Gout

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Gout

Postby r2160 » Thu Jan 24, 2013 12:54 pm

Has anybody had this affliction? What did they do to help its disappearance?

cheers
Glenn
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"Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever" Lance Armstrong
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by BNA » Thu Jan 24, 2013 1:21 pm

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Re: Gout

Postby simonn » Thu Jan 24, 2013 1:21 pm

My dad had it quite badly. Tried diet for many years, but after a particularly bad attack on a holiday once where he ended up needing a walking stick he went on, and stayed on the pills. He was an unhealthy fat person at the time though. He did get fitter later in life, but not sure if he stopped the pills or how this affected anything.

Apparently genetics are the biggest factor in the cause of it. Yay for me :(.
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Re: Gout

Postby ozzymac » Thu Jan 24, 2013 1:55 pm

Hi,
I get it.
It is a family thing passed on I think.

I mainly get it in my ankles and big toe.

And holy crap, when I have had it in my ankle it is just as bad as being broken, it is so frigging painful, especially when you first put your foot down and the blood goes back in. Wow.....

I found that taking a drug called allopurinol, seems to help keep it as away.

I don't drink a lot, so that probably helps to.

Haven't changed any part of diet etc.

Cheers

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Re: Gout

Postby drubie » Thu Jan 24, 2013 2:37 pm

+1 prescription for allopurinol. Mine was getting steadily worse until last year when I basically got crippled for two months. Mine is seasonal I.e autumn usually.

You need allopurinol to slow down the mechanical damage to your joints. Its a bit late for my left foot, don't leave it too long and go see a doctor. The drugs are cheap as they are on the PBS.
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Re: Gout

Postby RonK » Thu Jan 24, 2013 2:54 pm

Gout is caused by the crystalisation of uric acid in your joints. This happens because your liver is overproducing uric acid - you probably remember learning about saturated solutions and crystalisation from your high school chemistry lessons. If it crystalises in your kidneys the condition is known as kidney stones. Both can be excrutiatingly painful, as you are no doubt aware.

If you doctor prescribes anti-inflamatories, particularly Indocid, be very careful to take them with food or you may end up with stomach pains which feel like a heart attack.

You will need to be on Allopurinol for the rest of your life.
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Re: Gout

Postby Magnum9 » Thu Jan 24, 2013 4:12 pm

RonK wrote:You will need to be on Allopurinol for the rest of your life.


+1
Have been on this (Progout) for a couple of years. No side effects and no more gout, although my Uric acid levels are still bordering on high. Costs around 7 bucks for 2 months (60 pills).
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Re: Gout

Postby sogood » Thu Jan 24, 2013 5:27 pm

RonK wrote:Gout... This happens because your liver is overproducing uric acid...
You will need to be on Allopurinol for the rest of your life.

Not quite. While true that gout is associated with high blood level of uric acid, the cause is multi-factorial. It may be through a number of issues along the metabolic pathway. As for life-long allopurinol, that's also not necessarily true. Depends on the individual.
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Re: Gout

Postby RonK » Thu Jan 24, 2013 6:19 pm

sogood wrote:
RonK wrote:Gout... This happens because your liver is overproducing uric acid...
You will need to be on Allopurinol for the rest of your life.

Not quite. While true that gout is associated with high blood level of uric acid, the cause is multi-factorial. It may be through a number of issues along the metabolic pathway. As for life-long allopurinol, that's also not necessarily true. Depends on the individual.

Thanks for that information - I'll let my GP know next visit...
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Re: Gout

Postby marinmomma » Thu Jan 24, 2013 6:59 pm

Try going to a naturopath for an alternative to medication.

Mr MM was diagnosed with this in his knee last year, not keen on the meds and gave the diet changes a shot and now there's almost 100% improvement.

This naturopath tailors your diet based on your blood group, but for Mr MM eliminating gluten and dairy products had the biggest effect.

HTh
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Re: Gout

Postby sogood » Thu Jan 24, 2013 8:19 pm

RonK wrote:Thanks for that information - I'll let my GP know next visit...

Misunderstanding may be the issue. He may have been specifically commenting on your circumstance, one that relates to over-production. Further, it simplifies the explanation. Trying to give the full story on Gout, or any other medical condition, may cause more confusion than a clear understanding of one's situation. It's all good. Wikipedia is a good source of information these days.
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Re: Gout

Postby RonK » Thu Jan 24, 2013 9:47 pm

sogood wrote:
RonK wrote:Thanks for that information - I'll let my GP know next visit...

Misunderstanding may be the issue. He may have been specifically commenting on your circumstance, one that relates to over-production. Further, it simplifies the explanation. Trying to give the full story on Gout, or any other medical condition, may cause more confusion than a clear understanding of one's situation. It's all good. Wikipedia is a good source of information these days.

