- This topic has 18 replies, 6 voices, and was last updated 9 years, 11 months ago by
.
-
Posts
-
Greetings all gout sufferers,
?
Im sorry to say this, but I ve lost hope on allopurinol during the last month.The reason why is?I found no solution to my painful joints. My joints would just turn red and be sore if I do any acitivity involving them. So I grew fustrated and halted the medication. I know it was a very foolish decision of me of stopping . But I grew fustrated from this arthritic desease. (ex. fired from my job? and exempted from daily from friends activities) I ve decided to give this drug another try, sinced I know I wasnt on the right dosage. But my question to you gouties is will my doctor?start me from the beginning dose of 100 mg??(uping the 100 mg per month till the right dosage)or?back to?300? Oh, also Ive been talking NSAIDs but they only help during the 24 hour duration.
How long have you been taking Allopurinal? Were you taking 300 mgs when you stopped? What was your uric acid level? Have you tried Colchicine to take the edge off the attacks? ?As far as the NSAIDs some guys have been taking these daily for years.?What dose will?your doctor start you back on? Thats hard to say?cause they all seem to have a different idea of whats best.?What ever you and your doctor choose to do?I wish you luck. Limpy.
juggernaut,
just tell your doctor that you've already tried the drug and you know you?are not allergic to it and you would like to start with 300 mg. If he gives you a hard time tell him that you see no point in suffering weeks?more of needless pain because of an ineffective dosage.
Test after a month and if you get a SUA under 5.0 mg/dL?then just take that dose til the cows come home. If you cannot get down that low, consider upping your dosage gradually.
?
Don't give up on the drug. It will work if you keep at it.
Thank you Zip for your quick response,
I will take your advice and persistantly force my GP to start me at 300 mg.?After a month I will inform you on my SUA level. And I will hopefully up my dose and inform you on that. After 5 months of drinking litres of waters, using allopurinol and no relief. Saying “giving up hope” is a big understatement.?
?1?months and a half ago, my UA level was 6.74 mg/dL. Which is average, but my feet and hand still have numbness and redness residing on the padding. (I apologize I dont have photos to show you)
Maybe 6.74?is average for someone without Gout i'm not sure.?But its a killer for anyone that has it because?at that level the crystals are probably forming one day and breaking down the next. Putting you in a bad place. Where if you were on say 400 mgs of Allo and?your acid level was below 6 you would be melting away the crystals and in time the pain.?Good luck. Limpy?
juggernaut,
?
As limpy said, 6.7 is not a good enough level for proper gout treatment.
But maybe there was a misunderstanding? He was asking what your level was when you were ON the allopurinol. Is it possible the number you quoted was your level when OFF the allopurinol?
?
If a month of 300 mg. gives you only 6.7, then that is not enough of a daily dose.
?
If indeed the 6.7 was the result you got with 300 mg. AP, and if the doctor is the same one, it would not seem unreasonable to ask him to start you on 400 mg. allopurinol. There is also the possibility of using 300 mg. allopurinol along with 500 mg. probenecid. You can get VERY low uric acid numbers with the two drugs.
ltjuggernaut said:
1?months and a half ago, my UA level was 6.74 mg/dL. Which is average, but my feet and hand still have numbness and redness residing on the padding. (I apologize I dont have photos to show you)
If I were you, I'd question the number 6.74 mg/dL I have NEVER seen mg/dL expressed with two decimals. To me, the number looks very suspicious. I don't think that you have a correct SUA reading.
Yep,
Hans, you are correct on that overspecification. SOmeone else just reported a 3.90 and I suspected the British molar system.
But then computer programmers may have no clue these days what the term SIGNIFICANT DIGITS means. Few people really do. And the doctor blindly reports what the printout tells him.
?
I'm 6 feet 2.000 inches tall. (If measured with a laser.
)zip2play said:
…
But then computer programmers may have no clue these days what the term SIGNIFICANT DIGITS means. Few people really do. And the doctor blindly reports what the printout tells him.
?
I'm 6 feet 2.000 inches tall. (If measured with a laser.
)
They only know the term SIGNIFICANT OTHERS because they cost them money.
You are sure you are not missing the 0.0001 inch???
hansinnm said:
zip2play said:
…
But then computer programmers may have no clue these days what the term SIGNIFICANT DIGITS means. Few people really do. And the doctor blindly reports what the printout tells him.
?
I'm 6 feet 2.000 inches tall. (If measured with a laser.
)
They only know the term SIGNIFICANT OTHERS because they cost them money.
You are sure you are not missing the 0.0001 inch???
It's possible becasue I had a high protein meal yesterday…I might have grown
Just got back on allopurinol 200 mg. 2 weeks progress now. Before getting back to the medication my UA level was 12.2. My doctor is recultantly NOTgoing to increase the dose of allopurinol over 300 mg. But Im going to see a Joint Specialist that will increase the dose over 300 mg; hopefully. The schedule appointment is on Feb. 1st. Longs ways alway. My question is my soreness, redness and pain will it go away once allopurinol dose is above 300 mg?
