Part of the Disease
Gout is a kidney condition in which, for causes unknown, the kidneys fail to eliminate enough uric acid from the blood, or the body produces too much, causing concentrations rise to a point where the vile stuff crystalizes into sharp, needle-like bits, which are then carried by circulation and gravity into the joints, usually of the lower extremities (i.e. toes, ankles, knees).
I have gout. Most frequently my attacks occur in the big joint where the big toe joins the foot, but I have been hospitalized twice for attacks in the knees. The best one was when my right knee and left ankle were both inflamed, and I couldn't even use crutches to get around. Good thing I have a penis and had plenty of empty Gatorade bottles around! I've heard of rare occasions where other joints are affected, the two I've heard of are the elbow, and, (god forbid), the back. I have *absolutely* no desire to find out what a gout attack in the spine would feel like.
Treatments for gout are broken into two types, preventative and curative.
Preventative treatments include drug therapies, either using Allopurinol or Probenecid, depending on the results of certain tests your physician will preform. You get one if the cause of your gout is excess production of uric acid, and the other if your problem is insufficient elimination of the normal ammounts of uric acid your body produces.
Other preventatives are mostly diet related. Certain foods and drinks are known to exacerbate or promulgate gouty symptoms. Alcohol, particularly red wine, is bad, in some chemical ways, and some diuretic ways. Organ meats, shrimp and shellfish, red meat in general, and for some odd reason, peas, all contribute to flareups, and are best avoided. As it is a diuretic, caffeine is also something to stay away from.
Hydration may be the best preventative of all, for if your body has enough water, the uric acid never comes out of solution to form crystals in the first place, and the more you urinate, the more of it leaves your body. Other good ideas are cranberry juice and black cherry juice. There are also some herbal remedies, etc, but I've never had any luck with these.
Treatments are much more limited, but thankfully, also very effective.
Colchicine is the primary drug given to fight the symptoms, usually in conjunction with painkillers and anti inflammatories (NSAIDs), the best of which is called Toredol. Great stuff, if anyone out there knows how I can get hold of a bottle of the injectable form of this, drop me a line. DO NOT TAKE ASPIRIN if you're having an attack. It does nothing but make it worse, I guess through adding more acids to your system.
One of the odd collateral symptoms of gout is swelling, the joints filling with additional fluid to cushion themselves against the ravages of the tiny crystalline needles. Joints full of water are stiffer, and hurt more, and the fluid may also contribute to a future case of arthritis, so, if you get gout in a major joint (like the knee), you can look forward to having it drained.
The first time I had my knee drained was the single most painful experience I've ever had, followed by a near-orgasmic flow of relief. I've had my joints drained so many times now that I don't even bother to go to the doctor's office anymore, I just do them myself.