[andy popp]

Only a self-diagnosis at the moment but I think there's a good chance I'm 'enjoying' my first attack of gout. Its kyboshing climbing at the moment as my foot is too painful. Anyone got any experience of managing this? God, this makes me feel old.

[Jaspersharpe]

Lagers is your man for this one Andy.

[Houdini]

Wiki

Historically, it was known as "The Disease of Kings" or "Rich man's disease".

Gout is a disease hallmarked by elevated levels of uric acid in the bloodstream. In this condition, crystals of monosodium urate (MSU) or uric acid are deposited on the articular cartilage of joints, tendons, and surrounding tissues.

Dr hOU's ayervedic approach:  drink fresh urine w/ depressed levels of uric acid.  Preferably straight from the source, it must not chill.

 




[The 1st rule of Gout Club:  drink everything]

[Sloper]

Nothing a few rare steaks won't cure.

[andy popp]

Historically, it was known as "The Disease of Kings" or "Rich man's disease".

I wouldn't mind so much if I'd actually been enjoying some sort of debauched Regency lifestyle. That cartoon is scarily accurate.

Point Lagers this way then Jasper. I think Blunk has mentioned it too.

[Jaspersharpe]

Done.

[luckyjez]

Perhaps it's a surfeit of sandstone Andy (or brandy)?

[lagerstarfish]

 :'(   I feel for you Andy

Get yourself to your GP.

There are a few different medication routes to go down depending on how your gout attacks you - your GP should help you with this and also check that you haven't got some other medical problem which is causing higher levels of uric acid to be in your blood (eg kidneys are fucked). It's not a straightforward process. After blood tests showed that I had high levels of urate in the blood (and not much else was wrong - xrays done to check for injury) I ended up taking Allopurinol everyday (increased dose until we got it right) to keep this down and pain killers for the bad days (Diclofenac). Some meds can make gout worse to start with (ouch)

Climbing boots that fit tight make it worse.

As for managing it yourself - ice helps, ibuprofen works, sleep with your foot outside the bed covers (stops the duvet hurting you and keeps it cool), take your shoe and sock off whenever possible, raise your foot on a stool/cushions whenever possible. Drink plenty of water. try to go for a wee as soon as you need to and don't hold it in (this might be bollocks, but I used to go all day without peeing). reduce your alcohol intake. Wear socks in comfy climbing boots (it is OK to this as long as you have a Dr's note).

I tried smearing the joint with Voltarol cream before climbing, but this didn't help as much as double dropping the Diclofenac tablets

I no longer take Allopurinol and haven't had an attack for 10 months. I changed my diet to exclude processed foods and also to eat as little carbohydrate as possible, especially bread. I now eat a lot of fish, meat, fresh veg and fruit. I have reintroduced some carbs, but appear to have become intolerant to bread (the odd slice is ok). I had one huge gout attack 2 weeks in to the reduced carb diet and have been fine since then - soon dropped the Allopurinol and increased alcohol intake to more enjoyable levels and blood tests show that my uric acid levels are normal. The science connecting Palaeolithic Diet and curing arthritis is very sketchy, but in my sample of all of my lives (one) it has worked.

check out http://www.nhs.uk/Conditions/Gout/Pages/Introduction.aspx and the links

[andy popp]

Cheers Lagers, GP appointment was already booked (tho' the attack has been going on for a couple of weeks, thought I'd just done some soft tissue damage) and that website checked - hence the self-diagnosis.

Having been vegan for 20+ years and not overweight I had pooh-poohed the idea when someone first suggested it last week but a quick check reveals gout is known in vegans - just means I can't go down the obvious route of cutting out red meat, seafood etc. I do eat stuff with yeast extract in though, as well as mushrooms, spinach and legumes all seemingly implicated and bread. Most obviously I like drinking! I like beer but mainly drink wine (red and white). Also known to drink gin and cognac (Jez, you know me too well). I've been aware of not drinking enough water recently so that's one obvious change I can make easily.

