Gout

[hbelkins]

At least you've got decent healthcare to help you through this

I hit my deductible and out-of-pocket maximums last year because of my hospitalization (and to my surprise, my helicopter ride was 100-percent covered) and as a result, I didn't have to pay for any prescriptions for the second half of the year.

I dread to see how much it's going to cost when I have to refill my colchicine and allopurinol. A few years ago, I had gout in my big toe and had the doctor call in a prescription for colchicine. When I got to the pharmacy and was told it would cost $200, I told them to put it back and I would tough it out. I could do that with a toe, but not with a knee.

[sparker]

Gout runs rampant through my father's side of the family; my grandfather and father both had it.  I had my own first attack at age 29 when my right foot and ankle swelled up; went to the nearest hospital (at that time, Stanford) and was diagnosed (but hardly surprised considering family history).  My dad took Indocin for his attacks; both he and I were (are) allergic to allopurinol.  Soon afterward I became a patient of a different primary physician, who recommended Naprosyn to relieve my attacks.  Apparently the culprit in most diet-related gout are substances called purines; hence allopurinol.  Purines are found most often in red meat, some darker legumes, certain varieties of mushrooms -- and, in its most concentrated form, shellfish (shrimp/prawns are the worst, with clams and oysters a not-too-distant second).  Even turkey is relatively high in purines; the dark meat the worst of the lot.  Wine also contains substantial levels of purine as well (but simple grape juice does not!).  So I've given up alcohol in general as well as shellfish; I don't eat red meat two days in a row (give my system time to flush out any purines).  For 10 years I took prescription Naprosyn (in 750mg tablet form) as needed; of course, it was taken OTC back in 1992 as Aleve and its generic cousins, albeit at a paltry 200mg (+20mg of sodium).  There's a more recent drug on the market -- Toradol -- that's even better, but currently quite costly and still only available by prescription (its introduction by Syntex was one of the reasons why Naprosyn was made non-prescription).  So whenever I slip up (weakness: Italian cold cuts like dry coppacolla and Molinari salame) and a gout attack occurs I pop a couple of Aleve, wait a few hours, and pop a couple more; it's still less than my old prescription.  Trust me on this: gout's no fun at all!  For me, attacks usually happen on the tops of my feet or bunions -- but wherever a shoe is likely to come in contact with the foot can be an issue during an attack.  I keep a supply of cherry juice around as well; taking the Aleve with the juice usually speeds up recovery.