A BEGINNERS GUIDE TO GOUT (GOUTY ARTHRITIS)

[phofab]

A BEGINNERS GUIDE TO GOUT (GOUTY ARTHRITIS)

  

Some of the recent pleas on this Site, for people desperate for some immediate help with newly diagnosed Gout, have got to me and I have put this piece together as a summary of my own observations. The intention is to simply let them know that they are not alone.

I hope that I haven't duplicated anyone else's work.

  

If you are one of the fortunate people who can tolerate the medical treatments, with their side effects. You have won the lottery. Congratulations and you have no need to read further.

  

I had considered calling this POST, “AN IDIOT'S GUIDE TO GOUT” but there is one sided evidence that Gout sufferers in the past were the Leaders, which presumably indicates greater intelligence. However the non Leaders, followers, seldom have their history recorded. Hence the argument could be seen as one sided and unfair. Why should the bosses have all the Gout fun?

But from the commentary on this GP Site, there are a lot of very intelligent people who have Gout.

As these people don't have letters after their name, their advice would be suspect to the professionals.

It is very apparent that these same gouty people have a vested interest in finding a cure for Gout. They are in the main expert observers of the Gouty Arthritis condition.

1.      I have had Gout for 36 years and the subject is amply covered in my POST – Your Gout – Gout for 36 years and still counting. This POST is now starting to resemble “War and Peace” or a Bryce Courtney Novel.

2.      Having read this far, you are looking at alternative help for your condition.

3.      As mentioned by GP, once you have your first diagnosis of a Gout condition, you are no longer a Gout Virgin and vigilance will be a lifetime requirement.

• You may be fortunate to only have a few attacks and I hope that this will be the case.
• Gout can affect your life but doesn't have to control it.
• In my early Gout days (second last toe) I was able to still wear shoes, albeit with pretty extreme pain. I just lived with it during the day and pain killers at night, so I could sleep.
• Years later, when the pain popped up in my big toe joint, once the main swelling was reduced, I was able to return to work in steel capped boots. I modified an old pair by cutting out the side and leaving the steel cap intact. Looked odd but suited me and I was working again.

4.      Observation of your personal condition becomes immensely important.

• You are viewing this Site for reason – observation on my part.
• This may involve taking notes or a diary- works extremely well.
• The diary should be of your good days and bad days; Gout pops up without much warning.
• Prior to an attack, your partner may observe you are more irritable than normal.
• There will be twinges in some joints.
• The pain intensifies at dusk increasing around 3 AM and diminishes around dawn – this was one of the past recognised symptoms.
• After a while you will observe what your warnings are and you can commence treatment immediately before the attack fills out and will become lesser by the immediate counter attack by you – take the offensive.
• Be Prepared,
• Have supplies of your prescribed medicines on hand.
• I used to carry them in my lunch box each day and often had to use them away from home, for a new attack. I spent a lot of time on my knees with my bent over toes taking the pressure- not praying.
• Don't go away from home without your supplies.
• Plus a repeat prescription.
• Means that you don't have to wait hours, days or weeks for medical intervention.
• You have to work at it.
• Isolate the Gout triggers. Beer , sausages, spinach, rhubarb etc
• Injury of the affected joint is surely a part of the problem.
• If you have a partner, get your partner on side and you will find they have a better memory of your attacks than yourself. You are dealing with the extreme discomfort and pain, they are observing.
• Work together on the research, there is so much valuable information now available to what we had 30 years ago; when we were told to just stop eating meat and drinking beer.
• Remember that our ancestors found out which foods they could eat by trial and error. “Oh Ugg died last night”, “Oh maybe it was those berries he ate, I didn't like the look of them so I left them alone”. OBSERVATION.
• The human body is designed to be fuelled by a Hunter / Gatherer food intake i.e. nuts, berries, grains, fruits etc plus it adapted to include meat but this was hard to source and was mostly some other animals kill or natural death, until humans developed means and skills to hunt their own prey. So meat was in short supply and only an occasional food source.
• The fluid source was plain old water.
• We still have much the same body, machine, but put additional stress on it through our lifestyles and the manufactured foods and drinks we mostly eat and drink.

5.      Avoid becoming obsessed with the subject, research but get on with your life and deal with the attacks by whatever means you have been prescribed or directions you have personally selected.

6.      DISCIPLINE – Adopt or teach yourself to be disciplined. If you have to forgo some foods or drinks, there is plenty else to eat and drink. It is not a big deal. Enjoy what you can.

• If you decide to go down the Medical path, you will have to have discipline, otherwise when you are feeling OK there will be a natural tendency to drop the medication.
• If you go down the Natural path, you will require discipline to not venture off on the known dangerous sides of the path.

