Has anyone ever had gout?

A 20 y/o with Gout, eh?....:think
Uhhh, your next step is to find out where Doc Shivago graduated (if) & if he's board certified.:silly:

Some information can be found here:
http://www.rheumatology.org/patients/factsheet/gout.html
http://www.rheumatology.org.nz/nz08003.htm

LOL nephron, but this is one of the things the site I posted had to say...

"Gout and its complications occur more commonly and at a younger age in males."

Not sure what their definition of "younger" is though. :think

My father had a case of it years ago. It is a urick (sp) acid thing. I understand the proneness to it can be heriditary.
Neph, being a physician...is that the best you can do for the guy? You seem to go in-depth on things you have less knowlege of. :think .....

oppps...:o

I do regular battle with a condition in my left knee known as Chondrocalcianesis (sp?) which is also known as Psuedo-Gout because it is often mis-diagnosed as Gout.

It is a concentration of Calcium and Phosphorous crystals in fluid build up in a joint. As with the regular form of gout, there are two kinds, Acute and Chronic. Acute being realtively dormant most of the time, with occaisional periods of down right near death swelling and pain. Chronic obviousdly being something more constant.

My condition is more acute and the treatment is a daily dose of Colchicine for preventative measures. When an all out attack/flare-up happens, my dosage is increased until I can't keep it down, and then it is backed off a bit. Not pleasant, but that's the Rheumatologist's game plan.

Do you have other arthritic conditions? Many times it can accompany Osteoarthritis as well.

Cam -- if it's truly gout, you've got to learn to accept the fact that sometimes you'll have flareups that are not easily overcome. One of my best friends has had gout for years. It's the crystals in your joint that hurt. Preventative measures include avoiding alcohol, etc., but it's no longer considered a gluttonous condition. Check out the various web sources on what to avoid.

As to drug therapy, there are the simple pain relievers, and one (I can't remember the real name, but we call it the "Werewolf pill") that has distinct psychological side effects. :scream: Warn your friends if you need to take that one.

One side note, and I kid you not -- one of the common predictors of the disease is intelligence. Very smart people have a much higher prevalence of the condition than the general populace (I know, it can be due to associative factors). I even know of one pharmaceutical company CEO who took gout medication "prophylactically" -- for style points. LOL.

Good luck with it. It's manageable, but a pain in the a__.

p.s. pm me if you'd like me to research, or if my post unintentionally reads like I'm cavalierly dismissing a painful condition -- I don't mean to. And I live with one myself.

No Gout,

But I have Lupus. Going on 11 years now. Pretty severe arthritis pain and easily torn connective tissue. Flare ups in the summer but prety intense pain in the winter. First cold week and I cant even walk.

When it comes to stuff like this doctors dont know their head from their ass. They are gonna try to get you on non-steroidal anti inflammatory's. I avoid them. Sure they help a little but do some serious long term kidney damage and you will have the runs and poop blood.

My advice is to try this stuff called natures life Cholostrum at a health and vitamin store. NOT GNC!!! A real herbal store. And Alieve will work wonders. I start with that and when it gets bad i dope out on pain killers. Doctors wont prescribe them to chronic sufferers of pain, but I ask you who could need it more?! I have a good "neighborhood pharmacist" so I avoid the doctor problem.

I dont let the pain stop me from having fun. If I can walk this weekend I will be riding. If not i will be riding just on pain killers. I will be at rocky ridge in Dallas. So look for the idiot swerving on the rm 125. HAHA! You have been warned.

The most important thing you can do is get plenty of rest. Drink lots of water and eat right! Take the other only if you need it. I think the Vitamins are fine to take but buy them from a reputable store so you know what you are taking. There is very little regulating or testing in the "natural supplements" markets and all that is natural and good, is not natural and good.

And watch what your doctor says. Dont TRUST him or her. Research everything. Remember the doctors work for the insurance companies NOT YOU!! And when they say chronic what they really mean is they dont know @#it!!

Is it confined to one area? Or all over?


Take care,

kingriz1

one of the common predictors of the disease is intelligence

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My family and friends would argue that point.
I've had flare ups for the past 6 or seven years,(once or twice a year), very painful! When it first started I thouhgt I could tuff it out , wrong! The only time I take any medication is when it does flare up, is usually gone in a few days (3-4), the rest of time I don't notice it. In my case it is my left foot.
Good luck,

gout

My In Laws have the gout, it sucks! One thing that I didnt see mentioned in the posts was citirus. Any oranges or grapefruit products sets off their gout. They even have reactions to orange base hand cleaners. Just a thing to try it might help.

Cam

Gout's a bit unusual in a 20 y/o. In fact, I've never seen it, and have only heard of oddball diseases presenting as gout at that age. You MAY hear of an isolated case of idiopathic gout from an oldtime Orthopod or Rheumatologist, but to go into a doc, have him look at your ankle and say "It's the gouch!" without aspirating the joint, performing a serum Uric Acid level, or even considering other possibilities (including the possibility of a septic joint:scream: ) is, well, lame.