Well, I don't simply accept a prescription from my GP without explanation. My GP has changed several times since the original diagnosis, and I have discussed the continued need this medication with each of them. I don't want to take any medication unless it is necessary. The answer has always been unequivocal that I will need to take it indefinitely.

I have changed my GP again recently, and we reviewed this prescription only last week in conjunction with the results of recent a blood test. Since it was my first visit, she knew no more about me than these results, and that I was on Allopurinol. I didn't specifically ask, but there was no suggestion from this doctor that I should stop taking it. I'll make a point of asking next visit if I should continue to take it and why.
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Re: Gout

Postby TigerFilly » Thu Jan 24, 2013 10:33 pm

Gout is a form of arthritis. If you give the Arthritis Association in your state a call they will be able to give you more information about it. (I work for one of them :mrgreen: just don't ask for 'TigerFilly' lol).
Here's a couple of fact sheets -
http://www.arthritisaustralia.com.au/im ... 2/Gout.pdf
http://www.arthritisaustralia.com.au/im ... d_diet.pdf
You need to seek treatment because the classic thing with gout is that you will get an attack, then it seems like it goes away (so people think they can ignore it), but without treatment you will eventually get another attack, and then they will gradually become more frequent and you'll have permanent joint damage. This is a good little graph that shows you what will happen without treatment to lower the uric acid levels - http://1.bp.blogspot.com/-naLYTkn_LEI/T ... f+Gout.jpg
If you really want to gross yourself out then search google images for 'tophi'.
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Re: Gout

Postby r2160 » Sat Jan 26, 2013 9:14 am

OK, I have done a heap of reading about this and found out the following:
It is caused by:
Dehydration
Fructose (soft drinks, alcohol, fruit juices etc)
Beer/red wine
protein - meats, seafoods etc
being overweight and losing too much weight very fast
I also found out that the worst thing you can do to kill the pain is to take aspirin, as aspirin helps your body produce uric acid

What to do:
Get your doctor to give you indometacin
drink HEAPS of water - if you dont, as your body removes the crystals causing the pain, they make their way to your kidneys. If you dont drink heaps of water, you can end up with kidney stones
rest your foot as much as you can.

I have stopped the aspirin (I didnt know) and the pain stopped within one day. I am on day three using indometacin and no aspirin and the swelling has already started to go down.

Hope this helps somebody

cheers
Glenn
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"Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever" Lance Armstrong
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Re: Gout

Postby BoardRider » Sat Jan 26, 2013 9:27 am

This is a terrible condition ,several people I have looked after have the crystals breaking through their skin around joints causing excoriating pain.
This condition can progress significantly and needs to be controlled to prevent any further disability.
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Re: Gout

Postby gururug » Sat Jan 26, 2013 9:45 am

Apparently eating too many bananas can cause gout...
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Re: Gout

Postby RonK » Sat Jan 26, 2013 9:46 am

BoardRider wrote:This is a terrible condition ,several people I have looked after have the crystals breaking through their skin around joints causing excoriating pain.
This condition can progress significantly and needs to be controlled to prevent any further disability.

They must have endured terrible pain before it came to this. Poor buggers!

In hindsight I think I probably had some very minor flare-ups earlier, but it only took one serious flare-up to send me off to visit my GP.
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Re: Gout

Postby winstonw » Sat Jan 26, 2013 10:36 am

have had it since I was 28. genetics and life stressors unmasked it.

My main exacerbators:
dehydration (incl. that associated with drinking moderate alcohol)
bodyfat over 15%
psychoemotional stress and associated poor sleep
physical stress like knocking your knee or kicking your toe can set it off when you have crystals in joints.
sedentary lifestyle (sitting at puters for way too long)
hypertension even if as low as 130/90
eating more meat and starch, and less veges and fruit.

uric acid crystals can form from being an undersecretor or overproducer of uric acid.

Years ago, I saw a world authority in Brisbane, Bryan Emmerson, who soon after retired, and he did a very good job of educating me about the causes and appropriate management.

I had tried for years to not go onto allopurinol daily, but he convinced me the damage done by not doing so was not worth the risk.
I had to accept my "natural" ability to get on top of it was compromised. It's a pity more people in the natural therapies do not understand that all humans do not have equal innate ability to get over genetic limitations.

I strongly recommend you read Emmerson's small book to get a very clear understanding of the condition
http://www.amazon.com/Getting-Rid-Gout- ... 0195516672

Further, you need to get to the bottom of how bad it is, the earlier the better.
Crystals can destroy joints, kidneys, eyes, ears, and even worse, your heart valves, thereby setting you up for a stroke or heart attack.

