Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Gout

OK.... I spent 6 hours in the emergency department last night. I've been going through a rather spectacular flare up for the last week and a half. Both sacroilliacs are inflamed, my left hip, my chest is so sore I've become a master at shallow breathing. My hands and jaw are hot and sore... and for the last four days, my left foot has been red and swollen.

The foot pain is across the top of the foot, and along the outside edge.

When I finally got to see the Doc, he told me immediately that he has never heard of anyone getting AS in the foot. He ordered an xray, and you could see "cloudy" parts around the foot, but he thinks for sure the foot isn't broken.

He has come to the conclusion that I have gout in my left foot. I checked on the net last night, and I'm rather a lot confused. Firstly, my big toe isn't affected at all, and according to all the articles I read, it usually starts in the big toe. The article also said to cut back to two beers a day. This I would be happy to do except I don't drink (well rarely). It also says to cut back on red meat/offal. We rarely eat red meat, preferring fish and chicken. So... begs the question, if it is gout, how the heck did I get it?????

Does anyone here have AS in the foot? Has anyone else been diagnosed with gout? I'm going to see my Doctor asap, and would really like to know if AS can rear it's ugly head in the feet.

Thanks everyone.....

Maxine

May the roof above us never fall in, and the many friends gathered below it never fall out.

Just wanted to ask if you had a blood test to confirm it is gout? My dad has it in his feet (not in the big toes either), and they test for high amounts of uric acid (urate). I suppose if you yourself have high levels, its gout, and if you dont, maybe it is AS. AS can occur anywhere in the body, including feet (to my knowledge anyway!)

Either way, gout is another 'rheumatic' illness, so I suppose these things can occur together...?

Hey Maxine. Man, what is going on around here??! My ankles and shins have been bothering me, your feet. It's a conspiracy I tell ya, a conspiracy.

Actually, talk to Cheryl about AS in the foot. She's actually fused in the foot and can't wear 'proper' shoes with any comfort.

I do hope you're feeling better soon.

Many hugs,

Kat

Hi have a mate who has AS, not as bad as me, but he also gets iritis a lot, which I dont, and he has gout in one of his feet almost permanently, his consultant has said that it is one of the spin off's from AS.

Hi,

outside of the foot just below the ankle bone where the long toe bones come back to join the ankle, I get it there hotspot on the bone scan!

David

So he never heard of getting AS in the foot? Send him back to medical school and ask him to pay special attention to that portion of his education (probably about 3 hours) that dealt with an orphan illness like AS, one that's rather rare, isn't usually fatal, and therefore not all that important. And the next time someone says something asinine like that, it's your time to educate! AS, especially in women, often involves peripheral joints and yes, even in the feet! As a matter of fact I first got DXed (with RA) because of my left foot/ankle showing obvious damage, swollen and hot to the touch. As mentioned in another post, my left foot is actually fused, all the itty bitty bones somehow "melted" together I cannot wear shoes that cross the portion of the foot you described because it presses on my foot and causes pain, due to the mechanical damage, not active inflammation, since I'm in a sort of remission now due to finding the right meds. I have had shots in the past in my ankle and in the front of my foot (cortisone) which has helped a lot to reduce the inflammation.

Gout? Well, maybe they dwelled on that more in med school since it's so common, so it was what popped into his mind. I think I'd get a second opinion - - from a rheumy! The treatment for gout is much different than the treatment for AS, and you don't want your feet ending up like mine!

Cheryl


My guy

If you can't be a good example you'll just have to serve as a horrible warning.
Jennifer Cruisie

Dogs mean it when they kiss you

Hi Maxine,

I have it pretty bad in my feet right now. Ankles, feet, outside edges of feet. You get the idea. Started in the big toe so the GP assumed Gout even though I informed of my AS. I learned all I could. The blood test is the least accurate. So if negative move to the next test. There is a 24 hour urine test which is more accurate. I insisted on the test. It measures Uric Acid which I believe is what causes gout. If they say it is gout they will most likely want to put you on Allopurinal which is not needed if negative. With too much Uric Acid that your body can't handle you develope sharp crystals in the joints. If it is gout then you will need to follow a Low Purine diet.

Thanks my experience.

Chris

Oh jeez... thanks everyone! I thought I was going a little mental there for a while. The 'Doc' did actually take some blood to check the levels of (uric? acid), but I was a bit gobsmacked when he said about AS not going into the foot.

The way I look at it... where there's bone, there's always the damn possibility right?

To tell the truth, I wasn't that impressed with the care that evening at all. I had waited 6 hours in the waiting room to see that moron, and when they finally called my name, I had great difficulty getting out of the damn chair. In fact, it was so bad that once I got to my feet I almost passed out from the pain. The nurse had to come over and hold onto me to get me into the emergency department. I had been good and had shuffled around as often as I could, but as we know, it's hard to rely on a cane when your hands are so bad too.

Anyhow, just one last question. This swelling in my foot gets much worse at night. The top of my foot (where a sandal strap would be if I could put some damn shoes on! ) and all my toes get very hot and tingle. The tingle is just like when your foot goes to 'sleep' and then the feeling starts coming back. I'm thinking that the tingling is due to the reduced blood circulation, but any ideas on why the swelling is much worse at night? I would have thought that the swelling would be constant?

You know Cheryl - I'm real tempted to print out your post and mail it to that damn Doc. Not only was he very flippant he was pretty stupid too. I had just finished telling him that I can only take 10mg of Bextra every other day as it causes severe stomach upset, when what do you think he says? "DOUBLING the dose of Bextra for the next few days." Duh!!! I guess the look on my face said it all.... as he started to stammer and said " oh er.... guess not eh?"

I just wish that you didn't have to explain yourself and AS to just about every GP you come across. How many Doctors are there in Ontario? Maybe I could have some flyers printed and do a mailing!

(rambling....... rambling........grumble........grumble....)

May the roof above us never fall in, and the many friends gathered below it never fall out.

It must be a conspiracy!

People will be thinking we were hanging out drinking all that beer together!!!

Seriously though... how are things going? Are things getting any better?

Max

May the roof above us never fall in, and the many friends gathered below it never fall out.

Actually, Max, today I feel virtually human again. Still pain in all the same places, but I don't have to walk as tenderly as I have been. No pains shooting up my shins with every step. But my ankles feel as thick as a tree trunk!!

The whole coping thing is still an issue, but now that I'm not an alien anymore, it's not bothering me quite so much. And I'm angry as hell, but again, I'm not feeling horrible today, so I can keep it under control.

All in all, today is a relatively good day.

Many hugs,

Kat