---

My Self-Diagnosed Gout Update

My Self-Diagnosed Gout Update -- Posted by Shoeless Joe Jetson on 10-07-04 21:37

Thanks to everyone for posting. Now I know that Usenet News is still
where it's at. I've done Internet searches and posted to some
site-specific message boards. But you simply can't beat the sheer
volume of posts and the quality of informed suggestions Usenet offers.
This is still the fount of Useful information, excuse the
alliterations.

When I woke up this morning, the pain was moderate. While going
through my medicine drawer for more aspirin, I found a vial of 500mg
Naproxen which was prescribed to me last year for a fracture of my
right foot. I took a tablet of that and went to the City to take care
of some business. About 2 hours later, I could walk very slowly
without much pain. Still painful to go up or down the stairs or put
much weight on the right foot. Went to the supermarket and bought
some concentrated cherry juice. Also got a jar of generic Ibuprofen
from CVS.

As I write this, 8 hours after having taken my first Naproxen tablet,
there is almost no pain! This is incredible. There is still
considerable swelling around the achilles tendon. In fact, the
swelling seems to have increased -- that is, away from the tendon and
towards and around the ankle bone. But it doens't emit as much heat
and my fever seems to have gone away as well. Two days ago, I could
not sleep because of my foot and now I'm almost pain free!

I'm so glad I was able to self-diagnose and medicate myself. If it
weren't for the Internet and this newsgroup, I would still be limping
around or walking with a cane, wondering what had stricken me. Now
that I'm more informed about gout and what precipitates it, let me
share my story on how exactly I developed this painful condition.

About 18 months ago, I fractured my tibial sesamoid in my right foot.
For 3 months, I used a cane and wore a post-op flat-sole shoe. Then
began rehabilitation with a pair of orthotics. Sesamoid fractures
take notoriously long to heal, if at all, due to the lack of blood
flow and the difficulty of effectively immobilizing an area that's
essential for walking.

Well, after 7 months, I felt it had healed completely. So I decided
to prune some tree branches which were leaning against my aunt's
garage. I was on a ladder while doing this and since the branches
were perched rather high, leaned on my toes to get to them. I never
felt any pain but the next day, I could not move my foot and the pain
was excruciating. Went back to the doctor, took the x-ray and,
surprisingly, no fracture was seen. In fact, the doctor detected a
bit of "erosion" and "edoma" in the metatarsal above the sesamoid, but
no damage at all to the sesamoid.

This relieved me greatly because I was convinced that I had
refractured my sesamoid. Indeed, within 5 days, the pain completely
subsided and I was able to move around. 3 months later, I stopped
wearing orthotics, and now, 9 months later, I consider myself
completely healed, exactly 15 months after the original fracture of
the sesamoid.

I lost my job while recovering, so without much to do during the day
and unable to walk freely or run, I began putting on weight. And when
I moved to another part of the town, my diet was very poor: canned
meats like Libbey's corned beef; Chicken of the Sea solid chunk white
tuna; sardines; kidney beans; peanut butter sandwiches; Little Debby
treats and cakes; ice cream. Plus I consumed about a liter of soft
drinks per day or two.

Early summer, I found another job and began dining at my corporate
cafeteria regularly. Indeed, I never lost the weight I gained and
began to put on even more weight eating high-protein fare: BBQ
brisquets, roast beef, meatloaf, sirloin steak, ribs, roast pork. I
also love eating high caloric vegetables -- kidney and lima beans;
black eyed peas; fried okra; asparagus; artichoke hearts; lentils;
mushrooms, both dry and sauteed; broccoli; cauliflower; spinach. I
also eat everything very salty and spicy.

My eyes were bugging out like Rodney Dangerfield's when I saw my
favorite menu paraded as potential culprits for precipitating gout.
I'm now about 210 (5-10) and this is the heaviest I ever weighed and
the lack of exercise probably did me in.

In any case, my diagnosis now is that this was not the first attack of
gout. It was my second (or third, if I count the inexplicable pain in
my left knee about 2 weeks ago). The first one disguised itself as a
refracture of my sesamoid. When it was proven not to be broken, I
dismissed it as a bruise or tendonitis. But it was actually gout
attacking my toe joint. I always remembered how painful it was; the
pain was actually worse than when my sesamoid was broken. The pain I
experienced 2 nights ago equaled or exceeded that pain. If it weren't
for the lack of any preceding event, I would have guessed that a bone
or a ligament was completely broken or torn. In fact, I was in the
middle of my shift at my desk job when my ankle started throbbing and
hurting.

My best case scenario: with treatment and diet, this is the last time
I'll experience gout.

