Gout Attack - 4 Weeks Duration!!! Suggestions?!

Would really appreciate anyone weighing in on this. I've read all the posts regarding emergency treatment, etc. Had an mri today and am waiting for results. Symptoms tend to dissipate and then flare up every other day.

Many thanks,

david

Sorry you have lingering "gout". I don't know based on what you were diagnosed to have gout. The symptoms you have described are inconsistent with typical gout. Fyi:

* most gout patients have normal blood uric acid (ua) level (<7 mg/dl) during gout attacks -- because more ua is excreted during the attacks. The blood ua test done during the attack is useless in diagnosis of gout.
* if the joint fluid contains no msu crystals, theoretically you don't have gout. (there is a small chance that the crystals are there but were not found.)
* are you taking effective dosage of indocin? For bad attacks, it takes 50 mg 3~4 times a day.
* cortisone injection in muscle (in a larger dosage) works much longer than injection in the joint. The former can also avoid cortisone crystallizing in the joint to cause gout-like inflammation.
* rheumatologists are the best in treating gout.

My overall impression is that you did not wait until gout or the injury is completely healed before doing exercise. I would rest for a month after it is completely healed before running. Take care.

Thanks for your thoughts. I appreciate the points you've brought up.

Regards,

david

Hi david,
i don't have any advice for you but you are not alone. My 59 year old father had an awful bout with gout last december - he was unable to do anything for 1 month. He had all the same treatment you did and would feel better for a day or two then feel awful again. I'm not sure what meds. He was put on but it did eventually subside. It does come back occasionally but usually just for a day or two. Good luck!

I read, with interest, the notes stating that they have had, or know ppl who have had gout for 4 weeks! I'm wondering.....Did you finally get rid of it david? If so, how??? I have had it in my big toe and that general area for one month today. I am ultra sensitive to drugs and the nyproxen Dr. Started me out with made me sick, so I switched to ibuprofin but only about 3 tabs daily. I will notice it getting better and a couple of times even thought it was close to being gone, but then as soon as i'd put a shoe on for a few hours or go to the grocery store and walk a bit, the pain/redness/swelling would return. I now feel as bad as I did the first few days a month ago! It hurts that much! Dr. Put me on prednisone now but so far I don't notice any difference. I'm beginning to worry that there's something terribly wrong with me!!! Opinions and comments are welcome! Kay

I think the reasons your gout stays on for so long are:

1) you were not on an effective dosage of ibuprofen. For an acute attack it needs 800 mg of ibuprofen 4 times a day. (reduce the dosage as the condition improves).
2) you aggravated it by walking on not-yet-healed gout.

More gout info can be found at: http://www.Icuredmygout.Org . Good luck.

Thank you for your input. Do you think the prednisone I have begun taking will work? I am so down and stressed about having had this for 4 weeks! My boss won't allow me to return to work until I can wear a shoe and walk without limping. I've got a long way to go, since I can barely put weight on that foot right now! Does this all sound terribly abnormal???

Also meant to ask . . . .Should I take ibuprofin and the prednisone? Or just the prednisone? It seems everything with gout contradicts. I am religiously following the low purine diet - -then all of a suden i'll read that some of the things i've been eating precipitate gout attacks. One source will say dairy products are good, the next source says they're bad. One source encourages vegetables, the next one discourages them. No wonder i'm getting depressed an stressed out! I had a kidney stone 7 weeks before the gout attack so am trying to follow that diet too.

If I were in your situation I would:

1) go to my doctor or an emergency room and ask for an injection of a steroid (i.E., methylprednisone in acetate, 80 mg) in muscle. It will relief the pain almost instantly and last for about 2 weeks. (injection at the joint uses lower dosage and is effective only for several days -- it may not be long enough to kill the gout.)

2) ask the doctor if it's ok to keep taking ibuprofen or prednisone at a lower dosage for several weeks after the gout is gone. (this will prevent gout from coming back. Different med works differently for different person. Take the one that's effective and has the least side effect.)

3) ask the doctor about uric acid lowering therapy. (start it at a lower dosage and adjust up ever 1~2 months, with lower dose colchicine or an nsaid. Otherwise, it will trigger gout attacks.)

4) see a nephrologist (kidney specialist) or a rheumatologist (joint specialist). They are the best in treating gout and kidney stones.

