I Think I May Have Gout

I woke up at 4am with writhing and excruciating pain on Boxing Day. My left ankle was swollen and throbbing as if it was crushed by a car. Pain 10/10! I didn't know what I was suffering from, I thought this was the most unusual case I've ever experienced. The following day, the pain hasn't subsided, my feet turned into a balloon and it was lightly purple! My toes were like little sausages and I was in so much pain!

Then I finally chose to go to doctors and he kind of suggested that I may have gout because all the swelling is from the joint. I read up on gout and as I was reading, it basically described what I was dealing with. :( The only thing that baffles me is the diet part of gout, I am chef by trade and I eat everything under the moon so how does it make sense when gout starts now?

Does anyone here suffer from gout and how do you deal with it?

Comments

  • +4

    Typically with age! Same thing happen to hubby. Having red meat 3 consecutive nights is sufficient to trigger gout for him. Cut out seafood, beer & red meat.

    • this is a sign im getting old, god dayummmm. How often does he get gout? or is it under control now?

    • +4

      my mate who is 33 has gout

      overweight, poor diet

      couldnt even drive when he had gout

    • +1

      Same for me. Never had gout until 40. Now I can’t have red meat more than 2 times per week, no shell fish and no excessive beer consumption and I need to keep water intake up.

    • Thanks! Glad so many events over this season got cancelled. If meat has a smell, stay away!
      Anybody out here on Psyllium Husks? Know a personal doctor trying to talk me out of taking it!

    • Cut out seafood, beer & red meat.

      It's worth mentioning that wine is even worse than beer when it comes to triggering gout.

  • +45

    You don't have 10/10 pain. 10/10 pain causes people to call an ambulance immediately, not sit at home with no pain killers.

    how do you deal with it

    Would have been a good thing to ask the doctor.

    • +16

      Reminded me of that tool with the covid vaccination jab complaining that their injection site pain was a 12/10…

      • +2

        Everythings a 12 if there's a chance to play with the green whistle.

    • +5

      abit of an exaggeration but it was so painful i was considering on going to the hospital and seek medical help

      • +6

        You mentioned purple-ish colour tinge, like a bruise…are you sure you didn't roll an ankle? That aside, Gout is excess uric acid within the body, which crystallises within the joints, commonly foot and toe joints, and cause fairly intense pain. In days gone by, it was associated with high living, eg Stilton cheese, port….back when such a diet existed only within the privileged & wealthy. Nowadays, most of us eat both well and poorly, and many can be fair game for developing gout.
        Treatment does aim at minimising several foods which others have mentioned, and yes, removing or freshly reducing alcohol intake : the other aspect of treatment commonly involves Non Steroidal Anti Inflammatory medicines. Take x2 Ibuprofen 200mg tablets, and ALWAYS take these medicines with food, extremely important or gastric bleeding can occur. Other drugs from the NSAID group are only available on prescription….Indomethacin is the strongest of all, and must be used with the caution already mentioned re: taking them with food. Ibuprofen are readily available and inexpensive, x2 200mg tablets every 5hrs and repeat regularly to attain optimal pain relief. Paracetamol x2 tabs each 4hrs can be taken concurrently with NSAID's without issue, which will further augment pain relief.
        It tends to be sporadic once controlled, and confirmation is via blood test for raised Uric Acid levels among others.
        Good luck with it, it's a nuisance, but plenty of things far worse than gout.

    • -12

      Even with 10/10 pain some people actually just manage it themselves if its not life threatening instead of clogging up the already overflowing emergency system.

      • +25

        Then it's not 10/10 if you can "manage it yourself". 10/10 is things like limbs torn off, being burned alive, mangled in motor vehicle accidents, caught up in industrial machinery, (etc.. you get the picture) not something one could "manage themselves"

        • +1

          if such things are happening to you do you think you would be in a position to declare a pain score
          "yep doc, my arm is still holding by a ligament, its a 9.5/10"
          pain is subjective i dont know where people are getting these rules, i would imagine its more to monitor progression, eg its a 5 i give you something and then you say 4 or 6 to know how well whatever i gave you is working, in such a case, it can be 10 an then 9 or still a 10, no biggie

          • +1

            @juki: yes, people have had their limbs torn off and still contacted emergency services in time to be treated and saved from death/lifelong disability

            • -2

              @s1Lence: and how did they dial the phone with only one hand..?
              its kind of besides the point, in such situations do you think the paramedic will say "whats your pain score?" or "sorry sir, you cant score ten your arm is still half attached".

              despite the number of upvotes, i found pegaxs comment somewhat absurd and actually erronous, the objective isnt to standardise pain with the torn arm being the reference.

