Gout Remedy

Foreword:

Hello all! If you have arrived to this page, most likely you are very familiar with Gout and most probably you are just like me 2-3 years ago searching and "Googling" on the web for some kind of info on remedies, be it natural or modern drugs to cure the four letter word GOUT! Believe me I've been there and here I will summarise my experience and my accounts on treating gout attacks and prevent gout attacks all together. If you are in a hurry just skip everything and go straight to "2013" below.

Warning! I am not a Medical Doctor nor Health Advisor. All the medical drugs mentioned in this blog were prescribe by my General Practitioner and/or  Orthopedics. Please seek advice from your medical experts.

Background:

Before I run through the chronology of my "gouty-encounters", a bit of background of my health, body and fitness condition. I weigh around 79-84 kg , with my bmi somewhere around the edge of average and overweight. In terms of physical activities, I was MORE active back in university before I started getting gout, with an average of 2-3 exercise a week (medium to intensive Capoeira trainings mostly with some gym or swimming sessions).

2009 - Swelling, inflammation that's it right?

Some point late 2008 and early 2009, I vaguely remember getting some kind of joint pain; once on my little finger and the other on my ankle. The joint became red, warm and inflame generally. The level of pain was probably around 5 (from the scale of 1 to 10), it was painful, I can't bend my finger or rotate my ankle, but it was bearable that I would still able to ride the tube and attend classes or even attend Capoeira trainings (avoiding any contact on the affected joint of course). I went to GP once and I was prescribed with "Nurofen" which is just a normal Ibuprofen pain killer. Note here I was merely reducing the pain and waiting for it to go away in couple of days.

Then came summer 2009, completed my final year and just chilled in London for couple more weeks before I headed to Milford Haven for my internship program. One night I slept on a short sofa with my legs hanging at a higher level than my body & head, the next day I woke up, with very tight and painful ankle. Again, I thought it was the same issue thus I went to the nearest pharmacy to get some Nurofen and an ankle support (which made it worse actually). It went away in about a day or two.

I head back to Malaysia for good by the end of 2009 and it was such a great experience to be able to eat seafood (Malaysia, Chinese and Thai cuisines) as much as I like. Back then Arabic food restaurants have also started to sprout in KL. Most noticeably are those restaurants along Jalan Damai (before they were relocated) including Zahrat Al-Khaleeq (our fav!), Castle and Al-Rawsha. As a result, I started to eat more lamb than I used to. Before I forget, there is another thing that I love to eat when I was abroad, dried anchovies!! Worth mentioning here as these are the food I suspect to be the main culprit of my early gout attacks.

2010 - First Acute Attack & ACL Surgery

By now I heard of gout. Two of my older cousins have gout and they explained how painful the attack when they had it on their knees. Apparently our late grandfather had gout as well. Nice, in my mind then, it would never happen to me, I'm still young right? WRONG!

One night, I had that same feeling which I had back in London summer 2009. My ankle slowly feels discomfort, getting harder and harder to rotate and some pain were felt at when I forced my right ankle to extreme angles. I didn't what to do and slept it over hoping that it would go away the next day. Around 3 am in the morning, I was woken up by excruciating pain on my right ankle. It felt like as if a heavy truck is resting on it. Tried to go back to sleep but it was just so painful to do so. Finally I decided that I needed medical attention. I had to wake up my sis and brother in law all the way from PJ to pick up and bring me to the hospital. Arrived at the hospital I was limping in pain and got myself onto a wheel chair. Of course at this hours no specialist can attend me, thus I was given a jab (might be steroid) on my butt and requested to wait for the excruciating pain to go away. Correct me if I'm wrong but I think that was what they meant with "Acute Gout Attack" aka gout flare. As quoted from uptodate.com :

"Acute gout (or a gout flare) is an intensely painful and disabling inflammatory arthritis usually involving a single joint but occasionally involving two or more joints. The goal of therapy in an acute gout attack is prompt and safe termination of pain and disability. Without therapy, acute gouty arthritis usually resolves completely within a few days to several weeks, particularly in early disease. However, symptoms improve more quickly with administration of any of a broad array of antiinflammatory drugs"

The hospital requested me to follow up with their Rheumatologist, Dr. Mohammed Shahdan Shahid if I am not mistaken but I never went back to the hospital. The Doctor was those specialist which work for multiple hospitals thus it was quite tough to get an appointment with him.

At the end of 2010, I did my "ACL reconstruction" on my left knee and funny enough I never get any gout attacks as I was recovering from the surgery until early 2011.

2011 - Recovered from ACL & wedding

Starting from 2011, the gout attacks became more frequent. Initially the trigger were just red meat and seafood, it then grew to a long list (suspected causes) of long driving, lack of water, fried food, sugary drinks, MSG, process canned food and the suspected list goes on.

1st specialist attempt

At the final follow up with Dr. Badrul Shah Badaruddin (the Orto who did my ACL),  I explained to him my problem with my left ankle; the pain, the reduced flexibility, the gout issue and suspected old injury from Capoeira. He prescribed some gout prevention drugs which I will explain below. Again I wasn't happy as he didn't X-Ray my ankle to rule out any injury and he didn't take any sample from my ankle as well to check the for the formed crystals to confirm that it's gout (read about this on the internet). It was all based on my high uric acid. I didn't follow through with his plan hence I was back to square one.