Answers to your other questions can be found at http://www.Icuredmygout.Org .

I have now had the gout for 5 weeks and am convinced that I will just have to learn to live with it. I have taken ibuprofen, nyproxen, and most recently prednisone. Anything stronger or increased dosages make me sick, as I am hypersensitive to meds. For the past few weeks I have gone thru periods where it gets to feeling better, I think it's nearly gone and ease back into wearing a soft shoe & being on it a little. Within a day or two i'm back to square one - redness, swelling, pain. I am worried about losing my job - I try to go back when I think it's feeling better, but, like I said, I always wind up back at square one and feel like I did when I was first diagnosed. Help!

As I mentioned in the previous posting, the injection of steroids can relieve the pain almost instantly.

What strength of ibuprofen, naproxen, ... Are you taking? If you are not taking an effective dosage, it will not help. I suggest you see a rheumatologist.

Don't worry about losing your job. I think disability insurance will cover your loss. Good luck.

I am taking 1 ibuprofen about every 4 hours day & night. Even with that, my ulcer is bothering me. The Dr. Is talking about putting me back on prednisone but from everything I read about that, I am hesitant about that too. I have talked to people who have had the cortisone shot but they say it only lasts a couple of weeks. Then what?? You mentioned disability insurance. How do I find out about that? I have used up all of my "sick time" and in a few days my vacation time will be used up too. I am frustrated and worried sick.

Gout attacks can be dealt with in two steps. Step 1: to get rid of the inflammation and pain immediately. Step 2: to lower the blood uric acid in the long run. Cortisone shot can relieve inflammation and pain almost immediately and last for 2 weeks. Once gout has subsided, it may not come back for months. This will give you enough time to do step 2.

The recommended dosage of ibuprofen for treating acute gout attack is 800 mg 4 times a day. Since you can't take that much of it, you may like to switch to other med such as colchicine, prednisone, or celebrex which is less likely to bother your ulcer. Unless you take an effective dosage of the med the gout attack may linger on. Medicine is the necessary "evil". Taking the effective dosage of it for a few weeks to kill the gout attack is much better alternative than taking it at a lower dosage for longer period of time and suffering the pain and disability along the way.

Info about disability insurance should be available from the employer's human resources department and the state employment office. Check your pay stab. If you have been paying disability insurance premium, you are covered. Good luck.

One effect way to rid the body of excess uric acid is to take juniper berries. These berries (in capsule or extract form) have long been known to aid the kidneys in eliminating acid. Taking enzymes to aid digestion is particularly helpful, especially protease to help digest proteins. Gout is a good indication that the ph of the body is out of balance. Avoid all red meat, chicken, mushrooms, alcohol, peas, spinach, sugar, or flour products. Eat lots of cherries and drink black cherry, or tart cherry juice. Msm is also helpful to reduce inflammation

I just discovered I have gout after thinking I had a broken toe. It's recently started affecting my right outer foot. I'm 22 and attempting to get back to my workout routine after being out for a little while. I'm looking for any helpful suggestions.

words fail me..
after a month or so of persitant gout problems I swallowed my scepticism (so to speak) and tried the baking soda solution.
One dose on Friday night and I had shoes on come Saturday. Another dose Sat night and I went drug free (from indocid) on Sunday.
Come Monday, no drugs, no real pain. Still a little bruising.
I felt for sure I'd be on the toilet all day Sunday. Nope, nothing, no ill effects at all.
Either I was allready getting over the gout or (he still says hesitantly) IT WORKS.
Only read about this on JYY2s web site last Thursday.
Spoke to my chemist (druggist?) on Friday just to make sure it wouldn't kill me.
For mine, JYY2 should be sainted.

JYY2 above is good. If....it is gout most doctors and podiatrista will get results with an effective dosage of Indocin. For bad attacks, it takes 50 mg 3-4 times a day. Icuredmygout.org has some great info on gout!

Icuredmygout is a must read for all. It's the baking soda prescription with a lot of good and safe info. Do it now and get over the misery.

I'm now taking one s'bicarb tablet at night and it seems to be keeping the gout at bay. Got the tabs from the chemist. The caps didnt cost much.
I don't take them every night, just when it's been a big night like up the river fishing or after a big night out ect.