Chef Jim Posted November 3, 2012 Posted November 3, 2012 well I couldn't actually say yes....could I? Keep feeding these guys beef tenderloin with a nice glaze Chef.....it's good for business. No, actually the markup on a grilled piece of fish and steamed vegetables is MUCH better for business.
The Poojer Posted November 3, 2012 Posted November 3, 2012 no officer, i was only helping it over the fence....oh wait...GOUT??? never mind....
Wacka Posted November 3, 2012 Posted November 3, 2012 The last big flareup I had was so bad I couldn't walk or stand. Had to crawl around, help myself up on the toilet and pee sitting. Wanted to cut my foot off to reduce the pain. Was going to cancel a job I had, but it got better and I used a hiking stick as a cane. At the end of teh job it started getting bad again, but I was about 70 miles from home. It was my driving foot and had to endure excrutiating pain to make it home.
inkman Posted November 3, 2012 Posted November 3, 2012 Wacka, Maybe a stupid question, but have you been to the doctor?
Kelly the Dog Posted November 3, 2012 Posted November 3, 2012 I have had gout for 20 years. Here is my advice. First, I think that the red meat and alcohol stuff is mostly nonsense, as does my doctor. It has no affect on me at all, and I eat red meat almost every day and drink a lot. It has little to do with the flare ups and the doc has a lot of patients that are vegans and non-drinkers. Go to a foot doctor, or your regular doc and get a prescription for allopurinol, and hope you don't have a reaction like inkman. Most people there are zero side effects. Allopurional is a deterrent -- you take it to prevent flare ups. Colcichine is both a deterrent and a remedy for the pain and swelling and lessening of the uric acid.. The best remedy for it is usually indomethacin or Indocin (the brand name). Take that if it flares up and it will go away in a day or so. If you have good insurance and don't have to pay for any of this stuff, get all three. Take the allopurional and colcichine to prevent it, then if it flares up, drop the allopurional and start the indomethacin. Otherwise, just take the allopurional and it shouldnt flare up. A couple years ago, Colcichine went up about 1600% in price for no reason so don't pay out of pocket for it.
millbank Posted November 3, 2012 Posted November 3, 2012 It had gout about 20 years ago and was told i would need to take Allopurinol the rest of my life. At the time I was over weight and was in the habit of eating a fair amount cured meats, high in salt content. Once I eliminated cured meat, cut back appreciably on salt intake and got my weight in control have never had a instance of gout again .
PaattMaann Posted November 3, 2012 Author Posted November 3, 2012 I have had gout for 20 years. Here is my advice. First, I think that the red meat and alcohol stuff is mostly nonsense, as does my doctor. It has no affect on me at all, and I eat red meat almost every day and drink a lot. It has little to do with the flare ups and the doc has a lot of patients that are vegans and non-drinkers. Go to a foot doctor, or your regular doc and get a prescription for allopurinol, and hope you don't have a reaction like inkman. Most people there are zero side effects. Allopurional is a deterrent -- you take it to prevent flare ups. Colcichine is both a deterrent and a remedy for the pain and swelling and lessening of the uric acid.. The best remedy for it is usually indomethacin or Indocin (the brand name). Take that if it flares up and it will go away in a day or so. If you have good insurance and don't have to pay for any of this stuff, get all three. Take the allopurional and colcichine to prevent it, then if it flares up, drop the allopurional and start the indomethacin. Otherwise, just take the allopurional and it shouldnt flare up. A couple years ago, Colcichine went up about 1600% in price for no reason so don't pay out of pocket for it. thanks for the advice and tips....I have great insurance but dont like doctors/taking medication one bit...I know how stupid that sounds and my beliefs are certainly in the minority and if I dont want to take the advice I will probably just have to deal with the bouts of gout... however, it is so debilitating that going to the doc to have them give me a prescription might just have to be done are all of those medications only avail with a script or can they be had OTC? also about the medication....do you take them daily or just with a flare up? .
