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43 yrs old, first gout attack prob about five years ago,maybe six, and no major tophi – although my main big toe joint on the right foot (where Ive had the majority of my attacks) is larger than the left, so maybe there is something tophi-wise in there.
I started taking allopurinol about ten weeks ago. Ten days 100mg, ten days 200mg and 300mg/day since then. My previous experience of gout were isolated pain and swelling in the big toes, occasionally a stiff knee – although this only started happening just before this last Christmas. This last festive period was completely written off by a mega attack in my right big toe – being on vacation I was away from my doctor, and was unable to get immediate access to the diclofenac sodium (NSAID) which I used to alleviate the symptoms. It was shear hell. When I did manage to see a doc away from home, it took a good week of 150mg NSAID per day to calm things down. That was the final straw, and in mid January I visited my own doc and basically said gimme the drugs !!. I was prescribed alloprurinol and built up to a dose of 300mg/day. Since starting allopurinol, I've had gout attacks in places I've never had them before – my ankles, both knees, my fingers, my right elbow – if I hadn't read up on the likely hood of things getting worse before they got better I'd have chucked the pills in the bin. It was about six weeks before I was able to stop taking the anti inflamatories. I had one week free and then the pain returned – albeit with a lesser intensity. Back on the NSAID. My uric acid level was least tested two weeks ago, and it is down at 4.8 mg, the attacks are still continuing even at this low level – I put it down to the dissolved crystals coming out for a final fling. I consider that the worsening is a sign that things are moving in the right direction – just like descaling an old kettle – all sorts of cr*p will come out before things clear up !…… at least I hope so.