My worst case scenario: the onset of gout may have dietary and
biochemical origins -- I better follow up on the latter and see a
urologist to see if my kidneys are in good condition, as once they
were not. This scares me a bit as I don't have the best liver (fatty
liver) either, but I have no choice but to confront this possibly
debilitating condition.

Thanks, everyone for contributing their stories. This was mine.

Re: My Self-Diagnosed Gout Update -- Posted by Gwen Love on 10-08-04 10:54

Good luck for the future, Joe.
Gwen

"Shoeless Joe Jetson" wrote in message
news:lc6cm0dqgoebfusjlj3ts8pbfr30g14ndq@4ax.com...
> Thanks to everyone for posting. Now I know that Usenet News is still
> where it's at. I've done Internet searches and posted to some
> site-specific message boards. But you simply can't beat the sheer
> volume of posts and the quality of informed suggestions Usenet offers.
> This is still the fount of Useful information, excuse the
> alliterations.
>
> When I woke up this morning, the pain was moderate. While going
> through my medicine drawer for more aspirin, I found a vial of 500mg
> Naproxen which was prescribed to me last year for a fracture of my
> right foot. I took a tablet of that and went to the City to take care
> of some business. About 2 hours later, I could walk very slowly
> without much pain. Still painful to go up or down the stairs or put
> much weight on the right foot. Went to the supermarket and bought
> some concentrated cherry juice. Also got a jar of generic Ibuprofen
> from CVS.
>
> As I write this, 8 hours after having taken my first Naproxen tablet,
> there is almost no pain! This is incredible. There is still
> considerable swelling around the achilles tendon. In fact, the
> swelling seems to have increased -- that is, away from the tendon and
> towards and around the ankle bone. But it doens't emit as much heat
> and my fever seems to have gone away as well. Two days ago, I could
> not sleep because of my foot and now I'm almost pain free!
>
> I'm so glad I was able to self-diagnose and medicate myself. If it
> weren't for the Internet and this newsgroup, I would still be limping
> around or walking with a cane, wondering what had stricken me. Now
> that I'm more informed about gout and what precipitates it, let me
> share my story on how exactly I developed this painful condition.
>
> About 18 months ago, I fractured my tibial sesamoid in my right foot.
> For 3 months, I used a cane and wore a post-op flat-sole shoe. Then
> began rehabilitation with a pair of orthotics. Sesamoid fractures
> take notoriously long to heal, if at all, due to the lack of blood
> flow and the difficulty of effectively immobilizing an area that's
> essential for walking.
>
> Well, after 7 months, I felt it had healed completely. So I decided
> to prune some tree branches which were leaning against my aunt's
> garage. I was on a ladder while doing this and since the branches
> were perched rather high, leaned on my toes to get to them. I never
> felt any pain but the next day, I could not move my foot and the pain
> was excruciating. Went back to the doctor, took the x-ray and,
> surprisingly, no fracture was seen. In fact, the doctor detected a
> bit of "erosion" and "edoma" in the metatarsal above the sesamoid, but
> no damage at all to the sesamoid.
>
> This relieved me greatly because I was convinced that I had
> refractured my sesamoid. Indeed, within 5 days, the pain completely
> subsided and I was able to move around. 3 months later, I stopped
> wearing orthotics, and now, 9 months later, I consider myself
> completely healed, exactly 15 months after the original fracture of
> the sesamoid.
>
> I lost my job while recovering, so without much to do during the day
> and unable to walk freely or run, I began putting on weight. And when
> I moved to another part of the town, my diet was very poor: canned
> meats like Libbey's corned beef; Chicken of the Sea solid chunk white
> tuna; sardines; kidney beans; peanut butter sandwiches; Little Debby
> treats and cakes; ice cream. Plus I consumed about a liter of soft
> drinks per day or two.
>
> Early summer, I found another job and began dining at my corporate
> cafeteria regularly. Indeed, I never lost the weight I gained and
> began to put on even more weight eating high-protein fare: BBQ
> brisquets, roast beef, meatloaf, sirloin steak, ribs, roast pork. I
> also love eating high caloric vegetables -- kidney and lima beans;
> black eyed peas; fried okra; asparagus; artichoke hearts; lentils;
> mushrooms, both dry and sauteed; broccoli; cauliflower; spinach. I
> also eat everything very salty and spicy.
>
> My eyes were bugging out like Rodney Dangerfield's when I saw my
> favorite menu paraded as potential culprits for precipitating gout.
> I'm now about 210 (5-10) and this is the heaviest I ever weighed and
> the lack of exercise probably did me in.
>
> In any case, my diagnosis now is that this was not the first attack of
> gout. It was my second (or third, if I count the inexplicable pain in
> my left knee about 2 weeks ago). The first one disguised itself as a
> refracture of my sesamoid. When it was proven not to be broken, I
> dismissed it as a bruise or tendonitis. But it was actually gout
> attacking my toe joint. I always remembered how painful it was; the
> pain was actually worse than when my sesamoid was broken. The pain I
> experienced 2 nights ago equaled or exceeded that pain. If it weren't
> for the lack of any preceding event, I would have guessed that a bone
> or a ligament was completely broken or torn. In fact, I was in the
> middle of my shift at my desk job when my ankle started throbbing and
> hurting.
>
> My best case scenario: with treatment and diet, this is the last time
> I'll experience gout.
>
> My worst case scenario: the onset of gout may have dietary and
> biochemical origins -- I better follow up on the latter and see a
> urologist to see if my kidneys are in good condition, as once they
> were not. This scares me a bit as I don't have the best liver (fatty
> liver) either, but I have no choice but to confront this possibly
> debilitating condition.
>
> Thanks, everyone for contributing their stories. This was mine.

