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6:42 am
August 25, 2009
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cjeezy
Tophi Terror
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Hi GP,
I appreciate your comments and I certainly don't take them the wrong way. This board is about support and education and I value everyones feedback. Maybe I am worrying a little too much, but all of these health issues just popped up out of know where so I'm just trying to adjust…actually I was fine until this whole HDL thing! Anyways, I agree that I need to start Allpurinol, I just don't understand what the difference is if I wait 2 weeks to start? I have only had 1 attack in my life and don't want to be limping around when company arrives…we have quite a bit of walking to do in the city. I'm not saying this with the intention of never taking the drug because I certainly will. What, I'll probably do is start the 100mg today (since that is what my Rx is for), and take 1 Colchicine/day and see how that works. I will go back to the Dr in a couple weeks and see if he'll increase dosage if I'm still not below 6. My thinking (or hoping) is that I do not have many crystals since I'm starting this drug after my 1st attack. Anyways, in regards to my cholesterol, some things I'm going to do to help improve it:
- I quit smoking cold turkey yesterday…yes I can do it!
- I'm doing 20-30 min of cardio everyday…if I can walk :) (target heart rate of 150)
- I'm eating fruits and vegetables and fiber (I never really ate these things consistantly)
- I'm taking fish oil everyday
- I have a meeting with a Nutrionist today to discuss improving my HDL.
- I will have a follow cholesterol test in 3-6 months.
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7:40 am
August 25, 2009
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GoutPal
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That list sounds very positive.
The allopurinol now or in 2 weeks is no major issue, but please don't misunderstand the process. Nothing is definite here. As I said before, you are at risk of a gout attack from new crystals if you don't start allopurinol. You are at risk of a gout attack from old crystals if you do start it. There is absolutely nobody who can predict which is the higher risk – hence keep the colchicine on hand.
When you are walking round the city avoid tight socks and shoes. Keep legs straight when resting (preferably elevated). A long walk, then sitting for a meal is a classic gout-bringer if you tuck your feet under the chair and restrict blood flow. Carry water.
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Unless replying to specific points in this topic, please start a new topic. See new topic link above, or gout forum guidelines.
Current gout status in my profile.
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9:33 am
August 25, 2009
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cjeezy
Tophi Terror
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Hi GP,
Just got off the phone with my Dr. I got the rest of my cholesterol results back. I was a little bit off with what I said previously (I didnt have a pen handy when they called). Anyways, they were:
LDL- 121
HDL- 36
Trig.- 133
Total Ch- 184
I asked the nurse about the appropriate time frame to increase my Allopurinol dosage and she said 3 months if needed when I come back for a check up. I explaned that I did not want to wait this long to gauge if the 100mg is not working. She said I could make an appointment in a month and if needed the Dr would then issue another UA test. She also said not to take 2 Colchicine everyday unless it is needed. So long story short… I think I'm gonna find a new Dr :) What I'll do is start taking 100mg of allopurinol today. Track my UA results with my home test and bring them back in to a Dr in 30 days or less. Hopefully I won't need any Colchicine before then due to the low ineffective dosage.
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11:17 am
August 25, 2009
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Tavery
Swollen Joints
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cjeezy said:
I asked the nurse about the appropriate time frame to increase my Allopurinol dosage and she said 3 months if needed when I come back for a check up. I explaned that I did not want to wait this long to gauge if the 100mg is not working. She said I could make an appointment in a month and if needed the Dr would then issue another UA test.……What I'll do is start taking 100mg of allopurinol today. Track my UA results with my home test and bring them back in to a Dr in 30 days or less.
My doc said the exact same thing. Come back in 90 days and we will retest. I dont want to wait that long because its been a month for me at 100mg and my numbers are averaging 7.2 at home. I am going to go back early and get a retest and hopefully jump to 300mg now that we all know I am not experiencing any of the rare side effects.
I started Zocor for cholesterol at the same time as Allopurinol, I really wonder if they can know this soon if the Zocor is working or if that actually requires a full 90 day wait between test?
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12:33 pm
August 25, 2009
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GoutPal
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Apparently comedy writers are now drawing inspiration from this topic.
3 months on an inadequate dose!
If it wasn't so maddeningly, saddeningly true, it would be funny. Almost.
Can I ask both cjeezy and Tavery if your allopurinol came with instructions that I mentioned earlier?
I.e. 100mg dose should be retested WEEKLY until uric acid falls below 6mg/dL. If so, can your doctors explain the 3 month wait?
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Unless replying to specific points in this topic, please start a new topic. See new topic link above, or gout forum guidelines.
Current gout status in my profile.
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1:58 pm
August 25, 2009
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zip2play
Member
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NOBODY with gout can get away with 100 mg allopurinol, so why not just prescribe the 300 mg. and be done with it. For the one person in a billion who conmes back in 90 days with a uric acid of 2.0, they can cut the allopurinol back.
trev,
Yes, they can tell the effectiveness of simvastatin (Zocor) in a month: it's a very good drug. Did they start you on 40 mg?
