thomj513

Went to Kaisers' Urgent Care unit last Friday with a sore and swollen toe/foot. This is the third time since last October that I've had this. The last time I went to Kaiser, the UC doc diagnosed(?) it as an irritated and inflamed joint; gave me a prescription and sent me on my way. This time I was told that I had Gout. I'm 53 so I'm in the target age group for this. Will have to go and get blood drawn this week for lab tests; I hate this proceedure. Couldn't go for a ride this past weekend due to pain and inflexibility in my foot; bummer. I've also had swelling in my left ankle during this same eleven month period so I'm guessing that there's Gout in that joint also. What are your experiences with this and how do you cope?
Thx, Thom .

DocRay

This is not the place to get medical advice. See a Doctor.

Gout is usually tied to diet issues.

thomj513

My question is how do people with this condition cope with it in their daily lives. I'm already seeking medical attention.

chryst

Well, they usually start by asking a qualified physician, instead of the internet.

lotek 

very helpful answers.
The OP already has seen a physician. . .
I went to Md thinking that I had gout, had all the signs
i.e. putting on jeans hurt, sheets on toe hurt. . . didn't like the
answers I was getting re gout and treatment.
Went to podiatrist (primary md suggested this) he said it wasn't gout,
but not sure what it was. As he was taking a sample of toe nail to send
off found my toenail was split (kind of like sideways Y and the lower arm
was severely ingrown. how that happened I have no clue. removed portion
of toenail and instant relief (even after the procedure which hurt like hell).
Do a search on the web for Gout, there are some support groups out
there, and they have much better info than what you will receive
here.

Marty

Fat Boy Biker

I had a small bout of gout a while back. The meds (Indocin I believe) cured it with in a day or two. I also know a cronic gout patient, and when ever it flares up, his meds (stronger dose of Indocin) seem to do the trick for him. So if it is gout, I think the meds should work pretty well. If they are not working, get back with your doc, and let them know. It might be something else.
Do a google on gout or go to WebMD. Several factors come in to play, and diet is one.

Steve
-trying to cycle, eat right and stay healthy

FarHorizon

I must respectfully (and gently) disagree, Steve. Recent medical research has indicated that diet has little or nothing to do with gout. It may be a 1% factor, but no more than that for most gout sufferers.

Gout is a genetic disease (you'll either get it or you won't) that is caused when the kidneys don't effeciently eliminate uric acid from the bloodstream. When uric acid levels rise, crystals form (usually at joints) causing excruciating pain. Gout usually becomes worse with age (as kidney function normally declines anyway).

Gout is incurable, but gout attacks (where the joints hurt) are amlost completely preventable. Either "Probenecid" (which prevents the body from making uric acid) or "Allopurinol" (which assists the kidneys in eliminating uric acid) are effective when taken daily. Dietary restrictions are ineffective in all but VERY rare cases. The claim that "diet causes gout" has been effectively disproven.

Does diet have any effect on gout? Probably - but the effect (in most cases) has been vanishingly minor. Rare individuals can avoid acute gout attacks by avoiding certain foods, but which foods should be avoided are impossible to determine. What one individual finds effective usually has no effect at all on the remaining majority. Different individuals seem to have widely varying responses to avoidance of specific foods.

With Probenecid or Allopurinol treatment, most gout sufferers can eat what they want, and completely avoid acute gout attacks. My doctors contend that diet is 1% or less of a factor in gout. My personal experience is consonant with that estimate.

Thanks.

tippy

I had a bout of gout a few years ago. Did some studying and changed what I ate. Typically, what causes gout is what causes alot of other problems: overweight, to much protein intake, to much sugars, not enough excercise, not drinking enough fluids to allow kidneys to work properly, kidney disorders, and genetic tendency to have high uric acid levels.
I stopped eating tons of high protein meat, stopped drinking sodas and went to water, started eating more fruit, veggies, and salads and starting riding my bike more often. This tends to be a good start to help almost every possible health issue.
The book I read about gout said the biggest thing to do was to reduce or eliminate the intact of proteins and sugars (red meat and alcohol was at the top of the no-no list) and drink things that neutralize the uric acid (cranberry juice).

So to answer your question, how I cope is I made a major dietary change and took up exercising more. The problem I found is I am constantly monitoring my protein intact ... not to much for gout prevention but enough to support the needs of cycling. A delicate balance. I have not had a gout attack in over 4 years.

That's my experience with gout.

You should base your efforts on coping on what your doctor tells you to do.

d.tipton

KristenGilbert

I don't know anything about Gout but I feel your pain about dealing with Kaiser. I hate them so much because of the terrible care I received. I was born in Kaiser and went to them until I left at 23 to switch to Blue Cross. Good luck and I hope you get to enjoying riding soon.

LOOPDEELOOP

How about eliminating alcohol (beer, etc.)?

bellweatherman

Maybe your sodium balance is out of whack?

mriley

d. tipton is right on the money. I have gout, but don't need to take allopurinol (yet). Drink plenty of water, minimize the consumption of meat, and avoid booze (a half a glass of beer every now and then is OK). I haven't had an attack in 2 years.
M Riley

FarHorizon

Advice about controlling gout with diet is an artifact of the dark ages.

