Welcome to GoutPal’s Gout Forum. Anyone can post here – there is no need to register, though I can’t see why you wouldn’t all you need to do is register.
If you want to find answers quickly, please try this search:
… Or Post & Learn Even More
“Every time you respond to someone here, more people see the helpfulness, and they are encouraged to contribute. First with questions, but then with advice and support. It is a wonderful thing to see, and be part of. The diversity of views is very special, and I feel that this is only achievable through continuing natural growth”
This is the kind of spirit unique only to Gout Pal Interactive!
I would be grateful if anyone could advise on questions we should ask or tests we should request at our first appt for my husband (67 years old) with a rheumatologist on 21st Jan (2 days time).
He is a bit complicated as he has had gout since his teens (father also had it) he has never received any treatment and no interest was shown in his UA. He has been offered Allopurinol but has never bothered as he only had occaisional bouts of gout. This has changed.
The last couple of years he has had quite a few attacks – strangely enough only once in his life has this been in his toe (last year), usually it is ankle, knees & more rarely elbow.
About 3 months ago he had a TIA (ministroke) – no lasting effects apparent, also had one 3 or 4 years ago – very scarey for me to watch. Diagnosed with “small vessel disease”. I now suspect this is all connected with the long term raised uric acid, may be wrong. He is not a worrier so I do it all for him!
He has been very active all year, more so. Has worked in “The print” years ago and then as a painter and decorator, which he still is, but semi-retired. This year we also started a couple of allotments – great fun. He got gout in his knee from working out in full sun & little fluids but didn't last too long.
He also started with gout in his knee after starting 300mg Aspirin (initially for 2 weeks & then reduced to low-dose) for the TIA – he had to stop it. He is very reluctant to take other drugs for this. Simvastatin (spelling may be wrong) for cholesterol also triggered gout & so had to stop. Now takes Krill oil & vit e.
Since the allotment is quiet at mo as winter, he has been going to the gym & always feels better after it (usually 3 times a week).
We did a test for homocysteine which is high. He took a high dose B vits for this but stopped as his knee flared up again & I read that high B12 can trigger gout.
He was immobilised for about a month – couldn't sit in a chair so on bed for a month (I am wearing a groove on the stairs!). He had oral Prednisolone with little effect. The fluid was aspirated which helped for less than 2 days and then it was back. Finally I cracked & ordered him off the bed to his GP to demand a steroid injection into the joint, I was so worried about him being immobile for so long. His doc had previously refused to do it incase it wasn't gout! She by now had the result back which showed the uric acid crystals. That did the trick thank God. Up and mobile in a couple of days.
This finally settled – back at gym & here we are again! Within about 3 weeks approx it all flaired up again, swollen, immobilised. Now 3 weeks & able to walk a little now without crutches. Not as severe as last attack. We (I!) threw everything at it (all gleaned from this website!) – and he drank like a fish. Today is the first day he has stood for any length of time & it is all swollen up again but hopefully not back to square one.
The consultant rheumatologist we are seeing has an interest in polymyalgia rheumatica (he did some research) my hubby had this about 4 years ago. I have wondered if he might have a touch of this again and so thought he would consider this in any advice he gives him to deal with the gout.
Sorry this really is somewhat long & convuluted, I mention the history in case it might help us to ask appropriate questions, or request specific tests. As mentioned we go to the appt in 2 days.
At the mo I think we should ask A) about his kidney function, B) is he on over-producer of UA or an under excretor C) Is there an xray of some sort eg MRI he could have on his knee (he also had a ruptured Bakers cyst on his other knee about 18 months ago & I suspect had one on this gouty knee before it started too. It had a soft bulge at the back of his knee. I feel I am missing something though – its all becoming depressingly foggy. To start Allopurinol would be impossible at mo. I haven't encouraged in the past as I read in the side effects “risk of death”! Also the Stevens-Johnson syndrome worries me.
Trying to decide on the way forward for treatment is daunting & feels like Russian Roulette. He has started various suppliments, cut down protein foods (what the heck can I feed him!) & he has not had a single drink for months, even over Christmas (he used to love the occaisional beer or glass of wine).
Any obvious way to go with this appt?! It was implied by this consultant's secretary that he can be grouchy! I think we will need to be forearmed and clear about what we want from this appt. We should hopefully have some blood test results back to take with us. Thankyou folks!
