update on me again- ughh!!!

Hi everyone, Well I finally got in to see my doctor yesterday as he was on holidays for a few weeks. It has been 2 weeks now since my extremely painful episode in my knee but the pain is down considerably. After my visit to the emergency hospital that night they told me I had arthritis in my knee but I needed a second opinion. The X rays showed arthritis but I believe that something else caused me to wake up in the middle of the night screaming in pain? I have never experienced that level of pain before and I don't want to wish that on my worse enemy-LOL! My doctor seems to think that I have Gout and he is now sending me for tests to find out- they test your levels of uric acid in your body. I am still researching what Gout is and have cut and pasted some info that explains it well. This is good to know as many people who are obese are prone to it. After reading up on it and seeing that it can occur suddenly and unexpectedly I think that is what I experienced that night and it would explain my symptoms and why it just happened overnight without any warning. Below is a summary of what Gout is: Gout is a type of arthritis that results from too much uric (pronounced yur-ik) acid in the body. Uric acid is a waste product that naturally occurs in the body. It is normally flushed from the body by the kidneys through urine. With gout the body either makes too much uric acid or does not excrete enough. The uric acid forms into crystals that, because these have nowhere else to go, deposit in different parts of the body. Often the excess uric acid crystals deposit in the joints. This causes pain, swelling and tenderness in the area. This is called inflammation. Gout most often affects the big toe but can also affect the ankle, knee, foot, hand, wrist and elbow. Gout is a condition in which uric acid, a waste product that occurs naturally occurring within the body, rises above normal levels. Rather than being flushed by the kidneys and through the urine, as it normally is, it forms crystals and deposits in the joints. These deposits give rise to inflammation of the joints, causing pain, swelling, redness and tenderness of the area. Most typically the joint affected is that of the big toe, but gout can also affect the ankle, knee, foot, hand, wrist and elbow. Uric acid crystals may also form deposits in other areas such as under the skin or in other soft tissues, and in the kidney or urinary tract. What Causes Gout? A number of risk factors are associated with hyperuricemia and gout. They include: Genetics. Twenty percent of people with gout have a family history of the disease. Gender and age. It is more common in men than in women and more common in adults than in children. Weight. Being overweight increases the risk of developing hyperuricemia and gout because there is more tissue available for turnover or breakdown, which leads to excess uric acid production. Signs and Symptoms of Gout: hyperuricemia; presence of uric acid crystals in joint fluid; more than one attack of acute arthritis; arthritis that develops in a day, producing a swollen, red, and warm joint; attack of arthritis in only one joint, often the toe, ankle, or knee. Intense, ongoing pain in one joint, usually the big toe, that seems to have come on for no reason. Hot, red swollen skin and a feeling of pressure around the painful area. There may also be the feeling that the skin around the area is stretching or tearing. The onset of gout is usually quick and unexpected. Often, people who develop gout will do so during the night while sleeping, after having gone to bed in good health. During the night, they are awakened by acute pain in the big toe or, more rarely, in the heel, ankle or instep. This pain has been described as feeling at first like a bucket of cold water has been poured over the affected area, with the pain increasing to a violent stretching, tearing sensation. There is also a pressure and tightness around the area, and the pain becomes so acute that not even the weight of a bed sheet can be tolerated. The soft tissues, such as the muscles and tendons, around the joint can become hot, red and swollen, and wearing of a regular shoe may become impossible. ______________________________________________________________________ Well there you have it, I will keep you guys posted on what the tests will show. Take care everyone and have a great long weekend Sim --------------------------------------------------------------------------------------------------- Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has. Margaret Mead HW: 323 lbs; SW: 307 lbs CW: 254 lbs; GW: 150 June 26, 07- RNY, Seattle, WA

Gout can be painful. That diagnosis makes more sense than osteoarthritis coming on that fast. What can you do for gout?