How about going to the doctor with a gun and when he dismisses the risk of a gout attack in 90 days, shoot him in the foot and say “See how much it hurts?”
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2:48 pm
August 25, 2009
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Tavery
Swollen Joints
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The low doses were cautionary in case of <insert mocking tone of tv drug commercials here> “rare but serious side effects can occur”.
I am only on 10 or 20mg of Zocor. Both I think are too low to do any good. I will schedule an appointment to go back next week I think.
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3:06 pm
August 25, 2009
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GoutPal
Admin
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Post edited 8:11 pm – August 25, 2009 by GoutPal
My understanding of the 100mg starting point, is to safely isolate that very small percentage of people who have an adverse reaction. That group can be desensitized or found an alternative. For the rest, it's supposed to be weekly increments, but I would think that commonsense should prevail, and larger increments considered where this is indicated by uric acid tests. [sorry Tavery, your much more succinct reply came in as I was typing this message]
Coincidentally, shortly after my last post, when I was completely askance at the lack of care taken by doctors regarding alllopurinol dosing, I found an interesting report from U.S. Pharmacist.
They seem to have picked up on report from last year, where rheumatologists are keen to educate Primary Care Physicians about some gout essentials. In a nutshell, the rheumatologists see a real need to educate the PCP's about some key gouty issues, and now the pharmacists are joining in with their own views on filling some gaps. True to form, both miss some key gout patient issues. I'll start a separate topic on this soon.
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Unless replying to specific points in this topic, please start a new topic. See new topic link above, or gout forum guidelines.
Current gout status in my profile.
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3:43 pm
August 25, 2009
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zip2play
Member
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Post edited 8:46 pm – August 25, 2009 by zip2play
Just this weekend my doctor handed me my blood results and said your uric acid level is good because it fell within the printout's “range…at 6.6 .” I educated him by saying “not for somebody with gout!”
The poor dear looked confused.
trev,
Simvastatin at 20 mg. will give you some benefits (equivalent to 10 mg. Lipitor or 5 mg. Crestor) but don't bother with a 10 mg. dose.
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6:44 am
August 26, 2009
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cjeezy
Tophi Terror
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GoutPal said:
Can I ask both cjeezy and Tavery if your allopurinol came with instructions that I mentioned earlier?
I looked at the bottle/paper this morning and the instructions say “Take 1 daily preferrably with food or as prescribed by your doctor.”…or something like that.
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11:20 am
August 26, 2009
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Tavery
Swollen Joints
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Post edited 4:22 pm – August 26, 2009 by Tavery
No other instructions other than what I mentioned before. My bottle says the same as cjeezy.
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5:34 am
August 27, 2009
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zip2play
Member
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My last bottle was my first at the 300 mg dose (it's cheaper that way) and the bottle says “TAKE 1 TABLET DAILY.”
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9:59 am
August 27, 2009
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Jason
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Tavery said:
Its funny to read your posts becuase they are nearly carbon copies of my own posts over the last few months. I was at this stage a couple months ago and asking the same question.
Yes, it will get better. I had lingering soreness for quite a while also and it will eventually fade.
For general soreness, I would stick with Ibuprofen and only go back to Indo if the pain became problematic. In general, if you continue on a path similar to mine, it will go something like this.
- Soreness around bunion, by the end of the day you are ready to put your feet up. Wife gets mad the grass isnt getting mowed and the dog crap needs to be picked up.
- Soreness fades after three days or so, but the area is still sensitive to the touch (i.e. it hurts if you push on the bunion area) This lasts a couple weeks and you spend a lot of time in loose fitting shoes or soft slippers. You mow the lawn, but by the early evening you are looking for excuses to park your butt on the couch in the evening. Folding laundry became a personal favorite.
- Twinge! You wake up one morning and feel something not quite right but its not debilitating either. You pop some drugs and up your water intake. It goes away by the next day.
- You slide back into your old routine a bit and after a few weeks you wake up with that familiar pain of a flareup, except this time its maybe half as bad as your original. You hobble aned whine a lot and the wife reaches deep into her well of patience to keep from killing you.
- You hobble to the computer and spend the $150 to order a home test kit from Britian.
- Drugs, water and a week later you are back to soemthing resembling normal. Just in time to get your new home test kit. Number facination ensues. You spend a lot of time thinking about how to best poke your finger so you get a great blood sample.
- You spend a month or two being attack free and you think that with the diet changes, a bit more exercise and self monitoring you got this gout stuff licked.
- One morning you wake up to yet another twinge and you analyze everything you have eaten/drank for the past week and cant find a solid reason for a gout flareup. Now you are in pain AND pissed.
