Dr. Kevin Lam* Dr. Wesley Drew Chapman * Dr. Sean Dunleavy
Dr. Patrick Bartholomew * Dr. Lauren Pelucacci * Dr. Sahiba Singh
Dr. Jake Powers * Dr. John Crist * Dr. Isin Mustafa * Dr. Kaitlyn Ward
Welcome to the Family Foot & Leg Center Opened in 2005 by Dr. Kevin Lam
as the premier center for foot / ankle medical & surgical care.
Gout is a form of arthritis -- inflammation that can cause a sudden attack of attack of pain, stiffness, and swelling in a joint. This is caused by a buildup of uric acid in the blood.
Most common signs of gout are sudden attack of swelling, tenderness, redness, and sharp pain. These are sporadic and can last a few days or even for several weeks.
As many as 8 million people in the U.S. have gout. Gout is more common in men. For women, gout is more common after menopause.
Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
POPPING GOUT OUT
Here gout crystals are being pushed out of the foot. Patient had an ulcerated toe from severe gout attack.
Gout is a disease whereby the patient's body produces too much uric acid (protein byproduct) or can not excrete enough through the kidneys. Gout can be very painful. If you a red, hot swollen joint. Gout or Infection should be on the top of the list.
‘Tis the Season for Gout
Each year during the holidays, this common scenario plays out: You enjoy a scrumptious holiday feast, starting with shrimp and scallops in puff pastry with a rich cream sauce, a prime rib, scalloped potatoes, and a fine red wine. You finish off the evening with dessert and a glass of excellent brandy. Several hours later, you awaken in the middle of the night with an excruciating stabbing pain in your big toe. The joint at the base of the toe is red, swollen, and throbbing. Chances are you are experiencing a gout attack.
What Pulled the Trigger?
Gout is an arthritic condition that occurs when crystallized uric acid builds up in a joint. Uric acid is a byproduct of the breakdown of purines–chemicals that are naturally occurring in your body and in certain foods. Some people may overproduce or have difficulty eliminating uric acid from the body. It can build up and cause pain in any joint, but the big toe is the most common site.
If you are prone to gout, purine–rich foods, such as red meat, shellfish, organ meats, red wine, brandy, and rich sauces, may cause an attack. Other potential factors may increase your risk for this condition as well, including:
For many patients, the predisposition for gout is hereditary.
- High blood pressure
- Certain medications and vitamins
Fending Off an Attack
Give us a call if you have the symptoms described above. If gout is diagnosed, we may prescribe oral medications or injections for treating the pain, inflammation, and swelling. You may also need to rest your foot and keep it elevated. Gout symptoms will usually stop within three to ten days with treatment.
If you have more than one flare up a year, it may be time to step up your gout treatment. Until now, nothing targeted the crystals in the joints of the big toe joint, hands, or knees quite like Krystexxa. Krystexxa is the only gout treatment that controls chronic gout by changing uric acid into a water–soluble substance called allantoin that your body easily gets rid of through urine. For those of you that have kidney disease and can’t take the usual gout medications, Krystexxa can treat your condition without harming your kidneys. Family Foot & Leg Center is one of the few Krystexxa Infusion Centers in Southwest Florida. If you have chronic gout, contact us to find out more information.
GOUT AND HYPERURICEMIA
ARE LINKED TO MULTIPLE COMORBIDITIES AND OUTCOMES
Patients with gout usually have multiple comorbidities, including hypertension, chronic kidney disease (CKD), cardiovascular disease, obesity, diabetes, and hyperlipidemia, all of which have significant adverse impact on public health.
CHD, coronary heart disease; PAD, peripheral arterial disease; PVD, peripheral vascular disease; sUA, serum uric acid
Negative effects of gout on the heart, kidneys, joints
Some people may experience recurrent gout. If left untreated, there can be deposits of urate crystals under the skin nodules called tophi, commonly found in the fingers, hands, feet, Achilles tendon, and the backs of the ankles. Urate crystals may also collect in the urinary tract of people with gout, eventually causing kidney stones.
People with gout have also been found to have higher risk of cardiovascular disease. Hyperuricemia is associated with endothelial dysfunction, which may contribute to risk of heart disease.
How are purines turned to uric acid?
The purine nucelotides adenine and guanine are broken down to form uric acid.
People who have difficulty metabolizing purines (such as those with gout or hyperuricemia) are advised to limit the consumption of high-purine food and drinks. If the level of purines in the body is more than the ability of the body to process them, too much uric acid builds up in the bloodstream. This condition is called hypeuricemia and aside from gout, this can also cause kidney stones. Normally, uric acid is disposed via the kidneys. The human body cannot oxidize uric acid to the more soluble compound allantoin due to the lack of uricase enzyme.
Uricase converts uric acid to allantoin, which is more soluble than uric acid and passes harmlessly from the body. Uricase is an enzyme that catalyzes the oxidation of uric acid to 5-hydroxyisourate and hydrogen peroxide (H2O2). Subsequent hydrolysis and decarboxylation leads to the formation of allantion. During evolution, humans have lost the ability to produce the enzyme uricase. This loss of uricase activity along with the lifestyle and eating habits of today renders humans prone to urate crystal deposition and gout.
How do medications help people with gout?
Gout medications can be used to treat acute flare-ups and prevent future gout attacks. Some can also reduce the risk of gout complications such as the development of tophi.
Medications that block uric acid production such as allopurinol (Aloprim) and febuxostat (Uloric) limit the amount of uric acid that the body makes to lower the blood uric acid levels. However, these can cause side effects such as reduced liver function and heart-related problems. Even with oral medication, people with uncontrolled gout can have a difficulty getting rid of uric acid.
