DEAR DR. DONOHUE: Do you have information on gout? I am 65, and my sonin law is 32. We both have it. It is so painful. My doctor was pretty vague. He asked me to go on the computer to find which foods I should or should not eat. I found that you can’t eat meat and fish, but salmon and chicken are all right. Some vegetables can’t be eaten. How about tomatoes and tomato products? Does one attack mean gout is forever? What is the medicine of choice? — C.B.
ANSWER: Gout comes about when the blood uricacid level rises. Uric acid seeps into joints to form needle-shaped crystals that cause joint swelling and unspeakable pain. Uric acid, in turn, is a byproduct of cell chemistry. Its blood level rises because a person makes too much or passes too little into the urine.
A first gout attack most often occurs in the joint at the base of the big toe. The skin over the joint turns red, and the joint swells and becomes exceedingly painful. One of the best ways of diagnosing gout is to draw fluid from the affected joint and examine it with a microscope to see the needle-shaped uricacid crystals. Gout can affect other joints: the knee, wrist, ankle and fingers. One attack of gout doesn’t call for lifelong treatment.
Indocin (indomethacin) is the drug most often used for an acute gout attack. Colchicine and cortisone also work well.
Medicines for gout prevention are taken if a person has frequent attacks (two or three a year), has formed uric- acid kidney stones, has kidney damage secondary to gout or passes large amounts of uric acid into the urine. Zyloprim (allopurinol) reduces uric acid production. Probenecid increases its elimination into the urine. Uloric, a new gout drug, is for those not responding to these two.
Diet was the sole means for gout treatment in the old days. Now, with effective medicines, it takes a back seat. You ought to eliminate organ meats — liver, kidney, sweetbreads and brain. Decrease but don’t eliminate red meat and shellfish. Beer should be avoided. Wine can be taken in small amounts. Soft drinks containing high-fructose corn syrup (and most do) shouldn’t be drunk. You can eat all vegetables and any vegetable you want. That’s the gout diet. Not complicated.
The booklet on gout explains this common disorder in detail. To order a copy, write: Dr. Donohue — No. 302, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Is distilled water bad for drinking? Can you chew too much gum? My husband chews about four pieces every day. — P.M.
ANSWER: Distilling water involves boiling water and condensing the water vapor by cooling it. Components dissolved in the water are left behind. You can drink distilled water. You will miss out on the minerals contained in most water and on fluoride added to city water, but you can get these elements in other ways. If you chew too much sugar-containing gum, you promote cavities. Too much sugarless gum can cause diarrhea. Four sticks are not too much.
Readers may write Dr. Donohue at P.O. Box 536475, Orlando, FL 32853-6475. ©2011 North America Synd.