GoutPal Interactive

I am finding that a pair of sheepskin Ugg boots are the most comfortable footwear at the moment. I only have a pair of cheap imitation ones, but am seriously thinking of treating myself to the real thing for Crimbo. Fortunately, I don't have to wear a suit for work.

This thread is really long.

>It is amazing. My doctors also tell me the same thing – some mechanical problem, not gout,  >though they agree gout was present in the initial stages.

So you have confirmed Gout then? I hope you are getting it treated along with your mechanical problem? I don't even know what the hell is truly wrong with me. I am 100% convinced that I have something more than “just” mechanical problem.

Is your pain roughly constant 24/7?

10 more days to go to my next appointment. Why do I feel that I will never get to the bottom of this unless I put an axe to my foot? Sounds really tempting I must say.

Post edited 5:32 pm – January 19, 2010 by vegetarianGuy

So I went to another specialist that I was referred to. Technical orthopedist section of a hospital. The specialist checked my joint and called the head of the team too. They concluded that it's not Gout but starting of arthritis of the big toe. They took me to ultra sound section as they are testing a technique of using ultrasound to try to see the thickness of cartilage as X-rays don't reveal that.

The ultrasound technician said that he did not see a huge difference between the more painful  left toe joint cartilage thickness and the less painful right toe cartilage thickness.  The specialist wanted to be present there too so he arrived later. He seemed more interested in the technique than me. So he thinks it is early phase of big toe arthritis.

The ultra sound technical said the difference was simialr to 1.23mm against 1.27mm for example. She was not convinced of any big difference outside the scope of ultra sound error.

Here is the thing-

My Canvas SUPER flexible thin soled shoes cause the least amount of pain when walking.

My Addidas stiffer soled shoe but still able to bend shoe cause the maximum pain when walking.

This confused the doc as stiffer soul normally helps in this case and flexible soul is bad for the joint. His superior came then and explained the reason the Addias hurt more is because they are not stiff enough ie. they still bend and hence put greater force on the joint. Stiff and bendable = more force on the joint. I need shoes that don't bend at all. Stiff as wood to protect the joint.  Made kind of sense to me…..I think.

Anyway there is not much they can do now. They have a shoe section inside the hospital and they made me try some stiff shoes. I must say that if I wear my Addidas shoes then within few steps of walking I can feel greater pain. Their super stiff soled shoes did not cause similar pain after taking few steps. I don't know how it will be I wear for longer period though. They were very expensive and the choice was very limited. So  I wil be buying similar stiff shoes from mountaineering/hiking/sports type of shop. Completely stiff with rocker effect soul to make walking possible despite the stiffness of the sole.

So there is where I stand currently. If you remember my X-rays were normal according to everyone who had seen them. Althought the X-ray has a comment section where the X-ray department had written everything normal…..very slight irrelevant “bone scelorisis”.

So looks like I don't have Gout. Not sure if it was better to have Gout or this   I definitely have higher blood uric acid levels but all docs have said I should not worry about that

Ultra sound also revealed that I don't have any build up of fluid in the joint. Which is a good sign with regards to infection or fluid build up that occure in Gout patients. Hence easier to draw the fluid to test from the little joint. For a joint without any extra fluid buid up it is close to impossible to draw liquid for testing. Which different specialists have repeatedly told me.

To conclude I really don't know what to think of last 10 months or what I really have. I will go with big toe arthritis for now I guess and buy the super stiff soled shoe. Hope that helps a bit but looks like I will be going down slippery and painful slope of arthritis if the doc's diagnosis is correct. In my 30s and body already falling apart.

Post edited 10:51 am – January 20, 2010 by vegetarianGuy

This is what doctor at the X-ray place wrote about my big toe-

“Inconspicuous bony structures without osteolysis or sclerotic changes. No degeneration in the Big metatarsophalangeal joints. Appears normal to the sesamoid. Normal position. No soft tissue swelling”

I found this chart online.  Could I be on Stage 1 hence nothing in the X-ray? Although my joint pain is constant and hardly vague. Granted not extreme pain but based on the chart I think something would show up on the X-ray if it was athritis.

Post edited 7:05 pm – January 24, 2010 by vegetarianGuy

Utubelite said:

Hi vegetarianGuy,

I have gone through more( and still going through( than 75% of similar stuff that you are going through now.

I will write more details later but only wanted to tell you that though they told me similar arthritis stroy, I have been able to reduce my pain to a large extent and walk much better now.

Waiting for your reply I will hold on to anything right now for hope and solution. 

I joined a foot health forum and posted my X-rays there. The doc there thinks just like all the Rhumetologists I visited that my X-rays seem normal. I just feel that Osteopathist saying that I have Arthritis is bull and just guess work.

Yes it seems as if I don't have Gout. Unless I have some hybrid version just bubbling under the radar

Online a Doc said that maybe Bursitis could be the reason. I have looked into it's symptoms and does not look like it is that. I have taken online symptom quiz for Gout, Arthritis, bursitis etc etc and they all come to only 20-30% chance. Wtf do I have? (don't expect an answer just shouting out)

Post edited 7:29 pm – February 7, 2010 by vegetarianGuy

NEW DEVELOPMENT!!!

