New Gout Diagnosis

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I was recently diagnosed with Gout and put on allopurinol to reduce uric acid levels. Is there anything I need to do now or can I just wait to report it when I go in for my next medical (Feb of 2017)?
 
If you luck out Congress will pass PBOR2 or something like it and it won't be a worry. if you try and get a medical on Allopurinol you will be subjected to a battery of tests. In my case my insurance covered them, but it was a pain in the six (beats the pain in my right big toe all to hell). You have to see your physician within 90 days, and he or she has to write a letter saying your gout is under control, how it is medicated, the side effects of said medication, and treatment for any episodic gout pain. And a bunch of blood tests, check with your AME first. At least, this is what happened to me.

Also, check your BP. Allopurinol can drive it up.
 
Unregistered said:
I was recently diagnosed with Gout and put on allopurinol to reduce uric acid levels. Is there anything I need to do now or can I just wait to report it when I go in for my next medical (Feb of 2017)?
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Try huge changes in diet. I found lots of red meat and beer did it every time. Cut way back in both and no more problem.
 
write-stuff said:
Treatment for gout is disqualifying or requires an SI? Sheesh...
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It is neither. But you are required to produce quite a bit of documentation. It took three visits and about a month to get everything together for my last medical. A good sized part of that was the AME's fault, but I was the one who had to run around. PBOR2 cannot come soon enough for me.
 
My Dad has gout. Interestingly it's shellfish and asparagus that inflames him. He doesn't take medication just changes diet.

...Is gout hereditary? when would I see symptoms?
 
Unregistered said:
I was recently diagnosed with Gout and put on allopurinol to reduce uric acid levels. Is there anything I need to do now or can I just wait to report it when I go in for my next medical (Feb of 2017)?
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Try this link. It will tell you how bad your gout must be in order for an issuance to be deferred. I have had gout for 20 + years and taken allopurinol for most of that time, and my second class physicals have been walk in-walk out with with the certificate easy... Good Luck Gout Sucks.
http://www.faa.gov/about/office_org.../guide/app_process/exam_tech/item43/amd/gout/
 
Mtns2Skies said:
My Dad has gout. Interestingly it's shellfish and asparagus that inflames him. He doesn't take medication just changes diet.

...Is gout hereditary? when would I see symptoms?
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Gout is indeed hereditary, based on alleles that govern uric acid metabolism and some that govern function of the immune system. The fact that your father had it does not in and of itself mean you'll get it. I've been a vegetarian for 30 years, my attacks aren't really connected to anything except perhaps alcohol, which I'm not bloody well giving up.
 
steingar said:
I if you try and get a medical on Allopurinol you will be subjected to a battery of tests. In my case my insurance covered them, but it was a pain in the six (beats the pain in my right big toe all to hell). You have to see your physician within 90 days, and he or she has to write a letter saying your gout is under control, how it is medicated, the side effects of said medication, and treatment for any episodic gout pain. And a bunch of blood tests, check with your AME first. At least, this is what happened to me.
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Interesting, I've been thru two physicals since going on allopurinol and my AME just yawned. I guess I'll keep him!
 
I have been taking Allopurinol off and on for 20 years. Only question I have heard was, "Do you have gout?"
 
Time for a new AME. I'll miss mine, she's really good looking. But I think I'm getting the shaft.
 
so is allopurinol a lifetime maintenance anti-gout med or a take as needed if/when flairups happen? I know - ask my doc ... but since I have you here ... :D
 
Allopurinol is a competitive inhibitor of Xanthine oxidase, which is the first enzyme in the pathway that leads to uric acid production. It lowers uric acid levels in the body, so it doesn't form crystals at you joints hurt like all hell. Unless you make major changes to your lifestyle or diet, you'll continue to need it. My brother got himself off it with a vegan diet, which I don't understand because he got fat at the same time.

Me, I'm a vegetarian and I walk five miles a day. I rarely eat anything made with white flower or sugar. My one weakness is alcohol. I'd rather take the pill than give that up. Allopurinol is actually nearly a wonder drug. It can be taken orally and has few side effects (raising BP is one of them, though).

For flair ups you use NSAIDs like Ibuprofen. You can also use colchicine. It inhibits formation of microtubules, which cells of the immune system use to get to the inflammation site. Colchicine is old stuff, it was used by the ancient Greeks and Romans to treat gout. It aside effect include a nasty gastric upset, use it if you wan too loose weight the hard way.
 
Instead of allupurinol, I take uloric (generic name: febuxostat) which is nearly identical (at least in end result) but is supposedly better for people with mild to moderate renal insufficiency (which I have).

For flare ups, I have taken colchicine, but never again, it gave me horrible diarrhea which put me down longer than the flare up. Now I just take aleve, but I have only had two flare ups since I started taking the uloric approximately 6 years ago, and both were within a year of starting the medication. So while I guess I "have gout" I have not had a flare up in about 5 years.
 
Yeah, I'm done with the colchicine. I'd rather have the gout. Haven't had an attack in years, never had one while on allopurinol.
 
