Any gout sufferers?

Factual Questions
1

I’ve had a sore swollen middle toe for a couple of weeks now. I first assumed that it was some kind of injury, maybe due to overextension, from walking in new sandals. I’m beginning to worry, though, that it may be gout–mainly because I haven’t noticed much improvement over the last couple of weeks.

I know I’m in a low risk group (female, under 40, virtually no alcohol consumption), but what do you think? How can you tell the difference between a gout flare-up and an injury?

I have a doctor’s appointment tomorrow morning to have it checked out, but I’m driving myself crazy in the meantime and I’d appreciate any expert opinions.

2

Sorry. That should be under 50, not under 40–I just turned 42. Wishful thinking, I guess.

3

my father had gout and they told him he needed to cut out fried foods… Have you ever injured the toe before? From what I understand the acid tends to crystallize where there was a previous injury or on a joint (why most sufferers get it in the big toe or knee at first)

His was in the big toe and would get so painful that even the pressure of the sheet over the toe at night was unbearable. He hacked a couple of pairs of shoes so they had no toes on that foot so he could wear shoes during the attacks. This was for when it wasn’t too bad and he could walk on it.

Going to the doctor is your best plan. Good luck tomorrow.

4

Thanks. One hope I’m holding onto for now is that, although it’s swollen and uncomfortable, it doesn’t seem to be as painful as you describe. It actually seems to loosen up a bit when I walk, although I eventually need to rest and put it up or ice it a bit to reduce the swelling.

5

cher3

From here

6

My dad had suffered from the gout. He would sit in his recliner and keep his foot and eat chocolate covered cherries. The cherries were supposed to be helpful in some way.

7

I suffer from gout – in fact, I’m suffering from it right now. It is not fun, and I wouldn’t wish it on my worst enemy.

1.) Do you have gout?

Go to your doctor. They can perform a blood test for gout, and prescribe treatment if necessary.

Gout is much more than a “pain in the joint”. I can usually tell gout from a sprain or other pain in several ways. Gout is partticularly intense, and in a bad case I cannot stand even to have a light sheet resting on the inflamed joint. It feels as if someone is tryibng to tear the ligaments from your joints by pulling them until they rip out. It is a level or two beyond the pain of a sprain or stubbed toe. “gout in the toe” sounds kind of funny, until you consider that you have to bend that toe and have it bear weight if you want to walk. Yet you can’t take the pressure of a sheet lying on it. Fun.

2.) What causes gout?

Damned if I know. If you eat purines it is supposed to trigger an attack. Purines are in shellfish, so I haven’t had shellfish in years (and I like lobster). Some people claim that alcohol brings it on, but I have had variable results with drinking wines – sometimes I get an attack afterwards, sometimes I don’t. I’ve never heard of a correlation with fried foods before, and I haven’t experienced any correlation myself. I do know that pain from other sources seems to act as a nucleus for a gout attck. A sprained ankle seems to easily go gouty.

3.) What is gout?

An inflammation of the joint. Although many people – including doctors – seem to explain it as due to sharp and pointy tartaric acid crystals irritating the joint, it ain’t so. There seems to be some more direct, non-mechanical irritation mechanism. One treatment for gout is to relieve the inflammation with anti-inflammatories.

4.) What can prevent or cure gout?

Colchicin is one of the oldest medicines in use, and is supposed to alleviate a gout attack. I haven’t had much success with it. There are controlling substances, like allopurinol that are supposed to prevent the situatioons that lead to gout (although I haven’t had success with them, either). My best luck has been with anti-inflammatories, which usuyally stop an attack if taken early enough in the game.

Talk to your doctor. I’ve talked to other gout sufferers, and different combinations and concoctions seem to work for different people.

One last word. If you’re not sure if it’s gout, it probably isn’t. The first time I had a gout attack, I was sure I’d broken my foot. I went to the emergency room, and was astonished to find no breaks at all. There was a woman there with a broken foot. She wasn’t in as much pain as I was. (Heck, I’ve broken my ankle, and I know it doesn’t hurt as much.)

8

Well, my doc just put me on colchisin for the pain and inflammation of the middle finger of my right hand, which he calls “gouty arthritis”. Those who know me from the SDMB Weight Loss Club know that I have been eating a lot of red meat on The Atkins Diet, and I am going to modify that in conjunction with the meds he put me on.

Funny thing though. He told me take one pill like every two hours until I get the Sh*ts, and then back off one Colchisin to get my daily dose.

Sounds like fun. Hope it doesn’t happen to me while I’m “bagging” someone in a code in the ER. :smiley:

Q

9

I get what is sometimes refered to as “winter gout”. Foods, alcohol, etc. don’t affect me, but a real cold day in February can kick it in. Because I only get it about once a year or so, my doctor told me to only take the medication when the gout actually flares up. Even though the meds can prevent it, I guess they can also wreak havok with your body, esp. the kidneys.

