The health and fitness thread about random things

[T42]

Funnily enough (or not), Bike Forums sent me an email earlier on entitled " How To Entirely Empty Your Bowels Every Morning".

Wot, right back to the duodenum?  Wow.

[T42]

Cycling chum has a branch block and wears a 24/7 subcutaneous monitor.  Yesterday his cardiologist told him that the last couple of times he's fallen asleep his heart has stopped for a few seconds.  "We'll need to keep an eye on that - might need a pacemaker".

Leaves him - and me - wondering how likely it is to stay stopped.  He's a wee bit apprehensive now, to say the least.

[T42]

Own stress ECG yesterday, "much the same as last time".  What wasn't was that the nurse didn't let the pressure in the suction-cup electrodes equalize completely ("well the gauge said zero"/"it was measuring your brain-power") before wrenching them off my chest so I now have a couple of raw rings of peeled blisters there, as if I'd been struggling with something Capt. Nemo would have fled.

Once home, suffered all evening & all night, every time shirt or sheets came in contact. Brainwave this morning: taped a couple of perforated plastic eye protectors over the wounds, near-perfect peace ever since.

[Basil]

Having been 'pinged' earlier, my period of self-isolation ends at 23.59 tonight.  Looking forward to the pub on Friday night.
Thought it probably the pub where I made contact but no other regulars pinged according to the landlord (I thought it best to WhatsApp him to tell him), but it seems that the owner of the convenience store is also self-isolating, so it was probably there.

[mrcharly-YHT]

Age and damage-related arthritis. Osteoarthritis I guess.

I've had sore joints before and put it down to 'start of age-related arthritis'. That has waxed and waned a bit.

This time, no doubt. Little finger joint starting to swell, painful all the time. Although it is my strong (and not-so-damaged) hand, I'm finding excuses not to use it.

It is surprising how discouraging mild, but chronically persistent, can be. Dammit, I still have a lot I want to do!

[T42]

Dentist yesterday: three molars to come out* then I'll have the grub going over the side for 3-4 months while the craters heal, whereafter I'll finally join the crowned heads of Europe.

* that'll be a wrench, ho ho ho wot!?^®

[De Sisti]

Still have gout in my right ankle (since 3rd October 2020). Naproxen makes my heart rate
go off the scale the moment I do anything vaguely exercise related. GP says I may have to
live with the pain (and swelling).

[chrisbainbridge]

Gout does not last a year. Gout is an Acute severe pain secondary to a rise in urate levels with Crystal deposition in the joint.
Pain lasting a year may be gout related damage but is not gout.

If your urate is so persistently elevated as to cause 12 months gout then you are very very sick!

Ask for an x-Ray and referral to a foot and ankle specialist.

[De Sisti]

Gout does not last a year. Gout is an Acute severe pain secondary to a rise in urate levels with Crystal deposition in the joint.
Pain lasting a year may be gout related damage but is not gout.

If your urate is so persistently elevated as to cause 12 months gout then you are very very sick!

Ask for an x-Ray and referral to a foot and ankle specialist.

I will believe what my GP has told me, instead of advice from a cycling forum (unless you are suitably
qualified and are prepared to assess me in person).

[Jaded]

chris speaks a lot of sense there.

Also Naproxen should only be used sparingly, it's for acute attacks, not chronic pain.

[chrisbainbridge]

Hi, I am a consultant hand surgeon with over 30 years experience of treating people with gout and gout related conditions.

[hellymedic]

Well, some of us knew that…
…thanks for input!

[chrisbainbridge]

De Sisti is right. You should not take advice from people on the internet. I could also have phrased my reply a bit better. I am currently dealing with a number of similar cases affecting the wrist and hand, hence my rather brusque responses.

[hellymedic]

We all get overstretched on occasions!

[mrcharly-YHT]

Gout does not last a year. Gout is an Acute severe pain secondary to a rise in urate levels with Crystal deposition in the joint.
Pain lasting a year may be gout related damage but is not gout.

If your urate is so persistently elevated as to cause 12 months gout then you are very very sick!

Ask for an x-Ray and referral to a foot and ankle specialist.

Curious question; what happens to the crystals in the joint? Do they normally dissolve after a short period, or can they persist?

