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I saw the GP today and had both bloods and blood pressure taken. Despite taking predisalone for 14 days, the flare up has not been tamed and is giving me considerable pain. I have been referred to a rheumatologist, and will commence the colchicine x2 daily. I have not been prescribed and anti inflammatory although I have both anti inflammatory and pain relief, but GP did not suggest I take either. I’m surprised at this because you seem to suggest that colchicine should be combined with an anti inflamatory plus pain relief, paracetamol, in severe cases.
I have just received the results of my bloodtests. Liver and kidney function normal. Uric acid level 356. Two years ago, when I discontinued Allupurinol, my levels were recorded at 536 although I was informed they were normal at the time. Although much less pain, the ankle is still badly swollen. I will continue the medication as prescribed, but have further appointment to review next Monday. I am overweight so hope a gentle diet will brong the levels down further. GP prescribing colchasine in case of further flare up, but will also refer to rhuematology to rule out one sided arthritis if flare up doesnt subside.
You hit the nail on the head Geoff. White Coat Syndrome in spades. Testing myself all week, it was settling nicely, (I have my own bpm), it went through the roof this morning whilst being tested in the surgery. They have suggested 24 hour monitoring but they cannot facilotate it before I go on a 2month vacation. I have been prescribed another 5 day course of prednisolone, (already taken 3 days at 30 mgs, 4 days at 40 mgs + indometacin 25 mgs x 2 prn at night.) already administered. Additionally prescribed paracetamol / codine pain killers to replace indometacin. My ankle is more badly swollen than since the attack started, but the pain has reduced significantly to the point that I can now weight bare if I’m careful.
In terms of treatment, given that I’ve been symptom free for 2 years, I’d be looking at diet and herbal remedies in the first instance, but Allupurinol has worked in the past so that’s a possible last resort. My next worry is that the GP never gave any advice re tapering off the prednisalone, perhaps 12 days is a short enough treatment period to make tapering unnecessary? Nervously I ask, how do I move to the appropriate group? Again, thanks for your input, hope I haven’t disturbed too much of your vacation.
Many thanks for your detailed response. Sadly, although the prednisalone relieved the pain after only a few hours, the pain and swelling returned with a vengence and during the day I have been confined to a a lounge semi recliner chair with my leg elevated since. The pain is nigh on intolerable at times, particularly when I go to bed and have been self medicating my prednisalone with indometacin for the last three days. I take on board your comments re the cause being what I’ve consumed last year, not last week. Because I was wrongly informed by my surgery at the last test that my levels were normal, my diet has returned to ‘pre gout’ days over the last 18-24 months.
I have a GP appointment tomorrow, uric levels and blood pressure, the latter being high enough for the GP to advise medication. I declined this on the grounds that it might have been high having just learned that the surgery had given me incorrect information and had, in effect, jeopardised my future health. Hopefully it will be more settled when taken tomorrow! Am I correct in thinking that I need to find my way onto the Gout Recce group or Gout Group. Sorry for being so vague, Id very much appreciate a mentor to nail my condition asap.