Gout and the Active Person

UPDATE - The Gout is Under Control

2011-03-18T08:52:00.000+01:00

Since the move and the career change, I've really been slacking on updating this blog. Thankfully, however, there really hasn't been much to report. I haven't had a gout attack now for over six months! It's been a long road to recovery, but it's been worth it. I have even dropped my dose of daily Allopurinol from 600mg to 300mg. I still am having periodic bloodwork done in order to check my uric acid levels (and other important indicators). My last results came back amazingly good - uric acid, kidney functions, liver function, cholesterol - all of it - right in the normal range where they should be.

When I get some free time, I want to succintly write up what I've gone through to get my gout under control. I received a lot of good advice from other gout sufferers along with taking a few things, such as my diet and strict no alcohol rule, to the extreme - and it has worked! I think some people suffering with gout make things way, way too complicated. It is my feeling that you can control your gout with a few simple rules, but simple rules that you absolutely must adhere to. Just recently I was on a ski trip with a guy who asked me why I wasn't drinking any beer. I told him I had gout and that I stayed away from all booze now. He proceeded to tell me how he had really bad gout and how crippling and painful it was - while he chugged down a beer. I asked him what his diet was like, if he was taking any drugs for his gout, etc.... He was actively doing nothing to help himself or his gout and he really didn't seem interested in hearing my story. Fair enough. I was like that at one time. It took my gout getting so bad that it was ruining my life for me to take extreme action (and by God was it worth it!).

Just recently, I've started experimenting with a new diet, one I have read a lot about, and one that I know has worked great for some people I know. Now, this may sound counter-intuitive and some may ask why I would want to screw with my diet as my gout is coming under control. Again, I have read, and read, and read some more about this diet, and have talked with people who swear by it. It's the Paleo Diet, a diet where lean cuts of meat along with fresh veggies, fruit, and some nuts, rule. This diet is more about what you don't eat than what you do eat. The Paleo Diet requires that you stop eating all gluten, grains, bread pasta, bad starches, and most importantly, sugar. Any sugar you get should only come from natural sources (i.e. fruit). The cause of most autoimmune diseases (along with other afflictions) has been linked to out-of-whack insulin levels and inflammation in the body. The Paleo Diet looks to normalize these levels and greatly reduce inflammation.

My wife and I have been following the Paleo way of eating for about six weeks now - and we both feel GREAT. I've lost over 15 pounds (without really trying), have more energy than I've had in years, feel stronger, healthier, more vibrant, all gut issues have disappeared, and I've had not a twinge from gout.

Here is a great site that explains exactly what the Paleo Diet is: http://robbwolf.com/faq/

"Yes, but I've been taught my whole life that red meat will kill me and that it's the cause of gout"
Read This: http://www.rawpaleoforum.com/carnivorous-zero-carb-approach/gout-from-an-evolutionary-perspective/

Just do a Google search for 'Gout and Paleo Diet' and you'll find enough reading to keep you busy for weeks! What it all boils down to is that if a strict Paleo Diet is followed and insulin spikes are kept to a minimum, the Paleo Diet will help greatly with alleviating gout. So far it's worked for me and my bloodwork numbers confirm this. I will be the first to report if I start getting attacks again because of this diet. If you look at this as with a Cost/Benefit bent, the benefits so far have been amazing and there has been no cost to my health. If that cost eventually becomes more gout attacks, I will definitely have to modify my diet. However, from what I've read, I should be just fine - and that makes me happy!

New job, new life, new tasks = limited updates right now

2010-11-17T17:23:00.000+01:00

One of these days - I promise - I will update this blog with newer and better information. I have a lot to add, some stuff to change, and some new stories to share. I just haven't had enough time lately to do what I need to with this site. Well, I should say, I'm trying to focus on one thing right now and that is to get my burgeoning business off of the ground. One thing that I have realized since quitting my 9-5 job is that I have always had a tendency to take on way more than I should. It was driving me batty and wasn't doing too much for me health wise either. With this new venture, I'm working on getting to a point where I'll only have to put in eight hours a day and not the 12 to 15 I am putting in now. I really am enjoying what I'm doing, however, but there are other things I would like to spend some time on - like this blog. It will probably take me two to three months to get to a point of comfort.

Two things regarding my gout that I would like to report. My last attack, although very painful, was much shorter-lived than attacks in the past have been. This is definitely a good thing! Also, I did ski two days last week in the Austrian Alps. It had been over a year since I'd been on skis, and damn did it feel good! I still have some knee pain, but that has more to do with cartilage damage (perhaps from numerous gout attacks in my knees) than acute gout. I don't think this will be stopping me, though. I felt pretty good on the slopes and can't wait to go back in a couple of weeks!

Until next time.........

It was a good run..........

2010-10-27T11:53:00.000+02:00

Well, it was a good run. Three whole months without a gout attack. I was beginning to think that my body had rid itself of the last of the UA crystals that were residing in my joints and that life would be hunky-dory and 'normal' (what is that?) again. Alas, it was too good to be true. Yesterday I woke up with a sore big toe. It was annoying, but nothing of serious concern, that is, until the afternoon. Out of nowhere, the damn thing began to throb, turn red and hot, and swell like Violet after chewing the experimental gum in Willy Wonka.

Quick run down: I've been on 600mg/day of Allopurinol for almost one year with SUA readings below 4.9 for over 10 months. No alcohol, no red meat (hardly any meat) - eat very healthy. Gout sufferer for 15+ years with attacks in multiple joints. 36 years old.

Within the past month, I've started to exercise quite regularly and pretty intensely. I've been mixing things up between yoga, mountain biking, hiking, weights, and cardio on different machines. I've lost about 10 pounds over this time and have lost over an inch on my waist. I've been pushing myself hard, but still trying not to overdo it.

I know that exercise and rapid weight loss can cause attacks. I was at a point, however, where I figured my body was pretty-well cleansed out. This latest attack has proved otherwise. The pain I experienced last night reminded me why I have to stay diligent. Holy jumping up and down Martha did it hurt (and still does). On one hand, I'm disappointed. I'm making such good progress, getting in great shape again, and have been feeling healthier than I have in years and years. The brakes have been slammed on that for a few days at least.

On the other hand, perhaps this forcing of the issue (exposing deep-seeded crystal deposits) is a good thing. It will help me get rid of the shit that is in my body faster. If the crystals are there, they eventually would have reared their ugly head anyway - yes?

Crap, I'm trying to laugh this pain off, but it hurts. I wish I could just sit here with a bottle Bushmills or a Bob Marley-sized joint, work, and forget the pain. I'm actually more anxious over the fact that I'm missing out on a few days of exercise. When I start getting this way, at least I know that I'm once again dedicated to getting in better shape.

So, yeah, for those who are taking Allopurinol or any other gout drug, realize that it will take time. Try not to get too discouraged and stay on the path you're on.

15 Oct 2010 - Getting Settled in to the New Life

2010-10-15T14:35:00.000+02:00

I've made some big changes in my life recently and just haven't had any time to post. I now am writing from a new house in a new village and find myself with a new career. The settling in phase for the new home has just about passed, but I'm still getting used to working from home and being my own boss. I must say, however, that so far I really am enjoying it. My stress levels have decreased dramatically over the past two weeks and I'm feeling healthier than ever. It may be too early to tell, but I could be verifiable proof that office work can be hazzardous to your health!

As far as my gout, there have been no new attacks and nary a twinge since I stopped taking that evil, evil drug Lisinopril. In fact, I have been more active over the past two weeks than I have in well over a year. I'm not half-assing things, either. Just a couple of days ago, I made a 12 mile hike up the Schlegeis Glacier Valley in Austria to shoot photos. The day before that, I hiked down and on to and up the Pasterze Glacier in Hohe Tauern National Park in Austria. Two days before that, I went for a fun and somewhat challenging bike ride. I've even been working out, doing cardio and lifting some weights. Hell, the wife and I even did a bit of Yoga at 5:30 this morning before she left for work. It was just what I needed to stretch my overly-sore muscles!

I know I haven't updated the 'daily log' in quite some time, and I'm not sure if I will for much longer. If things keep going the way they are, there really is no need for it. I don't plan on going back to drinking beer or eating unhealthy food. My plan is to continue taking my Allipurinol and to continue to exercise as much as I can. I will also continue to severly limit my red meat consumption and not drink any beer (well, maybe one Rogue Dead Guy when I visit Oregon!). I'm almost positive that red meat and alcohol, especially beer, are my gout triggers.

If I continue to stay gout free and the path I'm on keeps working, I will update this site detailing what I have done over the past year to bring myself from gout hell back to a relatively healthy 36 year old who is once again participating in the activities he loves. I'll give it a month or two, but so far, things are looking good!

Stopping for a rest to look back on what I hiked up. Tell me that doesn't look painful for a gout sufferer! I began at the other side of the lake (Schlegeis Glacier Valley, Austria 13 Oct '10)

On the Pasterze Glacier, Austria. It was a helluva hike down and to the ice and then back up to the road.

22 Sept 2010 - My Experiences with Lisinopril and Gout

2010-09-22T13:53:00.000+02:00

Lisinopril belongs to a group of drugs known as ACE inhibitors. These drugs are used to treat hypertension and a number of other maladies. I was put on Lisinopril approximately three weeks after my blood pressure skyrocketed to 177/99 while I was at my local clinic, causing me to collapse in to a chair. This incident was brought on by a huge sleep deficit and extremely high level of stress. After about thirty minutes, my blood pressure did fall back to 139/92 (or so), which was still above my average BP over the last three months of 127/85. The doctor that insisted that I go on Lisinopril was not my regular doctor and in fact, was quite condescending, failing to listen to a word I said to him. On my medical records, it showed that at one point last year I turned down a prescription for Lisinopril. He chastised me for this, essentially guilting me in to trying it again while I was in a much-weakened state. I tried to tell him that I HAD taken Lisinopril before and found the side effects to be unbearable. He told me it was a medicine with little to no side effects. Buuullll Shhhit!
This past Saturday, after only 14 days, I quit taking the drug. I had been suffering horrendous stomach aches, headaches, joint pain, and general nausea the entire time I had been on Lisinopril. To top things off, my left ankle began to swell and became very, very painful. While eating dinner with my wife that evening, I nearly passed out numerous times while sitting at our table. I was hanging on to consciousness by a thin thread. It was the sickest I can ever remember feeling. I wanted to die.

All of the side effects from this drug were horrible. The swelling of my left ankle, although not the worst effect from the drug (that would be the head and stomach aches), was the most puzzling. The pain started out slowly, not unlike most gout attacks. However, there was no forewarning of this 'attack'. There was no twinge, no redness, no tenderness. It just began to hurt, and eventually, swell to the size of a softball. Even in this overinflated state, there was no redness at all and I didn't experience that warm, burning feeling that often accompanies a gout attack. The pain, though, was very familiar and felt exactly like an attack from gout. I'm sure what I experienced was definitely gout-related, but was it truly a gout attack? After some reading, I did find that Lisinopril 'protects' the kidneys, whatever this means. Does this limit the excretion of uric acid, perhaps, prompting an attack of gout? I'll have to do more research on this when I'm feeling a bit better. My head still isn't feeling quite right.

Two days ago I was able to see my regular physician. I told him what had happened and what was going on. He was glad that I took myself off of the drug and was surprised to hear that it was even prescribed to me. For now, I won't be taking any blood pressure drugs and will work on keeping it at normal levels naturally. Although I've always eaten pretty healthy, I've made two more changes to my diet that are sure to help - no more caffeine, which means no more soda of any kind, and no more added salt to anything. So far, three days in to cutting these things out, I don't really miss them at all. My ankle is still a bit swollen but is much better than it was three days ago. Although there still is some moderate pain, I can walk normally again.

I only have 4 more days left at my job. We move to our new house next Friday. I'm really looking forward to starting this new life and being able to focus on my health a lot more. Working from home, not having to worry about time off or when I can or can't go see a doctor, being able to rest gout-affected joints, being able to eat even healthier, not having to deal with incompetent boobs for project managers, not having to use my measly allotted vacation time for health issues, not stressing about any of this - it will be a breath of fresh air!

09 Sept 2010 - I haven't forgotten about this site!

2010-09-09T13:00:00.000+02:00

I've just been unbelievably busy the past month. Between travel and work and travel for work, there hasn't been much free time. I do have some good news, however - I will be embarking on a new career and working from home starting the 1st of October. I'm really looking forward to this. However, this does involve a short move, just one more thing to add to the pile right now. It will all be worth it, however. As far as my gout, it is still staying at bay with a few slight twinges here and there. I just haven't been able to take that good of care of myself with everything that has been going on, but I've been doing my best. I have had a few other medical issues crop up and will touch upon these later. I'm ensured the Lisinopril I've been given to bring my blood pressure down will not affect my gout. Of course, there are other side effects to worry about such as drowsiness and mild headaches and a general overall groggy feeling. Hopefully this will not be a drug I will be on long. The increased stress in my life right now did elevate my blood pressure a bit, though, prompting my doctor to put me on the drug for the time being.

That's all I have time for now. I will try to update with a bit more information later.

27 Aug 2010 - Traveling is hard on one's gout

2010-08-27T17:38:00.000+02:00

Finally, I've found a bit of free time to sit down at a computer, relax, and give some thought to what I've done over the past two weeks. First, let me start by saying that I am freaking exhausted! These last two weeks have had me constantly on the go, leaving my reserve tanks nearly empty. It has been a great trip, though, and I've thouroughly enjoyed it. I have put my poor body through the ringer, however, and frankly, I'm surprised that I'm still walking. Besides some left ankle soreness that has had me hobbling for a few days, my body has held up remarkably well despite what I've thrown at it.

Horribly unhealthy American restaurant food. Completely changing my diet while I've been away from home. Getting an average of 3 to 4 hours of good sleep a night. Walking for who knows how long each day and being on my feet way more than I'm used to. Being extremely stressed regarding mine and my wife's employment future. The boring-as-hell work conference in Chicago. Stressing over upcoming trips when we get back home to Germany. Having no time to let my body heal.

All of these things combined, to put it simply, have kicked my ass. Don't get me wrong - I've thouroughly enjoyed my trip, but I'm here to write about how the trip has affected my gout health and not to write a cheery Rick Steeves diatribe on how charming I found downtown Minneapolis (which I did, by the way).

If anyone looks over my gout tracker spreadsheet, they will notice that I have included a few entries under 'gout pain' meaning that I did experience some discomfort from gout while on the trip. Although I would not label these as full-blown attacks, they did affect me enough that I became concerned. Actually, I became concerned enough at one point that I visited in a clinic in suburban Minneapolis to procure some prednisone to knock the attack back. Luckily, this worked for the most part. I still am experiencing some pain and discomfort in my left ankle, but I think the threat of a full-fledged attack has passed.

Coming back to the US has been an eye-opener for me. The amount of bad food that is so easily available astounds me. The lack of good, healthy food one can find while out and about is amazingly minimal. Although I'm not watching my diet as closely as I have been over the past year, eating during this trip was like turning the volume up from 0 to 12 when I was only looking to crank it up to 3. But, when you boil it all down, I did choose to eat what I ate and I paid for it. I was out of rhythm, I didn't want to inconvenience others by making them eat my specialized diet, and I didn't want to starve so I ate what was available. I'm just looking forward to getting home where I can control my diet much, much better - and be able to drive a mile down a road and not see 76 fast food restaurants! * I must note that my in-laws did a great job of making good, healthy food available for me when we were at their house. I love them for that!

