Just left the E.R. for the second time in a week during the current flare-up.

I don't drink, I don't eat the stuff I ain't s'posed to, and I ain't rich.
What the heck gives????

For extra added fun, I have 3 drumming gigs and an 8-hour fishing program to do this weekend. There's nothing like stomping on pedals for 4 hours a night while your foot's doing its best to imitate a flesh-eating zombie. GRRRRR....

Indomethicin didn't do squat this time.

Now they put me on Colchicine. Lotsa horror stories about this stuff.

Anybody have any thoughts?

Well, off for my 4th glass of cherry juice today.

Gout was giving me fits til I was put on Phobenecid 500mg once daily. Once on it, you need to stay on it...It's generic, it doesn't cost too much and stops Gout.

Gout used to be called "The Rich Man's Disease"...I've proven that to be false.. :-)

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Regards,
Windjammer

I was in my early 30s when I had my first attack. Took a while, but now I take an allopurinol and a probenecid tablet daily. Never had another attack once the doctors figured out I needed both. Usually, one or the other prevents such attacks.

Gout is a very painful experience and may not be simply because you eat the wrong foods. Some folks just have very high amounts of uric acid, which triggers it.

Bob

I get it every once and a while now. Been 2yr (knock on wood) Broke my big toe 3 times and that were it gets me. I do take colchine only when I feel it coming on 2 hits a day for 2-3 days usally takes care of it.

My heart goes out to you. People don't know what pain is till you get a case of gout

I used to have some very severe episodes of gout. Many don't understand that gout can be a major health crisis with pain so severe that it can cause shock. Also, repeated bouts of it can cause severe damage to the affected joint. The things that contributed to my problems were being very overweight and eating too much protein. The idea that it is a "rich man's disease" came from a time when meat was a luxury for the wealthy. One had to be in the more affluent class to afford meat everyday.

In adition to the colchicine and probenecid, I was told to drink lots of water and cut out or very much down on animal protein foods, ie, meat. I did find this helped. As I am sure you know, certain other foods, high purine foods, can also be a problem.

The real frustration came when I finally started to lose a bunch of weight and that brought on attacks of gout! I don't know about your case, of course, but mine got so bad even a bed sheet was too painful to have over my foot. It felt like lighteneing was going through my foot. It was one of the most painful things I have experienced. You have my sympathy on this. I hope you get better.

Thanks for the support, guys.
Sorry you've had to deal with it, too.

For those of you forummers lucky enough to never have experienced gout, here's something that might put into perspective:

I once played in a band with a guy that had gout before I ever had it. (His was from drinking too much.)

This same fellow also once fractured his kneecap into small bits in a skiing accident.

He told me that if given a choice between having another gout attack or re-shattering his kneecap, he said, he'd TAKE THE KNEE!

Can't suck enough.

I am the grand master punjab of gout attacks! Thank God not lately though. The big thing to watch for is kidney stones. They seem to go hand in hand and you could get them later. They make the gout feel good! If you get a attack of gout I have found indcine SP?, helps. Reduce the swelling fast, but on that I need the bathroom handy.
Alapreino is kind of confuseing to be on. If you take it, you QUIT takeing it at the 1st sign of gout. Conversly, I belive if you dont take it, they put you on it when you get the gout. Go figure! You will find your 1st bout of gout is the worst. After that you seem to learn to bull it through. The same with kidney stones.

My grandpa, rest his soul, said the good Lord was punishing him with gout because, as a young man he used to laugh at all of the old men with gout. Proper diet will help.

I've had my big toe act up and I know it hurts. I recently developed Rheumatoid Arthritis, which feels like gout in every effected joint. I couldn't turn the key in the ignition of my truck or even hold an empty soda can. While researching RA I've read that gout is a form of arthritis. For those that haven't been there, imaging a small glowing charcoal ember in a joint. When you use the joint it is like blowing on the coal. Gout, arthritis... whatever. It's just no fun at all.

Brother, I feel your pain.

I reckon I'm just lucky, because I'm 41 years old and eat meat all day, EVERY day and have never had a case of gout.

