Early indicators for end of gout attack.

About GoutPal’s Old Gout Forum Forums Please Help My Gout! Early indicators for end of gout attack.

This topic contains 16 replies, has 8 voices, and was last updated by  Keith Taylor (GoutPal Admin) 5 years, 9 months ago.

Viewing 17 posts - 1 through 17 (of 17 total)
  • Author
    Posts
  • #3490

    simonbrooke
    Participant

    This topic covers a few aspects of gout. Especially:

    1. Not giving up beer & gout.
    2. Wine during gout attack.
    3. Can I drink alcohol during a gout attack?

    However, to get the most from these, and other alcohol & gout discussions, it’s best to read Best Alcohol For Gout, first.


    Hi all. What a great forum this seems to be (sadly for a horrid condition). I'm looking forward to getting (and hopefully contributing) some very useful advice over the coming months. It's so refreshing to see a forum (of any kind) that isn't infantile and trivial in its content.

      A little background; I have been in discussions with my GP in the last 12 months or so. He is aware of my 'suspected gout' but seems more concerned in finding the right medication for my blood pressure. Regards gout, he just keeps telling me to change my lifestyle – you know the stuff. I understand this, but as far as I can see from this site and others, once you have the gout it's pretty much with you for life. Tinkering round with diet and booze regimes may work, but only for a lucky few. The few who have the patience to scrutinise their intake and scour recipe books, specialist shops and so on, for gout friendly products.

     As far as I am concerned, I'd rather start the controlling drugs and pay a less stringent regard to managing the condition. This is not to say that I will not respect the condition and make some changes but I can't see me eating mainly group A foods and completely quitting the booze. Offal, game and stout, I can do without, but don't make me give up my stock cubes!

      This most recent attack is probably my worst, I'm signed off work and have had to get a prescription for codeine as the NSAIDs (I'm on max dose) don't seem to be helping much this time and they only give me 12 hours relief in 24. I haven't received the codeine yet, but am hoping I can use it to see me through the nights.

      This attack is a week and a half old and from past experience, I reckon it will be another week or so before it eases.

     

    My questions are:

     In the hope of raising my spirits a little, does anyone know of any early indications that an attack is about to end? That is, before the pain goes. I noticed this morning that my urine is less yellow coloured and smells less pungent than it has during the attack. I feel there is a definite change in urine during attacks. Does anyone have thoughts on this? (it could just be because I'm drinking water like and horse and have drastically cut back on the lager). I guess I'm hoping that as I must be properly hydrated by now, all this colouration and smell are signs of the crap that my kidneys are now able to get rid of.

     

    Thanks very much. I look forward to hearing from you.

    #10945

    trev
    Participant

    When you are drinking enough water the urine output generated will go clear when you're on the requisite amount .[Hopefully- but don't overdo it !]

    Attacks ending are mostly about pain easing- on its own accord. 

    Finish with lager etc.  until you're stable at a low SUA.

    #10946

    zip2play
    Participant

    Not giving up beer & gout

     In the hope of raising my spirits a little, does anyone know of any early indications that an attack is about to end? That is before the pain goes.

     

    I know people are different but MY attacks always stopped as abruptly as they started…with no warning.

     

    Have you thought of colchicine to stop the attack? It works better than either NSAIDS or codeine which just make pain, usually poorly.

     

    I think the only real competitor to colchicine for pain relief are steroids like prednisone…or the really hard drugs like opiates. But ONLY colchicine will actually work to STOP an attack.

     This attack is a week and a half old and from past experience, I reckon it will be another week or so before it eases.

     

    Past experience is a poor barometer for gout attacks. My first 4 or 5 attacks passed in EXACTLY 3 days requiring crutches but no drugs. My last, however, was a 9-day killer that had me bedridden in immense pain. I stopped that attack completely in a day with a massive dose of colchicine (22 little buggers.)  Next day I was perfectly well except for the feeling that I had had an enema with a firehose.

    I immediately started allopurinol and never had another attack, only twinges.

     

    I too have no use for dietary changes that are of dubious worth. I’d much rather take a daily pill than give up calves liver, beer, wine, shellfish, steak, fish, etc. etc. and I cannot afford daily cherry juice (can anyone?) 🙂


    #10950

    simonbrooke
    Participant

    Thanks guys. My GP was reluctant to give me colchicine (but I can't remember why). He seemed happier to give me the opiate (it baffles me too)! I am only going to use it to get me through the worst (when the NSAIDs fade during the night) and hopefully it will enable me to put my socks and shoes on after a welcome shower.

      As I am a regular drinker, the GP also told me that it can be dangerous to completely stop drinking very suddenly. So I've cut down to 'healthy' levels during this attack. Last night I had a couple of G&Ts which gave me less of a 'payback' than the three cans of lager the previous evening. (I needed some kind of painkiller after the NSAIDs wore off).

      I had intended to cut back on weekday drinking in the new year anyway. Perhaps this is the kick up the backside I needed! I am hoping though, that when the allopurinol takes hold, I can return to the odd weekend binge (and I don't mean rolling around in the gutter type binges!)