So, what did I learn on this trip about my gout? Basically, shove enough shit food down your throat while not letting your body rest is not a good idea when you are a gout sufferer! I also learned that Allopurinol is an amazing drug and really does work for me. Before being on Allopurinol, just one pastrami sandwich would have sent my gout spiraling out of control. With Allopurinol (and a maintained low Uric Acid level), I've eaten the average unhealthy American diet for two weeks and have come out relatively unscathed.

Alright, time to get to the airport and begin our 17 hour travel odessey back to Germany!

13 Aug 2010 - Latest Blood Test Results Back - and they are good!

2010-08-13T12:41:00.002+02:00

I just got back from the clinic and am pleased to report that my Uric Acid level is down to 3.3mg/dl. This is actually considered 'low' since a normal range is usually between 3.5 and 6.5, at least by the doctor's scale (gouties know it's a MUST to keep UA levels below 6.0!). I was really surprised to see a reading of 3.3, mainly because I have slowly started eating meat again, even some red meat, and even indulged in some wine twice (and a glass of Chimay beer). I've also been working out a lot more lately which does tend to elevate UA readings a bit. Now, I do know that this monthly blood test I get is only a snapshot in time and doesn't represent a true average of my UA levels, but it still is great to see it so low. The night before the test I even ate a couple of bison burgers which I thought would elicit some sort of spike.

This result tells me a couple of things. One, it is probably entirely true that diet alone doesn't have a whole heck of a lot to do with gout. I do have my suspected food triggers, which I believe to be beer and seafood, but overall, as has been stated on Gout-Pal.com over and over, your overall diet really won't make a huge difference in treating your gout. Now, with that said, I still think it is VERY important to cut out suspected gout causing foods when you first begin treating your gout. Let the drugs do the work, you helping them along by not aggravating your gout with things such as alcohol, shellfish, tuna, etc... I really think me being so strict with my diet helped my recovery immensely! Once you've been gout-free for six months or so and you have kept your UA levels below 6.0mg/dl, eat and drink what you want - in moderation!

Two, I probably should begin lowering my daily dose of Allopurinol. It's done it's job in getting my UA WAY down (maybe too low?). My liver enzymes are still slightly elevated, and this is probably due to me taking 600mg of Allo per day. I'll worry about this when I get back from my trip to the States, though.

Anyway, I am feeling a bit better since my last post. I'm still tired, stressed out and a bit moody, but these past few weeks have been stressful as hell. I'm really looking forward to getting back to the US to see some family and to do a bit of relaxing. The stuff I'm stressed about will work itself out one way or another. Time to let it go a bit. My body is still a bit achey, too, however. This is a bit discouraging. I'm still limping around slightly, but it is not because of gout. My joints just.....hurt. And, they are odd pains that spring up in one joint, subside, then spring up in another joint. For instance, right now, my left knee and left big toe are throbbing and my right ankle hurts. And, I'm just sitting here typing. Soon, other joints will start feeling the same while the ones that were just hurting will feel fine again. It's much different pain from gout, though. Perhaps my body still settling in to this new phase in it's evolution (revolution?).

Alright, so I'm out of here for two weeks and probably won't be able to post at all while I'm away. To whoever reads this blog and my ramblings, good health to you and we'll see you when I return!

10 August 2010 - Not feeling too well

2010-08-10T10:50:00.000+02:00

The last few days have been pretty dismal. I've been feeling under the weather and it's hard to pinpoint what has caused this. Since not much has changed in my diet or overall daily lifestyle, the only thing I can think of is the general lack of good sleep I've had over the past week. Even with a few solid nights of sleep under my belt now, I'm still feeling completely worn down, my body is achey and I've had a fairly severe headache the past two days. I guess some of this might be related to stress, too, as I have had a lot on my mind the past few weeks. All I can do now is try to stay hydrated, try to get some decent sleep, and try to relax a bit (which will be tough) and hope that I'm feeling better by the end of the week. Although I haven't been feeling particularly gouty, my joints do hurt and I'm hobbling around a bit. This is more of a general soreness and is affecting joints pretty much all over my body. Even my back is hurting me right now.

Starting this Friday after work, we will be attending a wedding a couple of hours from our home in Germany. Then, on Sunday morning, we fly to Chicago for a work conference. After that, it's off to Minnesota to spend some time with family. All in all, this will be two full weeks of being on the go. Mixed in with all this is me trying to plan for my future. I'm waiting on word from a few people to help me decide what direction I will be taking next month. This has been the main catalyst of my current stress. I hate being in limbo about things, especially things of this nature that are so big. I'm sure it will all work out, but not knowing and just waiting day after day for word on anything from anyone is getting tiresome.

I won't be able to update the blog much in the next two weeks. I'll try if I can, but I doubt I'll find much extra time to hop online while we are away from home.

02 August 2010 - Hiking Does the Body Good!

2010-08-02T10:29:00.000+02:00

This past weekend was spent in Garmisch, Germany, camping, hiking and taking a lot of photos. For the most part, my body held up quite nicely, even during some of the tougher hikes. I had planned on taking it easy to start things off, but our first hike ended up being quite a bit more robust than I originally thought it would be. A description of the Hollentalklamm (Hells Valley Gorge) that I found on the internets described it as a mellow, one kilometer walk through the woods. Yes, this is true for the most part, but this description turned out to be for the approach to the gorge, not for the actual hike through the gorge itself (German, heck, European websites, are notoriously bad at providing accurate information for a lot of things I'm interested in). The hike through the actual klamm was pretty intense, but also cool as hell. My knees and achilles were screaming at me for the first 45 minutes or so, but quickly loosened up. That loosness actually remained for the rest of the weekend and I didn't experience much pain in either my knees or achilles on the hikes the following days.

It was about 11 months ago, in the Garmisch area, when my world came crumbling down around me and I realized that my body was truly broken. At the time, I was hurting so badly, but was still being so pig-headed about it that I was attempting very difficult hikes in the Alps. I almost didn't make it down the Jagersteig, a very steep, switchback-laden trail that descends down from the base of the Alpspitze to the Garmisch valley below. It was after this hike that I had to stop all physical activity and that my battle with dealing with my gout began. This was the start of really bad time for me, one where I became very depressed, a time when I began dealing with constant off-the-chart pain from gout attacks in different joints. I never thought I would be able to hike, ski, bike or even walk normally again. I thought my life was over.

Although I'm not back to being 100 percent healed, it was amazing to get back up in to those mountains under my own power and to be relatively pain-free. I've still got a long way to go, but thinking back to what my thought process was almost a year ago compared to what it is now is amazing to me. I've gone from thinking I'd be in a wheel chair to planning even more hikes and adventures in the mountains I love. At this rate of improvement, I'm fairly certain that I'll even be able to do some downhill skiing this coming winter. I've still got a few months of training to go to get my body back in decent skiing shape, but if I can remain gout-free, this shouldn't be too hard to accomplish.

I really have to attribute most of my recovery to my wife, Dawn. She has stuck by me through this whole ordeal, been supportive when I needed support, and has encouraged me when I needed encouraging. The Gout-Pal website has also been huge in my recovery, providing a platform to talk with other gout sufferers and gleen information and knowledge from them when I've needed it. It has been, and still is, an immensely valuable resource. Thank you, Keith, for creating the Gout-Pal site!

29 July 2010 - Still pluggin' along...

2010-07-29T09:36:00.001+02:00

I thought I was going to have more time for a post this morning, but got a bit slammed with work. Basically, I've still been able to do quite a lot of exercise and am still feeling gout-free. My body is sore, though! Slow and easy, that's the approach I'm taking. I'm giving my body time to recover when it needs it and trying to be smart about getting myself back in shape. With that said, I have been pushing myself a bit also. Longer hikes, longer bike rides, being a bit more relaxed with my diet, and I've even gone to the gym a time or two to lift some light weights. This weekend, my wife and I, along with the dog, will be doing some moderate hiking in the German Alps. So far, so good. What I haven't done, though, is go in to get this months UA test. I just haven't had the time. I will definitely do this next week, though. I'm curious to see how my UA level is reacting to this change in my lifestyle. If I find it is elevated somewhat, I will definitely scale things back a bit. If it's still holding between 5mg/dl-6mg/dl, I'll keep on keeping on.....

22 July 2010 - Activity ramp up, still feeling good

2010-07-22T16:29:00.000+02:00

I thought I'd make a post while sitting in my blazing hot office waiting for the day to end. Only 15 more minutes.....

The past two nights I've gotten out on the bike for some decent rides. The first night, my knees were killing me, and did so for almost the entire ride. Towards the end of the ride, they did begin to loosen up, but any pedaling uphill caused quite a bit of discomfort. Last night, my brother and I attacked the same route as the previous evening and got through it about five minutes quicker. Again, at the beginning of the ride, my knees felt horrible. About ten minutes in, however, they actually began to feel okay. Not perfect, but at least thoughts weren't running through my head to abandon the ride like the night before. We even managed to tackle a couple of extra hills after we completed the 25-30 minute loop that I normally ride. I'm still not able to crank up the hills as I once did and must use almost my lowest gear to climb while sitting down. Standing and pedaling in a high gear almost left me in tears when I tried it.

I plan to continue riding and hope that my knees do start to feel better with time. If they don't start feeling any better, I may have to go in for another MRI or at least x-rays to see what the cartilage is like in there. I'm hoping, however, that by strengthening my quad muscles, my patella will be pulled back to a more normal position, aligned properly with the bones and the groove it's supposed to sit in. According to my orthopedic doc, this could have been what was causing me pain at the end of the ski season two years ago. I'll monitor it closely.

Today I did wake up and felt pretty darn good physically. My knees and ankles weren't nearly as sore as they have been over the past few weeks. With continued exercise, I'm hoping these little kinks work themselves out. Only time will tell if any permanent damage from gout has been done to these areas.

I do have a theory regarding my past history of knee problems and pain in my ankles but will have to keep it brief for now (only five mintues left and I can escape this hellaciously hot office....). In the past, my body was always going between horrible pain and brief moments of feeling okay. The gout really ended up wearing my body down and never allowed even minor injuries to heal. There was always inflamation to deal with and I was never able to fully recover nor rehab any injuries. Now, however, if I can continue this gout-free streak that I currently have going, I will be able to continue getting exercise, strengthening my joints and muscles, and this can only help.

Time to go! Thank God......

20 July 2010 - Vacation in Italy - a true test of my progress with gout

2010-07-20T07:46:00.001+02:00

I had a fantastic time in Italy, spending six nights along the Italian Riviera in the Cinque Terre area. It was HOT and HUMID, but quick dips in the Mediterranean made the weather somewhat tolerable. This trip was a true test of how far my battle with gout has progressed. I didn't go crazy while down there, but did get far more exercise during this time than probably the entire previous year combined and sampled some foods I haven't tasted for far too long. The Cinque Terre coastline is extremely rugged making for difficult and exhausting walks and hikes even in the five towns that comprise the area. Once outside those villages, the walking and hiking becomes even more extreme. And walk we did. Each morning I woke up more sore than I have been in ages, but I was able to overcome this by starting out slowly each day, working out the kinks and loosening the muscles before embarking on anything too rigorous. I think 'they' call this getting old! I'm just happy to report that none of the pains I experienced felt anything like gout, just overuse of underutilized joints and muscles.

Again, I didn't go bonkers with my diet while on holiday either. I did sample a calamari ring or two, had a few pieces of salami, and even sampled a hamburger while in Levanto (something we usually do when we travel - try a burger in each place we go to see what that place's take on it is - NOT good in Levanto!). I also did have a few glasses of Chianti and some of the local white wine, the first alcohol I've had in over 8 months. Although I do plan on re-introducing meat back in to my diet slowly, the alcohol will not become a normal thing for me. This was a rare occurrence where I felt compelled to try what I've heard so many talk about (and it was good!).

After Cinque Terre, we spent two night in the Brenner Pass area on the Italian side of the border. It was nice to get out of the stifling heat along the coast and to relax in this beautiful area. We did do a bit more hiking while there, but nothing too extreme.

Usually after a trip like this, I would expect to have been stricken with an attack of gout by now. So far, however, not a twinge to be felt in any of my joints. In fact, I feel more healthy and alive and better than I have in the last year after this trip. As I posted previously after my last bad attack, I do feel different now. My joints feel cleaner, I don't feel the impending twinges signaling large or even small attacks occurring which can only mean that the Allopurinol and my strict diet have really been working to cleanse my body. Am I out of the woods concerning my gout? I highly, highly doubt it. I do think that the worst is over, but I will need to be careful and vigilant with my diet and my lifestyle and will have to make sure I do not lapse back in to any bad habits. I think this is the key. I can't just proclaim, "I'm cured!" and resume living life as if gout was never a concern for me. Keep up a good and healthy diet, continue taking the 600mg of Allopurinol along with 220mg of Naproxen per day, continue getting regular exercise, and always remember that I am still living with the disease of gout and always will be.

I'm still not sure about skiing this coming winter, but things are looking better. If nothing else, I at least hope I'll be able to get out to do some touring. Downhill may have to wait, but at the rate I'm going, I may be able to go back to enjoying the mountains and the snow sooner than I think.

* a picture I took near Brenner Pass in Italy during an amazing lightning show last Saturday night:

07 July 2010 - Still gout free but body hurting a bit

2010-07-07T12:22:00.000+02:00

Streets and sidewalks tiled with oddly shaped cobblestones, awkwardly tilted sidewalks, dodging bikes and cars coming from every direction, climbing five flights of narrow and crooked stairs to the apartment - these are all potential pitfalls for a gout suffer in Amsterdam. I won't lie. By the end of each day, my body hurt. It wasn't from gout, however, but more from having not experienced that type of prolonged walking for months and months. My left ankle, both achilles, both knees - particularly the left one, and my calves all suffered from the hours and hours of walking around the city. The muscle soreness I could deal with fairly well. The ankles and the knees? Those were giving me some real problems. I don't know if these pains are caused by damage from gout or just from beating the hell out of my body most of my life. Probably a bit of both. Whatever the cause, these aren't slight annoyances or something that I would term trifling, but are pretty serious and pretty damn painful. With time and more exercise, I'm hoping these things eventually will work themselves out.

Yesterday afternoon I was able to climb on my mountain bike for the first time in almost a year and go for a short ride with my brother. I wanted to see how my knees and ankles would feel while pedaling in various conditions. It is good to know that I can still bomb a rough downhill section of single track quite well, but even the most gradual of uphill climbs put a lot of strain on my left knee and caused a lot of pain. On the gout front, I was happy to find that I had no pain in my hands, wrists or elbows caused by riding. This is great! My ankles also faired quite well. As far as I can tell, I didn't experience any gout-type pain from biking. I'm very happy to report this. It's just the other aches and pains that are giving me problems now.

As anyone who has suffered from gout and who is now in the process of controlling it knows, the whole ordeal is one long, drawn out process. Patience is an absolute must along with diligently following a gout-healthy lifestyle. I'm fairly certain that I've weathered the worst of the attacks for the time being. Now, it's time to slowly (very slowly) rebuild my body and bring it back in to shape. I know it's still going to take a lot of time to get back to anywhere near where I was only a few years ago physically, but I am seeing the benefits from the sacrifices I've made. There were many times where it didn't seem worth it and I came close to bagging the whole thing, but this is where the patience paid off. That and having all too fresh memories of my last horrific gout attack.

I still don't think I'm out of the woods yet, but I am feeling much, much better. To others who are in my predicament or who may just be starting to take action to control their gout, stay with it. Be patient. Treat your body well. Listen to your body. It will make a difference in the long run.