It is a huge pity that your husbands gout has never been managed properly through simple uric acid controls, but now is a good opportunity to take that simple path.
You need a plan to get uric acid below .35mmol/L permanently.
The first part of this plan should be at least 6 months with a much lower level ( around .2 mmol/L) in order to rapidly dissolve existing urate deposits. Review every 3 months to assess if urate deposits are mostly dissolved and dose can be relaxed to maintain uric acid at .35mmol/L.
The urate dissolving phase needs to be supported by appropriate pain relief, at least for the first few weeks.
The time to worry about side effects of medications is if you get them. I know it is hard to avoid apprehension when uric acid levels have never been managed properly, but you should allow the rheumy to at least try and give you a plan before looking for problems. Almost all the problems you read about on the net have no relevant context (i.e. most patients have no idea about the need for a phased plan to lower uric acid with appropriate pain relief and medication changes at different phases). You need to get that context with a clear plan for long-term uric acid management, and short term pain relief. Any problems that do arise can be dealt with in context – much better than random discussions about potential risks of irrelevant events.
In the foregoing, I am assuming that you will go with the rheumy and accept medical cures. Allopurinol or febuxostat for uric acid control mean that dietary factors can be more or less ignored, except for maintaining a generally healthy diet and normal weight, with above average fluid intake. If you really want to try supplements and severe diet restrictions in an attempt to control uric acid, it would be best to start a new topic in the gout diet section with full information about height, weight, uric acid levels, current diet and current exercise. Again, random food restrictions with no clear plan only bring misery, and have more chance of increasing suffering than reducing it. In any event, this would be best considered after your rheumatologist has investigated and made his own suggestions.
Remember, the only way to avoid “risk of death” is to be dead! Avoiding no quality of life is much more important. There might be very small risk factors with some drugs, but all you can ever do is balance those risks against the benefits of improved quality of life.
Focus on getting a good plan for uric acid control. The way to get the best professional help is to explain events and experiences as clearly and unemotionally as possible. Get the facts clear, and remain focussed on getting a clear plan.
Try to keep fears and questions until after you get the professional opinion. The best way is to list them on a notepad before the consultation, and add to the list during the investigation part if necessary. Once you have that plan you can discuss any uncertainties you have. Ideally, get a contact email where you can keep discussions open to discuss any points that arise during treatment.
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.
4:33 am January 20, 2010
trev
Tophi Terror
England
posts 749
3
Good advice GP! Grumpy medics indeed- they'll be wanting bonus deals, like 'the city' yet!
[NB: No caps- thery aren't worth it!]
Juliana- When you say you threw everything at the gout- did that include black bean broth (BBB) &/or Soda Bicarb?
I tnink they could help here, but two points to your message-
Remember- it has taken decades to get to this point (true for most of us) and it's going to take time to put right whatever transpires from now on treatment-wise.
There is nothing 'dramatic to the good' that is going to happen overnight here.
I hope you have a good visit, anyway.
Secondly, you look after yout Hubby very well- but like a lot of men he will let you worry for him- Don't let this extend to predicting any side effects for his meds.
If I had his history you described- I would be on UA reducers right now- and I do have them on the shelf, but never taken. I too, far prefer meds free, if possible.
5:48 am January 20, 2010
Juliana
Swollen Joints
England
posts 62
4
First thankyou Goutpal for a swift and intelligent response – very much appreciated. Hubby also says “thank you for sound advice”. We will take on all you have said. Its so good to have access to your knowledge & experience.
Our monitor is currently set for mg/dL so I think that would be to try for about 4? Maybe we should change the readings to mmol/L. How would we know if the urate deposits are dissolved? Also how long after these last bad attacks should we wait until starting any medication? (Had it in knee & ankle twice in last 3 months & just coming out of last attack – unable to walk normally yet).
He takes Diclofenac for pain relief & it seems to settle the gout eventually, not sure if this is the best anti-inflammatory for him.
He has been making a few notes. We will Bullet point them as clearly as possible & I will TRY not to be emotional!! (Had a good cry this morning reading your replies!). Not an easy one for me!
