Jump to content
  • Welcome to the eG Forums, a service of the eGullet Society for Culinary Arts & Letters. The Society is a 501(c)3 not-for-profit organization dedicated to the advancement of the culinary arts. These advertising-free forums are provided free of charge through donations from Society members. Anyone may read the forums, but to post you must create a free account.

Gout


Busboy
 Share

Recommended Posts

I had my first gout attack in 2001 and thought my toe would fall off completly before it let go of me. I didn't get diagnosed with diabetes until 2006 so for 5 years I sought the cure. With a serious look at my diet, I began to eliminate all the "bad" foods. Didn't do as well as I could have, but did manage to make peace with meat and wine, let go of chocolate and drank cherry concentrate from a shot glass. I had only 4-5 true attacks for the next 5 years and many tingling warnings of near excess that I did heed. Then, in 2006 I had emergency bowl resection and began my love affair with alipurinol. I have not had an attack since. I drink white zin, eat red meat 4x a week, still no chocolate, and life is good. This disease of excess may have ancient origins and a royal history, but it's still alive and well in the US.

Link to comment
Share on other sites

This reminds me of my first attack.  I was at work on a conference call  in the VP's office with the Pres and Sales Manager (small company, I wasn't that important). We were going over the spec of our software. It had been sore for a day or two and I was limping around. But it started to hit hard during the meeting. They got me to take my shoe and sock off, and we watched it swell and turn purple during the call.

I went to my doc after the meeting. He suspected a clot. He hooked two giant (almost as big as meat injectors) needles up to blood pressure gauges. He said, "You're not going to like this, but I'm going to take blood pressure readings from different areas of your legs. If they're not equal, you have a clot." Well after 3 or 4 really painful sticks, he told me not to move. If I did I could die. He called an ambulance to take me to the ER.

The doc there wasn't nearly as freaked out as I was. She hooked up a series of blood pressure cuffs from my groin to my toes, both legs completely mummified by these things. Then she pressurized them all the way down. Weird feeling.  She said, "Its gout, that guy's a moron." Take these.

Whew.

OMG!

I was scared right there with you.

Link to comment
Share on other sites

There are two main drugs that seem to be effective at preventing outbreaks -- allopurinol and probenecid. Your doctor should do a 24-hour urine test on you (lots of comedy potential as you carry around a jug of your urine all day) to determine if your high uric acid level is due to overproduction or underexcretion. I believe that allopurinol is prescribed for the former, who make up the majority of cases, and probenecid for the latter.

Lots of water will also help with the gout and with the kidney stones as well.

Link to comment
Share on other sites

Ive had gout ever since I was 12 years old. It used to be just my toes that got gout. I was on everything from allopurinol, colcicine and indomethacin. As time progressed, the frequency and duration of the attacks increased. The joint areas where I got an attack also changed. Sometimes I got the attacks on my shoulders, elbows, both knees, my hands and fingers. Eventually, I went into surgery to remove a huge uric acid ball that was preventing my hand from openning and restricting its function.

With gout attacks that last more than a month, I got cortisone shots right at the joints.

Now that my kidneys have failed, from having been over medicated with all the NSAIDs(non steroidal anti inflamatory drugs) on the market, I am now on prednisone. I am only allowed 1 litre of fluid intake per day.

Be carefull of those over the counter drugs like advil and aleve. They may offer you some pain relief but your kidneys are at risk.

Link to comment
Share on other sites

Alas, I too know it well. My first two attacks were a mystery, but curiously both happened the day I had to do some serious traveling. The second one came as I awoke in Chicago and needed to take a flight to New Orleans. Somehow, the adrenaline from realizing that I had to get to the airport and on plane (or else) got me out of the hotel and to the airport, and then when I rounded the corner and saw how far the gate was, I darn near fainted, but was able to explain to my traveling companion that there was no possible way I could walk that far, so they got me a wheelchair, and when I got to NO, a wheelchair again and the hotel lent me a set of crutches for the week.

A visit to a real doctor diagnosed "gout". The colchicine never helped me, but the Indomethacin did. Vioxx also did great for the time that it was on the market (lord knows what else it did to me), and now they give me monster doses of Naproxen, and for my last attack, a cortisone shot in the big toe.

I never found much correlation between eating meat and/or things with high purine content - the attacks come when they want to - and I have found that no matter how many cherries and how much cherry-juice concentrate (remember, they claim its the sour cherries that work), that doesn't help either.

