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trev said:
This doesn't quite ring the gout bell for me, VG!
With all that walking when it was worse -that would surely trigger an attack at 10+ SUA .
One thought, If it IS gout- then it may be that your immune system is not reacting as it should.
This is a part blessing- have you ever taken Immune boosting supplements like Vit C, E or Zinc?
If so, has it affected your foot pain? It does take time for the supplements to get your immune reaction levels up though and as you keep fit ,just a long shot.
Also, if your colds last a long time -or you get re-current infections?
Trev I take Berocca sometimes….once a week maybe but not regularly- http://www.berocca.co.uk/vitam…..nerals.htm
No it makes no difference to my foot pain. The foot pain is virtually constant 6 out of 10 (with +-10% variation)
No I don't have any infections and probably had my last cold 1 year ago. Both my feet feel a burning sensation but I wonder if that is more to do with current heat wave.
zip2play said:
To my eye, it looks most like you got a splinter or someting into the juncture of the toenail and the outer edge of your toe. It is indeed infected but it doesn't look gouty to me. Admittedly it's a hard call from the picture.
No the nail area has nothign to do with my pain. Here is an older photo that I had posted. It shows where the pain is. See the black dot? It's that joint that pains.
Took another home blood uric acid reading this morning and it is 10.2mg/dl again. That is almost 11 straight days at over 10mg/dl level. Everythign is pointing towards Gout I feel! If it is gout then I wonder how much more damage has been done due not receiving proper treatment for last 4 months!
I am feeling sorry for my body! I wonder what is going inside. If I have already problems in my 30s I wonder what other disease I will get later on in my life! Welcome to reality of human condition!
cjeezy said:
I don't think everyone gets a severe attack all the time…but I'm no Dr. At this point I would try Colchicine. What do you have to lose?
I would try it if I could . Is it not a prescription only drug?
I am seeing hospital doc in few days so I will have to wait.cjeezy said:
Veg,
Its sounds like you have a similar situation to mine (read my post “lingering symptoms)…I had 5+ weeks with lingering paiin (although initially I had a severe attack for a couple days). I finally got a Rx of Colchicine last week and that seemed to really help. My pain is now down from a 6 to about a 2…and hopefully fading in the near future. Like Zip said in my thread. “If Colchicine doesn't work, then there's a good chance it AINT gout!”
Yeah but I never had a severe attack
Do you mean that even touching it or rubbing it gently would hurt? I have always been able to rub and pinch without serious pain. If I press hard at some points then it is painful like a stabbing pain. Rest of the time I have a hot burning type of pain deep inside the joint. With some random pin and needles sensation thrown in. Actually it is hard to describe what I feel 
I really hope things will be clearer next week as I can't take this mental torture anymore!
Ok here are some latest photos. The photo with both feet together is with light coming from top right hand corner, so make allowance for extra shadow on the left foot. Sorry about the image quality on the first one.
Not confirmed Gouty but I have been thinking about my foot every minute of the day for last 4 months!
Sorry for the delay in writting back. Just 5 more days to my hospital appointment
Yes Travery I will post some new photos later today.
Zip2Play-
Does your painful toe bend inwards more than the unpainful one.
Nope. Both look exactly same.
Does it feel better if you spend a great deal of time barefooted?
Not hugely different. My pain is kind of constant with +- 10% fluctuation.
Does COLCHICINE make the pain stop quickly?
Haven't taken any medication so far (apart from creams/balms etc which do nada)
Also my feet are smooth and soft. No peeling of skin….no hardened skin anywhere. Apart from the 5-10% swelling in the toe region. Not very obvious swelling though.
Another interesting thing, for last few weeks my blood uric acid reading is in the 10-11mg/dl level constantly (using home test kit). All readings taken first thing in the morning on empty stomach.
Normally they used to fluctuae between 7 and 9. Now last 5 readings have been between 10 and 11. Unless it is because of exercise the previous day.
It's baffling that for last 4 months I have constant mid level pain 24/7 . No super painful attacks like typical Gout sufferers. I can touch the toe easily and rub it without wincing in pain or anything like that. X-ray shows no problems with the bones. Damaged tendon maybe??? I would know if I had hurtthem though!
I am still thinking that Gout is the most likely cause. Once in a while I feel slight twinge in the right toe as well.
Tavery thanks for the post. Yes it very well might not be Gout related in the end as some things just don't match in severity to typical Gout pain. I have spent nights Google searching toe pain related pages and forums. Nothing matches 100%. Hospital hopefully will get to the bottom of it as they have everything under one roof, so tests hopefully will lead to proper diagnosis. They have to as I am going nuts! Every foot step I take reminds me of the mid level pain….difficult to get on with things without thinking about it.