I like the idea of having a contact with the rheumatologist via email – that's a service I have never experienced in the NHS here before! My hubby is very friendly & even managed a photo with his last consultant re Polymyalgia, so perhaps it may be possible!
You are right – we should have acted before. I met him when he was 59 year old. He had the odd attack but recovered quickly & never complained, I never realised the consequences.
Trev – thanks for your advice too – you always have that empathetic human touch. I take on what you say too about, “if you had our history” we are both anti-drug treatment, but this seems like the time to throw that to one side. Maybe eventually if all goes well, he will be able to reduce it with a combination of diet. We'll see. I particularly like the idea of not worrying about side effects! I will try!
Yes I cooked a few batches of black beans but not the frequency of dose recommended. He also swallowed soda bicarb – half teaspoon here & there, and cyder apple vinegar & honey several times throughout this last attack. It was in fact much less severe so it may well have helped. I still am desperately trying to find the black soybeans that I suspect are more powerful. Wont go on here – will perhaps skip to the BBB thread.
I only mentioned mmol/L as I thought that would be what your specialiist would use. I tend to think naturally in mg/dL, then convert. Anything below 6mg/dL is good, but to get rid of the old crystals quicker, it is better to aim low. From all I've seen, 3mg/dL is a level that everyone says is safe and acheivable, but 4 is pretty good too.
TRY not to be emotional!! (Had a good cry this morning reading your replies!). Not an easy one for me!
And now, you've set me off! (in a good, nice to be appreciated way)
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.
9:29 am January 20, 2010
zip2play
Member
posts 1213
6
Post edited 3:33 pm – January 20, 2010 by zip2play
I would stick with mg/dL also since most of us here are more familiar with the American sysytem (even the Brits.)
Get a uric acid test at the doctor's tomorrow. Normall this helps with diagnosis but is moot since he has shown crystals on joint aspiration.
He and you will simply have to do away with your fear of the meds. He MUST be on one of them to manage his uric acid, there is NO other choice. To manage pain, the best drug is colchicine but it is not the easiest one to use. It's only rival is prednisone/cortisone but that is even LESS easy to use.
When will he be rid of urate? Never, it may be reduced to benign but it will never be gone.
I think he can forget the maxim to forestall urate lowering treatment until he is pain-free because he has left treatment so long that there may never be such a period. He'll have to bite the bullet and begin treatmment with either allopurinol, febuxostat or probenecid ASAP. Use colchicne to control the pain as necessary (couple ways to do it.)
Yes, running a 24 hour urine collection before starting any of the drugs is a very good idea. Perhaps it might show that probenecid is the drug of choice.
Side effects from allopurinol are rare, rarer than with probenecid and the jury is still out on febuxostat…too new.
He's going to have a tough year getting this all settled, both mind and body but now is the time to start.
P.S. Take vitamins for vitamin deficiencies, that's why they were developed.
P.P.S. In a couple months I will be your husbands age and I have been almost completely free of gout pain with daily allopurinol for almost 20 years and counting. I have NO dietary restrictions and do the gym 5 times a week.
4:16 pm January 20, 2010
Juliana
Swollen Joints
England
posts 62
7
Thanks zip2play. Helps to know what to expect, less chance of giving up & persevering with treatment.
If he is Rx Allopurinol, should he start on about 100mg or less for say a couple of weeks to see if any obvious side effects side effects or longer before increasing? Is it better to clobber it with a huge dose to get UA levels down more speedily? Just used monitor x2 – 9.4 mg/dl & 10.2- following a meal, so indicates it is probably around that region.
If he is given colchicine, would this be more advantageous than the Diclofenac that he normally takes during attacks?
Would there be any particuar vits recomended during this process. I suppose its the immune system, that is in need of support if it is constantly reacting to uric acid as an enemy.
Good to hear of your success with Allopurinol – that would be impressive for anyone who does not have gout!
A further thought, I wondered if these extra gout attacks could be because he has recently been taking celery seed, bromlaine, cherries or cherry extract, quercetin, coQ10……. he felt nausious & stopped the lot yesterday! I'm beginning to think I am “killing him with kindness”!