      Up to now, I estimate I was a 100 units a week person. I know the gout is almost certainly of my own making but please don't knock me for it. I never harmed anyone else in the making of this disease.

     

    Simon

    #10951

    MyFootHurts
    Participant

    Can I drink alcohol during a gout attack?

    From my experience, beer is probably the worst alcohol for gout, gin the best.  If you’re going to drink, be sure to drink plenty of plain old water.  Dehydration from alcohol consumption can really set off gout.

    #10955

    Is there something wrong with rolling around in the gutter?WinkSurprised

     

    Just to eliminate what might be an obvious gout source (it can't be just me?). What's your height and weight, Simon?

    #10956

    simonbrooke
    Participant

    About 5'7″ 13.25st – borderline I think?

    #10957

    simonbrooke
    Participant

    I have certainly gone to ground a few times in my drinking past. But I can honestly say, I've never fallen asleep in the gutter (in a garden, perhaps).

    #10958

    hansinnm
    Participant

    zip2play said:

     …I think the only real competitor to colchicine for pain relief are steroids like prednisone…or the really hard drugs like opiates. But ONLY colchicine will actually work to STOP an attack.

     … I cannot afford daily cherry juice (can anyone?) 🙂


    Zip, I have a slightly different point of view on your Colchicine/steroids/opiates.gout attack issue:

     

    A gout attack is accompanied by an inflammation which generally is accompanied by pain. Inflammation and pain are two different issues. They are both symptoms, not causes of the attack. The real issue is the cause: An increase of uric acid in your system (of course, there is are reasons for that to begin with) which generally trigger the deposition of those nasty critters, called uric acid/mono sodium urate crystals, which cause the inflammation, which causes the the pain.

    Now, if you want to first deal with the inflammation (the symptom of the attack and the cause for the pain)i, you take the Colchine which  is one, if not the best med for gout inflammation. (Colchicine does not reduce the pain, but the inflammation, which is the cause of the pain.) If you are in excruciating pain, you SHOULD take Naproxen or better Aleve (cheaper and just as effective.) Forget opiates, unless you are looking for some expensive highs. (There are cheaper ones than opiates.)

     

    Yes, I can afford cherry juice.Smile Montmorency (black, tart) concentrated cherry juice. 8×1/2 gallons, including S&H $169. That is ~$21 for 2 months of a daily cherry juice drink (1oz concentrate/day), that is 35 cents a day.  How much do you pay for a glass of orange juice?

    #10959

    simonbrooke
    Participant

    Hansinn,

      During attacks, my GP used to have me on Ibuprofen (1200mg per day) but I went back to him in the early stages of this attack because I thought it was not really helping much. So he put me on what he described as maximum dosage Naproxen (1000mg per day). This too didn't seem to be doing much and I concluded that I had become NSAID tolerant. I have since read that NSAIDs do not deteriorate in efficacy with extended use, so I must have been be wrong. Given that I was no further forward, I asked if there was anything else I could take to complement the Naproxen, giving me more cover throughout the day and hopefully more powerfully at night. He reeled off a list of possibilities (paracetamol among them) but they all seemed too weak. As I said in an earlier post, he didn't want to give me Colchicine (I think it may have been to do with stomach/bowel upsets). We settled on Codeine (which I've since found, also gives digestive problems). It beats the hell out of me!

      Surely though, this must be a common problem; no matter what NSAID you take during an attack, you can only cover 12-16 hours of the day? Most likely this leaves you overnight, without any relief. How do people deal with this? I'm hoping that I can use the Codeine just before I go to bed and then once more during the night, should I need to get up for a pee (which is very likely, as I'm drinking water and tea like a mad thing)

     

    Simon

    #10960

    hansinnm
    Participant

    simonbrooke said:

    Hansinn,

      During attacks, my GP used to have me on Ibuprofen (1200mg per day) but I went back to him in the early stages of this attack because I thought it was not really helping much. So he put me on what he described as maximum dosage Naproxen (1000mg per day). This too didn't seem to be doing much and I concluded that I had become NSAID tolerant. I have since read that NSAIDs do not deteriorate in efficacy with extended use, so I must have been be wrong. Given that I was no further forward, I asked if there was anything else I could take to complement the Naproxen, giving me more cover throughout the day and hopefully more powerfully at night. He reeled off a list of possibilities (paracetamol among them) but they all seemed too weak. As I said in an earlier post, he didn't want to give me Colchicine (I think it may have been to do with stomach/bowel upsets). We settled on Codeine (which I've since found, also gives digestive problems). It beats the hell out of me!

