Can Anyone Help Me Name Whatever Afflicted Me ?

[allane]

I'm 65, in normal health. I don't smoke, drink rarely, and do some exercise.  I'm a bit overweight, but no more than maybe 5 kg.  

One morning, a month ago, I woke up with serious pain in both feet and both hands, despite having done nothing in particular the day before. The location of the pain in each extremity was different, and seemed to me to be a recurrence of a particular minor or trivial injury that had occurred in the preceding month or so.  

After a couple of days, these pains began to subside, only to be replaced by serious pain in both knees and both ankles. After about three days since the onset, I was unable to stand without assistance, and also needed assistance to get in or out of a car.

At this point, I went to a hospital.  I was diagnosed with gout, given a painkiller, a muscle relaxant, and a gout medicine.

Reading about gout, I decided that I didn't have any of the predisposing factors, nor any of the normal symptoms of gout.  But, thinking the gout medicine would do me no harm, I took it for three days, then stopped because it was causing serious diarrhea, as I had been warned it might.  I carried on with the other two prescriptions, and after five or six days, was 80% recovered.  Even now, I still have minor pains in different places in each hand.

I want to get a second opinion, but don't know where to start.  Does anyone have any guess as to what I might have had ? What sort of doctor might I discuss this with ?  I don't want to go to a doctor or hospital which will test me for everything under the sun, whether because they have no idea what I had, or because they make money on every test.

Edited November 18, 2022 by allane
x

[Sparktrader]

Could be hepatisis or gout or something else. Get 2nd opinion

[clearance]

Did they test for uric acid levels? If you have it higher than normal, better to use Febuxostat (Feburic 80 mg).

[howerde]

what was the uric acid reading in the blood test? it is high if 7 mg/dL, or higher, if you have no history of gout, then getting it in feet and hands at the same time seems odd, gout is very painful, maybe a second opinion needed

[allane]

I did not have a blood test, only  pulse, blood pressure and temperature checks.  All of those were within the normal ranges.

[wangotango]

Well they could not have known it was gout if they didn't take a blood sample to check Uric acid levels. Get another opinion from a reputable doctor.

[howerde]

12 minutes ago, allane said:

I did not have a blood test, only  pulse, blood pressure and temperature checks.  All of those were within the normal ranges.

Well a blood test is needed no way did those checks diagnose gout,  you are right you do not want to go to a hospital and ask to see a doctor, they will likely send you to one of their permanent doctors and you could go round and round with tests, hope fully Sheryl will  be along and can point you in the direction, you are best looking at hospital websites and checking the doctors specialist field, as you are paying YOU select the doctor,  i have found the best ones only have clinics in the hospital at certain hours . you also want to see a doctor who has spent time in the west

 

 

Edited November 18, 2022 by howerde

[steven100]

If you PH level in your urine is not high then it's not gout.  The doctor can give you paper strips to measure this .....

I suspect it isn't gout at all,  I suffer from gout regularly .... and it's more painful than you can imagine with the swelling and throbbing continues ...  also gout is generally hereditary,   and unless you have a history of gout I doubt it would come on just like that. 

I bet the medicine you were given was Colchicine  ....  they do make the stomach feel sick. 

 

Sorry,  I can't diagnose what you do have I can only diagnose what you don't have.

 

 

Edited November 18, 2022 by steven100

[Mickeymaus]

36 minutes ago, allane said:

I did not have a blood test, only  pulse, blood pressure and temperature checks.  All of those were within the normal ranges.

"At this point, I went to a hospital.  I was diagnosed with gout, given a painkiller, a muscle relaxant, and a gout medicine." 

 

The only advice I can give you - NEVER go to this doctor again. 

[Will B Good]

Had a friend with something similar.....tendonitis.....no treatment ever given.....autoimmune disease i guess.....just given pain killers......

[Lacessit]

IMO first step would be comprehensive blood testing, which can be done at a pathology lab for 2000 - 3000 baht. The lab will report normal ranges as well as results, so the OP can see for himself if anything is out of kilter, then seek medical advice.

It may not be gout, because the first gout flare is almost always in a single joint, multiple joint flares come later.

IIRC, I was prescribed indocid for my one and only gout attack about 40 years ago.

A doctor diagnosing gout on the basis of BP, pulse and temperature is not one I would go back to.

[Lacessit]

1 hour ago, Sparktrader said:

Could be hepatisis or gout or something else. Get 2nd opinion

AFAIK nobody recovers from hepatitis in 5 or 6 days, I have had several friends that were flat on their backs for a couple of months.

[VinnieK]

I would go to a private lab and get a full blood test.

I see these advertised outside of lab 'shops'  for 3500 or so for a full test

Doctors here seem to loathe to prescribe blood tests..I don't know why 

Maybe they  are not aware that we are paying for them (unlike the Thais)

Also ..doctors generally are not good 

..and lastly..

Nobody will save you..

Change your habits 

I would go vegetarian if I was you.

It will solve a lot of issues...long term and short term.

Drop sugar too.

Everything is connected..garbage in garbage out.

 

 

[Sheryl]

You did not have an adequate work up for gout much less to exclude anything else.

 

You need to see a rheumatologist. The posisble differential diagnosis includes gout, rheumatoid arthritis and several other things. You need to have blood tests including uric acid, ANA, C-reactive protein, blood count with ESR to name a few.

 

Where in Thailand are you located?