1:34 am January 21, 2010
trev
Tophi Terror
England
posts 749
8
Sometimes , it's better to stop digging :)
I'm trying Goutcure again and this time I've noticed that it is causing niggles in old attack sites and even just recent injury where I lost two toe nails. If i don't keep the fluid up I can taste the goutcure herbs so i think they are helping. My last UA reading was 4.2- but it is early days.
The point I making is that herbal and other supplements can be quite effective and this is often quite user specific. ie: some get good effects , some bad and others nix!
One thing always advised is consult a Doc about their use ( they will usually smile benignly)- but the reality is that they can interact negatively with meds and at the moment there's quite a lot going on in your situation!
[I've used all the ones mentioned except celery seeds, without problems- but I do eat a lot of celery normally.]
1:45 am January 21, 2010
phofab
Swollen Joints
Western Australia
posts 84
9
Post edited 7:54 am – January 21, 2010 by phofab
You sound like my wife, your husband is very fortunate.
I have persevered with preferably the natural way for 36 years. The best selling version of this is on this Site.
Due to reactions to the Allopurinol I am attacking it from the lesser doseage end and increasing it slowly. I am into pain enjoyment, but after the initial 3 months of heavy duty reactions and gout flares. it does appear to be settling down. It is not a pleasant experience.
You seem like a person who doesn't mind giving up a bit of time and effort, give my recipe for Juicing a shot. See Gout Cures- Juicing etc. By the sound of it just start in slowly and only drink it over the same time as it would take to eat the vegies.
But remember that all natural cures take dedication and longer time to take effect. In your last post it would appear that your husband is attempting all the natural cures at once and it is possibly too much all of a sudden for his system. One thing at a time.
Severe Gout brings on nausea as do most of the medications prescribed to control it.
Juliana, here is one man’s opinion/experience with above items:
Celery seed: I have been consuming ground celery seeds for 2-3 years in salads, in/on beef, pork, chicken, and fish dinners, without ever experiencing any negative effects. I also eat a lot of fresh celery.
Cherries or cherry extract: I have been drinking 1 oz concentrated Montmorency cherry juice (diluted 1:1 with H2O) for nearly 5 years now and here I have experienced a slight nausea almost each time. And I have a theory: I am somewhat in a unique situation. I have been taking a 45 minute dry sauna practically each day for the last 35 years. (I know Zip, heat loves gout, but so does my otherwise healthy body, going on eighty.) After the sauna comes a ritual: 2Tbsp ground Flaxseed w/ 2 oz H2O, 2 oz cold cherry juice (1:1 juice/water), 8-12 oz cold LA mead (1/2 to 1 % alcohol honey wine). You got to remember that my body is slightly dehydrated, since I generally sweat off approximately 1 lb of “salty” water. And I haven’t eaten anything for 8 hours. That’s where my body slightly revolts: “Enough is enough!!!” My theory: The stomach acid (hydrochloric acid,), the cherry acid (whatever that is), and the oxidized alcohol(=acetic acid, know as vinegar) just ain’t good pals with each other. My recipe to calm them down is 3-5 minutes laying flat on my back with my warm hand on my belly and my stomach says: “Thank you! you can now go about your daily business.” This little gentle action to my stomach goes back almost fifty years when I experienced a similar nausea in the morning almost immediately after drinking pineapple juice.
I don’t know if my experience can be related to your husband’s, but I do know that the stomach acid (amount as well as strength) has a tremendous affect of what goes on in a person’s body.
11:24 am January 22, 2010
Juliana
Swollen Joints
England
posts 62
12
Hi, glad to be back here to you good folks! Thank you all for your contrib. & advice prior to my hubs appt. I did pick up your messages before we went & had hoped to report in yesterday but quite late home – it was like a good day out after looking at our 4 wall for weeks! Been wanting to have occaision for that face!
All went very well. We took a few bullet point questions plus a typed out chronological medical history with the gout history seperate.
Saw the Rheumatologist – seemed conscientious. In for about 40 minutes which included a ultrasound scan of knees, which was conveniently in the room next door. Scan showed some large deposits of ?urate ? calcium within the surrounding tissues & joint. Rheumy was “impressed” and said “poor man”! He said he had never seen this before! He used words like anmazing”. You can imagine my hub felt somewhat concerned at the exitement! He brought his trainee to look & then asked my hub what he was doing on Saturday! He is to be the patient on study for his Collegues (tomorrow)!
