- This topic has 11 replies, 4 voices, and was last updated 10 years, 2 months ago by
.
-
Posts
-
I am heading to the doctor today. My gout which I thought I had mostly under control has recently entered the chronic stage with lumps forming in my elbow within a 2 day span. Can anyone tell what to expect.
Ah, the dreaded elbow tophi. How is one expected to act like a gentleman with lums on the elbow?
I am treating mine to a 900mg per day blast of allopurinol. Too early to report progress yet, but I'll let you know.
zip2play said:
How have you been treating your disease over the years?
I took allipurinol for years until?my doc and i discovered it drove my liver ezymes up. so i quit taking it 15 years ago and moslty had it under control with the occasional?annual attack. now that i am older it seems to be happening more often. checking into urolic but i suspect it will have the same result to my liver. I guess i am looking at a complete life style change?? no nothing of all things good??
Keith (Gout Admin) said:
Ah, the dreaded elbow tophi. How is one expected to act like a gentleman with lums on the elbow?
I am treating mine to a 900mg per day blast of allopurinol. Too early to report progress yet, but I'll let you know.
Is surgery even a consideration? my doc doesn”t like it because of infection. However until i get the uric acid under control its probably a waste of time. this is the worst and highly embarrasing. my doc put on a 5 day blast of predisone and antibiotic because it looked to be getting infected. it has now softened up but not going away. Thoughts?
Surgery is a last resort to clear up infected tophi, or ones that are impairing mobility. It is only a temporary solution, so if allopurinol is definitely out, then you must consider uloric or probenecid, or a combination of both.
You do not say what your uric acid level is, but you need to get it to 5mg/dL or below. Similarly, you do not say how bad your lifestyle is currently, but even stringent lifestyle changes rarely improve uric acid level beyond 2 or 3 mg/dL.
Remeember too Rsholl, that liver damage shows LARGE swings in liver enzymes. Slight elevations of ALT or AST do not automatically signal the need for a panic reaction. Even doubling of the upper values is not usually indicative of anything serious.
?
Did your liver enzymes rapidly go back to normal after discontinualnce of the allopurinol (if you can remember back that far.)
?
Perhaps you should revisit the issue before you start suffering severe joint (and probably cardiac and renal) damage. Untreated gout just keeps getting worse and worse.
I need to go back and look at my records. If I remember correctly I my enzymes values dropped within 2 weeks.
?
My uric acis levels fluctuate. They are always 6+ and have been as high as 9.2 and I know that is my problem. To your point even when I am cutting back on all things purine the best I can do is get down to 6.1. So I am going to try Urloric to see if my liver enzyme level is acceptable. Thank you for your input. I will stay posted on my results.
rscholl said:
?I am cutting back on all things purine the best I can do is get down to 6.1.
Don't forget that food is normally less than half the source of purines. Most comes from your normal cell turnover. If you are overweight, or have a fasting/feasting lifestyle, this will put a massive load on uric acid. So will some meds, and excess iron in your diet.
zip2play said:
Remeember too Rsholl, that liver damage shows LARGE swings in liver enzymes. Slight elevations of ALT or AST do not automatically signal the need for a panic reaction. Even doubling of the upper values is not usually indicative of anything serious.
?
Did your liver enzymes rapidly go back to normal after discontinualnce of the allopurinol (if you can remember back that far.)
?
Perhaps you should revisit the issue before you start suffering severe joint (and probably cardiac and renal) damage. Untreated gout just keeps getting worse and worse.
Zip2play, do you have any easy-to-understand pointers for acceptable and unacceptable liver function test results?
I have come to realize that liver and kidney function tests are an important part of uric acid lowering treatment, but I do not have a clue about interpreting the results. I leave this to my doctor, but given that I usually see a different doctor every time I visit, and so far I have known more about interpreting uric acid test results than most of them, I would like a little more control.
If it is too complicated for easy-to-understand, give me something hard-to-understand, and I will start work on it.
- You must be logged in to reply to this topic.