How do you fix gout attacks?


9 replies to this topic
  • Pilate74

Posted June 07, 2008 - 06:18 AM

#1

I have been getting gout attacks for the last few years. I have changed my diet, limited my beer intake, lost 45 lbs and drink only water and unsweet tea. While I have not had a bad attack in a while, I still get some swelling and joint pain after exercise. The attacks happen about 2-3 days after a workout. Also they only happen in spring summer season.(used to get it year round before loosing weight)
I am trying to get a Doctor to believe that I have gout. Every time I go my urine acid is good. The attack goes away by the time I see the Doctor. My grandfather has been diagnosed with gout and my dad gets it as well.

I really need some help with this. I work for the feds and I cannot take a week off to let the gout go away.

I have been treated for nephritis (FSGS) in the past.
I still get the coke colored urine sometimes.
Two emergency room visits for dehydration last year.

I have been healthy for the last six months BP normal no obvious medical symptoms. Passed a physical fitness test ect..

I use 800 motrin for the pain. But it does little. I have prednisone to use as a last resort but I have no idea as to the dosage for gout. (do not like to take prednisone at all!!)

Any home remedies? Medications? (I live on the border)

Thanks Rob

  • DrMark

Posted June 07, 2008 - 07:03 AM

#2

The medicine to take is Zyloprim, also know al allopurinol.
You need to get it from a competent doctor, some in short supply down there.
You allso need to be on a diet.

  • Pilate74

Posted June 07, 2008 - 08:12 AM

#3

The medicine to take is Zyloprim, also know al allopurinol.
You need to get it from a competent doctor, some in short supply down there.
You allso need to be on a diet.


Thanks, I will ask for that particular medication. I have to drive 140 miles to see a Doctor that speaks english. I have had better luck with the Mexican Docs than the Mexican American Docs.

Mexican Doc= 15 min and 15$ + pharmacy (45 min total in Mexico)

American Doc= call for appointment, wait 1 week, take off half day of work, wait 2 hours in office, 30$ copay, 100$ lost time and wages + 1.5 hours pharmacy and more copay for the meds.

Both these Doctors were educated in Monterrey, Mex.
The Doctor in Mexico speaks better english than the Doctor here.

I drive to Monterrey or San Antonio for anything serious.

  • NxLevel_Chiro

Posted June 10, 2008 - 02:15 PM

#4

has anyone mentioned a low purine diet. Purines are amino acids that are found high in red meats. The by product of purine metabolism is uric acid.

  • Pilate74

Posted June 11, 2008 - 06:34 PM

#5

I had a attack tuesday. I called my nephrologist and she got me in to a arthritis Doc the same day. I drove 145 miles to San Antoino. It is wendsday the gout is under control. No more swelling very little pain. I will go for a two mile run in the morning. A good dose of prednisone is all it took. I am going back later in the month to see about my options for prevention.

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  • sealusion

Posted June 12, 2008 - 12:45 PM

#6

I have had gout on and off for a few years now. For me, orange juice, red meat, dry beans and shrimp seem to set it off. I have taken Endocin (sp) as a rescue med and it does good for me. When I feel it starting, I start my med and by the end of the day, I'm all good.

  • brtngrss

Posted June 14, 2008 - 01:07 PM

#7

I was told by my Gramps to drink cherry juice when the gout flared up.

I've never had a flare up so I don't know if it works or is an old wives tale.

:thumbsup:

  • snobuny

Posted June 15, 2008 - 05:35 AM

#8

prednisone works as a rescue but is not a good alternative for long term therapy. There are many consiquences to taking corticosteroids for management of chronic problems.

Gout is a condition where hyperuricemia develops and crystals of monosodium urate are deposited in tissue causing a gout attack resulting in pain and inflammation.

95% of cases are in the male population and it occurs mainly between the ages of 30-50 yrs old.

Attacks are usually percipitated by something i.e. following illness/surgery, exercise, dietary changes, physical or emotional stress, etc.

Gout can be primary or secondary. Primary is an inborn metabolic defect to excret uric acid and secondary is usually caused by another issue i.e. leukemia, diuretic (water pill) use for high blood pressure, etc. You need to determine if you are primary or secondary. In primary you treat the disease in secondary you remove or treat the cause.

Treatment involves diet modification with low-purine foods (google this for a complete listing) but avoid anchovies, organ meat (liver, kidney) spinach, mushrooms, asparagus, oatmeal, Beef, Pork, Bacon, Lamb, Seafood, (shrimp, scallops, lobster not fish), Foods that are made with a significant amount of yeast such as beer and bread, etc. I would recommend using a food log for awhile to see if you can determine what is triggering your episodes then eliminate that source if possible.

Controling weight is also beneficial but avoid atkins or low carbohydrate diets, limit alcohol and avoid beer due to the hops and yeast, choose another alcoholic beverage if you must drink (its ok in moderation)

If you are taking medications for high blood pressure, avoiding diuretics may be helpful. Unfortunately diuretics are a common medication for blood pressure control but there are many other alternatives that .

Motrin and aleve can be used for pain relief during an attack, Colchicine (perscription) given by mouth or IV is useful in controlling acute attacks and some studies have shown it is quicker at getting pain under control. Steroids can be used if patients are intolerant of other medications. Joint injections can be given when other medications are not helpful.

probenecid or allopurinol are used for chronic gout where patients cannot get control of attacks with diet modification and weight control. They are not very beneficial for acute attacks and should be started after your attack subsides. Sometimes gout attacks can occur with normal blood levels so treatment is more symptomatic rather than driven by lab values.

Indications for prophylaxis is more than 3 attacks yearly so you qualify but I would try strict diet modification prior to goin on long term therapy.

you can try the cherry juice if you are into alternative therapies, fruits and fruit juices are ok in your diet. It is touted to have anti-inflammatory properties and I know several people with rheumatoid arthritis who swear by it but have not heard of its use for gout.

  • qdog69

Posted June 29, 2008 - 07:38 PM

#9

I have been suffering 4-5 attacks a year for about 4 years They gave me Allupurnol to lower the Uric Acid but I would still get attacks, after seeing me a bunch of times they gave me a prescription for Colchicine. If I take it as soon as I feel an attack coming on then it never really develops...I keep a bottle at home and one in the office.

http://en.wikipedia....wiki/Colchicine

  • DrMark

Posted June 30, 2008 - 05:17 AM

#10

agreed.





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