Is there a certain kind/type of meat that causes it?

What is gout?

Gout is a kind of arthritis. It can cause an attack of sudden burning pain, stiffness, and swelling in a joint, usually a big toe. These attacks can happen over and over unless gout is treated. Over time, they can harm your joints, tendons, and other tissues. Gout is most common in men.

What causes gout?

Gout is caused by too much uric acid in the blood. Most of the time, having too much uric acid is not harmful. Many people with high levels in their blood never get gout. But when uric acid levels in the blood are too high, the uric acid may form hard crystals in your joints.

Your chances of getting gout are higher if you are overweight, drink too much alcohol, or eat too much meat and fish that are high in chemicals called purines. Some medicines, such as water pills (diuretics), can also bring on gout.

And, of course, your genetics play a major role in any type of arthritis.

Define "purines" please.

High uric acid levels may be caused by:

Individual differences in the way your body produces or gets rid of uric acid.
Conditions, such as:
Kidney disease or kidney damage.
The increased breakdown of body cells that occurs with some types of cancer (including leukemia, lymphoma, and multiple myeloma) or cancer treatments, hemolytic anemia, sickle cell anemia, or heart failure.
Other disorders, such as alcohol dependence, preeclampsia, liver disease (cirrhosis), lipid disorders, obesity, psoriasis, hypothyroidism, and low blood levels of parathyroid hormone.
Starvation, malnutrition, or lead poisoning.
A rare inherited gene disorder called Lesch-Nyhan syndrome.
Medicines, such as some diuretics, vitamin C (ascorbic acid), lower doses of aspirin (75 to 80 mg aspirin daily), niacin, and some medicines used to treat leukemia, lymphoma, or tuberculosis.
Eating foods that are very high in purines, such as organ meats (liver, brains), red meats (beef, lamb), game meat (deer, elk), some seafood (sardines, herring, scallops), and beer.
Drinking a lot of alcohol, especially beer.


Purines are a class of organic molecules consisting of an asymmetric fused double ring that contains substantial nitrogen. When these molecules are metabolized, they produce copious uric acid, which must be removed from the blood by the kidneys. If the kidneys can't handle it, the uric acid crystalizes out to produce kidney stones and/or gout.

In short, eating meat rich in internal organs, like the preserved hard sausages, and washing them down with beer, is a stress test for your kidneys.

Beach Elvis, I feel your pain, literally! I had my 1st attack a few years ago, I put off going to the doc because I felt like a dork, I mean, my big toe hurts, cowboy up! I finally went, she took one look at my big toe, and said it's gout. That sent me on a research bender, I finally had to be put on 300 MG of Allopurinol a day and it seems to keep my flare ups in check. THis was after numerous episodes, I mean, when you can't put your socks on because it hurts, you've gotta do something. I get the twinges, and occasionionally the water from the shower hitting my feet causes pain, and I know I'm on the verge of an attack.

Watch your diet, and you may have to go on a maintenance drug, it's the only thing that keeps me from having more frequent flareups.

Take care bro, I know how much it hurts.

That's a lot of GOOD information.

WHEW! Boy am I glad I'm not from Chicago! I'll bet that place is gout central...especially with those Bears fans, huh?

http://www.youtube.com/watch?v=JPP3aTB6nLo

Had gout when I was married to my first wife ... got a divorce and never had another attack. Now I am fighting asthma, ulcerative colitis, diabetes, osteoporosis and tinnitus. And if that ain't enough, I'm scheduled for an abdominal CT scan at the Prescott VA on the 25th because my last two blood labs show elevated liver enzymes. Getting older ain't for sissies.

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Fred
S&WCA 3238

Seafood will bring it on the quickest. Also they say meat organs like liver and kidneys, but I hate them. I also heard asspargas is bad. Getting your feet wet also can start it. However if you are a skinny health nut you probley can get away with everything. Its suppose to come from a lot of rich, spicey, fatty food. In other words, everything I like! (except for the organ meat).
Seriously, as I already said, and I cant say it enough as a vet, kidney stones seem to go along with it. The gout is or could be a warning siginal for stones, and brother, you dont want kidney stones! There isnt ANYTHING in this world that hurts worse than kidney stones!

