Need help with treatment plan

[Newstart]

I am aged mid 50s and have had gout once or twice a year for the last 6-7 years.
I do get other joint pain which has greatly affect my walking so it is time to eliminate any cause of inflammation that I can

Currently my kidney labs are not looking to good with Creatinine at 160 umol/L and eGFR 39 mL.

Ultrasound of kidneys shows no stones and good blood flow.

My Uric Acid is 0.69 mmil/L which I think converts to 11.6mg/dL

As I do not have very high blood pressure and am not diabetic I have arranged with my doctor to start Allopurinol at 300 once a day to reduce the load on my kidneys.

This is currently causing a gout attack but I am not concerned as I was expecting that it would.

What I would really like to know is how I plan the treatment to get the best long term out come so as to get my Uric Acid down to under the 5mg/dL level and keep it there… my own Swiftest Rocket.

Any guidance would be appreciated.

[KeithTaylor]

Welcome @newstart. A nice, interesting start to my day.

You have made a great start to your gout treatment plan by getting on allopurinol. To make this better, you need to keep thinking forward.

First, have you discussed a target uric acid level with your doctor? I notice you are aiming below 5 mg/dL. This is good, but for best effect, you need your doctor to agree. The best gout treatment plans are when doctor and patient are working towards the same goals. This is something that you can clarify at your next visit, which brings me to..

Do you have a forward plan for blood tests? Allopurinol must be monitored. It is best to start with tests every 4 weeks. Once results are stable, you can gradually extend the frequency, but never less than one test per year. Uric acid tests should always be accompanied by kidney function and liver function tests.

Finally, I find it useful to keep a track of gout attacks. I wish I had done this here in the forums so I had a permanent record. I have now gone over a year without an attack, so I’m satisfied I have gout under control. To gout patients who have not yet reached this happy state, I recommend keeping a diary of gout attacks, with dates and joints affected. This lets you check to see when you have gone six months without a gout attack – a milestone when you can celebrate getting gout under control.

When I finally launch my gout treatment planning service, I will include the facility to keep progress records. For now, it is easy to just keep a record here. This does two important things:

1. You can see your progress, and refer back to it. This helps if progress gets tough, and also helps you plan what to do next.
2. It lets other gout sufferers see that there is a way forward. They can use the best of what you have done, and are encouraged to seek their own Swiftest Rocket.

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