Yes I have always had cold feet ever since I was a kid. I do feel needle type of sensation since this pain started and as if a lump of hot charcoal is deep inside my joint. It's not hot physically though. Flat feet I don't have.
We shall see next month. I just need to talk with someone hence my posts. I don't want to speak about it again and again with my wife as she is already very worried.
Some questions-
Q1- Is there “Acute Gout” and then just plain “Gout”?
Q2- Early stage of of uric acid crystals build up in the joints = Gout or only a full blown attack is classified as Gout/Acute Gout?
Q3- Zip2play has confused me a bit now. Is there “Blood urea” and “Blood uric acid”? What is the exact difference and what is the normal range for both? What is their connection with each other? Where does urine ph levels fit in?
I edited my post zip2play, sorry I meant blood uric acid reading is always between 7to9mg/dL. Yes I am a vegetarian but my dad has Gout so that could easily cancel my good veg diet benefits no?
Yes I agree that with acute Gout I would be in severe pain and definitely not able to hike like I did. My non professional theory is that my excellent diet might be helping me not to cross into acute Gout land….YET. I feel the dam will eventually burst though.
Ok here are the facts once again, might as well recap as I have to explain it to the specialist next month-
F1- Last 4 months I have constant unexplained pain in my left toe with occasional 5-10% swelling. Swelling not always there though but low to mid level pain has been there for the entire 4 month period. No pause.
F2- Blood uric acid readings always between 7-9mg/dL. These include readings taken at my GP's place and using my home test kit.
F3- I feel strange sensation in my right toe too but no direct pain like the in the left toe yet. The general sensation is similar though.
F4- GP's initial diagnosis was that I have just over stretched my joint without me knowing how. X-ray of left toe shows no bone break or any bone erosion. My knee X-rays for somethimg unrelated also shows perfect bones with no wear or tear.
Three months on GP does not know why the pain does not go away and has refered me to hospital Rheumatologist.
GP now thinks that it's possible that maybe I have crystal forming which is causing the pain.
F5- I visited a Rheumatologist privately before and he said that in his opinion I don't have acute Gout. He does not exactly know why I have pain and that I should continue exercising etc as normal but just not bend the toe
The best he said he could do is give me second appointment to come back in September and test my blood uric acid levels. I cancelled that appointment as I have appointment next month with specialist at the hospital.F6- Yes I am vegetarian, extremelly fit and have had a very good diet for almost 10 years now. I have not touched meat, sea food, oily stuff, soft drinks, sweets etc for many many years. My dad has Gout though.
F7- I have full range of motion in my toes. The pain feels deep inside the toe joint and not on the surface. I can rub the toe surface without any oohh! arghh! type of pain.
F8- I am lost!
Ok so I went on holiday and hiked and hiked and hiked and hiked for hours and hours on end….6-8 hours a day for almost a week.
For last 3+ months my pain is constant 24 hours a day at level 4-5 (out of maximum possible pain level of 10) and my blood uric acid reading is always between 7 to 9mg/dL (excluding higher post exercise readings) . During the hiking trip my pain level stayed at level 4-5 and did not go up higher like I was expecting.
Every second of the day this thing is on my mind and it's driving me crazy!!!! I still have almost a month to wait before my appointment day to see the specialist at the hospital arrives. Why is my pain not going to level 10 like typical Gout patients? I rather have few days of level 10 pain than this constant low level pain chipping away at my sanity
Just needed to shout and get that out of my head
I really don't know what is happening with me!!!!zip2play said:
Post edited 5:38 pm – July 28, 2009 by zip2play
I mean what is the point of basing almost ALL blood testing on fasting samples when the ONLY time people fast is before a blood test…or they live in Sudan!
I find that silly as well. If crystals form at high blood uric levels then why would the crystals care about empty stomach readings? They will form when ever the readings are high…after sports or first thing in the morning.
That said empty stomach first thing in the morning readings is the only qualitative way of comparing your readings from one month to the next. Other wise factors like food you ate etc will come into play and complicate matters more that they already are.
zip2play said:
Post edited 5:38 pm – July 28, 2009 by zip2play
My faith in gout self-testing took a hit when I saw the all-over-the-lot readings that so many here were getting and even some whacked out readings from my labs.
Yeah me too but it was semi restored when my home test reading perfectly matched the one taken at the docs place. Both taken first thing in the morning on empty stomach on the same day. That said it all feels like hocus pocus science.
GoutPal said: regarding diet….
