Gout complicated by Massage

Foot care
1

Hi All,

Im new to this forum, desperately hoping for some help or advice as I am currently bedridden and on morphin in 300GBP a night hospital in Thailand as a result of what I believed was a gout attack....but now I feel as though my assessment if not wrong has been complicated.

I experienced the first classic tingling and burning on my shin just below my knee around 12th April. Sure enough in a matter of half a day a painful lump started to appear below my knee.

Never being one to sit on laurels I immediately start reading about gout as that is what I believe happended to me (and I still do after 3 weeks of suffering). It seemed home remedies where as popular as medication, so within hours Id acquired apple cider vinegar, a poor quality cherry juice (very hard to find in Thailand) celery, baking soda....the lot.

The gout at this stage although painful seemed perfectly manageable. So much so I didnt take any pharmeceutical remedie for a week.

Then I had an important meeting in another town 4hr drive from where I live. Drivin was no issue, the gout actually seemed in remission by day 5 so the home remedies where winners in my eyes.

However whilst in the town I took a fairly long walk. In total I must have walked about 4kms.  My gouty knee seemed OK but just tired and stiff with a littl bit of pain. I had to meet my associates in the evening....I had no home remedy with me, so decided to buy some ibuprofen. I bought 600mg tablets and popped one just before the meeting.

The relief was significant, however I still only stayed out an hour and then retired to my room.

I awoke in the night with a chill and I was soaking wet. This was clearly the side effect of a fairly large IBUPROFEN dose.  BUT when I pulled back the blanket to reveal my knee the result was even more remarkable. Barely I sign I had ever had gout! No heat, no swelling, and the lump under my knee was tiny. Made me wonder why I hadnt tried pharmaceuticals sooner.

However this was not to be the end of a story, but the beggining of one.

The next morning feeling bright and jolly, with a spring in my step for the gout being 95% in remission, I took  a short walk and wondered if a gentle leg massage might get rid of any remaining stiffness

The lady massaged my knee and leg for an hour, it was mostly soothing but at times I had to tell her ot ease up as she was pessing hard into my joint with her thumbs and kneeding the soft tissue outwards.This happended on the 22nd April.

I left the massage parlour and thought nothing of it. However a few hours past and i noticed a slight increas in pain. I went to room and rest.

The next morning my knee was playing up again become red and inflammed and swollen. I left to return home...but actaully had to stop 2hrs short in BKK for the pain...where I was meeting my wife anyway.

I spent the rest of the day laid up. By the following morning my knee had grown into a football my whole leg was swollen and i was in exquisite pain I simply couldnt evn lay still without crying out in agony.

That situation has now been going on a week. 

I admitted myself into hospital 36hrs ago as I could bare it know more.

Can anybody please tell me what happened to my knee and my life!

It seems the only soluton for me is poweful painkillers by needle that send me to sleep. I was technically ODing on all the oral ones and it still didnt abate pain. Just made me feel awful.

2

YOu may already have seen this page.

http://www.knee-pain-explained.com/gout-knee.html

I have gout but do not get attacks because I have been taking allopurinol for several years.

Generally, a gout attack will pass in a few days. (And then re-occur months or years later.  Gradually getting more frequent/severe).

3

Hey Jules. 

reading your message brought me pain! I've had gout attackes for 20 years and had many experiences when I tried the samethings you did - tried to expercise it out (walking) try to massage it out. Both induced gout to full flaming attacks for me. I don't know how gout works in our body but can only share with you what works for me:

I always carry DICLOFENAC (25mgx20) and Colchicine (0.5mgx10) when I travel. I may never need it but good to have it handy. from years of experince this is the best combination that works for me..and beleive me I've tried everything from steroids (prednizone) + ibuprofen + colchicine + everything else but this is plenty enough to cure it,

Key for me is to eat really light meals (sandwich + water) during an attack. this always helps to reduce food induced gout and helps DICLOFENAC to work (even better on empty stomach).

but the best thing is really to change your acidity in your body, the way to do this if you can follow lots of good advice you find in this forum - celery pills, cherry juice etc, but the most effective for me is to take CHLORELLA powder 5 grams/day for 3 months. this detoxed my body and changed the pH balance in my body so Ihave less attacks.