Re: My Self-Diagnosed Gout Update -- Posted by JimmyT on 02-24-05 13:52

I am in a similar, confusing situation as Joe involving a possible
gout/sesamoid combination. I awoke about 2 weeks ago to big toe pain,
redness, and swelling. This was after a big super bowl weekend of
drinking, golf, and topped with a 16oz sirloin. I researched gout
online and realized I had every contributing factor including a
previous injury (broken/heavily stubbed toe in '88), and every symptom.
Bought some cherry juice and advil, immediately changed my diet, and it
looked much better in the morning. Went to see the doc and she said
"good job, keep it up". By Wednesday night (Feb 9) I was dying. The
advil no longer worked. Went back Thursday and was put on Hydrocodone
and Prednisone.

The prednisone had an immediate impact, by Saturday I was off the pain
pills entirely. But the toe never completely healed up. There was
always some redness/swelling. The doctor was shocked that it wasn't
total history after 5 days of Prednisone, when I asked for a refill.
She felt there was an additional problem and recommended a podiatrist.
Here's where it gets crazy.

The podiatrist immediately said "How do you know it was gout?", and
"how was it diagnosed?", explaining that gout can ONLY be diagnosed by
examining joint fluid extract under a microscope. He took an x-ray,
which showed no "tophi" bites, but did show a 2-piece (bipartite?)
sesamoid. He felt I had fractured the sesamoid and was not convinced I
EVER had gout. He gave me an anti-inflam and an orthopedic sandal.

However, since that morning at the doc, the toe has twice flared up,
for no apparent reason (it was fairly pain free and benign at the doc).
Both of these flare-ups came in the evening, after fairly large (by
gout diet standards) meals, and seemed to have no relation to any
physical event (i..e...too much walking). Both flare ups had very
"goutish" symptoms...red, shiny skin, chills, horrible pain.

Now, granted the podiatrist told me it could get a little worse because
of coming off the prednisone, but I'm sort of confused here. I don't
mind fighting this thing, but I don't know what to fight. Should I stay
on a restricted diet? Or go with more physical
therapy...i.e....R.I.C.E.
Should I see a urologist or rheumatoid specialist and get a third
opinion? And also, I've read absolute horror stories about sesamoids.
If it's truly fractured, why isn't it fully immobilized so it can heal.
This stupid sandal is a joke. It hardly limits my range of motion at
all. The PAIN limits it a heck of a lot more than the sandal does.

Sorry to go off a little. It's time for a pain pill.

Re: My Self-Diagnosed Gout Update -- Posted by Karen Palmer on 02-24-05 14:23

I would get to a rheumatologist for a 3rd opinion..symptoms sound a lot more
like gout than fracture

