Gout and it's Pain

[tamara]

Well Thank God we are not Horses.

I have had gout that I have had to drag myself on the floor to get to the Toilet.

It is shocking pain, and I even got given a pair of crutches by a friend of mine !

Go back to your doctor, discuss the side effects and also the pain starting up again.

It will get better, otherwise instead of shooting you we will shoot the doctor! 

[Falkenbach]

Good point, kitkatz. 

Yes, very good point! My bad. 

[dawson]

Some information I've gathered over the years about gout...it is hereditary.  Uric acid levels rise with the amount of purines consumed in food.  Most food is broken down into levels of purines and the items in the number one (or worst for you if you're susceptible) are organ meats, scallops, legumes (beans and hearty vegetables), gravies and extracts (oxo), and salted fish such as anchovies and mackerel.  White bread and refined white sugars are better for you than whole wheat or browns or naturals (as far as purines go). 

I didn't know before reading this that gout was associated with the kidneys!  Thanks....

[Falkenbach]

the items in the number one (or worst for you if you're susceptible) are ...... legumes

Oooooooh, perhaps that had something to do with the gout attack I had. Luckily, I never had a repeat and that was a few years ago now.

Well, I think I'll keep eating legumes, but perhaps consider limiting the intake.

[keefer51]

It was own fault i should have gone on dialysis sooner but i wanted to do things i couldn't do when i was on before. I remember i was working and my wrist was hurting something bad. After going to the emergency room they told me it was gout. The pain was unbearable. They sent me home with pain pills and that was it. A few weeks later it was now in my shoulder, ankle, and hip. Words can't describe my friends. It was during this multiple pain i finally went on dialysis. It was a few weeks after that and it was gone.

[Falkenbach]

That sounds truly awful Keefer. Just having it on my ankle area was bad enough, it put me off my feet (and therefore, out of work - I was self-employed) for a week.

[Ken Shelmerdine]

Thanks for this thread, it is very informative. I have been having increasing levels of uric acid in my lab results, but I have never had an episode of gout. What do you think I should do? My doctors have never said anything about it yet. But I think I should call their attention to it and see if we can lower it. I don't eat any of the foods you cautioned about, except the meat and fish as protein sources. The other things I either don't like , or they are to be avoided on the hemodialysis diet anyway.

Iamillinger
I have been on dialysis for 10 months now but my kidney condition has been monitored for the last 19 years. 15 years ago my blood results showed an elevated level of uric acid. Although I hadn't developed gout they put me on allopurinol and I've been taking it ever since and have never developed gout. So my answer would be to ask your Doc. to start you on the drug as a preventative measure.

[Bajanne]

Well, folks!  Here it is - another gout attack!!  A lot of it is my fault, as I have not been taking the allopurinol  that was supposed to keep it away.  This time it went for my big toe (the classic gout region).  I have never had it there before.  This time my nephro gave me Indomethacin 50 mg. and for the first time, my pain subsided after a day or two.  I am accustomed to having this pain for weeks before it finally goes away.  I think I will get a presciption for allupurinol and take it!
My nephro said that this medication he gave me is not good for the kidneys but since mine are shot anyway......  Well, it works!  and I am glad.

Had spelled the medication wrongly.  I did a search and found out it is great for helping during attacks - Indomethacin

[Ken Shelmerdine]

Thanks for this thread, it is very informative. I have been having increasing levels of uric acid in my lab results, but I have never had an episode of gout. What do you think I should do? My doctors have never said anything about it yet. But I think I should call their attention to it and see if we can lower it. I don't eat any of the foods you cautioned about, except the meat and fish as protein sources. The other things I either don't like , or they are to be avoided on the hemodialysis diet anyway.

Ive been taking allopurinol now for fifteen years as a preventitive measure because my uroc acid levels were high. Luckily I've never had an episode of gout. Maybe you need to ask your doc. to prescribe allopurinaol just as a safeguard.

[paris]

Allopurinol has been a life saver for me.  I have been taking it for several months and have only had one small,short episode of gout.  I hated to add one more medicine, but it has made a world of difference. Bajanne, get the prescription -- it will help!

[Lulu]

the items in the number one (or worst for you if you're susceptible) are ...... legumes

Oooooooh, perhaps that had something to do with the gout attack I had. Luckily, I never had a repeat and that was a few years ago now.

