My first gout attack

[Carol]

I started my first gout attack a week ago today. It began in the evening and had gotten pretty severe by bedtime on Friday night. I tried Aspercreme on it and that didn’t seem to do anything, then I noticed some tea tree oil and put that on and got some relief. I spent the night waking and using the tea tree oil several times.

Saturday morning I went to an urgent care clinic. I told the practitoner (NP) that morphine caused me to stop breathing, so I wanted to be sure I didn’t get a pain med like that. She prescribed Tramadol (which, it turns out, has a warning regarding suffocation), so when I discovered that I threw away the med and have not take any pain med since.

I am also unable to take NSAIDS because I was on a 2-year course for my arthritis years ago till my kidneys started to fail, so she prescribed Prednisone. I really did not want to take steroids, so I held out till Sunday night, but the pain forced me to start taking it. I have now taken five Prednisone tablets, and I think there is a slight improvement.

My toe starts out not too bad in the morning but is pretty painful at night. I have just been soaking my foot in epsom salt water before I go to bed and taking 5 grams of zolpidem (Ambien) and sleeping pretty well.

I would like help with preventing future attacks, but I think I should tell you what I think may have brought it on. I recently started making and drinking bone broth, trying to drink a cup each day for about a month.

In addition, I was seeing a chiropractor who told me I should aim for 100 grams of protein a day, so I had been trying consciously to eat more meat than I was accustomed to, and he advised me to take 10 amino acid capsules a day, which I had been doing. (Swanson Multiple Amino Acids)

In February I was sick with bronchitis the whole month, and the first week of March, I had an aFib episode and was hospitalized overnight. I had never had aFib before and haven’t since, and I believe it was brought on by the bronchitis.

However, the cardiologist wanted to do a stress test. The results included a calcium score which was very high (1019), although my cholesterol is 165 with all the numbers in the ideal range, a 2.0 ratio of HDL and LDL.

I went online and found a recommended program for reducing calcium in the heart (http://www.drsinatra.com/how-to-test-and-treat-plaque-buildup-in-arteries) and started taking d-Ribose and K2 and L-carnitine. I had already been taking Cardiotabs omega3 and red yeast rice (four capsules each) for several years.

I also added MSM powder and cayenne and turmemric. Another recommendation for the heart was a cup of dark green leafy vegetables a day, so I had added a lot of spinach that I was not eating before.

My instincts tells me that the increased meat consumption and bone broth (maybe the high amount of amino acid capsules, which I have stopped taking) and the spinach may have caused the attack.

I would love to have your opinion and recommendations. Thank you so much for any attention you can give.

[Keith Taylor]

I don’t understand who diagnosed your first gout attack.

Please can you explain your gout diagnosis, together with your uric acid test results. When I have that information, I can start to put a plan together to help you control your gout.

[Carol]

A nurse practioner at Carespot walk-in clinic diagnosed gout and prescribed Prednisone. No uric acid test was taken then or since.

[Carol]

Maybe I should add that I went to the walk-in clinic the Saturday morning after the gout started on Friday night. The NP prescribed the Tramadol and Prednisone. I didn’t take the Tramadol, but I did take the Prednisone for 10 days, and by that time the gout had stopped causing me any pain. The NP said that the uric acid tests weren’t really helpful, and that was why she didn’t do one. I have read that same opinion (about the test) elsewhere, and that is why I have not tried to have one done.

[Keith Taylor]

Thanks for that information, Carol. I understand your situation now.

Carespot Urgent Care deal with day-to-day wellness issues. Great if you’ve got a burn or bruise. Not so good for a lifelong disease such as gout. They are set up to treat your pain, so it’s in their best interests to keep the attacks coming back. They won’t earn a cent from you if you control your uric acid properly, because you’ll never have pain again.

I’m tempted to rant about the injustice and inhumanity, but I’ll wait until I’m asked. What I need to focus on is getting you safe from further attacks. That means managing your uric acid, so you will have to get tested.

I’m so unhappy about all the bad information you have been given, but me moaning about that isn’t going to fix your gout. I can explain why the info is bad if you want me to, but I’m trying to encourage you to start again with a new strategy.

How do you feel about starting with a uric acid test? Is it easy for you to arrange one? Or do you want me to explain why it is important?

[Keith Taylor]

Carol, I ought to add a few other points about your original post.

You think you might have brought the gout attacks on yourself through certain diet changes. It’s not right to worry about that without considering all the facts. It’s more likely that it’s passed down to you in your genes. Without the full facts, I wouldn’t like to guess, but don’t beat yourself up about it. It’s good to manage meat consumption carefully, but that is just as true for heart health as it is for gout.

Information about amino acid effects on gout is limited. From what I’ve found so far, they tend to increase excretion of uric acid, and reduce uric acid in the blood. However, I can’t find any gout specific research, so the jury’s out. They are probably not bad for gout, but this type of relationship needs individual analysis. Often factors such as an individuals weight, uric acid level, eating habits, and exercise levels can change things like amino acid supplements from good to bad.

Spinach is generally good for gout, but again, it has to be assessed on an individual basis with respect to total diet, and the factors I mentioned for uric acid.

I think a simple approach is best for gout diet. Start with a good healthy eating plan. That’s also a good starting point for a range of diseases that are associated with gout, such as obesity, heart disease, diabetes, and high blood pressure. Once that is in place, it can be tweaked for better gout health, without increasing risks for other diseases.

Then, we can consider appropriate supplements where your individual needs suggest they might be beneficial. I believe supplements are only useful when you can identify specific nutrient deficiencies that can’t be achieved by changing food choices.

