Thursday 2 February 2012

ARTHRITIS and ATTITUDE GONE BAD

by Earlie Doriman
Gout attack on the big toe. (Photo by yahoo images)
For a long time, I suffered attacks of arthritis – matter-of-fact severe ones because it is gouty arthritis, the most painful of all the rheumatic diseases. You might ask my age now and well, I am only 37 years and that would surely surprise you. You would be more worried to note that I had it when I was 34 years. It had really gone bad that my typical routine, my work, and usual life were so much affected. During the first attack in 2007, I realized it could render me useless. As my big toe was swelling red, I could not lead myself to stand because of the excruciating pain at the joints connecting my toe and feet. It would normally take five to seven days to subside, and I lived in silent agony for that same span, I should say.





Desperate About Gout
More so, it happened frequently. Many mornings I woke up and found out that the gout has explored to other parts of my body, pain here and there, mostly in joints – fingers, knees, shoulders. Joints in my arms and feet started to build lumps and the inconvenience was completely frustrating. I have to buy new pair of shoes because my feet have literally enlarged due to the bulges at the joints. And for the longest time, I was desperate and uncertain. I was on for surgery, for more consultations, and all.
It was primarily because I was a massive stubborn at the start! My wife was like pleading me to take the right medicines but I was simply denying it. I had the prescribed drugs but I only put them aside. I tried to be my own ignorant doctor – an attitude gone bad as well. I even bothered my brother in the Philippines to send me some herbal tablets that claimed effective and easy healing to my condition, but even with loads of those China made capsules, remedy was to no avail. When attitude has gone bad, my condition has gone worse.

My Wife is Right
So finally, with my wife almost at the verge to give up prodding, I took the doctor’s advice and went regularly for my check-up. The blood test revealed that my urate level was very high, the main reason of the frequent attacks.  I was referred to Dr. Smith , an excellent rheumatologist at Rochdale Infirmary and he gave me a higher dosage of the medication, reminding me to take it as advised. He is brilliant to explain everything about gout and the risks that go with it. It would take a little longer to see the lumps subsiding and eventually the urate to come back to a normal level.
I am particularly happy now. No more severe attacks and the lumps building up in my joints are almost unnoticeable. My wife was in fact right from the very beginning. I was only in denial. Once you have gout, it would stay forever, but the attacks could be prevented by proper medication and correct diet. It is a responsibility now. I am still stubborn but I do take my medication religiously and I know it is for good.

The Medical Perspective
What causes gout? At the onset of my gouty arthritis, many people told me to avoid alcohol or eating beans and food that are rich in protein because they are the primary causes of gout attacks. They might be correct at some point, but medicine has a very detailed explanation why.
Gout is most frequent in men and it can affect to any age. Whilst it is true that if you stuff yourself too much with  alcohol or food, attacks of gout are more likely to occur, but that is not the entire story.  People will suffer gout because there is rather unusual in the chemical processes, which take place within the body. A substance which is called ‘URATE’ can build up as crystals in joints. When these crystals are deposited in a joint, they cause inflammation – the joint becomes red, hot, swollen, and extremely painful. Urate can also collect under the skin, most particularly on ears forming small but firm bulge called ‘TOPHI’.  

So where does urate come from? It forms as a final product of various chemical processes within the body.  All of the cells in the human body, and many of the foods we eat, contain substances known as ‘PURINES’.  As old cells are broken down or as food are digested these purines are converted to uric acid, which is carried in the blood as a salt called Urate.  It is actually healthy to have some urate in the bloodstream.  Its presence does not itself lead to gout, and even people with higher than normal levels of urate may not go on to develop gout.  When the amount of urate in the blood rises, the body normally rids itself of the excess through the kidney into the urine.  If this does not happen, the urate continues to increase until it reaches a level at which urate crystals can start to form. Urate crystals are fine needle-shaped crystals that may collect in the joints or under the skin.

What are the reasons why urate is not effectively washed out of the body? Gout is also genetic and therefore may run in the family.  There is an inherited tendency where your kidneys retain more urate than average. But this does not mean you have a kidney disease. Well, if you have, it may mean that your kidneys are not able to process urate effectively as they should.  If you have blood disorders where the body produces too much blood cells, as these cells are broken down they may release urate into the bloodstream more quickly than the kidneys can cope with.  Drugs such as diuretics, which drain water from the body may increase urate to a level which the kidneys can not handle efficiently.

Are there long-term risks of gout? Few attacks of gout will not cause permanent damage to the joints and a complete recovery can be expected.  However, when joints are repeatedly attacked by gout, the crystals can damage the cartilage and bone of the joint. This is not exactly the end of your happy days because the availability of modern medical treatments plus a serious look out of your diet can repair the damage eventually.  Just be very careful that when you already have attacks of gout, it is more likely associated with high blood pressure, diabetes, heart disease, and hyperlipidaemia or too much fat in the blood. It is always good to check this aspects of your health.