I reported gout many years ago and never had any issues with my medicals....at least the third class type. I tried taking allopurinol a couple times but all it did was cause flareups which lasted a long time. The docs suggested the issue was that it causes the body to dump uric acid and that after a bit things would stabilize and it would help instead of hinder. I couldn't handle 2 months of taking ibuprofen and haven't taken allopurinol since. The flareups have become less common since.
I drink lots of water to help keep things flushed and avoid shellfish as much as I can. Wife is from Maine and its not possible to visit there without eating a lobster or two.....or three. Usually brings on at least a mild flare. Beer makes life worse if a flare up is in progress but doesn't seem to induce them. It seems that as many folks that have gout have discovered there is no single answer for everyone. My dad had it and so do my brothers, my grandfather on my dads side,....his dad and so on. Yep, hereditary.

Frank
 
Actually, now under "conditions AMEs can issue" if you have no permanent joint deformity, we just issue the certificate. To Steingar, change comes at a glacial pace, but it does come.

I sure hope your doc covered the allopurinol with some indomethacin. Just starting allopurinol alone frequently STARTS an attack.....but then you stay on the allopurinol forever, and never have another attack.
 
I stopped drinking beer and distilled alcohol, haven't had an attack since.
 
I had gout for years, and only got off the Allopurinol less than a year ago. Lost a bunch of weight, started playing golf 3 times per week, and just started watching what I eat. I didn't have to give anything up, (I stopped drinking 20 yrs ago.) I just started being more careful about what I eat, when I eat it, and how often I eat eat. As long as I don't consume trigger food several days in a row, I'm good.

Got off BP meds too, but that's another story.
 
I sure hope your doc covered the allopurinol with some indomethacin. Just starting allopurinol alone frequently STARTS an attack.....but then you stay on the allopurinol forever, and never have another attack.


Nope, neither doc said anything which really ****ed me off. The second time I was prescribed allopurinol I spoke to the doc about the previous issues and he said I shouldn't take it when a flare up was occurring. When I said there was no flare up he said there must have been and I didn't know it.
I took indomethecin initially after being diagnosed with gout the first time and it worked ok. I found the Ibuprofen had less stomach troubles and seemed to work as well for the swelling and pain. I decided the occasional flare ups were less of a problem than the issues caused by the allopurinol. Maybe I'm just a blockhead but.....

I've noticed the online medical sites and some of the doctors and nurse practioners have been recommending ice packs for gout flare ups. Does that make sense? I tried that before I realized it was gout and it always made things worse by far. Doctors told me the cold can cause more crystallization of uric acid so cold packs are a really bad idea. Has something changed??

Frank
 
steingar said:
Gout is indeed hereditary, based on alleles that govern uric acid metabolism and some that govern function of the immune system. The fact that your father had it does not in and of itself mean you'll get it. I've been a vegetarian for 30 years, my attacks aren't really connected to anything except perhaps alcohol, which I'm not bloody well giving up.
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Addicted, or just an abuser? Oh, wait... wrong thread, wrong guy! (Heh!) :)
 
BiffJ said:
I sure hope your doc covered the allopurinol with some indomethacin. Just starting allopurinol alone frequently STARTS an attack.....but then you stay on the allopurinol forever, and never have another attack.


Nope, neither doc said anything which really ****ed me off. The second time I was prescribed allopurinol I spoke to the doc about the previous issues and he said I shouldn't take it when a flare up was occurring. When I said there was no flare up he said there must have been and I didn't know it.
I took indomethecin initially after being diagnosed with gout the first time and it worked ok. I found the Ibuprofen had less stomach troubles and seemed to work as well for the swelling and pain. I decided the occasional flare ups were less of a problem than the issues caused by the allopurinol. Maybe I'm just a blockhead but.....

I've noticed the online medical sites and some of the doctors and nurse practioners have been recommending ice packs for gout flare ups. Does that make sense? I tried that before I realized it was gout and it always made things worse by far. Doctors told me the cold can cause more crystallization of uric acid so cold packs are a really bad idea. Has something changed??

Frank
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Makes no sense at all. You wait a long time for alleve to work lengthening the "downtime" period.Indomethacin sustained is a bad deal- but you hardly ever need it for more than 48 hours.

The NPs and "addicted to insurance" PCPs- there is relentless pressure to reduce costs, costs of Rx etc and shift it into unmeasurables, like lost wages.
 
Thanks for the info.....glad to hear it too. I kept telling my brother not to do the cold packs but he's convinced the websites know more than those of us who already learned the truth. He's been whining about the pain too.....guess he needs more ice. I don't know whether to laugh and say I told you so or cry because I know the pain.

I've quit dealing with the insurance bunch at the local clinic.

Frank
 
BiffJ said:
Thanks for the info.....glad to hear it too. I kept telling my brother not to do the cold packs but he's convinced the websites know more than those of us who already learned the truth. He's been whining about the pain too.....guess he needs more ice. I don't know whether to laugh and say I told you so or cry because I know the pain.
Frank
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I think gout is one of the most painful things a man can endure. Biggest problem I had during an attack was sleeping. I do recall hobbling around on a January day in sandals.
 
