Gout, aspirin, and DVT

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nickji

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Hi Everyone,

DVT's still a slight concern, 4 weeks after RTHR. An extra reason for concern was a complication in the op. theatre that after the spinal block, an essential instrument was found to be missing, so I was immobilised for 4 hours waiting for the instrument to arrive, then had another spinal and a further 3 hours immobilised for the op; so total of 7 hours immobile on the table, and NO mobilisation for the first 2 days afterwards. All of which is to say, I imagine I must have some DV clots.

So, on Josephine et al's advice, have been taking 150 mg aspirin daily. And now have developed quite amazingly painful gout (not the first attack ever, but the first for a long time). I read that aspirin at any dose can spark off an attack. The standard med for gout, colchicine, almost killed me three years ago...

My Question: stop the aspirin (end the gout) and risk PE because no blood thinner, or keep taking it and risk PE through immobilisation due to impossibility of walking because of gout, (plus of course considerable pain)? Hmmmm.

Of course, it's a nice excuse to lie in bed and let everyone take care of me :), But . . .

Enjoy it all,
Nick
 
Having gout is certainly going to be a problem during recovery. You can't do the PT you need when you have a swollen gout joint. How about Celebrex? That is what my husband uses these days when he has a gout attack. There are other meds for gout also.

I think you need to call your primary physician and explain the situation....I would think he could prescribe something to relieve the gout swelling that would still allow you to take the aspirin.

Has your surgeon told you to take the aspirin or are you just doing it "just in case." If it's the latter, you probably should contact your surgeon and see if it is really needed at this point.

In your post, you talk like you believe you have deep vein clots.....they aren't a given, even with lack of mobility for a while during and after surgery. It's something you have to be aware of and watch for, but at this point maybe you are worrying needlessly about them. This is why I think it would be wise to contact your doctors and talk about what's going on. One thing is for sure....the gout is REAL!!! And it needs to be dealt with.
 
Nick
I would certainly take Jamie's advice and call your doctor or doctors at this point.
I had back surgery in Jan. and was in bed with the exception of 2 very small walks for 11 days. I had complications and was on bed rest only in the hospital. I did not have any treatment for blood clots at the time. So as Jamie says it is not a given, just something to be aware of. I did have swollen, painful muscles and had an ultrasound, no clots.

After my hip replacement I had the 10 days of blood thinning injections, then nothing so at a month who knows what your doc might say.

I know your surgery was in India, did you say you are completely released from your doc's care? Any follow up visits?
judy
 
Ooops......thanks, Judy! I completely forgot about Nick's surgery being in India. Nick, is it even possible for you to contact your primary doctor or your surgeon for assistance? So sorry I didn't recall this when I wrote my post. It does complicate things a bit, doesn't it!
 
Hi Jamie, Judy,
Thanks for the advice. After I wrote I discovered Apple Cider Vinegar which has reduced the pain 30% in a day. Walking is still a problem, but I can do leg raises, abduction, etc. etc. in bed, and hobble around my flat. My surgeon absolutely dismisses any worries about DVT - 'just keep moving and watch a few movies' is his advice; he says DVT is only a real problem for long term bed-bound patients and there's nothing to worry about. So your advice rather supports that view Jamie.
In view of what he and both of you say, I'll lay off the aspirin for a few days, keep up the vinegar (and an Ayurvedic remedy for gout), and move as much as I can. Should be better within a week. Incidentally, the allopathic 'cures' for gout are seriously dangerous and don't appear to usually work. Best is to lay off the red wine - but . . . . :) (actually, Rishikesh is a alcohol and meat free town, so no temptations)
Nick
 
Hi Jamie,
Just re-reading your post and see your husband has gout. Has he tried apple cider vinegar - two days ago my joint was unbelievably painful even when I wasn't moving, then yesterday I took acv three times, and today no pain at-all when I'm lying still or rotating feet, doing leg lifts etc., and not too bad when I walk (slowly!). Certainly seems worth a try - I just found out about it, and it seems a lot of gout sufferers take a spoon a day as prophylaxis. Celebrex is good, but the latest FDA warning last December is a bit of a concern.
Enjoy it all,
Nick
 
Thanks for the tip about vinegar, Nick. I asked my husband and he said he knew about the vinegar remedy but never took any. But he hasn't had a gout attack in years fortunately. He's a real fan of the Celebrex though when it does flare....it only takes a couple of pills and he likes how fast it works. Guess he's willing to take what risk there might be.

I'm thrilled the apple cider vinegar worked for you!!! Great!! Maybe if you're still worried about the clots, you could take the aspirin for a couple of days before your long flight and the day of the trip. It doesn't need to build up in your system or anything to work as a blood thinner. It would only be that trip you were planning that would be of concern to me. Please be sure you get up and walk around a little every hour or so on the plane. That is actually good advice for anyone on a long flight....not just those who have had surgery.
 
Well I thought I'd chime in. I'm a long term gout sufferer (20+ yrs). I take allopurinol (300mg/day) with no side effects and it keeps the gout attacks to a minimum. Aspirin at the recommended 80 mg/day for cardio health is not an issue, but prior to surgery and while on blood thinners they had me stop the aspirin. Otherwise for pain/inflammation I take 800 mg prescription (no buffers) Ibuprofen. My Docs are leery of prescribing Celebrex beyond surgery recovery due to the FDA warnings re affects on the heart.

As to diet, red wine and shellfish (especially shrimp) are to be avoided and I limit red meat to about twice a month.
 
Didn't I say 75mgs of aspirin daily, Nick? But never mind - you should stop it now. And like Jamie said, DVT is a possibility NOT an inevitability. I also think you are worrying unnecessarily.
 
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