03 July 2010 - Amsterdam

2010-07-03T10:14:00.000+02:00

I'm sitting here in Amsterdam on Saturday Morning, enjoying the relative quiet after an absolutely nuts afternoon/night in the city. Holland beat the number one ranked team in the world, Brazil, yesterday in the World Cup. Amsterdam exploded once the score was final and the partying lasted well in to the morning.

Friends just showed up so must keep this short. Gout is doing well, even after a ramp-up in the intensity of my activities. Feeling pretty good, but have a lot of sore muscles that haven't been exercised like this in a long time!

22 June 2010 - Not much time for updating the site right now

2010-06-22T16:24:00.000+02:00

The good news is that I'm still feeling pretty swell physically. I've even been exercising regularly now for over a week! It feels good to have some sore muscles and to work up a sweat again. The workouts haven't been too intense. Mostly just some short stints on the eliptical for 25 minutes or so, then some situps and then a couple of sets of pushups. I've been fairly surprised at the lack of joint pain in my wrists, hands and elbows when doing the pushups. That is a huge improvement. My ankles and feet are still a bit creaky and sore, but I attribute this more to prolonged damage from gout than any type of current attack.

This week has been the kickoff of a hectic summer for me. Between work conferences and planned trips, my updates could become pretty sporadic. After this Sunday, I will probably be out of touch for a good week +, be at home for a few days, and then will likely be gone for another nine days or so. After that, another two to three weeks at home and then I'll be gone for another couple of weeks. After that, a trip here, a trip there, some possibly large life changing events related to my job....... But, I will pop on here when I can to update my thousands and thousands of readers. Okay, so I made the last part up.

I will update after my doc appointment on Thursday. I will be receiving my new UA reading and will also be discussing lowering my Allopurinol dose to 300 or 400 mg/day with himi. I'm also going to ask him for some colchicine and give that drug a shot again. Until then.....

18 June 2010 - Learning as We Go

2010-06-18T06:44:00.000+02:00

This past week has been the most gout-free and best I have felt physically in a long, long time. It's just too bad that this period of relatively good health has coincided with an extremely busy work week and another round of cold, wet, German weather. I really can't complain, though. My biggest question right now is, "How long will this period of feeling good last?"

I'm hesitant to get my hopes up too high. On the other hand, I've received some very good advice via this here blog over the past month or two and this may be making the difference in my health. Splitting up my Allopurinol dosage each day and taking low to moderate levels of NSAID's could be the last piece to the puzzle that just may get me back on my feet. I actually really do think that these changes have made a difference. However, I have been taking 600mg/day of Allopurinol for over six months now, have followed a very regulated diet, haven't touched a drop of alcohol, and have basically been inactive 99.9% of this period, allowing my body to rest and recover. I was also reading that six months was the usual time period to expect results from Allopurinol. It just may have taken me a bit longer (and yet might take even longer).

I've had other periods over the last 7 months where I was relatively gout-free. However, this time it feels a bit different. A lot of the aches and pains that I used to get in my joints is almost gone now. I can only attribute this to the Allopurinol doing its work and cleansing out the UA deposits in those joints. My big toes still do hurt quite a bit, but that's more from joint damage than current deposits of UA.

I have many other thoughts running through my head right now that I'd like to write down, but I don't have the time currently. Instead, I'll leave it at this: I feel pretty good right now. I'm not going to rush in to anything. I will take it easy, take it slow and give my body some time to adjust. The most 'radical' I may get is riding my mountain bike on a graded dirt road up the hill from my house for some exercise. If I do experience another attack, well, been there done that. I really hope the worst of it is over, but only time will tell.

16 June 2010 - Feeling pretty good

2010-06-16T14:51:00.000+02:00

Quick update - not much time. I'm feeling better right now than I have in months and months. Still a lot of general aches and pains undboutedly caused by years of gout, but almost all gouty feeling is gone from my body currently. I figured I may feel a twinge or two from the meat I ate over the past weekend, but so far, nothing has materialized. I even mowed the lawn last night (not a small lawn, either), and beyond some muscle soreness, feel great.

I did go in to get my blood tested this morning. I will get the results back next Thursday when I see my doctor. I will also be asking him for some colchicine and will give this drug another go. It will mainly be used as a preventive device for when I do feel some gouty twinges.

Anyway, happy to report that things are going pretty well. I just hope they last longer than a few days this time around! I've been deceived by my body far too many times to get my hopes up too much.....

14 June 2010 - Gout-free in Dresden

2010-06-14T12:38:00.001+02:00

Just a quick update here. Work has me a little busy right now. The wife and I had a very nice trip over the weekend to Dresden where I was able to do some real walking and getting around for the first time in almost a month. It was nice to be mobile again. There were a few small twinges and some slight pain in my right ankle leftover from the last attack, but it really wasn't too bad. With breaks to rest in between exploring the city, my body held up better than it has in months. Even today, after two days of some fair walking, I don't feel bad except for a little muscle soreness in my legs. That's to be expected, though, after such a long period of inactivity. The splitting up of my Allopurinol dose and adding in the daily Aleve just might be doing the trick. Time might also be a factor here as my body continues to rid itself of uric acid. I'm not getting my hopes too high, however, as I've done that way too many times and have had way too many setbacks. Instead, I'll continue taking it easy, going for short walks to try to recondition my leg muscles a bit and may also start going on some short bike rides. I'll just have to see how my body reacts in the coming days. Today and likely tomorrow will be recovery days, however. I need it!

Another thing to note is that I'm going to start slowly introducing meat back in to my diet. Small 3-6 oz portions once or twice per week to start. One of the great things about living in Germany is the availability of high-quality, healthy meats straight from the butcher. I can actually get meat free of hormones and from sources that weren't stuffed full of genetically modified feed. I did have a small amount of sliced ham this past weekend, and last night, enjoyed a bison burger with no ill effects as of yet. I've been researching this a bit over the past week and I think it's important to include a bit of high-quality, healthy meat in one's diet. We humans, afterall, are omnivores, and I have no qualms eating responsibly raised, hormone free meat products. I've noticed over the past couple of days that my thinking seems sharper and my head feels clearer than it has in a long, long time. I don't know if there is any correlation here - only time will tell.

Here's a very quickly processed 360 degree panorama of Dresden - I took the pictures from the top of a hill - that I actually climbed with little problem! (click to view full size)

11 June 2010 - Gout isn't Just About Joint Pain

2010-06-11T06:59:00.002+02:00

For the last few days, I feel like I’ve gone 12 rounds in the ring with George Foreman. I’m talking the fit George Foreman, the one at the top of his boxing game. However, this version of Mr. Foreman wasn’t wearing boxing gloves when I stepped in to the ring with him. Instead, he had his signature product, the George Foreman 360 degree grill, taped to each hand.

Gout is a tricky disease. I would say that most people probably know that gout is a condition that is very painful. However, I doubt that many people, even people who have had a gout attack or two, realize just how many ancillary problems there can be to deal with after years of living and dealing with gout. Over time, the cocktail of medicine one takes before, during, and after an attack, can create some unpleasant side effects. The last three days, I have felt like absolute shit. I’ve had an extremely upset stomach, so bloated and painful that it felt like a balloon that could be popped with the gentle touch of a safety pin. Eating anything just made this worse. I have no idea exactly what caused this, though. Going off of the Tramadol? Adding high dosages of Aleve to my daily mix of pills? Stress from dealing with horrible gout attacks over the past three weeks? Lack of quality sleep for the last week? None of the above? All I know is that I have been miserable and it’s why I haven’t posted in the last two days.

I have also felt so low on energy during this time that I have done something the last couple of days that I rarely, rarely do. I’ve come straight home from work and have made it no farther than my bedroom before crashing out, fast asleep and oblivious to anything around me. I NEVER take naps. Sure, I’ve tried before, but naps just don’t suit me. It usually takes me anywhere from 30 to 45 minutes to shake off the effect of a nap and I always feel worse afterwards. These last two days, though, I have been so low on energy, so absolutely out of it, that I have literally passed out on my bed minutes after arriving home.

Feeling the way I have also affects other people. I’ve mentioned this before in my posts, but I sometimes hate how I am around others when I’m suffering through a gout attack or feeling the effects of something possibly related to gout. I fall back in to my own little world, trying to conserve what little energy I have for whatever tasks I have in front of me to finish. At work, this means not making small talk with others or caring what new all-season tires my boss ordered for her Volvo. Of course, people notice I look like shit and can tell I’m not feeling well, and then I have to hear about how they have a sniffle or how a bunion has been bugging them. It’s not that I don’t care, but I’m way beyond a common cold or some discomfort that someone is feeling in their shoe and I just don’t have the energy to garner much sympathy. It makes me look like an asshole.

The same applies when I get home. After a full day of work, I’m really out of it (see narcoleptic naps above). I feel horrible that I am not able to give as much attention to my wife as I want or that she deserves. I try, but I can’t. I can tell she gets frustrated with me, too. It’s just hard, when I’m feeling this way, to get too excited about measuring spoons I may have misplaced after I washed them or where an open plug for a fan is. Normally, I’d have some smart-ass, yet funny, comments for her regarding these things. I feel horrible when it comes across like I don’t care. I do care, I just have a hard time showing it when it feels like baby Godzilla is about to erupt from my abdomen, I haven’t eaten a proper meal in two days, and my head feels like it’s been repeatedly bashed in by said George Foreman Grill.

I really can be a nice guy when I’m feeling healthy. I can be a real bear when I’m not. Gout is evil in this way. All the more reason to keep doing what I’m doing and hopefully, get this gout thing under control. I am feeling better today, but my stomach is still a bit grumbly, my head is still in a fog, I still have some leftover gout pain in my right foot/ankle/achilles, but I can't complain. Well, I can, but at least I'm not as out of it as I have been.

8 June 2010 - Nearly back to walking normal

2010-06-08T12:47:00.000+02:00

There still is quite a bit of pain in my ankle and achilles, but I am getting closer to walking normally again. This is a nice change from the past couple of weeks. Instead of it taking 10 minutes to walk from my car to the office, it's now only taking two or three minutes. It's also nice not to have people staring at me or making jokes at my expense as I walk from my office to the restroom facility on my floor. It's unfortunate that I have to hold my tongue when these people make comments, as there are many, many things I would like to say to them that probably wouldn't make them too happy. Thing is, they would all be truthful. With a lot of these guys I work around, it wouldn't take much effort to come up with some caustic retorts. But, I bite my tongue and tell myself I'm above that. Just one day. One stinkin' day. I just want these a-holes who find my condition so amusing to suffer through what I go through for just one day. Perhaps then they wouldn't chuckle as I go limping by.

Anyway, enough about that. Right now I'm going to continue taking 300mg of Allopurinol every 12 hours for a total of 600mg per day. Hopefully, dividing the dose up will help alleviate the attacks that have been plaguing me lately. If I do continue to suffer attacks, I will be talking to my doctor about lowering my dosage of Allopurinol to 400mg/day. This seems like it would be better for me in the long run anyway. Out of all the posters on the gout-pal forum, I believe I'm the only one taking such a high dose of Allo each day. Yes, it's doing wonders for my UA reading, but the high dosage may also be prompting these severe and frequent attacks. I could live with a bit higher of a UA reading (still keeping it under 6mg/dl) if it meant not suffering through such debilitating attacks.

7 June 2010 - Another Weekend Hobbled by Gout

2010-06-07T06:17:00.000+02:00

Things are slowly getting better, but I still spent the entire weekend having to limp around gingerly due to my right achilles and ankle. Yes, the achilles has slowly become better over the past two days, but now the attack has moved in to my ankle. It isn't horrible at this point, but is still tender and painful enough to cause quite a bit of discomfort. Because of the attack, we ended up taking it pretty easy on Saturday and Sunday. We managed to have a fun BBQ at the house with some friends over, enjoying the first real day of spring we've had this year. Yesterday, we went out for a drive looking for a place where we could sit along a creek, letting the dog chase sticks we threw in to the water. I was hoping to get a bit more sleep over the weekend, but the pain in my ankle did cause me to wake up numerous times, prohibiting me from getting any good, solid rest. I'm still quite tired right now (6am Monday morning).

My next doctors appointment isn't until the end of next week. At this time, I'm going to discuss lowering my Allopurinol daily dosage. I've had it mentioned to me more than once that taking 600mg/day seems like more than I may need. It has been suggested in a comment on this blog (a commentor who provides a great deal of valuable and appreciated information), that the high doses of Allopurinol probably help in greatly lowering my UA levels, but also may be prompting the often and severe attacks that I've been going through. After seven months at 600mg/day, I'm ready to try something different. I will discuss this with my doctor to see what he thinks and also monitor my UA levels a bit more closely - perhaps two tests per month to see the effect of lowering the dosage. I'll report back on what we discuss later.

A picture from yesterday. My wife and the dog having some fun. No, I didn't go out on the log! I sat safely on the bank, snapping a few pictures when I could :)

4 June 2010 - The Achilles has gone nuclear

2010-06-04T08:43:00.000+02:00

So much for being able to get around this weekend. The gout attack currently happening in my right achilles progressively became worse overnight, becoming bad enough to disrupt my sleep in the wee hours of the morning. At least this allowed me to get up super early and finally get to some medical paperwork that I've pushed to the side for far too long. You have to look for some positives during times like these......

Driving in to the office this morning was horrible. It was extremely difficult to keep my foot on the gas pedal. Doing so put my foot in a position where direct pressure was being applied right to the affected achilles. I tried many different positions, but they all hurt. Using the brake pedal wasn't much better. At least my drive isn't that long, but it still was long enough to make me questions just how safe it was for me to be driving at all. The shuffle from my parking spot to the building I work in, along with the long climb up the stairs to my office was quite unpleasant as well. There is absolutely no flexibility in my right achilles right now and any attempt to bend or stretch it results in excruciating pain.

Now that I'm at my desk, however, things aren't too bad. I've found a semi comfortable way to sit, propping my feet up on a stool I have under my desk. As long as nothing is touching my achilles, it isn't too bad. What I dread is the inevitable walk to the end of the hall to use the bathroom facilities. I will be staying put in the office all day as there is no way I can handle leaving for lunch or to run errands.

Well, at least the sun is finally out. Tomorrow may see me spending a lot of time on a lawn chair soaking up a bit of rare German sunshine.

3 June 2010 - My Achilles is my achilles

2010-06-03T09:50:00.001+02:00

Seriously. Come on gout. What in the hell? After darkening my world for the past 10 days, I was beginning to see some light. Visions of a semi pain-free weekend were dancing through my skull. Yes, I felt your twinges yesterday in my right ankle, but I held on to some hope that they would only remain an annoyance. How about granting me a little break here? Why so soon again? I guess I didn't go through enough pain last week.

Yep, my right achilles is now undergoing a full-fledged attack. I really have nothing more to say about it. It is what it is and there is nothing I can do about it. I can't go begging for pain pills and I certainly don't want to take a sequence of prednisone again so soon. Right now, I can handle this as is. I'll just be walking around like Quasimodo for who knows how long again.

Last night my wife and I were getting plans together for a work-related trip back to the States in August. We will also be visiting her family while we are over there also. All I could think of as she read of the itinerary and the hours of travel we would face is, "how in the hell am I going to be able to handle this if I'm still in the condition I'm in now?" This isn't a simple trip either. It starts with a three to four hour drive, a wedding ceremony and reception, then an early rising and early drive to the Frankfurt Airport. After spending who knows how many hours in the air, we make a switch in Detroit and then land in Chicago on Sunday night. The next step is to try and get some sleep, wake early the next morning, and then look forward to a week on my feet. After that, off to my wife's home state. A short flight, a bit more driving, hob-nobbing with the family....... I just hope I can make it through the very first part of the trip. Ah, the thoughts that cross your mind when you suffer from gout. Gotta love it.