[Carol]

I am interested in and appreciate any and all information you have for me. I have no objection to the test, and it wouldn’t be especially hard for me to have it done. In fact, I am very curious as to what it would show.

I have been hit with a series of serious health issues since February of this year and have been overwhelmed with the amount of doctors and changes that I am dealing with now. I mentioned the bronchitis (February), followed by the aFib incident (March) and then gout (April) and then a TIA (May 19).

After the aFib incident, I had a stress test and calcium scan of my heart and had a calcium score of 1019. I have been on blood pressure meds for 30 years, including hydrochlorothiazide (which gave me pancreatitis) and now Lasix (for the last two years or so).

I am 100 pounds overweight and have not been active due to pain and disability from arthritis, one knee replacement and the other knee needing replacement, but since the TIA, I have been exercising regularly by going to the gym, using the elliptical machine and treadmill and 12 different strength-building machines for upper and lower body.

I have lost about five pounds because of the change in my diet, and my blood pressure is stable. I am feeling much less pain in all my joints and am walking much better just from this short time of eliminating meat and sweets and exercising. From all I have read about turmeric, I feel sure that it is helping too.

I will call my doctor’s office and ask for a uric acid test. I’m sure they will be happy to order it, and then I will let you know what it shows.

[Keith Taylor]

Hi Carol,

I’m pleased to know you’re going to get a uric acid test. I can’t wait to read the results.

I was told recently that I’m lucky to only have gout! Whilst that’s not strictly true, I certainly don’t have health issues that might compromise my treatment plan. I am aware that certain gout medications are restricted. It’s important to know about other health conditions that might affect gout treatment. Other health conditions and medicines for non-gout issues will complicate most gout treatment plans.

I’ll consider your complications when we get your uric acid test results, and start planning the best way to stop your gout. While we wait for your results, I have a couple of points.

Weight loss can help gout a lot, but it is best to do it gradually. One or two pounds a week is best. It doesn’t sound much, but over a year it makes a tremendous difference. And weight lost slowly is more likely to stay off – as long as it’s due to healthier eating, and not some unsustainable diet ‘tricks’

Turmeric is good for inflammation, but I don’t think it is much use in a full-blown gout attack. At this stage, for pain relief, I feel the complications need the input of your doctor, or a rheumatologist. I would normally recommend colchicine, an anti-inflammatory, and a pain-blocker for any residual pain. If you get chance, your doctor or a pharmacist should be able to advise you about gout-strength pain relief that is safe with your medical history and other medicines.

[Keith Taylor]

Hi @carol

Any news on your uric acid test?

[Carol]

Yes, I replied to your e-mail several days ago, but I just got bounce messages back several times.

My uric acid is 7.2. The doctor prescribed Allopurinol and wanted to retest in six weeks. However, in the meantime, I got quite ill from side effects of the Pravastatin they put me on after my TIA on May 19. I stopped taking it a few days ago, but I am still feeling ill with muscle weakness, sleep problems, fatigue, and especially digestive issues–nausea, diarrhea, etc.

I was not intending to start on the Allopurinol until after the six weeks check anyway, but this has cinched that for me. I don’t need any more confusion and upset to my system with a new drug. I want to see if the changes I made in my diet–no meat, fish or seafood and no sweets– was bringing my uric acid level down since I don’t know what it was before my attack. My diet now is beans, brown rice, eggs, vegetables, low sodium V-8 juice with cayenne, one or two bananas a day (needed because I take Lasix), occasionally berries or an orange, non-fat organic Greek yogurt, low fat organic cottage cheese with turmeric and black pepper, kefir, oats, hemp seed, nuts, cinnamon, and lots of coffee (mostly organic decaf, one or two cups regular), olive oil, some coconut oil, butter on my toast maybe once a week.

I still feel that the extreme changes I had made just prior to the attack–increasing my meat consumption to get more protein and drinking bone broth every day–may have precipitated the attack. And I have always eaten a lot of sweets. If so, the changes I have made may reverse it without drugs.

I have also changed doctors to one who is an MD who also believes in incorporating integrative medicine. My first appointment with her is July 17. My plan is to continue the no-meat, no-sweets diet until then and see what she has to offer. I’m sure there will be a recheck of the uric acid level, and I will be sure to let you know the outcome.

If there is no reduction in my uric acid on the next check, I will be open to whatever I need to do next, as I don’t want to let anything continue to destroy my joints. And if you see anything that I need to change immediately, don’t hesitate to tell me.

[Keith Taylor]

This old topic is generating a lot of interest from gout sufferers who are concerned about bone broth for gout. Also, lot’s of gout sufferers are also interested in relieving gout pain with Aspercreme. Unfortunately, there are no relevant discussions on the new gout forum. But, it’s easy to start a new topic. Then, I can give you up-to-date personal help.

If you want to discuss bone broth for gout, it’s a good idea to include a list of all the foods you eat regularly. Because individual foods are never to blame for gout attacks. So, we have to look at the big picture. Then, we can plan to incorporate favorite foods, such as bone broth, in your healthy gout diet.

If you want to discuss Aspercreme for gout pain relief, you need to be aware that it is a brand name for lidocaine. Now, this is unlikely to give effective pain control by itself. So, include all other prescription and OTC gout drugs that you are taking. Also include any herbal supplements, and treatments for other conditions. Then, we can plan a combination pain relief package that may, or may not, include lidocaine (Aspercreme).

Please start your topic in the new gout forum, now,

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