The Poojer Posted November 3, 2012 Posted November 3, 2012 there are a few on here that swear by the homeopathic remedies rather than pharmaceutical. i cannot remember who it is on here, but they seemed very knowledgeable,,,you may want to look at that option. thanks for the advice and tips....I have great insurance but dont like doctors/taking medication one bit...I know how stupid that sounds and my beliefs are certainly in the minority and if I dont want to take the advice I will probably just have to deal with the bouts of gout... however, it is so debilitating that going to the doc to have them give me a prescription might just have to be done are all of those medications only avail with a script or can they be had OTC? also about the medication....do you take them daily or just with a flare up? .
BillsFanM.D. Posted November 3, 2012 Posted November 3, 2012 I have had gout for 20 years. Here is my advice. First, I think that the red meat and alcohol stuff is mostly nonsense, as does my doctor. It has no affect on me at all, and I eat red meat almost every day and drink a lot. It has little to do with the flare ups and the doc has a lot of patients that are vegans and non-drinkers. Go to a foot doctor, or your regular doc and get a prescription for allopurinol, and hope you don't have a reaction like inkman. Most people there are zero side effects. Allopurional is a deterrent -- you take it to prevent flare ups. Colcichine is both a deterrent and a remedy for the pain and swelling and lessening of the uric acid.. The best remedy for it is usually indomethacin or Indocin (the brand name). Take that if it flares up and it will go away in a day or so. If you have good insurance and don't have to pay for any of this stuff, get all three. Take the allopurional and colcichine to prevent it, then if it flares up, drop the allopurional and start the indomethacin. Otherwise, just take the allopurional and it shouldnt flare up. A couple years ago, Colcichine went up about 1600% in price for no reason so don't pay out of pocket for it. Nonsense? There's lots of evidence with dietary correlation and gout flares. If you have no effect....great! But...don't blindly dismiss it for others. I could give you lots of 'success' stories as well as dietary failures. If you can avoid a 'periodic' flare of gout simply by modifying your diet that is a much better solution than taking a medicine every day the rest of your life. Not to mention, this 'patient' has had one flare of gout.....rather that he reported as 'gout.' Lots of folks have one or two episodes in their entire lifetime. I probably wouldn't recommend much based on one episode other than to look for obvious flares (recent binge drinking, or high protein consumption). Even then, I wouldn't recommend much based on one flare. Prophylactic meds such as allopurinol and colchicine are not indicated at all for one flare. As you point out there are potentially very serious reactions with any med (allopurinol is associated with a potentially life threatening, albeit very rare reaction). It's not worth putting a patient with an isolated flare of gout on this type of daily med(s) for a multitude of reasons. And... both colchicine and allopurinol are not indicated for 'everyone.' If repeated flares occur, then the diet changes should be tried and then prophylaxis should be considered. thanks for the advice and tips....I have great insurance but dont like doctors/taking medication one bit...I know how stupid that sounds and my beliefs are certainly in the minority and if I dont want to take the advice I will probably just have to deal with the bouts of gout... however, it is so debilitating that going to the doc to have them give me a prescription might just have to be done are all of those medications only avail with a script or can they be had OTC? also about the medication....do you take them daily or just with a flare up? . It's a free country and lots of folks don't like docs. No sweat. As I said earlier, I'm not gonna give advice other than generic information. There are benefits to weight loss and diet if this becomes a recurrent problem. Call your doc and just ask the nurse in the office if there is something you could use for a mild flare. You can also find this on the internet for sure. There are many OTC options that 'might' help your problem. Check with your doc as your underlying (if they exist) med conditions may affect your ability to take them. Good luck!
Kelly the Dog Posted November 3, 2012 Posted November 3, 2012 thanks for the advice and tips....I have great insurance but dont like doctors/taking medication one bit...I know how stupid that sounds and my beliefs are certainly in the minority and if I dont want to take the advice I will probably just have to deal with the bouts of gout... however, it is so debilitating that going to the doc to have them give me a prescription might just have to be done are all of those medications only avail with a script or can they be had OTC? also about the medication....do you take them daily or just with a flare up? . They have to be a script I'm pretty sure. The doctor will usually tell you to take the allopurinol one a day, and again, for me, there is absolutely zero side effects so I never notice anything when taking them. I have, however, usually just taken approximately 4 per week instead of 7, so I didn't have to take as many and I rarely if ever have flare ups (just if I don't take them at all).