7.      Keep up to date through sites such as this, just in case there is a miracle cure.

• Gout is considered to be hereditary- you've been given a problem past from your ancestors. It is not your fault.
• Even though there is no apparent family history, it can skip a generation by the carrier simply dying before they had an attack. My father was in his late 70's when he had his first attack. My Maternal grandmother (a vegetarian) suffered most of her life with crippled and deformed feet. So I have a double whammy.
• It was on the GP Site, I discovered that we are allowed a fair bit of humour, which is a great way to counter the Gout attacks. You are making light of matters that non sufferers don't understand. It is a very exclusive Club – THE GOUT CLUB.
• The humour expressed at your condition by non sufferers, including the Medicos, is non productive and in poor taste, so disregard it.
• There are so many triggers that an overall cure with no side effects, will be difficult to discover. Each body is different.
• From personal experience discussing the problem on Sites such as this, is extremely therapeutic.
• Spend some time on the actual Gout Pal Site as you will pick up a great deal of valuable information and observations. Unfortunately more than you will gather amongst the Professionals.

8.      Locate a GP or medico, Naturopath, who knows something about Gout or is willing to learn and work with you.

• It appears that since Allopurinol was created as a treatment for Gout in the 1960's, little research money or interest has been shown in improving the treatment or alternatives.
• Ask your medico questions, unfortunately they will generally have few answers, but by asking questions maybe they will take time to learn.
• I am sure that the training they receive for Gout is:-
• Blood test- elevated Uric Acid levels
• Obvious swelling of a joint, mainly the feet
• Answer Gout
• Treatment Allopurinol , Colchicines, pain killers
• If you ask what the drugs are for, you may be surprised by the response or lack of. It's just the recommended treatment.
• Bit like replacing a battery in the car because you can't start it.
• That's about it!!

9.      Drinking plain old water on a programmed basis rather than on need, works well for me.

10.  Balancing my diet worked for me for 36 years- reduce the amount of meat on the plate and more vegies. Cut back on the beer intake. Really not a big deal but requires personal discipline.

• I was advised by a specialist this year that food played no part in Gout and limited beer was OK.
• Counters my personal observation of 36 years and I won't be going back.
• She was not a Gout sufferer.
• For many years I have greatly reduced my beer intake and rarely drink during the week and have  a total of 4/6 stubbies (330ml) over Fri to Sun. Recently I have had a light bulb moment in that although the beer intake is small, I have in fact been binge drinking. Hitting my body with an onslaught (albeit small) on the weekends. My attacks are generally after a weekend!!!!

11.  Being overweight is reportedly a major negative factor, Solution reduce weight; maintain a healthy lifestyle and it will also benefit your body in other areas of health.

12.  Stress appears to play a large part in the onset of symptoms. Reduce Stress through breathing techniques, yoga, meditation or similar. Exercise within your bodies capabilities.

13.  As suggested on these pages have regular Uric Acid tests. Don't rely on annual checks, if suspect, but request more frequent checks. You will have to fight the system, here.

• Request a copy of the results for yourself.
• Record the results.
• If you are being good there is nothing more satisfying than viewing evidence of this fact in the recorded figures or on a graph.
• If you have been naughty the figures will equally reveal this fact and it is up to you to do something about it.

This is a starting point for GOUT 101 and I am sure that the other POSTERS have already and will offer more advice, along the track.

Remember to observe yourself, what you are doing and learn to live with the problem.

Whilst not wishing to demean Gout sufferers, there are far too many other people out there with greater illnesses and disabilities than we Gout sufferers.

The cure or means of living with the condition is up to you, regardless of which path you select. Others can advise, suggest but it is in your own interests to take control of managing your own health. You will personally benefit in Gout reduced or free body and not always subscribing to another persons pension fund.

We just need to manage and observe. Good luck and Good Health.

  

MAY THE FORCE (AND NOT THE GOUT) BE WITH YOU.

  

Back into my Cave, again

David

  

---

Beginner’s Guide to Gout

[Keith Taylor (GoutPal Admin)]

Ripper, mate – that deserves a stubby or 3

I think you saved the best 'til last with uric acid.

To beginners – at best, many doctors know that uric acid causes gout, but not how or why. I'll assume that as a beginner, either your doctor does not understand uric acid, or he cannot explain it very well (otherwise, why would you be here?)

If you don't know – and control – your uric acid you are not controlling gout other than by luck and misjudgement. So concentrate on uric acid first and last, then all the other stuff has some relevance. As David says, you need a number – an assessment of “normal” or “slightly high” means absolutely nothing.

