[Will]

Keith,

I wanted to give you an update. For the past 3 weeks any kind of activity I do is causing some level of pain in my foot. I went 6 months after starting Allopurinol with no pain but for the past 3 months I have had fairly persistent pain, and any activity causes more pain. My uric acid level is down to 4.3. The activity that is bringing on pain is not strenuous so I can’t blame that.
Prior to this 3 month stretch when I would have a flare it would last 3-5 days and then I would feel normal and could do anything. This time is not working out that way.
I have an appt with a rheumatologist March 2nd. But I am so confused now. I guess the low uric acid level could be speeding up dissolving crystals but I don’t get why I have had trouble for 3 months when the attacks used to last 3-5 days. I am really questioning whether or not what I am going thru is possible with gout?
I don’t know if it matters but it has been frigid cold here recently. I am not sure that matters because again I have been hurting the better part of 3 months but I thought I would mention it.

Any thoughts would be appreciated.

Thanks

• This reply was modified 6 years, 9 months ago by Will.

[Will]

Keith,

I got a call today and my uric acid level is now 4.3. It was 5.3 before I moved from 300mg to 400mg of Allopurinol.

My kidney and liver function tests were both normal.

[Will]

Tomorrow morning I have labs for uric acid, kidney and liver function. I had an x ray of my foot last Juky, just as I was starting Allopurinol and the dr said my foot looked good. But yi assume the crystals wouldn’t show on imaging anyway.

Twice this week I have had to take Indocin and Colcrys as I felt pain coming on in my foot and didn’t want a flare. Both times the pain went away quickly.
I just don’t get why I went 4 months with no pain and being able to exercise and now in last two months I have had a lot of days with some pain and several flares, though at their peak they aren’t as bad as they used to be before treatment. I don’t know if it is a combo of cold weather and crystals now desolving or if gout is not the culprit.

I will keep posting updates.

[Will]

Keith-
My doctor has not discussed a uric acid retest but I will call tomorrow and request one. My doctor also has never addressed my exercise program. I think the time has come to set an appointment with a rheumatologist.

Last week my attack peaked Friday. I made a mistake not starting the Colcrys earlier in the week. I took Indocin Fri morning and evening and by Saturday the pain was gone.

The first 5 months on Allopurinol I had no foot pain. But the last 2 months certain exercises have brought on foot pain and I have had several flare ups. We have had cold weather so that may be playing a part? Is it possible remaining crystals are “melting” after 7 months on Allopurinol? I am just trying to understand why I have had more trouble recently.

Thanks again for all you do.

[Will]

Keith,
I wanted to give you an update. About a month ago my doctor increased my Allopurinol to 400 MG. the past two weeks or so I have not been very active and my foot was doing really well. Well the past 3 days I have been very active and doing strengthening exercises for my ankle as well as range of motion exercises because the ankle that has gout doesn’t have the same range as my left ankle.
The pain has returned to my right ankle. It isn’t like a full blown attack yet but I am walking with a slight limp. The pain is on the outside of ankle and top of foot.
My question is this. I was on 300mg of allopurinol for 5 months and have been on 400mg for 1 month. Is it possible this pain is just irritation in the foot has been activated by exercise and the pain is due to some crystals that haven’t yet dissolved? I don’t know if this is a possibility or not. Activity and ankle exercises are clearly bringing on pain when I put weight on the ankle. Can gout cause nagging pain or does it only trigger full blown attacks?

Update: about an hour after I wrote this the pain has increased. It is now getting similar to a full-blown attack. Just thought that would be helpful to know in your response.

Thanks for your thoughts.

• This reply was modified 6 years, 10 months ago by Will.
• This reply was modified 6 years, 10 months ago by Will.

[Will]

Keith,

I appreciate your response. My update is this. My flare-up only lasted 1 day. The Colcrys/Indomethacin combo seemed to help a lot.

This week I had my uric acid retested and it came back at 5.3.

The nurse called and I asked for her to request my doctor in increase Allopurinol from 300mg to 400mg. The nurse called back this morning and said my doctor said that wasn’t a great idea and for me to just watch my diet more carefully. (I had eaten ham and turkey the day before my flare though I have no idea if this contributed to the flare or not).

I was a bit disappointed that my doctor did not increase the Allopurinol. I am not sure what my next step should be. Perhaps I wait and if I have another flare then I go in and force the issue?

[Author]

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