No Bubble shoe, just meds (not bread) and water

So here's an update of what's going on since my last post, "I need a Bubble shoe"

I finally got off my crutches, thanks to taking some OTC (over the counter) pain killers and grimicing each time I walk and landing on my heal first.  Decided since I'm not running, I would wear my Nike Vomero 8 (high cushion) to minimize the impact.  Yah, probably not the best form of pushing one self. (I call it being stubborn)

I went to my physiotherapist who later had pulled in her supervisor to take a look at my ankle.  After some discussion and consult.  She deemed that the issue I had is not related to my Crossfit (thank god), and not likely caused by the over stretching with yoga (yeah?!?).   All the symptoms I had described points to...  GOUT

What?
GOUT:  (also known as podagra when it involves the big toe)^[1] is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. 

http://en.wikipedia.org/wiki/Gout for a more detail explanation and pictures; we all like pictures.. ;) 

In additional to this, she suggested that I consult with my family doctor.   Oh, I love running around with a sore hoof.
Meanwhile, since I'm at the physiothearpy.  They treated me with a nice Contrast Water bath (where one insert injured/swelled-up body part into a bucket of Ice Cold water, and then after a minute there; you take it out and insert into the other bucket of warm water for another minute)  Repeat this process.  Think EMOTM if you are still in Crossfit mode..  ;)  The intention of this is to reduce inflammation.  Better yet, check out.... http://en.wikipedia.org/wiki/Contrast_bath_therapy
Other treatments that I received was the use of Ultrasound to break down scar tissue and as well as running an IFC (Interferential Current).  A form of electro-therapy.  It really doesn't hurt, you control the intensity.    You can read more about it here..   http://dcchiro.com/ifc-therapy/
 
Well, what did the doctor say?
Went and saw my doctor; had a nice discussion with him about the past week events.  After much discussion, he gave me one of those nice lab request to draw out some blood.  Basically it's to check the level of uric acid in my system.  I've done this test once before, eight plus years ago when a similar incident occur.   Thinking back a few months ago where I had some fever like symptoms, followed by some inflammation around the ankle, it might had been Gout as well.   It's really hard to say as it may had been masked by the injuries (Achilles Tendonitis).   Until the blood results comes back; I really can't confirm it's GOUT.  So, we will play the safe side and go with the assumption it is.


What others should not ASSUME and say..  
When an individual who is not knowledgeable about a particular topic, say GOUT.   They should do some research about the topic before voicing their opinions and making them sound like a fool. (I would use other words other than fool, hint; replace the 'f' with a 't').

One usually see the word GOUT and automatically thinks it's a diet thing.  As most of you already know, I have switch over to a Paleo lifestyle/diet/habit... call it whatever you will for the last FOUR months.  And with that said, the finger pointing starts.  I've already received my fair share of comments on how Paleo diet is the main reason why you are having Gout, therefore, Paleo is not good.    *GROAN*   That's the typical response from someone who has no idea of what they are talking about and has no sense of things.  Might as well tell them the planet is flat as well, and they will believe that too!  *Geez*


What causes it and what changes should one do?
Discussion with my doctor shed some interesting points.  Other causes which may provoke a flare-up of Gout are not limited to foods that produces high uric acid.

 - injuries
 - hydration

Most people already associate Gout with food that produces high uric acid.  One of those food is red-meat.  Which most of the uneducated people who don't understand that Paleo is not all about meat.  It's all about a balanced diet with an exclusion of Dairy, Grains, and  Legumes.    Yes, this will most likely start off another branch/discussion about Paleo.  It usually does as not everyone agrees with this lifestyle.  There will always be critics.  I'm sure there are critics about how much air we are consuming too, and we shouldn't breath so quickly as it will deplete our earths reserves of oxygen.  Sarcasm aside.