PaattMaann Posted November 3, 2012 Author Posted November 3, 2012 Nonsense? There's lots of evidence with dietary correlation and gout flares. If you have no effect....great! But...don't blindly dismiss it for others. I could give you lots of 'success' stories as well as dietary failures. If you can avoid a 'periodic' flare of gout simply by modifying your diet that is a much better solution than taking a medicine every day the rest of your life. Not to mention, this 'patient' has had one flare of gout.....rather that he reported as 'gout.' Lots of folks have one or two episodes in their entire lifetime. I probably wouldn't recommend much based on one episode other than to look for obvious flares (recent binge drinking, or high protein consumption). Even then, I wouldn't recommend much based on one flare. Prophylactic meds such as allopurinol and colchicine are not indicated at all for one flare. As you point out there are potentially very serious reactions with any med (allopurinol is associated with a potentially life threatening, albeit very rare reaction). It's not worth putting a patient with an isolated flare of gout on this type of daily med(s) for a multitude of reasons. And... both colchicine and allopurinol are not indicated for 'everyone.' If repeated flares occur, then the diet changes should be tried and then prophylaxis should be considered. It's a free country and lots of folks don't like docs. No sweat. As I said earlier, I'm not gonna give advice other than generic information. There are benefits to weight loss and diet if this becomes a recurrent problem. Call your doc and just ask the nurse in the office if there is something you could use for a mild flare. You can also find this on the internet for sure. There are many OTC options that 'might' help your problem. Check with your doc as your underlying (if they exist) med conditions may affect your ability to take them. Good luck! hey, stop calling me a 'patient', as if im not truly a patient haha....show me some respect....and its not an isolated flare up, this is the third such occasion in the past 8 months (when it initially started)....I do thank you for your general information though, it is much appreciated...if I ever get a flare up where I cant function (like the previous flare up - not the current one which is all but gone and was VERY mild) I will probably visit a doctor...guess ill actually have to get a primary care physician eh? Have great insurance, but have never gotten the chance to use it because I havent been to the doctor since I was 18....my wife swears by the insurance/docs though!
Kelly the Dog Posted November 3, 2012 Posted November 3, 2012 Another really important thing to know about gout is do not necessarily believe the blood tests. Gout very often will not show up in the tests but you still may have it. It happened to me three different times, as well as to my foot doctor himself, and many of his patients. Check out the symptoms, and if you have them, even if you are checked for gout and are told the results were negative, if they cannot find out what it is, you likely have it.
BillsFanM.D. Posted November 3, 2012 Posted November 3, 2012 hey, stop calling me a 'patient', as if im not truly a patient haha....show me some respect....and its not an isolated flare up, this is the third such occasion in the past 8 months (when it initially started)....I do thank you for your general information though, it is much appreciated...if I ever get a flare up where I cant function (like the previous flare up - not the current one which is all but gone and was VERY mild) I will probably visit a doctor...guess ill actually have to get a primary care physician eh? Have great insurance, but have never gotten the chance to use it because I havent been to the doctor since I was 18....my wife swears by the insurance/docs though! sorry. didn't mean to offend.....and sorry to you and Kelly if I got the story wrong. Wasn't sure how to 'label' you....I guess I shouldn't have. Kelly is correct about the meds he mentioned. They are all prescription only. There are other options, however, for mild flares. Many types are available OTC. Check with your new doc! Another really important thing to know about gout is do not necessarily believe the blood tests. Gout very often will not show up in the tests but you still may have it. It happened to me three different times, as well as to my foot doctor himself, and many of his patients. Check out the symptoms, and if you have them, even if you are checked for gout and are told the results were negative, if they cannot find out what it is, you likely have it. Here we can agree. The 'blood test' for gout is basically useless if used as a screening tool. Your serum 'uric acid' level is the test in question. I have many patients with very low uric acid (prior to any med such as allopurinol) and severe gout. On the flip side...I have folks with relatively high uric acid levels and they've never had a clinical flare of gout. Higher levels do tend to correlate with increased likelihood but it is NOT confirmatory of anything. In short, the test is supposed to be used as a baseline. I.e. a patient is diagnosed with gout based on clinical exam, story and, perhaps, joint aspiration of crystals. If these flares are recurrent, the doc should get a baseline for the uric acid level. It can then be 'followed' to monitor response to a med like allopurinol. I.e. the patients baseline level should decrease with med. Gout should not be 'ruled in' or 'ruled out' based on a blood test alone. Good point Kelly.....
