# Stuff and Things > HISTORY, veterans & science >  Friggen Gout attack.

## Crusader

Woke up last night at 0330 with my right big toe joint on fire, Ive had bouts with Gout there before but its been a really long time.

Had a big day planed with my wife but instead I cant do crap, thing hurts like hell. This really surprised me as all the way to yesterday I was active and working out, then boom cant do nothing. 

Anybody got some home remedies that may work to shorten the attack and ease the pain, I fricken hate Gout!

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## Big Bird

Yeah.
Unsweetened tart cherry juice.
I even started making slightly oaked dry cherry dry wine for my gout.

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Crusader (04-19-2020),Quark (04-19-2020)

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## HawkTheSlayer

My poor grandmother suffered with gout. I think it has something to do with uric acid buildup and crystallization.

She only had a piece of one kidney. Dialysis was in its infancy.

I hope you feel some relief soon.

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Crusader (04-19-2020)

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## Big Bird

Here's the stuff I always keep in the pantry for when I run out of cherry wine.

cherryjuice.jpeg

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Crusader (04-19-2020)

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## Big Bird

> My poor grandmother suffered with gout. I think it has something to do with uric acid buildup and crystallization.
> 
> She only had a piece of one kidney. Dialysis was in its infancy.
> 
> I hope you feel some relief soon.


It's brought on by what you eat. Organ meat is what would get me. Like smoked sausage hot dogs and the like. If I stay away from that stuff, gout leaves me alone.

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Crusader (04-19-2020)

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## Big Bird

Some times I'll get into that cherry wine _"just in case" or to see if it's still good._

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Crusader (04-19-2020),Kris P Bacon (04-25-2020)

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## Quark

I sure feel sorry for you and your gout. My wife has gout but it has gone away since retirement and no longer living on processed food.

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Big Bird (04-19-2020),Crusader (04-19-2020)

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## TrumpTrain/banned

> Woke up last night at 0330 with my right big toe joint on fire



Wow. You could have written this article:


*Gout*
Overview
Gout is a common and complex form of arthritis that can affect anyone. It's characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe.

An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable.

Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares.

Gout - Symptoms and causes - Mayo Clinic

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Big Bird (04-19-2020),Crusader (04-19-2020)

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## TrumpTrain/banned

*Prevention*During symptom-free periods, these dietary guidelines may help protect against future gout attacks:

*Drink plenty of fluids.* Stay well-hydrated, including plenty of water. Limit how many sweetened beverages you drink, especially those sweetened with high-fructose corn syrup.*Limit or avoid alcohol.* Talk with your doctor about whether any amount or type of alcohol is safe for you. Recent evidence suggests that beer may be particularly likely to increase the risk of gout symptoms, especially in men.*Get your protein from low-fat dairy products.* Low-fat dairy products may actually have a protective effect against gout, so these are your best-bet protein sources.*Limit your intake of meat, fish and poultry.* A small amount may be tolerable, but pay close attention to what types — and how much — seem to cause problems for you.*Maintain a desirable body weight.* Choose portions that allow you to maintain a healthy weight. Losing weight may decrease uric acid levels in your body. But avoid fasting or rapid weight loss, since doing so may temporarily raise uric acid levels

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Crusader (04-19-2020),Quark (04-19-2020)

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## Retiredat50

I have suffered from gout since my early 30s.  Be thankful you have the version that attacks your big toe (My version of gout can attack any joint and even soft tissues, so kees, writs, elbow and the worse Achilles heel, and at some point it may hit my femoral artery or heart or whatever).  My first gout attack sent me to the emergency room.  My foot swelled up to close to the size of a football and they were close to slicing it open to relieve the pressure so it did not split open on it's own.

At the time they did not know it was gout, I had never even heard of gout.  I had incredible insurance and was able to meet with a rhumentoligist at Stanford Medical and he was like the number three guy in the country.  His first assesment was that I had advanced probably had advanced rhumatoid arthritis, which would have been a death sentence.

