gout management without insurance

[Keith Taylor (GoutPal Admin)]

I am a 52 year old male 5'8″ 185lbs w/ reasonably good health(taking blood pressure meds) and have had occasional gout attacks (once a year, maybe less) for the past 8-10 yrs.  Each attack had been in my big toe until Nov. 28,'09.  This attack affected my left ankle and it swelled up pretty badly.  As with my other attacks I immediately quit drinking beer which historically has been the main step to recovery.  I also started taking  Indomethacin, drinking lots of water(usually a gallon a day), and a host of other home remedies such as baking soda, cherry juice, avoiding coffee, etc.   After the swelling went down and the pain eased (12 days), I had a few vodka drinks and two days later about 4 or 5 more.  I ended up setting the last drink down unfinished as I felt my ankle swelling up.  I went back on the Indomethacin, left the alcohol alone and after 13 days quit the Indo.  Now , 5 days later, I am getting a little pain back in my ankle.  I don't have medical insurance so drs. are out.  Any advice?

[Keith Taylor (GoutPal Admin)]

You have to get uric acid down to 6mg/dL – even lower for a couple of years to get rid of old crystals.

Without knowing what your current level is, it is difficult to be specific about what you can do, or even if it is realistic to try.

Some of the measures are:

• Lose weight gradually (the gout and weight loss tables indicate you have a good potential to reduce gout attacks)
• Increase daily exercise gradually
• Drink tea, coffee and skim milk
• Get more vitamin c (best from fruit or juice, but 500mg per day tablets have been shown to be good)

[odo]

If you can't afford meds, I'm afraid you will have to be very strict about diet, reducing your protein intake as much as possible. No red meat (maybe a little white chicken meat/white fish – no skin) No beer (traditionally the worst for gout) no spirits (as you have discovered – but maybe you can get away with an occasional glass of white wine). Even with this regime, maintaining a safe UA level will be a fine balancing act. You could also do with losing some weight – at least 20lbs. Carry on with all the other good things you're doing and keep in touch on here. And if you make these sacrifices, maybe you will be able to get gout meds with all the money you will be saving.

Sounds grim, I know, and it can take a while to fully accept the changes one needs to make to stay pain free, but you already know the consequences of your current lifestyle.

Good luck and all the best.

Odo

[zip2play]

rick,

Your method of dealing with your gout is very common and you are getting the common result: increasing frequency and severity of attacks. The end result of this is permanent crippling, chronic gout pain.

To break the cycle you need to get on allopurinol every day, probably one  300 mg. pill. Ideally, you need occasional uric acid monitoring but I know this is out of the question for some of us living in the United States with its medieval private insurance run medical care delivery system. So your MINIMUM is to see a doctor once and get a 3x refillable Rx for 90 pills and take them religiously, FOREVER.

[Richard Bell]

rickster, GP, odo and Zip have pretty much covered the bases but I would just add that if you’re in the USA and your attack is not bad enough to prevent you from walking, go to the emegency room of the largect hospotal in your local. You will have to wait hours no doubt but eventually you will be seen and treated. If you explain you suspect you are under a gout attack and the physcian knows anything he/she may have your blood tested for uric acid level and there is a good chance you will come away with a prescrition for colchicine at the very least and allopurinol or Uloric as well. I would suggest to the physician that you need 300mg of allopurinol or if it’s Uloric he/she prescribes, it should be 80mg. In spite of all the propaganda from the liberal left in this country, hospitals are mandated to provide care to anyone that shows up at the emergency room. No one need go untreated for a serious illness (And I think gouty arhritis is about as serious as it gets.) in the USA. AS I said, you may sit around for some hours waiting but you will be treated.

[Author]

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