Well, I think I'll keep eating legumes, but perhaps consider limiting the intake.

Hi Cyco - Not sure if you have to watch your potassium (off subject I know) but 1/2 cup of legumes contain roughly 1200 - 1500mg of potassium. Specifically, black beans, cranberry beans, garbanzo beans, pinto beans and kidney beans. Just an FYI.. I always knew about the phosphorus but never about the potassium.

Now on th gout - I have had it for well over 10 years. For some reason my previous nephs never diagnosed. My new neph on the old hand, spotted it right away. I have done a massive amount of research on it and here's what I know:
High Uric Acid is an indicator that gout symptoms can happen, but in some people they don't get the crystals and don't have symptoms.
The pain from a gout attack is from the uric acid crystal shedding it's outer protein layer.
White blood cells attack the raw crystal as a "foreign invader" becasue it appears new without it's outer protein layer.
You build up a new protein layer around the crystal and the pain subsides.
Allopurinol works by extracting uric acid from the blood. In kidney patients, the kidney is not usually able to do this. Thus, the allopurinol.
Allopurinol needs to be taken everyday to keep uric acid levels down.
Colchicine works by acting as a decoy so the white blood cells stopp attaking the raw crystals.
This is the reason colchicine iis usually taken at onset of symptoms and repeated later on in the day.
Usually two doses in one day is sufficient to help start to subside the attack.
A pain medicine is usually taken with colchicine, even something as simple as tylenol (no NSAIDS).
There are two dosages of colchicine .5mg and .6mg.
Usually patients take allorpurinol or the colchicine, not both. Consider it akin to steroid or non-steroid protocol for transplant recipients.

So, if you can tolerate allopurinol. Take it. It is certainly simpler than dealing with gout attack.

For me, I had every side effect in the book from allopurinol. Hallucinations, heart palpitations, blurry vision, all kinds of wierd stuff. I was like a zombie. So, I take colchicine .6mg x 2 at onset with 1000 mg of tylenol. And then repeat one more time if needed. THe mpst important thing you can do for yourself for a gout attack is rest. THis way your body can put a new outer layer over the crystals and the attack will subside.

My doc advised me to eat no, none, zip red meat or alcohol. Not even wine. SInce I have done that, my attacks have subsided greatly. Red meat really does it for me. WIthin 12 hours I can start to feel the gout. Also, I don't have typical kidney disease (no high blood pressure, no salt restriction). Mine is from scar tissue from surgery when I was a little girl. So, I am able to stay very hydrated. But, if I slip up - gout kcicks in.

I know this is long, but I was in so much pain for so many years. My gout spread to nearly every joint in my body. If I can spare anyone the pain and agony and the uncertainty of which med to take, I will have felt I have done a great service.

[Falkenbach]

Hi Lulu

I was very lucky, I only ever had one definite case of gout, and another possible one later down the track. Since my tx, I've not even thought about it.

I don't really have any dietary restrictions any more either, but thank you for that info, particularly re kidney beans as I do eat those quite a bit. My potassium is regularly checked in my routine blood tests.

I wouldn't wish gout on anyone, and I'm sorry to hear you have suffered it for so long.

[paris]

Lulu, my neph has me taking both allopuinal and clochicine. They work in different ways and have helped me greatly. 

[carolynt]

My gout was in my toes, elbows, knees and fingers.  It would just find a place to flare up.  I had a knee operation because my knee was blown up and they thought it was a torn miniscus but now I believe it was gout since my knee has never healed properly.  Allpurinol and Collechine seem to to keep it at bay.  All I know is that it was a horrible pain. 

[paris]

You can't even to begin to describe the pain.  It truly is debilitating.  Thank goodness for those two drugs.  I haven't had any problems since I started them.

[Bajanne]

Just today I remembered to ask my nephro for a prescription for allopurinol.  My problem has always been that when the pain stops, I forget I need to take this to keep it away.  I will fill the prescription tomorrow and start taking it properly.

[paris]

Bajanne, please remember to take it everyday. It will help so much and we don't want you in anymore pain.

[Lulu]

Lulu, my neph has me taking both allopuinal and clochicine. They work in different ways and have helped me greatly. 

