Tips for Managing Unpredictable Gout Flares

If I had a tips-and-tricks guide for gout when I first experienced it, I would have glued it to my hands. Gout can be a horrible experience, especially when you have chronic kidney disease (CKD) alongside it.

Managing pain without anti-inflammatories

Unfortunately, for those of us with CKD, anti-inflammatories may not be an option. This makes reducing swelling and pain much harder. If you have had gout before, you know swelling and pain make life miserable. It can affect your sleep, your work, and even your mood. Knowing how to manage it early is a lifesaver.

Spotting early warning signs

In my early years of gout, I wish I had known what to watch for. I was not yet diagnosed at the time. Early warning signs can include:

• Swelling around a joint
• Pain when touched
• Heat in the joint
• Stiffness
• Redness of the skin

In those years, I would often get a stiff, painful, swollen ankle. I assumed it was sprained or fractured. That meant a visit to the doctor to ask for a moon boot. It hurt a lot because any pressure on the swelling was painful. Looking back, I now realize these were classic signs of gout. Being aware of them earlier would have helped me manage flares before they got severe.

Lifestyle tips to avoid flares

Once I was diagnosed, I had to work around it carefully to avoid frequent flares:

• Stay hydrated: Kidney people already monitor fluids, but staying hydrated helps flush uric acid from the body.
• Adjust diet: Limiting foods high in purines, like certain seafood, helped reduce flare risk.
• Reduce alcohol: Flares were common after a night of drinking for me.
• Take drug as directed: A drug like allopurinol helped balance my uric acid.

With these changes, I have been flare free since 2021. This has made day-to-day life much easier and less stressful.

What to do when a flare hits

Knowing what to watch for is one thing. When a flare hits, it is a different story. As mentioned, anti-inflammatories are off the table for people with CKD. Acetaminophen does not help with swelling, which is a main cause of pain. My approach during a flare is:

• Rest the joint and elevate it as much as possible
• Apply ice packs regularly to reduce heat and swelling
• Use crutches if walking is necessary

Be warned, gout can get worse at night. Mine would often throb, making sleep difficult. It is frustrating, but giving the joint time to recover is the best approach. Do not overdo activity.

Finding relief and moving forward

Gout is unpredictable. Before my diagnosis, I had flares multiple times a year without realizing why. For anyone with CKD and gout, lifestyle changes can make a huge difference.

I started on a drug to manage uric acid levels. Over time, changes to diet and daily habits allowed me to stop the drug. Gout is difficult, but it is treatable. Spot the early signs and manage your lifestyle to stay as comfortable as possible.