7th Feb Sunday– I was working through the night on my computer (which I do quiet often) and  noticed around 6am that I was starting to feel bit more pain than usual.  It was slightly further up the actual MPJ1 joint and towards the side of my toe. Also similar pain on the ball of my foot. I went to bed and  woke up around 3pm. The pain has climbed to completely new level and more interestingly I can't bend my toe anymore. Through out last 1 year I have always had full movement of my toe joint and suddenly overnight I can't bend it. It hurt very much when I try to bend it. Actually I can't bend it even if I try to go past the pain barrier. It's as if the tendons have been cut and I have lost control of all the bending functions.

The ball of my left foot looks swollen and slightly reddish. The Orthopedist that I last visited said that I have “Big toes arthritis”. The pain is away from the MPJ1 now so I feel quiet confident that as suspected by me that he was talking bull just like all the other “specialists”!

I don't know what to do now or what my next step should be? Who do I see? Do I go back to wise @ss Rheumatologist who were clueless?  Am I finally having a proper Gout attack or is it non Gout related? I really don't know who to see now nor what the hell I really have

Following from my last night post……

……I have absolutely clear photographic evidence now. Left foot is lot swollen and definitely red in colour with dash of blue. It is also warmer to the touch compared to right foot.The cross marks show where I have hardcore pain.  I cannot put my body weight on the X mark. Absolutely not as it hurts badly. This is completely new and higher level of pain compared to last 10-11 months. 

What do you guys think?

Post edited 1:52 pm – February 8, 2010 by vegetarianGuy

trev said:

Post edited 12:10 pm – February 8, 2010 by trev

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However, your pic is a beaut for a gout book-

It's a beauty ain't it? I was starting to lose credibility round here. I bet you guys were starting to think that I was moaning too much and dreaming up the pain LOL Well the volcano burst and I am covered in hot lava for all to see.

So I went to ER today as I was not able to walk.  Lady Doc was not sure what was causing this. She thinks it could still very well be non Gout related.She thinks that Gout attacks come and go suddenly and 10 months of non stop pain sounds rather strange and not typical Gout modus operandi.

She remarked that my left foot was hot to the touch. She will be ordering reports from all the specialists I visited to form a fuller picture. She took my blood to conduct various tests. She gave me Ibofrofen 400mg tablets for next 3-4 days. After which I am supposed to take 300mg Alluprinol dose for a month to see what effect that has on my readings. She said that if Alluprinol works then we know it is Gout. If not then we know it is non gout related. She will be calling me next week. She did seem clued up on the whole.

Anyway the pain is flattening me. Walking is impossible. I went to ER by taxi but came back by public transport as I had to pick up Alluprinol from pharmacy. Big mistake as the trip home was torture and comical. I am really drained so I am hitting the bed.

P.S- Can only one month of Alluprinol 300mg use show noticeable reduction in blood uric acid levels? I mean enough to judge Gout as the cause?

Utubelite said:

Hi vegetarianGuy,

I will write more details soon. Just going to attend an urgent meeting.

Do not worry :-)

Ok after another 6 hours of sleep the difference in pain is like night and day. I can press areas which I could not even touch earlier today.So Ibuprofen did it's work by the looks of it. My foot is still puffy but not as much as before. I am not sure if the pain has actually gone or the pain killer is masking it. Can a Gout attack calm down within 12 hours? Or does this calming down point away from Gout?

Post edited 2:31 am – February 10, 2010 by vegetarianGuy

trev said:

If I pulled a name out of the hat for your description VegGuy, it would be 'Psuedo'gout - though it usually attacks in the knees.

Have you had your Calcium levels checked?

Don't think my calcium levels were ever checked. Unless the ER Doc is testing that too. She has my blood currently. Do you mean calcium in blood or in bones? Not really clued up on calcium side of things or how the readings are taken. I will Google it up. I do understand 'Psuedo'gout though. I don't know how relevant it is but I have hardly eaten dairy stuff in years. Some cottage cheese once in a while only.

VERY VERY INTERESTING DEVELOPMENT-

I just woke up and  decided to check my blood uric acid levels. Guess what? I thought I was dreaming when I saw the reading so I re did the test. Holy batman they were in 5.6mg/dL range. What is so special about that reading you might ask. Well in 40+ readings that I have taken over last one year (including the ones at the GP's place and one single reading from 2007) I have never got a reading below  7.13mg/dL (7.13mg/dL was my lowest ever until today). My average readings have always been in 7.5 to 10mg/dL range!!!!!!

My conclusion? —> As we know that during a Gout attack the blood uric acid reading drops so the case for what I had one day ago being a Gout attack strengthens. Do you see any merit in my thinking or am I wrong?

P.S- No I have not started taking Alluprinol yet. I will start it on 13th so the above reading is without Alluprinol.

P.S 2- One day before the attack it was 7.3.