2 June 2010 - As We Whimper in to June...........

2010-06-02T13:36:00.000+02:00

I've titled the post this way for two reasons. One, even though I am on the mend gout-wise, I just haven't been feeling that well. Two, the weather just really, really, really sucks here. I'm sure that isn't helping the collective mood of this grumpy nation, including me.

I don't have a lot of time. This week has been very busy for me at work and side projects have been sucking up most of my free time. So, I'll just report on how my gout-ridden knee has been doing the last two days.

Better.

That's about all I can say. The swelling is gone, almost all of the familiar gouty-type pain is gone, but there is still a lot of pain that may or may not be gout-related hanging on. The sharp pains continue when normal weight is put on my leg. The pain emanates from different spots under the left patella, sometimes shooting up in to my quad (what a weird sensation), sometimes down the outside of my leg, and sometimes the stabbing is localized in the knee and quite acute. Neither of the three are particularly pleasant. My knee still is not feeling very stable either. While at the post office today, it gave out as I was descending the steps at the front entrance, arms loaded down with two boxes. I was able to catch myself on the railing (and not drop a package), but it hurt. I still must be very careful when walking.

Off of the advice of a comment below, I think I will begin taking my 600 mg of Allopurinol in two doses now - 300 mg when I awake at 6 AM and 300 mg again at 6 PM. I'm curious to see if this won't make a difference in the frequency of the attacks I've been having lately.

Alright, back to work. Lunch is officially over.......

31 May 2010 - A pleasant long weekend

2010-05-31T16:51:00.000+02:00

Even with our trip to the French and Swiss Alps cancelled and with me feeling poorly due to the gout in my knee, we still ended up having a fairly decent weekend. We didn't do a whole heck of a lot, but did manage to get out here and there, made a couple of drives, took some pictures and tried to sleep a bit more than usual. With each passing day, my knee did feel better. Right now, it's to a point where I can almost fully bend it and the swelling is just about gone. I still have to walk somewhat gingerly and there still is some pain, but it's much better than it was just a few days ago. The percs and prednisone did the trick again! However, my elbow is still quite sore and painful to the touch, but there is little swelling and at least I can use it.

One thing to note about my knee is the intense and sharp pains I've been having in it. These are completely unlike any gout pain I've ever had. If just a bit too much pressure is put on my knee while walking, the 'stabbing' inside, although short-lived, is very, very painful. This has to be gout related, however, as I haven't suffered any traumatic injuries that I know of to my left knee. The pain does feel very similar to the pains in my damaged right knee, though, where cartlidge is a big problem for me (or what I have left of it). I just wonder if something hasn't broken off or been jarred loose in the left knee now. I still am having problems with my left knee giving out on me too. If I straighten the leg completely and try to step on it, it just gives - very similar to when my right knee goes out (a mis-aligned patella issue). I'll have to assess this over time to see if this situation doesn't imporve. It is a bit worrisome, though.

Another thing to note - I got a lot of sleep the last two days, way more than normal. However, I still feel very, very drained. My body fighting the attack? The drugs? (no pain pills for 2 days now, though). Just worn out? I've said this before, but I'm so damn tired of being tired all the time. I wish I could figure this out because my lack of energy is really putting a damper on my living.

Alright, back to relaxing a bit more. Back to work tomorrow.

28 May 2010 - Bleh

2010-05-28T11:23:00.001+02:00

What to say? Not much improvement overnight. I go to bed feeling okay, and then wake up in pain. This must be due to the pain meds wearing off overnight. It does not feel good to take that first step each morning. I experienced some sharp, sharp pains in my knee with that first step and they didn't go away until the percocet had kicked in while I was sitting at my desk in the office. I've somehow managed to stretch my three day prescription in to four days now, but I will be out of the pain meds tonight. It should make for an interesting and painful weekend.

I'm still feeling pretty tired today and also down in the dumps. Just pissed that another trip has been cancelled due to this blasted gout. So, here I have one of my only long weekends of the year in front of me and what will I be doing? Sitting on a goddamn couch doing nothing. It just feels like a neverending cycle of of living in pain, going to the office, coming home to do nothing - and there is no end in site. This is my life. There is nothing rewarding about it. Nothing to be excited about. Nothing to look forward to. It's a pretty bleak outlook, but it's all I see right now. I know that being in the office instead of heading to France has a lot to do with this right now, but I just don't see how much is going to change in the near-term. I don't see any way out of my job right now and the job is not helping things at all either. I've been doing what I'm doing for too long and just wish I could find a job and setting doing something I enjoy doing. Something where I can wake up each day and be excited about starting the day instead of dreading what's in front of me.

Like I said, bleh. Maybe I'll be more cheerful tomorrow when and if I can sleep in.

**Afternoon update - Feeling a tad better now that I'm at home. Sorry to be so bleak this morning. I just wasn't feeling that great early on. Time to work on some more photos. At least I have that to keep me busy - and I do enjoy the work!

27 May 2010 - The Long, Hard, and Tiresome Road to Work

2010-05-27T09:12:00.000+02:00

Yes, I finally made it back to the office. It was quite the harrowing experience as I nearly did doze off in one spot on my drive. I haven't done that...well, ever. It scared the living shit out of me and the experience at least kept me coherent for the rest of the drive in. It's not a long, drive. Only 10-15 minutes depending on traffic, but long enough that I see a lot of crazy stuff each day. No, I did not take any drugs besides the prednisone before hopping in to my vehicle, I'm just that worn out right now. I feel like I've gone 10 rounds with Tyson in his prime.

The pain in my knee and elbow has actually increased somewhat today. The tightness along the outside of my leg from my knee down to my ankle is worse as is the tightness in the back of my knee. However, the swelling has gone down two-fold which is really nice. It may hurt a bit more to move around, but moving around is easier now. I can actually bend my knee a few more degrees today and am getting closer to being able to straighten it. The pain in my elbow, although overrideen by the pain in my knee the past three days, is a lot more noticeable today. It's not too swollen, but it certainly hurts a lot worse. I'll just have to be careful when using the mouse while sitting at my desk. That's when I tend to bump the thing.

Overall, I'd say I am improving and am on the downhill slide with this attack. It will probably take another week or two before all signs of this latest battle are gone. All I can do is take it easy and be patient. I just hope this feeling of malaise and the tiredness improves. All I feel like doing is sleeping right now. Luckily, a long weekend is coming up. With the weather looking poor, our plans for our trip to Chamonix/Zermatt cancelled and nothing much better to do, I see a lot of movie watching and lying around in my future. We'll try to get out for a drive every now and then for a change of scenery and may even book a guesthouse for a night somewhere, but these will be very low-impact and the primary cause will be for relaxation - for both my wife and myself. She needs the break as much as I do, possibly more. I'm not an easy person to deal with when I get like this. Thank God I have her around to help me!

26 May 2010 - Down and Worn Out in Germany

2010-05-26T16:50:00.000+02:00

It took me a while to get to my gout updates today. I just didn't feel like it. I'm worn out and tired from battling this latest attack over the past few days. But, the knee is feeling slightly better and the prednisone is working. I have a bit more mobility but I have to be very careful when I walk. With the slightly added mobility comes a higher chance of my knee going out on me. See, even thought the pain has somewhat decreased, the swelling is still hanging around. With that swelling comes the knee instability and with that instability comes a larger chance of falling in to my slanted ceiling or nearly tearing down the shower doors in the bathroom. Both of these have happened in the past 24 hours with some other incidents thrown in for fun.

No, I didn't make it to work today. I couldn't. I made every attempt to get ready for work this morning, but the inability to climb in to the shower basin along with almost tearing down the glass doors around the shower while trying to climb in to said basin convinced me that I probably shouldn't be walking much, let alone driving a vehicle. So, that does it for every single bit of time off I could have taken. I'm down to zero hours now. But, I did cancel our extended weekend plans so that does buy me another day if I absolutely need it. I'm real tired after all these years of using what limited vacation time I have for sick leave. I could really use a real vacation. I think I deserve it.

After taking my dose of prednisone this morning, I started feeling and seeing results about an hour later. I should be okay to go in to work tomorrow. I'll just have to make sure that I hole up in my office for the day and keep the bathroom trips down to a minimum. Nothing like sitting uncomfortably in front of a computer for nine straight hours!

25 May 2010 - Update

2010-05-25T13:39:00.000+02:00

I just received my blood test results back from last week. My uric acid is down to 3.9mg/dl which is great. That means the Allopurinol is doing its job and cleaning out all those old deposits. I know this - just look at my knee below! Other tests also came out fine, so there is nothing to worry about there. It's just going to take time.

I also was able to put a prescription request in for the steroids and pain medicine that I need right now. Hopefully, the prednisone will be able to knock this attack back quickly. I really can't miss any more work. My wife will be picking this up for me in a couple of hours.

Today has been pretty uneventful. I was hoping to be able to do some work on my computer making some more posters and pieces from photos I've recently taken. But, it's just too damn uncomfortable to sit at my desk and I don't have the photos or the correct software on this laptop. That's fine, though. I should just be relaxing anyway.

25 May 2010 - Knee worsens overnight

2010-05-25T08:40:00.002+02:00

I guess there really isn't a lot that is new to type about my condition. My left knee is more swollen than yesterday afternoon and the pain is definitely worse. I can barely, and I mean barely, walk right now. When I do get up off of the couch, I have to scoot along in a crouched position as I can not straighten my left leg at all. Can't even come close to it. Although the swelling is mostly above my knee, the pain is still mainly on the outside of the joint/leg. If I twist the wrong way, even the slightest bit, I get horrible pains down my leg to my foot, all on the outside. It feels like tendons and ligaments wanting to burst out of my skin. This is a first for a gout attack in the knee. I have to be very, very careful when moving my leg and must keep the leg straight or the sharp, burning, intense pain shoots down the leg and is nearly unbearable. I haven't cried yet, but have come close. It's that bad. Last night I was jolted awake when I apparently tried to move the leg in my sleep. I woke up screaming in pain, the intensity and duration of the pain approaching epic proportions. It took quite a while for the pain, and my heart rate, to subside.

I've stayed home from work today, not by choice but by necessity. There is no way in hell I can drive. Hell, I doubt I could even make it to the car if I thought I could drive. So, I will use up my remaining four hours of sick leave and then figure something else out for the remaining four hours. Luckily, my wife was up this morning as I slowly (very slowly) made my way downstairs. With her help, I've been able to set up a nice and relatively comfortable nest on the couch. I've got the laptop, a full bottle of water, the remotes to the TV and our Ipod player and my medicine all within reach.

I'm going to be making some calls to my doctors here in a little while to see what my options are. I'm hoping I can have my German doctor make a house visit later since I can't make it to his office. I don't know if that will fly, though, but getting my knee aspirated (drained) and getting a steroid injection would really help. If not, I'll call my American doctor and see if he can't put in a prescription for some prednisone and percocet and have my wife pick it up. I don't know if that will work either, though. All I know is I need some kind of treatment or I won't be able to go to work for a few more days which will cause all kinds of problems for me.

I did take some new pictures this morning. Click on them to enlarge.

24 May 2010 - 3:30PM Update

2010-05-24T15:45:00.000+02:00

Here's the update - more pain, more swelling. Walking has become very, very difficult. My knee will not straighten and I can hardly put any weight on it. I left work 'early' today, but not really that early since I was in early and worked through lunch since I couldn't leave the office. The drive home was tons of fun. Thankfully it's a German holiday today so I didn't have to deal with too many maniacs on the road. I did see an American driving that for some reason thought he should signal before entering a traffic circle but then not use his signal to exit it. Pretty much on par for most transplants over here, not that the Germans come anywhere close to knowing the proper use of a turn signal either.

Yeah, I'm in a pissy mood and should stop writing. Here are a couple of pictures of my knee. Click on the pictures for the larger version:

24 May 2010 - Another Full-Blown Attack - I think

2010-05-24T06:18:00.000+02:00

My left knee was bugging me pretty bad by Saturday evening. Enough, in fact, that I think the pain had surpassed the 'bugging' level and had moved forward to the 'oh shit this really, really hurts to bend my knee or try to move' level. I was once again relegated to the couch, a friend's couch this time, and unable to partake in any of the birthday festivities that we had traveled north for. Upon awaking Sunday morning, I knew I was in trouble when I could barely put pants or socks on. These are not fun times when this happens. The rest of Sunday was filled with curse words leaving my mouth as my knee would collapse while shuffling to the bathroom or kitchen or couch, causing horrible, knife-like pain throughout the joint. By this point, I was finding it very hard to find any position that I would consider comfortable. This morning, I awoke with my knee even more swollen and the pain being even a little worse than yesterday. Oh, how I love Mondays.

However, I must reiterate a post from a couple of days ago - this attack in my knee is different than every other attack I've ever had in that joint. Yes, there is swelling now, but there is no redness and the knee is not sensitive to touch. All of the pain is internal and the back of leg behind my knee cap is extremely sore. The outside of my knee also very, very painful while I feel no pain on the inside of it. It feels more like an acute injury than gout, but I know that's not what is going on. However, my right knee is also hurting and this is from a former acute injury. The way I am forced to walk right now is putting odd pressures on my right knee and it too is hurting a lot. I guess my upper body wanted in on the fun too as my right elbow is somewhat sore and feeling gouty.

After seven months of 600mg/day of Allopurinol, is this supposed to be happening? I can think of nothing else to do to avoid these attacks. My little bit of walking wouldn't affect my elbow and almost never causes an attack in my knee. I've mainly seen a correlation with exercise and my ankles/achilles/toes hurting but never joints farther up my body. Is my body still cleansing itself? Do I still have huge deposits of Uric Acid in my joints being released by the Allopurinol and causing these attacks? Do I have some other undetected underlying problem that is causing all of this? What in the hell gives?

It will be interesting to see my UA levels on Wednesday morning. I'm sure they are still well below 6mg/dl, yet I'm still getting bad attacks every two to three weeks. All I can think right now, though, is just how much fun work will be this week. The driving, the walking up two huge flights of stairs, sitting in my chair for 9 straight hours, having to walk to the end of the hall to use the restroom, living with the stares from all the people visiting my floor as I hobble down the hall. God, I'm so sick of this. I might as well start eating large quantities of meat and drinking copious amounts of beer as nothing seems to be helping anyway. I really wish I could just take a few months off of work to let my body properly heal. That will never, ever happen though. Well, unless I revoke my American citizenship and become a German or some other EU citizen.

Well, off to work. This should be fun. Oh, and I'm supposed to take a driving test with a stick shift today. Hahahaha! I don't think that's going to happen but I'm sure going to get a lot of shit for not doing it. Maybe I'll get fired and then I can at least collect 100 dollars of unemployment each week while I try to heal my body.............

22 May 2010 - Gout in the left knee

2010-05-22T06:52:00.000+02:00

My knee has become a bit worse since I first felt the gout attack taking hold. The pain is not horrible, but it has been difficult to bend it and any sudden movement does cause a sharp pain. However, this attack feels different than any other gout attack I've had in my knee. It feels a lot more internal. Although there isn't dramatic swelling, it also does feel a lot less stable when compared to much more severe attacks I've gone through. I've wrapped it up this morning and it seems to actually be helping some with the pain and the stability issue. I do have a bit of walking to do today since we will be attending a friends birthday party, but I'll try to stay off of it as much as possible.

PS - it looks like we may actually get a spring-like day here for once. I see sun!

PPS - I should be able to provide more coherent posts next week. These past few days have been extremely busy for me. It makes me wonder if stress isn't a factor in this latest attack.