Hope this helps you, btw chlorella powder tastes pretty gross (like pond water) so if you're not gutsy you may want to take the pill version, just make sure you take enough to get the full effects.

Take care,

Gary

4

Hi  Gary,

Thanks for replying. Im wondering though, you say you have had gout manytimes over 20 years. Which joint? Was it your knee, and if so did it hospitalize you?  My main concern right now is the severity of the attack has even got the doctors question the diagnoses, they filled me with anti biotics against my wishes suggesting it looked like cellulitis, but of course if it where and id had this thing for 3 weeks already id probably be dead by now!

Clear thinking is getting lost in the fog of pain. I dont know whether to release myself from hospital, knowing that if its gout theres little they can do. Or stay in just in case its much more serious.

There is a very vague sign of improvement this morning as Im not crying out for morning injection of painkiller. Im curious to know if I can survive without it.

5

Jules,

I first had gout on my left big toe (for 10 years), then it migrated to my right foot, my back, my left elbow, and eventually I had it on my right ear. Doctor says it was a bit unusual but it happened to me.

5 years ago I had surgery to remove soft tissues on my left toe, left elbow, and right ear. I just had enough because gout really compromised my qualifty of life (i.e.: I couldn't realy eat anything heavy). I don't drink/smoke so doctor tells me I just have high uric acid genetically. After the surgery it's much better because the affected areas are not as easily flare up with pain anymore.

For you, I'd suggest that you stay in the hospital until doctor clears you. They will check your blood to make sure uric acid is 7mg/dl or below so you won't have an attack before they discharge you.

Honestly - the natural remedies take a while to work. the only thing i found effective is Chlorella and it took me 3 months to get gout under control. So please stay put and let your doctor take care you for now.

I don't understand why your doctor is not giving you DICLOFENAC? this is so common as first line NSAIDS that stops the pain and reduces inflammation, along Chochicine can effectively reduce your attack....so they must be trying to find the underelying reason on you, maybe it's not gout? if not then even more of the reason to stay in the hospital until they find out everything.

take care,

Gary

6

Hi Gary,

Thank you for being here on this page for support, and sorry for your own misfortunes with this god awful ailment...you must have been thru a lot.

Sadly you cant credit Hospitals or Doctors with same level of ability to either diagnose or treat things here in Thailand. I discharged myself yesterday afternoon after 3 days of comparitive hell. On one day I did even see a doctor all day. The nurses would enter the room and place my (inedible) meal on a table more than 4 meters from my bed.

None of them comprehended the pain, I ended up getting angry and told them to stop filling me with antibiotics and wasting my bloody time. The only relief i really got was from the painkiller they was injecting....so I made a judgement call that Id be better off bed ridden in my own home until I can find someone in Thailnd who knows what their doing....its  needle in a haystack exercise.

Anyway. I got back home yesterday about 3PM got on my wondeful bed, and had the most comfortable rest of day I have had since this flare started. In fact I was getting excited as for the first time I was feeling very much like there was drop off in the pain levels WITHOUT me having had a single painkiller for some 9 to 10hrs.

Two yellowish spots (look like zits!) appeared on my knee yesterday and have been getting steadily bigger. This morning there are three. Im guessing this is Tophi, and Im also guess this pretty much confirms my diagnoses. The other thing thats happened this morning is the swelling and inflammation around the knee has gone down.

My plan now is take ALLORIC (Allpurinol) 100mg 3 times a day. Painkillers as little as possible....by the way I was prescribed Cerebrex in the hospital oral. Wow didnt realise how powerful it is until I stop having the injectings. I took 1 200mg tablet at around 3AM (its always early morning its most likely to get more painful). Im also taking Uralyt - U whin seems to do a simialr thing to Allpurinol, but its powder form and easy to take...they give this to me to dissolve a 3.4m kidney stone, but research suggests its used a lot in combination with Allpurinol to lower Uric Acid in Urine.