Sorry for all you guys and gals that suffer with gout, as I do. Until I experienced it I had no idea what gout was.

I overindulged (the most delicious foods including organ meats, seafood and wild game along with copious amounts of alcohol) for most of 30 years. Then one day I started to experience soreness in the joint behind my right big toe. It would go away but, returned a couple of times over a year. Then one day, BAM. Extreme pain and no going away.

It took meds like allopurinol, steroids and severe dieting for over 9 months to significantly lower my purine levels and to become free of attacks.

Since those 9 months have passed, I do have small portions of seafood and some other prohibited foods but, no liver and onions. I also have one to two beers every day or two. More on some weekends. Thanks to allopurinol and watching my diet, no more attacks.

The attacks were so painful that I was willing to do anything to make them stop. I still am and I will again alter my lifestyle in any way that is needed should the attacks return.

Best wishes to all of the striken out there.

__________________
" I don't recall, senator."

I started having trouble with gout at 52. I am now 63 and it won’t bother me if I take care of myself. Google low pruine diet. I decided I didn’t want to die early because of liver failure after taking medications for gout. It’s a diet and weight problem. My diet consists of lots of vegetables, fruit and nuts. When I started this diet I was 6’ tall and 205 pounds. In six months I lost down to 180. Two years later I am at 175 with no gout attack for at least 6 months. I still get an attack at times, but it only lasts maybe 8 to 10 hours and very mild. Steak or beef of any kind could and sometimes will bring on an attack. I eat beef about once every 2 or 3 months and I expect an attack. It don’t always come. I eat meet once a day and only about 3 or 4 oz. Mostly its chicken, pork or turkey. I am in better shape now with lower BP.
This reply is getting long, you will just have to work it out, or take the medication. I made my choice and I’m sticking to it. Good luck.
Phil

Stress will bring on gout. Stress is a quiet killer in more ways than one. Organ meats (liver, heart, etc.) are bad. I used to get gout but haven't had an occurance in over 10 years. I know what the warning signs are and still have the medicine in case I get that heated 'tingle'...

I too have suffered with the Gout and here's a little limrick I've posted before in that regard:
'Twas a gouty young man so they say,
who's toe pained him in a horrible way.
With the cause traced to beer, his solution was clear;
he cut off his big toe the next day!

Must have been a true Irishman!

I know guys that have had the gout and I know it's painful BUT I also have a funny gout story. I got hurt at work one day and was waiting my turn in the E.R and there was a black guy moaning in a wheelchair like he was dieing. Someone asked him what was wrong and he replied "quote" " I gots the gout!" Then while his girlfriend pushed him in his wheelchair his "gout foot" blasted into a wall. So you can imagine that episode. It had to be as painfull as hell but it was as funny as a comedy skit!
I hope his foot is better.

Many years ago I was takeing my lunch break in the carpenter shop at work. A guy was moaning about the gout in his big toe. Another carpenter was walking past with a hammer in his hand and as a joke made a swing with it at his foot. The hurting guy by scared reaction kicked his foot right into the swing! It was something to behold!

If someone did that to me while having a gout episode, I would hammer his gonads to a wall with a dull, rusty nail!!! I forgot to mention that I lost a good deal of weight and stopped eating so much flesh and don't drink anymore. The gout went away and hasn't bothered me in about 5 years...thank God! The side effects of the change in diet have been lower cholesterol, reduced/normal blood pressure, reduced weight and generally feeling better. My father had bad episodes of gout. I suppose I got the genes for that from him.

I'm medical and also have suffered from gout. Gout is caused when uric acid, always present in the blood, reaches too high a concentration and precipitates out of solution in crystal form and accumulates in the joints. Like little grains of sand. Ouch!

