Sunday, March 25, 2007



Well, I went to the doctors, an urgent care center, for severe pain in my right ankle. His first impression was gout. Or a strain. Kept asking me if I'd injured it, and I kept repeating, no....not that I can remember. But a strain is exactly what I thought it felt like. I also mentioned that I have 2 fairly good sized dogs that I frequently walk with on uneven ground, so there may have been a minor pull at some point.

Do I have gout? Who knows, time will tell. If I have another "attack" I will have a joint aspiration done, and that will prove positive or negative. I doubt it's gout, simply because I don't really fit the profile. Recently I've had a lower protein intake than normal for me, I've not had a big massive gain or loss, have no family history and the symptoms don't match. This feels like a pull. According to what I've read, gout feels like there are needles or broken glass in the joint....and that is not what I felt. This was an ache. The more pressure I put on the joint and the more I flexed it, the more it hurt. The area was red and a bit swollen, but not like "typical" gout.

The first doc was fairly young, and I guess an intern or something, as he had to talk to another doc before prescribing. He immediately said gout. Now I know my age was a factor in his diagnosis, but I can't help wonder if my weight also was an influence. I didn't dare tell him I followed a low carb diet! Of course, he never asked. Never asked about "purine intake", which is supposed to increase chances of developing gout. He never asked about menopause, which is also supposed to increase risk. He did have my blood pressure, which was very normal.....120/82, and he did ask about kidney function....I'd had a creatinine level done recently and was fine. But he never asked about alcohol intake. (See The "risk factors" for developing gout here) he knew my BP was normal, and I am "obese" (but only a couple more pounds until I'll be "overweight"....but they didn't check or ask my weight). He knew I was a woman, but did not know my menopause status. Now I am completely grey, so I am sure to a young kid the assumption is that I'm well past menopause, despite my age of 53. He also knew I had, per my report, normal kidney function. I was never asked about diet, exercise, alcohol intake, other diagnoses other than for the meds I mentioned I was taking. I was never asked about thyroid function, or if it had been checked, nor was I asked about family history.

As I sit there, obviously very confused, the doc said he had to run things by the other doc (can't remember how he referred to him, but he was obviously in training). After a few minutes, the second doc came in. An older man, he also examined my foot and said he didn't think it was gout, but just an inflammation. He did say he wanted an Xray, and that if it didn't get better or if it came back I should be tested for gout (joint aspiration), but at this point didn't think that was the diagnosis.

I had an Xray, which was normal, and got a prescription for a "stronger" NSAID, nabumetone. I'd taken ibuprophen and tylenol with no little effect. I was hesitant about the prescription at first, the latest NSAIDs seem to be more dangerous than the older ones, but when I found it was one that is indeed older, figured I'd give it a try. I did, and the pain was gone within 15 hours or so. I only took 2 doses of the prescription (I got 20). it gout? Who knows. I have been having a problem over the past few months with joint pains. One joint in my body will just ache like might be my right elbow, or my left wrist, or one of my ankles, or a shoulder. Sometimes the pain last 3-4 days, but most of the time it's gone within 36-48 hrs. I think this was just another "attack" of this pain. I'd still suspect gout, but the joints involved are all over. My jaw, my back, knee or wrist. Never fingers and toes...and according to the literature it's more often seen in distal joints, meaning joints farther away from the body core.

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