But for this and several other related conditions, I have given up alcohol, and this may be responsible for the reduced frequency of my own attacks - but I've had kidney stones as well, some of which are uric acid, and again, nothing dietary has made a big difference. Only the anti-inflammatories help.

Of the no-no foods:

Purine-Rich Foods

According to the American Medical Association, purine-containing foods include:

* Beer, other alcoholic beverages.

* Anchovies, sardines in oil, fish roes, herring.

* Yeast.

* Organ meat (liver, kidneys, sweetbreads)

* Legumes (dried beans, peas)

* Meat extracts, consomme, gravies.

* Mushrooms, spinach, asparagus, cauliflower.

I do eat a considerable amount of foie gras and sweetbreads (probably more than most people) though I (sadly) don't drink alcohol any more in any form, and I've been gout free for a number of years.

My suggestion is to experiment with diet and see if it helps you, and to experiment with anti-inflammatories and see which one works best and quickest. Naproxen 500 mg now comes in a sustained-relase form called Naprelan (I take it for another arthritis) and that may help you- you take two at once each day.

I always found with the indomethacin and then the vioxx that it took 6 hours to start feeling relief, no matter which one I took - so I guess that's the minimum time for the inflammation caused by the uric acid crystals (shaped like daggers) to start reducing once the medicine hits.

I haven't had an attack in the two years I've been taking the time-released Naproxen (aka "Naprelan") so maybe that's keeping it at bay, who knows.

Sorry to learn that you're a member of our club !!

Overheard at the Zabar’s prepared food counter in the 1970’s:

Woman (noticing a large bowl of cut fruit): “How much is the fruit salad?”

Counterman: “Three-ninety-eight a pound.”

Woman (incredulous, and loud): “THREE-NINETY EIGHT A POUND ????”

Counterman: “Who’s going to sit and cut fruit all day, lady… YOU?”

Newly updated: my online food photo extravaganza; cook-in/eat-out and photos from the 70's

Link to comment
Share on other sites

... My first two attacks were a mystery, but curiously both happened the day I had to do some serious traveling.

Maybe not so curiously. Most attacks of precipitation diseases (especially kidney stones, but also gout) among people I know began at a time of dehydration. Including while traveling by air (disruption of usual habits, not maintaining usual liquid intake, breathing dry air extended periods in flight) or after sustained vigorous activity with inadequate hydration. Dehydration as trigger also appears in some medical writing I've seen about these diseases (again, expecially stones).

Link to comment
Share on other sites

... My first two attacks were a mystery, but curiously both happened the day I had to do some serious traveling.

Maybe not so curiously. Most attacks of precipitation diseases (especially kidney stones, but also gout) among people I know began at a time of dehydration. Including while traveling by air (disruption of usual habits, not maintaining usual liquid intake, breathing dry air extended periods in flight) or after sustained vigorous activity with inadequate hydration. Dehydration as trigger also appears in some medical writing I've seen about these diseases (again, expecially stones).

Well, my first happened the day before I was to leave for Europe, and another one happened the day before I was to travel somewhere. The one above was actually my third - but your explanation makes great sense, and because I have other conditions that come from dehydration, I now remember to stay well-hydrated at all times. How the gout knew I was just about to travel the first two times was a mystery to me.

Overheard at the Zabar’s prepared food counter in the 1970’s:

Woman (noticing a large bowl of cut fruit): “How much is the fruit salad?”

Counterman: “Three-ninety-eight a pound.”

Woman (incredulous, and loud): “THREE-NINETY EIGHT A POUND ????”

Counterman: “Who’s going to sit and cut fruit all day, lady… YOU?”

Newly updated: my online food photo extravaganza; cook-in/eat-out and photos from the 70's

Link to comment
Share on other sites

  • 3 weeks later...

well well well... try having gout as a 21 year old woman :) not so pleasant either.

I have tried every trick in the book.... every trick and nothing has worked except two things which I had just slipped upon

1.) NO TIN FOODS... it is incredible, i still eat meat now and again, i still enjoy my red wine every other night, and lets not forget salmon... mmm so yes, no tin foods is a must.

2.) My recent trip to Sri Lanka was life changing. We went to organic farms where they showed us what cardamame, peppers, pineapples, mango etc are used for.

They offered me this bottle of PURE honey with cardamame and citrus... It was special for Gout... this was two years ago, I took it for three months and I haven;t had an attack since.