The old treatment was a combination of indomethacin and cholchicine. Indomethacin is a powerful non-steroidal anti-inflammatory, in the same class as ibuprofen (Advil). Colchicine is derived from the autumn-blooming crocus and has been known as a treatment for gout for two thousand years. Colchicine inhibits uric acid (urate) crystal deposition, which is enhanced by a low pH in the tissues, probably by inhibiting oxidation of glucose and subsequent lactic acid production in white blood cells. The inhibition of uric acid crystal formation is a vital aspect on the mechanism of gout treatment. However, colchicine is mildly toxic, and that is why doctors typically recommend that patients take indomethacin to relieve the inflammation (for most people it takes the "edge" off) while the colchicine works to prevent the deposition of more uric acid crystals. Also, doctors typically will tell the patient to take the colchicine until one of two things happens: the gout subsides, or, the patient is stricken with diarrhea.

Some physicians will prescribe indomethacin alone, and this works (at least it did for me) to stop acute attacks.

One approach -- very painful, but briefly so -- is the direct injection of a steroid by needle -- into the affected joint. This works very quickly -- in a few minutes -- to totally relieve pain, but be sure to ask the doctor for a soft cast .45 Colt 255 grain bullet to bite on before he sticks you. You will be glad you did, and the doctor won't be so likely to hear the string of cuss words that will try to come out of your mouth when he jabs you.

The problem with these treatment approaches is that they are reactive, and that patients almost always suffer recurrences.

The better approach is to prevent the attack in the first place.

The drug most commonly prescribed to prevent gout is allopurinal, which acts by inhibiting the production of uric acid, but there are others, including probenecid, which acts by preventing the reabsorption of uric acid in the body and causing its greater excretion, and hence leads to a lowering of uric acid levels in the blood.

Under development and now in Phase III clinical trials (final pre-marketing phase) is a drug called pegloticase, which will dissolve uric acid crystals safely.

Diet makes a difference since uric acid production is related to the level of purines in the blood, and protein, fat, and alcohol all contribute to elevated purine levels. However, I have never heard of anyone whose gout was controlled by diet alone.

Personally, I have found that 800 mg. of Advil (4 gel caps) taken every day, seems to prevent attacks. I take this dose (which is the dose they will give you in the hospital and can be repeated every 8 hours; the over the counter stuff is only 200 mg. per capsule) every day to control my mild osteoarthritis, and it seems to have the effect of preventing further bouts with the gout. However, this is non-scientific evidence, some people cannot tolerate this dose, and I am not recommending it to anyone. Your treatment should be decided in consultation with your physician, not some guy on the internet.

By the way, do not -- never -- take aspirin for pain control with gout. It will increase acidity and make the condition worse. if you have trouble with indomethacin or ibuprofen, talk with your doctor. There are other non-steroidal anti-inflammatories available, and one of those may be right for you.

I hope this helps.


Bullseye

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Five screws and 3-1/2 inches.

My brother-in-law, who suffers from periodic gout, had a stent put in, and then was put on the 81 mg aspirin program. Guess who went right into a gout episode?

Barb, you are an angel for working with older people. You have my blessings.

I have Rheumatoid Arthritis. I know pain personally, we are constant companions. Gout is terrible pain, but at least it is only one or two places. Both of my hands and feet are deformed. All of my major joints, and most of the smaller ones, are affected. Every facet of life is affected.

If Gout is preventable, by all means do what you have to, to prevent it. RA has it's own time table, when 'Uncle Arther' comes to town, be ready for a rocky visit.

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PC, censorship
with a smile.

Bullseye and others, thanks for the effort you have taken to explain gout. I am earmarking this and appricate it! I havent got hit for close to a year and the last few bouts have been less sevier, but I have put up with it for close to 25 years off and on! I really dont take medication except when I get it. And maybe not then, if the prescription ran out. The real hurt was years ago in the first attacks, I seem to be able to live with it now that I am retired and not walking on the job. The same for kidney stones, first one I almost wanted to die! I had several after that and bulled it through. My dad many years ago experianced the same, and would just "Bull" through the stones after the 1st time. He said he went through it close to 10 times!

