So, I woke up during the night with a very painful foot. Pain is isolated to the metatarsal-phalangeal joint of the big toe. It hurts pretty bad, but is less painful now that I am at work (although I’m limping a bit).
From things I’ve previously read/heard I think I have gout. On further research, I’m now 95% certain I have gout. Reading over things to avoid, realistically that aint gonna happen.
Anyone care to share their experiences? I have read that an attack usually resolves in 5 - 7 days. I avoid NSAIDs due to the amount of alcohol I consume, but I can take a week of pain.
I have only had gout attacks twice, both times after eating a double portion of lobster. Maybe examine your recent eating history and see if you can isolate something you may have consumed more of than usual.
Well, my daughter and her boyfriend were in town and I prepared filet mignon on the grill that was to-die for. ( I got the filets from a real butcher, who cut them “special occasion” thick)
Served with chimichurri sauce and oven fried potato wedges.
My “attack” never resolved…on its own I mean. I have to take medicine everyday. After a couple of years the Dr. took me off of it and within a week the gout started up again, so now I’m back on it indefinitely.
I got it years ago and started on medication. About a year later I didn’t bother renewing my prescription and stopped taking the medication and stopped drinking red wine. That worked for a long time then I had another bout that I put down to prawns so I stopped eating them. Again it ceased for a long time and then I had a bout due to grapefruit. Stopped eating them. Then a year later I had a bout that I couldn’t identify a cause for so I went back on the medication and can now eat and drink anything.
One tip if you do go on the medication. When you start on it the medication itself may trigger your gout. Dirty trick but it only happens once.
Gout is–or can be–pretty god damn horrific. A real bout is not pain you can live with for a week, unless you don’t have a job and can stay home and scream. My husband has another, unrelated, condition that caused many, many horrible tooth abcesses and he’d put gout pain in that range.
The Mister has gout. Staying very well-hydrated helps a lot, but daily allopurinol helps a lot more. (Fortunately, the medicine is pretty cheap. Doc prescribes 300mg daily, but 100mg controls things just fine. So his gout pain stays away for 90 days at a cost of about $10.00 US. That’s kind of a modern medical miracle, no?)
The first time I had a gout attack (on my honeymoon!) I thought I had broken a toe. The pain was excruciating. We went to the hospital, and learned that I didn’t have a broken toe. There was woman there who actually HAD a broken toe, and she was in less pain.
I suffered through the rest of my honeymoon, unable to bear even the touch of a bedsheet, watching old movies on TV while Pepper Mill went snorkeling.
I later learned that Indomethacin, taken at the start of an attack, could usually work wonders in stopping it (but see below). Now I;m on allopurinal, and haven;'t had an attack in ages. Some people do well on colchicine, but it didn’t do anything for me.
I had one attack, though, that was awful. even indocin didn’t stop it. My foot swelled up and got overheated and had the continuous grinding pain gout at its worst can deliver. To releve the heat, I filled a plastic bag with ice wrapped it in a towel, and put it on my foot. No good. I removed layers, until finally I was holding a piece of ice on my inflamed skin and watching it visibly and rapidly melt. Once I saw that, I knew what to do. I emptied all the ice intto a buxcket, filled it with water, and plunged in my foot. It simultaneously cooled my foot and deadened sensation. But my foot remained swollen and in deadened pain all night. Of course, I got no sleep. I watched epic after epic on video.
He’s no pussy, but his first attack had him at the doctor’s office after a single day - he thought, like many upthread, that he had somehow broken his toe while asleep.
He’s one of the lucky ones - he stays VERY hydrated all the time (seriously, for a few weeks, peeing was like his favorite new hobby) and red meat/shellfish is a special-occasion food now. Doesn’t need meds to control it daily, and has attacks maybe every 6 months that he recognizes PDQ now and either mainlines some H2O, or takes indo for.
Don’t feel too bad if you do have it - it’s very controllable most times, fairly cheap medication, and the lifestyle changes required are mostly healthy things to do anyway.
Though note that one of the reasons this is one of the less common NSAIDs out there is that it makes a non-trivial number of people violently, horribly ill. And, except for gout, it really isn’t any better than the others. But it’s great for gout, for most people.
Fortunately, it never made me ill at all. And it is unparalleled in treating a gout attack, in my case, at least. Colchicine does nothing for me.
Also fortunately, I haven’t had to take indocin in years.
I read the literature about gout because I have had it for years as a result of taking
HCTZ for high blood pressure. Hydrochlorothyazide is great for lowering BP but it also
increases serum uric acid. Excess uric acid gets deposited as monosodium urate chrystals
in a wide range of locations (joints and muscles) but they become more concentrated in the thumb metacarpals and the big toe metatarsals.
You can request copies of any blood work (serology) ordered by your doctor.
Look for “uric acid” on the print out. If your uric acid is above 6.7, you are on the way to
gout. Don’t expect anyone to tell you this fact. Gout is a money maker for them, just like
sugar diabetes.
I keep a bottle of 25mg Indomethicin in the nightstand - if I wake up with gout (I’m becoming an expert on joint pains), I take 2 and go back to sleep (or not). If it continues (very, very rarely) I take another every 4-6 hours.
Has never lasted more than a day.
There are 2 approaches:
Allopurinol is a preventative - if you use it, it is an every-day-you-don’t-want-pain.
Indo and colcin… are firefighters - wait until it hits, then put it out.
I tried allopurinol for a few months, but saw no reason for the expense. Using Indo, it is $10 for 2 years vs $10/month for Allo.
IMHO, it doesn’t make sense to take allopurinol until you are having frequent attacks. Mine started about 10 years ago, and I had them every few years. In the last year, however, I had 4. Time for the preventative.
( I got the filets from a real butcher, who cut them “special occasion” thick)