However in all my reading so far...there seems to be some missing explanation of the bodily process that removes Uric Acid from the BLOOD, and or changes the bloods PH...in fact I would deem this impossible.  So how can lowering Uric Acid levels in Urine help? Im assuming it is like a queueing system? If theres to much Uric Acid already in your Urine, then your bloodstream/kidneys WILL NOT process any access uric acid thats drifting around in your body, for fear of renal damage? I read somewhere Gout is your bodies way of protecting your kidneys? Theres too much Uric Acid around so the body just dumps it in a joint?  Dont know how much of science you have read, but your clearly someone for whom gout has seriously impacted your life....cant beleive people make light of this conditions, it is possibly the most painful and deabilitating thing I cam imagine. I think its going to take me at least 3 months maybe 6 months physio to be able to use my knee again thats if the gout flare even ends!

I uploaded a picture. I know it looks wierd barely resembles a knee, but i think thats becuase most of the swelling is actually above the knee and below it...making the knee look small by comparision. if you look closely you can see two yellowish spots. I think this is tophi...this morning there are three of these that they are bigger, but overall swelling is down. As if the process the cells engulfing the crystals is well advanced...Im hoping I'll see a decline in pain over the coming days...then I can worry about getting rid of tophi.

Thanks again

Jules

7

Jules,

Wow, your picture sure brings back memories for me. But b4 I forget please try to get more info on taking Allopurinal when you're under an attack. I tried it before and it delayed/intensified my pains somehow....so be careful when you're on it (esp 300 mg/day). 

You're smart on trying to get off from painkillers. Both Cerebrex/Diclofenac have warnings that excessive use may double our risk of heart attacks. But I can't help it when the pain gets too intensive I'd take 75mg x2 Diclo/day for relief. this is pretty effective for me when taken with Cochicine 05.mg/every 3 hours.

I tried a relatively new Uric Acid reducer this year called "FEBURIC" 80mg/day. this works pretty well and doens't give you skin rash (and in some instances severe allergic reaction) as Allopurinal would....you may want to read online and try it. it's new and less dosage, so by theory less strains on your body, it's only 80mg/day. You shuld be able to get this at any pharmacy in Thailand.

Rest up/relax,

Gary

Soon when this attack is over please look into Chlorella, It helped me and I wish nobody will have what we experience again.

8

Jules

           You need to get a tablet called  ARCOXIA 120mgs

      it's the best cure I have ever taken, absolutely brilliant you will need a persciption from a doctor.

9

Hi Kieth,

Thanks.....as time goes on its apparent there are loads of possible solutions....right at this momnt nothing Ive tried to date has stopped the pain, it truly is incredible the amount of pain this knee is giving me, as Im sure other Gout sufferers know...theres simply no describing it!

10

Allpurinol - IMPORTANT:

Allpurinol is  great drug and keeps me gout free.

HOWEVER, it is NOT a quick fix. It takes months and (maybe a year) be fully balance your system.  

It will NOT improve your short term issues.

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http://www.arthritisresearchuk.org/arthritis-information/drugs/allopurinol.aspx

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Hi Dewsbury,

Thanks, I do understand that point. Where gout knowledge and thus treatment seems to be lacking, is that apart from addressing pain and inflammation what DOES address the quick removal of Uric acid from the blood stream? Im taking several Uric acid lowering medicines at teh same time now with the long term perspective that Allpurinol will likely become a maintenance therapy. But one thing thats rather confusing all these treatments address uric acid in the urine, not the blood (all levels have always read in normal range anyway just to add to the confusion!)

What really scares me is that Ive been bedridden for some time now my other legs muscle mass is shrinking, I can't move my Gouty leg at all, the pain simply isnt worth it,this thing is going on way to long to be "normal",  This was one of the reasons for the title of my OP....it just seems Ive got a gout flare up from hell going on with little way of stopping it or knowing when its going to end. Taking way to many painkillers for my liking.  Knowone seems able to suggest any way forward,

The short term is my main concern what should I be trying to do! My knee is now oozing around what look like tophi deposits but the are not hard they are like puss. Inflammation up and down the leg is diminishing very slowly day by day, so i know there is no infect. (that and the three course of intravenous antibiotics the hosptial put me on earlier in the week!)

13

A final work on Allopurinol.

It is a great long term solution but may take months.

In the immediate term it can make things worse BUT stick with it.

It needs to be taken continuously without stopping.

I've had gout for years ... thanks to Allopurinol .. I play football twice week!

14

Thats what worries me. Do I even have Gout....it certainly acted like it up until the fact its now running into weeks to resolve.