Gouty Arthritis A Problem?

What a peaceful, wonderful picture!

But, unfortunately life is not always peaceful, and for some, STRESS brings on the painful reality of GOUT! Ouch.

Gout is caused by the deposit of uric acid crystals in the joints, most frequently of the feet, but they can occur in other places too..knees for example.

Gout is one of the most painful processes you will ever experience.  For some people, there are a lot of food "triggers," like pork, bacon, shellfish, and other rich foods, and one of the most frequent offenders BEER!    In the 1800's it used to be considered a rich mans disease.  Not true anymore! Of course, part of the reason for that is the easy accessibility of rich foods and plenty of them.

Now that the explanation is out of the way, what are the answers if you develop this painful condition?  Well, some say a natural remedy is Cherry Juice.  The problem with that is finding the purest of cherry juice in the highest concentration.  Cherry Juice may help prevent Gout, but I haven't found it to be of much help once the process is actually in place.

Now, let's get to medications.  There is virtually no over the counter medication that will relieve the pain of an acute gout attack....no matter how much you take.  So it's a trip to the doctor guys!
For many years people have been put on Colchicine, and other "maintenance" meds to keep gout from reoccurring.  I have found, however, that these have a lot of unpleasant side effects.  Indocin or Indomethacin does seem to give relief of the pain in some individuals, but again can have the most unpleasant and dangerous side effects.  For me it caused extreme nausea and digestive upset.  It can also cause stroke, heart attack and bleeding issues! Lordy, if you read the warning label your heart rate will definitely increase!

I have only had about 4 gout attacks over the last ten years.  The best medication in the last two attacks was a Medrol Dose Pack (methylprednisolone).  It is a six day course of methylprednisolone which starts with a larger dose and tapers off to nothing.  It is mandatory that you take it exactly as directed!  But, the up side is this - within 24 hours or less the gout attack will begin to back off.  By the time you finish the dose it will be gone! NOTHING else works this well.  Check the reviews by other gout patients and you will find this to be true in 99% of the cases.  Believe me, the pain of gout is excruciating and downright crippling, so the fact that you can back it off in this amount of time is amazing.

I am not a physician, I am a retired RN.  I am extremely careful with my diet and find that I don't seem to have any particular food triggers, the one exception is BEER...since I don't like it anyway, this is no great loss.  You will have to figure out what your particular triggers are and sometimes it means giving up a favorite food such as bacon.  You don't want to have to take ANY medication too frequently, so a change in habits or food choices is your best advice in avoiding the pain of gout.

But, if you are a gout sufferer, talk it over with your doctor and see if this will work for you.  It has for me!

PEACE, LOVE, JOY and GOOD HEALTH!

Gout and Corticosteriods

I have been fighting a gout flare for two days. I am a retired RN, and I am not an advocate of taking "maintenance" medications available for gout. I can usually keep the gout at bay with proper diet, rest and lots of water! Cherry juice is also useful. But, one of the biggest triggers for gout is stress, and I have had more than my share of that over the last two months. I finally lost the battle.

These are my normal feet, and the lower picture is the appearance of my right foot today...

This morning the pain became so intense that i finally contacted my internist to ask for something for relief. She called in a Prednisone dose pack. Now, I have taken this drug for bronchitis attacks, but have never heard of it being used to quench the effects of gout.

I am happy to report that less than ten hours later I have marked improvement in the pain and symptoms which were plaguing me this morning. Amazing. I did some research, and found the following report on the world wide web. If you are a person who has occasional severe gout flares, you will find this very interesting information.

IMMEDIATE GOUT TREATMENT

Corticosteroids may be used for fast gout treatment if NSAIDS (including indomethacin) and colchicine fail to deliver gout pain relief, or patients are unable to tolerate them because of other medical conditions. Corticosteroids are also more likely to be used if more than one joint is affected and for the elderly.

Corticosteroids work as anti inflammatory hormones. They are the strongest anti inflammatory medication but are used very cautiously. Prednisone is the most commonly prescribed corticosteroid for fast relief. Other prescribed steroids include prednisolone, triamcinolone, corticotrophin (ACTH).

Prednisone decreases gout pain and inflammation by halting the white blood cells’ (neutrophils) attack on the inflamed location. It usually works within a few hours. Only the lowest dosage of prednisone is used, and as infrequently as possible, because prednisone and other corticosteroids suppress the immune system.

Dosage Orally as a tablet. 20-60mg mg initially, followed by tapered down dosages. Or, in some cases, such as emergency gout pain relief, prednisone, triamcinolone or corticotrophin are injected into the attack site(s) if there are two or less. The dose is based on the size of the affected joint (s) and the extent of the inflammation.

Your doctor may prescribe prednisone tablets for emergency treatment when travelling. If you are taking corticosteroids, make sure you follow the doctor's instructions accurately, or any other gout drug for that matter.

Possible side effects include Colds and fevers; slow wound healing; increased levels of blood sugar; increased appetite and weight gain; poor sleep; heart failure; higher blood pressure, diarrhea; headache; nausea; and others. Side effects are very likely, the longer you take corticosteroids - one reason why they are are not long term treatment. Maximum is probably 30 days.

If you’re taking prednisone or any other corticosteroid, any noticed side effect should be immediately reported to your doctor.

Corticotrophin (ACTH) Corticotrophin may be used as an immediate treatment instead of prednisone or the others. Corticotrophin stimulates your body to produce corticosteroids. It may be beneficial for elderly patients, who can't take steroids.

Possible side effects include vomiting; appetite loss or increase; diarrhea; constipation; sleep disorders and others.

As I have said, less than ten hours later I feel much better and am on the mend.
I have got to find a way to deal with my current stressors in order to stave off future attacks, but right now I am just thankful for the immediate relief provided by the steroids.

My foot is still swollen, somewhat reddened and sore, but much better. If you are suffering from gout, check with your physician. Proper diet, stress relief and proper hydration should be the first line of defense, but when all else fails, medication may be the answer.