What Treatments are available? There are non-steroidal anti-inflammatory drugs available through doctor’s prescription. These are basically drugs that relieve pain and help reduce inflammation (such as Naproxen, diclofenac, and indometacin), they do not prevent the occurrence of gout attacks. There are also urate-lowering tablets (like Allopurinol) and the purpose of these drugs is to reduce urate levels in the blood.  This will eventually drain the deposits of urate in the joints and other parts affected by gout. Some drugs to wash out excess urate are also available through medication.


Reference
Gout: An Information Booklet
ARC: Committed to Curing Arthritis
February 2008



  

29 comments:

  1. To reduce your uric acid eat at least 1 pear a day I read that on my book "plants and health". It will help to reduce your uric acid. Well its good for gout and arthritis.

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    1. Thanks for the suggestion jenny..and that's really part of my diet since last year.

      i just the idea that i could no longer eat peanut as much as i want.

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  2. what have you been doing? you are so young to have arthritis... jenny is right, avoid foods that are high in uric acid...

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    1. Yun nga ang kasabihan..'masarap and bawal' at ang daming bawal sa akin ngayon kaya talagang napaka hirap ng may ganitong kondisyon.

      Thanks for dropping a note Romelo

      Delete
  3. Anti inflammatory dugs is really needed for gout or else you will end up living with the pain associated with it.We all know how painful it is so take the prescribed madicine and right food.

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    1. Yes Tess, i have my regular medication and i am taking it regularly otherwise ako lang din ang mag suffer.

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  4. is gout hereditary? it runs in my family. you do have to avoid beans

    fabgirl from fbu

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    1. It is not purely hereditary..in fact there is a very small data to support that...it is more associated with diet and lifestyle.

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  5. I had exactly the same medical condition since I was in my late thirties like you. I only have it in my left toe during attacks for more than 20 years now and its less frequent now.

    The best way to prevent or should I say minimize gout attacks is lifestyle change but I can understand it could be a bit difficult for your age now. So I say, just eat less, blog more. :)

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    1. I was very complacent before..it started in my toes but never mind it until it got worse.

      But at least, my medication has helped a lot.

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  6. My mom has osteohroarthritis, she is in pain most of the time. Why I was reading this, although totally different her case, I remember her coz mostly the symptoms are the same. Gout runs in the family also as I have uncles who hav gouts. Thank you for giving a broad perspective about gout, these are helpful infos.:)

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    1. Thanks also for your message. keep coming back

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  7. My uncle suffer the same I could see how it taken its on him. Thanks for sharing.

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  8. I hope I don't get this. Thanks for the tips. I'm scared kasi I'm 31 na and sometimes, my knees hurt. Yikes.

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  9. oh my you cannot do more if it attacked you, I hope I wouldn't got it I am on 30's now

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  10. Urate on its utmost level- sounds similar to those bad cancer cells in our body that when triggered would cause havoc to one's entire system.

    I have members in our family too who suffers arthritis but gouty ---I didn't know there's such type of arthritis until I came across of your post. Given this situation I guess all we can do is to follow orders from health experts as religiously as we can; otherwise, the consequences is ours to live with.

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  11. tigas ng ulo! lol! buti very patient wife mo!... lesson for the day: eat healthy, exercise and always follow your wife's advice! :)

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  12. So cut off your purine-rich diet, as doctor tells, avoid grains and internal organs. This is very painful I know, some can not even walk. I usually give my patients with injectable drugs to manage the pain
    -----
    Regards, Edmaration

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  13. Oh no, I'll be 36 by March, hope i don't get it just yet, it's hard not being able to do a lot 'coz of arthritis or any sort of pain, I guess it's just a matter of taking care of our selves while we're still young.

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  14. i'm worried. my friends had gout in their early 30s

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  15. thanks for sharing, i have no idea about this, but now i know :)

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  16. I don't think arthritis is hereditary! My uncle used to crawl, shrunk to when his arthritis attacked him. It was too painful. I pitied him. Medications pacified his ordeal temporary. When he ran out of meds, he started his routine of agonizing. What a pity! He just died without recovering from such life threatening disease.

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    1. From some studies and brochures that I have gone over, the hereditary aspect of gout is very small..it is commonly associated with diet and lifestyle.

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  17. ohe i miss listening to such topics since I took up nursing and now a nurse. but once i graduated and left school, all my learnings and lessons as well were left.hahahaha

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  18. i love that i learn something b4 i go to bed! i have problem with my right foot as well as if the bones and nerves were not used to wearing flats or anything like slippers as well most of the times i have my high heels with me. so i visit my foot reflexologist once a month to relax my nerves and bones as well. thanks for the info! xx

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  19. my friend had arthritis when she was in HS, so it's not solely because of age...avoid foods with high uric acid like nuts, beans, laman loob, etc.

    take care of ur body and listen to ur wife ;)

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    1. i do now yuuki...i should have long time ago..but i am a very daft stubborn

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  20. i was 18 when i had my first gout attack, it was horrible, im now 23, and i currently have gout in both my feet, not in the big toe, but in the center of my feet, its a horrible feeling, specially since it cost me multiple jobs, unable to walk for a long distance, stand for a long period of time, and carry anything that is more then 50 LB's. for anyone that reads this, please watch what you eat, take care of your body,

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