Gout Attacks

[phuturatica]

Since being diagnosed with gout in January I have suffered 6 attacks and this one has to be the worse one yet. I was literally woken up with the intense pain and was in tears just trying to get to my bathroom. I've barely slept and I'm now just preparing to find some kind of clinic of hospital to help me as this pain is not easing up and I have been awake since 4am.

I'm already on Allopurinol 100mg every day which I take and I have altered my diet substantially so that the attacks should stop and I have quit drinking all together. I have been eating cherries and drinking baking soda...

Why am I still getting these attacks?

I have Chronic Kidney Disease so my uric acid is higher anyway but this is ridiculous! I thought allopurinol STOPPED the attacks?

The main problem I have is that I cannot take NSAIDS (anti-inflammatories) because of my renal failure and no painkiller appears to be working.

I read something about a cortisone injection which is a non-steroidal anti inflammatory injection into the joint site where the gout is and apparently this is much safer than taking NSAIDS for someone with kidney failure. Is this the best course of action for me to take and can I get this at a local doctors/clinic rather than paying stupid amounts in a hospital?

This gout is actually ruining my life, I'm unable to go to work today as I can't physically walk and I've had no sleep. I am desperate need of something to sort this out.

[MrsMills]

Have you tried Colchicine ?

[phuturatica]

I was told to stay away from it and its dangerous for people with chronic kidney disease.

[lopburi3]

Allopurinol can only reduce the uric acid production - it will not stop the pain/attack if levels get too high. But I suspect 100mg is just too low. Are you limited to 100mg because of other factors? I was started on 300mg 20 years ago and have continue at that level and no attack since. I get levels and liver functions tests regularly and have been normal. I obvious do not eat too much of the bad things but in general can eat anything in moderation (and even above).

[thenervoussurgeon]

I cant take nsaids, the only thing that works is colchicine ,kills the pain dead , my uric acid levels are not high , also baking soda was a waste of time.

[phuturatica]

Allopurinol can only reduce the uric acid production - it will not stop the pain/attack if levels get too high. But I suspect 100mg is just too low. Are you limited to 100mg because of other factors? I was started on 300mg 20 years ago and have continue at that level and no attack since. I get levels and liver functions tests regularly and have been normal. I obvious do not eat too much of the bad things but in general can eat anything in moderation (and even above).

I was prescribed it by a renal specialist here and he did not say anything about being restricted to a 100 mg dose. Am I better off going to a small doctors/clinic and explaining the situation? I'm just worried that they will not understand my renal failure and try and prescribe me NSAIDS or colchicine. I've been told that both of these things are bad for people with renal failure.

[beano2274]

My friend had problems with his gout as well, he started drinking Cranberry Juice every day, and has been free from any attacks for quite a while now.

[stoneyboy]

As someone who has also suffered with gout recently I certainly feel for you,it does start to really get you down after a while,I had it in my left knee for nearly 3 weeks,the worst attack I have ever suffered,could not sleep,its a fact it really comes on at night.

But unlike you I don't have any other medical conditions,all I will say is that obviously the 100 mg a day is not enough,I've always had blood samples taken in the past to determine the dose and I've taken 200 mg since,my recent attack has come about due to laziness on my part,not taking the pills for 3 weeks,so given the right dose they should keep it at bay

Have you done this the blood tests to determine Uric acid level ?

Fortunately Allopurinol is readily available,it was for me up in Phetchabun I managed to get 2 months supply for 225 bht and the indomethacin also.

I hope you are free of your pain soon,I wouldn't wish gout on my worst enemy.

Edited March 14, 2012 by stoneyboy

[phuturatica]

As someone who has also suffered with gout recently I certainly feel for you,it does start to really get you down after a while,I had it in my left knee for nearly 3 weeks,the worst attack I have ever suffered,could not sleep,its a fact it really comes on at night.

But unlike you I don't have any other medical conditions,all I will say is that obviously the 100 mg a day is not enough,I've always had blood samples taken in the past to determine the dose and I've taken 200 mg since,my recent attack has come about due to laziness on my part,not taking the pills for 3 weeks,so given the right dose they should keep it at bay

Have you done this the blood tests to determine Uric acid level ?

Fortunately Allopurinol is readily available,it was for me up in Phetchabun I managed to get 2 months supply for 225 bht and the indomethacin also.

I hope you are free of your pain soon,I wouldn't wish gout on my worst enemy.

My uric acid was last checked in January and was 11.7 which is quite higher than what it should be. I've been taking allopurinol but it's obviously too low a dosage. I've doubled my dose now to 200mg to see if that helps.

As for pain relief and seeing as I can't take indomethacin or any anti-inflammatory drugs I'm on tramadol, valium, tiger balm muscle rub, even smoked some green earlier but I'm still in a lot of pain. My whole right foot is throbbing intensely and I've been lying with my foot in the air to reduce blood flow and hel with the throbbing but I'm pretty much in tears and gritting my teeth with the pain.