He had more xrays of both knees (our local Trust wouldn't part with the recent ones he'd had unless we paid £50! He also had blood test to ascertain that he doesn't have a calcium problem.
He said as firmly as you folk did- you need to be on Allopurinol. So regime is to be 200mgs Allopurinol daily, plus Colchicine .5 (?G) twice a day. Colchicine for 1 month only. He will be seen again in 2 months.
I asked what his 'goal' was (thanks goutpal) for the uric acid. He said 350 mmol/L. He said that some would like it lower. I asked how long did he anticipate this would take – answer 6 weeks.
Having read much of your experiences I would guess he was over optimistic but I really hope he is right!
He gave him a steroid shot in the posterior to “settle” everything & said he should start the treatment in 2 weeks time. (Took advantage & had a meal out – hub at last ate roast beef without fear!)
We were both “happy” with his advice.
Thought that was it – way to go. At 2am in the morning, my dear hub suddenly remembered that about forty years ago a doctor gave him a drug for gout – he took one & “felt poisoned, thought I was actually dying”. Saw the doc the next day & told to stop…which of course he already had! WHY remember NOW!!! Very inconvenient – 24 hours earlier we could have mentioned it to the rheumy. I guess it was probably Allopurinol – hub thinks he would have remembered as doc would have said “take it for life”. Don't know how long Allopurinal has been around.
Told him he has to tell Rheumy at his “modelling” appt tomorrow! Maybe he could give him a small tester dose? He is a lot older now & so may not survive to tell the tale if he swallows it again! Oh dear
I did ask if there was a way to contact him during the treatment (as advised on here) He said we could contact a nurse & aquired her number. She could hopefully relay any concerns to him.
Zip2play – sorry I asked about Colchicine – I noticed afterwards you have already said quite a lot about it. Have read some now but will persuse it all – I can be abit dopey.
Trev thanks for good wishes prior to appt. did have a quick look. You are doing amazingly well with a UA of 4.2 as I believe you are not swallowing Allopurinol. Brilliant!
Phofab Thanks for advice re juicing – will have a look at your write-up. I did juice for a while about 4 years ago but it wasn't in connection with gout. At the time it was not such a persistent problem.
Hansinnm My hubby added – it wasn't just all those suppliments I mentioned, but the combination along with …lots of lemons, vinegar & honey, soda bicarb & black bean broth. Had to laugh – did sound somewhat over the top!
Ground celery seed sounds interesting (probably cheaper than the bought suppliments). He was consuming daily flax seed oil – he likened it to drinking “engine oil”. You sound like a gluten for punishment – something must be working though!
Forgot to mention blood results taken 3 days before visit his serum urate was said slightly raised 412umol/L (during gout attack) but I think that is considered normal. Hb12.7 (slighty low) RBC 4.29 (bit low) Heamatocrit 0.38 (low) 1.2 lymphocytes – low. CRP 16mg/L (raised), & ESR 48 (raised). There were no comments at all about these results (apart from reassurance that HB ok so not sure af any significance, & UA slightly raised).
Thank you so much.
1:28 pm January 22, 2010
phofab
Swollen Joints
Western Australia
posts 84
13
Post edited 7:31 pm – January 22, 2010 by phofab
Julianna said :- He used words like amazing”. You can imagine my hub felt somewhat concerned at the exitement! He brought his trainee to look & then asked my hub what he was doing on Saturday! He is to be the patient on study for his Collegues (tomorrow)!
Just curious, does being a guinea pig to be poked a prodded bring any benefits such as payment or reduced charges?
Or will you be billed, for multiple consultations?
I still believe in fairies and Father Christmas
It is great that you seem to now have a plan. Keep up the good work.
2:31 pm January 22, 2010
Juliana
Swollen Joints
England
posts 62
14
Unfortunately no benefits in the way of time or travel expenses despite a 90 mile round trip! However his consultation & xrays/blood tests were all on the NHS. We have both contributed for years though. He doesn't mind fortunately. It would have cost a fortune as a private patient.
We thought we had a plan – still need confirmation to go ahead with a drug that may almost have killed him after one pill though!
10:33 pm January 22, 2010
phofab
Swollen Joints
Western Australia
posts 84
15
Post edited 4:40 am – January 23, 2010 by phofab
Julianna
Have a read through my POST Your Gout “Gout for 36 years etc”.
