OK, anybody here have any experience with pseudogout? Looks like I now have it [along with fragile little footbones that like to snap with no warning ]
I have a brand new scrip for indomethican and as soon as the doc’s office is done writing it an FMLA letter so I can call out if I have a flare up and cant walk. This current flareup has my foot an overall 2+ centimeter edema and I cant even fit my foot into a large soft slipper. I don’t even want to get into how much it hurts
Any idea how often it might flare up? I know everything online and that my doc knows there is no dietary link but are there perhaps triggers you may have noticed? mrAru just installed a grab bar in the bathroom to make it easier for me to gimp around. Any other suggestions that might come in handy?
You probably already know that pseudogout and regular ol’ gout are caused by different crystals, so have you had your thyroid/parathyroid functions checked? How about your iron–is that OK?
Indomethacin is a wonderful thing for those of us that can tolerate it well. I hope it works as well for your pseudo as it does for my gout.
Make sure your shoes fit well, or loosely (when you can put them back on).
Uh, don’t stub your toes. (Sorry. I got nothing more.)
They told me for years that I had pseudogout. It turns out they were wrong – I had regular gout.
Indomethacin/indocin is wonderful stuff if I take it at the beginning of an attack. Usually. I just got over an almost 2-week gout attack. The indocin definitely helped, but I’d feel better if it had eliminated it at the start.
Everyone seems to respond to different drugs. Colchicine is the classic gout drug (I don’t know if it does anything for pseudogout), but it never did me any good. I take Allopurinol for gout on a regular basis. Other people seem to respond better to colchisine.
I still don’t know exactly what causes gout attacks. I’ve been told that the purines in shellfish are powerful agents, so I avoid them altogether. Some say red meat brings on attacks, but I’ve never noticed any correlation. Wine does seem to sometimes bring on attacks, but it’s not invariably true. If I hurt myself, the hurt site seems to provide a “nucleation site” for gout.
As ever, Your Mileage May Vary. I hope you have no (or at least very few) attacks.
Pseudogout tends to flare at times of physical stress to the body. That’s probably more a reflection of some degree of (often occult) dehydration than anything else. In other words, when people are seriously “sick”, they tend to drink less than normal thus causing the concentration of everything in the blood and so-called “interstitial tissues” to rise. Such a phenomenon would tend to promote precipitation of previously dissolved crystals.
Moreover, when we’re sick and dehydrated, blood flow may be altered such that the most peripheral and/or least critical areas of the body receive less blood flow than usual. This too would tend to cause crystal precipitation in any affected areas since “stagnation” of blood and tissue fluid flow might lead, once more, to decreased crystal solubility. Likewise, our tendency to be less mobile during times of illness might also lcontribute to stagnation with precipitation of crystals as a result. Finally, since crystal solubility increases with increasing temperature and vice versa, cooler parts of the body may be more likely to become sites of pseudogout activity. Indeed, when you think of it, peripheral joints seem to be ready-made candidates to be sites of pseudogout (which is exactly where it’s most frequent).
I suppose that all this means that it’s important to keep well-hydrated, especially during times of intercurrent illness. And, given the business about immobility and stagnation above, it would seem prudent to maintain at least a modest degree of physical activity (if feasible) when you’re sick (remembering, of course, that joint trauma itself may lead to an attack of pseudogout!).
We know it isnt gout classic, the blood test for the uric acid came back negative=)
Iron is fine, and now that I have had the offending parathyroids yoiked out, my remaining parathyroids are behaving themselves [had the job done oct 17th]
I am told there is no dietary component to the whole mess, so I can eat shellfish until I can pop …
Near as we can figure the operation caused me to sit on my arse for the last 2 weeks, and the day stuck in the hospital and day after are probably the culprits as I know that I was dehydrated when I finally stopped sleeping [I basically kept nodding off and spent almost the entire time from when I got out of recovery at noon on the 17th until about mid afternoon on the 19th sleeping. I was ravenously thirsty as I had drunk pretty much nothing because of sleeping [and I normally tank down almost a gallon a day of assorted liquids, usually tea and water]. So surgical insult, indolence and dehydration =)
My doc didnt give me colchicine because he pointed out that you need to start it when you get the first pain, otherwise it makes it worse. I have a scrip for some for the next flare up. he indocin seems to help, and it is going away slowly [i am down to edema of 1 cm overall, from just under 3 cm. My foot looked like a cartoon puffy foot :eek: ] I sort of wish I had a picture of both my feet from saturday when it was at its worse for people to look at, but the pain had me to the point of screaming [which for me is amazingly unusual as I normally have a very high pain threshold and endurance] though it still hurts like a mother, I can actually crutch around and let the foot hit the floor. Before, even moving teh leg without the foot actually touching anything was agonizing. I now understand why they report that the pain is actually worse than childbirth/kidney stones/broken bones in a bad flare. I have done the labor and broken bone thing, so I can compare 2 of 3 items…and pray tht I dont get kidney stones to compare the pain to!
I started out using indomethacin. It worked well at first, but seemed to lose its efficacy over time. I have since found that sulindac works more reliably for me. Taken at the first hint of an attack, it knocks the inflammation right out. (Whether it’s gout or pseudogout shouldn’t matter, since indomethacin and sulindac both treat the common symptom: inflammation.)
I don’t know if it would help with pseudogout as there are calcium deposits instead of uric acid crystals but I have had a lot of luck eating cherrys at the first sign of an attack. For me they are as effective as the Indomethacin at getting the attack under control, YMMV.
For this last attack I tried pomegranete juice and it was about as effective with less vitamin C (so a slightly less risk of kidney stones, at least I hope so). Again YMMV.
Either way (cherrys or pomegranete) my attacks usually only last about a day or less.
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