Injuries; as explained by my doctor that injuries as small as stubbing your toe can aggravate your body and starting a chain reaction.   An example of this is when the a liquid (uric acid) starts to builds up, and for whatever reason your body is not flushing it out.   As the concentration increases, eventually it goes through a process similar to crystallization where the liquid turns into a solid crystal.   Usually this liquids builds up in your joints.  For us men, it's usually the big toe, or ankles.  Lucky us, not!  When the in solid form, this is the sharp pain we received in our joints as well as burning sensations (which then results in inflammation).  You can actually see this on your skin (all red).

Other injuries which may also cause some stress to the system, such as my recent case with my Achilles Tendonitis.   I was told by my physiotherapist (mention a few times in my blog) that I have loose joints around my ankle.  That's why you see me around the gym and as well as doing yoga, wearing an ankle tensor wrap.  Let's play it safe.

Hydration; not having enough water to allow the body to flush out the uric acid.   You wonder why there is a big push for 8 glasses of water a day.  We need to help the body push out waste and other particulates.   I know I drink a lot of liquids when I do any form of exercises.   And for all of those who read my blog, you already know that I do the following these weekly.   Everything except for B causes you to sweat profusely.

a) crossfit
b) relax and restore yoga
b) warm yoga
c) hot yoga

In one of the conversation with my physiotherapist, she had asked if I was doing Hot Yoga.  I had mention to her that I was.   She mention that with Hot Yoga; we have to make sure we hydrate ourselves the day before, the day of, and and after the Hot Yoga session.   I remember that my Yogi instructing me that as well.   I thought I was drinking enough fluids; but I guess I'm not.
Now before all of those who do Hot Yoga starts in on me.   I think Hot Yoga is still great, and it's definitely one of the my favorite to out the toxins out of your body, via sweat.   However, for me; I'll have to make some modifications in the future..

Why the worry on the Hot Yoga?  Well, it's not the Hot Yoga by itself; but it's the Crossfit that happens the following day.   And it's not a typical crossfit day, as Monday is benchmark day.  The benchmark days are much more intense than the other day.   Also, Monday can be a Hero WOD (even more intense).    So, your hydration levels in your body may be overtaxed as you have two days, back to back sweating out more than your body can keep.

And since my focus has been on Crossfit, I would rather drop a yoga class instead.  I'll play around with my schedule.  Keep doing three days of crossfit, and drop it down to two days of yoga.  Or I can keep doing the three days of yoga; but switch out the Hot yoga for something else.    Either way, I'll keep everyone posted.

The fix?
I asked for a medicine/treatment that I had received about eight years ago.   I had mention it to him and he prescribe the same medication.  He gave me enough for my current situation and spare one for the future.  I had to ask him if I could have an extra dosage as when this is occurring, I really am in no shape nor emotionally sound (think grumpy and cranky) to be running around town to see the doctor, and then getting medication.  Remember my ankle, toe, or some joint will be inflamed and I'll be almost immobilized.  He caved and change my refill count.   He did say that he hoped that I will have it under control and I won't have to use this medication.   Me too, I said to him!

So what is this medication?
Colchicine:  a type of pain reliever that effectively reduces gout pain — especially when started soon after symptoms appear.  One dosage consist of three pills.  You take two pills and then within one hour, you consume the other.  According to the medical information.  The affects will be felt within a few hours.

And the next day.....
Yup, most of the pain is gone around the ankle, swelling is gone around that area; but still at the bottom and around the edges of my foot.  I have more mobility.  I'll be drinking a lot of water today and the rest of my life to stay hydrated.   I'll also continue with physio to ensure that the mobility around the ankles comes back and my odd walking (Zombie like) hasn't put too much stress on my other part such as the achilles.

As for my diet, I'lll still be doing Paleo.   I'll just wait until my blood work results comes in and then make some fine tuning.   One of the fews things I wanted to mention is that despite the thought that red-meat is the leading cause.  There are actually some vegetables/greens that produce higher uric acid (mg) per 100 g of product than red-meat.   Now, I'll just have to adjust/avoid those particular products if Gout is the problem.