Gout trumps most stuff.

[Yikes]

Some of you may be aware that in mid April I had Gastrointestinal bypass surgery. It appeared to go really well. I was recovering/responding better than anyone I've ever heard of. Then in May A Gout flareup started (I'd never been officially diagnosed with Gout, but I might have had 3-4 brief (2-3 day) flareups over the last 15 years), it was misdiagnosed at the ER which directly resulted in my having a severe G.I. bleed. I ended up almost dying, spent six days in the hospital (where I received 12 units of Plasma and 9 Units of Whole Blood). To make a long story shorter I'm still fighting the same Gout Flareup. 3 Fucking months and on-going.

The last month I've been on steroids, which helped a lot. The gout was almost gone, but the steroids ended last Wednesday, by Saturday I could feel twinges of the gout in my foot and right arm. Today it has really come on strong, over a period of about 6 hours my right arm has gone from a little pain when I move it to a continuous pain in the 3-4 range (in the elbow area) and a lovely new symptom; my arm heading toward the wrist is numb. WTF! Numbness. Is the swelling in the elbow cutting off the blood flow? Or pressing on nerves? Either way it's fucked.

I need to get a job. How do you get a job when you can't use your arm because of a gout flareup? Or when you are forced to wear an orthotic on your foot? Or when it's really bad in your feet crutches? At the moment I can barely use my arm, much less type with my right hand.

A Three month long Gout Flareup! At what point is it no longer a flareup? I'm squarely in what I am calling the FU Zone. Out of the three months I might have met the Social Security definition of disabled for two weeks, but the gout is still keeping me from getting a job. So I'm fucked, the gout isn't severe enough to qualify me for SS, but it is severe enough to keep me from getting a job. My savings are gone. I'm now selling off my not insignificant stockpile of toys.

So taking stock.

The good

I'm down to 304 lbs from 361 on April 14th (435 lbs last September)

The surgery has pretty much cured my Type 2 diabetes (I'm now what would be called non-symptomatic)

The bad

Gout non-stop to varying degrees (the severity and duration of the gout is almost certainly due to metabolic changes from the surgery, which they never mentioned)

Sorry, the Gout trumps the positive aspects of the surgery. I couldn't move around well at 435, but better than I can now. The Type 2 I had under control with diet and oral medications before the surgery. I'm sorry, next week I'm probably going to change a major digit (299 lbs), but the gout has me totally demoralized. Anyway.... Just venting.

[xand1x]

Sorry to hear that you're going through so much agony! I wish you a speedy recovery from what has already been a few months of discomfort and pain. I recall as a kid seeing my uncle go through weeks and weeks of pain. He was on crutches for maybe a month or two

[Yikes]

As time goes by I am less enamored with my surgical team. There was no mention of increased instance of Gout in the seminars leading up to the surgery. Just to night doing research I discovered that there is a firmly established link.

After the surgery the body consumes (eats it's self) a lot of protein and hopefully fat, but it does consume a lot of protein. When it does this it ultimately floods the body with levels of Uric Acid the likes of which the body has never seen before. So it is the reason for the severity and duration of this outbreak. It's one reason why they have the patients taking protein supplements. In the first month I took the supplements religiously, but I then began decreasing them. My body was responding well and I had no issue consuming meat (after the surgery most people have problems with beef and chicken, I didn't so I reduced the supplements). So I have restarted the whey protein supplements in the hope that my body will release less uric acid.

The fucked up thing. I had to research and learn this on the Internet, my surgical team should have made this possibility known to me, they didn't. Now the hopeful news: the data shows that this period of increased gout passes and that ultimately the surgery usually improves or cures gout (people who had frequent gout outbreaks before the surgery initially have SEVERE Outbreaks after the surgery but eventually the gout goes away once the body has acclimated (6-12 months).

This make me feel much better, I feared an existence where gout was going to be an ever-present antagonist. Now at least I have the hope that this condition will be finite. I can hang on if there is an end in sight, whether it's 3 month or 9 months there is a good chance it will end. In the meantime I may take up residence in a shopping cart, methinks I should be paying more attention to my portable rig

[boomana]

Ethan, sorry to hear you're going through this. I had a boss once who'd get gout flare ups from time to time, and they were pretty debilitating.

