[DL35]

Pen,

You do fit the typical treatment is what Keith is trying to tell you. Most people who suffer from gout need to be on medication to lower their uric acid. If you are on Urate lowering therapy such as Allo or Uloric your diet does not really matter all that much if you are on the right dose and your UA levels are low. I have not changed my diet very much at all and my UA has dropped from over 7 to 3.3 in 5 weeks on Uloric. This is not to say that a better diet will not be beneficial for a variety of reasons, but it is not the end all be all. Also, just because you get you UA in the 3’s or 4’s does not mean you will not have some pain in the beginning. I am still having pain, but as per my Dr. this should subside after a few months.

Hope this helps.

[DL35]

So I just got my blood test results back after 5+weeks on 40mg Uloric:

UA level is now 3.3, with no kidney or liver abnormalities. I have made no real diet changes, other than trying to limit beer (though still having some). Just as a reminder these were my numbers prior:

03/11: 5.2 (during attack)
09/11: 6.1
12/11: 6.6
01/12: 7.0
03/12: 3.3 (on Uloric)

As far as pain goes it has been hit or miss, but I have had no real flares. I actually had a couple days where I almost felt like I did prior to all of my symptoms. I got really excited, only to experience more pain in the last week or so. Most of the pain has been in my right knee, right great toe, right foot, and right achilles and it is more of a burning pain than anything else. Spoke to the doctor who said off and on pain is to be expected and could last for months, but that at my levels I should eventually feel much better.

He has me going for blood tests every 3 months for at least a year and wnats me to come into the office a month after each test to discuss.

So I can happily say that I think I am on my way to recovery and hopefully by summer I will be pain-free.

I will keep everyone updated and thanks for the respones. To Keith, I can honestly say that without this site, I would be in a much worse place today than I am, so thanks and keep up the good work.

DL

[DL35]

Just one more thing since someone may ask:? Cost to me for a month's worth is ~$15.? I also believe that I can get the card and possibly pay nothing, but not totally sure.

[DL35]

So got the results back from my 24-hour urine test and my excretion was in the normal range.? After a talk with the doc about habits (alcohol, etc.) he decided to put me on 40mg Uloric.? He stated that Uloric was a better option for some who drinks alcohol fairly regularly and he only decided this after asking me the questions.? Before the questions he had actually talked about Allopurinol.

I have been taking it now for two days, so really too early to tell how it is working.? I can say that I have had no flares and my feet actually feel a little better today.? Knees have kind of a dull ache which is different than the more burning pain I was having prior to starting the drug.

I have a follow-up appointment in a few weeks to talk with the doc and get full bloodwork done.

Wish me luck!? Hoping this is the beginning of getting life back to normal.

I will keep everyone updated on the progress

[DL35]

So I got my results?of the blood test back on Friday.? The tests other than for Uric Acid were normal, so I think we have?now ruled?out most anything but gout for what has been causing my issues.? UA levels were 7.0, which is? now my 4th test and each time the number has been slightly higher.? Below is breakdown of tests:

• 03/11:? 5.2 (during attack)
• 09/11:? 6.1
• 12/11:? 6.6
• 01/12:? 7.0

Spoke to the doctor and it now seems clear that I have a uric acid problem.? He?wants me to schedule a follow-up after my 24 hour Urine test, which I am doing today, to talk about next steps including a discussion about drugs.

Seems like this guy is the real deal and?we are on the right track.? Don't really want to go on a drug, but at this point I am not sure I have a choice.? Seems like only other choice is to drastically change the diet and?I don't think I?could follow-through long term with that.

I will give a further update after next results.

DL?

[DL35]

So I had my appointment yesterday with the new doc.

Overall, a very good experience so far, as this doc really seems to have a good handle on gout and was impressed with the research and knowledge that I had done.

First step was to do some more blood tests, specifically:? UA levels and some tests for some rare tick borne illnesses (due to some different symptoms) just to rule them out.? Based on previous tests he has basically ruled out RA and based on my history he is convinced that I have had 3 gout attacks in my right big toe.? He is still not sure that some of my other joint pain is related to the gout, but did not rule it out either.

Also he is having me do a 24-hour urine test and had new x-rays done on my big toe.? Dropped off x-rays and he called me back within 2 hours.? Said that I defintely have osteoarthritis in both big toes ( said this in office also, based on movement), but no gouty erosion signs.

Thought my case was quite interesting based on the fact that I do not fit profile and with where my UA levels are.? Next steps are to see where my levels are and the results of the 24 hour test.?

He agrees that levels like mine, while not going to cause imminent damage, may need to be treated with urate lowering therapy particularly if I have another attack.? He also did state that many people who need therapy need to get under 4 to get relief, which jives with everything I read here.

This guy really seems to know his stuff and did not treat me like I was some crazy person like others.

[DL35]

So….

Going to the new rheumatologist tomorrow morning, hoping that some answers will come.

Wanted to see if anybody had suggestions of the questions that I should make sure that I ask to get the most out the visit.

There are obvious questions, but is there anything i should ask for or about to make sure I am not missing anything.

I will post after the appointment with new numbers, etc.

Thanks,

DL

[DL35]

Keith,

Thanks for the prompt response.

To be clear, I am changing Rheumatologists because I beleived the first had laizze faire attitude about it, but he did say that if I wanted he would put me on something.? To be honest that is not the response that I wanted.? Would rather have a frank discussion about where I am, what I can do outside of medicine, and then a plan if that did not work.

My appointment with the new Rheumatologist is on the 24th of this month, so I should have a new baseline for my UA levels shortly thereafter.? If it goes higher and moves into the 7-8 range I think it may be time to try the drugs at some point fairly soon after.? If they are lower than the last reading, then maybe it makes sense to try some of the other diet changes, etc. that may help get me in a safer range.

As far as natural cures for lowering UA levels by a point or so, what do you reccommend?? I have tried many of the wives tales such as ACV, without much success and I don't think that would lower levels anyway.? Currently, have cut out beer and will do so until the appointment to see if that changes the numbers any.? May have a glass of wine or two, but no beer.

Once again, thanks for the response and if you have any ideas on the natural cures that would be great.? Also, would it make sense for me to wait on the cures, lifestyle changes until after the next reading?

Thanks,

DL

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