Does a gout attack set years of UA lowering treatment back to square one?

[cjeezy]

Hi All,

After reading this board I've become confused in one area and could use some clarification.  I've read that if someone is on a UA lowering drug and they have an attack down the road that they are basically back to square one (before they started using the drug) IF the attack was due to new crystals forming.  Is this correct as this doesn't make sense to me. 

[zip2play]

I don't think so.

I think it's more like ultimate damage is the cumulative effect of attack after attack after attack, each depositing more crystals and each causing the immune system to do yet mor damage to a joint or joints.

So someone with ONE attack will likely be wary but someone with 100 attacks will be permanently crippled and in continuous pain.

[cjeezy]

Thanks Zip,

That's what I was thinking

[Keith Taylor (GoutPal Admin)]

Yes, the “back to square one” idea (if it came from something I wrote) alludes to the game of correctly lowering uric acid.

In this game, you get points for every day that your uric acid is below 6mg/dL, and lose points every day that your uric acid is above – one point per mg.

Each game starts at square one (start of urate lowering therapy day). Each square represents one day, and you win points as above. Before you start, you set your Target Uric Acid Number.

Round 1 involves lowering your uric acid level to Target Uric Acid Number (somebody think of a better phrase that gives a good acronym please)

pause

OK Planned Uric Acid Level.

Once you maintain PAUL for 2 consecutive tests, you progress to round 2

Round 2 involves maintaining PAUL for 6 months without a gout flare. Everytime you get a gout flare you start counting 6 months again. You must take a uric acid test at least every 3 months and if you rise above PAUL by more than 1 mg, you start your 6 months again. (different regions have slightly different rules).

Round 3 continues forever, but if you ever have a gout flare you go back to square one.

You do not lose your points – you still have the benefit of all those urate free days – but you start the game again.

[yes, I know there's a deliberate mistake]

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