My dad used to get gout when I was younger and he looked like he was physically in a lot of pain but I never realized the true extent of how painful it is. I don't wish it on anyone and this is literally ruining my life right now. I shouldn't be getting gout being a 24 year old woman. People don't even believe me when I say I have gout as its so rare for my age group!

[Sheryl]

Given your renal; problems you should not alter the dose without checking first with your doctor, and also should get a repeat creatnine & BUN a week or so after any dosage increase and then periodically thereafter.

Your info re use of NSAIDS is absolutely correct, ditto colchicine. Must avoid.

it is possible to get symptomatic relief in inflammed joints through steroid injection, obviously more practical if the inflammation is limited to 1 or 2 locations. that should be done by either a rheumatologist or orthopedic specialist. Wrong injection technique can cause serious problems including nerve damage.

Steroid injections cannot be repeated often so this would be an emergency measure only, need to get the gout controlled through regular meds, altho that will be a challenge given the renal issues.

None of what is discussed here can safely be done by other than well trained specialists and you will not find them outside of hospitals. Small clinics are not a good bet in Thailand and for someone like you with a serious chronic disease should not ever be used.

Good luck!

[phuturatica]

After speakig with my renal specialist in the UK, I have now doubled my dosage of allopurinol and spent the last few days off my face on tramadol and using tiger balm ointment on my foot. The gout attack is now going away but very slowly. My doctor told me to eat as many cherries as possible and she said the baking soda thing won't work. Thanks for the advice people, it is most appreciated.

[bdenner]

A long story but several years ago I had a gout attack whilst visiting my elderly Mother, had no medication. She gave me a pill she uses for her leg pains containing 500 mg Naproxen Sodium. It worked a treat.

I went to a Chemist, in Australia, to buy some but couldn’t as they are on prescription only. After a few seconds the female shop assistant went off and came back with a blue box of 24 pills but only 275mg each. Same active ingredient manufactured by Bayer called Naprogesic, “Treats the Cause of Period Pains” to quote the description on the box. They work great and I always bring back an adequate supply with me each trip. I do not use any other medication or restrict my diet for gout.

[Sheryl]

A long story but several years ago I had a gout attack whilst visiting my elderly Mother, had no medication. She gave me a pill she uses for her leg pains containing 500 mg Naproxen Sodium. It worked a treat.

I went to a Chemist, in Australia, to buy some but couldn’t as they are on prescription only. After a few seconds the female shop assistant went off and came back with a blue box of 24 pills but only 275mg each. Same active ingredient manufactured by Bayer called Naprogesic, “Treats the Cause of Period Pains” to quote the description on the box. They work great and I always bring back an adequate supply with me each trip. I do not use any other medication or restrict my diet for gout.

These are NSAIDs, the OP can't take them due to his kidney problems.

[lopburi3]

Flame removed.

[SouthernMan3]

Allopurinol can only reduce the uric acid production - it will not stop the pain/attack if levels get too high. But I suspect 100mg is just too low. Are you limited to 100mg because of other factors? I was started on 300mg 20 years ago and have continue at that level and no attack since. I get levels and liver functions tests regularly and have been normal. I obvious do not eat too much of the bad things but in general can eat anything in moderation (and even above).

I also take 300 mg./day and monitor my diet.

It seems to work pretty well.

I do have very minor pain in my left big toe knuckle pretty much all the time.

But very minor.

I also do not drink alcohol.

I have found that this Chinese herbal medicine that I take helps a lot !!!

It also helps with my chronic shoulder, neck and back pain !!!

It's a big jumble of roots. sticks, seeds, bark, dried flowers and who knows what else.

It comes with a cloth bag.

I put it in a big pot of water and boil it for like 10-15 minutes.

Take about 2 shots in the morning and the same in the afternoon, every day.

Reheat every morning just to boiling point.

When it's almost gone, fill the pot with water and start again.

One bag, 1000 bht., lasts me and my mother in law over a month !

This is some seriously excellent medicine.

I have had the chronic neck and shoulder pain for about 15 years and the chronic back pain my whole life.

They are now the least amount of pain EVER !

Very highly recommended.

I get it from an old lady (of course).

I can find out the name (if there is one) and if it's available anywhere else here in Thailand if anyone is interested.

I suppose I could even mail it around Thailand to those who need.

But would want some kind of compensation for my time, naturally.

I am a very busy person but I can relate to pain.

So, there you have it.

My story re : the terrible gout........

And my amazing tale of an amazing natural cure

[SouthernMan3]

As someone who has also suffered with gout recently I certainly feel for you,it does start to really get you down after a while,I had it in my left knee for nearly 3 weeks,the worst attack I have ever suffered,could not sleep,its a fact it really comes on at night.

But unlike you I don't have any other medical conditions,all I will say is that obviously the 100 mg a day is not enough,I've always had blood samples taken in the past to determine the dose and I've taken 200 mg since,my recent attack has come about due to laziness on my part,not taking the pills for 3 weeks,so given the right dose they should keep it at bay

Have you done this the blood tests to determine Uric acid level ?

