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View Full Version : Dude, you've got gout!


vegashomeexpert
07-22-2006, 11:31 AM
Are cherry's and a changed diet the trick to surviving this "disease of kings"? Woke up one morning last week with a sore ankle. Thought I must have slept funny because I had not twisted it or rolled it prior. Got worse and worse. By the end of the day I couldn't walk. Slept poorly. Crawled to the bathroom the next morning (last Saturday) and decided to take myself to ER. They took Xrays and the doctor said there were not noticible breaks so it had to be a sprain. I specifically asked it if could be gout (I have friends with it) and he said no, if he touched anywhere near the area I would be in agony. (I WAS in agony but he was a doctor...). They wrapped it and told me to stay off of it and ice it. I stayed off of it all day and tried icing it, but the ice was murder. Went with friends (2 of which have gout) to an outdoor play that night and both of them laughed at me and said "dude, you've got gout". The pain was unbearable and we left the kids with them and my wife took me back to ER. The nurse and the next doctor both chuckled and said "dude, you've got gout". Now, with the pain I was in, all of these people saying this with a chuckle didn't get to me. The doc prescribed a steroid and anti inflamitory and gave me one of each at about midnight last Saturday. We were leaving for Don Pedro Sunday morning so I was hoping the drugs would work. Got up Sunday and I could actually put enough pressure on my foot to shower. Had the kids and wife do all of the packing while I directed from my perch on crutches. Felt much better that evening when we arrived. Was at 50% Monday. Surfed monday aftenoon. Skied Tuesday morning, wakeboarded Tuesday afternoon and it just got better and better. The steroid was a 5 day treatment so the last pill was Thursday night. Friday evening I feel a tingle in the foot and here it is Saturday morning and I am thinking the gout is coming back! Dang, I am on my way to get some concentrated cherry juice to see if that will work. Anybody else have any suggestions for treatment? Also, if someone tells you they have gout, or their symptoms suggest that from your experience they have gout, DO NOT chuckle and say "dude, you've got gout" 'cause its not funny.

tex
07-22-2006, 11:34 AM
I heard that you cannot eat red meat or have beer when you have gout? Just put the gun in my mouth!

vegashomeexpert
07-22-2006, 11:44 AM
They gave me an instuction manual for surving gout. No organ foods (yuck), no or minimal alcohol (won't happen), one serving of meat a day, no rich sauces etc., a lot of seafood is bad, dried beans and peas, mushrooms, even spinach and cauliflower can cause a flare up. No wonder old people are complaining all of the time!

bigmac
07-22-2006, 11:47 AM
If your stomach can hack it, naproxen and indomethicin is the best short term treatment, sometimes colchicine, but it may take a few days to a week to resolve the acute attack. Then you and your regular doctor have to start thinking about prevention. Diet changes, maybe low dose aspirin, maybe some other drug (allopurinol) to get your uric acid levels under control.

Good luck with that - be diligent about the anti-inflammatory you were prescribed.

tex
07-22-2006, 11:51 AM
If your stomach can hack it, naproxen and indomethicin is the best short term treatment, sometimes colchicine, but it may take a few days to a week to resolve the acute attack. Then you and your regular doctor have to start thinking about prevention. Diet changes, maybe low dose aspirin, maybe some other drug (allopurinol) to get your uric acid levels under control.

Good luck with that - be diligent about the anti-inflammatory you were prescribed.

So doc, ever serve time...wait, that's the start of another Chevy Chase thread...

Good advice Bigmac!

JimN
07-22-2006, 12:43 PM
If your stomach is OK with naproxen sodium (Alleve), Walgreen's and Osco have generic versions at much lower price. This stuff works great for sprains, arthritis, etc. It'll be two years on Labor Day weekend since I launched my ankle and I had some Vicodin from when I narfed my finger with my router, so I tried it. It did absolutely squat for my ankle. I couldn't put any weight on it and when I tried to sleep, I could either not be in a lot of pain and my leg would twitch or I could be in a sh!tload of pain with no twitch. After a couple days of not being able to do anything, two generic naproxin and a half hour- I could walk on it and flex it.

Gout is a lifestyle issue and if it gets bad enough, activity isn't an option. Maybe WebMD has more info or yahoo Health. Good luck with this.

PendO
07-22-2006, 12:55 PM
If your stomach can hack it, naproxen and indomethicin is the best short term treatment, sometimes colchicine, but it may take a few days to a week to resolve the acute attack. Then you and your regular doctor have to start thinking about prevention. Diet changes, maybe low dose aspirin, maybe some other drug (allopurinol) to get your uric acid levels under control.

Good luck with that - be diligent about the anti-inflammatory you were prescribed.