Your doctor is a dangerous fool. The dosing instructions for allopurinol are quite clear unless you have kidney problems.
Allopurinol should be started at 100mg then incremented in 100mg stages until uric acid stabilizes at, or below 5mg/dL (0.30mmol/L), with a maximum dose of 900mg per day. Aiming for a lower target for 6 months or more will increase the rate at which old uric acid crystals dissolve.
The risk of soreness, redness and pain continues for 6 to 18 months (possibly longer) after you have reached the 5mg/dL target. If you do not reach that target, the problem will persist, and get worse, until your joints are damaged permanently.
Your doctor is not at risk of being crippled – you are. Take all possible steps, including legal action if necessary, to get the treatment you deserve.
Thank you Keith. I dont consider my doctor a fool but Im really glad she sent a referal for me to see a Joint Specialist. Sorry I didnt mention that; my apology. Its just sucks cause im have an gout attack right now.
ltjuggernaut said:
Thank you Keith. I dont consider my doctor a fool but Im really glad she sent a referal for me to see a Joint Specialist. Sorry I didnt mention that; my apology. Its just sucks cause im have an gout attack right now.
Vincent, you may not consider your doctor to be a fool, but, if you don't mind me saying so: I think YOU are the fool. Please, don't chop my head off!!! (I mean well.) THINK: You said on Oct.8, that 1 1/2 months ago (~ end of August) your SUA was 6.74mg/dL. Zip and I questioned that figure. Yesterday, Dec.22, you tell us that b/4 Allo your level was 12.2, (you must give us the correct units of measurement, otherwise, all figures are meaningless)? and I guess you meant 12.2 mg/dL. This is an extremely high level for a GOUTIE, and YOU are a goutie. Your Oct/Aug figure could be 0.67mmol/L or 674 ?mol/L which would translate into ~11.4 mg/dL. In other words: You have been at a dangerously high SUA level and your doctor will not increase your medication. In addition: She sends you to a joint specialist instead of a rheumatologist, the “specialist” most qualified to deal with GOUT, YOUR GOUT.
Keith already gave you his assessment and advice for your condition (with his knowledge and personal gout experiences, he'd make a hell lot better gout doctor than most GP's on this planet), all I can and will say: Either get your doc to play ball with you and up your Allo or get another GP, and above all, see a rheumatologist instead of a GP.
LTj – I'm afraid I have to agree with Hans that you're being very badly advised by your Dr, who clearly has no idea how to treat gout and why he is handing you over to someone else. Unfortunately, he doesn't even know who the right person you should see is.
Only you can improve your situation: first, find out if the 'joint specialist' is in fact a rheumatologist and if not, go back to your Dr and insist that you get referred to one; otherwise, you may find yourself having to wait another couple of months before you get re-referred. Secondly, if I were in your position, I would start taking 300 or 400mg per day (because this is what you should be taking – minimum) and then say the dog ate my pills or some other excuse and get a replacement prescription when they run out. Then do it again if necessary. You need have no fears about this being an unsafe dosage.
ltjuggernaut said:
Thank you Keith. I dont consider my doctor a fool but Im really glad she sent a referal for me to see a Joint Specialist. Sorry I didnt mention that; my apology. Its just sucks cause im have an gout attack right now.
Maybe I was hasty describing her as a fool, but I find it very difficult to understand why anyone has the power to prescribe a drug, then prescribes it incorrectly. I am only a layman, but I take this very? seriously.
?
If one underprescribes pain relief, the only consequence is that the patient suffers more pain than they need to. This does not apply to some drugs. Antibiotics are the most well known, where underprescription (or patients not conforming) causes bugs to become resistant is worst, as it affects everybody.
?
Aside
What does she prescribe for a headache? One quarter of an aspirin pill?
Underprescription of allopurinol only affects the gout patient, but it does it in a serious way. There is only one action required of allopurinol, and that is to lower uric acid to the safe level of 5mg/dL (0.30mmol/L). There is no value in taking allopurinol if it does not achieve that, and no point in introducing arbitrary limits below 900mg. The consequences of the foolishness of underprescription, with mg/dL achieved on the left) are:
- 5-6
- Warning! Still at risk from new crystals forming if natural fluctuations in temperature and uric acid levels exceed saturation point.
- 6-7
- Danger! This is the place nobody wants to be. Daily variations result in constant pain from old crystals dissolving, and new crystals forming.
- over 7
- Nothing achieved except may slight reduction in the rate at which new uric acid crystals form. Waste of time, effort, and money
?
Surely, she gets paid enough to warrant better. This is not difficult, just a bit of very basic science that is in the public domain.
?
Having said which, I got some pretty stupid advice from one of the overpaid part-timers at my doctors, so I misheard him, and doubled the dose. Very useful at times, this dodgy hearing (as in “Do you want to go to sleep or what?” – “What?”)
- You must be logged in to reply to this topic.