1. < Bones, Joints & Muscles

What kind of doctor should I see for gout?

Posted by bhb30602 @bhb30602, Oct 3, 2024

I was diagnosed w gout early summer and was referred to a kidney doctor (by my primary care dr.) due to a slight to moderate decrease in my kidney function (68yrs old). Primary care was prescribing 10, 10mg of prednisone on request, to take as needed for gout flare-ups which were happening every week. 10 tablets would last me 1-2 weeks and I would only take them as needed.
My kidney doctor replaced the 10mg of prednisone with a 4mg dosepk of methylprednisolone and the dosepk is working well. It is a 6 day regimen of taking 6 tablets on day 1, 5 on day two, 4 on day three and so on. Usually after the first 3 tablets on day one my flare-up is resolved. I followed the directions and took all 6 days for the first two dosekpks, but cut back on the third so I would have some on hand for flare-ups. My kidney doctor told me yesterday he shouldn't be the doctor to continue prescribing flare-up meds and that I should reach back out to my primary care doc or a rheumatologist. I've reached out to primary care doc to clarify. The allopurinol the kidney doc prescribed is slow to work - I've been taking it for 2 months and continue to have flare-ups between the prednisone and methylprednisolone. I've avoided all red meats, shellfish, organ meats, sweet drinks and am drinking at least 60 oz of water and a sugar-free drink (Powerade) daily that contains electrolytes. I have also avoided beer and wine, but have had an occasional bourbon over the last few months but not to excess. On days when I'm not in pain, I'm able to exercise (walk 2.5 miles in 45min) but those days are limited in number. I need to lose 20-30 pounds but is slow to accomplish when mobility is so limited.
My question is, should I seek a rheumatologist or stay with my primary care doctor for treatment? Any recommendations are appreciated. I should hear from my primary care doctor today or tomorrow but would like to hear recommendations based on anyone's actual experience.
Thanks in advance.
B Burris

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bhb30602 | @bhb30602 | Dec 23, 2024
In reply to @emo "You would want to see a rheumatologist—they treat gout. But it may take a long time..." + (show)
@emo

You would want to see a rheumatologist—they treat gout. But it may take a long time depending on where you live to get a rheumatologist appointment, so if it were me, I’d follow with my PCP until you get in with rheumatology.

I guess it depends on how often you end up having flare-ups and how long it takes to get in with rheumatology, and which if your current providers is comfortable with helping you manage medication for flares.

My uncle has gout, so I’m not as familiar with it, but I have a different inflammatory arthritis (which is treated by a rheumatologist). But that sounds odd to me that your primary sent you to a kidney specialist only, and not to rheumatology?

You want to be cautious with prednisone; it’s a very strong medication that can cause long-term challenges even when it has to be used that way.

I hope you’re able to get connected with someone soon and get things managed with minimal flares.

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The long awaited day as come! My appointment with a rheumatologist is this afternoon at 3:00. The previous comment about the wait time to see a rheumatologist was a valid one as it has been a 3 month wait.
My kidney Dr upped my dosage of Allopurinol from 200 mg p/day to 300 p/day 3 weeks ago. At that time, bloodwork showed my uric acid was down from 10 to 6.5 (barely w/in normal range) but he wants it down to more like 4.0. Still experiencing flare-ups and I've been taking prednisone (20 MG tablets) that work well. The script comes with 10 tablets and instructions say to take 2 p/day but I only take 1 p/day and within 3-4 days the flare-up is resolved and I'm good for another week or so. I hoard the remaining tablets for the next flare-up. I'm cautiously optimistic that the flare-ups are not as severe as they were 6 mos ago.
Questions for the group:
1)what treatments do rheumatologist usually prescribe?
2)what can I expect from my visit this afternoon? (I'll have a current list of meds, and she has access to the test results) I mentioned.
Thanks in advance - hoping you all have a safe and wonderful Holiday Season.

REPLY
1 reply
covidstinks2023 | @covidstinks2023 | Dec 23, 2024
In reply to @bhb30602 "The long awaited day as come! My appointment with a rheumatologist is this afternoon at 3:00...." + (show)
@bhb30602

The long awaited day as come! My appointment with a rheumatologist is this afternoon at 3:00. The previous comment about the wait time to see a rheumatologist was a valid one as it has been a 3 month wait.
My kidney Dr upped my dosage of Allopurinol from 200 mg p/day to 300 p/day 3 weeks ago. At that time, bloodwork showed my uric acid was down from 10 to 6.5 (barely w/in normal range) but he wants it down to more like 4.0. Still experiencing flare-ups and I've been taking prednisone (20 MG tablets) that work well. The script comes with 10 tablets and instructions say to take 2 p/day but I only take 1 p/day and within 3-4 days the flare-up is resolved and I'm good for another week or so. I hoard the remaining tablets for the next flare-up. I'm cautiously optimistic that the flare-ups are not as severe as they were 6 mos ago.
Questions for the group:
1)what treatments do rheumatologist usually prescribe?
2)what can I expect from my visit this afternoon? (I'll have a current list of meds, and she has access to the test results) I mentioned.
Thanks in advance - hoping you all have a safe and wonderful Holiday Season.

Jump to this post

bhb30602, Have your questions written down that you want to ask on paper....that way you will not forget or get off track.

My husband is treated by his (new) primary doctor for gout. Recently his doctor increased his Allopurinol from 300 mg once a day to 2 300 mg tablets (600 mg) a day as he was having gout flare ups. His uric acid level is great now.

