GoutPal Interactive

The gout forum has a ranking system that applies a badge to contributors depending on the number of posts they make.

I have toyed with the idea of dropping this completely, but I believe most people welcome it. One problem is that current rankings can be confusing to new forum members. The main problem is that the rankings now do not make sense. They rise in severity of goutiness as you post more. But this does not make sense – the longer you contribute to the forum, the better your gout should be.

Another problem has surfaced (unnoticed I think) as our most prolific and respected poster has passed the top rank that I set. His unique style deserves to be celebrated, but at the moment, the rank simply drops to ‘Member’. Of course, I could just increase the top number, but I think it is time for something better.

My first objective is to improve clarity. Therefore the new suggestions will be a little longer, and include a link to an explanations page.

My suggestions are:

1 – 5

Gout Forum Newbie. Please be gentle.

6 – 20

Gout Forum Settler. This place is just swell.

21 – 49

Gout Forum Regular. I like this joint.

50 – 499

Gout Forum Expert. Alas poor Uric! I knew him, Allopurino, a fellow of infinite pest.

500 – 4999

Gout Forum Guru. Crystal clear – I love it here.

5000 – 49999

My name is zip2play

Please vote for the gout forum ranks you like or dislike. Please add your suggestions below.

As discussed in the forum recently, I am upgrading this website, and giving the look & feel a makeover to make it easier to read, and to unite, where possible, different parts.

There will be 3 separate sections to air your views, share your experiences, ask gouty questions and generally interact with fellow gouties so that we can all learn and understand more.

I’ve also had a heads-up on surveys, so I’ll start a new section on this just as soon as you tell me it is important to you.

As new suggestions are made here, I will add them to the GoutPal Interactive Improvement Poll, and you can vote for the improvements that are important to you. Each improvement is presented as an answer, and you simply vote up those that you want to see. Very rarely, you may see an improvement that you really think is a bad idea. You can vote this down, but it would be nice if you could also add a comment here to say why you think it is a bad idea.

Please check out the list of potential improvements to GoutPal Interactive, and vote up those that you like. Please think about any other things you would like to see, and add them as comments below.

Please note that this is for interactive pages here at gout-pal.com. I have a separate discussion for improvements to the main gout reference site, GoutPal.com.

I am constantly on the lookout for new information to add to GoutPal.com.

I also like to improve the way the information is presented wherever I can to make it easier for you to find the gout information that you need.

I have recently started to add discussion topics here to talk about issues raised by specific pages. This page is for discussing topics that are missing from GoutPal.com, or for suggesting improvements to layouts and features.

As new suggestions are made here, I will add them to the GoutPal Improvement Poll, and you can vote for the improvements that are important to you. Each improvement is presented as an answer, and you simply vote up those that you want to see. Very rarely, you may see an improvement that you really think is a bad idea. You can vote this down, but it would be nice if you could also add a comment here to say why you think it is a bad idea.

So please check out the list of potential improvements to GoutPal.com, and vote up those that you like. Please think about any other things you would like to see, and add them as comments below.

I often think food is an obsession amongst gout sufferers, and should not have as much importance as it does. But as a gout forum regular commented recently

Personally as someone who is past the nooby stage of understanding Gout. I am more interested in diet related info ie. what food items are good and which are bad for Gout. Info is very lacking on that side everywhere.

Solid research papers/clinical studies on diet + Gout is what I am most interested in as all the hearsay of this food is good that food is bad has not convinced me. For example Cherry and BBQ seems to have cult status but it did absolutely nothing for me. I ate unbelievable amounts of both for months without any improvement. So I am not sure if they actually work or some people are just having placebo effect

I could not agree more (thanks VG). At an early stage of my research, I started looking at diet. What does it really mean?

I found 3 meanings:

1. The usual food and drink of a person or animal.
2. A regulated selection of foods, as for medical reasons or cosmetic weight loss.
3. Something used, enjoyed, or provided regularly.

Meaning 3 strikes a chord with me. If diet is not enjoyed, it will not be sustained, so lists of foods, though useful in some contexts, are just a research and planning tool. What we really need is a sustainable approach to diet planning that sees gout as one of the restrictive parameters, but not as a goal..

My Gout Diet section is certainly not going to be about regulated selection. If you want to be told what to eat, look elsewhere.

I will focus on the first meaning (“usual food and drink of a person”) and return to the original Latin root of the word diet. It comes from diaeta, meaning way of living. So I will advise gout sufferers what will be their usual food and drink for gout. I will also put this into the context of a way of living. Diet is one important aspect of lifestyle. Exercise and metabolism are equally important components.

For me, the third definition is key, except I change the or to and. The GoutPal diet is something used, enjoyed, and provided regularly – a way of living that eases gout pain and gives your best chance for long term health improvement.

I’ll soon be introducing a voting/polling section to measure the importance you attach to gout diet in general, and specific topics within the subject of gouty lifestyle. In the meantime, here is a good place to discuss gout diet. What is important to you?

I know what the leading medical authorities suggest as the best way to manage gout because I research it every day.

I know what typical gout sufferers need to endure, because I am one.

I know when a doctor is giving bad advice. The first comment here is transferred from a separate discussion because it is extremely important. Yes, it refers to allopurinol, but it raises a much larger issue. The writer is clearly unsure about the professional advice given. In this case the advice is clearly wrong. But what should you do when you do not trust medical advice from professionals, and what should I do to give advice that you know you can rely on even though I cannot treat you professionally?