20 May 2010 - Knee and back acting up again

2010-05-20T14:37:00.000+02:00

It's been some time since my knees have experienced any pain from gout. Last night, however, I noticed that my left knee was starting to feel a bit stiff and slightly painful and that a little swelling was starting to be noticeable. Of course, as it always goes when this happens, my left knee has become bothersome enough that I'm having to limp a bit on it. When the fluid from the inflamation starts to collect in the joint, the joint becomes a lot less stable causing it to collapse at the most inopportune times. The pain isn't horrible yet and I don't think it's going to get all that bad (one becomes experienced in judging these things after 15 years), but it sure is making life more difficult for me.

I had to do way more walking today than I should have been doing on a faulty, gout ridden knee and with my aching back. There is no need to go in to details, but the job dictates what I must do, and with the tasks handed to me, a lot of walking was involved. BUT, I did take the first step towards launching my side business today (taken care of on my lunch break). If all goes as planned, I'll have a new website up and running and be able to advertise said website in about one month. Even without any real advertising, I've already sold a few pieces of my work which is exciting. Ultimately, I would love to make this my full time gig, but there is still a lot of work to be done. Not only would this be a much, much, much more enjoyable profession for me, but it would also allow me to take care of my health a lot better. Besides eliminating stress, I would not be forced to work while under attack from gout and would be able to dictate my own schedule. I'm keeping my fingers crossed that this will all eventually work out......

19 May 2010 - Getting blood drawn ain't always easy

2010-05-19T07:57:00.000+02:00

It took four attempts to get the blood out of me today. I had the same person as usual doing the sticking at the lab and he is usually very, very good. This actually wasn't his fault, though. It turned out the tubes for collecting the blood weren't working properly and he had to trash them all. I now feel like The Ultimate Warrior with the bands around both arms.

I have an appointment to meet with my doctor next Wednesday to go over the results.

17 May 2010 - A busy week ahead

2010-05-17T18:42:00.000+02:00

I may not be able to post much this week due to work and other obligations. On Wednesday I do plan on making a quick stop at the clinic to have my blood drawn for my monthly UA testing. I would have done it today or tomorrow but my schedule wouldn't allow it.

Right now, I'm actually feeling pretty gout free. My ankles are still slightly sore, but I'm not even limping anymore. My boss noted this too, which was nice. This morning she didn't think it was me coming up the stairs because "it sounded like a normal person walking." My back, however, is another story. God, two hours of walking and schlepping around a small camera bag and it's killing me. I tried to lay down and rest as much as possible yesterday, but it's still killing me today. I've got to get this checked out soon!

Okay, my wife just got home. I best go say hello.......

16 May 2010 - The Life of a Hermit

2010-05-16T09:01:00.000+02:00

After two weeks of very little to no activity, I've come to the conclusion that I would make a horrible hermit. Sure, I've always dreamed of getting away and living in some remote cabin situated along a bubbling brook teaming with wild trout, but a hermit I would not be. My fantasy includes a lot of hard labor, hiking, fishing, exploring the surrounding terrain, and in the winter, skiing un-skied peaks and climbing un-climbed mountains. So, yesterday, after sitting on my ass for two straight weeks, the wife and I headed to Regensburg to grab a bit of sushi and to slowly stroll through the ancient streets of the old city. I knew I may be pushing things with my just-healed gouty ankles and feet, but I had to get out. Besides, I was out of picture material for art projects and never had been successful at photographing Regensburg well in the past.

After eating at the sushi joint, where I admittedly had very little actual sushi (raw fish and gout? not the best combination), we ambled amongst the cobblestone alleys and along the Danube River under a blanket of gray and ominous looking clouds. Still, I was able to get a lot of good pictures and we were able to access some unique vantage points with great views that most people visiting the city probably don't know exist. For the first two hours or so, I felt pretty good. We were walking slow and I was being as careful as one possibly can on old cobblestone.  My back was actually the first thing to start hurting, and when it did, I was ready to call it a day.  There was absolutely no need to push things. I had already got what I had come for.

On the walk back to the parking garage, I did notice both achilles starting to ache.  They didn't feel gouty, but just sore. Upon waking up this morning, I felt like an older man than I actually am. I think I actually heard my back creak when I sat up in bed. Yes, my ankles are sore, but it feels more like overuse than anything. Today will have to be an easy day, once again, for me. Again, no need to push things. The weather sucks outside again anyway. Spring in Germany is just so lovely........

So, now I sit here thinking, what is going to take to get myself back in any type of shape if my activity is limited for another six months? A year? Two years? After only two weeks of inactivity, my energy and endurance are ridiculously low. Is that the tradeoff? Feeling like a lethargic slug instead of having gouty and painful joints? I think that the tradeoff is worth it and it may just take a complete change in my frame of mind and how I approach my day to day life. It's depressing, though. A complete departure from what I've been so used to in my life. I think it says something about me that I have actually been researching the off road Segway human transport dealybobbers. I'm still not ready to give up.

14 May 2010 - Not a lot to report - and that is a good thing!

2010-05-14T07:48:00.000+02:00

Things seem to be going much better than they were just a few days ago. The major pains in my joints are gone and all that is left are some lingering aches and some minor discomfort. I'm still taking it pretty easy when walking as a bad step here and there can cause some sharp pains to occur in my ankles and feet. At least they don't last and are only momentarily bothersome. My right index finger is still stiff and a bit hard to bend, but the pain isn't too bad. I don't think this will get any worse.

My body still is feeling a bit run down, and even with a good nights rest, I still wake up not feeling fully refreshed. This, too, is getting better, however. At least I'm not having the accompnanying headaches along with the tiredness anymore. I'm just going to keep taking things day by day and will hopefully continue getting slightly better as time goes on. Hopefully this fog that has enveloped my head will eventually lift - I'm sick and tired of being so tired!

This weekend I may get out to do a bit of walking and picture taking if the weather shapes up. It's been a dreary week here in Germany. Rain, wind, and cold! People always ask me if this type of weather affects my arthritis. I've never noticed a correlation between the weather and my gout attacks or joint stiffness, so I tell them, "no". I also tell them that I've lived in very warm and very cold places and my condition never seemed to get any better or worse based on environmental factors. Just some food for thought.

Have a good weekend!

12 May 2010 - Day two with No Pepsi

2010-05-12T11:30:00.000+02:00

I feel like Jack Kerouac in Big Sur. You know, towards the end of the book when he and some friends are visiting the cabin on the coast and he's having a physical and mental breakdown due to boozing too hard. If that doesn't work for you, the shaking I'm experiencing from quitting the Pepsi Max cold turkey is akin to Gene Wilder's shooting hand tremors in Blazing Saddles ("Steady as a rock". "Yeah, but this is my shooting hand... (hand/arm shaking violently))"

Okay, so it really hasn't been that bad giving up the Pepsi. It's not like I'll never have one again. I just needed to stop buying it in large quantities and bringing it to work. I drank way too much of this stuff when doing this. Instead, yesterday I had a couple of cups of tea along with my water while at work and it was fine. Today, I've had a mug of coffee and a bit of tea. I go through these phases where I like to change things up every once in a while, so it really hasn't been that difficult switching to other beverages. In the future, I will just have to be conscious of how much Pepsi I drink during the day and make sure not to go overboard on it.

As far as gout pains are concerned, I'm doing pretty damn good today. My ankles are still a bit sore but aren't too bad at all. My right index finger is starting to feel gouty but I don't think this will go in to full-blown attack mode. It's more stiff than anything and I know this is from gout due to previous experiences I've had with my fingers.

I just hope to continue to improve and really hope that no more bad attacks come on. The last two weeks were really rough for me. Besides just getting around and doing the daily things that one normally does, I was becoming severley worn down which made me grumpy and short tempered. I'm feeling much better now and I know that my mood has improved drastically. I did also start taking 1000 units/day of Vitamin D-3 and I 'think' these are somewhat helping with my mood and general disposition.

11 May 2010 - Almost feeling back to normal

2010-05-11T06:53:00.003+02:00

I must emphasize that 'normal' is a fluctuating and relative term for me, but I am feeling much better. My right ankle is still a bit sore and I'm still going to have to be careful with it, but almost all of the pain on the left side of my body is gone. My right ankle feels similar to a sprained ankle about a week after the initial sprain. Not horrible pain, but still aggravating and you are still aware that something just isn't quite right.

For a while now I've been trying to think of a way to describe the pain and sensations I sometimes feel in my knees, ankles, wrists, etc. before and after a gout attack. Let me give it a shot here. Okay, imagine, if you will, a Berliner doughnut after it's been sitting out on the counter for a few days. The outsides get crusty and a bit hard while the inside stays soft due to the filling. If you apply pressure to one side of the pastry with the palm of your hand, it takes a little pushing before the crust gives and you feel the softness of the inside. The crust gives in different places or doesn't break evenly.

My ankle kind of feels like this now. I can walk normally, but if enough pressure is placed on the ankle, it kind of 'gives' causing a shock of pain throughout the foot and ankle. It feels mushy when this happens and not at all stable. Kind of like the doughnut would. This is common during the first day or two of an attack coming on, but this type of feeling is mainly prevalent when recovering from a prolonged attack.

I wish I had more time to clarify, but I must get off to work. At least it won't hurt so much going up and down the stairs today. It's been a while.........

**2:00PM Update - My left ankle and the top of my left foot are feeling some gouty twinges. Crap.

09 May 2010 - Most pain from attack has subsided

2010-05-09T15:53:00.000+02:00

Not a lot to report today. I'm actually not feeling too bad. Most of the pain is gone but I still have to be very careful when walking. Little missteps here and there do lead to some sharp pains, but at least they go away quickly. Because of this, I'm trying to stay off of my feet as much as possible. I'm just afraid that too many of these missteps or if I took a really bad step could lead to another prolonged attack taking hold. Right now, it's better to be safe than sorry.

I did go out and snap some pictures this morning but there wasn't much walking involved. The sun finally came out again so the wife, dog and I loaded up in to the car and drove to a few nice spots with good views from the road. To add some color to this page, I thought I'd add a couple of posters I created from the pictures I took this morning.

08 May 2010 - This is going to be an interesting Saturday

2010-05-08T06:59:00.000+02:00

Sleep last night was pretty much non-existant. It had nothing to do with pain or gout, however. Instead, it all had to do with me turning the heat up in the bedroom a bit too high making for very uncomfortable sleeping conditions for me. I'm going to blame it on the crazy spring weather we've been having here in Bavaria. Last week it was sunny and we even hit 80 degrees one day. This week? Cold, wet, blustry and grey. It's made it difficult to regulate a comfortable living environment in the house! So, because of the overly warm conditions while sleeping, I found myself awake at 3am, tossing and turning and just unable to get comfortable. When this happens, I find it's usually just better to get out of bed and go do something else. This morning, I began working on my new photography website and actually got quite a bit done.

Anyway, enough about that. I'm sure the lack of sleep will hit me later and a nap will definitely be in my future plans. As far as the gout and the other pains, I really can't complain too much. Things continue to slowly improve on the gout front. My ankles are still a bit sore and my knees are suffering some gouty twinges, but I am feeling a lot better than I have been. I'll just continue to take it easy and try to stress my joints as little as possible.

I hope everyone has a good weekend. It does look like some sun may be breaking through the blanket of grey finally. Perhaps some driving around and taking some pictures may be in order later today. Don't worry - I'm talking nothing more than stepping out of the car to take some landscape pictures. No hiking or walking will be involved!

06 May 2010 - Aches and pains springing up all over the place

2010-05-06T13:55:00.001+02:00

Although my achilles is finally feeling much better, I'm now experiencing pain and gouty aches in a number of other joints. My left ankle is especially affected but in a different place than where the pain occurred over the last week or so. My left toe is also getting worse as the day wears on and my left knee is feeling pretty gouty. None of the pain is horrible, but it's bad enough that I am gimping around. I've had to be very careful with my walking today. One slight misstep while at the post office earlier led to a not-so-nice expletive slipping from my lips - right in front of two little kids. I felt pretty bad about that as did my toe and ankle. I feel like a penguin when I walk, hobbling back and forth on two stiff ankles. I must look pretty humorous to those that see me.

Thankfully, the weekend is almost here and it looks like our plans to visit friends has fallen through. This will let me completely rest this weekend and stay off of my feet as much as possible. Not that we would have been doing much while at their place, but the getting from here to there and other added short walks would not be beneficial right now.

In case you missed it, there has been a great conversation going on in these comments regarding the amount of liquids that should be taken in each day while on Allopurinol. I was under the impression that more was better but it turns out I was wrong. I've been drinking way too much water and other fluids and it could be contributing to some of the attacks I've been experiencing. I thought I'd never say this, but I'm going to have to work on NOT drinking as much throughout the day. I've always drank a lot of water and it's become a habit for me. I think the first thing to go will have to be my intake of Pepsi Max, my beloved, non-sugary soft drink that keeps my eyes open at work each day. I'll miss it dearly, but it's another sacrifice I'm going to have to make. Goodbye, Pepsi.............. : (

05 May 2010 - not exactly skipping, but at least walking better today

2010-05-05T10:21:00.001+02:00

I knew something was different when I woke up this morning. After swinging my legs off of the bed and placing my feet on the floor, I realized that much of the pain I had been feeling over the past two weeks in my ankles and feet was almost gone. Not totally gone, of course, but the intensity and level of the pain has diminished greatly. My right achilles is still pretty sore but I am nearly able to walk normally again. I just hope it keeps improving like this.

I may update this post later today if anything new pops up. If anything, as a day drags on, the pain usually does get worse. Perhaps that won't happen today? I'll keep my fingers crossed.

** 7:30 PM update - the pain in my right foot and ankle did increase throughout the day, especially after lunch. I had to check my mail at the post office and then do some very minor grocery shopping and this was enough to aggrevate the joints. The pain still isn't as bad as it has been, so this is a good sign. Still keeping my fingers crossed for continued improvement.

04 May 2010 - The latest attack drags on

2010-05-04T13:39:00.000+02:00

One thing I must say about this latest gout attack is that it definitely has been different than any other attack that I've ever had. Oh, the pain is pretty familiar, but the way that certain joints and areas in my ankles and feet hurt is not normal. For instance, I will wake up and the achilles on my right foot will be extremely sore. This is the only area where the pain has been constant and persistent, by the way. However, the excruciating pain that existed in my left ankle the night before will have disappeared. As the day goes on, pains will spring up in my feet and toes for an hour or two and then go away. Usually in the evening, something, somewhere, in my left foot/ankle will really begin hurting, almost to the point where I don't even want to attempt walking. By this point, my achilles is feeling the repercussions of use throughout the day and is throbbing quite badly. As if that's not bad enough, the pain in my left foot/ankle will almost match the pain in my achilles. This usually goes on until bedtime. I will then wake up with the pain in the achilles being less severe and the pain in other spots almost being gone. Sometimes, though, I will wake up with bad pain in a completely new spot that then seems to go away after a few hours.

I've never had the pain jump around like this before. Sure, I've had many, many attacks in multiple joints at the same time over the years. In those cases, the attacks in each joint would last for days, if not weeks, before subsiding. The pain coming and going has never been this pronounced before. Maybe this is a good thing? Different joints are getting cleansed enough that the pain isn't lingering as long? I don't know.

Right now my achilles is killing me. I wish this pain would go away for a few hours, preferably at night so I can get to bed easier. This has been going on for over a week now and just does not seem to be improving. I'm not quite sure what I should do beyond waiting. Ughh, and it's only Tuesday........

