Gout

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Russ

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Hi
New member here, can anyone give me some advise on treating a client with gout? I am about half way through my trainging and I want to treat my father but he has gout in his big toe (left foot), can you give me any advise on what kind of treatment I should give him and how often.
Thanks
 
Hi,
Gout is not something you can easily treat physically. The only two topical therapies that help are warm foot baths and gental skin brushing.
Gout is caused by an excess of Uric acid in the bloodstream. The uric acid can christalise to form monosodium urate christals, just where you don't want them, but normally in the big toe joint. The excess uric acid can come from 3 sources: hereditary predisposition, inhibition of excretion by kidneys, excess purines in the diet. You cannot do much about the first, the second is usually caused by excess alcohol, the third is often caused by beer, which has an exceptionally high purine content. Protein containing foods contain purines, but you have to eat them. Beef and chicken are better than pork and lamb. Liver, pulses and lentils also contain purines, but you can find lists of the foods to avoid on the net.

Historically gout was caused by port or porter. Port was once contaminated by storage in lead lined casks. Lead can bring on the condition. Porter is beer we know as guiness, high in purines. Many people think that red wine brings on gout (due to the confusion of it being port-like), but in fact it contains stuff that helps (but don't drink too much because of the negative effects of the alcohol). Other dietary helpers are water (drink lots), fresh lemon juice (3 lemons/day) but use juice of 1 lemon with 1pint of water or it will take the enamel of your teeth, potatoes and berry juice (especially cherries).
Herbal helpers in order of importance: Pycnogenol, Quercitin, Ruthin, potassium citrate, bromelain, vitamin C, celery seed & grape seed extract. You can get most of these at a healthfood shop.
The symptoms of gout (swelling, inflamation and pain) are brought on because the body detects the christals and thinks that they are invaders and so mounts an immune response. Acute conditions like that are probably best treated by the doctor. The initial treatment is usually with Naproxen which is often very effective.If it keeps reoccuring, or you are suffering from continued small depostions of chistals called tophi, the doctor will give you allopurinol, which is effective at keeping gout at bay (but has side-effects).
It is important to tackle gout, because excess uric acid can cause the development of kidney stones. For an accute attack see the doctor, for ongoing management seek dietary improvements as autlined above and herbal helpers,

Cheers,

Nick
.
 
I have treated an elderly lady who suffered from gout.

She had 6 treatments with me and the pain she experienced with the gout lessened considerably.

I noticed that she seemed to suffer from loss of sensation in her feet and would often ask for more pressure, which I simply wasn't comfortable to do, cause I felt it was inappropriate and didn't want to risk causing her pain, a lighter treatment can be just as effective as a deeper one if applied correctly.

As we were treating the gout itself as one of our primary objectives, I included a lot of mobilisation and massage and a slightly shorter reflexology treatment overall. The massage is good for loosening up tight muscles and really helps relieve the tension and pain gout sufferers experience. If you've been taught diaphragm rocking it's a technique I use a lot with people who have gout and arthritis cause it frees up tension so quickly and can be quite gentle too.

After her first treatment she said she felt a bit achy, but as the next treatments went on she really started to feel the benefits, she had permanent aching in her feet and this subsided, also pain when she stood which was greatly reduced. The improvements were also visual - her toes were very stiff and bent up and they were much more relaxed when she stood.

I would personally advise weekly treatments, more regular if you can, focussing on the massage and see how he goes. Use as many mobilisation strokes as you know, toes circles aren't bad either. Make it quite light and I would probably just do a massage and walk the zones for the first treatment, and then assess how he got on with that and makw the next ones a bit longer and in depth.

Apologies if this is a bit garbled, if you need me to expain any more let me know.

Don't be afraid to treat him, when you are studying it's the best time to experiment, you have the support of your tutor and if you go to them with a treatment concept and ask their advise, they will normally let you know if your plan sounds feasible. You wont harm him, you might just make him feel a bit better.
 
Hi,

Just to comment that the christals are there in the joint no matter what. It is feasible that massage can make them disolve and be taken up by the lymph system. This is more likely to happen at higher temperatures when christals dissolve more easily. Long term management must address the issue of excessive serum uric acid, which is usually postprandial.

Cheers,

Nick
 
Thanks for that Info Nick
Very thouragh - I will print a copy of it a give to my dad

My dad also suffers from gout but he just loves his Guiness - but hes not an excessive drinker or anything
 
As an occassional gout sufferer I offer some comments from the victims side of the fence.