My priority back then was to recover from the ACL surgery before my wedding. The gout "problem" was still not on my top priority list.

2012 - Drugs, remedies and run!

Throughout 2010 - 2012, the resistance to drugs became more apparent. Whilst the total excruciating attacks (usually 2 - 3 emergency case a year) decrease whilst minor attacks increases. There was one advantage though, it was really easy for me to get medical leave.

I've already been prescribed several drugs which are:

Minor Gout Attack:

Colchicine pills (NSAID)

Voren (diclofenac sodium pills (NSAID)

Voren gel - usually Voltaren brand (NSAID)

Major Gout Attack:

Steroid Pills – Prednisolone

Prevention Drugs:

Allopurinol

"Lanolone" = Allopurinol + Benzbromarone (recommended initally by Dr. Badrul my first Orto then later by Dr. Yong my 2nd Orto to fix gout)

By now the frequency of the gout attacks were unpredictable. I was very cautious of what I eat, and I can really tell if I am getting gout (from the twitching sensation in my ankle). My left knee has recovered well from the ACL surgery and I started to run in 10k running events (hoping that increasing physical activities will eliminate gout).

I have already conducted my own research on the web on natural remedies and tested on myself. Some works some do not. It was important for me to move to natural remedies as I am aware of all the side effects of the drugs prescribed to me above (impact on kidneys etc.).

Celery Seed Supplement - tried one bottle of this. it usually gives me some twitching initially then it goes away. stop using this supplement after one bottle.
Alfalfa (GNC's Triple Alfalfa) - it was generally expensive and I can't really tell the effectiveness, thus stop taking this as well after one bottle.
Misai Kucing Tea (Java Tea) - I personally felt that this tea helped me along the way fighting gout although I felt the response was somewhat slower than other remedies.
Green Tea - This is one of the remedy which sometimes it feels that it's helping and sometimes it feels like it's promoting gout (for me at least). Still a good tea to drink during normal times.
Apple Cider Vinegar  - Initially I had this for weight loss and read somewhere that it can helped reducing the pain from gout. I feel indifferent on this.
Water  - This is a must. Especially during attacks I would have plenty of water to "flush" my system.
Stinging Nettle (GNC for instance) - this supplement works well on me as well! I read somewhere on the internet traditionally people would rub stinging nettle on inflamed area to reduce the swelling. I don't want to do that but taking the supplement is a piece of cake.
Black Cherry (GNC or fresh or freshly squeezed) - we only get imported cherries in certain month here in Malaysia and not to mention cherries are quite expensive. Thus the GNC Black Cherry supplement is my easier option for routine maintenance of gout prevention. Taking the freshly squeezed organic cherry is another option. Btw check this out as discussed in "14 Foods That Fight Inflammation" 
"Tart cherries"
"In a 2012 presentation, Oregon Health & Science University researchers suggested that tart cherries have the “highest anti-inflammatory content of any food.” Studies have found that tart cherry juice can reduce the inflammation in lab rats’ blood vessels by up to 50%; in humans, meanwhile, it’s been shown to help athletes improve their performance and reduce their use of anti-inflammatory pain meds."
Vitamin-C (e.g. Redoxan) - I take this once or twice a day. I read that Vitamin-C also helps us to flush our system hene flushging out the no-good Uric Acid. Highly recommended.

The highlighted green drug and remedies above are the combination that I used together with regular gym visits to prevent gout. I will explain further on this below.

It is the end 2012. I was fed up with the unpredictability of my gout attacks and upset as despite me running in 10k events and practice sessions throughout the year, I still get at the very least minor gout attacks which would last one day.

2nd specialist attempt
I went back to PCMC this time randomly picked another doctor (Dr. Yong Chee Khuen) to get fresh view of my gout condition. He X-Rayed my ankle and concluded nothing wrong with the joints and bones. As I kept complaining of certain pains and restrictions, I was also instructed to go through physiotherapy where the therapist conducted ultrasound, massage and run electrical currents to improve the muscle around my ankle. Overall in 2013 it has been a very good year, I had probably 2 obvious gout attacks; one was when I had to stay up all night when my baby was born (most likely the sweet canned Nescafe drink) and the other was during fasting month (most likely insufficient water). I would see him every one or two months for my Uric Acid monitoring. When it the number went up, he advised me to take double dose of "lenolone" instead of one. After Eid, I started going to the gym consistently doing mostly weight trainings. Slowly I also improved my eating habit especially avoiding sugary drinks. By December 2013, Dr. Yong decided that I can stop the monitoring program. I won't say I am free from gout but at least it is obvious to me some improvements have been made.

2014

As we entered 2014, I wondered if there anybody else in the world having the same problem as I did. Most importantly I wish other young people would be able to resolve this matter. It was quite annoying when doctors, bosses or even anybody started to say "You have GOUT? But you are sooo young!". For now my solution is firmed:

Lonolone pills for prevention (1 or 2 before going to sleep) +
Black Cherry supplement +
Stinging Nettle.

Vitamin-C drink (Redoxan) - Once or twice a day

When I get twitches (like the other day when I had my first steak in years):
- water
- Vitamin-C
- Stinging Nettle
- Vlack Cherry

Most importantly I try to avoid the NSAID and def, the steroids at all time.

I'm going to put more pictures and fix my grammar later but in the meantime I'm going to publish this.

Enjoy!