Anywho, flushing out your body is incredibly important. Now and again i feel my toe ache and I know I have to pound back a few ltrs of water in 1 hour... and it works... i stay away from all tin foods and eat meat once a week... try eating Cherries as well. they are a natural healer :)

Good luck and welcome to the life of Gout

As a tall, poorly coordinated individual with a liking for strong drink and bare feet, I am not altogether unfamiliar with the way a toe or two feels the morning after having been smashed against something the night before, a door-jamb while on the way to the cellar for another bottle, perhaps, or a bit of baseboard while journeying to the kitchen for something cold from the fridge: that sear when you role over and smush the toe(s) against the mattress, the colorful bruises encircling a joint or two, the pointless trip to the doctor where he says "yup, it's broke," tapes the toes together and advises you to wear hard-soled shoes for a while.  But I was mystified by this one.  I'd been on a belated "get-in-shape-for-summer" program and living entirely on food and water for days at a time, so it seemed odd that I couldn't remember the cause of the searing pain at the base of my big toe. 

Whatever it was, walking around on it -- limping, actually -- didn't seem to make it any better and so, at the pleading of my wife I wandered into the emergency room about 7 AM last Saturday morning (a surefire way to beat the usual mobs of bleeding and/or unconscious emergency room victims to whom triageurs might assign a higher priority than your toe) and hobbled out with a diagnosis of gout.

This shit hurts.  More than that it's inconvenient -- it makes everything from cooking dinner to walking to the bus stop  a pain in the ass foot.  It also sounds stupid --it's not like I'm some French lord living on foie gras and caviar.  Try saying "I can't, I have gout" to someone with a straight face. 

And worse, it's messing with my dinner -- no meat, fish, poultry, tofu [!] or booze, at least for as long as the outbreak lasts.  Gout is indeed caused by one's diet, and it's not only sweetbreads and rognons du veau which are to blame.  Apparently all meats, but especially red meat, and even that demon spinach are high in the feared purines, which elevate the level of uric acid (ick) in the bloodstream which then cause little deposits to form on your toe joints after which, depending on the direction you're counting, that last little piggie does indeed cry "wee wee wee" all the way home. 

So, my question: anybody out there ever had this? Any tips for speeding the healing process?  Do Quercetin and B-5 work? Is there a "safe" level for meat?  How does one diminish the odds of a recurrence without living like a vegan?

Any tips or amusing stories appreciated.

Link to comment
Share on other sites

Most beans not just soy are on the no no list also..so you basically cant have anything but iceberg lettuce...sorry...

My B-I-Ls both get this really bad - one of them swears by Organic Cherry Juice

He even gave everyone a bottle at Christmas

The other one just drinks more beer to feel better

Like mentioned above Water Water and more Water...and it seems to run in families too

tracey

feel better

Fortunately, we are in the midst of cherry season right now, so I'm able to bypass the juice and go straight to the source. Otherwise, I was pleased to determine that pizza is approved, as well as cheese and broccoli, so I'm able to buckle down to a weird but tasty diet.

Thanks everyone for all the tips, I'm hoping to get through this without having to hit the doctor for drugs or abandon sweet breads for life and will report back, in case I learn anything of use.

Hit the doctor - preferably a rheumatologist (although they are hard to come by). An excellent internal medicine doc will do in a pinch. For flare-ups - a pred pack is usually the best way to go. But then you will have to work on a long term plan. Drugs (colchicine - allopurinol) - diet modification - or a combination of both. I am not a doctor and cannot advise you what is best for you. All I know is gout is not a benign condition if left untreated properly - and the internet is a lousy place to get medical advice. Robyn (I have gout too)

Link to comment
Share on other sites

I'm sitting here, waiting, just waiting for it to strike. Gout does seem to run in families, and both my father and my late mother were sufferers. When Daddy can home with his diagnosis, we ribbed him with all those Country Squire cliches. He was not amused. Mummy was stricken a few years later.

I thought: "Oh well, the 'rents are major gourmands."

Daddy's sister, my Aunt Char, is abstemious, mostly, and a sensible eater. This is how Iknow I'm doomed: they wheeled her out of Pearson Airport in Toronto, a lovely 78 year old lady crippled by gout. Had she come back from a winetasting tour of the Cote D'or?

Nope. She came back from a trip to Asia Minor with her church group, retracing the footsteps of the apostle Paul.

Not fair.

Margaret McArthur

"Take it easy, but take it."

