Dr. Paul Waytz

He stopped the medication and within a month had an attack that brought this guy to tears. I mean, this was a professional football player who's, you know, been beat up and strung up and all this kind of stuff. He was in tears because he was in so much pain. So if there's gout and it's a treatable condition and in 2024 people, we shouldn't be seeing the amount of gout that we do.

He stopped the medication and within a month had an attack that brought this guy to tears. I mean, this was a professional football player who's, you know, been beat up and strung up and all this kind of stuff. He was in tears because he was in so much pain. So if there's gout and it's a treatable condition and in 2024 people, we shouldn't be seeing the amount of gout that we do.

Yeah. So the typical symptoms is very abrupt onset, pain, severe pain, redness, warmth, and swelling, usually in the big toe. However, and so people say, oh, it's in the big toe. 30% of initial attacks of gout are more than one joint. which throws some people off because they say, well, you've got three joints, it can't be gout. Or it's not the toe, it's the ankle and the knee.

Yeah. So the typical symptoms is very abrupt onset, pain, severe pain, redness, warmth, and swelling, usually in the big toe. However, and so people say, oh, it's in the big toe. 30% of initial attacks of gout are more than one joint. which throws some people off because they say, well, you've got three joints, it can't be gout. Or it's not the toe, it's the ankle and the knee.

The way to prove that, and this sounds barbaric, is you put a needle in a joint and you take a little fluid out. And you look at it under the microscope. And with very easy techniques, you can identify those crystals. And then you say, aha, I've made the diagnosis. I'm going to reduce the inflammation with one drug.

The way to prove that, and this sounds barbaric, is you put a needle in a joint and you take a little fluid out. And you look at it under the microscope. And with very easy techniques, you can identify those crystals. And then you say, aha, I've made the diagnosis. I'm going to reduce the inflammation with one drug.

And then I'm going to put you on another drug that doesn't fight inflammation, but lowers the uric acid in your system. The interesting thing, Clarence, is that say somebody comes in with an attack of gout. in their knee and you prove the diagnosis.

And then I'm going to put you on another drug that doesn't fight inflammation, but lowers the uric acid in your system. The interesting thing, Clarence, is that say somebody comes in with an attack of gout. in their knee and you prove the diagnosis.

I can guarantee you, almost guarantee you, that if I put a needle in a wrist that's not even symptomatic, I would find some uric acid crystals because that process has been going on for years. Wow.

I can guarantee you, almost guarantee you, that if I put a needle in a wrist that's not even symptomatic, I would find some uric acid crystals because that process has been going on for years. Wow.

Yeah, it's because we're making uric acid on a daily basis. Okay. And you can lower it, but once you stop the drug, the processes that created that the elevation of the uric acid will just go right back to where they were. And again, we talk about diet and this and that and the other thing. A lot of it's genetic. The most part is genetic. So you're going to have it.

Yeah, it's because we're making uric acid on a daily basis. Okay. And you can lower it, but once you stop the drug, the processes that created that the elevation of the uric acid will just go right back to where they were. And again, we talk about diet and this and that and the other thing. A lot of it's genetic. The most part is genetic. So you're going to have it.

And so here's another interesting story. The ancient Greek physicians recognized that gout would occur. And you can find gout in mummies, you know, so it's been going on. And the treatment at the time was to go chew on willow bark. Willow bark has acetylsalicylic acid in it, which is the basis of aspirin.

And so here's another interesting story. The ancient Greek physicians recognized that gout would occur. And you can find gout in mummies, you know, so it's been going on. And the treatment at the time was to go chew on willow bark. Willow bark has acetylsalicylic acid in it, which is the basis of aspirin.

And if you take enough aspirin or if, I mean, usually low doses of aspirin can aggravate gout, but if you take a lot of it, that will reduce the inflammation. So we, that was recognized, you know, many centuries ago.

And if you take enough aspirin or if, I mean, usually low doses of aspirin can aggravate gout, but if you take a lot of it, that will reduce the inflammation. So we, that was recognized, you know, many centuries ago.

And that was the 1860s. I think Napoleon had gout. I think some of the czars had gout. And there's talk about wars that were either won or lost because somebody had gout or, you know, and they couldn't show up.

And that was the 1860s. I think Napoleon had gout. I think some of the czars had gout. And there's talk about wars that were either won or lost because somebody had gout or, you know, and they couldn't show up.

Exactly.

Exactly.