We can help beginners train their doctor's to understand uric acid better. You might not even need him for meds if you are around 8mg/dL, but much above that is extremely hard to manage on lifestyle changes alone (0.48 mmol/L according to the new uric acid calculator, but you might as well round that to 0.5).

Even if you rely on lifestyle changes, you must continue to monitor uric acid. The consequences of not doing so are so serious that one wonders why doctors do not make routine uric acid tests more available.

If it is your first uric acid test, chances are it has been done during or immediately after an attack. Uric acid in the blood is usually lower at these times, so your blood test is not representative. Logan, Morison & McGill reported an average fall of 0.12 mmol/L (2mg/dL). Note that this is an average, and individual differences can be higher or lower.

The good news is – if you do control uric acid – you can live a normal, and more enlightened life.

[phofab]

Thanks chaps for the positive comments. I thought I may have gone a little over the top but I was attempting to set up something for the newly recruited Gouty people and possibly those that had been unable to satisfy their need for an instant cure. People need reassurance when hit with something like our problem. It needs to be kept in balance- the knowledge, seeking of knowledge and the UA levels.

I come from a generation of Australians (WW2-war baby) where we had little support and we found solutions to our own problems and in the process helped others.

When you look at the POSTS on “Your Gout” the number of hits against the two older persons contributions- Richard's and Mine, it would appear that there is still some value in the older persons knowledge, even if it is about Gout.

I think I have done my dash for the time being with my last three POSTS, so I'll go back to the cave again and just observe. It's too hot to hibernate- 40'c today. Dropped a part of the vacuum cleaner on my afflicted pinkie yesterday- it was not pleasant – I'd forgotten what real pain is like. I remember that I read in a medical journal that the Gout pain is considered “exquisite” ( intense; acute, or keen, as pleasure or pain.). Food for thought!!

Kind regards

David

[johnpeterson]

Thank you David!  I am definitely new to gout as this has been my first and very soon after (within a few weeks) second bout!  I have been doing the baking soda, black cherry juice, huge diet change… if I have read it and it said “relief” I am doing it!  I am actually beyond the severe pain at this point but have swelling, stiffnes and an incredibly annoying inabliity to move my big toe.  Any suggestions as to how to relieve that part of it? 

BTW – your assessment of the meidcos was dead on for me… it was a diagnosis of conveinence and my wife and I both kept researching and talking to people to find out that it was for sure gout … then back to the doctor to tell him that we knew it was!  The meds they gave me for the pain and inflamation gave me horrible migraine headaches so… that didn't work! 

I am so grateful for this site and I look forward to hearing from any/everyone who has input!

Thanks!

[zip2play]

My take on gout is a little simpler:

Purines are breakdown products of cell nuclei, whether from lean body tissue or from diet. They can further be used as food by a readily available enzyme xanthine oxidase (XO) and the purines are readily converted to uric acid. Uric acid is not very soluble in the body and settles out in the coolest parts if even slightly too high. The immune system treats these deposits as foreign bodies and attacks them with inflammation…a gout attack. Some people attack the deposits more furiously than others.

Animals have another enzyme which can break down uric acid but humans lack this enzyme (uricase) presumably because high uric acid has given us an evolutionary advantage somehow.

So we can treat gout by either lowering our purines somehow or interfering with conversion of purines to uric acid or by getting rid of urate faster. There really is no other way of dealing with gout.

We can lower production of purines by cutting back drastically on meat and fish consumption and eliminating organ meats and gravies. Or we can tie up and neutralize XO by taking daily allopurinol. An alternative is to take a uricosuric drug to pee out more uric acid.

Whichever method we choose to deal with gout, measuring the uric acid content of blood is the way we determine our effectiveness.

That's gout in a nutshell.

[phofab]

Apologies JP, I didn't pick up your query. I hope that your toe has improved by now. I am not the best person to ask as my big toe is very similar at the moment and all I can do is take 3/4 colchicine a day and my Voltaren Rapid once or twice a day and over the course of about 7/10 days the swelling goes down and movement returns. I can't say that the medication makes me feel well and I experience headaches  but it is less than the foot aches.

One little bit of reassurance is that the longer you have Gout the less pain you experience, or in my case. Or maybe the pain tolerance increases. It still is an outstanding pain and I saw it quoted in a medical book as an “exquisite” pain (of consummate excellence or beauty). Obviously not a written by a Gout sufferer but a medical practitioner.

I hope things have improved for you and that the above notes are of value. You are not alone.

David

[GoutPal HelpDesk]

This brilliant guide to gout has stood the test of time. It’s been referred to as Gout For Dummies. Keith sees a personal irony there. If anyone wants to know about that, please ask in the new gout forum.

If you have any other questions, experiences, or opinions about gout, please share them in the new gout forum.

[Author]

Posts