              • +3

                @juki: https://www.chicagotribune.com/news/ct-xpm-1992-01-21-920106... Quite a popular case

                "Thompson`s early acts of courage and common sense went unwitnessed: He was alone, preparing to load grain, when his arms were ripped off at the shoulders by a spinning power takeoff shaft. He made his way 100 yards to the house.

                Unable to open a sliding patio door because it was locked, John entered the attached garage and somehow opened a screen door.

                John raced inside and kicked in the door to the den, the only room with a push-button phone. Knocking the phone off the hook, he grabbed a pencil in his teeth and punched his cousin`s number as he lay on the floor in his own blood."

          • +1

            @juki: Exactly, its subjective. Its strange that people want to apply their rules and views upon strangers, as if they are the ones that are running the show. If he said he felt a 10/10 then who are people to say nah you didn't.
            Its way off topic for what he's actually trying to talk about anyway. Smh.

      • +1

        10/10 pain is absolute maximum. As pegaxs says, having a limb torn off by a piece of machinery, falling several stories and having many broken bones and ruptured internal organs, being in a severe car crash with similar etc, would be 10/10 pain, not gout.

        • +6

          Like i said, pain felt like my ankle was being crushed and I was super worried about something i've never felt before and experienced. So you could imagine the intense anxiety. Plus, pain is all subjective. Everyone feels and perceive pain differently. My feet was a balloon and it was purple.

          • +15

            @NamandSpam: The way you describe it, combined with your blasé approach to seeking medical help is very odd.

            “Super worried” and “finally chose to go to doctors” just don’t compute.

            • +3

              @thrillhouse: typical guy… i used to only show up to a GP when i could barely breathe/walk, usually a week after the incidents.. i know…

        • +10

          Pain is very subjective and some people really do manage awful pain themselves rather than go to the doctor. Maybe they're scared, maybe they're hopng it will go away by itself. My sister works in aged care and sees it all the time. It's not always rational.

          Also, the few people I've known who have had gout say it is truly excruciating.

          • +5

            @Lastchancetosee: Pain scores a pretty useless for grading pain in an individual and harmful if using it to titrate pain relief. It has a limited role in scientific studies. Functional scoring is more useful, that is what the pain stops you being able to do e.g. stand vs walk vs run.

            • @spurf: I actually have it now, thus reason for reading this thread. Mine has only happens in my big toe. At most it is uncomfortable especially when walking, yet it doesn't feel as bad when playing beach volleyball, on soft sand. also tomatoes are a big no no…

        • +1

          While not as gory, the pain from gout is arguably comparable.

    • +8

      Mate - read up on the most painful conditions, it’s right up at the top. Have you had gout? It is excruciating.

    • +1

      5/7 pain is the worst!

    • +4

      its just a description, pain is subjective, i dont believe there is a rule stating you must call an ambulance at 10/10

      • +2

        No, but by definition, 10/10 means literally you couldn't conceive more pain. To me, that means screaming, hysterical, death-is-preferable, needs morphine ASAP pain, i.e. burnt alive, severe organ injury, losing your skin in a road accident, wartime injuries, etc.

        The OP sounds reasonably lucid, at least enough to sit on it, take painkillers and post on Ozbargain. That doesn't sound like 10/10 pain, but we're splitting hairs.

        • I think being burnt alive isn't actually meant to hurt that much after the initial injury since all your nerve endings are fried.

          Gout however is commonly described as one of the worst pains you can have. Even a piece of tissue paper touching a gouty joint can cause agony.

          • +2

            @Save Medicare: Only third degree burns. There's a whooole spectrum of pain before and after that.

            Which is why I'm not convinced the OP has it.

        • +1

          by definition, 10/10 means literally you couldn't conceive more pain

          not necessarily, it just means it has reached a threshold, nobody said it has to be "ultimate pain", it sort of reminds me of teachers not giving a full grade because "nothing is perfect

          • @juki: So there's 11/10 pain? 27/10 pain? It's a scale, and 10 is the maximum. This isn't an external party grading an exam; if you look at standardised questionnaires used by medicos, it will typically use language like 'if 0 is no pain at all, and 10 is the worst possible pain imaginable, where would you grade your pain now?'