But, after tests it turned out that it was gout.  A lot of people, even doctors, know very little about gout.  For the majority of people it is confined to the first (big) joint in your big toe.  The reason is because the big toe is farthest from the heart and the blood flow slows in your feet (that is why a lot of people, especially women, have cold feet).  The blood slowing in that area allows the excess uric acid in your blood form into what they call sharp crystals.  These sharp crystals then lodge in your joint.  The next thing that happens is that the body classifies these crystals as foriegn bodies.

Now, when you have foriegn bodies in you the body is triggered to make more white blood cells (the cops of the blood) and send them to capture the intruders.  Here is where the pain and swelling happens. The way a white blood cell apprehends the offending material is to engulf it and then move it to your liver for disposal.  Now, imagine that these sharp crystals, aptly named, look like a toothpick without the middle part, in other word just a point on one side and a point on the other.  So, when the white blood cell surrounds it for removal the white blood cells is punctured and destroyed, leaving it's dead material which then requires more white blood cells to come and clean up.  Thus, a never ending cycley of pain and swelling (well, until your gout attack stops anyway).

So that is what causes the pain and swelling.  How to prevent it and how to make it hurt less.  Everyone is different, the medical community has absolutely no idea what causes gout.  Well, they know it is caused by excess uric acid that builds up and creates the crystals, but that is as far as their knowledge goes.

Everyone has a different trigger for gout, for some it is rich foods like organ meats, for some it is beer or wine, some people can drink all the wine they want but 3 beers sets them off and vice versa.  For some a piece of sausage will result in an attack whil other can eat sausage all day and no problem.  And for others... they never can pin it down to just one thing.

Oh, and the black cherry juice, yeah, some swear by it and others can drink a gallon a week and still get gout attacks (It never stopped my attacks).

I tried the medications Allopurinol and then Colchicine they instantly put me into a crazy bad attack and my doctor told me to ride it out and then I would be done (both times) he was wrong.  Now, there is a very strong NSAID that will helkp a ton that is Indomethacin.  Unfortunatly for me, the second time I went to the ER for gout (in my wrist, had me in tears, not crying just so much pain that tears were coming out) they gave me Indomethacin but the nurse did not give me anything to eat and it did something to my stomach lining and after that it was too dangerous for me to take.  The docotor told me that if I threw up something that looked like coffee grounds to call 911 immediatley.

The only thing that helps with gout are NSAIDs.  So, if you have no medical condition that prohibits you from taking ibruprofen that is the only over the counter medicine that will help you.  The most popular brand name is Advil, but it is a waste of money since all ibuprofen is the same and you pay multiple times for a brand name, just buy Equate Ibruprofen from Walmart, 2 bottles of 100 pills each 200mgs for like 4 dollars.

Home remedies for the pain.  First, even though you have swelling do not use ice or anything cold!! Just don't, that slows the blood which is the opposite of what you want.  The slower your blood is at the attack site the more problems you will have.

For me, I use warm to hot flowing water over the affected area when I can.  It may hurt at first but it speeds up the blood and stops more crystals from lodging in the joint and it will make it feel better.  You can also try soaking it in hot water and epsom salts, I have had relief with that for when it has hit joints that I could soak.

I do have an idea, one that I will never put to the test, sadly, but it could make me a trillionaire if it worked.  That is to make a small, portable, handheld ultrasound unit.  Ultrasound is used to break up small kidney stones, and these uric acid sharp crystals are smaller and much more fragile than a kidney stone.  So, if you applied ultrasound waves to the area, like a big toe, then the crystals would break down into smaller peieces and the white blood cells could do their job.  An hour after the attack starts, you could be pain free and over it.

Actually, I think I will look into it, so no one steal my idea!!

P.S. Sorry this is so long.

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Crusader (04-19-2020),NORAD (04-20-2020)

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## tom

Canned cherry pie filling worked for me. I ate it straight out of two cans. It's much too sweet but the only thing I could find at the time.

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Crusader (04-19-2020)

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## Crusader

Yeah this one really surprised me, I’m not overweight and I work out religiously. It’s been such a long time since I had an attack, I wanna say at least two years and then I was carrying more weight and not working out as much. I think I may be over doing my protein intake, too much chicken and pork. Gonna have to adjust my diet and get more of my protein from low fat dairy sources.