Karen
"JimmyT" wrote in message
news:1109281958.908411.218880@f14g2000cwb.googlegroups.com...
>
> I am in a similar, confusing situation as Joe involving a possible
> gout/sesamoid combination. I awoke about 2 weeks ago to big toe pain,
> redness, and swelling. This was after a big super bowl weekend of
> drinking, golf, and topped with a 16oz sirloin. I researched gout
> online and realized I had every contributing factor including a
> previous injury (broken/heavily stubbed toe in '88), and every symptom.
> Bought some cherry juice and advil, immediately changed my diet, and it
> looked much better in the morning. Went to see the doc and she said
> "good job, keep it up". By Wednesday night (Feb 9) I was dying. The
> advil no longer worked. Went back Thursday and was put on Hydrocodone
> and Prednisone.
>
> The prednisone had an immediate impact, by Saturday I was off the pain
> pills entirely. But the toe never completely healed up. There was
> always some redness/swelling. The doctor was shocked that it wasn't
> total history after 5 days of Prednisone, when I asked for a refill.
> She felt there was an additional problem and recommended a podiatrist.
> Here's where it gets crazy.
>
> The podiatrist immediately said "How do you know it was gout?", and
> "how was it diagnosed?", explaining that gout can ONLY be diagnosed by
> examining joint fluid extract under a microscope. He took an x-ray,
> which showed no "tophi" bites, but did show a 2-piece (bipartite?)
> sesamoid. He felt I had fractured the sesamoid and was not convinced I
> EVER had gout. He gave me an anti-inflam and an orthopedic sandal.
>
> However, since that morning at the doc, the toe has twice flared up,
> for no apparent reason (it was fairly pain free and benign at the doc).
> Both of these flare-ups came in the evening, after fairly large (by
> gout diet standards) meals, and seemed to have no relation to any
> physical event (i..e...too much walking). Both flare ups had very
> "goutish" symptoms...red, shiny skin, chills, horrible pain.
>
> Now, granted the podiatrist told me it could get a little worse because
> of coming off the prednisone, but I'm sort of confused here. I don't
> mind fighting this thing, but I don't know what to fight. Should I stay
> on a restricted diet? Or go with more physical
> therapy...i.e....R.I.C.E.
> Should I see a urologist or rheumatoid specialist and get a third
> opinion? And also, I've read absolute horror stories about sesamoids.
> If it's truly fractured, why isn't it fully immobilized so it can heal.
> This stupid sandal is a joke. It hardly limits my range of motion at
> all. The PAIN limits it a heck of a lot more than the sandal does.
>
> Sorry to go off a little. It's time for a pain pill.
>

Re: My Self-Diagnosed Gout Update -- Posted by Janet R on 02-24-05 18:40

I took a picture of mine when it was inflamed too...it was always worse in
the evenings. Some blood and urine tests should tell the docs what they
need to know.

I see a Rheumy and Urologist for my gout.

Janet R

"JimmyT" wrote in message
news:1109281958.908411.218880@f14g2000cwb.googlegroups.com...
>
> I am in a similar, confusing situation as Joe involving a possible
> gout/sesamoid combination. I awoke about 2 weeks ago to big toe pain,
> redness, and swelling. This was after a big super bowl weekend of
> drinking, golf, and topped with a 16oz sirloin. I researched gout
> online and realized I had every contributing factor including a
> previous injury (broken/heavily stubbed toe in '88), and every symptom.
> Bought some cherry juice and advil, immediately changed my diet, and it
> looked much better in the morning. Went to see the doc and she said
> "good job, keep it up". By Wednesday night (Feb 9) I was dying. The
> advil no longer worked. Went back Thursday and was put on Hydrocodone
> and Prednisone.
>
> The prednisone had an immediate impact, by Saturday I was off the pain
> pills entirely. But the toe never completely healed up. There was
> always some redness/swelling. The doctor was shocked that it wasn't
> total history after 5 days of Prednisone, when I asked for a refill.
> She felt there was an additional problem and recommended a podiatrist.
> Here's where it gets crazy.
>
> The podiatrist immediately said "How do you know it was gout?", and
> "how was it diagnosed?", explaining that gout can ONLY be diagnosed by
> examining joint fluid extract under a microscope. He took an x-ray,
> which showed no "tophi" bites, but did show a 2-piece (bipartite?)
> sesamoid. He felt I had fractured the sesamoid and was not convinced I
> EVER had gout. He gave me an anti-inflam and an orthopedic sandal.
>
> However, since that morning at the doc, the toe has twice flared up,
> for no apparent reason (it was fairly pain free and benign at the doc).
> Both of these flare-ups came in the evening, after fairly large (by
> gout diet standards) meals, and seemed to have no relation to any
> physical event (i..e...too much walking). Both flare ups had very
> "goutish" symptoms...red, shiny skin, chills, horrible pain.
>
> Now, granted the podiatrist told me it could get a little worse because
> of coming off the prednisone, but I'm sort of confused here. I don't
> mind fighting this thing, but I don't know what to fight. Should I stay
> on a restricted diet? Or go with more physical
> therapy...i.e....R.I.C.E.
> Should I see a urologist or rheumatoid specialist and get a third
> opinion? And also, I've read absolute horror stories about sesamoids.
> If it's truly fractured, why isn't it fully immobilized so it can heal.
> This stupid sandal is a joke. It hardly limits my range of motion at
> all. The PAIN limits it a heck of a lot more than the sandal does.
>
> Sorry to go off a little. It's time for a pain pill.
>

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