The first few attacks usually go away in a few days and only affect one joint. As your gout goes untreated, however, attacks will last longer and longer (up to 3 or 4 weeks in some cases) and they will be much more painful and can attack a multitude of joints.
The longer you wait to take control your gout, the worse it will be. Joint damage and permanent crippling can occur.
The only way to truly determine whether or not you have gout is to extract fluid from an affected joint and have it tested. Having the fluid extracted will not hurt nearly as bad as a moderate to severe gout attack. Try to have this done locally as too much jostling of the sample can destroy the UA crystals.
The longer you have had gout, the longer it will take to flush the excess uric acid crystals from your body when you decide to start taking action to control the disease.
A gout sufferers Uric Acid (UA) level should be kept below < 6 mg/dl
Changing your diet alone will only lower your UA levels so much. This likely will not get you under the < 6 mg/dl level and you will continue to have attacks. You will need drugs to help your body excrete any extra or built up UA in your body.
If you are a longtime sufferer and have just started taking UA lowering drugs, don’t expect results right away. You may suffer some horrendous attacks as your body adjusts. It will take time to flush the built up UA in your system.
Have your UA levels checked monthly at first, preferably when you are not suffering from a gout attack
Taking blood for a UA test while in the midst of an attack will usually return lower UA readings than you would expect. This is because much of the UA in your system has been deposited in to specific joints and is not circulating freely in the bloodstream. Always try to get a UA reading when you’re feeling healthy. This will give you a truer measure of your day-to-day UA levels.
Unfortunately, if you’re like me, you may have to eliminate alcohol from your diet completely. Great, I’m living in Germany and can’t sample the beer.........
What to Discuss With Your Doctor
When the first gout attack hits, you may think you have suffered some traumatic injury to your big toe (or other joint), but you can't remember where or how it happened. The pain will usually be bad enough and unique enough that it will eventually lead you to the doctors office. Try to pick a doctor that you are familiar with and who you communicate well with. This will be a huge help. Also, arm yourself with as much knowledge about gout as possible. Be prepared to ask a lot of questions. I spent nearly 14 years seeing various doctors and none of them could diagnose what was happening to me. After I found Gout-Pal.com, I knew what questions to ask and exactly what I needed to do to first verify that I had gout and then how to take control of it.
Read up a bit on the following drugs that are used to treat gout:
- Colchicine (used to either stave off an attack or help with inflamation)
- Indomethacin (Anti Inflammatory used for gout cases)
- NSAIDs (Non Steroidal Anti-Inflamatory drugs such as Naproxen and Ibuprofen)
- Allopurinol (taken to keep uric acid levels down)
- Febuxostat (aka Uloric or Adenuric used to lower uric acid levels)
The doctor may want to take x-rays of the affected joint(s). This is fine as it will provide a baseline of the joints x-rayed for future reference.
Ask the doctor about taking a fluid sample from the affected joint. This is the only way a diagnosis of gout can be confirmed! It really is not as bad as it sounds.
Propose a schedule for having your UA levels tested once a month by your doctor. Tell the doctor that you need to be flexible as having UA levels tested during an attack will not give you an accurate reading.
Although there are different theories on how much you should use your gouty joint during an attack, it is still important to rest said joint and get plenty of sleep. Although sleeping may be tough, your body needs the rest in order to recover.
DON'T numb the pain using alcohol! I speak from personal experience here!
What I Have Done to Control My Gout
***Keep in mind; I'm a longtime gout sufferer who has a backlog of uric acid crystals to get rid of. This list is not meant for the average gout patient or someone who has just learned they have gout. These are just the steps I've had to take to begin taking control of MY gout.
- 600 m/g of Allopurinol per day. I will be staying at this level for the foreseeable future.
- Stopped drinking alcohol completely
- No red meat, only small portions of fish twice per week. Lots of fruits and veggies
- Increase intake of dairy products for calcium and protein benefits (all organic products - no hormones, etc.. More can be found on diet by following the 'Gout and Diet' link.
- Exercising when possible. This is not always easy with gout. I'm taking baby steps with this. I want to be able to ski, surf, hike, bike and climb for as long as I can in life. I've had to take this last year off from any activities due to my gout but hope to return to these activities later this year. I'm slowly on my way! See the 'Gout and Exercise' link for more information on this.
- Get proper amounts of rest and sleep. I'm notriously bad about this, but am doing my best to change.