PaattMaann Posted November 3, 2012 Author Posted November 3, 2012 I was just bustin your chops MD, thanks for your advice!
Kelly the Dog Posted November 3, 2012 Posted November 3, 2012 sorry. didn't mean to offend.....and sorry to you and Kelly if I got the story wrong. Wasn't sure how to 'label' you....I guess I shouldn't have. Kelly is correct about the meds he mentioned. They are all prescription only. There are other options, however, for mild flares. Many types are available OTC. Check with your new doc! Here we can agree. The 'blood test' for gout is basically useless if used as a screening tool. Your serum 'uric acid' level is the test in question. I have many patients with very low uric acid (prior to any med such as allopurinol) and severe gout. On the flip side...I have folks with relatively high uric acid levels and they've never had a clinical flare of gout. Higher levels do tend to correlate with increased likelihood but it is NOT confirmatory of anything. In short, the test is supposed to be used as a baseline. I.e. a patient is diagnosed with gout based on clinical exam, story and, perhaps, joint aspiration of crystals. If these flares are recurrent, the doc should get a baseline for the uric acid level. It can then be 'followed' to monitor response to a med like allopurinol. I.e. the patients baseline level should decrease with med. Gout should not be 'ruled in' or 'ruled out' based on a blood test alone. Good point Kelly..... Thx for your input. "Nonsense" was not what I should have said. I believe from what my doc said that only 10% or so of purines are affected by diet. I really should have qualified to say that just stopping drinking for a week or not eating red meat or shellfish or salt was going to stop it from occurring, or having those things greatly increases the likelihood. You know better than me, but all indications I have had is that the rich people and rich foods and booze were predominantly wives tales.
BillsFanM.D. Posted November 3, 2012 Posted November 3, 2012 Thx for your input. "Nonsense" was not what I should have said. I believe from what my doc said that only 10% or so of purines are affected by diet. I really should have qualified to say that just stopping drinking for a week or not eating red meat or shellfish or salt was going to stop it from occurring, or having those things greatly increases the likelihood. You know better than me, but all indications I have had is that the rich people and rich foods and booze were predominantly wives tales. No problem. Your doc may have been referring to those with more frequent occurrences and, in those cases, most folks need meds to prevent flares. Diet alone becomes less of a benefit. That makes perfect sense. some folks are very sensitive to diet changes. I have a guy that comes to mind. If he even thinks about eating steak he gets a flare. Booze is a relatively consistent trigger as well. Point being, that some folks like yourself have no dietary 'influence' at all. Others, are very sensitive and there are 'classic' triggers for most of them. Most are somewhere in between where only the most gluttonous eating/drinking would trigger their gout.
Wacka Posted November 4, 2012 Posted November 4, 2012 Wacka, Maybe a stupid question, but have you been to the doctor? No insurance. The attack I mentioned was about 4 years ago. Have only had twinges since. When I get the twinges, I drink a lot of water.
TakeYouToTasker Posted November 4, 2012 Posted November 4, 2012 yea it hurts worse in the AM...does feel better throughout the day... the last time this happened I couldnt walk or really even touch it....this time (starting this morning) it isnt nearly as bad, I can walk on it but i notice it hurts and it is sensitive to the touch for sure... I would advise you to solicit the professional medical opinion of a podiatrist.
BuffaloBill Posted November 4, 2012 Posted November 4, 2012 No insurance. The attack I mentioned was about 4 years ago. Have only had twinges since. When I get the twinges, I drink a lot of water. No insurance as in none? That's a tough road to travail...
PaattMaann Posted November 4, 2012 Author Posted November 4, 2012 No insurance as in none? That's a tough road to travail... I thought that was illegal these days
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