Initiation of drug treatment?
I know that drugs are generally not Rx’d during anacute attack but are instead initiated after an attacksubsides.
However, I wonder if the people on this list wouldagree that it is proper to only initiate drug therapyto lower uric acid levels after the second attack ofgout, but not after the first attack of gout?
Sabina Shamel on August 31st, 2007
I sure do wish I had never had my second attack. It lasted twomonths during which I was barely ambulatory. If you talk to arumatologist he will advise you to start allopurinol as soon as theattack starts to subside and continue with the nsaid that is workingtill the pain is gone. 300 mg of allopurinol will probably takeeffect within 3 weeks for a first time offender and after that youcan reduce it to 100 mg if your serum urate is under about 5 which itvery well should be.
As to how long to continue, you will know what is right for you andno one can tell you. My criterion is that if I can walk without anoticible limp in my normal, 2 sized larger than normal shoes, Idon’t need the NSAID but then other people may be different.
Why do you think molybdinum and iron have an influence on gout?
Terrance Molock on September 1st, 2007
Real tough call bud..reflecting on Walters thoughts.. There is a 99% chance that you will have another attack within 10years.HOWEVER the attack could come in 1 or 2 years..or? Pretty much guaranteed the next attack will be a LOT worse.Andseemingly..the longer it takes for the attack to happen..the worse itwill be.. The real problem as I see it..when do you want to have the attack?I know that you don’t..but seeing as how it is pretty much a foregoneconclusion..maybe you don’t EVER want another attack to the pointthat you want to prevent it now..you know that answer and how toprevent it. The attack could come when you are on holidays..in anothercountry..can you maybe afford to be laid up for a month..ortwo..without any warning..I don’t know..I guess these arelifestyle..maybe income questions. More and more now..the experts in this field are reccommendingallopurinol after 1 attack.
On a personal level..I had a debilitating,agonizing pain in myhip..in 1990 at age 35..for about 2 weeks.I let it ride.Again in96..this time I sought medical help..they had no idea what it was.In99 I had a ferocious gout attack in both my feet.1 Dr.said this is abad enough attack..even though it is your first..to go onallopurinol.Another Dr.said it was not neccessary..wait till a fewmore attacks.My next attack was in 2001..I spent 8 out of the next 20months in bed..20 hrs a day. I wished I had listened to the first Dr. Believe me if this happenned to me..fit,healthy,near perfectdiet,average uric acid levels.All I can do/say is YES! this can..doeshappen to anybody.
Do a bit of digging on this site..there is a wealth ofinformation..to help you decide..