NSAID Question Regarding Gout

I get extremely bad flares of gout on occasion.  My foot surgeon told me that, in the end, it is basically a genetic thing, that my body just does not process purines properly and never will.  He also added, that while some things (tart cherry juice) might keep it at bay for a bit, that no diet will realistically help over the long haul, especially with the high  protein we need.

As I left the hospital, two weeks ago tomorrow, I felt the gout coming on, by that Monday when I  could get to the doctor, I was in tears.  I can only use meds that my insurance covers because of financial issues.  I had used Indocin (indomethicin) which is an NSAID, but 2 or three doses would take care of a flare.  He gave me a steroid pack and it took away the bad pain but did little else.  I am on Day 4 of 7 of 20mg of Prednisone.  I am at the same stage, where the horrible pain is not there, but it does still hurt and is not going to go away.

I had my 2-week-check-up the other day and my surgeon said I needed to be on Zantac, 150 mg. twice a day to counteract the gout meds as I told him that I had to see my primary doc in a month about going on allipurinol full-time to avoid these attacks.

My surgeon is in the hospital and having surgery on his knee tomorrow but I am thinking that now that I have taken the Zantac for a few days, I am going to try maybe three doses of the Indocin to finally get rid of this pain.  I guess it is not any worse than the allipurinol that I will be taking forever and I will only be using a little bit.  I took an adult aspirin every day for years, but my cardiologist let me go off the aspirin and back of Plavix.

My question is this.  How will I know if I have caused myself an ulcer?  I have never had stomach trouble of any kind, no reflux and was never bothered by any foods.  I need to know what to look for before I turn ghostly white and fill the toilet or sink with blood.

Boy, this is really a great question.  We tend to be busy talking about the typical things with WLS and there are so many things that go on that effect our health because we are not suppose to have NSAID's.  I remember having Indocin suppositories for my migraines many moons ago and it really helped with the pain.  But this is a drug that has side effects for many people, so I cannot make a call on this, only your doctor.  I know of people who have gout and this is no joy ride for them.  It is debilitating for many and I don't have to tell you that.  You know.....

My surgeon puts all his patients on prilosec way before surgery then continues for a minimum of three months after and the rest of us take it for other reasons every day.  I am on pain meds and even though they are not an NSAID's they said to continue the prilosec as it's not going to hurt me.  Not all doctors would agree or other people would say it's not neccessary so again, everything is an individual choice.  I wish you the best!  Jane