My plan right now is to.
ice it every hour.
drink lemon juice and apple cider vinegar three times a day
tart cherry juice three rimes a day...thanks big bird, wife went to get some.
and an anti-inflammatory.

Just read the post not to ice it, thanks.
Wanna knock this out quick, got things to do.

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## Retiredat50

> *Prevention*
> 
> During symptom-free periods, these dietary guidelines may help protect against future gout attacks:
> 
> *Drink plenty of fluids.* Stay well-hydrated, including plenty of water. Limit how many sweetened beverages you drink, especially those sweetened with high-fructose corn syrup.*Limit or avoid alcohol.* Talk with your doctor about whether any amount or type of alcohol is safe for you. Recent evidence suggests that beer may be particularly likely to increase the risk of gout symptoms, especially in men.*Get your protein from low-fat dairy products.* Low-fat dairy products may actually have a protective effect against gout, so these are your best-bet protein sources.*Limit your intake of meat, fish and poultry.* A small amount may be tolerable, but pay close attention to what types — and how much — seem to cause problems for you.*Maintain a desirable body weight.* Choose portions that allow you to maintain a healthy weight. Losing weight may decrease uric acid levels in your body. But avoid fasting or rapid weight loss, since doing so may temporarily raise uric acid levels


Oh, this post reminds me! I tried a low purine diet.  Sure the first question is what are purines?  Who the hell knows. This diet I tried for about 8 months.  Basically it was a vegan diet and did not include any of the delicious vegetables like mushrooms (yeah, not veg, but still) and asparagus, no asparagus? Yeah, it did not help.

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Crusader (04-19-2020)

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## TrumpTrain/banned

What was it that Barney Fife always had? Was that Gout?

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Crusader (04-19-2020)

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## Retiredat50

Gout is called the disease of Kings! Why? Because it was believed that it was brought on by over indulgence of food and alcohol. 

Also called the disease of kings based on a story of a King, I think it was one of the Henry's that could not take the pain and had his foot cut off.  Of course in a short amount of time his remaining foot was afflicted with gout.

The pain of a gout attack is at the level of a fresh broken bone on the pain scale  :Smile:  And it can last for a moth or more, no wonder he flipped ou

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Crusader (04-19-2020)

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## Taxcutter

Allupurinol (400 mg/day) and colchisine and lots of potassium salts.

Lay off shellfish and other fish.

Works for me.

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Crusader (04-19-2020)

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## TrumpTrain/banned

> Oh, this post reminds me! I tried a low purine diet.  Sure the first question is what are purines?  Who the hell knows. This diet I tried for about 8 months.  Basically it was a vegan diet and did not include any of the delicious vegetables like mushrooms (yeah, not veg, but still) and asparagus, no asparagus? Yeah, it did not help.


That was from the Mayo Clinic. Big friggin deal, fluids and eat right. LOL

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## Crusader

Yeah and what blows is I rarely ever drink, probably been three or four months since I had a beer, think I had one scotch and water last month but that’s it.

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## Retiredat50

> That was from the Mayo Clinic. Big friggin deal, fluids and eat right. LOL


I don't care if it was copied and pasted from the creator of the universe, it does not change the fact that gout is different for everyone.

And, what is eat right, define that please and define it as it applies to gout.  

I have dealt with gout for about 25 years, I am fairly sure I know more about it than a Mayo Clinic article that is basically a copy and paste from any other article they post.

Heart problems =  fluids and eat right
Overweight =  fluids and eat right
Diabetes =  fluids and eat right
Stupid =  fluids and eat right

You can miss me with that call to authority, thanks.

P.S. Yes, I respect the Mayo Clinic, but I also know that they will not post anything other than ambiguous information because they would be opening themselves up to lots of lawsuits.

