What can I do when I feel Gout attack is coming?

Gout is very special that you can "feel" it's attack before it arrives. Can we do something to prepare its arrival?  How to prevent it from happening or to reduce the pain?  Here is one of my experiences.

On night, while on the way home after attending a banquet,  I felt that the Gout started attacking my left foot.  Thanks for the the great food served on the table. Actually I just can do nothing as I did not have any pill at home.  I just prayed that the attack would not be so severe.  Nevertheless, I did the following that night before I went to sleep.

1.  Drink a lot of water immediately.

2.  Try to keep my foot as warm as possible by covering it with a blanket while sleeping.

3.  Elevate my left foot using a pillow while sleeping.

Then hoped for the best to come.  Fortunately, my left foot was in good condition in the next morning. I have tried this several times. And it seems to work most of the time.  

Why did I do such 3 things? 

1. Drink a lot of water.  

It is never too late to drink water even you start feeling the gout attack.  As mentioned in my previous post, drinking more water can help not only diluting the uric acrid concentration in blood but also discharging the purine inside the body.  So I will drink water until I go to washroom for around 2 times before I go to sleep.  But bear in mind that one should not drink more than 0.7L (24 ounces) per hour.  Our kidneys cannot handle that much in a short period of time.

2. Try to keep my foot as warm as possible.

That is related to the gout attack formation process.  Gout attack is actually an joint inflammation caused by needle-like urate crystals depositing in the joints.  The crystal is formed when the uric acid concentration is so high that it reaches its saturation point.  This saturation point is temperature dependent.   The lower the temperature, the lower the saturation point.  This is the reason why gout attack usually occurs at the extremities , especially the big toe.  While sleeping, our body temperature is low and the extremities is even lower.  Hence, the winter night is most favorable for gout attack.   Therefore, to keep the foot warm while sleeping is important to prevent or improve the attack.

3.  Elevating the foot using a pillow while sleeping

While keeping the foot warm is crucial, good blood circulation is also important.  Elevating the foot should help the blood flow away from the extremities and reduce the chance of the crystal sticking into the joints.  Most importantly, elevating the foot should reduce the swelling and the pain if the Gout attacks!

I hoped this experience can help the others.  So, if you have any idea of how to prevent Gout attacks, please feel free to share.

Suggested Reading

1. With Gout, how much water should I drink?

2. Urate Crystallization is temperature dependent

3. Gout attack form at lower temperature

4. Formation of Gout attack

Is Gout genetic?

For me, it is not difficulty to conclude that Gout is genetic, at least in my case. Just like other illness such as cancers, the gout gene increases the risk of getting attack. With the right amount of high purine food, it triggers the joint pain in an hour or two.

If you are interested in my experience, please read on.

Gout in my family

Believe it or not, I had not heard of gout until I got the first attack. It is understandable as none of my family members had suffered from it before. I was fortunate enough to be the first one, with the only known reason of eating high purine food, of which my favorites were mushrooms, tofu, and broccoli. My younger brother was the second victim. Both of us got the first attack in our early thirties. My mother was around sixty when she felt the pain as female usually has gout attack after menopause. Even though gout had become a common suffering for we three, we did not think of it as genetic. Food was the only to blame.

Explanations from two doctors

Until one day, I went with my mother to see her doctor, who was also a friend of mine, for her body check report. She told us the report showed that my mother's uric acid level was high. When she knew that both of us had gout attacks, she said my gout could be genetic from my mother. That was the best answer for me. It also explained why both my brother and I got the attack earlier than the average. I/we did nothing wrong to get gout.

Since then, I got a chance to talk to a Chinese medical doctor about Gout is genetic as there were three people in my family having it. She seemed to disagree with that. Her explanation was family members usually share the same diet habit. So, if the whole family have high purine food a lot in the diets, the chance of the members to have gout increase. It seems reasonable as well.

The Exception

Wait a minute! How about my father? It seems that we forgot the other member who shared the same diet habit with us. No, he does not have Gout at all and he drinks beer almost everyday for more than thirty years. Should this is a very strong case to defend the food as the prime suspect? One family has three non-alcoholic members suffering from gout and the only alcoholic member is gout free! Amazing!

Case in Family Trees

How about the other members of my parents' family trees? On my father's side, none of my father's siblings has gout. On my mother side, out of seven siblings, two brothers, who lives in the US and Australia, have had Gout for a long time. Apparently, this is somehow related to the gene of my mother side. Including my mother, the chance is one out of four. That coincides with my friend's conclusion.

Now, my brother and I have got married and do not live with our parents. My uncle is living in the US and certainly does not share the same diet habit with us. Living in different places and different diets with the same gene, we all have gout.

Finally

For me, it is not difficulty to conclude that Gout is genetic, at least in my case. Just like other illness such as cancers, the gout gene increases the risk of getting attack. With the right amount of high purine food, it triggers the joint pain in an hour or two.

Suggested Reading

1. Gene linked to higher gout risk. (BBC)