Fortunately Allopurinol is readily available,it was for me up in Phetchabun I managed to get 2 months supply for 225 bht and the indomethacin also.

I hope you are free of your pain soon,I wouldn't wish gout on my worst enemy.

My uric acid was last checked in January and was 11.7 which is quite higher than what it should be. I've been taking allopurinol but it's obviously too low a dosage. I've doubled my dose now to 200mg to see if that helps.

As for pain relief and seeing as I can't take indomethacin or any anti-inflammatory drugs I'm on tramadol, valium, tiger balm muscle rub, even smoked some green earlier but I'm still in a lot of pain. My whole right foot is throbbing intensely and I've been lying with my foot in the air to reduce blood flow and hel with the throbbing but I'm pretty much in tears and gritting my teeth with the pain.

My dad used to get gout when I was younger and he looked like he was physically in a lot of pain but I never realized the true extent of how painful it is. I don't wish it on anyone and this is literally ruining my life right now. I shouldn't be getting gout being a 24 year old woman. People don't even believe me when I say I have gout as its so rare for my age group!

Wow, a 24 year old woman.

Very unusual.

You NEED this Chinese stuff that I take.

It's incredible...

[SouthernMan3]

Given your renal; problems you should not alter the dose without checking first with your doctor, and also should get a repeat creatnine & BUN a week or so after any dosage increase and then periodically thereafter.

Your info re use of NSAIDS is absolutely correct, ditto colchicine. Must avoid.

it is possible to get symptomatic relief in inflammed joints through steroid injection, obviously more practical if the inflammation is limited to 1 or 2 locations. that should be done by either a rheumatologist or orthopedic specialist. Wrong injection technique can cause serious problems including nerve damage.

Steroid injections cannot be repeated often so this would be an emergency measure only, need to get the gout controlled through regular meds, altho that will be a challenge given the renal issues.

None of what is discussed here can safely be done by other than well trained specialists and you will not find them outside of hospitals. Small clinics are not a good bet in Thailand and for someone like you with a serious chronic disease should not ever be used.

Good luck!

Actually, I beg to differ.

The small clinic that I use is owned and run by the top 2 doctors (husband and wife) at the BIG BIG local hospital.....

[Kabinretiree]

Since being diagnosed with gout in January I have suffered 6 attacks and this one has to be the worse one yet. I was literally woken up with the intense pain and was in tears just trying to get to my bathroom. I've barely slept and I'm now just preparing to find some kind of clinic of hospital to help me as this pain is not easing up and I have been awake since 4am.

I'm already on Allopurinol 100mg every day which I take and I have altered my diet substantially so that the attacks should stop and I have quit drinking all together. I have been eating cherries and drinking baking soda...

Why am I still getting these attacks?

I have Chronic Kidney Disease so my uric acid is higher anyway but this is ridiculous! I thought allopurinol STOPPED the attacks?

The main problem I have is that I cannot take NSAIDS (anti-inflammatories) because of my renal failure and no painkiller appears to be working.

I read something about a cortisone injection which is a non-steroidal anti inflammatory injection into the joint site where the gout is and apparently this is much safer than taking NSAIDS for someone with kidney failure. Is this the best course of action for me to take and can I get this at a local doctors/clinic rather than paying stupid amounts in a hospital?

This gout is actually ruining my life, I'm unable to go to work today as I can't physically walk and I've had no sleep. I am desperate need of something to sort this out.

[Kabinretiree]

....see a Doctor.

[Sateev]

Allopurinol can only reduce the uric acid production - it will not stop the pain/attack if levels get too high. But I suspect 100mg is just too low. Are you limited to 100mg because of other factors? I was started on 300mg 20 years ago and have continue at that level and no attack since. I get levels and liver functions tests regularly and have been normal. I obvious do not eat too much of the bad things but in general can eat anything in moderation (and even above).

For people with CKD, the dose of allopurinol is usually no more than 100mg, but depends on GFR. Follow your doctor's recommendation. Steroids may relieve the pain, but have their own side effects, and should be used carefully, again, under doctor's instructions.

Gout is caused by either over-production of uric acid, or under-elimination of it. Allopurinol helps reduce production (if over-production is the problem), and Benemid (probenecid) helps increase excretion of of uric acid, but is ineffective in patients with GFR < 60, which is only mild kidney disease. Diet is the most likely solution for you: if you don't eat purines, you won't make uric acid.

If your doctor hasn't discussed these things in a similar level of detail, find another doctor. Gout is not brain surgery, and even with CKD, you should be able to control it.

Good luck.

[ripstanley]

I have been having gout attacks since I was 29 (some time ago) I can use anti-inflammatories and they have helped very well over the years. I have recently read that pineapples are good for gout. Do a google search of pineapples gout and you can read these articles. Good luck.