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Crusader (04-19-2020)

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## Old Tex

I've got gout too. But mine is an odd case. Back in my early 20's I noticed that the knuckle on both of my thumbs started getting knots on them. The doctor checked it out & said I have gout. He put me on a couple of meds. I took them for a few months & they KILLED my stomach. So I said screw it & stopped taking them. That was more than 40 years ago & the knots are still there but no bigger. About once in 8 to 10 years I'll step wrong & a sharp pain shoots through my big toe. That's it, that's all there is to my gout. Never had an attack, nothing.

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Crusader (04-19-2020),Retiredat50 (04-19-2020)

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## Retiredat50

> Yeah and what blows is I rarely ever drink, probably been three or four months since I had a beer, think I had one scotch and water last month but that’s it.


And there you go.  99% of doctors will ask if you drink and 100% of those doctors will tell you to stop drinking and you will not have gout anymore.

But, in your situation it is obviously not alcohol.  So, if you did drink and then stopped it would not prevent the gout attacks. Doctors only know what they read in books and that is often wrong.

Here is the problem, Gout is not a big money maker like diabetes or cancer, so no one cares.

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Crusader (04-19-2020)

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## donttread

> Woke up last night at 0330 with my right big toe joint on fire, Ive had bouts with Gout there before but its been a really long time.
> 
> Had a big day planed with my wife but instead I cant do crap, thing hurts like hell. This really surprised me as all the way to yesterday I was active and working out, then boom cant do nothing. 
> 
> Anybody got some home remedies that may work to shorten the attack and ease the pain, I fricken hate Gout!



I've had trouble with Planter Fashititis for months. You don't think much about your feet until they fail you. I can't take NSAIDS due to previous stomach surgery and the Podiatrist prescribed something called Voltaren, a topical NSAID which relieved the swelling and pain considerably. I'm not sure if that would work with crystals stuck in your joint. Best of luck.

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Crusader (04-19-2020),Retiredat50 (04-19-2020)

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## Big Bird

> Woke up last night at 0330 with my right big toe joint on fire, Ive had bouts with Gout there before but its been a really long time.
> 
> Had a big day planed with my wife but instead I cant do crap, thing hurts like hell. This really surprised me as all the way to yesterday I was active and working out, then boom cant do nothing. 
> 
> Anybody got some home remedies that may work to shorten the attack and ease the pain, I fricken hate Gout!


I forgot to tell you, *do not use aspirin* use ibuprofen. Aspirin will make it worse.

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Crusader (04-19-2020)

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## Dan40

> Gout is called the disease of Kings! Why? Because it was believed that it was brought on by over indulgence of food and alcohol. 
> 
> Also called the disease of kings based on a story of a King, I think it was one of the Henry's that could not take the pain and had his foot cut off.  Of course in a short amount of time his remaining foot was afflicted with gout.
> 
> The pain of a gout attack is at the level of a fresh broken bone on the pain scale  And it can last for a moth or more, no wonder he flipped ou


The pain of gout is describe thusly.  Put the affected joint in a vise, tighten the vice until the pain is unbearable........... Then tighten the vice one full turn more!   That is gout.

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Crusader (04-19-2020),Retiredat50 (04-19-2020)

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## Crusader

> And there you go.  99% of doctors will ask if you drink and 100% of those doctors will tell you to stop drinking and you will not have gout anymore.
> 
> But, in your situation it is obviously not alcohol.  So, if you did drink and then stopped it would not prevent the gout attacks. Doctors only know what they read in books and that is often wrong.
> 
> Here is the problem, Gout is not a big money maker like diabetes or cancer, so no one cares.


I agree the best doctor is usually the one with the best guess.

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Retiredat50 (04-19-2020)

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## keymanjim

This is what I take:

https://www.amazon.com/Solaray-Total...%2C182&sr=8-12

Two tablets every morning. Even when I don't have a flair up.

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Crusader (04-19-2020)

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## Kodiak

> I've had trouble with Planter Fashititis for months. You don't think much about your feet until they fail you. I can't take NSAIDS due to previous stomach surgery and the Podiatrist prescribed something called Voltaren, a topical NSAID which relieved the swelling and pain considerably. I'm not sure if that would work with crystals stuck in your joint. Best of luck.


