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Arthritis (Expert Forum)
First Gout Flare Up
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
First Gout Flare Up
by pem0608, Jan 24, 2007 12:00AM
Hi, Thanks for this service.
I am 35, have a history of gout in my family, I am overweight, but active, and of course, I was a beer drinker. Most of my relatives developed this in their 60's, I am 35, while I accept that I didn't do everything to avoid Gout, I thought it was something older people got. Anyway, the week between Christmas and New Year I had a flare up of gout, classic symptoms affecting the main joint on my big left toe. I had to wait to see a doctor because of the holiday and he prescribed indocin and colchecine. I did not use the Indocin as the worst was over before I saw the doctor, I have been taking .6 mg of colchcine a day as prescribed. I have also been drinking a lot of water, watching what I eat, and cut out beer. I never drank a lot of hard liquor, I had a few drinks at a wedding a few weeks ago (vodka/soda) and that didn't seem to cause any issues.
So here is my question.....the symptoms have gone away, and I have not had any new attacks, but I just can't get my foot back to feeling 100%. There seems to be some residual pain and my foot/toe seems very susceptible to injury, I have stubbed it a couple of times which seem to cause a lot of lingering pain, though no real gout flare up..........is this normal? I though these symptoms were more likely to come and go, not linger, at least at first. I have not been able to get back to my regular Doctor as I have been traveling for work. Is it possible that one attack (which I do not think was really severe) could cause joint damage? Or am I just not getting over the attack completely for some reason? Is a joint more sensitive to injury after a flare up? Just looking for advice, I know this is a distance relationship not a "real" diagnosis.
Thanks for the response.
I am 35, have a history of gout in my family, I am overweight, but active, and of course, I was a beer drinker. Most of my relatives developed this in their 60's, I am 35, while I accept that I didn't do everything to avoid Gout, I thought it was something older people got. Anyway, the week between Christmas and New Year I had a flare up of gout, classic symptoms affecting the main joint on my big left toe. I had to wait to see a doctor because of the holiday and he prescribed indocin and colchecine. I did not use the Indocin as the worst was over before I saw the doctor, I have been taking .6 mg of colchcine a day as prescribed. I have also been drinking a lot of water, watching what I eat, and cut out beer. I never drank a lot of hard liquor, I had a few drinks at a wedding a few weeks ago (vodka/soda) and that didn't seem to cause any issues.
So here is my question.....the symptoms have gone away, and I have not had any new attacks, but I just can't get my foot back to feeling 100%. There seems to be some residual pain and my foot/toe seems very susceptible to injury, I have stubbed it a couple of times which seem to cause a lot of lingering pain, though no real gout flare up..........is this normal? I though these symptoms were more likely to come and go, not linger, at least at first. I have not been able to get back to my regular Doctor as I have been traveling for work. Is it possible that one attack (which I do not think was really severe) could cause joint damage? Or am I just not getting over the attack completely for some reason? Is a joint more sensitive to injury after a flare up? Just looking for advice, I know this is a distance relationship not a "real" diagnosis.
Thanks for the response.
Doctor's Answer
by Kevin Pho, MD, Jan 25, 2007 12:00AM
, Jan 25, 2007 12:00AM
Typically if there is no gout flare, there should be little - if any - residual symptoms, unless chronic gout is present (see below). Checking the foot for any other abnormality (infection, fracture, sprain) can be considered. Obtaining X-rays would be the first step. Further evaluation can be obtained with an MRI.
Chronic gout can lead to joint and bone deformity. Imaging studies can help determine if this is the case.
A referral to a podiatrist can be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Chronic gout can lead to joint and bone deformity. Imaging studies can help determine if this is the case.
A referral to a podiatrist can be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
I expect that readers of this post are most interested in curing their gout. But it is even more important for your long-term health and life expectancy to be sure that you don’t have sleep apnea. Unfortunately, most doctors do not routinely screen for sleep apnea, and they don’t know that your gout should trigger sleep apnea screening.
My great disappointment in the lack of adequate attention to sleep apnea by most medical practitioners has induced me to author a book about sleep apnea for general readership. It was published just a few weeks ago. The book describes in more detail than my website the connection of sleep apnea to gout, as well as many other consequences of sleep apnea. It also provides self-help suggestions for individuals to use to protect themselves and their loved ones from the perils of sleep apnea. It is available at amazon.com - just search for apnea,epidemic.