Gout, worse pain ever?!

[Ray Von]

Woke up with a slight pain at the "knuckle" of my big and index toe on Christmas morning - PRIOR to any overindulgence of the festive season.  What it grew into was the worst pain I have ever experienced in my life.  Needless to say, I had a tame Xmas and at its peak the agony (which crept up on me) was unbearable.  I should add that i have a rather dull diet, due to genetically high cholesterol, and as such gout was most unexpected!  (Oh, lucky me!) If anyone else wakes up with this niggling pain in the base of the toe, my advice would be to not delay - contact your GP and get "colchicine" prescribed.  It made me sick as a dog but numbed the pain over the three days I was allowed to take it.  (After 600mg a three day break is recommended, and I'm not surprised!) 

[Tim Dubya]

I lost a stone due to the side effects of colchicine in about 3 days!

 

I 5hit you not!

 

no, it's true

[Ray Von]

1 minute ago, Tim Dubya said:

I lost a stone due to the side effects of colchicine in about 3 days!

 

I 5hit you not!

 

no, it's true

Yes, the "evacuations" I experienced were frequent and copious.  I'm still not over it, my foot is mauve at the base of my toe and I'm not able to put on footwear. 

[Tim Dubya]

I couldn't eat mushrooms for a couple of years after.

 

I take a medication called Allopurinol now, so rarely get attacks (unless I need time off the housework )

 

[Steamport Southport]

I had it at a music festival and just put it down to wearing boots whilst standing up for five days solid and hot weather.

 

It wasn't until getting home and the alcohol effects started to wear off that the real pain stated.  Apparently it was brought on by a build up of uric acid due to dehydration. It was only in one foot and it was swollen and bright red!

 

It went after about five days and the only thing I took was paracetamol. Which was what was advised over the phone. I didn't take up the option to go the "walk in centre" if it got worse, as I couldn't walk. 

 

Never had it since though and that was nearly ten years ago.

[John ks]

Many years ago(might have been the 90's) I went (limped into) to my doctor with a painful big toe

Not my regular doctor

She looked at me & my foot & said you got Gout

After me denying it & her saying it was Gout I finally  gave in to her greater knowledge

IIRC I was given 2 choices a drug or an injection which she said would make the pain go away in a day or so & it did

I've had a few relapses over the years & the injection usually works

Reading from a prescription I got in 2014

Kenacort-A 10 10mg/mL Injection

This has worked for me with no adverse side affects

Consult your doctor to see if it is suitable for you

John

[SRman]

I have suffered from gout a few times, and yes it is very painful, but the most painful thing I have experienced is passing kidney stones, with the first two by far the worst.

Still, gout sufferers, you do have my sympathy. 

[New Haven Neil]

I haven't had gout, but suffered a foot injury called a Lisfranc Fracture - that and the two bouts of surgery that resulted to make a repair - well, the best they could manage - were truly awful, so I can sympathise with foot pain! The hip surgery I had a few years previously didn't make it on to the scale of this pain.

 

If you're squeamish, look away now....

 

 

 

 

 

 

 

 

 

[Rivercider]

My mother had severe pain, and lack of mobility in one knee, which was diagnosed as pseudogout 

which is similar to gout but with a build up of calcium crystals rather than uric acid.

She had no actual treatment other than to rest her leg (easy as she could not really walk anyway)

 

cheers

[mcowgill]

1 hour ago, SRman said:

I have suffered from gout a few times, and yes it is very painful, but the most painful thing I have experienced is passing kidney stones, with the first two by far the worst.

Still, gout sufferers, you do have my sympathy. 

 

I was admitted to hospital a number of years back with kidney stones.  The male Doctor and female senior nurse successfully took my mind off it a little by arguing between them whether he was qualified to describe it as the worst possible pain as he hadn't had first hand experience of childbirth 

[SRman]

58 minutes ago, mcowgill said:

 

I was admitted to hospital a number of years back with kidney stones.  The male Doctor and female senior nurse successfully took my mind off it a little by arguing between them whether he was qualified to describe it as the worst possible pain as he hadn't had first hand experience of childbirth 

A female friend told me that kidney stones were as painful as childbirth ... however, I'm not sure she was entirely qualified to comment as she had never had children herself.