Untreated it can be agony with extreme swelling in the worst cases

I (of course) went to my GPabout it long ago, and he prescrbed me some pills (indomethicin I think - from memory). Catch the attack early and they kill it immediately.

More recently I was chatting to a firend who had become a recent sufferer.and he had been recomended (by whom I know not) one of these magnetic bracelets and was swearing by its efficacy - butI think you do have to wear it all the time.
 
Hi,

I discovered all the things about gout when I first started to suffer. I have only had the one attack and manage to keep it a bay whilst still drinking a moderate amount of beer. The factors that I think have been the most effective are:

1. Avoid eating too much protein. The max amount needed by a human is probably about 70 gms. 1 oz of meat or cheese has about 7 gms of protein, but you find protein in lots of food in lesser amounts, even bread and potatoes. Protein is used to support growth and repair, it is only the excess protein that is metabolised to produce uric acid. Most people over-eat protein, so keep it moderate and supply only what your body needs.

2. Keep fluid intake high. Your kidneys are responsible for extracting uric acid from the blood and discarding it in urine. The more fluid you drink, the more urine you generate, the more likely you are to flush out the unwanted uric acid. Try drinking plain spring (not mineral) water rather than tap water. All fluids count, but water and dilute lemon juice help the most. Tea and coffee are diuretics, so they will help to get the kidneys "going".

3. Use sea salt in moderation. Sea salt contains all the minerals from the sea and is beneficial to the body. The normal table salt not only does not contain all these extra minerals, it contains residual contaminants from its processing and so is bad for you. Monosodium urate needs sodium (from salt) to form, so be careful how muchyou eat. Unless you sweat profusely or live or work in very hot conditions you only need about 6 gm/day. The most likely sources of unwanted excess are processed foods.

4. I recently discovered that potatoes contain substances that help keep uric acid levels down. Use plain boiled new potatoes and retain the water for gravy or soup.

5. Beer and especially Guiness contains nutrients, but red wine contains even more and things that help releave gout - so less beer and more wine. It is believed that moderate drinking has greater health benefits than no drinking. It is not known whether it is actually the alcohol that does this or just experiencing a more relaxed convivial atmosphere on a regular basis. Aguide to sensible drinking can be found at [link=http://www.drinkingandyou.com/site/uk/biggy.htm]http://www.drinkingandyou.com/site/uk/biggy.htm[/link]
The Australian guidelines are most in line with published research. The two days "off" are very important becausethey allow the liver to recover. The days should be consecutive. Note that research is always done using a "drink" as a standard measure. This is 12 fl oz for beer. So 4 drinks is 48 fl oz. An "English" "pint", you might think is 20 fl oz, but in fact it is 19.2. Take off1 fl oz for the standard English head and it is nearer 18. So surprisingly, 4 drinks lies equivalent to somewhere between 2.5 and 3 English (4%) pints.

Cheers,

Nick
 
Thanks for the great information - My hubby suffers from severe gout and as a self-employed person this causes havoc with his work as he generally has to take a week off during each acute episode. He suffers mainly in his big toes but has also had it in his ankles, knees, elbows and wrists. He is on 3 lots of medication.

One of the reasons I became a Reiki practioner and am now working my way through gaining all the holistic therapy qualifications I can is in order to help him through these attacks.

I will print off all this info for him to read, thank you for taking the time to post it.

