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.
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Nate, one thought which I know works for a lot of people: To fight tiredness, low energy, depression, irritation, expose your body to the sun (not at noon, but 8-10/11AM and/or 3-6PM) if you got sun. That's why I love New Mexico with its 300+ days of sunshine. Don't counteract the effects of the sun rays with drowning your body in sunscreen. (Google sunscreen effects, you’ll be surprised what bad info the sun screen industry has put into our heads, just like the food industry.)
ReplyDeleteBtw, I am about to reach 30 minutes (1800 seconds)/day of sun gazing.
That could actually have something to do with it and I think it would help, at least a little. Problem is, we're still in early spring mode here in Bavaria! 50's and raining all weekend and the same for the next couple of days. It's been bad. But, now that I think about it, I never had that much of a problem in Alaska with lack of sunlight. In fact, I loved the winters up there.
ReplyDeleteI need to read more about this sun gazing. I've seen it mentioned but haven't heard much about it. It sounds interesting!
Here is a start:
ReplyDeletehttp://www.youtube.com/watch?v=zlCJPxxKoaY
This is what got me started.
For a starter:
ReplyDeletehttp://www.youtube.com/watch?v=zlCJPxxKoaY
This what got me started.
Nate,
ReplyDeleteI am very glad your gout attack is subsiding. Have a few comments for your reference:
1) When the present attack is over, I strongly suggest that you keep taking anti-inflam at prophylacic doses. This can prevent future attacks and/or reduce the severity of the attacks. For prophylaxis, gout literature suggests: Naproxen: 250 mg 2x/day; Colchicine 0.6 mg 1x/day; or, Indomethacin, Diclofenac, Prednisone, etc. at low doses. Gouties are recommended to take prophylactic anti-inflams with Allo for the first 6~12 months of the Allo therapy.
2) Taking Allopurinol 600 mg 1x/day (1-dose solution) can trigger more gout attacks than taking Allo 300 mg 2x/day (2-dose solution).
Each molecule of Allo can cause the liver to produce 1 molecule less of uric acid. Therefore, the total amount of the reduction in UA production is the same for both 1-dose and 2-dose solutions. This is why your doctor and pharmacist said it makes no difference if you use 1-dose or 2 does solution. However, they do not seem to be aware of the fact that sudden fluctuation of the blood UA levels is a major trigger of gout attacks. And, 1-dose solution causes much bigger plasma UA fluctuation that 2-dose solution. Therefore 1-dose solution can trigger gout much more often than 2-dose solution.
Both Allo and its metabolite, Oxy-p (Oxypurinol), inhibit production of UA from purines. Allo has a plasma half-life of 1~3 hours; oxy-p, 12~30 hours. If we use 12 hours as the half-life of Oxy-p in plasma, we find, by computation, the following approximate maximum and minimum of Oxy-p levels in plasma during a 24-hour period:
1-dose solution: max = 798 mg (133% of the original 600 mg Allo dose), and, min = 198 mg (33% of 600 mg), and,
2-dose solution: max = 600 mg (100% of 600 mg), and, min = 300 mg (50% of 600 mg).
Clearly, 1-dose solution has much bigger fluctuation than 2-dose solution. This may be a reason why your gout attacks never stop.
Since your doctor and pharmacist approved of 2-dose solution, you might like to try 2-dose solution to see if it can reduce the number of gout attacks.
Take care.
(by annon.nn)
JY wrote:
> Nate,
>
> I am very glad your gout attack is subsiding. Have a few comments for your reference:
>
> 1) When the present attack is gone, I strongly suggest that you keep taking anti-inflam at prophylaxis doses. This can prevent future attacks and/or reduce the severity of the attacks. For prophylaxis, gout literture suggests: Naproxen: `250 mg x2/day; Colcicine 0.6 mg/day; or, Indomethacin, Diclofenac, Prednisone,or ... at low doses. Prophylactic anti-inflams have been recommended to be taken with Allo ... for the first 6~12 months.
>
> 2) Taking Allopurinol 600 mg once/day (called 1-dose solution) can trigger more gout attacks than taking Allo 300 mg 2x/day (called 2-dose solution).
>
> Each molecule of Allo can cause the liver to produce 1 molecule less of uric acid. Therefore, the toal amount of the reduction in UA production is fixed for both 1-dose and 2-dose solutions. This is what your doctor and pharmacist talked about. However, they do not seem to be aware of the fact that sudden fluctuation of the blood UA levels is a major trigger of gout attacks.
> s
I
> Since 2-dose solution causes less fluctuation than that of 1-dose solution, 2-dose solution is ( that of 600 mg/day, it is better to take 300 mg x2/day. The computation below explains why is that so.
>
> The effectiveness of the half-life of Allo (and its metabolite, oxypurinol) is
>
Hans,
ReplyDeleteI started to watch the sun gazing video, then realized it was 47 minutes long! I will check it out when I get home tonight. Hey, we actually can see the sun today here in Germany. It's been a while!
Hans,
ReplyDeletethat's some interesting stuff. Too bad I live in a place where the sun is rarely out! Have you found doing this has given you more energy? Have you been able to eat less while doing this?