[chrisbainbridge]

Curious question; what happens to the crystals in the joint? Do they normally dissolve after a short period, or can they persist?

The crystals dissolve again.  The synovial fluid (joint fluid) for some reason seems to either accumulate the urate or for some  other reason it becomes saturated and the crystals occur.  once the urate level in the blood reduces then the crystals dissolve and disappear.  Takes a few days to about a couple of weeks for the severe pain to go.

[mrcharly-YHT]

Curious question; what happens to the crystals in the joint? Do they normally dissolve after a short period, or can they persist?

The crystals dissolve again.  The synovial fluid (joint fluid) for some reason seems to either accumulate the urate or for some  other reason it becomes saturated and the crystals occur.  once the urate level in the blood reduces then the crystals dissolve and disappear.  Takes a few days to about a couple of weeks for the severe pain to go.

Thanks.
That sounds like immediate treatment would focus on getting urate levels down. Then looking at what made them elevated in the first place (reminds me; must take my citrate pill; prophylactic for kidney stones.)
 

[chrisbainbridge]

First thing is to control the pain!!!

The urate by the time they get to hospital is usually already on the way down and may even be back in the normal range which can cause problems with diagnosis.

Colchicine will help to reduce the inflammation of gout specifically. Then allopurinol will help keep the urate level low (but can precipitate an acute attack initially and therefore is usually covered with colchicine first off).

Lifestyle choices are then important in the context of reducing the risk such as less red wine!

[De Sisti]

I drink very little alcohol, but like a cake and biscuit. GP wouldn't give me allopurinol, but
prescribed Naproxen (which made me fart a lot ). I have a phone appointment next Monday
(earliest I could get).


* I was given another drug to stop the tummy inflammation, but I can't remember what it was.

[chrisbainbridge]

* I was given another drug to stop the tummy inflammation, but I can't remember what it was.

probably omeprazole or similar

[hellymedic]

I don't think cake & biscuits are particularly bad for gout. Excess body weight might be bad for joints in general, admittedly.

Uric acid is produced when purines in cell nuclei break down so a lot of meat, or chemotherapy for cancer, can precipitate gout. Some folk just produce more uric acid than others and allopurinol helps reduce blood levels.

[De Sisti]

 * I was given another drug to stop the tummy inflammation, but I can't remember what it was.
 

probably omeprazole or similar
 

Yes, that’s the one

 Some folk just produce more uric acid than others
 

Yes, probably me.
It'll be interesting to see what the GP says on Monday if I insist on a particular course of treatment*. The xray that I had late last year didn't prove anything (according to the GP and the specialist who analysed it).
 
Colchicine, Allopurinol or Corticosteroids

[T42]

Lifestyle choices are then important in the context of reducing the risk such as less red wine!

Oh hell yes.  My diabetes was originally diagnosed when I went to the GP with forearm pain near an elbow*.  A comprehensive blood analysis showed glycated haemoglobin through the roof, cholesterol near Alpha Centauri and triglycerides dancing a jig.  The elbow pain was gout: the way I'd been holding a heavy book to read it had opened up a nice synovial backwater for the crystals to moor in; when I put the book down this closed up and ouch.

Once treatment started the pain went away and the figures returned to low Earth orbit, but it still took me a while to drop the Château Lirac and Châteauneuf-du-Pape.  Been off the stuff for >25 years now.

* stop sniggering at the back, it wasn't from that.

[T42]

Just had the results of my (long, boring) stress/rest scintigraphy exam last week: no myocardial ischaemia during effort at 97% theoretical max, ejection fraction 68% under stress, 70% after 2 hours at rest.  Stress test electrically and clinically negative. ECG/BP profile boringly normal.

One is crowing.  OTOH I wish they hadn't picked the last decent cycling day of September to do it.


ETA: Interesting titbit: when I was all done with the scintigraphy they handed me what looked like a credit card receipt which bore the cost of the exam: 472.72€.  One US insurance purveyor gives the average US charge for the same thing as $4113, boasting that with their insurance it would "only" cost $1874.  Since I'm a permanently diseased old bugger it cost me exactly nowt.

[Wowbagger]

My dear wife and I have just had our flu jabs.