Studs Terkel

1912-2008

A sensational tennis blog from freakyfrites

margaretmcarthur.com

Link to comment
Share on other sites

  • 2 weeks later...
As a tall, poorly coordinated individual with a liking for strong drink and bare feet, I am not altogether unfamiliar with the way a toe or two feels the morning after having been smashed against something the night before, a door-jamb while on the way to the cellar for another bottle, perhaps, or a bit of baseboard while journeying to the kitchen for something cold from the fridge: that sear when you role over and smush the toe(s) against the mattress, the colorful bruises encircling a joint or two, the pointless trip to the doctor where he says "yup, it's broke," tapes the toes together and advises you to wear hard-soled shoes for a while.  But I was mystified by this one.  I'd been on a belated "get-in-shape-for-summer" program and living entirely on food and water for days at a time, so it seemed odd that I couldn't remember the cause of the searing pain at the base of my big toe. 

Whatever it was, walking around on it -- limping, actually -- didn't seem to make it any better and so, at the pleading of my wife I wandered into the emergency room about 7 AM last Saturday morning (a surefire way to beat the usual mobs of bleeding and/or unconscious emergency room victims to whom triageurs might assign a higher priority than your toe) and hobbled out with a diagnosis of gout.

This shit hurts.  More than that it's inconvenient -- it makes everything from cooking dinner to walking to the bus stop  a pain in the ass foot.  It also sounds stupid --it's not like I'm some French lord living on foie gras and caviar.  Try saying "I can't, I have gout" to someone with a straight face. 

And worse, it's messing with my dinner -- no meat, fish, poultry, tofu [!] or booze, at least for as long as the outbreak lasts.  Gout is indeed caused by one's diet, and it's not only sweetbreads and rognons du veau which are to blame.  Apparently all meats, but especially red meat, and even that demon spinach are high in the feared purines, which elevate the level of uric acid (ick) in the bloodstream which then cause little deposits to form on your toe joints after which, depending on the direction you're counting, that last little piggie does indeed cry "wee wee wee" all the way home. 

So, my question: anybody out there ever had this? Any tips for speeding the healing process?  Do Quercetin and B-5 work? Is there a "safe" level for meat?  How does one diminish the odds of a recurrence without living like a vegan?

Any tips or amusing stories appreciated.

I had a hip replacement about a month ago and the following week, had a horrendous gout attack. My doctor responded with, "Oh, surgery often brings on an attack". I was surprised to discover that the trusty ole Vicodin I was taking post op had precious little effect on the gout pain.

I have only had a few attacks over the last ten years. The first time, the pain was so severe, that even pulling a sheet over my toe sent me screaming. At that time of the first attack, I had been eating very little meat, and in fact an almost vegetarian diet, with lots of spinach,, portabello mushrooms, asaragus and beans. The first doc misdiagnosed it since I did not eat offal, very much meat, drink alcohol etc. After reading up on it, I realized that I ate alot of purine froming foods regularly. I went to another doctor and Bingo, he said I had gout.

These days, attacks can be set off by various ingredients. Last June, I ate pork roast three days in a row ( to get rid of leftovers) Bingo!, and the last time it was shrimp that set it off. I wish it were more predictable/ preventable.

As many have mentioned above, hydration seems to be key for the cure. So, at the first sign of a twinge I start hydrating. I can't really say if the cherry juice cure works, It seems to simmer down after three days of cherrirs and juicing. But that seems like a long time to me. But, I still take the cure, since I love cherries.

Link to comment
Share on other sites

  • 4 weeks later...

I first started getting gout in 2001 (I was 29.), but didn't realize it at first. I had started playing tennis again, so the little twinges I felt in my feet I put off on just tweaking my ankle a little. I did a little research after getting these twinges a few more times, and realized it sounded a lot like gout. But since it's usually older men who develop it, and especially after seeing the treatment (being a dry vegetarian), I decided I didn't have gout. Heh. And then one day, I woke up and just rotated my foot slightly and almost screamed, it hurt so bad.

Over the years, I've tried altering my diet, going through phases. I've never done any one 'alternative' treatment for a long period, usually because my attacks were fairly spaced out, and I'd get bored with it. Then a while back, I had a bad attack in both knees at the same time. It looked like I owed some guy named Guido a whole lot of money. I was on the couch for a month and out of work (restaurant business - the perfect occupation for having gout) for six weeks.

