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Hi all,
Here is a forum I never thought I would need to join, but alas, I am here. I could really use some advice. I am 37 yr. old male. 225 lbs. Overweight in midsection but still quite active. I work out and do cardio a few times per week. I have a definate problem with overeating though. I do not drink alcohol.
From what I can remember, I am now in the middle of my third flare-up in 5 years. My last was approx 3 years ago, which is when I was diagnosed with gout. I thought I had blown my knee out. I was completely unable to walk or move and the gout pain was unbearable. My knee started swelling bad. This lasted about 5 days. I went to an orthopedic surgeon and he drew the fluid off me knee. I left expecting to be sceduled for an MRI, but instead got a call the next day that I had uric acid crystals in the fluid…gout. My family doctor prescribed my allopurinal 300mg but told me nothing about my condition. I took for about a year then stopped. All was well, with the exception of occasional minor to med knee pain, that I have always attributed to my flat feet. All was well until my current situation.
On or around June 14, my knee began to get quite sore, especially at night, progressively more uncomfortable each day until
June 20, knee locking up pain very bad.
June 21, knee completely locked in 160 degree angle..pain is otherworldly! I cannot explain, although I'm sure most of you know, the level of pain. I had no idea the depths of pain that a human could experience without passing out, now I know. Made it to doctors. Blood work showed Uric levels at 5.8 (wtf?). Prescribed indocin and vicodin.
June 22-23 no improvement, agony, completely immobile. Now knee swelling bad above knee cap and behind knee. Very sharp localized pain in an exact spot on outside of knee joint.
June 24 Second trip to doctor, knee drained, fluid predictibly showed uric acid crystals. Doc prescribes 6 day prednisone treatment. Tells me to start back on daily 300mg allopurinal when flareup goes away.
June 25 – June 30 gradually getting better painwise every day. Still cannot straighten or bend knee atw.
June 30 – First day off crutches, still limping a bit
July 1-10 – Getting better every day, almost able to walk without any pain at all. Still cannot bend knee all the way, but can fully extend.
July 11-13 – knee getting sorer every day.
July 14 – Intense otherworldly pain is back, absolute agony. I could not believe I was going through again. Completely immobile for next 3 days. I had doctor call in script for colcicine and tramadol. I took one pill per hour for 9 hours, then fell asleep. Slept for about 6 hours. Awoke to extreme nausea lasting all day, pain somewhat better.
July 15 to present – very slowly getting a bit of relief from pain. Mobility not back at all. I cannot walk at all without crutches as I can put no weight at all on leg. Knee still swollen. I cannot straighten nor bend knee very much at all.
I am starting to get very depressed about this. I have not started allop due to it has never gone away. I have given up red meat and pork this whole time. Still eating chicken and turkey and lots of veggies. I am scared as hell that there is some serious damage in my knee but my doctor seems unconcerned. I have been trying to get an appt. with a rheumatologist but after calling every doctor in my city the earliest I can be seen is late September. I need relief soon!
I have so many questions and everyone in my life seems to have a damn opinion. Should I start taking allop now even though I cannot walk? Is there something I am missing? Is there a trick to getting an appointment with a rhematologist sooner than next damn Christmas? Why was my U/A # so low, or at least somewhat normal? Should I have MRI? Is it common to have gout last this damn long?
I am sincerely sorry for the length of this post? Its just all building up inside me. I am so frustrated. So any and all help/advice/experience/strength/hope would be greatly appreciated.
George
How much prednisone did they put you on? After I could finally hobble to the doctor after 12 days in bed with gouty knees and feet, I got six days of prednisone.. 24 mg the first day, 20mg the second, 16mg the third, etc. That helped, but the attack was already ending by the time I started the prednisone.
After the six days, pain and swelling returned (not as bad, though) and I went to a different doc and got 40mg prednisone for 3 days, then tapering off for a total of 15 days.
The higher dose made me almost pain free, at least for now (I'm on day 5). Rather than messing with something like vicodin and tramadol (which is basically codeine) see if they can't give you a decent dose of prednisone. At your weight you ought to be able to handle 50mg per day initially.
I found that soaking in very hot water helped. Drink lots of water and keep the knee elevated.
It's normal for UA levels to drop during an attack. I guess a lot of UA precipitates from the blood and lodges in the joints.
Hang in there. This will pass, and hopefully the experience will motivate you to stay on the allopurinol.
George, sorry to here about your pain. I've been going thu the same thing. Thankfully most of mine has retreated for now. I was up and down on doses of Pred. starting at 20mgs and going as high as 60mgs. That went on for a couple of months it would get better but as soon as i would start to wean off of it. Boom I'd get another flare. After a little over a month on the Allpo it started to help. I've been off the Pred. for just about 2 weeks. I started Allpo the 22nd of May and got another attack on the 27th but the doctor said stay on it. Also started .60 Colchicine 1 pill 2 times a day on the 16th of June for pain. It's hard to believe how slow time goes when your in pain from this. Hang in there after you get on the right meds it will get better. As far as your acid level it will drop during a flare. I'm sure you'll get some help on here from people that know alot more about this curse then me. Good luck LIMPY
JohnESmoke said:
My family doctor prescribed my allopurinal 300mg but told me nothing about my condition. I took for about a year then stopped.
That was a very expensive mistake! Once this attack passes make sure you stay on AlloP. It will make the difference between a normal joint and a severely damaged joint. Not to mention the host of other health problems associated with Gout if you don't controal your SUA. During the attack SUA readings go down in many cases.
This will pass so hang in there. I suffered more than one year of non stop pain and am surprised that I did not go insane
So let it all out here 
The knees are the worst. I've probably suffered through 10 or so horrible attacks in my knees over the past 5 years or so. Absolutely f'ing brutal to go through! I feel for you!
STAY ON THE ALLOPURINOL when you start it back up! I actually started taking 600mg / day about 9 months ago while I was experiencing a bad attack in my knee. I was basically going from attack to attack in different joints with no breaks in between. I figured it couldn't get any worse, so I started the Allo. Now, 9 months later, I'm fairly confident that I'm over the worst of my gout. I will be taking Allo for the rest of my life as I never want to go through that type of pain again!
I still am experiencing pain in my knees and I'm sure it has a lot to do with the gout attacks I went through. However, I also have some pretty screwed up knees from sports. I don't know if my knees will ever be the same after the damage that has been done to them. Hopefully, with only a few attacks under your belt, not that much damage has been done and you can return to a normal state.
Stay on the Allo, eat healthy, avoid the alcohol and keep your chin up! It will get better!
best of luck to you!
Thanks for all of the advice and hope. I started 60mg of Pred yesterday and I am already feeling much relief. Can almost walk without crutches. My doctor said that as soon as I have a few days of relief start on 300mg allop. Finally got an appt with a rheumatologist as well on Aug 5. Not too bad. Much better spirits today. Thanks guys!
George,
Eventually with an attack that goes on and on, one has no choice but to toss out the common wisdom and just start the allopurinol anyhow, pain or no.
It is a shame that so many doctors are afraid to use what thousands of doctors for hundreds of years have used: high dose colchicine to stop a long painful attack. So you get the runs…there are far worse things (like foot pain.)
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