Purne list
Sorry. Hopefully this link will work
www.britishdalmatianclub.org.uk/downloads/Purine%20Table%202003.htm
Also, i have been on colchicine for a over a week now. I am juststarting to walk on my foot now but my big toe is still swollen andi can not bend it as normal.Should i start the Allopurinol now or wait till the big toe hasreturned to normal size. (There is no pain in the big toe now)
Terrance Molock on April 25th, 2007
EXCELLENT! question..I know of(and have had) SEVERE! swelling fromgout..with no pain!..Meaning the “attack” was gone..WELlll..sometimesthe swelling comes AND STAYS because the uric acid deposits are goingto stay there and partially decompose..while MORE deposits MAY beadded to it.IF the attack has left deposits there..and it is a repeatsite..the deposits will PROBABLLY NEVER leave without drugtherapy.During my time of foolishness..my feet just got more and moreswollen..even though I wasn’t always in pain.It appeared that theswelling would not go down.I saw several Dr.s and they ALL agreedthat the swelling was caused by gout..at the time I was NEVER goingto go on allo.NEVER!The Dr’s were not sure if the swellng wasdeposits or not.None of them actually knew how long..OR if allo woulddeal with the deposits in a “normal” time frame..average is 1 to 3years..up to 10 years.I started allo and the swelling went awayFAST!..it ALSO caused then deposits to move elsewhere..
LOL..well..I KNOW..NOT! funny..but there is the chance that theswelling will NOT go down(like me) UNTILL you do the allo..PERHAPSthe only way to find out is to do the allo..
I would start the allo now..that is what I would do..and myadvice..
(Not being able to bend it as normal..COULD be either deposits ORinflammation)I am guessing WITH the colchicine AND the pain gone thatthere are some deposits..DON’T!! be fooled into thinking that theyare gone..IF you get the joint movement back..the deposits may havejust moved..around a bit..)
Norbert Figueiras on April 26th, 2007
most definately you should wait until this flare up is over, as yourDoctor and or Rhuemetologist should have told you that startingAllopurinol during a Gout flare will most always make it worse beforeit gets better.
Sabina Shamel on April 26th, 2007
Start your allopurinol now. You can go on cortizone if youhave to butget on allopurinol and drink lots of water now.
Terrance Molock on April 27th, 2007
Welcome back! Where ya been?..I’ve been battling and holding downthe fort..YES! I have had some help..THANKS!..There were even someGOOD!..VERY GOOD things said about you!!..I HAD TO CORRECT THEM!
Wanna fight??..I am getting pretty fit!..ski season a coming..
GOOD!! to hear from you bro!!..
Gotta go now and have a baloney sandwich..AND somebroccoli..LOL..ROFL..LMAO..you think I am kidding??? I AM NOT!
Norbert Figueiras on April 28th, 2007
Walter,why on earth would you encourage someone to jump on steroids if maybethey don’t have to? are you some kind of Doctor? Have you experiencedthe effects of starting Allopurinol during a Gout flare or do youjust know everything? I was just offering my opinion from personalexperience but i guess BALONEY is the correct way to go, see you atthe deli.
Terrance Molock on April 29th, 2007
Mike..NO-ONE here..wants to offend ANYONE,SCARE themaway.EVERYONE’S viewpoint is welcome!..HOWEVER with a disease such asgout..that has ONLY in the last 40 years..(with allopurinol ONLY)FINALLY has been brought under control.ALSO and very importantlly itis also ONLY in this time that there is some CONCRETE knowledge ANDsomething that WORKS! about gout.This disease is ABSOLUTELLY FILLEDfull of garbage..old wives tales,biblical stuff,anecdotal stuff,stuffthat is ABSOLUTELTY 100% UNTRUE and doesn’t work(Remember: The BOGUSarthritic scams are NOW in the 10 Billion..with a “B” $ per year.
I personally and MORE AND MORE others feel that there is LESS ANDLESS room/need for nonsense..and MORE and MORE need for FACTS,TRUTH..
WE ARE!/HAVE suffered ENOUGH and NOW we want/need the truth..
Sure..some of us are a bit testy..I am NOT ashamed at the factthat I can be downright hostile..when people start postulatingnonsense..or other stuff that has NO BASE/PROOF..or WORSE has PROVENNOT!! to work.