Krystexxa works differently than the above oral gout medicines. Krystexxa is the only gout treatment that converts uric acid into water-soluble substance called allantoin. Allantion is very soluble and is readily excreted through urine. The uric acid level then reaches a point in which uric acid crystals can dissolve. New uric acid crystal buildup also stops forming, thus taking control of gout.
Proud to be a Krystexxa infusion center to help our patients get rid of gout from the body.
See us now to see if you are a candidate.
For adults with chronic gout that hasn’t been controlled with other treatments
IF YOU HAVE MORE THAN ONE FLARE A YEAR, IT MAY BE TIME TO STEP UP YOUR GOUT TREATMENT
Recurrent gout flares may be your body’s way of telling you that oral medicines aren’t doing enough to lower your uric acid level and prevent the harmful effects of out-of-control chronic gout. KRYSTEXXA has been helping gout patients for nearly 10 years. Studies show that one IV treatment every other week for about 6 months is all you may need to take control.
KRYSTEXXA WORKS DIFFERENTLY THAN ORAL GOUT MEDICINES TO QUICKLY DISSOLVE GOUT BUILDUP
KRYSTEXXA has a different way of lowering uric acid levels, which is the key to stopping gout flares. In about 6 months, it can safely and effectively remove years of uric acid crystal buildup from your joints. KRYSTEXXA is also a safe option for uncontrolled gout even if you have kidney disease.
IMPORTANT SAFETY INFORMATION
What is the most important information I should know about KRYSTEXXA (pegloticase)?
Serious allergic reactions may happen in some patients who receive KRYSTEXXA. These allergic reactions can be life threatening and usually happen within 2 hours of the infusion.
Before you receive KRYSTEXXA, tell your doctor if you:
Know you have G6PD deficiency
Ever had any heart problems or high blood pressure
Are pregnant or planning to become pregnant. It is not known if KRYSTEXXA will harm your unborn babyAre breastfeeding or plan to breastfeed. It is not known if KRYSTEXXA passes into your breast milk
Tell your doctor about all the medicines you take. Do not take any other uric acid lowering drug, such as allopurinol or febuxostat (Uloric®), while taking KRYSTEXXA.
Prior to your treatment with KRYSTEXXA, your doctor may give you medicine to help reduce your chance of getting a reaction. Take these medicines as directed by your doctor or nurse. Your doctor will also test your uric acid levels prior to each treatment to monitor your response to KRYSTEXXA.
THE MORE GOUT BUILDS UP, THE MORE HARM IT CAN DO
Out-of-control chronic gout can be painful, unpredictable, and cause permanent damage. Even after gout flares end, uric acid crystals from gout stay in your body, settle in your joints, and damage your bones. Uric acid crystals can also build up in vital organs like kidneys. If you have gout and kidney disease, it’s important to take control of gout because gout can lead to kidney disease progression.
Unlike medicines you take long term, KRYSTEXXA is given every 2 weeks for about 6 months.
THE MORE GOUT BUILDS UP, THE MORE HARM IT CAN DO
KNOW YOUR OPTIONS: TALK TO A GOUT SPECIALIST
HEAR IT ALL FROM REAL KRYSTEXXA PATIENTS
EVEN IF YOU’RE MANAGING YOUR SYMPTOMS, YOUR CHRONIC GOUT MAY BE OUT OF CONTROL
Out-of-control chronic gout is gout that continues to flare up even though you’re taking a daily oral medication to lower your uric acid level and medications like anti-inflammatories to treat the symptoms of your flares. Experiencing recurrent gout flares while on oral gout medicines is one sign your gout is chronic and out of control.
OUT-OF-CONTROL CHRONIC GOUT IS ALSO REFERRED TO AS:
- Uncontrolled gout
- Recurring gout
- Advanced gout
- Refractory gout
- Tophaceous gout
- Chronic gouty arthritis
- Persistent gout
FFLC Gout Institute
We welcome you as a patient to our podiatry practice in Florida. We currently have 8 locations across Lee, Collier, and Charlotte counties, We are grateful that you have chosen us as your complete foot and lower leg care center.
how is gout treated?
Gout can be effectively treated and managed with medical treatment and self-management strategies.
- Manage the pain of a flare
- Prevent future flares.
- Prevent tophi and kidney stones from forming
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.
- Eat a healthy diet.
- Avoid foods high in purines such as red meat, organ meat, and seafood
- limit alcohol intake, particularly beer
- Exercise regularly, engaging in low-impact activities such as cycling, walking, swimming
- Maintain ideal weight
- Consult your doctor and follow the recommended treatment plan
- Protect your joints from injuries that can worsen your condition
We have several locations from Collier, Lee, & Charlotte Counties to serve your foot and ankle needs:
Part of Family Foot and Leg Center, PA
Why do I have gout?
Uric acid levels spike when the body breaks down purines, which are found in certain food such as red meat, seafood, and organ meats as well alcohol, particularly beer and fruit drinks. Urate crystals then develop and build up in your joints. These sharp, needle-like crystals lead to the gout pain.
What are the symptoms of gout?
- Swelling of the joint, commonly the big toe
- Very painful joint
- Redness and inflammation
- Limited range of motion
What are the treatments for gout?
The treatment of gout aims to lessening your pain and preventing gout flare-ups in the future. See your physician for a thorough evaluation and treatment plan.
Our team at the Gout Institute, a part of Family Foot and Leg Center, P.A. work together to provide the best gout treatment for your specific needs.
Get relief from your gout.
Schedule for an evaluation today at the Gout Institute at Family Foot and Leg Center, P.A.
8 locations throughout Lee, Collier and Charlotte Counties to get you back on your feet
*East Naples / Marco Island
*Fort Myers @International Blvd
*Fort Myers @Colonial Blvd
Call Today: 239 430 3668 (FOOT)
Self Service # 844-889-1725
Fax: 239 692 9436