It doesn't happen often for me but it happens, maybe once every couple years. I know eating crab will trigger it but sometimes it can come randomly. A few doses of colcochine takes care of it.
 
gout is a pretty obvious thing - once you read up on symptoms = it tends to go away after a few days [10 or s0] and changing your diet will keep it away usually.

The tried and true method of avoiding reporting diagnosis on your med form is to not get a formal dx.

It's not like a stroke or MI . . . treatment doesn't change the course at all. Sorry Doc.
 
Sac Arrow said:
It doesn't happen often for me but it happens, maybe once every couple years. I know eating crab will trigger it but sometimes it can come randomly. A few doses of colcochine takes care of it.
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You treat crabs with colcochine? I just use RID.
 
Sac Arrow said:
It doesn't happen often for me but it happens, maybe once every couple years. I know eating crab will trigger it but sometimes it can come randomly. A few doses of colcochine takes care of it.
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Colchicine doesn't do a damn thing for me, and I'd prefer the gout to its side-effects.
 
comanchepilot said:
The tried and true method of avoiding reporting diagnosis on your med form is to not get a formal dx.

It's not like a stroke or MI . . . treatment doesn't change the course at all. Sorry Doc.
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The web is not always the best place to get medical advice.
Further, gout can hide other problems, and lastly untreated gout can cause other issues longer term (arthritis is the most common issue I know of).

And going back to my first point, do not just read/follow what you see on the web. Talk to a couple of professionals.

Tim
 
steingar said:
Colchicine doesn't do a damn thing for me, and I'd prefer the gout to its side-effects.
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I'll agree they aren't pleasant, but me personally I'll take them to the gout. However, it actually works on me.
 
write-stuff said:
Treatment for gout is disqualifying or requires an SI? Sheesh...
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Not at all. I have a 1st Class with documented daily allopurinol. AME approved right away.

Mtns2Skies said:
My Dad has gout. Interestingly it's shellfish and asparagus that inflames him. He doesn't take medication just changes diet.

...Is gout hereditary? when would I see symptoms?
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Gout is frequently hereditary and the dietary triggers vary from person to person, and it often cannot be controlled by diet alone. I started seeing symptoms around the time I turned 33. My doctor said that 30 is usually the common time where it starts happening.

Allopurinol is amazing.
 
gkainz said:
so is allopurinol a lifetime maintenance anti-gout med or a take as needed if/when flairups happen? I know - ask my doc ... but since I have you here ... :D
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As a single, personal anecdote...

I was diagnosed with gout back in the 1980’s - also in my 30’s - and was put on Allopurinol. Subsequent blood tests showed it was working, and the doctor gradually reduced the dosage. Long story short, within a few years I was off the drug completely and still with normal uric acid levels, and it never recurred.

So it’s at least possible it’s a transient condition.

As an aside, I was then and am now a vegetarian, and ate none of the food “triggers” that normally cause or aggravate it.
 
FastEddieB said:
As a single, personal anecdote...

I was diagnosed with gout back in the 1980’s - also in my 30’s - and was put on Allopurinol. Subsequent blood tests showed it was working, and the doctor gradually reduced the dosage. Long story short, within a few years I was off the drug completely and still with normal uric acid levels, and it never recurred.

So it’s at least possible it’s a transient condition.

As an aside, I was then and am now a vegetarian, and ate none of the food “triggers” that normally cause or aggravate it.
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Gout started for me in my late forties. My triggers are beer and distilled liquor. FML. Excess sugar or shellfish can do it too. But stopping the beer stopped my attacks so I don't need Allopurinol. One beer can start getting twinges now, so I avoid it. Red wine is ok, but I really don't drink much. My Uric acid is always in the normal range, albeit closer to the high normal when I have an attack.

Being a vegetarian probably helps you a lot. I just have no desire to become one.
 
FastEddieB said:
Upthread, steingar mentioned he was also a vegetarian who got gout.

Only 2 data points, but diet is apparently only one factor.
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It's definitely hereditary for me. There are vegetarian triggers, legumes, nuts to mention a few, asparagus doesn't bother me . But on the whole, high fats, high carbs, shellfish and high purine alcohols trigger me. Vegetarian would take care of many of the triggers for me I think, but as I said, no desire, unless I start having issues again.
 
Like I said, susceptibility to gout is ruled by alleles for uric acid metabolism and immune function. My brother claims his went away, I'll bet cash money he's just between attacks. I haven't had an attack on the allopurinol, so I don't see any exigent reason to stop taking it. The AME at my last medical seemed pretty down with it too, so perhaps there's something to what Bruce was saying.
 
Does Allopurinol cause liver damage? I turned 30 three months ago. I was on vacation with my wife and ate shellfish almost every meal and had plenty of beer laying around on the beach. 4 am I woke up in the worse pain I’ve ever experienced. Since then I’ve been pounding cherry tart juice, apple cider vinegar, and chugging water. Almost been a week and still barely able to walk and now my calf is really messed up from limping. Airline pilot and go back to work in two days. Never went to the doctor because I don’t want to risk my medical and or be locked on a pill the rest of my life. I’m for now just watching what I eat and not drinking any miller lite.. thanks for the responses.
 
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