For my specific advice about allopurinol, please see my reply to the first comment. For a discussion on how to handle bad advice, please read on. Read the rest of this entry »

I am a female my weight now is 105 lbs, I have always fought a low body weight and ate any and everything to keep weight on. I ate canned sardines and oysters; I love liverwurst!!

5 years ago I had severe pain in my hip for over a year (to the point of being disabled to work) and finally convinced my doctor to test my uric acid since gout runs in my family He argued that gout does not happen in the hip. (11.6 was the outcome).

My history is of being a commercial fishing captain where I sit in a chair with my feet propped out the window and my but being to lowest center of gravity.

My questions:

1. How often does gout occur in only the hip?
2. When it lasted as long as it did is there anything to help my hip (I rarely have flareups of gout but have constsnt pain from the prolonged gout)? I can not afford the MIR etc.. my doctor wants me to have.
3. How can I gain weight back?

Thank you very much for your time, I know this has been a long letter,
Terry

The most recent article on gout from the UK’s leading medical journal

Gout. The Lancet. Jan 2010.pdf (781 KB)

GoutPal Note:

This is an excellent summary on the current understanding of gout, and how best to treat it. Towards the end, the authors note:

patient information seems to be an outstanding issue in the management of gout—every patient should be informed about the disease, its curable nature, the targets and practicalities of drug therapy, how to prevent and handle flares, and the importance of lifestyle and dietary factors.

And that, my friends, is the GoutPal raison d’être.

Prompted by a tidying up of old forum discussions, I notice that there are occasional calls for recommendations for a doctor with good gout knowledge. Rarely are these answered, but some of that may be due to the way topics that ask that question are scattered over many forums.

I’ve decided to try and build a list of recommended gout doctors, and I can only do it with your help.

If your doctor is particularly good with gout, please pass on their details, but first contact them to check this is OK. I will start a new list organized by country and region with the details.

Similarly, if you are looking for a gout specialist, please say which area you are prepared to travel to.

To kick things off, the old message that I have just deleted was seeking a gout doctor in London UK, but prepared to travel to the home counties. Nobody was able to respond at the time. Do you know a suitable gout doctor?

Also, a gout specialist was named in a different context, but the writer didn’t actually say he was any good or not. This makes me realize that if you are going to recommend someone, you should say why.

Hello, i run into web site after helplessly trying to get some info about gout. My dad is visiting me here, and he is having one of his attacks. He is 72.

I guess he was never diagnosed properly, and last 15 years he was given some non-steroid, anti-inflammatory medication. At the end he ended up in a hospital for a bleeding ulcer, and that was first time he was diagnosed with gout. That was last year in September.

His gout was so bad, that he couldn’t walk. He was given injections for pain and inflammation. They put him on allopurinol 100 mg. he got better, but never 100%. When he came here, I looked through his lab tests. Back in September his uric acid was 516 umol/l. Average should be 182-403. In November it was 400umol/l, and in December was 474umol/l. All this time he was taking 100mg allopurinol.

I was trying to contact his doctor and ask, and comment, that 100mg is not working for him, but no luck getting right answer. Right now he is having another attack, his elbow is swollen, hot ,red. His foot ankle has same problem. He is cold all the time, not a happy camper. I increased his allopurinol to 200mg one week ago.

Today we had his blood drawn, and I will know his uric acid measurements tomorrow. His diet is very healthy, no alcohol, lots of water. I am not giving him any ibuprofens because of his stomach ulcers.

Please advise about mg of allopurinol/ uric acid levels, or any other medication that might work. Do you know how long it takes for allopurinol to have an affect on uric acid? Thanks a lot. Nina

US biotech firm BioCryst Pharmaceuticals, Inc recently announced the initiation of a Phase 2 human clinical trial of the drug candidate BCX4208 in patients suffering from gout.

BCX4208, co-developed by New Zealand crown research institute IRL, is a next generation purine nucleoside phosphorylase (PNP) inhibitor, which a recent study shows may have utility in diseases dependent on T-cells, B-cells or uric acid.

The latest trial is designed to determine the effect of different doses of orally administered BCX4208 on uric acid levels in the blood, the build-up of which can lead to the often painful condition known as gout.

BCX4208 differs from existing gout treatments in that it targets an enzyme known as PNP (purine nucleoside phosphorylase). This novel mechanism gives the drug candidate the potential to address unmet medical needs across a broad spectrum of inflammatory diseases in which this enzyme plays a role. It has the potential for once-a day dosing suitable for chronic administration and has been shown to be well tolerated in safety studies. Existing treatments have a range of side effects.

Dr Jacquie Harper, who leads the gout research programme at Malaghan Institute of Medical Research in Wellington, NZ, says: “Gout prevalence is increasing worldwide and is a real problem in New Zealand. A major risk factor for developing gout is excessive uric acid levels in the blood but the choice of uric acid lowering drugs is limited. A new, well-tolerated treatment for controlling uric acid levels would be good news for gout sufferers.”

Dr Richard Furneaux, who heads IRL’s Industrial Biotechnology research, says: “BCX4208 is the second drug candidate we have discovered in collaboration with Professor Vern L Schramm, the Ruth Merns Chair in Biochemistry at the Albert Einstein College of Medicine at Yeshiva University in New York City. Our first is in a pivotal Phase 2b human cancer trial for Cutaneous T-Cell Lymphoma with results expected in 2010.”

The gout trial is recruiting 120 patients at 12 hospitals in the US and is expected to run till September 2010.

There is an interesting video news clip, Relief for gout sufferers thanks to Kiwi company, with some ‘juicy’ gout images.