Colchicine is usually given to break up a gout flare up....we keep those on hand and usually within one day, it completely knocks out a gout flare up. He has not had a gout flare up since doubling the Allopurinol.

Things that cause gout flare ups for my husband before doubling the Allopurinol were:
Orange Juice, Shrimp, Barbeque or any kind of pork.

He has had gout in the knees, ankles and toes. If he ties his tennis shoes to tight on the top of his feet, it has caused a flare up. Anywhere there is a joint, you can get gout.

Gout is a form of arthritis and I personally believe it's hereditary as his dad had to take Allopurinol for the gout and our son has also had the gout at a young age.

Praying for you to get answers and relief. Not trying to discourage you, but, prednisone is temporaroy for the gout. It works for most folks short term, but, you need a preventative for the gout.

Tart cherry juice or the tart cherry tablets have also been mentioned by many under People's Pharmacy online.

Merry Christmas and God bless you greatly. Blessings.....

REPLY
1 reply
bhb30602 | @bhb30602 | Dec 23, 2024
In reply to @covidstinks2023 "bhb30602, Have your questions written down that you want to ask on paper....that way you will..." + (show)
@covidstinks2023

bhb30602, Have your questions written down that you want to ask on paper....that way you will not forget or get off track.

My husband is treated by his (new) primary doctor for gout. Recently his doctor increased his Allopurinol from 300 mg once a day to 2 300 mg tablets (600 mg) a day as he was having gout flare ups. His uric acid level is great now.

Colchicine is usually given to break up a gout flare up....we keep those on hand and usually within one day, it completely knocks out a gout flare up. He has not had a gout flare up since doubling the Allopurinol.

Things that cause gout flare ups for my husband before doubling the Allopurinol were:
Orange Juice, Shrimp, Barbeque or any kind of pork.

He has had gout in the knees, ankles and toes. If he ties his tennis shoes to tight on the top of his feet, it has caused a flare up. Anywhere there is a joint, you can get gout.

Gout is a form of arthritis and I personally believe it's hereditary as his dad had to take Allopurinol for the gout and our son has also had the gout at a young age.

Praying for you to get answers and relief. Not trying to discourage you, but, prednisone is temporaroy for the gout. It works for most folks short term, but, you need a preventative for the gout.

Tart cherry juice or the tart cherry tablets have also been mentioned by many under People's Pharmacy online.

Merry Christmas and God bless you greatly. Blessings.....

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@covidstinks2023,
Thank you for your reply - and blessings. I wish the same for you, your family, and everyone on this site.
I'm excited that this day has come and am praying to get my life back soon w the right treatment plan. I'll post outcomes soon.

REPLY
covidstinks2023 | @covidstinks2023 | Dec 23, 2024

bhb30602, I am trusting that you will get your life back soon with much prayer and wisdom from the doctor as to how and treat you. It took a few tries for my husband and they finally got the right combination that works for him. They keep a check on his uric acid level through bloodwork.

Please do keep us posted on your recovery. I believe it will come for you. CHRISTmas Blessings....

REPLY
bhb30602 | @bhb30602 | Dec 26, 2024

Just following up as promised: I like the rheumatologist I saw Monday and appreciated her taking time to ask probing questions and listening to my concerns. Her staff/clinic were professional and efficient as well.
She prescribed more prednisone to take as needed for future flare-ups and sent me for bloodwork and X-rays to determine if there was any damage to my feet and ankle joints. X-rays showed no damage and my uric acid is down to 5.6, the lowest it's been since this all started. I should be able to start exercising again and I see her in 3 months for a follow-up. Feeling optimistic and looking forward to exercising again.
I hope everyone's Holiday's are filled with peace, joy, and wellness.

REPLY
1 reply
covidstinks2023 | @covidstinks2023 | Dec 26, 2024
In reply to @bhb30602 "Just following up as promised: I like the rheumatologist I saw Monday and appreciated her taking..." + (show)
@bhb30602

Just following up as promised: I like the rheumatologist I saw Monday and appreciated her taking time to ask probing questions and listening to my concerns. Her staff/clinic were professional and efficient as well.
She prescribed more prednisone to take as needed for future flare-ups and sent me for bloodwork and X-rays to determine if there was any damage to my feet and ankle joints. X-rays showed no damage and my uric acid is down to 5.6, the lowest it's been since this all started. I should be able to start exercising again and I see her in 3 months for a follow-up. Feeling optimistic and looking forward to exercising again.
I hope everyone's Holiday's are filled with peace, joy, and wellness.

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bhb30602, Praise the Lord....wonderful news.

I question if athletes are more prone to gout? My husband and his dad both were very athletic. Gout is a form of arthritis and athletes put a lot of stress on their joints. Just my thoughts.

New Year's Blessings to you & yours.

REPLY
1 reply
blessedsista24 | @blessedsista24 | Dec 27, 2024
In reply to @covidstinks2023 "bhb30602, Praise the Lord....wonderful news. I question if athletes are more prone to gout? My husband..." + (show)
@covidstinks2023

bhb30602, Praise the Lord....wonderful news.

I question if athletes are more prone to gout? My husband and his dad both were very athletic. Gout is a form of arthritis and athletes put a lot of stress on their joints. Just my thoughts.

New Year's Blessings to you & yours.

Jump to this post

Blessings 🙌
I've heard if you drink a little tart cherry juice daily ir helps with flare up of gout .
I was a pharmacy technician for 12 year's.
Blessings for the New Year 🙏

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