Gout incredibly painful | Page 4 | The Boneyard

Gout incredibly painful

Chin Diesel said:
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.
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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.
 
HuskyHawk said:
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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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.
 
Chin Diesel said:
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.
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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.
 
Chin Diesel said:
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 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!
 
HuskyDevil said:
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!
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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.
 
Chin Diesel said:
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.
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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.
 
.-.
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.
 
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
 
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.
 
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:)
 
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.
 
.-.
HuskyDevil said:
How goes the recovery Chin?
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Well, he pulled stitches and wire yesterday. About another month of walking sandal and boot.

Some swelling and bruising remain.
 
temery said:
what's the wire for?
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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.

IMG_20240206_105204.jpg
 
The pea looking thing was a ball which covered the end of the wire sticking out of toe.
20240222_103009.jpg
 
Chin Diesel said:
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
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The three screws are forever.
 
.-.
Chin Diesel said:
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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Maybe the radiologist read the Cliff's Notes version - pretty poor.

Hope the recovery/rehab goes well.
 
temery said:
I guess I forgot to upload a picture. It burst like an overcooked brat.

View attachment 96953
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That was one of the issues with them deciding on gout. The pain is similar to what you described and I never had the swelling and redness in the toes. Mine was on top of my feet.
 
DrZzzz said:
Yes. You can get killed in a car crash with a seat belt at 30mph. And survive another without it at 40 mph. If you want to maximize your chances of surviving a car wreck, wear a seat belt. If you want to minimize your chances of getting gout, weigh 130, not 230. I am an actual doctor FYI. You really gonna argue with me? And sorry for the preaching. Anesthesiologists dislike people that go from 130 to 230. If you had gout at 130 you probably have a genetic predisposition. But what's with the 230? It's easier to keep you safe at 130 than 230. If you eat more, walk more.
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Doc, I gotta stand with Temery on this only because it’s really hard to go from 230 to 130. I don’t know his height but what about a change of diet and exercise if lacking to be fit at 200 lbs with good blood and blood pressure numbers? As a doctor you know how out of shape the American population is and how bad their diets are. Just take a walk through Target or Walmart.
 
huskyharry said:
I just injected one of my patients with Kenalog/Lidocaine into his first metatarsal-phalangeal joint immediate and lasting relief
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When you say lasting relief, how long would you say it lasts for? When my podiatrist gave me the Kenalog in to the MTJ he said it might be something he'd have to do every 6-9 months and that's why he recommended surgery.
 
.-.
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