My husband gets gout secondary to his BP medication.He just got over the worst attack of his life, which lasted 2 weeks in the acute phase (no Allipurinol) and another 10 days to totally recover. The attacks are not just caused by food. When the body does work, first you sweat, which can dehydrate you and then the body has to deal with the cell repair and flushing of cell by-products, which increases uric acid. Flexing the forefoot (bike riding, ladder-climbing) can also aggravate the toe joint and forefoot pain, prior to an attack.
As I understand it, the BP meds reduce fluid retention, which concentrates the uric acid. He has to balance his intake of the ACE, diuretic and Allipurinol and has discovered the Allipurinol also reduces BP. Indimethicin actually doesn’t help him as much as Aleve.
The cherry juice is good as an anti-inflammatory during an attack. We use a concentrate and he makes it strong.
A high concentration of anthrocyanins (the anti-inflammatory substance found in all blue and red fruits) is in the skin of Black Turtle Beans, the small, shiny ones found in the Spanish shops and Latino food section of the grocery store. The beans themselves are full of purines, however. The way to get the bean broth is to take 1 cup of black turtle beans, boil in 2 1/2 liters of water, covered, for 90 minutes. Drain, give the beans to someone else, and drink the broth. I cup of the broth 2x a day hot or cold or use the broth as a base for a tomato vegetable soup, making sure not to include any of the high purine green vegetables. My husband takes this in addition to the cherry juice, cherries, blueberries and strawberries.
Alcohol is diuretic and dehydrating. Once you are controlled with Allipurinol, small, infrequent alcohol intake, followed by a glass of water seems to be tolerated.
Beer is bad because of the high B-vitamin content.
Vinegar and honey or maple syrup works over time. Use Bragg’s organic vinegar, with the mother. 1 Tbs vinegar, 1 Tbs honey, 1 Tbs water 2x day. IMO, this is a cumulative treatment.
Devils Claw seems to work for the pain. We found an herb tea called Yogi Tea-Joint Comfort. One of the main ingredients is Devils Claw. He says it is the most effective pain reliever. I brew it strong. He says it works almost immediately.
Keep the affected foot elevated. Keep it warm. Either wrap in a warm towel, make a warm pack with rice, or soak the foot in hot water. Using a hot tub gave my husband a lot of relief. Ice did not help him.
Keeping the Allipurinol in your system is important. He will stop Allipurinol after being pain free for months, because it has its own side effects and can aggravate uric stone formation in the kidneys. If you don’t get a rash from the Allipurinol, use it as directed. You cannot use it during an attack, as it flushes uric acid which accumulates in the foot. Once an acute attack ends, the Allipurinol will kick in after about a week or less and you can bring back some purine-containing foods. We avoid dark meat of chicken and have to limit the intake of venison to once every few months. Ditto shrimp/lobster, legumes (peanut butter doesn’t seem to bother him, though)and anything containing B-3 (Niacin). I do use a small amount of barley in vegetable soups, for body, but it does contain niacin. Dark green anything is limited. I use iceberg or red leaf lettuce. Celery and celery seed are diuretic, so I am not comfortable adding much of that to his diet or using celery seed tea.
A pair of sandals with adjustable straps over the forefoot can help. Strangely, I cannot recall him ever having an attack in the winter. Hydration as a preventative and to flush the uric acid crystals during an attack can help.
He has never taken colchinine. It is poisonous, has terrible side effects and the other things mentioned help the pain enough that he isn’t even tempted.
Horrid condition and full of Catch-22s for the sufferer if they have high blood pressure and are on medication for that and are stone formers, along with working/being active in the summer. Keep that foot elevated at night. As you know, it will come on overnight, as the body clears out the days cellular debris and the by-products of work. I wonder if not having the foot elevated at night has anything to do with it.
You have my sympathy.
All very good ideas.
Last night I hit what was in the pantry. Orange/Apple/Cherry juice in one iced pitcher and V-8 and Lemon Juice in the other pitcher and a liter of water.
The NSAID patch was not working so I switched to Tylonal (rarely touch that but luckily had some in the emerg kit).
Woke up this morning with no overnight pain (lotsa potty runs during the night : ) )
Pain is down 50% this A.M. and gone from the heel end of the foot.
So I can walk without chronic pain on my heel.
Lotsa popping in the foot too I suppose the inflamation going down is allowing cartiledge/bone to re align.
Going to repeat last nights liqued therapy and go get some cherries today.
And you are right about the excercise bringing it on that is what I thought at first living in an all sloped/uneven property as our deck (all flat) was being refurbished (dog poop area was closed) I had to spend the last few weeks walking around the property for dog duty.
So it very well could of been a big toe grout mixed with upper foot strain.
My foot fit into the shoe this morning too. I have worn Birks for 30yrs due to the nature of my work as a careprovider and relief from low back. Having duck feet too. Size 5/6 triple wide not so easy to find in a comfortable shoe when on the feet as a careprovider.
Some of the care needs I require dont get done so I cut corners and do my best. I am one person taking care of two so my son comes first and his care needs are immeadiate for survival.
Which is pretty typical of us single Moms with severely medically handicapped sons/daughters.
We have our medical respite provider coming in today so that will be some help in assisting while I get both feet up and running again.
And my Son is a good prayer warrior who also has two events coming up this week end so I have to get back on my toes. : )