Gout attacks increasing due to decrease in Kidney function.

 

Question  My father has had minor issues with Gout for many years no , and the attacks are becoming more frequent and intense. HE was taken out of work for short term disability in April because he could not hardly walk, and has developed problems with his shoulder, elbow and arm all on his left side. The swelling in his feet ankles, and knees is atrocious. They turn purple and extremly swollen. He is getting one attach after another within days of each other now. He is very very sick. He was in very good health up to this point. He has to use crutches some days, and other days cannot even walk. They took him out of work for a longer period of time because he can now barely use his arms, and are saying it is from the use of the crutches. THey had planned to do surgery on his arm this week but had to postpone. He had to go to the ER this AM for severe pain and was UNABLE to move. They ran a few tests and are saying it is probably rheumatoid arthritis. He has shown elevated uric acid levels on SEVERAL occasions. They are also saying his liver function is low, and his white blood cell count is up. Can rheumatoid arthritis be this debilitating and come on so suddenly? Could this be something else going undiagnosed? Could this be a more serious illness brought on by years of damage due to gout or the gout meds? His regular doc is saying there is noithing else he can do, and the orthopedic specialist is saying to go back to the regular doc because there is nothing else he can do. He has been reffered to a doctor specializing in rehematiod arthritis. Shouldn;t he see an endocrinologist? THe doctors keep upping his doses on allupurinol, indocin, naproxin, vicodin, and percocet, to name a few, and nothing is helping. He keeps voicing his concerns over taking such high doses to no avail. Is this not cause for concern? The doctor said he could not get a medical retirement or long term disability because gout is considered a controllable ailment. BUT THEY ARE NOT CONTROLLING IT!!! THe battery company he works for is infamous for "letting people go" in this situations. He is 62 years old and is going to lose everything if this happens. What are his options? Any advice would be helpful. He has been such a hard dedicated worker all of his life, and never lets anything get him beat. , but it honestly looks as if he is dying.
 
Answer  As we age, kidney function may decline and the risk for gout increases.  People who previously had infrequent intermittent attacks may begin to experience more frequent, more debilitating attacks.  Many effective treatments for gout exist, and only your father's care providers can decide on just the right ones.  Interestingly, gout appears to protect people from developing rheumatoid arthritis, and they are rarely to never seen together

Last update: 09:38 AM Wednesday, October 17, 2007

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Jon Giles, M.D.

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