUT, that is a RHEUMATOLOGIST. It's most GP's who know little or understad less about gout.
My research to date indicates that there is a small proportion of general doctors who have studied gout, and are capable and experienced in managing it.
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On the other hand, there is a small proportion of rheumatologists who believe gout is a self-inflicted condision and they have no time for it, and no experience diagnosing it correctly.
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The only answer I can find to the problem of getting stuck with a doctor who knows too little is to read GoutPal.com, discuss the problem here, then instruct your doctor clearly and precisely, or find a new one.
hansinnm
I think we are all entitled to opinions?and my opinion, (at least in the US) is that a HUGE percentage of rheumatologists look at gout as a super easy, simple, no problem disease.? They LOVE the challenge of the complexities of RA, and in fact I've personally had 3 rheumatolgists say NO WAY do you have gout.? Even with UA of almost 10.? They've then spent thousands of dollars in tests, trying to prove I have RA and not GOUT.
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In fact one of the teaching heads of ALL rheumatologists in the US, made a statement that gout is basically beneath us and any run of the mill GP can treat it.?
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Getting lulled to believe that Rheumatologists are better at treating gout is a VERY DANGEROUS and EXPENSIVE belief?and may cause more damage than good.
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So, my statement was just that no sense going to a self proclaimed high end doctor.? As most GP's really don't get gout either.? You have to be educated, know the facts, then SEARCH for a regular old GP who understands.?
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Keith nailed it above?”The only answer I can find to the problem of getting stuck with a doctor who knows too little is to read GoutPal.com, discuss the problem here, then instruct your doctor clearly and precisely, or find a new one.”
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