            Now, from the OP's post history and comments here, does that sound like 'unspeakable, bedridden, and delirious pain' to you? Or is it more plausible they hopped on WebMD, self-diagnosed gout, and retroactively claiming 10/10 pain? If the OP produces a diagnosis of gout, I'll eat my hat.

            • @SydStrand: No that's not my point at all, being a certain point you stop counting.
              I've fallen off a building and a motorcycle I can't tell you which was the most painful but they both score 10.
              Even if the form says that I'm sure many people report Willy Nilly what would you do ? Say no sure your passion isn't a seven I won't give you analgesia and piss off hmm, I hope not, some people are pretty stoic for no reason going off their score would also be detrimental. I think the form says that so there is no confusion about 0 is less 10 is more. And that the purpose is to monitor evolution from that point.

              As for op I don't know, what kind of hat do you have? I liked to imagine a fez ;), jokes aside this is just some internet post I assume we'd all use common sense and don't know why we're v arguing really

              • @juki: No one is arguing that pain tolerance isn't subjective, but 10/10? While still being able to think straight, taking over-the-counter painkillers and commenting away on Ozbargain? A 10/10 self score is frankly implausible, regardless of thin-skinned the OP is. I don't believe it one iota. I believe it as much as a fouled soccer player holding his leg in pain on match point.

    • +1

      Lol as someone who had a collapse of their femoral head due to avascular necrosis, I find it hilarious when people say 10/10 pain but they sit home.

      Had to call Ambulance a year ago for pain in my right hip, while being on Targin for my left hip. Had undiagnosed avascular necrosis in right femoral head, collapsed.

      That was a solid 9/10.

      Loaded me up with pain killers, referral to ortho and MRI.

    • If you had bad gout, you wouldn't say that. It can feel like it's broken.

      It can be managed with medication, but you have it for life and flair ups are no fun.

    • 10/10 of pain you wouldn’t have the capacity to call an ambulance?
      I mean it all depends on your definition of 10/10 pain doesn’t it?

  • Indocid

  • Drink beer? That's a cause apparently

    • i dont drink alcohol often and havent had any for over half a year

  • -1

    Raise your problem feet up when you sit or lay down. Don't cover anything on the foot nor apply any cream. Doctor should be apply to prescribe this gout medicine when it happens.

    Sometimes gout can switch between foot, this is normal.

    When you don't have gout anymore: The one thing I do now is to heavily reduce sugar intake and take the celery supplement daily. You can drink beer or eat red meat but better in reduced portions.

    • -1

      Thanks fox, i didn't know it could jump from one side to the other?!

      I've applied voltaren? it helps reduce inflammation?

      • +1

        So the Dr didnt give you anything?

  • +8

    Change doctor and get a proper diagnosis.
    Blood test will indicate uric acid.
    MRI will show joint problems.
    Gout symptoms usually appear at night when the acid crystals settle in the joint.
    Voltaren is pretty good, but I find that exercising (probably more like furious wriggling) seems to slow down the process and the crystals break down and get reabsorbed and released into the wild through normal bodily functions.
    The pain is pretty good, but not 10/10 IMHO. I've had a lot worse.
    As a chef, you are probably not helping your body by being on your feet for long periods.

    • I've just turned 27 and have been a chef ever since highschool and have consumed everything under the moon. And ive started eating relatively healthy again because i've gained 20kilos this year and have recently lost 10. So it just sounded strange that i have gout

    • This. My boss is 60 and pretty fit, plays golf etc. and he has a terrible attack of gout a couple of weeks ago which started in one foot and then also moved to the other. Could barely walk, and worked from home after taking sick leave.

      OP needs to get on to it with a good GP and start managing it now, particularly as he's only young.

    • +1

      You dont need an MRI for the diagnosis of gout… it's clinical + urate levels + joint aspirate if atypical history or atypical joint (i.e. not first MTP)
      See your doctor. Make sure your doctor rules out septic arthritis.
      Then indomethacin (or any other similarly effective NSAID) / prednisolone / cholcicine / or sometimes local steroid injection. Your doctor should explain the best treatment modality.
      Then after the acute event, think about long term urate lowering therapy requirements i.e. allopurinol to prevent attacks. I'm sure your doctor will walk you through this too.

      • Even a joint aspirate might not pick it up. Mine didn't and it was quite painful.