Uric acid tends to build up over the years in joints, and by the time you are having occasional attacks, you have quite a reservoir.
Usually you go on a higher dose of allopurinol initially to get rid of this reserve.
Then you go on a lower maintenance dose.

Since going on allupurinol, losing weight, cleaning my diet, regular cycling, more generally active, I honestly don't have attacks.
It is a relief, because when I do have them I am crippled, unable to walk, unable to sleep well, and suffer delirium from the massive inflammatory reaction, and miss days of sleep. It is truly a hell realm.

IME, as soon as I felt an attack coming on, I'd manage it thus:

- start taking high doses of voltaren
- ice it aggressively 30 mins on 30 off for 5-8 hours.
- increase water intake
- I never felt colchicine helped for acute attacks.

- the worst attack I had I needed an ambulance, because I was in amongst the worst pain of my life and unable to get off the floor or walk. This was brought on when I had a massive knee effusion, and had just been to a GP. In his wisdom he decided to push the effusion around aggressively, which led to it blowing up within 30 minutes, shortly after I arrived home. The ambo took me back to the same practise and I saw my regular GP, who tapped the fluid out of the knee and injected HCLA (hydroncortisone and local anaesthetic) or celestone (similar to HCLA), and pethidine tablets. I was stunned at how quickly the pain settled with the injection, which I've had around 4 of into the knee when I had attacks. My attacks could stop me from walking for around 1-2 weeks, so you really need to get on top of them.

Getting gout at a young age made me realize how important it is to do everything in your knowledge and power to keep yourself healthy.
None of us have perfect physiology. We all have kinks in our genes, and the Aussie 'she'll be right mate, have another beer and sausage" is just plain ignorant and dumb.
Australia would do well to look at it's culinary 'culture' and get it more into line with scientific and medical reality.
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Re: Gout

Postby Mulger bill » Sat Jan 26, 2013 10:59 am

gururug wrote:Apparently eating too many bananas can cause gout...

:( Damn, I hope this is wrong...
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Re: Gout

Postby gururug » Sat Jan 26, 2013 11:09 am

My bad, bananas alleviate gout, teaches me to listen to some novice nutrition lecturer :evil:

http://www.quickcare.org/musc/foods-tha ... -gout.html

The good news is.....according to this site coffee is also beneficial YAY!
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Re: Gout

Postby Mulger bill » Sat Jan 26, 2013 11:10 am

gururug wrote:My bad, bananas alleviate gout, teaches me to listen to some novice nutrition lecturer :evil:

http://www.quickcare.org/musc/foods-tha ... -gout.html

The good news is.....according to this site coffee is also beneficial YAY!

:D :D :D Best news I've had all day 8)
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Re: Gout

Postby sogood » Sat Jan 26, 2013 11:38 am

gururug wrote:Apparently eating too many bananas can cause gout...

You got it mixed up with those with kidney failure. Banana is to be avoided in those cases for its high potassium load.
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Re: Gout

Postby Releng » Sat Jan 26, 2013 2:31 pm

I also developed gout at a relatively young age, I first had it in my late 20's.
Lately I am winning the battle against it (touch wood).
I have lost some weight, drink plenty of water and not too much beer. And try to do plenty of excercise.
I am managing to stay off the full time medication and only get mild symptoms when I mess up one of my controlling strategies.
The last couple of events have been: riding too far without proper hydration, and drinking too much alcohol.

When it does start playing up, I take some mild anti inflammatories and drink lots of water. I am not convinced that diet has too much affect, at least for me.
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Re: Gout

Postby RonK » Sat Jan 26, 2013 5:25 pm

As winstonw posted, your alternative treatments may be suppressing the symptoms, but you may still have crystal deposits in your joints and organs, gradually eroding them.

I have used allopurinol since my first recognised flare-up, nearly twenty years ago. I've always been concerned about the long term use of drugs, and over the years I've asked my doctors to reconsider if I needed it. The answer has always been unequivocal - I'll be taking Allopurinol for the rest of my life.
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Re: Gout

Postby RonK » Sat Jan 26, 2013 5:33 pm

BTW - is there a standard dosage for Allopurinol? I'm taking 300mg per day and it's keeping my uric acid at normal levels according to regular blood tests.
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Re: Gout

Postby ozzymac » Sat Jan 26, 2013 5:51 pm

RonK wrote:BTW - is there a standard dosage for Allopurinol? I'm taking 300mg per day and it's keeping my uric acid at normal levels according to regular blood tests.


Don't think there is a standard dosage, I thought it just depends on what keeps it under control.

I was on 200mg, but it was suggested that I try 100mg and so far it seems to be ok. Not sure if higher doses are worse for you in the long run or not.


Cheers

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