Bugger! Don't fancy the prospect of giving up bread and booze and climbing - not liking the idea I need a Dr's note to go climbing!!

[Jaspersharpe]

I think Lagers meant socks in boots were only acceptable with a Dr's note. At least I hope he did.

[nash1]

Nasty nasty business gout.
I believe tomatoes are not good for it either, my doc told me no tomatoes as well as all the other no no's.
Only had one attack tho', and the tablets cleared it up after about 5 days.

[SA Chris]

I think any acidic fruit / veg is bad.

I remember an (idiot) friend of mine decided to try a citrus fruit diet to lose weight for climbing and got gout so bad he couldn't wear his climbing shoes. How we laughed.

[lagerstarfish]

I think Lagers meant socks in boots were only acceptable with a Dr's note. At least I hope he did.

Yes, that's what I meant. Apart from the pain, this is the worst effect of gout.

[Joepicalli]

Also known to drink gin and cognac

So when do you think you might be able to come over for a meal again Andy?
(Sorry that was really evil, but I couldn't resist. Really hope you get on top of it soon)

[andy popp]

You bastard Picalli! Mind you, that was nothing to the hoots of derision from Ewan last night and Chadwick'll have a field day when he finds out.

[BenF]

You bastard Picalli! Mind you, that was nothing to the hoots of derision from Ewan last night and Chadwick'll have a field day when he finds out.

Ah, so that was that the noise I heard emanating from the Widnes area last night!  I suggest you keep your head down for a bit Andy.  Close the woodie for renovations or something.  Just keep those p*ss-taking vultures away.

[andy popp]

You bastard Picalli! Mind you, that was nothing to the hoots of derision from Ewan last night and Chadwick'll have a field day when he finds out.

Ah, so that was that the noise I heard emanating from the Widnes area last night!  I suggest you keep your head down for a bit Andy.  Close the woodie for renovations or something.  Just keep those p*ss-taking vultures away.

True to form, Pete's just texted: 'Fuck me, the vegan Falstaff!' So at least I've got a potential route name out of it.

Anyway, confirmed by GP today. New regime (drink fuck loads of water and gobble ibuprofen) has already made a big difference. Apparently my dad got it just once at about my age so fingers crossed.

[BenF]

True to form, Pete's just texted: 'Fuck me, the vegan Falstaff!' So at least I've got a potential route name out of it.

  Typical Pete.

Talking of which, are you not climbing for a bit then?  Give me a bell if you want to get out/manage to create any child free afternoons.  Otherwise I'll be forced to come round to get a kicking on the board.

And rather off topic, did you have a look at or improve that Harmer's guide text I sent you?

[badong]

I changed my diet to exclude processed foods and also to eat as little carbohydrate as possible, especially bread. I now eat a lot of fish, meat, fresh veg and fruit. I have reintroduced some carbs, but appear to have become intolerant to bread (the odd slice is ok).

You might have Coeliac disease, I guess your doctor probably considered this but nearly everyone in my girlfriends family has it and it can lead to some pretty nasty things if left unchecked.

[tobym]

I'll do you a note, for the socks, Andy 

[andy popp]

Much appreciated Toby! Funnily enough the blood results came back normal.

[Blunk]

Andy--

Seems you've got it pretty well sorted out, but I'll throw in my experience for good measure. Blood results often come back normal, my doc did not know why. Dietary changes in many cases seems to make no impact, I can do steak and beer with absolutely no increase in attacks. I take allopurinol, used to get by without it but getting too old now I guess.

And my best cure for attacks is to put on climbing shoes, I shit you not. If I can crush the swelling down then the attack ends much more quickly. The wife and kids are conditioned to ignore my howling.  But in all honesty I think my attacks are less painful than many others I hear about, so the tight shoe advice may be madness to try...

Best of luck figuring it out. It sucks but is generally manageable in the long run.