    • +2

      Blood test will indicate uric acid.
      MRI will show joint problems

      Yeah nah

    • +1

      doesnt something like allopurinol or sodium bicarb (baking soda) solve that issue?

    • +1

      Blood test will indicate uric acid.

      Uric acid levels can drop to normal level during attack for some people. Conversely many people have high uric acid levels without having gout.

      MRI will show joint problems.

      No not the test of choice. (Unless things have changed recently)

  • Don't tomatoes trigger gout?

    • duno

    • father in law gets gout, he said tomatoes trigger his and he loves them and still eats them. Go figure.

    • It can, any purine rich foods can

  • +2

    Get your blood tested to check if you have High Uric Acid. If you have Gout avoid red meat, beer and high purine food + eat everything in moderation. If you can control your diet and know what triggers it normally doesn't happen too often, but most people go on Allopurinol for life to avoid future flares

    • +1

      will do! thanks for the suggestion

  • +1

    do u eat alot of seafood, the shell type (prawns, lobsters)
    that brings it on too for some

    • so we had a christmas gathering and i was the one that catered for family. We had chicken, sausages, beef, squid, lamb and a few sides. These are foods that arent special, I eat these occasionally and never had any gout??

      • usually a combination of things but once u get it shell fish brings it back in. and red meat and beer

  • Gout hurts like fark and can last days…
    Dr will give you some good stuff, cant think of what the stuff i was given is, but took 2 days to clear up

    • ye this is my 4th day and its slowly reducing in size and pain. i can definitely stand but not flex my ankle much. Docs has given me gout meds and anti inflammation pills.

  • If really bad ask your Doctor about getting a cortisone shot.

    Worked wonders for a family member.

    • heard these injections makes your tendons and bones brittle. I'll steer clear unless i absolutely need it

  • Don’t eat anything high in Uric acid like shellfish.

    Apple cider vinegar, lemon juice, and turmeric are each frequently recommended anecdotally for gout. Together, they make a beverage and remedy. Take in small quantities

    Tastes like sh!t. Must be good for you

  • So what did the GP suggest? Any follow up bloods? What's your uric acid?
    I am not quite sure what exactly are you asking here? There's no one size fits all approach with gout. I know someone who cannot bear the weight of their pyjamas on their feet during a flare up. What works for someone may not work for you. It depends on the severity of it and your own bio markers. If you need specific pointers for a general discussion, then you will need to provide more detail. In all likelihood gout is controlled by allopurinol and colchicine, if control via diet fails. Dietary changes are the most effective way to reduce risk of gout. Obviously not medical advice.

    • im seeing him tomorrow for an update.
      What I'm asking is people's experience with gout. I've heard gout before but never thought i'd get gout myself because i eat everything as im a chef and have never experienced such a thing.

      • +2

        but never thought i'd get gout myself because i eat everything

        Sorry to say, but this is the epitome of ignorance. It is almost like saying, I eat sugar all the time, I wonder how it increased my chances of diabetes. Gout is serious (and might I add, debilitating) shit. Now that you have it, you will most likely deal with it for a long time. I reckon you should start reading more about it - what it is, what exactly causes it and what you can do to avoid future flare ups. An Eastern saying is, “When diet is wrong, medicine is of no use; When diet is correct, medicine is of no need.”

        Another word of advice, gout is often misdiagnosed (either way). If your uric acid level's aren't high enough (and you have eliminated sea food) and the GP insists you have gout - get a second opinion. I have seen cuboid syndrome and peroneal tendonitis (since you are a chef and am assuming you are on your feet mostly) misdiagnosed as gout. Occasionally gout is also an indicator of kidney health - a competent GP would include getting tests for your kidney as well, if not, you should discuss this aspect as well. HTH

      • its not like an allergy or a reaction to certain foods

      • +5

        I have suffered with gout since my early twenties. I have been through hell with it. Old mate above being pendantic above saying “it couldn’t be 10/10 pain” is just being an ass. It can most definitely reach 10/10.
        I have permanent damage to my knee because of the poor way it was handled by doctors. If you can find a doctor who specialises in arthritic diseases like gout. I can’t tell you how long I suffered because a doctor told me to stay away from sardines and tomatoes (I hardly eat either) and take nurofen, I thought that’s all there was to it.
        Until I had to get taken to hospital after being bedridden for almost 2 weeks with 10/10 pain and got to see a proper specialist, I never got the proper care I needed.