Kindest regards
 
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    All season wellness center : New Young girl big breasted beautiful buttocks charming temperament big boobs Doris ,Young girl big boobs beautiful face deep massage Midi ,Young girl big breasted beautiful buttocks charming temperament Lala,Young beautiful face sexy body and good deep massage Maggie, Enchanting sexy petite deep massage Sherry ,๐Ÿ  address: #5-30 Rambler dr Brampton ,Ontario L6W 1E2โ˜Ž๏ธ4376655510 ๐Ÿ‘„๐Ÿ‘„๐Ÿฆต๐Ÿฆต๐Ÿˆต๏ธ๐Ÿˆต๏ธ๐Ÿ‘…๐Ÿ‘…
  36. Endless Joy Spa:
    โœจโœจโœจโœจโœจ[GRAND OPENING]โœจโœจโœจโœจโœจ ๐Ÿ’žEndless Joy Spa๐Ÿ’ž ๐ŸŽ‡ (155 East Beaver Creek Rd Unit #8, Richmond Hill) 416-731-8565๐ŸŽ‡10am-2am, New First Day Young Slim Sexy Chinese Faye, Slim Petite Chinese Vivi & Slim Sexy Chinese Coco & Young Slim Sexy Chinese Jasmine
  37. wonderspa:
    wonderspa: ๐ŸŒบ๐ŸŒบ Weclome to wonder spa (9421Jane st unit127)L6A4H8 โ˜Ž๏ธ416-5000-800,.๐Ÿ˜on Saturday4younge girl working Ensuit shower available ๐Ÿ’„new young girl Cici is beautiful Sweet and friendy girl good deep tissue massage ๏ผŒback walking,nice body slide,๐Ÿท nice Amy Vietnamese young girl,open maid,everything she can do,give you warm time,must try๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ‘many more ๐ŸŒน๐ŸŒน
  38. Sparkling Spa:
    โšก๏ธ๐ŸŒŸSPARKLING SPAโšก๏ธ๐ŸŒŸ โœ…50 Lockridge Ave Unit 8โœ… ๐Ÿ‘ŒMarkham, ON L3R 8X4๐Ÿ‘Œ โ˜Ž๏ธ (905) 604-8186 Spa Land Lineโ˜Ž๏ธ โ˜Ž๏ธ (437) 446-6688 NEW Spa Cell Phoneโ˜Ž๏ธ (West of Warden & 16th Ave) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…NEW MANAGEMENT๐Ÿ’ฏNEW GIRLS๐Ÿ”ฅSUPERSTAR SERVICE QUEENS AVAILABLE AT SPARKLING SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅSEXY NEW YOUNG GIRLS ALWAYS WORKING - Todayโ€™s Schedule isโ€ฆ๐Ÿ”ฅ Foxy -๐Ÿ”ฅYour new addiction at Sparkling Spa! A tall 5โ€™7โ€ sexy Korean girl with a wi
  39. Golden Sunshine Spa:
    โœจClick on our Username and FOLLOW US for updates and special services ! โœ… Today๐ŸŒธClaire๐ŸŒธBree๐ŸŒธRebecca๐ŸŒธFran๐ŸŒธEly Call us โ˜Ž 905 - 265 - 2158โ˜Ž๏ธ Your ultimate service awaits! โœจ
  40. Soul Relax Spa:
    โœจ Looking for a relaxing escape? โœ… Meet๐ŸŒธHatti๐ŸŒธTina๐ŸŒธTaniaCall us today for the best treatment and service experience. Click on our Username and FOLLOW US for updates ! Call now โ˜Ž 289 - 298 - 5662โ˜Ž๏ธ Your ultimate relaxation awaits! โœจ
  41. Jennyโ€™s Spa:
    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅTODAYโ€™s ROSTER INCLUDES: Apple๐Ÿ˜˜ - Brand new girl from Taiwan ju
  42. lovefeetspa:
    Love feet spa ๐Ÿ˜โค๏ธ๐Ÿ’„3641 wolfedale road Mississauga phone โ˜Ž๏ธ 4169890520today we have 3 girls work tina ella and lily beautiful and young girls ella can do dragon tendon massage all girls big boots my girls body smooch hand soft 100% no rush be make you happy l am promise you no regret come here
  43. AliceSpa:
    SATURDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—”, 4915 Steeles Ave. E, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿฎ๐Ÿต๐Ÿด-๐Ÿฌ๐Ÿด๐Ÿต๐Ÿด. 4915 Steeles Ave. E, Scarborough 416-298-0898 [/color] 3 Top Girls Today at Alice Spa. Open 10am to 9pm: BEBE (10am-9pm): is a nice young Korean girl with a natural super busty DD Cup, petite small body, open minded bbby cim cof rim, always cooperative, excellent services. JULIA (1pm-6pm) from Philippines, young girl