I've been dealing with Gout attacks off and on for about six years now. I'm 59, 6'3", 270 lbs. I know my weight is a contributing factor. Add to that, stress and not enough sleep can add to bringing on attacks. Too much processed foods, fast foods, TV dinners don't help either.

One thing I found out will help prevent Gout, or lessen the severity is drinking cherry juice. I'm talking about real 100% cherry juice. It's not cheap, but it's a small price to pay. Eating fresh cherries helps too! Drink a lot of water too. I also keep a bottle of Indocin on hand and as soon as I feel a Gout attack coming on I start taking them for a few days. It can help in making it less painful.

One time I had it in my ankle, instead of my big toe. It was so bad the doctor recommended he drain it to relieve the pressure. I knew it would hurt, but I was so desperate for relief that I agreed. Doctors always say "this won't hurt". But this time he warned me over and over that I should be prepared because it was going to hurt more than I could ever imagine! He had me lay on the exam table and told me to hold on to the side rails tight. When he stuck that needle in it hurt SO BAD that my reaction actually bent one of the hand rails! One time I was tempted to shoot my foot so I might feel a lesser form of pain! That's how bad it hurts!

Not exactly the gout, but arthriteous in the knee, memorial day I had to take my wife in for treatment. They also almost killed her tapping fluid out behind the knee cap. Then they injected steroids. She got vilantly sick from some reaction and couldnt get away from the bathroom for a good week. Sometimes the cure is worse than the cause!

A 2003 study by Jacob et al. (J Nutr. 2003 Jun;133(6):1826-9) demonstrated that sweet black Bing cherries do cause a significant reduction in serum (blood) uric acid levels probably because compounds in the cherries inhibit the pathways that lead to inflammation. However, it took 10 ounces of pitted cherries to get a statistically significant effect. This doesn't mean you should not try this, but if you use cherries (or pure black sweet Bing cherry juice) just be ready to make sure that you are consuming enough of it daily to have the desired effect.

Also, there is some reasonably credible anecdotal evidence that Damson plums have the same preventative effect, but no scientific studies have been done of which I am aware.

Just remember, while there is some good evidence that Bing cherries can lower uric acid levels in the blood, there are no studies that prove a significant effect in actually preventing gout attacks. And, it is clear that once an attack is underway, cherry juice is probably not going to do you much immediate good.

The current thinking in most progressive medical institutions is to use these complementary and alternative treatments side-by-side with conventional medical treatments. This certainly makes good sense, as it is likely that if the complementary approach has an effect, even a weak to moderate effect, then, it may reduce the severity of symptoms or the length of the episode or both, in combination with standard medical treatment.

Ask your doctor about this. Most are willing to try something new if there is good scientific evidence to back up what you are requesting, and in any event, you do not need an Rx to buy Bing cherries or cherry juice.



Bullseye

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Five screws and 3-1/2 inches.

i got my first flare up at 25 eating lots of red meat and beer and other bad foods did it my doc says. also organ meat and asparugus is high in purines. also some stress can bring it on.

the purines crystalize in your blood and for some reason settle in your joints and for some other reason tend to settle on the right side of your body. anyway, know those pepper grinders that are clear and you can see the pepper corns mashing around ? think of the peppercorns as the purines and the grinder as your blood in joints. every time you move yoru joint the purines grind and flare up the joint. i went to the ER for my 1st attack thought i had necrosis or some spider bite. now i keep a bottle of Indomethacin (prescription) handy and when i feel the tingle coming i start popping those pills. gives me great gas. havnt had a full blown flare up since. just tak ethe pils to keep it down and drink LOTS of water during an attack. the worst was when i was in mexico on vacation and i had a flare up. so i went to a pharmacia and i think they were surprised i wasnt trying to buy viagra. with my broken spanish and their broken english i convinced the pharmacist that i needed indomethacin for gout and they had some. i took it all while i was down there so i wouldnt be busted trying to get that back over the border since its prescription

google "purines" and you come up with lists of foods that have them.