Anti inflammatories and the sleeve.

I have a history of gout attacks but it doesn't attack my toes or regular gout joints. Instead it attacks my ankles or feet making it hard to walk at all. I am in so much pain right now and all I've been taking is Tylenol which is not helping. I had the sleeve done just over two weeks ago so I know oral anti inflammatories are out but what can I do for this horrible 9/10 on the pain scale pain?  I have seen some people use the salon pas or voltaren gel but does that really work?  I haven't slept in two days and I'm almost in tears from this pain. My surgeon is impossible to get ahold of so I don't think he'll be much help. I also don't have a family Dr. 

I am also a GOUT sufferer, the third day after surgery I developed the worst gout flare I have ever experienced and like you I get it on my knees and ankles, never the toe. That being said I called my surgeon and right away he prescribed me COLCRYS, this medicine is specific for gout and you have to take it with omeprazole. You do need a prescription for it but you do feel relief after the second day that's in your system. It was explained to me that the attack was brought on by dehydration so drink plenty of water! I feel for you, this last attack was so bad I was literally crying in bed because of the pain. FEEL BETTER.

P.S. People don't know what suffering is until they have experienced a gout attack!

I tell people it is like having a red hot nail driven into your foot.

Lol, but very slowly and constant! 

I would recommend getting into a rheumatologist and getting an injection into the site.  When I had my gout flare, I had to take a couple of Aleve so I could walk.  Even the hydrocodone was not relieving the pain.

See my profile about my gout attack last summer. 

I am now on Uloric and my uric acid levels are well under control.

  Here is my blog post:

This has not been a good day. I got woke up this morning by a dull ache in both knees.

A little background. I have suffered from gout since about age 18 and I am currently 51. For the last 2 years, I have had it pretty well under control with my PCP and quit seeing my rheumatologist. My surgery was in late April and I was concerned about gout. Drastic weight loss can trigger a gout attack as uric acid is stored in fat. To address the issue, I made an appointment in June with my rheumatologist so I would be on his radar. Sure enough a week later I find out my uric acid levels are elevated so he upped my meds.

Subsequent to seeing him today, I started my workout routine. Where before I had slowed down to 2-3 lbs lost per week, in the last 3 weeks, I lost 15lbs. My doc believes that weight loss combined with the previous loss triggered the attack. Now, I have had worse attacks located in a single joint but for the first time, this attack hit both knees, my left elbow and the toes on my right foot. The elbow and foot pain level was about a 4 while the knees where pushing 7-8.

As stated before, I was woke up by a dull pain. Well, during the day, that pain increased considerably and my knees were getting stiff. Having it in both knees makes it considerably more difficult to walk.

As part of warding off a gout attack, one of the meds you take is colchicine. The directions say to take 2 tabs and then one per hour until the first sign of sickness.(Nausea, the runs or full blown chunks). Lovely, the medicine that might help, can make you very ill. But a little nausea et al is diffinitely better than a full blown gout flare. Alas, the colchicine did not work and I found myself in a full blown gout flare in multiple joints.

Now, the reason for this post is two fold. Share a little of my misery and to serve as a warning to anyone who has ever had gout in their lives and are going to have WLS. The importance of hooking back up with the rheumatologist was that he is more likely able to treat the acute flares. Most MDs, while they can prescribe the medicine, are reluctant to give you cortisone shots in the affected joints. I called his office at 1:15 and I was in his office by 3:15. Luckily he understands how painful these attacks can be so he does everything possible to get you in. I ended up with a shot in both knees and those should cover the other joints. Part of the treatment is to drain any fluid from the joints. The right knee was the only one with a substantial amount and he pulled out 15cc. He held it up to me and said, "That is proof this was not imaginary pain."

He has changed my meds and hopefully that will cover the problem. But, I am so glad I saw him in June as he probably would not have seen me today. (it had been 2 years since I last saw him).

A side note, I have a prescription for hydrocodone and in the past, I have always taken 2 for these type of attacks. I am finding out 1/2 a tab is sufficient. Strangely, hydrocodone did not hit me that hard post surgery. I also told the doc, that this gout attack was way more painful then any of the surgery pain I had.

So to reiterate, if you have ever suffered from gout and are due for WLS, get a rheumatologist and monitor your uric acid levels closely. BTW, rheumatologists can be someone difficult to get into especially if you are a new patient.

I agree with the Urologist suggestion. BUT, my surgeon told me that he would not let me suffer if eg, my arthritis flaired up. So keep trying to get to your surgeon, there are things you can do.

I'm not sure this would work on Gout but its worth a try. I use this cream for almost everything and it works great for my arthritis, neck aches, headaches, sprains, even helped stop an ear infection, its MSM cream. http://www.swansonvitamins.com/swanson-premium-msm-cream-96-natural-2-fl-oz-59-ml-cream

Good luck, Christine

call your surgeon I was able to take nsaids after 1 month you need to get on the correct meds as soon as possible