Crazy, I had never heard of that foot ailment before, now I have heard it twice just tonight you and Gregonejeep.  He mentioned it in the shoe thread Jen started.

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Crusader (04-19-2020)

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## Jen

> What was it that Barney Fife always had? Was that Gout?


There used to be a newspaper comic strip with Jiggs and Maggie .  Jiggs had gout.

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Crusader (04-19-2020)

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## Crusader

> This is what I take:
> 
> https://www.amazon.com/Solaray-Total...%2C182&sr=8-12
> 
> Two tablets every morning. Even when I don't have a flair up.


Does it help when you already have a flare up, flush it out faster or just as a preventative.

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## nonsqtr

> Woke up last night at 0330 with my right big toe joint on fire, Ive had bouts with Gout there before but its been a really long time.
> 
> Had a big day planed with my wife but instead I cant do crap, thing hurts like hell. This really surprised me as all the way to yesterday I was active and working out, then boom cant do nothing. 
> 
> Anybody got some home remedies that may work to shorten the attack and ease the pain, I fricken hate Gout!


No. Indomethacin (Indocin) is your best friend. Always take it with food and don't take it for more than 30 days in a row. It's bad for your stomach, so if you notice cramping or bloody stool stop using it. Most people tolerate it quite well - it's for acute use though, just don't take it forever.

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Crusader (04-20-2020)

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## Dan40

Regular lab work will tell you if uric acid level is at 8 or more, if so expect a gout attack. Last lab mine was 5.

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Crusader (04-20-2020)

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## keymanjim

> Does it help when you already have a flare up, flush it out faster or just as a preventative.


It'll speed you through the process. But, mainly it's to prevent them from happening in the first place. Though, it's not 100%.
Gout is something you'll have to live with for the rest of your life. All you can do is mitigate it's effects on your body.

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Crusader (04-20-2020)

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## donttread

> Crazy, I had never heard of that foot ailment before, now I have heard it twice just tonight you and Gregonejeep.  He mentioned it in the shoe thread Jen started.



There is tissue ( my doc said not really a ligament) that goes from the heel towards the front portion of the foot. You can stretch it by pulling your toes up Once you pull/aggravate that tissue it can be with you on and off for a long time. An injection helped quite a bit. Then being old with bad joints the limping causes other joints to flare up from Arthur. It's not fun.

On the other hand for an old, slightly over weight guy who tries to stay quite active if something doesn't hurt check the obits. LOL

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Crusader (04-20-2020)

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## Crusader

Well after six days my Gout is almost all gone, hope to be 100% by Monday. So pretty much shut me down for a whole week, but starting on Thursday I was able to start doing some light workouts(bench or seated)and I got some reloading done 250 rounds of 357, 1000 38. Stuck to the plan I posted earlier and got some of the Total Cleanse Keymanjim talked about, think it all helped to shorten the duration. Now gonna have to be more careful with my protein intake, looking back on it the week of the attack I had too much organ meat and asparagus.

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Retiredat50 (04-24-2020)

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## Retiredat50

> No. Indomethacin (Indocin) is your best friend. Always take it with food and don't take it for more than 30 days in a row. It's bad for your stomach, so if you notice cramping or bloody stool stop using it. Most people tolerate it quite well - it's for acute use though, just don't take it forever.


Indomethacin is ibuprofen on steroids.  The problem is that as much as it is better at being a non-steroidal-anti-inflammatory it is also that much worse for your liver and kidneys, plus it can an will destroy stomach lining if you take it on an empty stomach.

But, it is the best source of relief for gout pain.  As you mentioned, just take it when you have extreme pain, in other situations use ibuprofen.

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Crusader (04-25-2020)

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## Retiredat50

> Well after six days my Gout is almost all gone, hope to be 100% by Monday. So pretty much shut me down for a whole week, but starting on Thursday I was able to start doing some light workouts(bench or seated)and I got some reloading done 250 rounds of 357, 1000 38. Stuck to the plan I posted earlier and got some of the Total Cleanse Keymanjim talked about, think it all helped to shorten the duration. Now gonna have to be more careful with my protein intake, looking back on it the week of the attack I had too much organ meat and asparagus.


