Hello everyone. I am 1 year of post tx. 5 days back i developed pain on back of my one ankle, severe at morning. It's probably gout. As i am a tx patient i don't want to take pain killer but i m helpless. Whic pain killer is safe ? Need sugession if someone go through this problem? Thanks---

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  • Hi, Mary M.
    I am taking approximately 4 litres of water in 24 hours but my nephrologist said not to take too much as u've one active kidney. It may cause my kidney enlarge then normal. yes I know the friendship between gout and dehydration, it's like me and my new kidney hahaha Anytime can breach the bond haha. Hope it'll not. By d way, love to know that u all r fine. Write u later----
  • Hi, shahariar.  We are doing very well here, thank you for asking.  Forgot to mention, in case you don't already know, dehydration is gout's best friend.  Make sure to drink a lot of water each day, which will also help maintain a healthy creatinine level.  Lastly, alcohol in any form is something else that can bring on a gout flare.  There's much controversy within the medical community in this country as to which foods, if any, affect gout/uric acid levels.  What's not in question is alcohol.  Be well, shahariar.     

  • Hello Mary M ,
    How r u doing ? Yes better late then never. Your suggestions definitely will help me. My acute attack subsided, hope not come again. I've completed two years of my post transplantation. Thanks to Allah. Hope ur hubby will be fine. Now a days I am getting good response with my diet control. Trying to take uric acid and protein less diet. Already taking a lot of medicine, don't wanna take more. Keep on touch and take care of u and ur husband.
  • Coming in late in the game but better late than never.  Husband, now 4 years post kidney tx, suffered almost 20 years with gout.  Traditional treatments ineffective, so for pain ate ibuprofen like candy, often to no avail.  Had no idea at that time he had smoldering kidney disease.  (Later earned NSAIDS not friendly to kidneys.)  Finally found a phenomenal rheumatologist at Univ. of Chicago, Dr. Michael Becker, who was principal investigator in USA working with Takeda Pharmaceuticals in Japan on new drug for gout, Uloric. Two other drugs in FDA pipeline at same time. Began Uloric, effective most times. When experiencing severe flare, high-dose prednisone utilized and closely monitored by rheumy. MUST wean off VERY SLOWLY, we now know, or you invite another flare.  Not to be done without close supervision.

    Shortly after tx, rheumy indicated new clinical trial using IV drug "pegloticase" showing very good results.  As hubby was doing well now on the Uloric (and very infrequent prednisone necessary) he passed on invitation to participate in trial.  

    As an aside, having had gout for almost two decades, he's had it in virtually every joint in the human body.  Months after tx, has worst sore throat ever.  Our Internal Med. doc admits to local hosp.  Over next 4 days, calls in every specialist one can imagine.  No dx, not even an educated guess, but husband says feeling better (liar) so discharged.  Within 48 hrs., low grade fever.  This time, contacted local transplant team at U of C (we live in Chicago area, tx at Vanderbilt in Nashville, upon returning home established relationship with transplant clinic at Univ. of Chicago, in case of emergency.)  Admitted for 5 days to U of C.  Every specialist consulted (except rheumy) and every conceivable test done.  Only symptom was worst throat pain of his life; couldn't swallow own saliva.  Day 2, I email rheumy; not happy with lack of progress.  He, furious he was not notified of his patient's admission, looks up labs.  Advises kidney looks good, all labs look good, give a little more time.  Day 5, Sunday, still no ideas, still no dx.  Husband so disgusted he's going to leave AMA.  In walks genius, Dr. Becker, who, though never notified or consulted, followed labs online and did own research.  His suggested dx was most bizarre: laryngeal gout (can't remember medical term; do Google search.)  The gout had actually attacked a joint I never knew existed. Treated with high-dose prednisone until clinic visit with Dr. Becker the following Tuesday. Now is able to leap tall buildings in a single bound, and subsequently, very, very slowly weaned off pred.  Took approx. 8 more weeks before he was completely asymptomatic.  

    Moral of the story:  Gout is no joke and nothing to play with, especially post tx.  Find a great rheumatologist who's not afraid to touch you because you've been transplanted (most drs. are terrified to treat tx pts.)  Sorry for droning on.  Hope I've helped.          


  • Thanks Mimi duncan. Yes i know prednisolone is a good option but as far as i think after 2.5 months of post tx he was on high dose of prednisolone. Would you please tell me the dose he took before and after his 40 mg of prednisolone?
    • that was all he took  for it.  3 days of prednisone, 40 mg., and that cleared it up.    hope you are doing better.

  • My husband is 2.5 months post kidney tx.   he had a severe issue with gout 2 weeks ago.  they put him on 40 mg day of prednisone for 3 days.  it cleared it right up.  he could not even walk bc it was so painful in his knee.   he did take a couple of days of reg. Tylenol, with not much relief.    hope you are doing better.

  • Thank you all for your valuable advice. Nephrologist suggest not to take NSAIDS if helpless then acetaminophen and in severe cased tramadol hydocloride is bit safe then other nsaids. Still i don't take any medicine but i'll take acetaminophen first. Thanks again-----
  • Also- i know nsaids are not usually recommended for TX patients, I have been told to take acetaminophen if anything. If your doctors has okayed it that may not apply but if not make sure you check to see if you can take them.

  • I was hit head on by a tractor trailer in 2011 and as a result had a tib/fib fracture that required two plates and four screws and since then have been in pain mgmt. My pcp prescribes me Oxycodone and Oxycontin which she feels are the cleanest and less risky with my medical history. My transplant doctor foes not object and I try something simple and natural first and if that doesn't work next step is Tylenol. I have the meds if I need them but I don't take them unless my pain is 7/10.aybe you should talk to the person treating you and see if there is a way to treat your pain on a sliding scale or ask to see a pain mgmt specialist to see what else can be done. I tried nerve blocks and other options and maybe there is something to help you that you don't know about that will work for you without taking more medications. Also I am a big acupuncture enthusiast. Hope you get some relief soon!

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