Men who get gout should be aware of what kind of meds the Dr. wants to give you. Some are such powerful anti-inflammatories that, not only will they reduce the swelling of your toe, they can also prevent the swelling in other body parts, if ya know what I mean;)

When I get gout in my toe or ankle, the affected area not only swells and get’s red, it gets kind of a shine to it.

10

We sell this stuff in our store, and have had GREAT results with it for at least arthritis. I haven’t heard anyone raving about thier gout being cured, but I know it’s mentioned in the pamphlet that we hand out all the time. It’s expensive, yes, but it works wonders. I know someone who, after starting with cherry juice concentrate, quit getting cortozone shots for his arthritis.

(As a shameless plug, Coloma I see sells it for $30 delivered, I could probably see it for a bit less, depending on your zip code)

11

'Nother gout guy here.

I only seem to have a flare-up after eating a large steak or something like that. I used to like liverwurst, but that’s out of the question now. I also found out that I can get a flare-up if I stand in the water while fishing.

Indomethacin works for me.

12

I’ve got something going on with my foot right now. very painful, typically on the big toe joint. swollen, red, all the symptoms of gout. A walk in clinic Dr told me it was gout. She said she sees it a lot in the summer, people open their barbeques and eat lots of meats, drink lots of beer which dehydrates them. She said it’s typical of overweight older men.

However, I have not eaten meat in over 20 years and Id be surprised if I drink more than a 6 bears in a year. Im 6.3 @ 200lbs, certainly not overweight and Im 45. I dont know if thats old?

I explained to her it started after some exercises, doing calf raises that day. Been swollen and tender for 7 days now.

using anti inflammatory and ice.

how can you tell the difference between a break, a sprain, torn ligaments, or gout?

13

I wonder if zombies get gout?

Not a doctor, but an occasional (1-2x/year) gout sufferer. If the pain is localized to a joint or two, then absent a trauma event I’d say gout would be a likely candidate. But if the pain is wider, and affects non-joint areas, I think it would likely be something else.

I would think a reasonable determination could be made by trying colchicine or colchrys for a few hours and see if it gives relief. Again, though, IANAD.

14

First, you go to college. Then you take the MCATs and then attend medical school. Once you do that and complete the internship, residency and so forth, you should be able to distinguish among these.

15

Can we have the OP return for an update, since the doctor apt was a few days ago? I don’t think it was gout since the OP is female, it is not the big toe, and she is able to walk, but it would be good to know.

I am going thru a flare right now. It’s been a few years since my last one, so I think I have been managing things properly, but made some mistakes last week which led to this (3 days in a row of strenuous cycling, wrong foods, and dehydration). I guess my kidneys are not what they used to be.

Some of the changes I have made to reduce the risks of a flare:

  • Diet. Cut animal protein back by about half. I try to only eat meat once a day or less, and only a small portion. I have avoided red meat and stick to mostly poultry and fish (lower purine species) in this area. If I know a meaty meal is on the horizon, I compensate beforehand, as well as after, by trimming back meat consumption.
  • Diet. Some veggies that are considered very healthy harbor purines and I try to avoid them (cooked spinach, asparagus, oatmeal). Note: I have not cut anything out of my diet entirely, just have things in moderation, and plan ahead. There are a lot of purine charts and tables on the internet to help manage this.
  • Hydrate better. Drinking a lot of water helps flush the uric acid out of the body.
  • Alcohol - not really an issues as I don’t drink much, but beer has been avoided for the most part (I have one occasionally), as it is high in purines.
  • Get plenty of exercise - at least 3 times a week for 30 mins or more, as this helps excrete the uric acid. If I go more than a couple days without a bike ride or run or long walk, I get a bit antsy.

Also, everything CalMeacham stated. Ironically, my daughter drove me to the pharmacy yesterday to pick up Colchicine, and with all the walking (limping), I think that is where I threw-out my back. Well, at least the foot is not as painful any more!

16

For large values of “a few days”. (The OP is from 2003.)

17

Huh, that’s still sounds a bit higher than average. I guess we can add bears to the shellfish, port wine, etc list.

“how can you tell the difference between a break, a sprain, torn ligaments, or gout?”

In my experience the pain from gout comes on over a period of about 2 hours or so, is concentrated at the joint and is very intense, sharp and unrelenting. The joint may have a red, puffy appearance but there’s really not any appreciable swelling beyond the joint and shouldn’t be any bruising. And the pain… while a break or tear or sprain may ache, usually if still you can find a reasonable position to let it lie. With gout no matter what you do the pain makes you look at the spot and wonder "My god, how can such a small spot hurt so freaking bad.

I too have had zero success with colchicine but allopurinol keeps me attack free (as long as I don’t forget it on vacation). If I do have an attack, I’ve been prescribed Medrol, a steroid, and it provides almost complete relief in as little as an hour or two, that until I can catch up with the allopurinol.

18

OP here. Wow, my first zombie thread!

Actually, it wasn’t gout, it was incipient arthritis. Not much to do but live with it.

19

I totally missed that this was a zombie thread! LOL

cher3, I hope you are doing OK with it.