02 May 2010 - Feeling a bit more chipper today.....

2010-05-02T08:59:00.000+02:00

.... but still a bit worn down. I'm starting to suspect that I may have contracted a mild illness while in Vienna. I just spoke with my wife on the phone and she sounds horrible. Probably nothing more than a bad cold, but she does not sound good. She's slowly been getting sicker since our last day in Austria and I'm hoping that this will be the worst of it. As for myself, I did have a few bouts with sneezing this past week and my nose has definitely been more snotty than usual. I also was experiencing an annoying background headache that made staring at a computer screen painful after a couple of hours. This, combined with the general malaise that usually accompanies a moderate to severe gout attack, was probably enough to knock me down a few rungs on the 'feel good' ladder. My mood has also been a bit darker than even I'm used to this past week, even while getting plenty of rest, eating well and generally relaxing. But, I do feel as if I'm on the mend now - and the blasted headache has finally mostly disappeared.

My foot and ankle are feeling a bit better today as well. It is still quite painful to walk and I doubt I'll be wearing any normal shoes for the next couple of days, but the swelling is slowly subsiding along with the redness in my foot. If the past indicates future recovery success, I'm expecting to be feeling the lingerings of this attack for at least another week and a half. It's always good to be on the downward slope of the pain bell curve, though.

I'll leave it at that for now. I think the couch and the book I'm currently enjoying are calling to me right now. Enjoy your Sunday!

01 May 2010 - A weekend of rest lies ahead

2010-05-01T06:57:00.001+02:00

No update for yesterday. Just didn't feel like it. Some days are like that.

This weekend my wife and I had plans to go to Cesky Krumlov in the Czech Republic with friends for a short weekend stay. Well, I'm staying home with the dog and she will be going to show our friends around this historic town. She's a bit bummed I'm not going, of course, but she realizes it's for the best. I've also discussed with her cancelling our trip to Chamonix, France at the end of this month. After what this last trip to Vienna has done to me, I really can't risk these types of trips until my body says it's okay to do so.

The repercussions of Vienna are still lingering heavily. Not only is this latest gout attack still with me, it seems to be getting a bit worse - at least it seems that way early on this Saturday morning. I also still feel wasted and drained and I've had a headache that just won't seem to relent.

It really is true that all gout sufferers experiences are different. This is quite evident when reading through goutpal.com. There are just so many factors that play in to how a person's body deals with gout. It is no wonder that people who have gout, along with the doctors who treat it, can become so frustrated with this disease. What may work for one person may not work at all for another. On the flip side, some actions can make an attack spring up in mere hours for someone but will not affect another person in the least. What an odd, odd and cruel disease, especially for a person like me who always seeks out concrete answers.

From my research and readings on gout, I have been led to believe that after one starts a regime of allopurinol, one should expect to experience some very bad attacks in the beginning. As time goes on, these attacks should become less severe as the allopurinol works on cleansing the body of old, built-up deposits of uric acid. Eventually, if one can successfully keep their UA levels under 6 for an extended period of time, the worst of the attacks should stop and one should be able to resume a somewhat normal, albeit cautious, lifestyle. One thing that I haven't really seen quantified yet, however, is the absolute length of time this process will take. I've seen six months thrown around a few times, but again, this is going to be very different for different people.

After being on allopurinol for six months now, I didn't think I'd be suffering through attacks like the attack I'm going through now. With the steps I've taken during these six months to change my lifestyle, I figured I would slowly be able to resume a more familiar way of living, especially regarding the activities I like to partake in. What I'm finding, though, is that my body is broken much worse than I ever suspected. It needs rest, and a lot of it. So, I will continue on with what I'm doing and not even worry about 'exercise' for now. That is just something I will have to deal with when my body is ready to do so.

Hope everyone has a good weekend!

29 April 2010 - a three-toed sloth with a broken leg could beat me in a race right now

2010-04-29T08:43:00.000+02:00

I want to state something right off the bat here - I am NOT writing these updates every day for the purpose of garnering sympathy. I have never asked for anyone to feel sorry for me or be sympathetic of my troubles. I only ask that people I know to at least try to understand what it is that I'm going through. I write these blog posts and fill in my daily gout tracker as often as possible for a couple of reasons. One, it is so that I may be able to identify what it is that causes my gout attacks. Two, by doing this, I'm hoping to see some progress in my battle with gout (and I have seen progress). Three, so others may be able to learn something from my struggles with the disease of gout and be able to avoid all of the trials and tribulations that I've been through.

Okay, with that said, what's going on today? Well, my achilles is feeling a bit better, but now, new and excruciating pain has popped up on the whole of the top of my right foot. With both the top of the foot and my achilles now hurting, it is making it very difficult to walk. I kind of have to drag my foot sideways with each step and make sure the foot is turned almost 90 degrees, toes pointing out, before placing any pressure on it for a step to avoid the worst of the pain. It makes it a very slow process of getting from here to there. Just getting in to the shower today took a monumental effort. I did somehow make it to work, however, and was praying to the lord above that nobody would pull out in front of me on my drive necessitating a sudden stop. Since it is my right foot giving me the problems, using the gas pedal and brake is not easy right now. After getting to the parking lot by the building I work in, I slowly scooted across the pavement and then somehow made it up the two large flights of stairs to my office. It was not a fun experience. Now, I'm just sitting here with my foot throbbing and I'm having a very tough time finding a comfortable position to sit in. I have a headache too and am feeling pretty damned drained still.

So, that's it in a nutshell. Another fun day in the office to look forward to. Also, since I forgot to bring a lunch in, I will either have to go hungry or make another monumental effort to go out and get some food. I'll probably choose go hungry as the thought of walking at all makes me cringe.

28 April 2010 - Still feeling like crap

2010-04-28T10:27:00.002+02:00

Tired, worn down, dizzy, out of it, in pain - just a few words and phrases to describe how I feel today. I did make it in to work this morning, but am not having a fun go of things. Sitting here is very uncomfortable and I'm having a tough time keeping my eyes open. I slept decently last night, but feel like I got no rest at all. To add to the tiredness, my achilles hasn't gotten any better and my back has resumed hurting. This is after taking it completely easy all day yesterday. I think my body just really, really needs more rest. How to accomplish this, though? I can't just not show up for work, especially since my manager is gone and my other co-worker is MIA and is due to quit in a couple of weeks. Someone needs to be here to man the office. I guess that's me.

I received a comment to yesterdays post that was honestly brutal - and completely true. You can read it and my comment back to it below. This has got me to thinking quite a bit this morning. I know what I need to do, but I have no idea how to accomplish this. I guess the first step is going to have to be cancelling all trips I have booked for the upcoming months and just stay at home to rest. As this past weekend showed, I can't even go out for a walk without my body rebelling. There is no way I'm going to get better if I keep treating my body like this. I'll have to keep coming to work, of course, because I have no choice in the matter. As much as it hurts to come in some days, I really have no recourse. I can't work from home, I can't miss multiple days of work to heal up and I highly doubt that management will let me take any type of extended leave from the job. That's just how American life is setup. Go to work spending most of your life doing something you don't really enjoy, beat your body to hell so you can't even enjoy yourself when you finally retire, then die.

Sorry to be so morbid, but that's the type of mood I'm in today.

My biggest concern about getting myself healthy is how selfish it seems to everyone else. Sure, most of my friends and family have an idea of what I'm going through, but they truly don't fully comprehend my situation. Even after barely being able to walk for four days, I still had to explain to my wife why I didn't want to go to the store after we got back from Vienna on Monday. Making a trip to the store is something that may seem very simple to most people but something I couldn't do that day and it disappointed her. What am I supposed to do in that situation? How is she going to feel when I tell her I can't do other things, things that make living in Europe attractive? I can't travel. I can't go for walks or hikes. I can't even go mosey around some of the nearby cities to explore. All of those things leave me in agony. How long is this going to last? How long will it take for my body to get better? Will I ever be able to resume life as I once knew it? How do I get people to better understand what I'm going through?

On a bit of a lighter note, here's something I've been working on over the past couple of months. Who knows if I can ever do something like this for a living, but I'm doing what I can in my spare time to see if it pans out, even a little bit: Taku Photography and Posters Pass the link on to your friends or anyone you know! I love doing this type of thing and would love to do it for a career some day! It's rough right now. Finding enough spare time to devote to this project isn't always easy. That's what I need - time. Time, time, time. Time to devote to giving writing a more serious whirl. Time to market my photography and art. Time to figure out how to take all of the skills that I have doing this stuff and turn them in to a career. Maybe some day this will all pan out. Sooner would be much more beneficial for my body than later!

23-27 April 2010 - Vienna, Austria trip and the aftermath

2010-04-27T14:18:00.000+02:00

The trip to Vienna went well on some fronts and not so well on others. We really enjoyed checking out the city and we thoroughly enjoyed our side trip to Bratislava. The weather was lovely for most of the trip and the people we met were great. However, my fun was somewhat tempered by my bad back and my gout. We tried our best to use public tranport when possible to help us get around, but it still wasn't enough for my gout-damaged joints and my newly persistent bad back. Each day ended with me being in horrible pain, barely able to get off of the bed. My lower legs, from my toes to my insteps to my ankles to my shins, hurt like never before. This was a different kind of pain and soreness from the usual gout attack, however. Even though my ankles, feet and my right achilles tendon were feeling very gouty, they still weren't horrible as far as gout attacks are concerned. Yes, they hurt like hell, but it was the combination of all of these joints hurting along with the shin splints and sore calf and hamstring muscles that made things so bad. Throw in the bad back and at times, the pain was almost unbearable. By the end of each day, I was waddling around like a penguin.

I really tried not to overdo things while on the trip. I rested whenvever things started feeling too bad, drank plenty of water and maintained a healthy meal plan. I just don't think my body can take much walking anymore. It makes me really fret for the future. It seems no matter what I do, my body continues to get worse as far as activities are concerned, being able to handle less and less stress as time goes on. Even last year when I was suffering through horrific gout attacks, I could still go ski or bike or do long, rough hikes when the attacks subsided. I never felt this kind of nagging pain in my joints and muscles after partaking in these activities. Now, just walking for an hour or two wears my body down to a point where I either need to stop doing what I'm doing or rest for a prolonged period of time. It's very, very frustrating!

I do know that my back isn't helping things and may be making me walk a little different than normal adding some stress to my joints. Still, it shouldn't impact me this bad. One weird note about my back - it was killing me after the first two days in Vienna. I even had to leave a concert and go sit outside for an hour because I couldn't stand any more. Even leaning against a wall and watching the show was too much for my back (and my sore feet/ankles) to handle. However, I woke up the next day and my back felt fine. I went from barely being able to walk or stand due to my back to having it feel almost normal 8 hours later. It still is feeling decent a couple of days later. I don't get it, but I'll take it for now.

I actually had to take work off today (Tuesday) due to my gout. Again, I'm not in the throws of a full-scale attack, but my achilles and my left ankle are so sore and painful that I can't even put shoes on. I'm having a really, really tough time just getting around the house right now thanks to them. My body as a whole just feels completely worn down too. I expended so much energy over the weekend just trying to get around on my sore joints and with my sore back that I have nothing in reserve today. I feel wasted. My mind still feels sharp but my body feels like a rag doll. It will be interesting to see what tomorrow brings after a day off of my feet. I'm nearly out of sick time so I don't think I will have a choice about going to work. Just getting up the two large flight of stairs to my office could be problematic, however. We'll see.

22 April 2010 - Good Doctors visit and good UA Test Results

2010-04-22T10:31:00.000+02:00

This mornings visit to the clinic went much better than the previous two trips. I was able to see my regular doctor and to have a good, long discussion with him about where I'm at with my gout and the best way to continue with my treatment. My Uric Acid level from my test last week came back at 4.9. This is a very good thing and let's me know that the dose of Allopurinol that I'm taking is continuing to work. I mentioned to my doctor that I would be buying some self-testing UA strips in order to perform home tests and monitor my levels a bit more frequently. He liked this idea and agreed that we would still do the monthly tests also. He also mentioned to me something he had learned about the benefits of Vitamin D. There is an ongoing discussion about Vitamin D on the Gout-Pal forum that I need to more thoroughly check out. I'm not sure what the benefits are for gout, but the doctor did mention that it might help brighten my mood a bit. Hey, I'll try anything to lift my spirits. I also did receive a prescription for Tramadol to help deal with my chronic pain. Besides the gout, I had the doctor take a look at my back. He couldn't believe how tight the muscles were in my lower back and recommended that I go and visit a therapist at my old German orthopedic clinic. I will be checking that out next week.

What else...? Liver levels were a bit elevated but this was expected due to the 600mg of Allo per day. Nothing to be alarmed over, however. Kidney functions were normal. Blood Pressure was good and is slowly coming down which is really good! He did mention that the 24 hour pee test was not a good idea, disagreeing with the previous doctor I had seen. I would have to go off of Allopurinol for two weeks before doing the test which is a BAD idea.

One other thing to mention. I told the doctor about my body's reaction to the 'exercise' I've been doing (sorry for quotes, just never thought such light activity would be considered exercise by me). He said I should hold off for a bit and just let my body rest. I agree. Maybe in another month or two I can try again and see what happens. It's all trial and error at this point.

Pain-wise, I'm about where I was at yesterday. My achilles and ankles are still bothering me quite badly and my back is still a total mess. I'm hoping the Tramadol will help with this somewhat as the past four days have been miserable.

This will be the last update until next Tuesday. The wife and I are leaving for Vienna, Austria for a break from the real world early tomorrow morning. The plan is to buy a ticket for the tourist 'hop on, hop off' bus for Saturday to help me avoid walking too much. Sunday we will either drive or take a boat over to Bratislava to check that city's core out. Monday we will explore Vienna a bit more and then head home. I will be taking it as easy as possible, letting myself rest often when we are out and about. We're looking forward to the trip. Even if we just end up spending time in one of Vienna's great parks lounging in the sun, I will be happy. No computer, no phone, no work, time alone with my beautiful wife...... I can dig it.

20 April 2010 - I think my body is telling me.........

2010-04-20T13:59:00.000+02:00

to never do any physical activity again. At least that's what it feels like. It seems no matter what I try to do for exercise, no matter how light, my body rebels and a minor gout attack ensues. Go for a walk? My big toe starts hurting. Do 20 minutes on the eliptical? My ankle will hurt the next day. Clean the car? (like that's even exercise). My ankle, big toe, achilles heal and my knee start bugging me. I'm almost afraid to make a bowl of cereal for fear that I won't be able to get out of bed the next day.

Okay, so maybe it's not that bad. Over the last month or two, doing any kind of exercise, like a session on the eliptical or going for a walk, has resulted in a minor gout attack, usually the next day. At least this time I was able to get four days of light activity in before my joints said, "enough!" My whole body is feeling quite gouty right now, my right achilles tendon being the worst spot for pain. My left foot/ankle isn't far behind, though. My left big toe and left wrist along with my left knee are also giving me some problems. This is all compounded by my f*#%#@& back which is also very, very sore. Who knew that vacuuming out a car was so hard on the body?

I do have a doctors appointment scheduled for Thursday and hopefully I will get my latest UA readings then. If I'm still hurting, I'm also hoping to get a bit of respite in pill form from the doctor. I am currently taking two diclofenac tablets a day to try to help with the pain and they do absolutely nothing. Diclofenac, or Voltaren as it's sometimes called, is an NSAID given out by doctors to help with arthritis and acute injury pain. Yeah, maybe if I weren't dealing with a bum knee, bad back and simultaneous gout attacks in five of my joints, I 'might' feel some benefit from taking this supposed 'wunderdrug' (oh yeah, it's GREAT stuff say my German friends and doctors). If my internal organs could handle it, I don't think I'd feel any benefit from eating twenty of these pills at once. I'm on an entirely different level when it comes to pain, being able to withstand more than most mere mortals are supposed to and still keep a smile on my face. It's the days, like today, when even my pain threshold is surpassed, when I may need something a bit stronger. But, I'm labeled a 'druggie' or an 'addict' if I so much as ask for a three day supply of Percocet or even Tramadol (I like the latter much better than the narcotic pain pills - works better).

