To the Pain: Day 4, 5, 6

So, hey, it's been a couple of days. I guess time flies when your not having constant pain. And that's a great thing for me. I have a sense that life is improving because of less pain. Every step doesn't cost me. Every keystroke doesn't make me hesitate. I like it!

It's even possible that this could be a new lease on life. For example, I went for a walk/ run with my son, Andrew, the other day. It was gorgeous outside and I felt terrific. He said, "let's go for a run." I said, "how about a walk." We compromised and off we went. We covered between 4 and 5 miles. And, actually other than being a little soar from not regularly exercising, I don't have the pain I normally would have after such an excursion.

So, things are good on the prednisone trail. No adverse side effects to speak of; at least none that I'm aware of. (Last night's waterworks not withstanding) And, the direct and desired effect of reducing the inflammation and tenderness in my joints is being achieved. As I said, I like it!

The regimen starts with a higher dose and tapers down for 9 days. This is day 6, so starting tomorrow, I will be taking 1 pill a day. I interested to see if the effects will be lasting. Presumably, this is a temporary fix for the purpose of giving the joints time to recuperate. But I don't think the prednisone has any effect on the uric acid crystals that cause the irritation in the joints.

If that's true, then the next step in this process is critical; namely introducing allopurinol. This is the medicine the doctor says will fix what's ailing me. It's a drug I'll have to take for the rest of my life. That in itself is an interesting proposition for me. But we'll save that for another time.

For now, what is Allopurinal and what does it do. For this we turn to that most reliable of sources, wikipedia:

Allopurinol is a drug used primarily to treat hyperuricemia (excess uric acid in blood plasma) and its complications, including chronic gout

Allopurinol is a structural isomer of hypoxanthine (a naturally occurring purine in the body) and is an enzyme inhibitor, inhibiting xanthine oxidase. [it] is responsible for the successive oxidation of hypoxanthine and xanthine resulting in the production of uric acid, the product of human purine metabolism. In addition to blocking uric acid production, [it] causes an increase in hypoxanthine and xanthine... Allopurinol therefore decreases both uric acid formation and purine synthesis.

Allopurinol does not alleviate acute attacks of gout, but is useful in chronic gout to prevent future attacks.

...allopurinol has two important disadvantages: its dosing is complex, and some patients will be hypersensitive to it. Therefore, use of this drug requires careful monitoring.

Side effects of allopurinol are rare, though significant when they occur. A small percentage of people develop a rash and must discontinue this drug. The most serious adverse effect is a hypersensitivity syndrome consisting of fever, skin rash, eosinophilia, hepatitis, worsened renal function and, in some cases, allopurinol hypersensitivity syndrome. Allopurinol is one of the drugs commonly known to cause Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TENS), two life-threatening dermatological conditions.

Allopurinol can cause severe pancytopenia. It can also cause breast enlargement in both males and females.

Allopurinol can lower blood pressure in mild hypertension.

Sounds fun... I guess I give it a whirl.