Plus Gout Cures : A beginners guide to Gout.This one will be right up your alley
My apologies for my last POST, it was a poor attempt at humour, Many of us have found that looking at the funny side of Gout or making fun of it does truly assist coping with it.
Your mention of severe problems with a drug (possibly Allopurinol, created circa 1960's) at age 40, raises warning signals that I can relate to.
Described In my above POST after bad reactions to Allopurinol, I am attempting to use it again. But I have commenced on what the Doctors consider a minuscule dose of .25mg x 3 per day,(.75mg per day) and have over a period of 4 months managed to get up to 150mg per day. It hasn't been a fun trip and extremely painful for 3 months, but it all settled down for a month and I took myself up to 200mg per day, the side effects have kicked back in again and the joint pains, but at a greatly reduced level.
Result, I am back haunting these pages and making poor jokes.
Have a read of the abovementioned POST and draw your own conclusions.It is your husband's body, he knows it better than anyone else.
Keep on Trucking, you will win.
Your husband has to be a willing participant ! He has most to gain.
You already have your own plan, it sounds like your husband is prepared to attempt to overcome his symptoms and he has a very caring wife who is desperately attempting to assist him. What can defeat that power?
David
12:26 am January 23, 2010
trev
Tophi Terror
England
posts 749
16
Glad you're making progress Juliana- you sound so much more bouyant after a few days coming to the Goutpal saloon :)
My SUA levels have dropped over the months- I'm not sure whether it's the diet, BP meds combo or the Goutcure+plenty H2O recently restarted after 3 years break.
I can see why you worry over AlloP. It's tricky to judge cause and effect with something as deeply established as gout- Though urate may be rather insoluble in water there are things like care,application and persistence that a simple compound doesn't have over us, sometimes vulnerable, humans.
You can both win together ,I'm sure, with or without AlloP forever.
My levels have been down to 265umol [the 4.2 was a typo-should have been 4.5 repeated yesterday- rising to 5.3 after 12 hours] and just twinges of a very minor call.
The thing I'm realising, is the role of fluid [good water mainly] intake in this and, with the Goutcure, running to the loo at 10 min intervals on occasion.
5+ pints/day takes some doing when a bit sedentary.
Also, diuretics cause gout by dehydration,I believe , from experience. I still take one, 1/2 dose ,but I realise I have to do more to get back to system balance.
I think you know you have a way to go- but there is light in the tunnel now.
If urate lowering drugs aren't tolerated then my figures show there is a way forward.
6:15 pm January 23, 2010
Juliana
Swollen Joints
England
posts 62
17
Phofab – no prob with your post/humour, it was nice to hear from you, sorry if I gave that impression in my response.
I have just read both the threads you mentioned. Both interesting. Your experience of Allopurinol is pretty daunting but good to hear you come out of that depressing experience I read parts to my hubby, he is interested to know what the side-effects were of the Allo. I didn't realise 25mgs of Allo was available (unless you chopped them up?)
We saw the Proff of Rhemy again today (where hub did his bit as a model!). We had a chance to mention our concern about hi being given “something” for gout 35-40 years ago that made him literally feel he was dying in the night. He felt absoutely dreadful, the idea of taking another would have been suicide to him. This is a man who rarely complains about pain & waits until he is nearly dead before he mentions anything normally!
I am trying not to be overly anxious but my thought was that it was a good chance that it was Allopurinol (or cochicine) – no way of knowing. If it were then what would it do to him now he isn't as resilent. We mentioned it to the Proff & he had little time for us, just stated his years of treating gout & that Allopurinol rarely caused more than a skin rash. I mentioned Uloric (Feboxostat?) as I know it couldn't have been that. He said it was too expensive & “Better the devil…”. Proff Rheumy then dismissed us with a suggestion that we forget it, full stop & just continue as we are – take nothing. He missed the point completely, he seemed deaf to the fact that we are wanting to get his UA down & feel now feel it needs drugs, just needed some reassurance or an alternative to Allo/Cochicine.
My hubby sat on a bed for an hour whole 3 groups of doctors had a go at practising ultrsound on his knees & ankles. They said he would get a little present in the post….. perhaps there are fairies – my hub said “As long as its not a pen!”.