I am in NO WAY being harsh,critical of you..not at all myfriend..BUT I am sort of defending Walters quick decision here.
It is really old school thinking to delay the start of allopurinoluntil the attack is over.If you have gout and are SERIOUS aboutdealing with it then get on with it NOW! Start the allo when you aresick of gout.A LOT of this idea came from the fact that people wenton and off allo..then came this idea to stop the allo..even when youwere on it..during an attack.This stuff only makes gout WORSE.
What we then end up with is a patient who has been on and off alloso many times..who has MOST LIKELY during the off times..hit thesnake oil/diet/faith thing..whatever flavour/saviour of the day thingand THINKS that THIS works.Then OF COURSE NONE of it works..hohum..back to the gout attacks..worse and WORSE..THEN he wants tostart allo AGAIN…AND then he gets an attack..and blames theallo..goes off etc., ETC.,..this is not that uncommon..(I have beenthere) that they CANNOT shake off the attack.AND are now left with NOchoice but to start allo during a savage attack.
Trust me..these are NOT often the cases of someone who has had anattack or two..THEN decides during an attack that gout is really notall that great a friend.These are ALL too often cases of over andover denial/snake oil/diet/neglect.
ANOTHER VERY! important factor here is a fact:Patient has goutneeds allopurinol. Goes to the doc..yayaya..he is GOING to go on the allo WHEN theattack is over.SOooo he makes the diet thing/drink..OFTEN hitting thesnake oil..sure the attack is over.What does he do? Go on the allo??NO NO NO..often he ends up BELIEVING that the snake oil and stuffworked and starts running off at the mouth..see..see SEE..you don’tneed allo..they end up out here yammerring away..others believe them..
THEY all end up sorry ass’s..and start complaining that when theytake a bit of allo thet get an attack..so they stop..AND start.
There is NO need for this sufferring.IF you have gout.Go onallo.The sooner the better.
Said here before..IF the allo sets off an attack..or makes one abit worse.. it will be NOTHING at all compared to the next attackthat WILL COME anyway..without it.
Lesha Corle on May 1st, 2007
Ok. So what to do? I’ve had this current attack for a month now. Ithas come and gone in severtiy but never leaves. Been on thecolchicine the whole time. Can not get rid of it. Help!I’m scared to jump on the A train as i don’t want to induce afurther attack but it’s hard to ignore the advice i’m receiving hereto start taking it.
Sabina Shamel on May 3rd, 2007
After a month of an attack, you are starting to lose bone mass inyour toe area and it may extend all the way into your foot. You haveto get it stopped.
Short term recommendation.1. Start taking 300 mg of allopurinol a day, today.2. Go on a white rice diet for at least three days, that will reduceyour purine ingestion rate to almost zero.3. Drink at least two times as much water as you are currentlydrinking and yes, it will mean several trips to the bathroom in themiddle of the night. Particularly at night, after urinating, drink afull glass of water before going back to sleep.4. Take 1000 units of vitamin C and 1000 units of vitamin E daily.5. Drink skim milk -fat free-milk during the first three days of therice diet.6. Continue your NSAID treatment as well as culcicine but you mightask for a perscrription for a prednizone-cortizone-regime in case youget really bad off when you start the allopurinol.
The problem with a longer term gout attack is that you are just aslikely to get really bad, that is a lot worse off than you are now,as you are to get better. You have to get at the fundamental cause,which is excess uric acid production-or failure to remove same- andthe sooner you get that started the sooner you will get back to yourformer life.
Look, all of you who have gout symptoms and who are trying to treatthe symptoms and desperately trying to find food that you can eat,and sometimes enjoy, you are kidding yourselves. How many days areyou going to limp to work, if you can even get to work, how manyhours will you spend awake at night because of the pain, how manytimes are you going to scream in pain because you accidentally hityour toe when walking up a stairs or worse scream at your kid orneighbor or wife because they accidentally touched your leg.
There is a life out there that you used to live and just because youmanaged to get through the last attack and are now ok, it will beback and it will be worse. Go read the statistics and understand thatwhen you are blessed by the almighty with gout, you own it for lifeand you are not going to make it go away by eating properly or byconsuming Maiden Mary’s Modern Herbal Remedy. You will have to get onallopurinol some day and the sooner you climb on board the A train,the sooner your life will be returned to you.
