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Gout incredibly painful

Chin Diesel

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So, some long-term follow-up on this for me.

Turns out I didn't have gout but rather have torn LCL's on my first metatarsal (both feet). Ended up getting an MRI to find out what x-rays amd blood work couldn't find.

Some inputs from this thread.

Allopurinol was a non-starter for me due to side effects.
Drank the tart cherry juice.
Mottin 800mg once or twice a day was fine. I'm prior militsry so my body basically requires Motrin to function.
Took Colchisine during flare ups. Didn't do anything so thst helped rule out gout.
Being that my first comment on this thread was June 2022, it took almost a full year to figure out it was ligament damage.

I needed a flare up to occur to get a good diagnosis.

Even with the ligament damage diagnosis the pain and inflammation was excruciating. Doc gave me some steroid injections and that helps immensely but he says doing thst every six months isn't a solution.

I'm going to have surgery in December to get feet right.

All that being said, it's a great feeling being able to sleep pain free and walk without a limp.

OBTW, in the midst of all this, I also contracted Cellulitis on a business trip a few months ago which wrecked my left ankle and foot for two weeks. Bacterial infection that made it feel like I took a crow bar or tire iron to my Achilles and sprained my ankle at the same time. That pain was 10x worse than the flare ups from ligament damage.
 
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Wow. Good luck. Can't believe they didn't test your uric acid levels before diagnosing you with gout, but as someone with high uric acid and ligament issues in at least one foot, i literally feel your pain. I been on allopurinol for 9 years and never experienced any side effects knock on wood. Were you concerned about them or did you experience some?
 

Chin Diesel

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Wow. Good luck. Can't believe they didn't test your uric acid levels before diagnosing you with gout, but as someone with high uric acid and ligament issues in at least one foot, i literally feel your pain. I been on allopurinol for 9 years and never experienced any side effects knock on wood. Were you concerned about them or did you experience some?

I had several blood tests and my uric acid level is always above the level they look for but it doesn't fluctuate and taking or not taking meds had no effects on the levels.
We didn't do a deep dive in to removing foods from diet and tracking based on that. We just realized food wasn't affecting uric acid levels. We were working our way through some of those steps when the MRI came back and we decided to get that right before going deeper in to other stuff. There's also some arthritis down in the feet.
As for the Allopurinol, doctor wasn't against it but he said once you go on it, you are on it for life.

I type all of this as I just finished off a great breakfast of eggs over easy on top of a crab cake which was devine.
 

HuskyHawk

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So, some long-term follow-up on this for me.

Turns out I didn't have gout but rather have torn LCL's on my first metatarsal (both feet). Ended up getting an MRI to find out what x-rays amd blood work couldn't find.

Some inputs from this thread.

Allopurinol was a non-starter for me due to side effects.
Drank the tart cherry juice.
Mottin 800mg once or twice a day was fine. I'm prior militsry so my body basically requires Motrin to function.
Took Colchisine during flare ups. Didn't do anything so thst helped rule out gout.
Being that my first comment on this thread was June 2022, it took almost a full year to figure out it was ligament damage.

I needed a flare up to occur to get a good diagnosis.

Even with the ligament damage diagnosis the pain and inflammation was excruciating. Doc gave me some steroid injections and that helps immensely but he says doing thst every six months isn't a solution.

I'm going to have surgery in December to get feet right.

All that being said, it's a great feeling being able to sleep pain free and walk without a limp.

OBTW, in the midst of all this, I also contracted Cellulitis on a business trip a few months ago which wrecked my left ankle and foot for two weeks. Bacterial infection that made it feel like I took a crow bar or tire iron to my Achilles and sprained my ankle at the same time. That pain was 10x worse than the flare ups from ligament damage.
Holy crap. Glad you have a way forward. Foot pain is so limiting. I have foot pain and wondered about Gout, but it just doesn't fit. I think I have early bunions forming and some other things. Sadly, most podiatrists I've ever seen have been useless orthotic salesmen. I did that most of my life, not going there. But I probably should go get checked out.
 
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I had several blood tests and my uric acid level is always above the level they look for but it doesn't fluctuate and taking or not taking meds had no effects on the levels.
We didn't do a deep dive in to removing foods from diet and tracking based on that. We just realized food wasn't affecting uric acid levels. We were working our way through some of those steps when the MRI came back and we decided to get that right before going deeper in to other stuff. There's also some arthritis down in the feet.
As for the Allopurinol, doctor wasn't against it but he said once you go on it, you are on it for life.

I type all of this as I just finished off a great breakfast of eggs over easy on top of a crab cake which was devine.
I tried the gout diet before meds. Nothing worked. I forget the exact numbers but i think normal uric acid levels were like a 6 and i was well over 9. Its the only med im on. I frigging hate it. I had "taken myself off" but at my last physical the uric acid levels were through the roof again, even though i had no "flare ups", so I'm just gonna accept i have to be on the crap.

Feet problems have to be worst next to back problems. Everything is supported from the feet up.
 

Chin Diesel

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Holy crap. Glad you have a way forward. Foot pain is so limiting. I have foot pain and wondered about Gout, but it just doesn't fit. I think I have early bunions forming and some other things. Sadly, most podiatrists I've ever seen have been useless orthotic salesmen. I did that most of my life, not going there. But I probably should go get checked out.

Bunions are the final part of my solution. The bunion pushes the big toe against the metatarsal which puts strain on the ligaments.
My surgery is going to shave off some bone on the big toe and then he's going to break the big toe in a couple of places to align that toe more forward. Then he's going to repair the ligaments on the toe next to it.
 