- Tired of laying awake and thinking about your own mortality and tired of trying to fight it, you then go back to the doctor and request 100mg of Allopurinol and set a date three months hence for another review.
- You are on a pill every day for the rest of your life, but you sleep better. You make a few changes to your lifestyle anyway because you know its the right thing to do.
Tavery: That is very good advice. I am new here and just recovered from my first bout attack about 4 weeks ago. But I am left with a bunion that is tender but not painful. It's a little red and swollen. I am just wondering when it will go away altogether. I am now only taking Advils. I have tried ice pack, but it didn't seem to work. Thanks.
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2:19 pm
August 27, 2009
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GoutPal
Admin
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For that lingering tenderness try WWW – Warm, Wet & Walk.
Keep the joint warm at all times (except perhaps for 10 minutes if you are applying ice, though this seems more use to me in reducing acute onset pain rather than lingering tenderness).
Keep youself wet – i.e. drink plenty of water and other soft drinks.
Walk as much as you can, or other gentle excercise to keep the blood flowing. Don't overexert, and when you do rest, try to keep the effected area above the heart.
On the earlier point about instructions for allopurinol, my mind was on OTC meds, forgetting that Rx stuff is just left to the doctor to explain. Silly me.
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Unless replying to specific points in this topic, please start a new topic. See new topic link above, or gout forum guidelines.
Current gout status in my profile.
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3:48 pm
August 27, 2009
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Tavery
Swollen Joints
| | Seattle Region | |
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| posts 70 |
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Its took about 3 weeks for every last bit of pain to disappear. Its such a gradual change I thought it would never end.
One comment about GP's post above. Walking is great, but you should avoid overextending the toe. If you are still having pain movement helps keep it loose and increased blood flow. However, attempting to forcefully stretch the toe (i.e. stretching it into a semblance of full range of motion) may cause additional damage from the crystals.
The crystals are spear-like in shape. Grinding them around the joint by trying to force a range of motion will just make them jab into the surrounding tissue and cause more damage. Look at the link before for a pictureof what they look like (in this case in a petri dish)
http://www.diseaseaday.com/wp-…..-thumb.jpg
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3:59 pm
August 27, 2009
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Jason
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Thank you both for your prompt response. I now feel better and tell myself to be more patient. Will post more in a couple of weeks. Jason
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7:22 am
August 28, 2009
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zip2play
Member
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Post edited 2:52 pm – November 12, 2009 by zip2play
During my only horrific attack of 9 days podagra, I could no more have walked on that foot as I could have flapped my hands and FLOWN. To get to the bathrrom I had to crawl on all fours making sure to keep my right foot raised a FOOT off the floor at all times and not touch the hallway wall. That process was Hell on my knees on hardwood floors.
For previous attacks in other parts of my foot (before the gout diagnosis that generally ran about 3 days each, I used crutches to get around. Not sure why I didn't use crutches for the BIGGIE..perhaps a narrow hallway or perhaps just letting the painful foot HANG was too painful.
I guess I never experienced “lingering tenderness” because the attacks stopped as abruptly as they started and I was immediately good as new. “Throw away your crutches and WALK”…it was positively BIBLICAL.
I guess what I am saying is that there is the kind of attack that is orders of magnitude more painful than “soreness.” The pain can reach the level of crucifixion and my exaggeration is only slight.
Maybe for those with lingering tenderness, a trial with some of those OTC gel sole orthotics, or even the foam cut-to fits is wise. They are cheap and comfortable.
You're right, GP…maybe this thread is getting a bit “RUN-ON.”
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3:30 pm
August 28, 2009
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cjeezy
Tophi Terror
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So here is an update on my gout. It has been about 7 weeks since initial attack and lingering symptoms are still present. The pain is a bit different lately though. Originally it started with my right bunion area for the most part (touching it or not touching it). Now,I have this weird tenseness and pinching that comes and goes for a second or 2 throughout the day in my right and left bunion area as well as the arches of both my feet. The odd thing is is that these areas don’t really hurt to the touch. While I feel 100 times better than the acute attack, this still sucks!
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3:40 pm
November 11, 2009
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rucyrius
Toe Torture (status changes after 50 posts)
| | new york city | |
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| posts 35 |
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do you have to take colchisine when you go on allopurinol or uloric? i thought they were not doling that out so much anymore due to some complications it might cause…my number is around 10.3 and havent stopped having some sort of minor attack since the beginning of the summer…
john
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3:44 am
November 12, 2009
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GoutPal
Admin
| | Baildon, Yorkshire | |
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It is not compulsory to take colchicine, or any other form of preventive pain medication, when you are on uric acid lowering therapy. Some doctors advise it – others recommend keeping pain relief on hand just in case.
John, You need to get that number down!
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Unless replying to specific points in this topic, please start a new topic. See new topic link above, or gout forum guidelines.
Current gout status in my profile.
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