If I could be granted one wish pertaining to all of my medical woes but wasn't allowed to wish my problems away, that wish would be to have every medical professional experience just one week of what I go through. I'm sure most chronic pain sufferers would wish something similar just so people would understand them better and understand what they have to deal with just to try to live a normal life. I guarantee that most people would be crying for their mommy after just 12 hours of going through a single gout attack in a single joint. Try it for 15 years or longer.

I apologize for my tone today. I'm in a rebelious mood and not looking for sympathy at all. I've got my 'screw it all' attitude going and feel like dusting my mountain bike off, putting a stick between my teeth and going for a long ride on the most rugged trails I can find - damn the pain. I've lived through worse. I'll still outride you and beat you down the hill. It will make me feel tough and make me feel like I've accomplished something and make me feel like I'm in control. In reality, though, it will just make things way worse and put me in a state where I won't even be able to move for a week. I know this and I've learned this through doing exactly what I described above. I may be dumb, but I'm no idiot.

Okay, so I'm really just hoping that the pain I'm feeling right now doesn't get any worse. I have a very nice trip to look forward to with my wife to Vienna this weekend. I just need something that will allow me to at least get out of the damn hotel room in case this pain does persist. Is that so much to ask? Does that make me a bad person? It seems in some people's eyes, it does.

19 April 2010 - Just a quick note on this fine Monday morning

2010-04-19T09:34:00.002+02:00

I may have overdone things just a bit yesterday. We spent a couple of hours slowly ambling around the Nurnberg Spring Festival which wasn't too bad. We then spent a bit of time walking the large expanse of park surrounding the festival grounds, seeking out old NAZI relics from some of the finished and unfinished projects during that time. After about thirty minutes, my ankles were starting to get sore and my big toes were experiencing some familiar gouty twinges. That was when I decided to pack it in for the day and not push things. Still, I may have overdone it just a bit.

Here's the weird thing, though - yesterday it was my ankles and big toes sending me the warning signs. Today, not a peep from any of those joints. It's my right achilles tendon, a VERY familiar place for me and bad, bad gout attacks, that hurts. It's getting worse as the morning wears on, too. I don't think this will manifest in to a bad attack, but it is giving me a slightly gimpy gait and I'm being careful when I walk. The wife and I have a long weekend trip planned to Vienna starting this Friday and I don't want to be hobbled while we're there.

My plan was to do another light workout session on the eliptical tonight or to maybe even go for a short walk with the dog. Instead, I think I'll just take it easy and see if this latest minor flare-up doesn't subside. I will be going in to the clinic tomorrow to schedule another appointment with my regular doctor, but I'm unsure of when that will take place. Since he's been away, he could be a bit booked. I just hope I don't need any emergency meds before the trip this weekend!

2 PM Afternoon Edit - Right Achilles is feeling worse and now a weird spot on the top of my left foot is feeling gouty. I say weird because you wouldn't think this is a place gout would strike but it's pretty familiar to me. I don't 'think' this could be from the accidental meat I ate on Saturday. Most gout sufferers don't totally turn away from meat altogether like I've done. I think it's from too much exercise and walking the past four days. See, exercise can be bad for you :)

My damn back hurts too. I need a new office chair.

18 April 2010 - Not a bad day on Saturday

2010-04-18T08:01:00.000+02:00

Yesterday went pretty well. The weather was sunny and warm indicating that our alloted 1 week of spring in Germany may have finally arrived. I'm sure the rain will return soon, but it's nice to have this type of weather on a weekend for once! We took full advantage of this by waking early, packing up our things and the dog, and taking off for little towns and villages around our area to take some photos. We spent most of the morning doing this which did involve a bit of walking, did a bit of shopping and then went to a friend's birthday party. A nice walk that evening ensued and was relatively pain-free for me. So, got some fresh air, a bit of sun, and some light exercise - a great day in my world!

Awoke this morning dragging a bit since we got back home so late last night, but I'm feeiling pretty darn good. I do have a bit of gouty ankle pain going on, but nothing severe. Other than that, it looks like most of the gout pain has been fought back for now. My damn back is still sore, but even that is feeling better. The knee? Well, it does what it wants, goes out when it wants and locks up when it wants. But, it also isn't that painful, more of a nuisance than anything. It does limit what I can do of course, but I'll worry about that once the gout is more under control and the back is taken care of. Funny, putting this damaged of a knee third on my list of problems.....

One thing to mention - I did have a bit of meat yesterday - by accident! Some yummy bean dip was brought out at the party and I did eat a few healthy scoopfuls of the stuff only to have my wife inform me that there was hamburger in it. No wonder it was so good! I don't think it will make much of a difference with things, but we'll see.

Also - I'm not going to do the 24 hour pee test today. I'm going to talk to my regular doctor and discuss the folly of this with him further. I see no need to pay for this or do it. I'll report more on that later.

Okay, need to go enjoy this beautiful day!!

16 April 2010 - New UA Test today

2010-04-16T09:31:00.001+02:00

I finally got in to the clinic to have some more blood drawn. I won't know the latest reading until sometime next week. Even though I was feeling a bit gouty, I figured I would have this done anyway. I was also given a jug in order to do a 24 hour UA pee test which I will have to do this weekend. Basically, after waking up and getting rid of my stored overnight fluids, I have to pee in to this jug, record the time of fill-up, and then put the jug in the refrigerator or on ice until the next time I have to go. It's going to make getting out of the house that day to do anything interesting. I guess we can just haul around a cooler with some ice if we do decide to go anywhere.

Yesterday I did manage to do a bit of exercise which was nice. I've been in a bit of a funk the past few days and needed to do something to try to get myself out of it. Yes, my ankle and wrist were hurting, my back was giving me fits and my knee was creaking and popping loudly, but I still managed to hop on the eliptical and slowly and gingerly work up a sweat. I also got out in to the yard to pick up a winters worth of dog poop, something I've been meaning to do for a couple of weeks now. Oh, and I also tried out some of the doctor's back exercises which may not have been so smart. Those hurt. I need to see a real back doctor and get a real examination instead of some GP throwing some generic back rehab papers at me when he has no idea what's going on with my back.

Getting some exercise did make me feel better and has somewhat gotten me out of my doldrums. Exercise usually does. The only problem is that exercise can also cause me a lot more pain, putting me out of commission longer than I would have ever thought which in turn puts me in to a deeper funk. I'll just keep taking it easy (again) and try to ease in to this as painlessly as possible. My gouty ankle does hurt today and my back is killing me, but the rest of me isn't doing too bad. Right now, I'd say my back pain has surpassed my gout pain. Just another problem to worry about, but I'll just keep working on them one at a time.

15 April 2010 - The doctor episode revisited

2010-04-15T08:42:00.001+02:00

Now that I've had a bit of time to think about this, I can understand where the doctor is coming from - somewhat. I still think his approach was unprofessional and his outright accusations were uncalled for. To have gone through what I have for the last year and then to have to sit and listen to someone basically tell me that I'm fabricating things to get certain prescriptions, well, that set me off. This guy doesn't know my full history, but he also never tried to find out. As I tried to explain to him, in as succinct a way as possible, all of the problems I've dealt with concerning gout over the past 15 years plus the other ordeals that I'd been through over the last 14 months, I could see his eyes gloss over and a look of 'yeah, whatever', come over his face. He just didn't seem to care and was basically casting me to the side. Sort of a, 'heard this all before', scenario. At the time I felt like strangling him, if only my gout-ridden hands and wrists would have been able to perform this physical feat.

Over the past 6 months, this is what I have done to try to improve my condition:

1) Quit drinking alcohol entirely.
2) Quit eating all red meat and only occasionaly eat fish
3) Altered my diet to include many more fruits and vegetables, staying away from 'bad' gout foods
4) Religiously have taken 600mg/day of Allopurinol
5) Upped my intake of water and liquids consuming no sugary drinks at all
6) Sleep more and better
7) Exercise when possible
8) Make regular appointments to see doctors about my condition
9) Researched as much as I can about gout
10) Gave up my favorite activity - skiing - to let my body rest
11) Have only pursued very light activity - no biking, no running, no strenuous hikes
12) Keep my mind active by delving deeper in to photography and art

Number 10 was a big one for me. BIG. My body essentially fell apart right as ski season was kicking off. There were a few times where I almost said, 'screw it', and went skiing anyway. But I didn't. I could have and it would have hurt and it would have set me back greatly, but it would have also given me some sort of sick satisfaction. I live 2 to 3 hours north of the damn European Alps, I have 7 pairs of skis in my garage, I have no qualms about throwing myself down steep, powdery slopes, but I didn't. I sat at home all winter and chose not to partake this year. This was not easy, especially as I sat at my computer at home and updated the ski club website that I run for a local club, putting down trip details, looking through snow reports and forecasts, pursuing pictures that members had sent in from trips. Yeah, it sucked.

I guess that's what really pissed me off about that doctors visit. I, at least I think, have made some drastic changes in my life and lifestyle and it has not been easy. To have a doctor basically say that I don't look that bad and that things must not be all that bad and that I only want f'ing prescription drugs? Yep, I've done all of the above so I could get a three day supply of Percocet every month or two. Right on, doc. You hit the nail right on the head. To also hear him say that what I was doing wasn't working really gave me insight in to his understanding of the disease of gout. For some reason, many doctors believe that if you pop an Allopurinol or two every day for a couple of months, your gout will just magically go away. It is so damn frustrating at times dealing with these people and at the same time, trying to maintain some semblance of a normal life with gout. It's also very exhausting. Even with close to eight hours of sleep each of the last two nights, I feel drained, more mentally than anything. With each success there always seems to come a setback in dealing with this crap, whether it be another gout attack, my back going out on me, my knee hurting or dealing with a new doctor who has no understanding or sympathy for my case. God, I wish it were Friday.....
-----------

I'm due for another UA test but won't be going in until next Wednesday. I'm still feeling a bit too gouty to get tested right now.

Guestbook for General Blog Comments

2010-04-12T15:15:00.001+02:00

This isn't a true guestbook, but it is a place where general comments or questions about the blog can be posted. These would be comments unrelated to specific blog posts - just somewhere to share some information. We'll give this a shot and see if there are any takers.

You can find the link for the guestbook on the right side of the page near the top.

Please leave any comments or questions you have below by clicking on 'Comment'. Thanks!

12 April 2010 - Still some soreness but slowly getting better - and a doctor rant

2010-04-12T14:05:00.000+02:00

The right hand and wrist are still giving me some problems but are feeling a lot better than last Friday. Most of the swelling has gone down too, likely due to the prednisone which seems to work well at knocking back most of my gout attacks most of the time.

I did have an interesting visit with the doctor on Friday. He is new to the clinic and a bit, well, I don't know how to put it, but just weird. I've now seen this guy the last two times and have told him that I have a working history with another doctor at the clinic. I don't want to get too much in to it, but it's pretty obvious that I know a lot more about gout and how to treat it than he does. After telling him I'd been suffering with the disease for 15 years, he started saying I needed to do this and do that and try this and try that. To everyone one of his suggestions, I calmly replied, 'been there, done that, didn't work'. He then said I needed to go to a rheumatologist to be treated. I repeated that I had done this for almost two years, seeing a German rheumatology specialist and nothing he did helped. He treated me for rheumatology and not gout and my pain and suffering only escalated under his care. He then said that what I was doing obviously wasn't working (in a smarmy way) and I had to fill him in on the FIFTEEN YEARS that I have been trying to deal with gout and how only recently I had began taking 600 mg of Allopurinol per day to clean my system of the backlog of deposits. He then questioned if I even had gout, asking why I didn't have any tophii deposits. I have had them, dude.

Anyway, enough of that. What really pissed me off was that he basically accused me of being a prescription drug addict. Yes, I have taken a lot of pain pills over the past year. I've had some horrific gout attacks, a jaw broken and fractured in multiple places, two surgeries for that jaw and I've torn some ligaments in my knee. Just two months ago, my back went out on me so bad that I couldn't walk or stand up for two days. It's still bugging me quite badly and went out again on me badly two weeks ago. I have suffered through some terrible pain in the past year and have had some kind of pain that would make most people cry going on every single day. I deal with it. I live. Yes, sometimes I do need pain pills just to be able to get out of bed and get to work. I was pissed at the accusation. This guy doesn't know my history. Even when he went to look it up after telling him prednisone and percocet worked very well on my bad gout attacks, he came back saying I had been in there twice a month asking for pain pills. BULL SHIT. I've been in there twice in the past six months with bad gout attacks looking for help just so I could get through the day.

Anyway, I'm so sick of dealing with all doctors. Unfortunately, I have to deal with them if I want to keep my job. Otherwise, the next time a bad attack occurs or my back goes out or my knee decides to pop out, I'll have to stay in bed for a week or more because I will not be able to move or function. God I hate this situation.....

I'm going in to get my uric acid checked again on Thursday. He told me to do it last Friday when I went in and I had to explain to him that it doesn't work that way. I have to wait until I'm gout-free or fairly gout-free before checking my UA levels or I'll get a false low reading.

Well, at least I can type again..... :)

09 April 2010 - the party is in the right wrist

2010-04-09T07:26:00.000+02:00

i would love to type more but can't. too painful

08 April 2010 - Not in much of a typing mood this morning

2010-04-08T06:37:00.001+02:00

I woke up, both wrists are killing me. This has only happened once before - the double wrist attack. I used to get attacks in my wrists, bad attacks, very often. However, not so often at the same time. The pain from these current attacks is nothing like the pain of days gone by, but damn if they still don't hurt. I have no flexibility in either wrist and they are both slightly swollen. The left one is 'twinging', or pulsing, more than the right. Yesterday it was just my right wrist. The left quickly caught up and has now surpassed the right in levels of severity. I really hope this doesn't last too long. It's hard to pick up a camera, let alone a spoon, when they get like this.

Here's hoping for a work day light on emails - typing is not fun right now.

06-07 April 2010 - 'back' at it again

2010-04-07T18:59:00.000+02:00

My damn back. It's been giving me fits the last couple of days making life not so easy. I need to see someone other than a general practitioner about this. As far as gout, yesterday was fairly pain-free. Today, however, I've had some more than minor aches and pains pop up in my right wrist and right elbow. My left big toe was also hurting when I walked. The elbow and the wrist, though - they hurt. I don't think these will manifest in to full attacks, but more than likely the pain, stiffness and slight swelling will hang around for a bit. I was thinking back over the last couple of weeks and realized just how finicky the disease of gout can be. One day it will be my finger. The next, a toe. The next, an elbow. There is no way to predict what joint will be sore when and for how long. There is absolutely no discernible pattern. It doesn't matter what I eat, how much rest I get, how much water I drink, if I get exercise or not, if the moon is full the grass is green or a rainbow appears on the horizon. One thing I can be certain of is that at the very least, one of my joints will hurt. I'm still going to chalk this up to my body getting rid of the excess uric acid that has built up in my joints and soft tissue over the last 15 years. Maybe the body just does it haphazardly, joint by joint until there is no more to get rid of. Beats me.

When all is said and done, however, this minor pain is much, much better than the full-bore attacks I was having just 5 short months ago. Now, if I could just have a relatively gout-free day AND my back and/or knee didn't hurt, then we'd be in business.