I seriously modified my diet, and was okay for months. But earlier this year, I had another mild attack. But it lingered for over a month, coming and going. So I finally went on probenecid. So far, so good. Like an earlier poster, I really wanted to do this 'naturally'. Not that I dislike drugs in general, but that gout really pisses me off. For years, decades even, I was fine. Then one day, my body decides it's not going to get rid of the uric acid anymore. Why? That's what irks me the most - that there's not much to why it happens other than genetics and predisposition and other general stuff. It's very annoying.

In my research, I've found that the non-animal food sources aren't that bad. Mushrooms, broccoli, beans, etc. have the purine causing chemicals, but they are slightly different. The worst things are red wine, offal, shellfish, beef, and oily fish. (I've noticed, like one poster above, that a lot of foods that are 'good for you' are bad for you if you have gout. Drinking a glass of red wine for reservetol, etc.; oily fish for the omega-3s. Gout is truly an evil condition.) Things that are mildly bad would be cheese (anything with protein), the vegetable/beans category, chicken and turkey. (Maybe other fowl too. And I think bison might fall in this category because of it's low fat and nutrition profile. But I haven't been able to find anything about it.) In between would be all other meat and alcohol.

And lastly - none of that is necessarily true. Gout seems to be a very individualistic condition. It will effect people very differently. To all the people above who are dealing with it, good luck.

-Greg

Link to comment
Share on other sites

The worst things are red wine, offal, shellfish, beef, and oily fish.  (I've noticed, like one poster above, that a lot of foods that are 'good for you' are bad for you if you have gout.  Drinking a glass of red wine for reservetol, etc.; oily fish for the omega-3s.  Gout is truly an evil condition.)  Things that are mildly bad would be cheese (anything with protein), the vegetable/beans category, chicken and turkey.  (Maybe other fowl too.  And I think bison might fall in this category because of it's low fat and nutrition profile.  But I haven't been able to find anything about it.)  In between would be all other meat and alcohol.

And lastly - none of that is necessarily true.  Gout seems to be a very individualistic condition.  It will effect people very differently.  To all the people above who are dealing with it, good luck.

-Greg

I think that was me with the good for you foods are bad for gout. Sad, but true. I haven't pushed it lately, but the drugs seem to be workin'. Finally. Minor pain, but no real bad attacks for a while.

May try a sardines and sangria combo next weekend if the weather gods are kind. that will be a real test.

Wish me luck.

Cheers,

Geoff

Link to comment
Share on other sites

  • 2 months later...

My bouts with gout have been horrendous. I've been hospitalized once, been to the emergency room several times ...

I get it throughout my body - no joint seems to be immune. There have been times that I not only couldn't get out of bed, but couldn't move while in bed. Turning over was impossible - and on good day I could turn over in bed but it might take as uch as 30 minutes to do so.

I'm now on Allopurinol daily and take an anti-inflamatory should there be the slightest sign of a flareup.

I just read today that aspirin can contribute to or exacerbate gout

 ... Shel


 

Link to comment
Share on other sites

My bouts with gout have been horrendous.  I've been hospitalized once, been to the emergency room several times ...

I get it throughout my body - no joint seems to be immune.  There have been times that I not only couldn't get out of bed, but couldn't move while in bed.  Turning over was impossible - and on good day I could turn over in bed but it might take as uch as 30 minutes to do so.

I'm now on Allopurinol daily and take an anti-inflamatory should there be the slightest sign of a flareup.

I just read today that aspirin can contribute to or exacerbate gout

Just curious - do you have a rheumatologist handling your case? Robyn

Link to comment
Share on other sites

My bouts with gout have been horrendous.  I've been hospitalized once, been to the emergency room several times ...

I get it throughout my body - no joint seems to be immune.  There have been times that I not only couldn't get out of bed, but couldn't move while in bed.  Turning over was impossible - and on good day I could turn over in bed but it might take as uch as 30 minutes to do so.

I'm now on Allopurinol daily and take an anti-inflamatory should there be the slightest sign of a flareup.

I just read today that aspirin can contribute to or exacerbate gout

Just curious - do you have a rheumatologist handling your case? Robyn

I've got some good doctors on the case, and apart from a flare-up in May, I've been free of any serious gout problems. One of the problems I had resulted from the number of medications I'm taking for other issues, and it took a while to find the right balance so that all the meds would work together. It was, for example, determined that one of my blood pressure meds was a contributor to episodes of gout.

 ... Shel


 

Link to comment
Share on other sites

 Share

  • Recently Browsing   0 members

    • No registered users viewing this page.
×
×
  • Create New...