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I had several blood tests and my uric acid level is always above the level they look for but it doesn't fluctuate and taking or not taking meds had no effects on the levels.
We didn't do a deep dive in to removing foods from diet and tracking based on that. We just realized food wasn't affecting uric acid levels. We were working our way through some of those steps when the MRI came back and we decided to get that right before going deeper in to other stuff. There's also some arthritis down in the feet.
As for the Allopurinol, doctor wasn't against it but he said once you go on it, you are on it for life.

I type all of this as I just finished off a great breakfast of eggs over easy on top of a crab cake which was devine.
Have had periodic flare ups over the years and have been able to resolve through supplements (so far). Sounds like your situation might include other physical ailments that you're looking into. I will say this about gout and diet. There are certain foods and beverages that can accelerate or contribute to gout or gout-like conditions. One of those is beer. My Mother had a condition referred to as pseudo-gout. Gout-like conditions but more arthritic in nature.

Good luck with game plan. Definitely worth getting it figured out.
 
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Bunions are the final part of my solution. The bunion pushes the big toe against the metatarsal which puts strain on the ligaments.
My surgery is going to shave off some bone on the big toe and then he's going to break the big toe in a couple of places to align that toe more forward. Then he's going to repair the ligaments on the toe next to it.
I did something similar in 2021, brace yourself for a pretty uncomfortable rehab. Shaved down bunion, broke and reset two hammer toes...but now I can ski, play tennis, and ride the Peloton pain free again. One other silver lining, no PT for this...just R&R. Good luck Chin!
 

Chin Diesel

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I did something similar in 2021, brace yourself for a pretty uncomfortable rehab. Shaved down bunion, broke and reset two hammer toes...but now I can ski, play tennis, and ride the Peloton pain free again. One other silver lining, no PT for this...just R&R. Good luck Chin!

Sounds about right. Doc said it will be 7-10 days of no weight bearing on the foot following by 2-3 weeks of the walking boot and finally a few weeks of the velcro strap sandal boot. He said at the two week follow up he'll know if everything will be healed within 6 weeks or if there's a possibility of having to go back in and take a second stab at it.
 

Waquoit

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Turns out I didn't have gout but rather have torn LCL's on my first metatarsal (both feet). Ended up getting an MRI to find out what x-rays amd blood work couldn't find.
The same thing happened to my brother a few weeks ago, he was sure the gout came back and it turned out to be a toe thing. I wonder if there a bunch of sprained toes out there not getting better with the cherry juice.
 

Chin Diesel

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Finally had foot surgery today.
It was actually scheduled a month ago and day before my surgery there was a water main break on road outside the hospital anld all procedures for two days had to be rescheduled.
Two hours under the knife to perform a bunionectomy- shave, break, trim, realigned and screw back together. Also found remnants of gout flare ups which he cleaned up. So, some dietary changes and meds are coming my way.
Finally, had the ligaments cleaned up and re-attached.
Sitting at home recovering.
Interesting enough, since I was given oxycodone as a narcotic they automatically give you narcam too.
One week complete no weight bearing, two weeks in the big boot and then a walking sandal.
 

Chin Diesel

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I now have a wire going through my toe. The green tip is just for protecting the end of the exposed wire. Hopefully it gets pulled out next week for the post-op follow-up.
IMG_20240202_140230.jpg
 
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I know a lady who had that done and she was on a knee scooter and did not have the wire pulled for at least 3 weeks.
 

QDOG5

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Hey Chin, I'm not a Doctor but it looks like they lopped off 3 of your toes. If I were you I'd start asking some questions!!! Jokes aside, good luck on your recovery:)
 

HuskyHawk

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I now have a wire going through my toe. The green tip is just for protecting the end of the exposed wire. Hopefully it gets pulled out next week for the post-op follow-up.
View attachment 95975
Hoping you heal quickly and fully. That doesn't look enjoyable.
 
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Speedy recovery Chin...I had similar a few years back with the bonus of breaking and resetting two hammer toes. Bizarre feeling when they pull that wire.
 

temery

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Chin Diesel

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what's the wire for?

So, the toe next to the big toe needed straightening. So he drilled a hole in to my bones and inserted a wire through the toe bones and in to my foot to get it to align correctly. And then he reattached ligaments and repaired the plantar plate.

The part of the x-ray which is pointed forward is a set screw which kept a protective ball in place to keep the end of the wire protected.

IMG_20240206_105204.jpg
 

Chin Diesel

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The pea looking thing was a ball which covered the end of the wire sticking out of toe.
20240222_103009.jpg
 

temery

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So, the toe next to the big toe needed straightening. So he drilled a hole in to my bones and inserted a wire through the toe bones and in to my foot to get it to align correctly. And then he reattached ligaments and repaired the plantar plate.

The part of the x-ray which is pointed forward is a set screw which kept a protective ball in place to keep the end of the wire protected.

View attachment 96818

This is what a gout toe looks like. Kidney stones are more painful, but not by much.
 

Chin Diesel

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So, the toe next to the big toe needed straightening. So he drilled a hole in to my bones and inserted a wire through the toe bones and in to my foot to get it to align correctly. And then he reattached ligaments and repaired the plantar plate.

The part of the x-ray which is pointed forward is a set screw which kept a protective ball in place to keep the end of the wire protected.

View attachment 96818
The three screws are forever.
 

Chin Diesel

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This is what a gout toe looks like. Kidney stones are more painful, but not by much.

Well, he had to remove some gout damage too. This in spite an MRI last summer being read by a radiologist as negative for gout.

My foot was a mess.
 

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