As for the juicing – wouldn't that increase the Uric acid, extra veg? I get nervous nowadays just cooking him broccoli or a token mushroom!
Trev thanks for your post. One thing that has really gone in is WATER WATER WATER. Thinking of setting a timer every couple of hours as a reminder! Sometimes I wonder if it was starting the celery++ etc that triggered the last attack (ok, I'm digging…. I'll stop!).
Another thing that seems eorth looking into is the “Goutcare” is there more than one make of this?
Your management of your UA is impressive. Doing it diet/natural only way though, without effective strong antiinflammatory help for my hub, I suspect would cause lots of flares of gout given the amount of urate he must have laid down in his tissues.
Thanks for the encouragement again.
7:23 pm January 23, 2010
phofab
Swollen Joints
Western Australia
posts 84
18
Juliana
I am in the 66/67 yo age bracket and dealt with the complaint now going on 37 years.
As you will have read in my POSTS, I have followed the natural path with anti inflammatory drugs- my choice Voltaren, for quick relief from the pain and swelling.
I have a pill cutter and cut down the 100mg pills to quarters. Started out on 1 x 25 for a week or so and built up to 3 x 25mg per day and up to 150mg, sat there for about 2 months, while I got used to the side effects and bit the bullet and took another 50mg , up to 200mg. The side effects (lesser) have come back and I am perseveringly at this level. Maybe I should have only gone up by.25mg?
I understand this treatment of starting lesser and working up, possibly prolongs the agony, but like your husband, if I went onto 300mg straight off, I would cease to exist.
In addition to the side effects of Allopurinol there are the ongoing gout flares and attacks, which are beyond a joke. No sooner is one attack finished than another starts. The worst part is that you look at the foot after an attack and it is looking good and not so flushed and that night another starts.
From GP's Site I gained the knowledge (not known to the GP's) that when your Uric Acid Level is reduced sufficiently, the long embedded UA crystals leave the joints and are attacked by the bodies immune system bringing on an attack or flare. You are being rewarded for being good by more pain.
These attacks/flares are of short duration but seem to be one endless attack.
I started Allopurinol 15/9/2009 but by mid December, things settled down and I gave myself a break to recover before proceeding further. I guess the increased dosage has freed more crystals.
It is not a fun time and it is possibly better to sleep in separate beds as the patients sleep is very disturbed and I had need to get up at all hours to bathe my feet in water and Epsom Salts to ease the pain and swelling.
As to the side effects , they are many, I've written them up somewhere on this Site, but currently the constant need for sleep,, drowsiness, headaches and overwhelming tiredness are the current culprits.
I did try 300mg for a day and half and the effects were frightening and this is one observation:-
My main purpose in continuing the treatment, albeit at the low dose of 150mg / per day and still function, is to reduce the toe tophi , I can well cope with the few attacks a year that I normally suffer. The effects I experience on 300mg of Allopurinol are life changing and I pretty much cease to function. Movement outside of the house is not really an option as I can't drive or walk, converse or think sensibly due to the side effects.
Your experience with the medical profession is mirrored all over this Web Site.You are not alone. They seem to cover up their lack of knowledge with arrogance.
As to the natural cures :-
As with Trev, I have used water on a timed basis and not by thirst.Very important.
The juicing I describe has been one of the best solutions I have come up with and reduced my UA down to .40mmol/l and more recently .33mmo/l. If you follow the link on the Juicing page you will note that all the veges used are high in alkalinity.
It is all trial and error, either medically or natural .
Treat it as a science experiment, you will generally have less side effects from the natural cure but it will not be a quick fix. Neither is the Medical way which I am proving out.
Hang in there.
David
7:36 pm January 23, 2010
phofab
Swollen Joints
Western Australia
posts 84
19
Found the diary notes I put together over 3 months, should be enough to put you off.