See a doctor who graduated med school in the last few decades. GENETICS - not diet determine if you'll get gout. The internet is awash with hooey about what to avoid eating to prevent gout attacks. The hooey is not only wrong, but it is virtually 100% contradictory.

See a competent doctor. Any one of them will confirm what I've said.

Terex

Farhorizon states: "Advice about controlling gout with diet is an artifact of the dark ages. See a doctor who graduated med school in the last few decades. GENETICS - not diet determine if you'll get gout."

Respectfully suggest Farhorizon do a little research. From Medline, "Dietary Risk Factors for Gout Clarified, March 11, 2005 issue of the New England Journal of Medicine". A study of 47,150 men aged 40 & over for a period of 12 years. Basically says that there is a strong positive between gout and ingestion of meat, esp red meat. Potential beneficial effects from ingestion of dairy and vegetable products.

"Gout is thus no longer a disease of the wealthy; rather, its appearance reflects an increase in access to fatty meats and a decrease in the intake of dairy products worldwide associated with Westernization. Gout should thus be considered part of the current global epidemic of obesity, hypertension, and diabetes," he writes. "Diets that are rich in fruits, vegetables, and low-fat dairy foods, such as Dietary Approaches to Stop Hypertension (DASH), may reduce not only blood pressure but also the frequency of gout. Such interventions may be of particular importance if clinical studies confirm the experimental evidence that uric acid has a role in the pathogenesis of hypertension."

Genetic component of gout is estimated at about 25% of total (from other sources, including MayoClinic.com).

Thanks for being so sure of your knowledge, Farhorizon. Comments like yours always prompt me to do the research. Guess I won't be going to Outback for dinner tonight...

FarHorizon

My "knowledge" is courtesy of Pennington Biomedical Reaserch Center and Ochsner Medical Foundation. I trust them a bit more than I do "Medline." You're welcome to get your medical info anywhere you choose to.

lilHinault

I'll tell you what you do, first you name yourself The Captain, then you get two little kids who look alike to play tricks on you, or do stuff they're not supposed to do that you're supposed to catch them at, and do. And spend the rest of the time resting with your gouty foot done up in a big bandage. Oh yeah, and grow a beard.

Nicodemus

Gout is crystallization of uric acid in the bloodstream, and is recognised as one of the most painful medical conditions. I get it in the ball of my foot and I CANNOT walk because it's so excruciating.

Gout can be hereditary. It is exacerbated by a lethargic lifestyle and/or indulgence in rich foods.

Anyone who says diet is not a factor does not know what they're talking about. Claims that the information is contradictory are understandable, because different foods affect different people, and some people's gout is not affected by diet.

It can be mushrooms, offal, meat, alcohol, or nothing.

I always got a heavy dose of gout after christmas. I am a very indulgent person. Since I have changed my diet and lifestyle, I haven't had an episode in 3+ years now.

Drinking water helps. Drinking booze won't. I believe the drug is Indomethacin, and it works a treat.

A test will confirm if it's gout.

Terex

Medline is just a source of reference to the article from the New England Journal of Medicine. Take a look at the authors of the study and the institutions. Trust but verify. Oh, same data resulted in other publications, one of which indicated obesity as another postive factor. Yea, you may be more genetically susceptible to gout than the next person, but diet is a critical factor in development and control.

You've only provided anecdotal responses. No further comment from me. Thanks for participating.

thomj513

Got a call from my regular M.D. yesterday evening, the lab tests for Gout are negative. He's not ruling it out just yet; the next time I have a flare-up I'm to call his office and get in immediately to run tests and have him do a first hand exam rather than having to rely on the urgent care doctor's opnion. For now it's a waiting game.

FarHorizon

"How absolute the knave is! we must speak by the card, or equivocation will undo us."

I have been less than clear. Apologies.

The studies previously referenced concern the incidence of gout attacks vs. diet.

A healthy human, sustained by burgers and beer, can overload a healthy set of kidneys with uric acid, precipitating a gout attack. This does NOT mean that the victim has the genetic disease "gout." It only means that uric acid elimination is insufficient to cleanse the bloodstream.

A person with the genetic disease, "gout," will reach the state of uric acid saturation in the blood with or without dietary compliments. For those with the disease, "gout," diet is virtually a non-factor. The body's propensity to generate and retain uric acid wil cause repeated acute attacks until treated with daily medication.

aabcdelight

Keep in mind that gout and lyme disease can share symptoms. Lyme gets misdiagnosed
as gout often.

Nicodemus

my gout is hereditary, and diet was a strong factor.

FarHorizon

My gout is also hereditary, but eating a vegetarian diet exclusively had no effect whatsoever on my frequency of attacks. Since I've used either Probenecid or Allopurinol, I can eat anything and not have any attacks.

Kazooschu

I've had gout since I was about 35. First time I had it I did not even know what it was. Kept thinking it would go away. Finally went to Dr. with it. I take Colchicine. Others have prescribed Alopurinal. The Alo takes awhile to get rid of the excess Uric Acid in your system. And then works to keep the levels low (at least thats what my Dr explained to me). But I find far quicker and better relief with the Colchicine. Cutting down on red meat and caffine helps greatly as well.

But for those who never had it, it is so painful that you can't even stand the weight of a bed sheet on the affected area. And getting anykind of footware over a gouty joint is almost impossible.

Good luck

Nicodemus

Yeah, you know what I'm talking about.