Do I sound harsh, well maybe I do. I really don’t cere because I amcorrect and I have absolutely no doubt in my mind, at all, that I amcorrect.
Have you been in contact with someone who has rhumatoid arthritis?Have you seen how bad they look?How swollen their joints are?How weak and frail they are?Well, you might go back in the literature and read about what theworst of all arthritis diseases is.
It is gout.
We have modern medications that relieve symptoms and they are moreeffective against gout than against rhumnatoid arthritis but theseverity of gout should not be underestimated and those of you whoare in your first attack and feel that you can beat it on your own-well you are just wrong.
Sabina Shamel on May 4th, 2007
First of all I didn’t suggest that they just jump on a treatmentprogram of prednizone, I did suggest that if that is what it takes toget started on allopurinol, then by all means do it.
I will gladly engage any physician, a Rumatologist if you want,although I seriously doubt that you will find a Rumatologist who hasan opinion different than the one I stated, but bring him or her onwith detailed statistical references about my statement.
Baloney! and I will stick to it.
Start allopurinol as soon as you are certain that you have gout.Please note that I said, certain that you have gout. If you are inthe middle of the attack from Hell then even more reason to startyour allopurinol. A physician who says otherwise is, in my opinion,guilty of malpractice. When I say begin a course of Prednizone, Isuggest that as a last resort to get you through the pain till theallopurinol is able to kick in but that should be within 14 or sodays. Most people will not require the Prednizone and can get by withNSAID’s and Culciccine.
It is foolish to wait till you are free of pain before starting on toallopurinol and I will say it again,
“BALONEY” to the physician who suggests otherwise.
I would love to know the name of the Rumatologist who says otherwisetoo. I seriously doubt that there is such a person. A gereralpracticioner who has learned his information about gout from theclassical medical text book that has not had the gout section updatedin 25 years will start you on allopurinol after your third attack andthen only after your attack has subsided. Modern treatment will startyou during your first verified attack.
Post script:I am interested in the statements about and perscriptions ofallopurinol for the treatment of high uric acid levels in people whohave had no gout symptoms. High uric acid without the presence ofmono sodium urate crystals in the joint area is a much less acceptedpractice.
Allopurinol will certainly reduce the overall urate level in theblood and it is known that high levels of urate will cause high bloodpressure, so, the treatment is both rational and appropriate but itis less accepted as a methodology. I personally believe that it isgood to treat high uric acid that occurs without gout symptoms withallpurinol but it should be followed up with periodic blood tests forurate. My personal belief is that a lot of the hypertension that wehave in the world is a result of too much urate in the blood and thatallopurinol should probably be perscribed for a lot more people whosimply have very high urate levels, lets say the high end of theacceptable range, like 7.5-8, and who also have hypertension.
This is all just my relatively informed opinion and please “Mike”bring on your physicians and perticularly your Rumatologist, we willsee if we can get him, or her disbarred.
Terrance Molock on May 5th, 2007
.you are indeed correct..BUT UNLIKE you I havenot/had not “lost most of my patience”.Nor did I.I had (at times)LOSTIT ALL!.. Some points of view are NOT what I’ld call “silly”..after seeingsome of the horrific results..they are downrightdangerous,ignorant..and can quickly become just plainSTUPID..worse..AND the VERY WORST! are those that have NOT even beendown the road..either in true experience or with knowledge..and areyapping off..giving people advice..arguing with those that haveknowledge,experience and are here to help..when they know JACK.I wishthose types would shut the F… up.And yes..sometimes I do tell them. I try and be humble,remember my beginnings..in the lovely land ofgout.I try and consider the source of the information where it camefrom..there is my friend..STILL A HUGE,HUGE amount ofmisinformation/GARBAGE.. about gout..been here for eons.Sadly FAR toomuch of this shit information is CONTINUALLY perpetuated by thosewith some junk to sell..
True..some you can’t reach..BUT with the positive feedback Ireceive here..it does feed on itself..makes/keeps me interested inlearning more..helping others more.I feel I can moreso now..thanbefore..and more and more..offer a better informed source ofinformation,help..and yes I can also offer a pretty informed,powerfulrebuttal,argument..and hostility to those peddling crap.I am ALWAYSopen to ideas/new ideas/dialogue/discussion..and try not todisuade/discourage people.You are right in the sense of some of thatold crap..I have no time for that anymore.