[findlay13]

Rheumatoid Arthritis

[allane]

18 minutes ago, Sheryl said:

You did not have an adequate work up for gout much less to exclude anything else.

 

You need to see a rheumatologist. The posisble differential diagnosis includes gout, rheumatoid arthritis and several other things. You need to have blood tests including uric acid, ANA, C-reactive protein, blood count with ESR to name a few.

 

Where in Thailand are you located?

Sheryl, I greatly appreciate your reply.  I have no idea what a rheumatologist does ! I live in Bangkok, west of the river. Someone west of the river would be nice, but I can travel if necessary.

[tomazbodner]

2 hours ago, clearance said:

Did they test for uric acid levels? If you have it higher than normal, better to use Febuxostat (Feburic 80 mg).

How does it compare with Benzbromarone? I found this by googling and neither looks good. I've been using Benzbromarone for several years now...

 

Heart-related effects. Another key study found that febuxostat is linked to a higher risk of heart-related deaths than allopurinol. As a result, experts recommend allopurinol over febuxostat — especially for people with the following: Heart disease due to atherosclerosis (hardening of the arteries)Jan 7, 2565 BE

 

But then:

 

Benzbromarone is a nonpurine xanthine oxidase inhibitor used for the treatment of gout, but never approved for use in the United States because of concerns over reports of acute liver injury and deaths with its use.

[clearance]

Just now, tomazbodner said:

How does it compare with Benzbromarone? I found this by googling and neither looks good. I've been using Benzbromarone for several years now...

For me Febuxostat is much "softer" in terms of side effects, but I don't have a heart disease.

[papa al]

Maybe try fasting for a few days.

 

[Sheryl]

31 minutes ago, allane said:

Sheryl, I greatly appreciate your reply.  I have no idea what a rheumatologist does ! I live in Bangkok, west of the river. Someone west of the river would be nice, but I can travel if necessary.

Rheumatologists treat disorders of the joints, including arthritis of different types and gout; they also treat a variety of automimmune disorders.

 

on the west of the river I suggest:

 

   https://www.siphhospital.com/en/medical-services/doctor-biography?id=165

 

If this does not work out to your satisfaction,  there is a bright  comparatively young rheumatologist recently (i.e. a few years ago) returned from a fellowship in the US at Bumrungrad   https://www.bumrungrad.com/en/doctors/Supat-Thongpooswan

 

 

 

 

[allane]

Sheyl, again many thanks.  I will try the Dr. at Sirirat.

[blackshadow]

WE are not doctors on here.....GO SEE  a good doctor.......it is as simple as that....!!!

[Lemsta69]

11 minutes ago, blackshadow said:

WE are not doctors on here.....GO SEE  a good doctor.......it is as simple as that....!!!

He's already seen!l a quack, he went to the blimmin' hospital.  Sheryl is a nurse I believe, with many years experience and has a stellar reputation on this forum. It is as simple as that!

[Lemsta69]

2 hours ago, clearance said:

For me Febuxostat is much "softer" in terms of side effects, but I don't have a heart disease.

Why not the good old go-to Allopurinol, which is what I use to keep the disease of Kings at bay? Does it not work for you?

[Puccini]

4 hours ago, Lemsta69 said:

Why not the good old go-to Allopurinol, which is what I use to keep the disease of Kings at bay? Does it not work for you?

Bad advice. He has already posted that he will see a rheumatologist mentioned by Sheryl and in my opinion this is the best way to go forward.

 

No more speculation in this topic about his condition is of any practical use, nor suggestions about medicines to take.

[Lemsta69]

9 hours ago, Puccini said:

Bad advice. He has already posted that he will see a rheumatologist mentioned by Sheryl and in my opinion this is the best way to go forward.

 

No more speculation in this topic about his condition is of any practical use, nor suggestions about medicines to take.

I'm not advising the OP, nor am I speculating. No need to as Sheryl has already set him straight. I was asking the other poster why he suggested Febuxo over Allo for gout. Not worth staying a new topic over  I'm pretty sure that the OP is clever enough to work that out. 

Edited November 19, 2022 by Lemsta69

[1FinickyOne]

18 hours ago, steven100 said:

I suffer from gout regularly .... and it's more painful than you can imagine

I had a very minor case of gout, diagnosed correctly on sight as my big toe was swollen, then confirmed w/a blood test. My case was very mild and still extremely painful. 

[steven100]

5 minutes ago, 1FinickyOne said:

I had a very minor case of gout, diagnosed correctly on sight as my big toe was swollen, then confirmed w/a blood test. My case was very mild and still extremely painful. 

correct .....  I have had gout in both ankles at once, numerous times in one ankle, and other times in my knee and toe and as you know it's bloody painful,  the throbbing is horrendous.  He didn't have gout because he wouldn't be able to walk at all if it was. 

[Moonlover]

You can continue finding doctors @allane who may or, it seams, may not be able to help you, or you can become proactive and summons the best healer of all. The one within you.

 

I'm 76 years young now and I've been practicing 'Medical Qigong', a branch of Traditional Chinese Medicine for around 12 years now. Although I occasionally suffer the kind of symptoms you mention, I can fend them off quickly and effectively using the techniques I have learned over the years, without medicine bottle in sight.

 

And I enjoy it at well, what a bonus that is!

 

Start with this book and then read the testimonials and the blogs. You will not regret it.