…..It is also largely irrelevant for gout sufferers whose gout is caused by heredity……
Just to back up what GP said. I have been hardcore 100% vegetarian for almost a decade. I eat very healthy diet and am very fit, active, not over weight at all. I have been hit with what is most likely to be Gout too. My blood uric acid readings are in the 7 to 9mg/dL range constantly. Last 3-4 months I have constant low to mid level toe pain. There is absolutely nothing more I can do as far as diet is concerned, heridetary factors did not care about my excellent diet. Sad part is that unlike most here I actually find my vegetarian diet extremelly tasty and enjoyable. Also never saw the point of filling myself with alcohol…..but despite all those good lifestlye choices for almost 10 years I could not correct my genetic time bomb! I really did not want to be hit withall this in my 30s
zip2play leave his nail alone
Ok so I got appointment letter from hospital's Rheumatology department today. Appointment is in one month time
Atleast it is one hour appointment so I will be well prepared with all my blood uric acid readings and detailed case info. I hope I get a decent doc and not some clueless pen pusher moron.Hmm just did a search on the doc who wil be seeing me, looks like a young doc in his early 30s. Not sure if that is a good or a bad thing.
You are in good hands here as far as getting decent advice is concerned. I feel for you and am posting to give you moral support.
Wimpy I am hoping there is some kind of light at the end of tunnel for you. You have suffered too much!
Thanks Tev for posting the image. That looks painful. If I see correctly then you have quiet a few tophis. How long have you had Gout? At what age did it all start for you? How is your treatment going?
Yeah last year when I went on a similar five day holiday I walked from 8am to 8pm everyday
Don't know how many miles though and I did not drink enough water like I should have. Five days later on the way back home I fell severely ill for 2-3 weeks. I had super high fever for 10 days non stop. Fever meds would not do anything. I started seeing things due to the high fever and passed out at home. All I remember was my wife crying and thinking that I was dying Went to ER and after battery of tests the docs said that apparently I had caught a very bad virus. After I finally became normal I had lost 5-6kgs in a space of 2 or so weeks
Would be interesting to see my blood uric acid readings from my ER visit. Maybe I should contact the hospital to get hold of it. I am not buying the virus thing though. Anyway as far as I know that incident had nothing to do with Gout.This time I won't walk that long. I will take lot of breaks and drink plenty of water. Hey Trev I meant water not beer and wine
I have always had slight knee problems ever since I was a kid (non Gout related). I wonder how many times the discomfort I felt in recent years was related to my old problem and how many times mabye due to crystal formation.
One thing is know 100% for sure currently- My toe joints and both knee joints are perfectly healthy ie. there is no cartilige wear or any damage to the bones. So I hope that means that I am at early stage of Gout. On the other hand if the things on my finger is Tophi then I really don't know what to make of it all as far as which stage I am in is concerned.
Ok it's late in the night and I think I have read almost all gout related post online and on this forum. I feel like ranting
1st Rant- Waiting for the hospital to call me and give me an appointment with the next specialist is testing my patience. I want to get started with my treatment asap!
2nd Rant- I think lot of doctors are useless. My bloody test readings from 2006-7 clearly shows that my blood uric acid readings were close to 8….. but the doctor told me back then that everythign was ok with my blood! I wish I had seen the sheet back then and not in 2009 when I asked for a copy of current readings.
Which brings me to the clueless specialist I visited privately. Unless the toe is size of a football they don't take things seriously. Bloody hell if someone has high uric acid readings, Gout in the family, unexplained pain in the toe for 2-3months and older high blood uric acid readings from 2-3 years ago then obviously there is something wrong!
3rd Rant- From my research strict vegetarians who are very fit, active, healthy and eat balanced diet have an extremelly low chance of getting Gout unless via their parents. My dad, granddad and great grandad were/are hardcore excess meat eaters and very greedy when it came to rich food. Thanks for screwing my life as I wil be paying the price for their lack of control!
This part of my situation is what I find most unfair! I wonder what my condition would have been right now had I been eating like them 4th Rant- I have a holiday planned in a week that involves fair amount of walking. I really don't know if I should cancel it or not. Hopefully drinking lot of water and resting a lot will keep things in check. I am just worried that I might get hit with my first hardcore Gout attack. If anyone is still reading then any suggestions to not get caught out while I am hiking? Btw in last two months I drank enough water to fill an Olympic sized swiming pool
marky5 I am 35 and about to start my Gout journey
All the problems you mentioned happened despite taking Allurpurinol for last 16 years? OR could you not take them due to adverse reactions? Could you please clarify.Either way I felt your pain on reading your post
I hope you find some relief.Trev your post made me smile (the medal bit)
I kept the bike in the shed. Just low maintainence exercise at the gym is all that I am doign now.Thanks for the post and the info zip2play
Anything and everything is nice to read for my current state of mind.If it is less hassle for you then you could mail me the images at-
You know you say that the white marks seem smaller than average but don't they start from small and gradually get bigger? They have to start small….no?
