Foot Pain since PD

[rookiegirl]

I don't know if my medical condition is to blame.  Since I started PD, I sometimes have pain in one of my foot.  About 6 months ago, it was my right foot.  I just woke up one morning and my foot hurt so bad it was hard to walk.  It last about a week and it was gone, just like that.

Now it's my left foot and this time is worst than the right foot.  It started last Thursday.  I woke up and when I got out of bed, I almost fell from the pain.  The pain is on the outside of my left foot beginning from the middle to the top. It hurts bad when you squeeze the side.  I went to the Podiatrist yesterday.  They did an X-ray of my left foot and didn't find anything that would contribute to the pain.  The doctor took some blood work to check the uric acid in my blood.  He said high level of uric acid in the blood could contribute to Gout.  My foot is not swollen, not red, no bump, not hot to the touch.  It looks normal until you touch it or walk on it.  I have been walking on the inside of my foot because it will not let me put pressure on the entire foot without hurting.  The foot doctor just couldn't figure it out.  The only thing he could do is give me that special shoe which helps with my walking and pain killers.  He also prescribed some anti-inflammatory, but my Neph doesn't recommend I take it.  My Neph said this filters through my kidneys.  He said if I take it, I will have less urine output and less filtration.  I refuse to take it just because I don't want to damage the little residual I do have.

My foot is still sensitive but much better than before.  I was on-line last night reading up on causes of foot pain.  I came across one site that talks about medical conditions can contribute to foot pain.  It said something about high blood pressure causing poor blood circulation.  I wonder if this could be what's causing the issue.

Does anyone out there have the same or similar issue with their feet since they have been on dialysis?  I'm so confuse.  I'm really confuse now since the foot doctor (Podiatrist) don't even know.

RG

[dh514]

It sounds like gout. I take allopurinol daily and I havent had an occurance in awhile. I have colchine to take when I need it.

[paris]

It sounds like gout. I take allopurinol daily and I havent had an occurance in awhile. I have colchine to take when I need it.

I agree.  I take the same meds and they have really helped.  The blood tests will beable to rule out gout.  I hope you find an answer soon. 

[djgaryb11]

I had something very similar happen with me but mine was before I started on PD.   I would wake up one day and one of my feet would have this kinda intense pain, almost to the point that I could not walk on it.  My Doctor said it did not appear to be gout, and he was not sure what it was, but suggested it might be "plantar fascilitis".  I tried using extra heel cushions and other types of inserts in my shoes, and that helped somewhat.  It would usually go away after a few days.  This happened several times , and it sometimes happened on the other foot, but never both feet at the same time.  Ever since I started PD it has not happened...so who knows what was going on.

[george40]

It sounds like gout especially with the elevated Uric acid. Have you been eating lots of red meat lately? shrimp? ... some food will bring this on more than others. Allupurinol is good for preventive measures. Did the doctors talk about a taper of prednisone in case it is gout? I hope you feel better.

[rookiegirl]

It's been 3 days since I went to the Podiatrist.  I'm surprise they have not called me with result of my blood work.  From what I have read on here and the website, it does sound like gout.  It makes since about the high level of uric acid specially people with kidney disease.  I just wish the foot doctor would have called by now to let me know what he found in my blood.

I need meds to hurry and fix the pain.  My foot still hurts.  Tonight I went ahead and took 1 pill of the anti-inflammatory medicine.  I really didn't want to because of the side effects on my kidneys and dialysis.  My Neph told me if I don't pull out enough fluid on PD, he said to use stronger solution 4.25%.  If that don't work, I was told to discontinue the anti-inflammatory meds (Lodine).  I'm afraid to damage what little function I do have because of my foot.

It's damn if you do and damn if you don't.  I can't win.  So frustrating.

[Red from Canada]

RG, It does sound like gout.  My Neph puts me on a short course of Prednisone, which takes the pain away pretty quickly. Start with 6, then 5, 4 3 2 1 and you're done.  Once the pain is gone, THEN they should put you on a daily dose of allopurinol for prevention.  Hope this helps you.