[Reorte]

I've had what I think it gout in my foot a few times, although not as badly as some here are describing thank heavens. In the joints, swollen, very sensitive to touch.

[meil]

Time to cut out: beer, mackerel, herrings, asparagus and offal. Drink plenty of water to dilute the Uric acid.

[F-UnitMad]

2 hours ago, SRman said:

A female friend told me that kidney stones were as painful as childbirth ... however, I'm not sure she was entirely qualified to comment as she had never had children herself.

I had a 6mm kidney stone stuck in the tube between kidney & bladder; took 2 months and 2 operations to deal with. I was reliably informed by several women who have had both children & kidney stones (maybe not together!!) that the pain from kidney stones is as bad as childbirth.

 

My dad had gout in a big toe so I know it is also an extremely painful affliction.

[Ray Von]

2 hours ago, meil said:

Time to cut out: beer, mackerel, herrings, asparagus and offal. Drink plenty of water to dilute the Uric acid.

Oh dear, just had mackerel for lunch!! 

[F-UnitMad]

2 hours ago, meil said:

Time to cut out: beer, mackerel, herrings, asparagus and offal. Drink plenty of water to dilute the Uric acid.

Four out of five of those, I couldn't cut out, as I don't eat them in the first place....

[Fat Controller]

The list of possible triggers varies from person to person- in my brother-in-law's case, it includes brocolli. I suffer occasionally from it; my doctor prescribed me something called 'Colchicine', which you take initially for three days. Cleared it up a treat.

As to pain; anything involving the feet is bad, as there are few ways of avoiding using them. 

[russ p]

I had a severe attack of gout just after the start of the first lock down 

Went through various items id drank as I can't actually eat solid food the main cuppas tomato juice! 

I was on about ale and real cider to the doctor and she actually said real cider was good for it 

[The Johnster]

I had a bout back in the 90s and very unpleasant it was too, but medication, can't remember what but not any of the above, had me able to walk about with a stick fairly quickly and it cleared up after about 6 weeks.  I remember my GP mentioning that, from being a disease of overindulgence by the rich in the 18th century, it was now regarded as a problem of the underclasses, like obesity.  I tick quite a few of the underclass boxes (clinically obese, rent my home, lived on benefits for many years, most of my friends use cannabis).

 

I am a cheeseaholic and used to eat very large quantities of the stuff (it is one of my basic life tenets that there is no aspect of human endeavour that cannot be improved with cheese), and the GP's advice, as cheese dependency is apparently tougher to kick than heroin and he described it as basically spreading cholesterol on the  inside of your arteries, was to eat stronger cheese but in much smaller amounts.  I took this advice, and so far have not had a recurrence of the gout beyond an occasional left big toe mild throb, which does not last long.

 

The pain was certainly very bad when your weight was on the toe (and reminded me how much toes being curled is a vital part of walking), but not the worst I'd ever encountered; that honour goes to being kicked, hard and deliberately by the way and by a teacher, in my goolies in school rugby.  This is so bad that you can't even scream, all you can do is lie curled up in a ball and force yourself to breathe. Initially you are afraid you are going to die, then after a few seconds you are afraid you aren't.  I contend that this is worse than childbirth because women enduring this torture can, and do, scream; it helps with the breathing I'm told.  Glad I never had to do it and full respect to those that did, though.

 

At least they got half shares in a baby out of it and hopefully some fun at the start of the process; all I got was about a month of walking funny, and a loss of interest in girls for about 3 months, after which time a girl called Susan Maunders helped considerably and with some enthusisam and dexterity, bless her...

Edited January 5, 2021 by The Johnster

[Mark Saunders]

17 hours ago, Tim Dubya said:

I lost a stone due to the side effects of colchicine in about 3 days!

 

I 5hit you not!

 

no, it's true

 

I was smug about not having this side effect, then the last day of the course!

[russ p]

Mystery double posting 

Edited January 5, 2021 by russ p

[SRman]

Yes, Colchicine/Lengout/Colgout affects some people's stomachs (mine included). When those don't work, Solone is even worse as it is also cortisone-based so has other side effects - it should only be used for a few days at a time.