        Anyway the best way to treat it is with prednisone, hands down the quickest most effective solution, clears it up in a day. Colchicine is another one, although I found it doesn’t really work for me. Unfortunately once you have had gout once, you are going to get it again… for long term you need to take allopurinol daily if your getting gout more and more often.

        I feel for you mate, it is a terrible, terrible thing to have.

        • +2

          Have you tried minimizing sugar intake and have no sugar days in a week? Note those fruits that usually sweet is counted as well.

  • +1

    https://pubmed.ncbi.nlm.nih.gov/30485934/

    Conclusion: The risk of hyperuricemia and gout is positively correlated with the intake of red meat, seafoods, alcohol or fructose, and negatively with dairy products or soy foods. High-purine vegetables showed no association with hyperuricemia, but negative association with gout. Coffee intake is negatively associated with gout risk, whereas it may be associated with increased hyperuricemia risk in women but decreased risk in men.

    as previously suggested, see a gp

  • +2

    See your doctor.

    Allopurinol works as well as a change in Diet.

    For me less Red Meat, Port and Red Wine.

    Everyone is different, as are the triggers.

    • +2

      My trigger is dehydration. I am a chronic non-consumer of fluids, even on stinking hot and humid days. I just cant bring myself to drink water.

      It was funny when the Dr told me all the things not to eat and I don't eat any of them. I don't eat red meat, shellfish, any alcohol or overly fatty foods. He said the only thing left was "so, do you drink enough water?" and i laughed and said, I barely drink anything… since I have started forcing myself to drink water more regularly, I have not had a gout incident since.

      • hmmm how old were you when gout started?

      • +4

        Here's an easy reminder, every time you see a "whose fault is it" post on ozb, have a gulp.

    • fuxkkkkkk, i love red meat esp wagyu. so long frens. I think I'll try and eat red meat one more time just to see if i have gout. Probably wagyu from KOBE wagyu in Sydney. (profanity) amazing this place.

    • +2

      Yes. You need a food diary.
      Certain things that trigger for others May not trigger for you but there are some higher risk food and drinks.
      And even then they change with age/time (unfortunately , thevrange of suspects only increases)

      Eg. At first it was Beer.
      Then Lamb. Innards. Anchovies.
      Then later, too much red wine. Peanuts. Sardines. Mackerel.

      Eventually you'll be left with just cardboard and water.

  • Sounds like you have gout.

    You should go get a proper diagnosis with a blood test to see if your uric acid levels are high. If your gout flare up is left untreated it could take a few weeks to a month for it to go back to normal on its own versus a few days using prescription anti inflammatories like colgout (colchicine) or prednisolone. Neurofen only helps a little. Get a compression sock as it helps with the circulation in your foot and reduces the swelling. Keep it raised and ice it.

    For prevention, just don't go hard on purine rich foods like beers, seafoods or gravy. Tart cherry is known to lower the uric acid levels so you could take something like these when you plan on drinking. The tart cherry tablets are good too when you have have a gout flare as it may even shorten the time.

    Treat it when you feel the early signs. Prescription of prednisolone will get you walking again in a day or so without having to use crutches.

    • Thanks for the advice. merry christmas

  • If you drink alcohol consider stopping for a while or cutting back. I think over consumption of alcohol can make it harder to deal with the uric acid and can make the accumulation worse. Easy to over indulge at this time of year.

    • +2

      I dont drink often. Last time i drank alcohol was before lockdown so beginning of the year and I dont see myself drinking alcohol as it holds no benefit for me.

      • That’s good. What a bummer to have gout if that’s what you have. I’ve heard it’s really painful.

  • Gouts a western diet thing & it’s painful as it is random on when it strikes you low. A GP will quickly rule out the alternatives like blood clots or kidneys with blood tests

    In my case care, pills and 2 weeks and I’m right again. Alas not everyone is as lucky

    Be aware that early treatment means a faster recovery as often it’s not always so acute and you just try living with it and waiting for it to go away is not the right solution for gout.

    • +1

      Gouts a western diet thing

      I know of a number of Thai men who get gout, and they don't eat any western food.

      • 13.3% of Chinese high in uric acid .
        1.1% of Chinese already show the symptoms of gout.
        60% of patients are 18-35 years old.

  • Urine test collected in 24 hrs can also indicate if it’s gout.

  • I use Lengout, when I feel the tingle in my foot a day before I pop a pill and the pain is still there but bearable! Have to slap it down fast

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