Here is close up of two white looking spots on one of my finger (left hand). Different views of the same spots. Spot A is more defined and 1-2mm raised. Feels almost like a grain of salt when I rub with my thumb. Spot B is flush and not raised. Could these spots be Tophy?
Would it not be bit early for Tophy if I have not even had a severe full blown painful acute Gout attack?
I will obviously show it to the expert when I get my hosptial appointment but as it could take anything from few days to few weeks to come through……
zip2play thanks for the reply. Yes you are right but based on my luck I wil probably get all of those diseases as well. Trust me, plenty of diseases on both my mum and dad's side to go around for me. Looks like everything my dad got later on in his life I am getting in my 30s!
Man so many years of good diet, healthy living, no smoking or alcholol and what do I have to show for it? Yeah Gout in my30s!
Ok I am fit atleast but that will go downhill fast if I can't do much fitness.Ok some “IF”questions-
-Q1) If I go on Allopurinol eventually and my blood uric acid reading go under 6 then from my understanding I have to continue taking it for rest of my life to keep levels down. That is fine but can I continue doing fitness? Moderate weights? Cardio? Biking? Or do I have to wrap myself in cotton wool?
-Q2) From the posts here it seems that diet can only do so much with the exception of maybe red meat, alcohol and few other food items that I have not consumed in 10 years anyway. So my question is that if eventually I am on Allopurinol with readings lower than 6 then do I have to watch out for high protein foods like chickpeas, tofu or other high protein vegetarian products?…..beans that some seem to suggest are a NO NO?
Won't Allopurinol take care of that side of things?
-Q3- Possible side effects of allopurinol according to wiki have been included below. How will I know if I am having just mild side effects or some of the more serious ones? What happens to the few who can't take allopurinol? Are they shafted?
The most serious adverse effect is a hypersensitivity syndrome consisting of fever, skin rash, eosinophilia, hepatitis, worsened renal function and, in some cases, allopurinol hypersensitivity syndrome. Allopurinol is one of the drugs commonly known to cause Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TENS).
Allopurinol can cause severe pancytopenia if given with azathioprine or mercaptopurine, due to inhibition of xanthine oxidase which metabolizes these drugs. It can also cause breast enlargement in both males and females
In conclusion I would like to say that human body is nothing but a pile of fatty red yellow stuff inside a skin bag
Hello friends. I visited my GP today as I could not get direct Hospital appointment. My GP today referred me to the Hospital Rheumatology department. I have to wait for my appointment to come through now.
Basically since my last post my readings have continued to be high. Ranging from 6.4 to 8.8. Today I took my reading first thing in the morning and it was 8.7. Then I measure it at my GP's place and it was approx. 8.7 too.
My left toe continues to be in medium level pain. Not excruciating pain like typical gout sufferers though. I have also started to feel strange senstion in my right toe these days (no pain though).
As things stand it is looks 95% certain to me that I have Gout
My reaserch basically has counted every other possibility almost out. Additionally I see two small white bits on my finger. I am not sure if it is Tophy or just some hard skin thing. I will post a photo later. If it is Tophy then boy I have gone from normal to screwed very fast! Still holding on to the 5% chance that it was all a bad dream but I am starting to accept the invitable….
I will come back with some Gout controlling questions later, currently I am too depressed.
I normall get my bike out in summer (now) and go two times in a week for 40mile ride. Not sure if I should even try it considerign I don't even know if I have Gout or something else. I might start next week to see what happens 🙂
Just got off the phone with Siemens and have been informed that two of my local hospitals HAVE DECT (Dual Energy Computed tomography instead of joint aspiration) machines. So I know where I am tying to go next
Not sure if the hospital doc will send me any where near the machine but it's better than going to a Rheumatologist in private practise with no direct acess to the machine.Looking at the image from http://w1.siemens.com/press/en…..905045.htm
I assume the red parts are the crystals. The photo looks that of an advanced case. I wonder if it is any good for someone with early stage of Gout?
>Good move- the more you know the better,
Yeah I took an online “Test your Gout knowledge” test and got the answers 100% correct.
>Yours may not be, but I would guestimate much higher than 50/50 chance and the fact that you are here seems to indiicate your suspicions also.According to another online “Do you have Gout” test I got 30% probability based on my symptoms. I think in reality it is probably 65% + chance that I have Gout.