[ed1234]

Johnster is correct, much of the old tropes about gout have been somewhat debunked - there is a far larger universe of things than port and red wine that can trigger gout, and as others have mentioned your triggers will differ from mine. Unfortunately many GPs have not kept up with their reading and their advice regarding gout is 20+ years out of date - if you find this recurring, I strongly suggest a visit to a rheumatologist if you can get a referral (or pay for it privately, if that is an option).

 

Medicine-wise you have drugs that lessen the effect of an acute attack, and drugs that lower the chance of attacks in the first place. In the first category, colchicine and indometacin are popular in the UK because they work and are cheap, overseas they tend to prescribe various flavours of diclofenac, prednisone and other generic anti-inflammatories. In the second category, allopurinol is the main drug of choice, but it has to be started carefully and not in the middle of an attack (starting allopurinol often triggers an attack, because in essence it works by flushing out the uric acid via your kidneys, so tends to cause an initial spike of uric acid in the bloodstream). There is another drug, februxostat, that does much the same thing if you have an allergy to allopurinol. Allopurinol is often spoken of as a 'rest of your life' drug, but modern rheumatologists will disagree - it tends to be a medium term drug which you tail off after a few years once your diet and other aspects of your life are better suited to someone with a gouty disposition. I started on 200mg (a low dose to begin with) and tapered to 100mg after a couple of years. Patients with worse problems than mine can be on 500mg+ daily.

 

The other enormous gout management piece is diet and lifestyle. Finding and avoiding your own trigger foods, keeping well hydrated, being careful with one's feet (not letting them get too cold, in particular) are generally the main elements here. Keeping the weight down, if possible, to relieve stresses on joints generally is also recommended, though you have to be careful with sudden increase in weight-bearing exercise, and crash dieting is also capable of causing a uric acid spike. If you do a lot of walking, decent shoes that take a lot of the impact of walking on rocks, etc. are important too.

 

Ice and/or heat are good pain relievers as well. Invest in a couple of good ice packs or bags, and some heat presses too. There are some that say you shouldn't ice a gouty joint as cooling the joint encourages crystals to form (just as sugar dissolves faster in warmer water). I'm not sure there's much science behind that, and every rheumatologist I have proposed it to thinks it's more 'internet forum science' than real science. Personally I found keeping the joint warm was both more pleasant for me and easier to achieve.

 

Finally, one other thing that kept me going in attacks in my feet was the knowledge that it's relatively easy to keep off one's feet (save for a colchicine induced hop to the bathroom), whereas some people get this sort of attack in joints that would be much harder to deal with - neck and back being the ones I'd really dread.

[Halvarras]

I had a gout attack on my right ankle in January 2009 and had to go to work in sandals (in January!) as I couldn't get a shoe on. My GP directed me to search the internet for info regarding foods to avoid, but I don't eat most of them anyway. However like The Johnster I do like cheese, so I've had to exercise greater self-control when that's on the table. I've been on Allopurinol ever since, with Colchicine as a (very effective) back-up in case it flares up, which it does very occasionally in my big toe joints, but it doesn't give me much trouble these days and I consider myself luckier than some other sufferers I've known. It can be a very debilitating condition.

[Ray Von]

Spoke to my GP today (actually it was a very pleasant younger chap and not my designated doctor) - it turns out that he'd had gout in the past, which made me feel a bit better!  He was sympathetic and we had a long chat about it.  Shame that doctor's receptionists at my surgery aren't one millionth as helpful - seriously, are they born or knitted!?  I hobbled all the way to the surgery to collect my sick certificate, because the "link" for my virtual one didn't work.  On arrival the old trout at the door informed me that I had to phone and speak to a receptionist in order to remedy the situation.  That receptionist that I could see thru the door, the receptionist 12 feet away from me? "Yes." You can't just tell her? "No." Ok, I phone the GP (whilst outside the building) and recorded message : "The reception will be closed between 12:30 and 13:30"  So, I inform the power crazed Nazi on the door of this, and: "Well, I can take your details, but I can't guarantee that you'll hear back today, it might be Monday."