Organ meats and asparagus are high in purines.  For a lot of people, purine-rich foods are the trigger for gout. Here is a concise list of foods that are high and low in purines:

Low Purine Diet Explained with List of Foods to Eat or Avoid

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Crusader (04-25-2020)

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## Crusader

> Indomethacin is ibuprofen on steroids.  The problem is that as much as it is better at being a non-steroidal-anti-inflammatory it is also that much worse for your liver and kidneys, plus it can an will destroy stomach lining if you take it on an empty stomach.
> 
> But, it is the best source of relief for gout pain.  As you mentioned, just take it when you have extreme pain, in other situations use ibuprofen.


So far I’ve been able to stay away from the prescription meds for it, don’t like what I’ve been told and read about them. And so far the attacks have been few and far between, it’s been a couple years since I had one like this.

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Retiredat50 (04-25-2020)

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## Crusader

> Organ meats and asparagus are high in purines.  For a lot of people, purine-rich foods are the trigger for gout. Here is a concise list of foods that are high and low in purines:
> 
> Low Purine Diet Explained with List of Foods to Eat or Avoid


thanks for the list, I see a couple things on it I know I eat too much off the week of the attack.

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## Retiredat50

> thanks for the list, I see a couple things on it I know I eat too much off the week of the attack.


You are lucky if you can identify those items that trigger your attacks, really lucky.  Even a die-hard alcoholic would stop drinking if they knew it was what triggered that pain.

Just hope that your gout never goes from the little joint of the big toe to the big joints like your knee or elbow or wrist.  And, really hope that you never have it move to soft tissues.  

But, if you have spent more than a few attacks just on your big toe that is where it most likely will stay.  I could do a gout attack in my toe like it was a vacation  :Wink: 

Honestly, after I changed my diet years ago I have not had a serious attack.  I eat healthily, and that includes a lot of protein.  I eat mostly a paleo diet, meat, veggies, fruit.  Yes, I add in bread and pasta now and again, but not often.

I am in no way saying that a paleo diet is a way to avoid gout.  No one is the same.  For some, one beer will trigger an attack, for others they can drink a case of beer and be fine, but if they eat one sausage they are in pain.

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## Physics Hunter

About a decade ago, when I was late 40-something, first day of hunting season, my already damaged right big toe and entire foot swelled up and was hot as heck.  I went hunting anyway and killed a buck with a bow.  I had to track the damn thing 1/2 mile cross-hill, it was torture.

Doc told me it was not gout, just acute arthitus in a damaged joint.

Somebody told me about Aleve.  It is not a wonder drug, but it dulls the pain and lessens swelling.  I keep it around for any arthritis attacks, or joint injuries.  I use it, and the only other pain reliever I use is aspirin.

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## Retiredat50

> About a decade ago, when I was late 40-something, first day of hunting season, my already damaged right big toe and entire foot swelled up and was hot as heck.  I went hunting anyway and killed a buck with a bow.  I had to track the damn thing 1/2 mile cross-hill, it was torture.
> 
> Doc told me it was not gout, just acute arthitus in a damaged joint.
> 
> Somebody told me about Aleve.  It is not a wonder drug, but it dulls the pain and lessens swelling.  I keep it around for any arthritis attacks, or joint injuries.  I use it, and the only other pain reliever I use is aspirin.


Aleve is a brand name, like Advil.  They are both NSAIDS I have tried both for gout and found Ibuprofen (Advil) to be better.  But, everyone is different so if you have gout try both. (whichever you choose do not buy the brand name, uness you are just a complete idiot).

Aleve was marketed as a back pain medicine.

Ultimately, if you have gout the best medicine for the pain is indomethacin, hands down, nothing is as good.  The problem is you have to be very careful with it and it is by prescription only.  Sure you can order it from India but you take a chance doing so, but not that big of a chance.  Oh, and you can get Cialis and viagra from India as well  :Wink: 

My personal recommendation would be Cialis over Viagra, it is much better.

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