Hi - Just wanted to make sure I am being heard correctly. Please keep in mind I have done a ridiculous amount of research on gout I am just sharing what I have learned with everybody. It just doesn't make sense that docs still prescribe allopurinol and colchicine to both be taken. It really should be one or the other...Or - if you have both colchicineis best taken at onset of symptoms. But, it just doesn't make sense to take them both because the allopurinol should reduce the uric acid level so that the gout symptoms are virtually nonexistent.  Before allopurinol was available people had to deal with the crippling effects of tophi (I am going to a rheumatologist as I believe this is starting for me). I wish I could take allopurinol, but alas I can not.

Anyways, just wanted to make sure that everyone knew that my big long post earlier was not geared in response to anyone. I was just sharing what I know. The only point I am desparately trying to make is don't needlessly take two drugs for the same thing. Allopurinol and colchicine were not meant to be taken together on a daily basis. Some docs just don't know any better. .

[cabarle]

Being a chronic Gout sufferer, I can tell you there is no other pain in the world like it. I get it in various places such as my knees, feet, ankles, etc. Sure, I'm on meds for it, but sometimes that doesn't help. People are right: You can't walk, not even to the bathroom. For me, it strikes in the middle of the night oftentimes with no warning. When I have an attack, I need help getting to dialysis and help getting in the damn chair. The pinch of the needles are welcome relief for the momentary second of distraction from the Gout pain. For me, it takes about 2 weeks to recover to the point of being able to walk. I've seen different doctors over the years, tried every med imaginable, led a purine free diet - but I still get it. I've tried eating fresh cherries to lower the purine, blueberries, etc. It's enough to make me suicidal. Because the pain is so intense, I can't sleep - not even in the chair. So, to top everything else - I'm tired, in pain, and my family cannot fathom why I'm such an asshole when it strikes. I'm the kind of person who wants to be left alone when I'm sick - but life doesn't work that way. My dog is the only that understands me, so I allow her to stay with me when Gout strikes. The only description I can give is this: Imagine the biggest guy you know hammering your joints with a sledge hammer consistently on one side, while someone else stabs your joint with a big knife and leaves it in there on the other. Now, imagine that happening at the same time for two weeks. You might get an idea of Gout Pain.

 

[Falkenbach]

The more I read in this thread, the happier I am that I've only ever had the one serious attack - and it wasn't "serious" compared with many of those described here. Sure, it put me off my feet for a week, but it WAS only the once.

I don't envy you regular sufferers. You have my utmost empathy.

[Lulu]

Being a chronic Gout sufferer, I can tell you there is no other pain in the world like it. I get it in various places such as my knees, feet, ankles, etc. The only description I can give is this: Imagine the biggest guy you know hammering your joints with a sledge hammer consistently on one side, while someone else stabs your joint with a big knife and leaves it in there on the other. Now, imagine that happening at the same time for two weeks. You might get an idea of Gout Pain. 

This is a very good description. I get it in akk my joint too. It's horrible!!! When it hit my hands it really drove me nuts. I tried the cherries too. I am at the point of going to see a rheumatologist as I am getting the tophies because I cannot take the allopurinol. Have you seen a rheumatologist already? If so, just curious what they said.

[Bajanne]

I am SO embarrassed.  I lost the prescription the neph gave me.  Asked him for another one last week and cannot find it.  I checked with the pharmacy and 30 tablets will only cost me $4.50.  But I am so ashamed, I am going to find another doctor at the hospital when I go on Friday and ask him to write me up.  What scared me is that my uric acid results this week are sky high.  I am just priming for another attack.  I become a cripple.  I don't want it again.

[paris]

Do I need to fly down there and hold the prescription for you??    I want you to start taking the medicine before you are in total pain!   On Friday, get the prescription, go straight to the pharmacy and then post here so I know you have it!  Does Kitkatz need to get her big stick?      We love you and don't want the gout to take over

[goofynina]

Hold on Paris, if your going, then i am going with you    Bajanne, GO GET THOSE PILLS A.S.A.P!!!     Take care girlfriend, WE love you 

[Bajanne]

My nephrologist passed by with lots of good news concerning my end of month blood results.  He also announced that he is leaving the country.  So I plucked up the courage to ask him about the prescription.  He filled it very cheerfully, giving me lots of repeats.  (Of course, I found the last one when I got home, but it didn't have any repeats so that was good). 
Now to remember to pass by the pharmacy!