BigMac ... my copay is $35:)

bigmac
07-22-2006, 12:59 PM
If your stomach is OK with naproxen sodium (Alleve), Walgreen's and Osco have generic versions at much lower price. This stuff works great for sprains, arthritis, etc. It'll be two years on Labor Day weekend since I launched my ankle and I had some Vicodin from when I narfed my finger with my router, so I tried it. It did absolutely squat for my ankle. I couldn't put any weight on it and when I tried to sleep, I could either not be in a lot of pain and my leg would twitch or I could be in a sh!tload of pain with no twitch. After a couple days of not being able to do anything, two generic naproxin and a half hour- I could walk on it and flex it.
Vicodin is only a narcotic pain medicine with some acetominophen (ie Tylenol). It has no anti-inflammatory properties. VHE has joint inflammation as the source of his pain.

Gout is a lifestyle issue and if it gets bad enough, activity isn't an option. Maybe WebMD has more info or yahoo Health. Good luck with this.
There are other causes for increased uric acid in the blood besides gout. Those are unlikely in VHE, but I'd be inclined to recommend he see a doctor rather than get his advice off the internet. Unless the ER doctor actually aspirated the joint, the diagnosis of gout is only a clinical one. Just my :twocents:

bigmac
07-22-2006, 01:04 PM
BigMac ... my copay is $35:)Waived. Part of your Team MasterCraft benefits.;)

rektek
07-22-2006, 01:51 PM
lay off the booze and red meat, drink a boat load of water everyday, more water than you think is possible. anti-inflammatory drugs can help with symptoms but life style changes will ultimately get you going in the right direction.

TMCNo1
07-22-2006, 03:38 PM
I have had gout about once a year for the last 12 years and had it 2 weeks ago in the right wrist. Primarily appears in the ankles, sometimes in the knees and wrists that become swollen, hot to the touch and very painful, especially when touched by anything. Ice helps relieve the pain somewhat. It is caused by Uric Acid in your sytem, that crystalizes into sand like particles in the joints of the extremities. Doctor always prescribes a 6 day regimen of 10 mg. prednizone and [1] 0.6mg Colchicine twice a day, Any more Colchicine will cause an severe case of green apple high steps, and that's trouble if you can't walk, much less run to the toilet. Prednizone will make a diabetics sugar go sky high, give you the munchies and weight gain. Mine is usually gone by the second day of medicine and dropping back to a low fat diet, until you loose self control.

Leroy
07-22-2006, 05:34 PM
Do kidney stones go with gout? I see uric acid and think that is the same crystaline action that causes kidney stones.

I feel for you Vegas. Painful longterm treatment!

TMCNo1
07-22-2006, 06:06 PM
I have also had a couple kidney stones and was informed by the Urologist that the stones are calciun deposits that form in tiny pockets in the wall of the kidney. Everyone has these deposits, it's the ones that fall out of the pockets in some people that get into the urinary tract and create havoc on their way out. He showed me a poster of the areas effected and said around here, the stones are aggravated by the mineral deposits in the water and drinking a lot of ice tea.

bigmac
07-22-2006, 06:12 PM
Do kidney stones go with gout? I see uric acid and think that is the same crystaline action that causes kidney stones.

I feel for you Vegas. Painful longterm treatment!

Uric acid stones do go along with gout fairly often. It's the reason drinking lots of water is important in people who have high uric acid levels, such as gout patients.

MarkP
07-22-2006, 06:13 PM
:eek: Just curious if we can ovoid this gout thing??

Leroy
07-22-2006, 06:23 PM
I had stones at 19 and 29. Most incredible pain in the worst place. The Dr analyzed the stones the second time but was inconclusive. Told me to drink more water and avoid:

People prone to forming calcium oxalate stones may be asked by their doctor to cut back on certain foods if their urine contains an excess of oxalate:

beets
chocolate
coffee
cola
nuts
rhubarb
spinach
strawberries
tea
wheat branUric acid stones do go along with gout fairly often. It's the reason drinking lots of water is important in people who have high uric acid levels, such as gout patients.

bigmac
07-22-2006, 06:23 PM
:eek: Just curious if we can ovoid this gout thing??

Drink a lot of water and select your parents carefully.

bigmac
07-22-2006, 06:28 PM
I had stones at 19 and 29. Most incredible pain in the worst place. The Dr analyzed the stones the second time but was inconclusive. Told me to drink more water and avoid:


Yes, quite painful. Worse than childbirth, I'm told. Calcium oxalate and calcium phosphate stones are most common, about 80% of kidney stones. Uric acid stones are about 10% of all stones.

MarkP
07-22-2006, 10:46 PM
Drink a lot of water and select your parents carefully.LOL

Gulp!!