[george40]

Just as Red said. Prednisone works fast. My nephrologist made the call to start me on the treatment. Im not sure if your podiatrist will act on this. Forget the podiatrist and tell your neph. you need help and you need it now. I hope you feel better.

[monrein]

I also do a quick tapering course of prednisone if I get gout which has happened on two separate occasions.  It works fast and so far I've been able to avoid adding allopurinol the my list of meds.

[LightLizard]

i've been experiencing foot pain for some time now and i've been on P/D for a little more than two years. initially, it was suspected to be gout, but upon closer examination and observation my neph insists that the problem is neuropathy. at this point, for me, he says there's really nothing they can do about it. it comes and goes, so i'm adjusted to simply enjoying the time that it goes...

[drinkboy]

If it is neuropathy, there are certain meds to take that can help.  My mom had bad neuropathy in her feet, hands, and legs and some things helped a little but when the real severe attacks came, there wasn't much that helped and she dealt with it.  Hopefully, for anyone that has neuropathy, one of the meds that is out there will help.

[rookiegirl]

I received my blood work result on Monday.  The podiatrist nurse called me and it was "gout".  My uric acid level is elevated.  Here's the frustrating part.  I asked the nurse if the Dr will prescribe meds to treat gout? The nurse said she will ask the Dr.  It's now Wednesday and I have not heard back from them.  I do have a follow up appointment with him next Tuesday.  I turned around and called ny Neph office and spoke to my Neph's nurse.  She said there was nothing they can do at this time since my Neph is out of the country and will not be back until next week.  I was told to follow up with the podiatrist and he can prescribe some meds.  I'm so glad the pain finally went away because if I was still in pain, I guess with the run around I'm getting, I be dead.

I have more questions.  Why is gout so common?  What can I do to prevent it without taking meds?  Why is this now happening after 38 years of my life, I have never experience anything like it?  Will I continue to have this?  I pray not. 

Thanks,
RG

[george40]

How can your doctor not have a backup while he is away? What about your drs at the pd clinic?....

RG, your questions sound like mine when I first got an attack. Uric acid should dissolve in the blood and get filtered out through the kidneys. So with kidney failure there's a greater chance to get it. Foods high in purines are not good for gout; Red meat, organ meats, shrimp, seafood, some beans and other foods can be bring it on. Medications can even be the culprit.

A basic gout diet calls for:
    * Cut back sweets
    * Cut back on the amount of red meat and seafood you eat.
    * Avoid alcoholic beverages. (especially beer)
    * Eat more low-fat dairy products.
    * Eat more complex carbohydrates, such as whole-grain breads.

I dont know your medicine list, but once it come on meds like water pills (furosemide/lasix) can make it worse. Three years ago I had an attack and I was I was off my feet for an entire week. I think I was on a steak, burger binge when it first came on.  Well after the episode I stopped eating red meat, cut back sweets and cut shrimp (all foods I love), and ate less fish. Oh, I switched from eating dark meat (chicken and turkey) as the dark meat has more of these purines.  These changes in my diet dropped my uric acid levels. My neph then gave me allupurinol as a preventative measure. Now that I'm on PD the challenge is to eat more protein. The nutritionist keeps nudging me to try a burger or take protein powder. I decided 3 years ago that if I can help it I didn't want to feel that pain again so for me diet change + meds (allupurinol) has worked to a degree. It hasnt been all smooth, about a year ago I gave in and ate a bunch of shrimp (it was good too...lol) , sure enough even with the meds I had a flareup. But, my neph gave me a prescription for a prednisone taper which knocked it out before it became a full flareup. Anyways, thats my experience to date. I hope you feel better.

heres a link to a food chart: http://arthritis-symptom.com/Gout-Symptoms/gout-diet.htm
   

[theone]

Grout is considered as a 'rich person's disease' as it is caused by rich protein. I had grout problem before and yes, I know the pain.

I have prescription to take care the problem but I just don't want too much mediation and so I just watch my diet carefully.

Avoid bean and red meat if possible. You need to talk to a dietitian to find out what sort of  food you need to avoid to prevent grout from happening.