03-05 of April - Gout pain low, other pain approaching 'off the chart' levels

2010-04-05T16:01:00.000+02:00

We had a good trip this past weekend but it was almost spoiled by my back going out on me. When I awoke early Saturday morning, I was happy to find that I hardly had any gout pain going on. Not 30 minutes later, however, I started feeling the familiar radiating pain in my lower back that seems to come on whenever I am starting to feel healthy. Seriously, this is like three times in a row that this has happened now. My gout pain approaches zero and then something else in my body decides to fill the pain void. Frankly, I'm quite sick of it and am becoming a bit disillusioned over the whole situation. Three times in the last 2 months this has happened. It's either my knee or my back, two areas I've been having a lot of problems with recently, two problems I've had thouroughly checked out by doctors, and two problems that I have received no answers for.

We did a lot of walking on Saturday and I'm happy to report that I felt no real gout pain in my toes, ankles or anywhere else. Most of the walking we did was on uneven cobblestone or on old, worn steps. Usually, these types of surfaces can be a worst nightmare for gout sufferers. So, chalk up a victory for me there. My damn back, though. It hurt like hell throughout the entire day. Finally, at around 9pm that night, it went out completely. I was lucky to make it back up the stairs to the room we had rented for the night. I was not a happy camper. I'm also (un)happy to report that my knee went out on me three times during the day. There wasn't much pain involved with this, but it was a bit akward. Take a step and.....no more support from the right leg which in turn wrenched my back as I tried to keep myself from tumbling to the ground.

The pain in my back had subsided somewhat by Sunday morning. We did a quick morning walk (shuffle for me) around the pedestrian area to take some pictures and then loaded up and drove back home. Each bump in the road, every pothole hit, every train track crossed reminded me of my back pain. I was happy to get back to the house.

Today (Monday), the back is still hurting and now I am experiencing some sharp pains under my knee cap again. Both are unrelated to gout but they still hurt. So, no starting the workout plan quite yet. I'm sure once my back feels up to it, the gout will come back on. I'm just drawing from previous experience here.... perhaps I shouldn't be so negative, though.

I turned 36 today. I feel every one of those years old - plus 10 more. I've got to get this stuff under control or the next 36 years are going to be absolutely excruciating. Yes, I'll still be patient and hopefully, very soon, I can start with some light activity. I'm just tired of waiting.......

02 April 2010 - A sunny disposition

2010-04-02T10:15:00.001+02:00

I have titled the post this way for two reasons. One, it's actually sunny in my little area in Germany. That could be cause enough for celebration. Two, I'm feeling less gouty than I have in a long time. I would love to put my pain level at a '1', but my elbow is still just sore enough and I'm still feeling some minor twinges in my big toes to keep it at a '2'. Other than that, I'm doing pretty well. This even gives me further hope that I'll be able to embark on a slow but steady exercise program to get my stationary ass back in shape. This weekend should be a good kickoff and a good test as to how my body will react to some light stimulus. I'll be doing plenty of walking and I've actually got a good feeling that my body will be able to take it all in stride. I'll hopefully be able to follow up the weekend with some light cardio and light weights. With weather like we have today, it makes me want to hop on my mt bike to hit some trails. If all goes well, perhaps I'll be able to do just that in a week or so.

I won't have any updates for this weekend as we'll be on the road for a short trip. I'll update the tracker when I get back Sunday evening and post again that night or Monday morning.

01 April 2010

2010-04-01T11:05:00.001+02:00

My pain level is actually quite low. It's been a few weeks since I've felt this good on the gout front. The finger that was acting up yesterday feels much better as does my elbow. I did notice some slight twinges in both my big toes this morning but they don't seem to be getting any worse. However, I am still feeling really run down and tired. I don't know what is causing this since I'm getting plenty of sleep and eating healthy. Just general stress perhaps. I do have a lot going on and a lot on my mind. I'm going to hold off on doing anything too strenuous until I have a couple of days in a row of gout inactivity. I don't want to spur anything on like I did last time. We will be doing quite a bit of urban walking this coming weekend, so that will be a nice warm-up in to hopefully a more rigorous workout regime starting next week. I'll keep my fingers crossed.

31 March 2010 - About the same as yesterday

2010-03-31T09:16:00.000+02:00

I'm still feeling pretty worn down today. Having an uber-busy morning isn't helping matters either. So much to do, so little time. My right elbow is still a bit tender. Not much change there. My right pointer finger is starting to get gouty at the middle knuckle. It's been a while since I've had gout in one of my fingers. It's never pleasant considering the amount of typing I do each day and how much mouse work I do on the computer. Hopefully this won't get any worse.

Must keep this short - things to do!

30 March 2010 - Tired so far this week

2010-03-30T09:05:00.001+02:00

I seem to have run out of energy. I don't know if it's from the prednisone or the percocet I took last week, but I'm drained. Yesterday I think I even dozed off at my desk for a few minutes. At least 95% of the gout pain I was experiencing last week is gone. My elbow is still a bit sore but much, much better. There are a few twinges in my right big toe but I don't think it's anything to worry about. The weariness can probably also be attributed to just overworking myself. I may be trying to do too much at once. My regular job is keeping me very busy and I've piled a few things on top of that also that don't give me much time to relax. I'm not necessarily stressed, but just worn down. This also could have something to do with my last attack I suppose. I think the only thing that is truly stressing me is the fact that I'm still unable to workout and try to get back in shape. I have too many little nagging injuries hanging around and really don't want to aggrevate those. If I've learned anything over the past couple of months it's that I shouldn't rush back in to exercise. Each time I've done it, I've ended up aggrevating whatever it was that was hurting me even worse. This always leads to prolonged time off from most activity. I'll see how I feel at the end of this week and then maybe I can slowly get back in to things and keep on going for once, finally establishing a workout routine. That's the goal at least.

28 March 2010 - Dreary Sunday

2010-03-28T16:59:00.001+02:00

Not a lot to say today except for the day does seem to be zooming by thanks to the time change here in Germany. Yeah, it's only an hour in time lost, but I'm sitting here wondering how it got to be 5pm already. Not much to report on the gout front. My elbow is still a bit sore and my big toe has had a few small twinges but nothing major. My knee is hurting, but this is the non-gout injured knee pain this time around. We did quite a bit of walking yesterday in Nurnberg and my knee is definitely showing signs of still having cartilage damage. I need to get this thing checked out soon. If I do need to have surgery, I'd rather have it sooner than later. Right now, I'm just happy that I was able to stave off the major gout attack that hit me hard on Friday. The last thing I need is another three or four weeks of major pain and limited mobility. I've had enough of that over the last few years. I'll look upon this as a success and hope that any future attacks can be handled just as easily.

27 March 2010 - It's amazing the difference that one day can make

2010-03-27T09:41:00.002+01:00

Yesterday I woke up and could barely get out of bed. When I did manage to pull myself in to a standing position, I found walking to be quite problematic. My knee was swollen, warm and I experiencing a fair amount of pain. If I wasn't careful, just a bit too much weight on the knee at the wrong time would cause it to give out from under me. On top of the knee hurting, my elbow was giving me fits also. To try to rememdy this situation, I went to the doctor and was able to procure the drugs I needed, hoping that they would work their normal magic in getting me back on my feet. I've received some negative feedback from other gout sufferers regarding this course of action, but it has almost always worked for me - prednisone and percocet. These are definitely not the first drugs that come to mind when one thinks of treating an acute flare-up of gout. I think I have proven to myself enough times now, however, that this combination does work and works much better than the normal indomethacin or colchicine route.

This morning, less than 24 hours after starting the perc/pred pill regime, all gouty pain in my knee is gone. My elbow is still sore, but it feels MUCH better than it did yesterday. I still do have the non-gouty tendon/ligament pain in my knee and it feels a bit weak, but this is entirely due to other injuries to that joint. I feel good enough today in fact, that I will be going with my wife to Nurnberg where we will be meeting some friends, hanging out in the Altstadt, taking some photos and just enjoying a leisurely day of being out. To me, this is any absolutely amazing turnaround considering how bad I felt yesterday.

I had an interesting chat about this with my brother back in the States this morning. He thinks that the overall change in my diet over the last five to six months is probably a big factor in limiting the amount of time a gout attack takes hold. My body is just fighting the attacks better since I'm eating so much healthier and am abstaining from alcohol. I think he's got a very valid point.

I know that a lot of people may frown upon my taking a narcotic to deal with these attacks. I know that some people may not be able to get a prescription for percocet as easy as I can. When I 'walk' in to the clinic, obviously in a lot of pain and obviously having very limited mobility, the doctors get an idea of what I'm dealing with. To seal the deal, I just show them my knee that usually balloons up to two or three times it's normal size. I believe, and thankfully they do too, that pain management is just as important sometimes as getting the swelling to go down in a rapid manner.

Time to get ready for the day. I'll be taking it easy, but it will feel good to be out and about rather than stuck inside laying on the couch with painful joints!

26 March 2010 - resetting the 'days since last attack'

2010-03-26T07:31:00.004+01:00

I made it 82 days without a bad gout attack. That's pretty good. I wish I could have continued that streak....forever. But, this morning I awoke with horrible pain in my left elbow and the pain in my knee is now feeling gouty. I still have the pain in the back and on the outside of my knee, and now, to go along with these pains, I have the all-too-familiar gout feeling right on my patellar tendon. I don't know if the gout in the knee was spurred on by the other pain or if the other pain I've been feeling the last two days was gout, just in a new location. Either way, this is not a fun way to end the work week. I would still classify this attack as only being moderate, but it does feel like it's going to get worse. The familiar burning and throbbing pain are both present in my elbow and knee and there is starting to be some swelling. Now, the tough choice - go see a doctor today about this or take a chance that it won't get any worse and just live with this. If it does get worse, however, I will have to wait until at least Monday to see a doctor.

My biggest worry is how long this will last. On average, gout attacks that spring up in my knees and elbows usually hang around for two or three weeks. It's absolutely defeating to deal with this type of pain for that long. It makes me feel worthless since I can't do much more than sit. Even doing little chores around the house becomes a huge ordeal. I may want to nip this in the bud as soon as possible. I'll give the clinic a call and see if I can't get some colchicine, something I haven't taken for years. I hate that drug due to the side effects, but maybe it's time to give it another chance. I'll report back later.
------------
10:40am update
It was pretty amazing this morning how quickly my knee went from tolerable moderate pain to being very painful. But, I did make it down to the clinic and was given some prednisone and percocet for the pain. This usually helps to knock out the worst of an attack in a day or two. Some people frown upon this method, but it has always worked for me. I'm not a big fan of taking narcotic pain relievers, but without them, I wouldn't be able to function. The typical NSAIDs that people say to take to help inflamation and to fight pain do absolutely nothing for me. It looks like this weekend is pretty much shot for me. At least I've got plenty of photography and picture work to do on the computer to keep me busy.

25 March 2010 - So, this knee......

2010-03-25T11:55:00.000+01:00

I have no idea what is going on with my right knee. I know there are some cartilage issues with it and I know that my patella is a bit out of whack and I know that I had a small tear in MCL last year. I was told with rest and time that it would heal itself. I'm sorry Mr. Doctor, but no, it won't. It's worse than ever! Right now there is some pretty bad pain in the back of my knee and it feels like it's all internal. If I'm not careful while walking, my knee will give out on me right when I put my full body weight on it. When it does give out, it almost feels like a hyperextension with my knee wanting to go the opposite way of its intended design. I don't think this is gout, either. I can poke and prod and even hit my knee (within reason, of course) and there is no pain. There is a little swelling, but it's minor and nothing like the swelling I've had when I was experiencing an attack of gout. There is also no redness and I never felt the 'twingy' feeling before the onset of the pain in the back of my knee.

I'm going to give it a couple more days to see if it gets any worse or if it just goes away. This knee is the one that I've already had three surgeries on. This is also the knee that usually has the worst gout attacks. I can't remember any traumatic injury that has occurred to my knee in the last few weeks. So, I just don't know. Maybe it is gout related, though. I only say this because I'm having some minor twinges in both ankles and my right elbow is starting to act up. My big toes also feel a bit gouty.

This is a bit of a setback for me. I've been very patient and very good with my diet the last few months. I was hoping I could start up a regular exercise routine again soon. It seems whenever I do feel good enough to get back on the eliptical machine or to go for a walk or hike, something else pops up, and as a result, I'm unable to workout for days at a time. My goal is to get myself in better cardiovascular shape and to drop 25 pounds in order to get out this summer for some glacier skiing in Austria and to do an epic hike or two in the Alps. It all leads up to being able to do some real backcountry skiing next winter.

I'll continue to be patient and hope that these little flare-ups run their course in due time. The knee thing, though, still has me puzzled. Another surgery might be in order - at least this has been mentioned to me on more than one occasion......

24 March 2010 - New Page Added - Gout Tracker

2010-03-24T08:14:00.006+01:00

Instead of clogging up the home page with a new spreadsheet each day, I've created a new page to hold the gout tracker. Just click the 'Gout Tracker' link above to view the spreadsheet. A new spreadsheet will be created each month, while another page in the spreadsheet will hold the data for the year. I'm sure as I get more in to this, I'll come up with something else to make this visually better, but right now, it's fairly easy to read and update.

Wow, not much sleep at all last night. Maybe a good 3.5 hours of decent sleep and then restlessness the rest of the night/morning. I also woke up with some new and weird pains in the back of my right leg just below my knee. I have no idea what this is from and I'm pretty sure it is not gout related. It may be due to the muscle relaxers the doc has me on for my back, but I don't know. This is my first time ever taking muscle relaxants so I have nothing else to base this experience on. All I know is that it hurts and it's a bit hard to walk. It feels as if my knee could go out on me at any time. I'll be off the pills after tomorrow and we'll see if this ends.

23 March 2010 - The beginning of my lifestyle tracking

2010-03-23T16:24:00.007+01:00

I've mulled over a few ideas for keeping track of my lifestyle and how it affects my gout. For now, I will use a simple format in each post that details any food I may eaten that is questionable, what type of pain I'm in related to gout, any exercise I may have done that day and anything else that pops in to my head. I will also be keeping track of this all in an Excel Spreadsheet. I just haven't found a good way to implement that in to the site yet. I'm doing this so I can run some statistics and grafs after I've collected enough data. So, for now, please bare with me as I use this simplistic format to record my gout statistics.

Well, it seems I found a pretty easy way to add a spreadsheet to the page using google documents. The formatting controls aren't great, but this works perfectly between blogger.com and google docs (since they are both google).

First post on the new blog!

2010-03-22T21:13:00.003+01:00

If you've somehow stumbled across this site during your search for gout related topics, you must be fairly desperate for help! Trust me - I know what it is like. That is the point of me creating this site - to better help others control their gout without having to go through what I did. As a fellow gout sufferer, I know exactly how it is to live with this crippling disease and how it affects all facets of one's life. Just living a normal, day-to-day existence becomes extremely difficult when you're suffering through an attack. As a person who enjoys backcountry skiing, hiking, biking and other outdoor pursuits, I realize just how painful gout can be and how frustrating it is when you can't ski after a two foot dump of snow due to a gout attack. Using myself as the guinea pig, I will update this Home page frequently, tracking my progress in controlling this disease. My ultimate goal is to be back on the slopes for the winter of 2010/11, the painful days of sliding a gout-affected foot in to a ski boot long behind me. I hope that you find the information on this site useful. There is a lot more to come and this site is most certainly still under construction!

Please check the 'About this Site' page for more information as to my intents with this site.