  44. luckywellness:
    Lucky Wellness Center 4379721888 295 Eglinton Ave E,Unit 7,Mississauga kiki and Mia
  45. Annie Spa:
    ๐ŸŽ‰๐Ÿ’ANNIE SPA๐ŸŽ‰๐Ÿ’ โœ…7-1001 SANDHURST CIRCLEโœ… ๐Ÿ‘ŒSCARBOROUGH ON M1V 1Z6๐Ÿ‘Œ โ˜Ž๏ธ (647) 891-9688โ˜Ž๏ธ โ˜Ž๏ธ (416) 291-8879โ˜Ž๏ธ (FINCH & MCCOWAN) OPEN 9:30am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…NEW MANAGEMENT๐Ÿ’ฏNEW GIRLS๐Ÿ”ฅ๐Ÿ”ฅ ๐Ÿ”ฅGORGEOUS NEW YOUNG ASIAN GIRLS - TODAYโ€™s ROSTER INCLUDES: ๐Ÿ”ฅ Judy๐Ÿ˜˜๐Ÿ”ฅOur new Asian massage girl Judy is a vision of refined sensuality, with a graceful figure and smooth, flawless skin that radiates warmth and allure. Her striking black hair frames her delicate features, and her poised elega
  46. HollywoodSpa:
    Saturday at ๐ŸŽญ๐—›๐—ข๐—Ÿ๐—Ÿ๐—ฌ๐—ช๐—ข๐—ข๐—— ๐—ฆ๐—ฃ๐—”๐ŸŽญ, 4578 Yonge St, Unit 100, North York, ON: COCO & SISI. โ˜Ž416-222-5554โ˜Ž When you visit ๐ŸŽญHollywood Spa๐ŸŽญ, you will be treated with tender care and your visit will be a fulfilling one. Nice Massage, Young Pretty Girls. We have Chinese, Japanese, Korean & other attendants. COCO is an attractive attendant with nice massage skills & good services. SISI is a sweet slim beauty, 5โ€™5โ€
  47. ForeverWarden:
    Saturday at ๐Ÿซฆโค๏ธ๐Ÿ”ด๐ŸŸฅโ™พ๏ธ๐“•๐“ž๐“ก๐“”๐“ฅ๐“”๐“ก ๐“ข๐“Ÿ๐“โ™พ๏ธ๐ŸŸฅ๐Ÿ”ดโค๏ธ๐Ÿซฆ 2190 Warden Ave, Unit 201, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿด๐Ÿฌ๐Ÿฌ-๐Ÿณ๐Ÿด๐Ÿด๐Ÿณ: Reika, Tracy & Cindy. Reika is Japanese, loves to please. Tracy is an incredibly cute & pretty Japanese/Taiwanese mixed spinner, about 5โ€™1โ€ and 100 lbs. She is very popular for her exotic massage, bbbj & cfs. Her bubbly personality vastly enhances the experience. Cindy is a slim beauty
  48. Eva Vivian - Elegant Asian Sweetheart:
    ๐Ÿ’ฏ๐Ÿ”ฅ๐Ÿ˜˜Iโ€™m Eva Vivian, your independent open minded slim sexy massage girl available working in Scarborough and North York. Available to provide you massage and extra services at Hawaii Health Spa in Scarborough and Greenway Spa in North York๐Ÿ’ฏ๐Ÿ”ฅ๐Ÿ˜˜ HAWAII HEALTH SPA: โœ…Hawaii Health Spa @ 3110 Kingston Road in Scarboroughโœ… โ˜Ž๏ธ416-261-8088โ˜Ž๏ธ ๐Ÿ’ฏEva available every TUESDAY, THURSDAY & FRIDAY from 10am to Late Night๐Ÿ’ฏ โ˜Ž๏ธCall Hawaii Health Spa 416-261-8088 to book appointment with Evaโ˜Ž๏ธ ๐Ÿ’‹Every
  49. bnwellness_wilson:
    We have 4 girls are working today, young cute slime Sophia and young fun Tina with curve body 36DD open mind, sweet EFG Lina and pretty Ella are providing deep tissue and sensual massage, pls call 416-3985777 book appointment and walk in always welcome, back entrance and parking available. 350 Wilson Ave North York
  50. HolidaySpa:
    Saturday at ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…๐“—๐“ธ๐“ต๐“ฒ๐“ญ๐“ช๐”‚ ๐“ข๐“น๐“ช๐ŸŒ…๐Ÿ˜Ž๐ŸŒด3517 Kennedy Rd, Unit 4, Scarborough โ˜Ž๏ธ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฎ๐Ÿฐ๐Ÿณ-๐Ÿญ๐Ÿญ๐Ÿต๐Ÿตโ˜Ž๏ธ: AMY & NANA. AMY is an attractive young lady with larger breasts and a nice bottom. She has outstanding oral skills, and is very popular. Donโ€™t miss out on her special skills Nana is a slim and very sexy Korean lady, very pretty and accommodating. Come and try, you will like. ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…HOLIDAY SPA๐ŸŒ…๐Ÿ˜Ž๐ŸŒด
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