      Surely though, this must be a common problem; no matter what NSAID you take during an attack, you can only cover 12-16 hours of the day? Most likely this leaves you overnight, without any relief. How do people deal with this? I'm hoping that I can use the Codeine just before I go to bed and then once more during the night, should I need to get up for a pee (which is very likely, as I'm drinking water and tea like a mad thing)

     

    Simon


    Simon, as I have said in my earlier post, as long as you don't deal with the cause you are just doing what the majority of so-call doctors do: Treat the symptoms, don't eliminate the cause, or we will lose our jobs and a very nice, easy income. (Besides, the pharmas would go broke, too, and they put a good chunk of $ in our pockets.)
    You can take all the pain killers in the world, if you don't eliminate your cause: INFLAMMATION you are out of luck or out o' brains. (Sorry! I, really don't mean to offend you, it's the medical profession who has lost its brains and substituted it with greed and ignorance.)

    By the way, “stomach/bowel upsets”=diarrhea=shits is a common occurrence with a lot of meds. It's your call how far/fast/long you want to go/run!!!

    #10961

    Ravenwood
    Participant

    zip2play said:

    My last, however, was a 9 day killer that had me bedridden in immense pain. I stopped that attack completely in a day with a massive dose of colchicine (22 little buggers.)  Next day I was perfectly well except for the feeling that I had had an enema with a firehose.


    Lol – I'm beginning to really enjoy this forum!  It's not only a great source of information from people who share the same condition, but the personalities here are great too.

    #10962

    simonbrooke
    Participant

    Perhaps I didn't make it clear, the GP is going to put me on allopurinol but is just trying to get me through this attack before doing so. Well I sincerely hope that's the plan.

      We, in the UK, like to think our GPs are driven entirely by altruism. I think to a very large extent, this is true and is quite well respected the world over. Like all doctors, however, they do have pressures which are contrary to this goal. As in many countries, they simply don't have time to get to know a patient's particular requirements and thus tend to give very scant advice. That's why forums such as this are so useful in formulating considered questions to take back to them, during the all too short consultations. I think. it's probably as much my fault as the doctor's that I may not have the best painkillers for my situation. Maybe if I'd read a bit more on this forum, I could have persuaded him to give me the best stuff.

    PS I'm not blowing smoke up anyone's arse!

    Let's hope my attack subsides tonight and I can get something more appropriate when the early allopurinol attacks begin!

     

    Simon 

    #10963

    Brett Thurston
    Participant

    I know this thread has shifted away from the alcohol drinking mentioned earlier, but I just thought I would chime in with a little personal experience of my own.

    I was a very heavy drinker up until about 1 year, 5 months and 11 days ago (not that I'm counting!). You can read into that the obvious fact that it wasn't entirely under control, and that my doctor might have been warning me about it. (As was my wife!).  And yes I have fallen asleep in a gutter. Things are rather different now.

    Anyway I digress. What I wanted to mention is that when my drinking was at its heaviest, my gout was at its worst. I was drinking strong alcohol beer (8% – 10%) and also strong scrumpy cider (8%). Hardly anything else, but of course anything would do!

    I can't put the disappearence of my gout entirely down to stopping the alcohol, but I can tell you that after about a month of stopping drinking my gout attacks went away and have never come back. I also made a lot of changes to my diet at the same time so it is no doubt a combined effect. But the amount of alcohol I was drinking was huge, and removing this from my diet and my life would have to be a significant factor.

    If you are a heavy drinker then apart from the other obvious reasons for cutting it out, getting rid of your gout should be high up on your list of reasons to stop!

    #10968

    zip2play
    Participant

    Hans said: An increase of uric acid in your system (of course, there is are reasons for that to begin with) which generally trigger the deposition of those nasty critters, called uric acid/mono sodium urate crystals, which cause the inflammation, which causes the the pain.

     

    Just a little quibble: Inflammation cause a localized acid condition which casues MORE urate to precipitate thus self perpetuating the attack. In addition to mitigating the inflammation, colchicine is thought to alkalyze the joint further stopping the runaway process. There is evidence that colchicine also tempers the body's immune response to the urate. Colchicine does things that no other drug does.

    I find my response to colchicine is nothing short of remarkable. A small sample, granted, but enough to convince me that it is the best drug by a wide margin for a frank gout attack.

     

    I don't differentiate between inflammation and pain (and even swelling). Whether it is a gout attack, an abcessed tooth, an appendicidis, or a strep throat, inflammation and pain seem to me to be very much the same thing.

     

    Brett,

    You have nice looking feet.

    #10970

    hansinnm
    Participant

    zip2play said:

     … Colchicine does things that no other drug does….


    Thanks, Zip, for shedding more light on the inflammation issue.

    I second your Colchicine comments. It has terminated attacks/flares/twinges/inflammations in 1-4/5 days for me. Half of the time without having to take any additional pain killers, like Naproxen/Aleve.

    #14576

    If you are looking to stop gout early, please consider GoutPal’s Stop Gout program for a personal gout treatment plan.

    Note that for more discussions about alcohol, you should see the Beer and Gout Forum. But before you do, it’s best to read Best Alcohol For Gout, first.

Viewing 17 posts - 1 through 17 (of 17 total)

You should log in to GoutPal to reply to this topic.
If you do not want to log in, use the orange Support button, or raise a new GoutPal helpdesk ticket. Please note that I respond quicker in the gout forums, compared to the helpdesk.