What is Gout?
Characteristically, gout flares up in the toes over a few hours.
Quickcare or ER
Red flags that will send you to the ER include:
- pain that is unbearable.
Gout is normally seen in a clinic/Quickcare setting
What will your doctor ask?
Your doctor will want to know your gout symptoms. Remember, a symptom is your description of your condition to your doctor. It is your story.
The answers to these questions, will help your physician get good picture of your condition.
When did it start?
What makes it better/worse?
Have you ever had it before?
Did you injure yourself?
Do you have fever associated with it?
Typical gout symptoms of the foot include a red painful swollen big toe that was preceded by an injury.
What is you doctor looking for?
Your doctor will look for signs. Remember, signs are an objective finding that a doctor sees during an examination.
Your doctor will look at your temperature. A high fever indicates that there something more going on than simply an inflamed toe.
Then the doctor will look at the inflamed joint. Usually it is red, swollen and tender.
A pain in the toe may not seem like much. However, it may mean that the patient has an infection. Or, it may mean that he has a broken toe. Usually, most would remember such an injury. Why? Because it hurts!!
What is your doctor thinking?
Your doctor will create a mental list of possible reasons for your signs and symptoms of gout. This list is called a differential diagnosis.
It is natural to think of a broken bone (fracture).
With pain and swelling, consider an infection such a cellulitis of the skin. Your doctor will need to consider septic arthritis which is an infection within the joint.
Furthermore, elevated uric acid done with a blood sample suggests gout.
The definite test is to use a needle and remove some of the fluid from the affected joint. The distinct crystals will make the diagnosis.
Another arthritis similar to gout is “psuedogout.” The presentation is similar but the crystals are different.
What is the treatment of gout?
Gout treatment includes a number of medications. Medications for gout include:
Patients ask me often how to get rid of gout. First, I start with their diet. A “gout diet” would entail staying away from the rich foods. Foods to avoid include red meat, processed foods, and shellfish.
How long will you be sick with gout?
For many people, gout is chronic. It flares up every once in a while and then gets better with medications. With the proper treatment, a flare-up will resolve in less than a week
Let me tell you a story
Mark was just a natural born athlete. Always got chosen first for teams. A man amoungst men. Playing 100% all the time had its drawbacks. He had his share of injuries. Now that he is 40 years old, the littlest aches have started to creep into his life. So when he woke up to a right hurt toe, it did not surprise him.
Was it during the racquetball game? Or was it the pick-up basketball game at the local YMCA?
“I don’t remember hurting myself. I never had anything like this before, ” he told me
In Mark’s case, the pain was local, throbbing, constant. There was no associated fever or discharge.
Mark normally had a great diet but noticed that he was binging on steaks and lobster after his sudden wealth from selling his shares of an IPO.
After a short course of allopurinol, colchicine and indomethacin, he was back in the athletic mode showing off to the youngsters.
I hope this helps