The typical goucho is a 30-50 y/o obese male that does a bit of, shall we say, imbibing in 2-carbon anesthesia.:) The youngest case I've seen is a 38 y/o. The epidemiologists suggest it exists rarely even under the age of 40.

In my mind (which may be, uh, nevermind;) ), one must first establish the diagnosis without question at your age. ie, tap the joint, look for typical needle-shaped negatively bi-refringent crystals, make sure the cell ct/diff doesn't suggest an infection, check gram stain....blaah, blaah, blaah (hey Jaybird--you wanted it, right?:D ). Then, if it IS gout, determine if it really is one of those 1 in a million (and I mean that!) cases of idiopathic gout in a 20 y/o, or if it's secondary to underlying disease. If it is gout, per se, it's most likely to fall into one of the 3 following categories (rather than being bread & butter idiopathic stuff):

1) Athlete specific syndromes, such as occurs with (only examples here) "sesamoid" gout, "os trigonum tarsi", etc.--never heard of ankle disease.
2) Familial/genetic diseases such juvenile familial gouty nephropathy & other inborn errors of metabolism resulting from aberrant renal urate handling--obviously NOT going to be this, since you would have forwarded a positive family history from the beginning..??right??:think
3) Underlying lymphomas/leukemias--unusual to present JUST AS gout.

I am just suggesting that you need a better workup. If you were a fat, hypertensive, beer guzzling diabetic male--no problem. But a 20 y/o? Give me a break! It's possible, and yes, I could be wrong...But like I said, medicine is a game of numbers and probabilities. And you, my friend, DO NOT have gout until proven otherwise.

This effusion/joint pain could be a LOT of things besides gout (pseudogout, inflammatory effusion nos, trauma/bleeding, infection (septic joint), and many others). Go to a rheumy (rheumatologist), and be sure to get back with me.

Thank you, Nephron. :) Better late than never. :p

Yes I did. Thank you, sir-very informative!:)

Originally posted by nephron
...imbibing in 2-carbon anesthesia.

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That's a goot one.:) Can I use it?:)

That's a goot one. Can I use it?

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Sure! Of course, I borrowed it--held retractors in a Liver Transplant for 14 hours :scream: years ago as a medical student. I thought the transplant surgeon was kind of a numbskull, but after that surgery he said he was going to go partake in a little 2 carbon anesthesia (CH3CH2OH), and I thought that was kind of funny. I've never heard it since.

Originally posted by nephron
This effusion/joint pain could be a LOT of things besides gout (pseudogout.......

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Nephron, have any alternative drug suggestions other than Colchicine I can ask my doctor about for the maintenance of Psuedogout? The stuff is a nightmare on the stomach.

Thanks

vintage knees, er I mean, txvintage--If you're already seeing a rheumy, you're a step ahead of me. But, the answer is a resounding, non-halfhearted....maybe. Well, probably not. I mean, daily bid colchicine's been shown to reduce yearly attacks from approx. 30-10 episodes/year. If you're taking more than 2 .6mg tabs daily, then yes, there's something you can do--like cut down on the dose. But since you're probably not, I'll just be able to tell you that for the progressive form of CPPD (calcium pyrophosphate deposition disease) a simple Magnesium Oxide supplementation might be of some help. However, this typically only helps those with "chronic hypomagnesemia"--which is pretty damn uncommon. The other thing that's been done in those chronic progressors (which you apparently are not)--a prophylactic course of GAG sulfate (glycosoaminoglycan) injections might help. The initial study describing this was in 1988, but has never been replicated--so it's validity remains in question. The current name-brand injection is Syn-Visc or Arteparon. If you don't like that, you might just try some good 'ol homeopathic OTC doses of Glucosamine and Chondroitin Sulfate, although their utility is debatable. The other possibility is switching prophylactic meds to a traditional NSAID (like Relafen) or COX-2 (Vioxx/Celebrex), and use the Colchicine for attacks (1 every 30 minutes until relief, diarrhea, or 4 doses--whichever occurs first!;) ). You KNOW, the good ol dreaded steroids, like Kenalog/Depomedrol injections or Medrol po dose packs still kick serious butt, but don't tell your rheumy I ever said anything about them.:D

I wish I could have answered your question better, but a possible answer for you is up there somewhere. Best Wishes.

Thanks Nephron, I pretty much figured I was a ways down the known path already. Such is the life with a grade 4 arthritic knee which is afflicted with psuedogout as well.

I did note that you said take Vioxx and then take Colchicine when it flairs up. Hmmm, I aready do 25mg of Vioxx a day and .6mg a day of Colchicine. Maybe this explains the stomach problems....:think

Yep, the good old steroid injections work the best, and my Rhuemy even agrees, but she won't do them less than six months apart. My ortho on the other hand will do them 3 months apart if absolutely necessary.

Perhaps later we could muse on the arthritic nature of the right shoulder. Man, I gotta stop falling down:scream: