Gout
This gout is a strange, peculiar type of ailment. I’m 60 yrs old, male, andhave had gout since I was 28. I’ve tried a number of medicines, done a lotof reading, and feel today I know about as little about it as I did beforemy first attack. I take allopurinol, and can woof down all foods exceptliver (I get a moon shot if I eat liver). I can swill booze with no problem(goutwise).
The one certain thing is there are many manifestations of gout, manytriggers, and a number of things that help some individuals. Some peopleare very diet sensitive, others are not. Some people can tolerate certainpreventatives and pain reliefs, some cannot. Certain medicines work wellfor some people, while others aren’t as effective with them.
Gout can hit us just about all over the body. I’ve had attacks in the jointat the base of the big toes in both feet, both ankles, both knees, bothhips, and my lower back. Recently, I read about someone who had it inhis/her wrist. I’ve also had what I thought were gout attacks in mytendon/heel area on my feet. Some reports tell me this is more likelypseudogout. I don’t know.
Gout seems to occur because of uric acid crystal concentration between thelinings of impacted joints. This causes intense pain, some swelling, andinflammation (that’s those hot, pink skin areas where the pain is). The onething I haven’t found explanation of is why, in gout sufferrers, our bodssuddenly begin a runaway overproduction of uric acid. Maybe the why of thisis unimportant. I don’t know.
Now, if you look closely at the timing/sequence of events in a gout attack,you’ll see why, in many people, lab tests of blood drawn during a goutattack can come back normal in uric acid levels. What happens is that, inmany of us, the attack develops so quickly that the spike of uric acid haspeaked and subsided very quickly, and is back to normal while the crystalsprecipitate and gravitate to the joint area they will eventually inflame.By the time you start agonizing, and someone draws blood,voila—-everything’s back to normal. In others, things progress moreslowly.
What pharmacology will help us prevent gout? There is one drug (I’veforgotten the name and need help here) that helps our bods not produce anoversupply of uric acid. Then, there’s allopurinol, which helps our bodseliminate over productions of uric acid. Allopurinol, incidentally, seemsto be tolerated well by most, and has few adverse side effects.
Then there’s the pain of gout attacks. Pain relief falls into three maincategories. One is non-specific analgesics (NSAIDS) [[[can’t remember whatthe full accronym stands for; need help here, too]]]. These includeaspirin, tylenol, etc. DO NOT take aspirin or aspirin based compounds forgout pain relief. The aspirin base fights with the inflammation from gout,and makes the pain worse. I can get fair relief by gobbling lots oftylenol. Others say tylenol doesn’t help them one bit. Another of thesecommonly used is Indomethicin. Indo is very effective in most people, butgives rather pronounced indigestion and tummy upset.
Another category of gout pain reliever are steroids. Steroids, as a class,are pretty good pain relievers. Be aware of prolonged use, though, becausethey tend to have adverse side effects, such as bone marrow attacks, waterretention, etc.
Then there are narcotics. Narcotics are very effective at knocking down thepain, but we all know what trails those can too easily lead down. Narcoticsare rarely prescribed for gout pain.
One of the things that tends to pop up recurringly is the thing aboutcranberry juice. The role of cranberry juice is interesting, but doesn’ttie directly in with gout. What happens is that cranberry juice relieveskidney discomfort in many people. We can get kidney discomfort from manycauses, including gout.
The high uric acid levels during/preceding gout attacks have to be dispensedwith somehow. Well, that overload gets filtered out through the oldkidneys. Is some cases, this causes discomfort to the kidneys. Thus,cranberry juice can help relieve that discomfort in some people. But, ithas nothing per se to do with gout, only indirectly.