Hi Holly, Here is some info on what one can do. I don't drink or eat shellfish or organ meat which are considered some of the trigger foods and beverages. The bad news is that aspirin works the best for the pain and inflammation but is not good for my pouch of course. Home remedies which can alleviate the symptoms of acute gout include resting and elevating the inflamed joint. Ice pack applications can be helpful to reduce pain and decrease inflammation. Patients should avoid aspirin containing medications, when possible, because aspirin prevents kidney excretion of uric acid. --------------------------------------------------------------------------------------------------- How is gout treated? Preventing acute gout attacks is equally as important as treating the acute arthritis. Prevention of acute gout involves maintaining adequate fluid intake, weight reduction, dietary changes, reduction in alcohol consumption, and medications to reduce hyperuricemia. Maintaining adequate fluid intake helps prevent acute gout attacks. Adequate fluid intake also decreases the risk of kidney stone formation in patients with gout. Alcohol is known to have diuretic effects which can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism and cause hyperuricemia. It causes gout by impeding (slowing down) the excretion of uric acid from the kidneys as well as by causing dehydration, which precipitates the crystals in the joints. Dietary changes can help reduce uric acid levels in the blood. Since purine chemicals are converted by the body into uric acid, purine rich foods are avoided. Examples of foods rich in purine include shellfish and organ meats, such as liver, brains, kidneys, and sweetbreads. Researchers have reported, in general, that meat or seafood consumption increases the risk of gout attacks, while dairy consumption seemed to reduce the risk! Protein intake or purine-rich vegetable consumption was not associated with an increased risk of gout. Total alcohol intake was strongly associated with an increased risk of gout (beer and liquor were particularly strong factors). Weight reduction can be helpful in lowering the risk of recurrent attacks of gout. This is best accomplished by reducing dietary fat and calorie intake, combined with a regular aerobic exercise program. There are three aspects to the medication treatment of gout. First, pain relievers such as acetaminophen/Tylenol or other more potent analgesics are used to manage pain. Secondly, anti-inflammatory agents such as nonsteroidal antiinflammatory drugs (NSAIDS), colchicine, and corticosteroids are used to decrease joint inflammation. Finally, medications are considered for managing the underlying metabolic derangement that causes hyperuricemia and gout. This means treating the elevated levels of uric acid in the blood with medications that reduce these levels. NSAIDS are effective anti-inflammatory medications for acute gout. These medications are tapered after the arthritis resolves. Common side effects of NSAIDS include irritation of the gastrointestinal system, ulceration of the stomach and intestines, and even intestinal bleeding. Corticosteroids, such as prednisone, given in short courses, are powerful anti-inflammatory agents for treating acute gout. They can be administered orally or injected directly into the inflamed joint. Corticosteroids can be prescribed to patients who have accompanying kidney, liver, or gastrointestinal problems. Long-term chronic use of corticosteroids is discouraged because of serious long-term side effects. In addition to medications for acute gout attacks, other drugs can be taken over prolonged periods to lower blood uric acid levels. Lowering blood uric acid levels reduces the risk of recurrent attacks of arthritis, kidney stones, and kidney disease, and also dissolves hard tophi deposits. Medicines used to lower blood uric acid level work either by increasing the kidney excretion of uric acid, or by decreasing the body's production of uric acid from the purine in foods. These medicines are generally not started until after the inflammation from acute gouty arthritis has subsided because they can worsen the attack. If they are already being taken prior to the attack, they are continued and only adjusted after the attack has resolved. Since many patients with elevated blood uric acid levels may not develop gouty attacks or kidney stones, the decision for prolonged treatment with uric acid-lowering drugs should be individualized. The drugs used lower the blood uric acid level by preventing uric acid production. It actually blocks the metabolic conversion from purine in foods to uric acid. They need to be used with caution in patients with poor kidney function, as they are at a particular risk of developing side effects, including rash and liver damage. Uric acid-lowering drugs are usually instituted only after complete resolution of the acute arthritis attacks. If patients are already taking these medications, they are maintained at the same doses during the acute attacks. ___________________________________________________________________ I will be getting lab work done this coming week to confirm that I have gout and then I will go from there. --------------------------------------------------------------------------------------------------- HW: 323 lbs; SW: 307 lbs CW: 253 lbs; GW: 150 June 26, 07- RNY, Seattle, WA Surgeon: Dr. J. Hunter Take care Sim

Hey Sim, Sorry to hear about the gout. I have an aunt who has severe gout and my family swears by the remedy of cherry juice. Who knew? It tastes good and apparently it really does work. C

Hi Sim, Sorry to hear about the gout. My brother-in-law suffers with it and it sounds like it is agonizing. I find it hard to believe that it could be osteo-arthritis. While you probably have that it would not cause you so much pain. Keep us updated on your progress. Your WL is going great. Take care, Gale.

hey sim it didn't seem like arthritis as it shouldn't come on right away . At least after your lab work you will have definite results. which is good. Glad to hear the pain is not so bad now. hopefully you are walking around better now.