Maristar210
07-22-2006, 11:40 PM
Waived. Part of your Team MasterCraft benefits.;)

You rock big mac !!!

vegashomeexpert
07-23-2006, 01:20 PM
Great advice all around! Yes, will see my regular doc this week. Yes, will change my lifestyle. Saw Steely Dan & Michael McDonald last night, no alcohol and no dinner at Lawry's before (but the gout free people we went with did). You are right Big Mac, the ER doctor did not do any blood tests. He said they could stick a needle in the joint and biopsy some crystals or do a blood test and check the uric acid levels. Either test would take longer than I had, so I will check with my doc this week and get one done (don't want the needle in the joint biopsy, though). Yes, passed a kidney stone at 19 so there could be some correlation. Don't with either on anybody. My recommendation is drink lots of BOTTLED water, not Vegas tap water or any other hard water. A lot of the guys I grew up with have had kidney stones over the years and I attribute that to the hard water. Now, on with the lifestyle changes.......

tex
07-23-2006, 01:36 PM
Great advice all around! Yes, will see my regular doc this week. Yes, will change my lifestyle. Saw Steely Dan & Michael McDonald last night, no alcohol and no dinner at Lawry's before (but the gout free people we went with did). You are right Big Mac, the ER doctor did not do any blood tests. He said they could stick a needle in the joint and biopsy some crystals or do a blood test and check the uric acid levels. Either test would take longer than I had, so I will check with my doc this week and get one done (don't want the needle in the joint biopsy, though). Yes, passed a kidney stone at 19 so there could be some correlation. Don't with either on anybody. My recommendation is drink lots of BOTTLED water, not Vegas tap water or any other hard water. A lot of the guys I grew up with have had kidney stones over the years and I attribute that to the hard water. Now, on with the lifestyle changes.......

I will p/u your slack on the drinking and red meat! I'm there for you bro!
Good luck!

bigmac
07-23-2006, 01:47 PM
Great advice all around! Yes, will see my regular doc this week. Yes, will change my lifestyle. Saw Steely Dan & Michael McDonald last night, no alcohol and no dinner at Lawry's before (but the gout free people we went with did). You are right Big Mac, the ER doctor did not do any blood tests. He said they could stick a needle in the joint and biopsy some crystals or do a blood test and check the uric acid levels. Either test would take longer than I had, so I will check with my doc this week and get one done (don't want the needle in the joint biopsy, though). Yes, passed a kidney stone at 19 so there could be some correlation. Don't with either on anybody. My recommendation is drink lots of BOTTLED water, not Vegas tap water or any other hard water. A lot of the guys I grew up with have had kidney stones over the years and I attribute that to the hard water. Now, on with the lifestyle changes.......

Hard water can be a contributer to calcium stones, but unrelated to uric acid stones.

The problem of diagnosis as to whether or not this is gout (as opposed to trauma or an infected joint) might only be resolved by joint aspiration to look for uric acid crysals, but that's going to depend on your symptoms, medical history, physical exam, and your doctor's resultant comfort level that this is indeed gout. He would likely check serum uric acid levels and if they're high, gout would likely be a safe assumption. If they're normal (as often happens in an acute attack) the diagnosis is in doubt and he may recommend joint aspiration.

I hope it all ends up being simple for you and you can get this managed quickly.

JimN
07-23-2006, 02:36 PM
vegas- I hate to rain on your parade but a lot of bottled water is tap water. They supposedly purify it but it's not all really special, they just put it in a bottle and charge a lot. If you're talking about the 5 gal bottles, that may be different. Just about everyone I know in PHX has a water cooler.

bigmac
07-23-2006, 03:57 PM
vegas- I hate to rain on your parade but a lot of bottled water is tap water. They supposedly purify it but it's not all really special, they just put it in a bottle and charge a lot. If you're talking about the 5 gal bottles, that may be different. Just about everyone I know in PHX has a water cooler.

It's an interesting topic (OK, not really)...

Water is considered "hard" water if its calcium content is greater than 100 mg/liter. The Las Vegas Valley Water District reports that the water from its two pumping stations is 275 mg/liter calcium. Phoenix and most of the southwest is as bad or worse.

OTOH, JimN is correct in that there is huge variation in calcium carbonate content of bottled water - all the way from 0 (very soft) to over 500 mg/liter (d@mn hard).

Bottom line - if you have had calcium-based kidney stones, get a water softener at home and look carefully at the calcium content of your bottled water. If you have a home water softener, your urinary calcium is likely lower than someone drinking bottled water.

Generally speaking, bottled water is pretty hard. Those water bottlers balance hard water calcium (bone health) and magnesium (heart health) against soft water sodium (high blood pressure, congestive heart failure).

PendO
07-23-2006, 04:01 PM
http://www.evian.com/us/

mmmmmmmmmmmm thirsty:)

they have an interactive website kinda cool.

bigmac
07-23-2006, 04:10 PM
http://www.evian.com/us/

mmmmmmmmmmmm thirsty:)

they have an interactive website kinda cool.
Evian, for example, happens to be very low in calcium (78 mg/l) - very soft water.

Leroy
07-23-2006, 06:35 PM
Thanks for the education, hope Tex doesn't join the gout parade next!

Since I've had kidney stones twice I should be even more careful. Thanks for the reminder!

JimN
07-23-2006, 08:08 PM
Put some vinegar in the water- if it fizzes, it's hard. If it boils, make some concrete.