My First Week of Gout Pain and How I Treated It
My First Attack of Gout
When I had my first attack of gout, I did an Internet search in an effort to understand what it was. The one thing I was unable to find was a day-by-day description of what the disease is like. I decided to record what happened to me during the first seven days of the attack. Since the initial onset, I have altered my diet—greatly increasing the amount of water I drink—and I have made more of an effort to eat less meat by increasing my fruit and vegetable intake.
Even though this article offers some insight to the symptoms of the disease, it is not meant to replace a doctor's advice. Nor is it an indication that your gout symptoms will be the same as mine. If you have an attack, you should see your doctor as soon as possible.
My first attack of gout started off as more of an annoyance than any significant pain. It started on a Friday evening when the big toe on my right foot felt like it needed to "pop"—like cracking your knuckles. I tried to get it to pop, but when I could I took two Tynenols, and the irritation went away. I slept fine that evening, but the following day was not so pleasant.
When I woke up the next morning, the toe was definitely starting to hurt. On a scale of 1-10, I would give it a 4. I took a couple of Tylenol (I have a medical condition that prevents me from taking ibuprofen), but they were ineffective. I had to drive several hours that morning, and when I got out of the car I could not apply much pressure to the right foot. I had to hobble inside.
At this point, the pain had increased to a 6-7 level, and I was beginning to believe that I had broken the toe since I was unable to move it. But there was no reason to believe it was broken, since I had not injured it. The right side of the toe was also becoming extremely sensitive. It was reddish-pink, and the swelling was below the base of the toe by at least an inch.
I knew my grandparents had suffered from gout—and I remembered hearing about the father in "Everybody Hates Chris" suffering from it, so I looked up the symptoms online. One of the ways of reducing the pain, an article said, was with Advil or any of the NSAIDs. Although I am not supposed to take them I took three, and it did reduce the pain down to a 2 or 3. It did not seem to have any impact on the swelling.
Once I learned that gout is caused by a buildup of uric acid, I started drinking a lot of water and flavored water (Propel, tea, MIO, etc.). I also drastically cut back on my pop consumption since one study indicated there may be a connection gout and drinks that are sweetened with high fructose corn syrup.
I slept okay that evening, but the pain did wake me up in the night. I started alternating Tynenol and Advil. By the time I went to bed I could not apply much pressure to the foot.
The pain increased even more on the third day, hitting at least an 8 on a scale of 1-10. I could not walk easily since the foot couldn't handle any pressure. I also had to sit with the foot elevated, The more I sat without elevating the foot, the more painful the toe becomes.
Even though I am not supposed to take ibuprofen, I continued to take it since it did seem to dull the pain to a manageable level (3 or 4). But as the day wore on even the Advil had quit working. By bedtime, the toe was throbbing, and the swelling had extended across and down the foot. The swelling was still pinkish-red, but it was becoming more reddish in color.
I had started icing the foot on day 2, and it did ease the pain somewhat. But by the third night even that was not helping. I was only able to sleep three or four hours that night due to the pain—and I kept an ice pack on my foot for most of the waking hours. I also tried massaging the toe, which did help some.
Day 4 was when the pain peaked, probably because I was finally able to get a doctor appointment. The foot was swollen enough that I could not wear a shoe—I wore a shoe used when the foot is broken. The doctor was able to see me early Monday morning and confirmed it was gout, but he ordered a blood test to double-check my uric acid level. He also gave me a seven-day supply of Prednisone, which I took three times a day (20mg). A few hours after the second dose I could tell a reduction of pain and swelling. One I started taking the Prednisone I quit the ibuprofen.
I still spent a lot of the day with the foot elevated, but I no longer needed to ice it. I slept well; no painful episodes to wake me.
On the morning of Day 5 the toe was considerably better. It was less sensitive, less swollen, and it was not as red. However, if I sat too long with it unelevated, the pain could return to a 3 or 4 level.
Day 6 was the first day I felt I could walk easily without too much of a limp. The swelling was gone. The redness and soreness were also less severe. At this point I had been on my medication for two full days.
By Day 7, when I had been on the medication for a full three days, had applied a lot of ice, and had done a lot of resting and elevating the foot, I felt like my foot was healed. I spent the afternoon doing some yard work. After about 2-3 hours on my feet, my foot started hurting again. I rested, elevated, and iced it—and by Friday, it was back to feeling normal. However, my foot continued to "flare up" over the next three days. I eventually ordered a refill of my medicine; I took it another day, and for the most part I haven't had any more issues.