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September 2, 2011 at 8:43 AMComments: 0 Faves: 0

Handling Gout

By Dr. Jeff Chamberlain, MD More Blogs by This Author

Dr. Jeff Chamberlain talks about how to handle gout both during an attack and prevention.
Host, Gerry Barnaby- Hey, what’s happening? Barnaby here—another HelloLife Moment with my friend and compadre, Dr. Jeffrey Chamberlain, who is a family medicine specialist. So, let’s talk about this—gout—because some people have gout, apparently. I have never had gout, I’ve never known anybody with gout. Have you had gout?
Health Coach, Dr. Jeff Chamberlain, MD- Actually, I have had gout. During my first year of medical school, I was running on a regular basis, and one morning I woke up in the middle of the night, and my toe was killing me. Excruciating pain—I thought I broke something when I was running. This was before I knew about gout. I thought it was so bad, I knew I had to have broken something while I was running, and a bone chipped or something got into the joint—
Barnaby- Hurts that much?
Dr. Chamberlain- It was unbelievable pain. I went in to get looked at. They’re asking about my family history, and I said “Oh, I don’t know anyone with gout,” and they told me “Well, you’ve got gout, here’s what to do,” they sent me home. Turns out everyone in my family has gout. All my grandparents had gout, my dad has gout, and so it ran in my family and I just never knew, and I was at a higher risk, and I didn’t know until I suffered from it myself.
Barnaby- Ooh, a dirty family secret. Is it something to be ashamed of? “Don’t tell anybody I had gout!”
Dr. Chamberlain- No, not really. It’s really genetic. A lot of cases of gout are because genes passed down, people who basically have bad genes so our kidneys don’t filter out the uric acid as much as they should. Gout is caused because uric acid crystals form in the joint, which causes a lot of swelling and inflammation and pain. We get uric acid in our bloodstream—it’s a normal part of metabolism when we break down proteins, and then there’s certain foods that have higher uric acid levels than other foods do, so there’s some foods that can put us at risk.
Barnaby- Click some of them off so we can steer clear of those.
Dr. Chamberlain- The big culprits are—alcohol is a biggie; red meats; any type of organ meats, like kidneys or liver or all those type of things, are really high. A lot of seafoods are really high also. There’s some debate about nuts. Traditionally, they’ve always said nuts are high in purine so they’ll cause gout, but in some of the most recent research it looks like nuts don’t really set off gout for people, and so nuts—it’s still up in the air.
Barnaby- Well, you know, you rattled off a bunch of mainstream foods right there, and so for that, is there a way to get, like, a pre-screening to see if you’re predisposed to gout, so you can take appropriate action?
Dr. Chamberlain- We usually don’t screen people for it, but things to look for is if you have a lot of family members that have a history of gout, you run a higher risk. There is a test that looks at your uric acid level that actually does tell you if you’re at a higher risk. Usually, this is more—we check after the fact; someone suffers from gout, we check the uric acid levels to see if they’re really high.
Barnaby- Okay, so, let’s see. You get diagnosed with gout, you were in the ER complaining of the swollen toe—what do they do for you? What do they say you should do to lessen the effect or the pain of gout?
Dr. Chamberlain- I break this up into two categories. One is: what do you do if you’re having an acute gout attack, when it’s flared up and painful, what do you do? And the other is: what can we do to keep it from happening again in the future? When it’s going on, it’s literally so painful, you’ll do about anything to get rid of the pain, and so there’s really some good things to do and some bad things to do. Good things to do include drinking plenty of fluids—being dehydrated can set it off, and making sure you’re well hydrated helps make sure the crystals aren’t forming in the joint, so staying hydrated is important. Once things are flared up and you’re in a lot of pain, using anti-inflammatory medication like the ibuprofen or naproxen can be really helpful because that works on pain and the inflammation. There’s an old-school medication called colchicines, which works really well for gout. It also causes diarrhea, so it’s not the most fun thing in the world to take, but if you’re desperate, you know, people will use it. Medication I don’t like using is narcotic medication, like your vicodins or your methodones, or things like that. That covers up pain, but it doesn’t get rid of the problem. The problem is inflammation, so taking anti-inflammatory medications really is the key. And then sometimes people’s gout is so bad they put them on steroids to try to reduce the inflammation. There’s an old-fashioned trick that I use when there’s a lot of pain. I take a boar brush, like a boar-hair brush, one of those brushes with all the tiny bristles on it, and if you just lightly rub it on your leg when you’re in a lot of pain, it just modulates and brings down your total pain level, so that’s actually—you have a natural way to modulate pain in general, and I recommend it for people who have gout, because it’s a natural way to modulate your gout pain also.
Barnaby- Though the pain is in your toe, say, by massaging with the boar brush on your thigh, that somehow lessens—
Dr. Chamberlain—brings your pain down. And the interesting thing is, it could be on your right foot, and you could do it on your left thigh, and it’ll still help out with the pain.
Barnaby- That’s interesting advice. Now, what about having gout, and have it also be an indicator that you’re suffering maybe from something else?
Dr. Chamberlain- Yeah, so, gout goes along with a lot of things. If you have gout, you’re at a higher chance of having high blood pressure, a higher chance of having diabetes, high cholesterol, higher chances of even dying from heart attacks and strokes down the road, and so it’s important to make sure these things are taken care of. It’s also important to make dietary changes to make sure you’re avoiding the gout, so avoiding the red meats, staying well hydrated, being physically fit actually reduces the chances of gout, so just being physically active and staying physically fit. Being overweight increases your chances of gout, being at a healthy weight decreases it, so staying at a healthy weight is important. Then there’s some natural supplements that actually have been shown to help with gout. High doses of Vitamin C can help—actually, drinking coffee is associated with decreased instances of gout as well also, so that’s another thing that people can do to help avoid gout.
Barnaby- Wow. Thank goodness there are some sort of treatments for the pain, ways of maybe just flushing the body through water and that sort of stuff, and I’m sorry for your—only one instance of gout in your life?
Dr. Chamberlain- Only one. Since then, I’ve kind of learned my lesson, and I watch what I do a lot more carefully.
Barnaby- Man, I tell you—it sounds awful. But, you know, if you’re suffering from gout, some great information, delivered once again by Dr. Jeffrey Chamberlain here. Another HelloLife Moment, because we are all about matching your commitment to a healthy lifestyle. Check back whenever you can!

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