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Seeking responses

I am a 54 male.  I am healthy (according to tests & exams anyway) but I am overweight by 50 pounds.  In the past 10 years I began having a yearly bout (occasionaly 2) with gout (ankles & feet).  It was always easily controlled with a prescribed medication (Indomethicin?)or Naproxen, and within 3-4 days I felt 100%  In December 2012 I developed terrible ankle and foot swelling with unbearable pain, to the extent that on certain days I could not walk or put weight on that ankle/foot.  Naproxen and other OTC drugs did little to repeal the pain and inflammation. I also began experiencing knuckle & wrist discomfort, and noticed I was dropping things constantly. It eventually cost me my job, because I could not (at times) walk or stand the entire 8-10-12 hours required shifts. I finally went in to see a doctor (internal medicine) and he requested both a serum uric acid & automated ESR blood test. The SED rate test was normal and the uric acid test, just a little elevated. (normal range is 3.5-8.5) I was an 8.8.  He did not prescribe anything but, just said get more exercise. He did not discuss with me the knuckle & wrist pain, or why I was dropping things constantly. I made the mistake of asking if "anything had been missed,or if other tests should be executed?"  I think I made him angry for posing such a question. So here I sit; still in pain not able to get around, and when I do it feels like one wrong step is going to break my ankles. I have shooting pains under my feet, numb toes on occasion and sharp pains going up my legs reaching my calves and even knees. What in the world is going on? Anyone, please give me your ideas.
7 Responses
Avatar universal
Well, compression stockings might help with the foot and ankle swelling, but check to make sure of any warnings/contraindications.  Icing and elevating your legs as much as possible can help with swelling.  It's best if you get your feet above the level of your heart.  If you sleep on your back, prop them up at night too.  

There are a bunch of causes of swelling like that, some of them serious.  You should check out arthritis symptoms and see if you think they fit you.  Your doctor sounds like a bad one if he won't listen to you about sudden symptoms with unknown cause that's aggravated by the treatment he suggested (exercise).  I would get a new one, and consider seeing a rheumatologist if you think it's arthritis.
875426 tn?1325528416
Besides the sedimentation rate, did he check the rheumatoid factor, etc.?

Did you have an MRI of your brain to rule out MS?  Did you have an EMG done where the numbness is (your peripheral neuropathy in your lower extremities) and also to test your upper extremities, as you are dropping things?

Did you get tested for all the things known (the medical world does not know all causes) to cause peripheral neuropathy?
(An example: I have a parent who has had numbness in toes, etc. from MGUS, which was discovered by a neurologist who tested for known causes of peripheral neuropathy.  Also, my parent had doppler testing to test circulation in lower extremities.)

See private message for more info.
4851940 tn?1515694593
Sorry to hear that you are unwell.

Gout is a type of arthritis.  With gout uric acid crystals get deposited around the joints causing the inflammation and pain.  Uric crystals are hard needle-shaped crystals that build up slowly over several years.

As you are suffering with the joints at present the doctor should have prescribed you with medication like Allopurinol to control the uric acid.

A predisposition to uric acid is being overweight, having diabetes, high blood pressure, long term kidney problems, as we get older, but men are 3-4 times as likely to get gout than women.  Also a diet rich in purines can also increase your risks to getting gout.  Beer and spiritis, sardines and liver are high in purines.

Uric acid is normally excreted by the kidneys.

For the pain you could take pain relief tablets, but if you are having an inflammatory episode, you should also be on the gout medication.

With the sharp pains you are experiencing in your feet, it could be likely that you have bone spurs now caused by the deposits of the crystals.  The doctor should send you for xrays.

I suggest that you look at your lifestyle to see what you can change to make things better for you, for example cut out any rich purine foods and drinks.  Drink plenty of water.

I would also suggest that you go back to your doctor or a different one in the practice and explain how you are.  If he does not suggest sending you for xrays to find out the cause of this excrutiating pain in your feet and legs and your wrists, perhaps you could mention this to him to see if there are any bone spurs.

Avatar universal
Thank you jemma116.  Having a history of gout (a bout, maybe 2 a year) I have done some studying on this issue.  A new doctor has done 7 different blood tests and so far all are normal (lyme disease,rheumatoid factor, vit. b-12, thyroid, a complete metabolic panel,uric acid,sed rate.) No x-rays and he will not discuss if it could have anything to do with my flu shot or enviromental. He did put me on indomethicin for the inflamation, which only worked so-so. Needless to say, I am still hobbling around and in some pain, severe at times. Thanks again.
Avatar universal
Thank you for your reply. Very kind of you.
Avatar universal
Thank you for your reply. I appreciate everyone on this site for their insight.
4851940 tn?1515694593
I suffer quite badly from osteoarthritis, and sometimes have pain under my feet, been quite bad these last few days.  
I can't take Ibuprofen (anti-inflammatory) because my legs swelled, got red and a different type of pain on top of the normal pains.  I have to keep moving about though or I will completely stiffen up.

Worst is in the mornings and after sitting still for a short time.  Standing and walking also makes everything worse.  I definitely need to lose weight too.

Although your wrist pains are more than likely to be linked with the other arthritic problems you have, you may also have carpal tunnel or tennysonovitis.

You can get some wrist splints to imobilise the wrist to help it heal.  If you work and have a repetitive job, then that would aggravate the wrist and cause the problems.

When you are really bad, rest.  When you can and the pain is not too severe, move about.  

Best wishes
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