15/9/2009 Commence Allopurinol 3 x 25mg / day
30/9/2009 Increased dosage to 3 x 50mg / day
Side effects:-
Palpitations
Drowsy
Indigestion
Reduced appetite
Ongoing flares and attacks
Lack of energy
15/10/2009 Jumped dosage up to 3 x 100mg for 4 tablets
Side effects:-
Burning face
Strong palpitations
Indigestion
Vague
Difficulty carrying on a conversation – talked rubbish
Difficulty concentrating whilst driving- shouldn't have been driving
Drowsy
Generally unwell
Onwards Ongoing Gout flares and attacks
15/11/2009 Little toe was extremely painful (ache) to the extent the pain made me feel sick and purple in colour. – angry.
Bathed foot in Epsom salts and the tophi erupted, putting out creamy type pus for several days. Covered it each day with a band aid and antiseptic cream.
20/11/2009 Gout in lh foot increases
21/11/2009 Foot inflamed and swollen 2 x Voltaren 4 x Colgout
22/11/2009 4AM woke with bile in mouth, reflux and terrible belching, stomach bloated, bad indigestion – 1 x Voltaren and 3 Colgout
8PM Colgout starts to hit
23/11/2009 From 1AM, visits to loo almost on the hour until 7.30am. Woken by bile in the mouth and belching before each visit- this settled down for a short time after the visit. Put out a terrible amount of fluid. Unable to drink as it brought on the belching again.
Foot very inflamed to the extent that the skin parts on the toe joints.
Things gradually settled down from about Mid Day.
Foot remains inflamed
Continued with Allopurinol throughout. Stopped Colgout
24/11/2009 Exhausted and drained
27/11/2009 Foot looking healthier in AM. Stress – became inflamed in the PM. Back on Volaren and Colgout
28/11/2009 Foot swollen and sore, low activity 4 x colgout and 2 x voltaren per day
29/11/2009 Swelling inflammation reduced helped with housework and a bit of light gardening. Stopped colgout, continued volaren x2. Bloated, burping, bad wind.
30/11/2009 Difficulty sleeping, uncomfortable, got to sleep around 4am. Woke 7.30 am - luncheon swelling down, Ok in shoes, enjoyed myself, ate main meal and sweet with difficulty, not hungry. Drank only water. Overfull had light evening meal. Very tired
1/12/2009 1am woke with a jet of bile in my mouth, felt bloated, sitting up.
Note :- That over eating brings on discomfort. I have reduced my intake over the past 6 months and have lost about 3 kgs.
2/12/09 Full nights sleep. Gout flares still hanging around. No Voltaren, 1 colgout
3/12/09 Awake 3.30 Indigestion, wind reflux, uncomfortable. No Voltaren,1 Colgout – Bicarb, soy milk around 7am had some biscuits and got back to sleep. As above – did blood test.
Foot looking much better. Must be another attack coming on. Foot looked quite thin and almost a creamy colour. No Voltaren, 1 colgout
4/12/2009 1.30am – strong pains left side, wind , a little reflux- bicarb, and a biscuit. Foot inflamed on standing. Settles down. EP bath. Little toe quite angry.
5/12/2009 Foot reasonable
7/12/2009 Wore boots for about 4 hours, a lot of discomfort with small toe. Toe inflamed. Soaked it and it settled down with spikes of pain throughout the night.
Ground celery seed sounds interesting (probably cheaper than the bought supplements). He was consuming daily flax seed oil – he likened it to drinking “engine oil”. You sound like a gluten for punishment – something must be working though!
…
Thank you so much.
Juliana,
1) Ground celery seed: 5 lb bag for $10.63 from Bulk Foods-USA, Tel: 419-537-1713 (4/2007)
2) Flax seed oil: I am taking 2 Tbsp of ground flax seeds each day. Does a beautiful/gentle job of getting rid of UA, no matter how much or little, the one of the ways Mother Nature tells you to go (and as we say in German: Even the Emperor of China must go by himself – he can only be carried to the imperial House, the rest, he on his own.)
3) Gluten for punishment: People have called me by far worse names than that, however, I am not quite sure for which item you consider me a gluten.
4) Something must be working though! Besides some other items of my inheritance, my stubbornness is working at top efficiency.
Login
Register
Forums
(in a good, nice to be appreciated way)
)
Been wanting to have occaision for that face!
He used words like anmazing”. You can imagine my hub felt somewhat concerned at the exitement! He brought his trainee to look & then asked my hub what he was doing on Saturday! He is to be the patient on study for his Collegues (tomorrow)!
Topic RSS 
Entries (RSS)