[kevin gilmore]

allopurinol is cheap and very effective for most people.

uloric is better, but is currently very expensive even with good insurance.

There are many ways to get the protein you need without eating red meat.

i've cut my uric acid levels by 75% over the past 5 years. Not fun.

Try to stay away from the steroids. The more you take them, the more you need them.

And they cause eyesight and liver problems.

[Salt Peanuts]

Sorry to hear about this Ethan. Here's hoping you'll have a speedy recovery.

[The Monkey]

Ethan, I'm sorry to hear about the gout, but WOW you have lost a lot of weight. That's great!

As for the job stuff, as you well know, it sucks out there now. Given your current medical conditions, have you considered applying for disability?

[Torpedo]

Best wishes Ethan, get well soon. As Kevin said, ask your doctor if it'd be possible suppressing the corticosteroids or substituting them for other NSAI. Getting rid of all that uric acid is what you need. Deposit and inflammation are just consequences.

[Yikes]

Thanks Everyone, I've been on colchicine for about 6 weeks, primarily because with the surgery (and the GI bleed) NSAID's are a no-no. Colchicine is normally fairly effective, it obviously hasn't stopped this Gout episode, and I can only speculate about whether the colchicine has lessoned the severity of this prolonged Gout attack.

I've been taking Allopurinol (To lower Uric Acid level) for about ten days. It doesn't seem to be helping, but who knows how bad it would be now if I were not taking it.

Earlier today I restarted taking Protein (Whey) supplements. This should also help reduce my Uric Acid level.

As far as disability goes I have looked into it. Taking the SSA guidelines as Gospel I wouldn't qualify. They have strict guidelines and my condition doesn't qualify (It has qualified for maybe 3 weeks out of the 3 months, but it would need to be that bad for much longer 3-6 months before I'd be considered for SS Disability).

I'm hopeful because of two things; my restarting the Protein supplements and that data shows that this period of increased Gout will pass.

[Genetic]

The fucked up thing. I had to research and learn this on the Internet, my surgical team should have made this possibility known to me, they didn't.

Bonjour Ethan,

If I were you I would keep this fact as a wild card in your back pocket. In a near future if your relation with your actual medical team suddenly goes south this could represent an opening to the legal way of getting ''r

[Torpedo]

Ethan, if your stomach can endure corticosteroids you could take NSAI with proper gastric protection. Anyway, I understand your doctors prefer the corticoids, yours must be a tough case and corticoids are more effective. It's the long term side effects which are to be feared. I hope you can stop using them soon Oh, I re-read your first message and looks like they were suppressed last week, so the new symptoms started. In this case I wish you won't need to take them again.

Edited August 10, 2010 by Torpedo

[Dusty Chalk]

Dude, that sucks.

Sorry, I'm socially inept -- I basically don't know what to say, other than I sympathize.

[deepak]

You should probably be on a PPI even if you're not taking NSAIDs. Steroids can be harsh on the stomach as well.

[Yikes]

Been off the roids for almost a week, so not an issue.

My right arm is no worse than it was ay 4am this morning. Still picking up a shoe is painful enough to cause me to grimace in pain. Oh well, time to switch hands.

[CarlSeibert]

Dude, that sucks.

Sorry, I'm socially inept -- I basically don't know what to say, other than I sympathize.

x2

[manaox2]

Really hope that your hopes come true and fast Ethan, it truly sounds like a horrible and frightening experience.

[Yikes]

No need to post anything. I appreciate good thoughts, but I posted to vent.

Frightening, a little, but what's Frightening is having people who depend on you and being in similar situations, or having people depending on you and being a 99er (Unemployment running out). The only person depending on me, is me. So absolute worse case I end up staying on friends sofas, or dying because I can't continue to pay for my health insurance. What would freak me out is not being able to take care of someone I was responsible for. Which is no one, so...

[kevin gilmore]

One major other thing i forgot is that a lot of gaot attacks are due to STRESS.

So you need to reduce your STRESS level. Drinking booze definitely will make

it worse. Lots and lots of water makes it better.

[vickywatts]

Hi Ethan, I'm sorry to hear about the gout,but don't worry get well soon.hoping you'll have rapid recovery.