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Ask A. Schuyler, NP Your Own Question
A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 16292
Experience:  Board Certified NP, MS, RN. 25 years private practice & hospitalist
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I have two things of concern at the moment. Number one being

Customer Question

I have two things of concern at the moment. Number one being Gout like pain in my right ankle, left knee and right elbow. This may be causing problem two which is panic attacks randomly during the day. I haven't been sleeping much at all some due to the pain and some due to the fact that my father is in the hospital. what I would like is something for gout. The symptoms only seem to come around every year or two. I have taken Colchicine in the past and have had success. The panic attacks and loss of sleep I am open to suggestions.
Submitted: 4 years ago.
Category: Health
Expert:  A. Schuyler, NP replied 4 years ago.


Answers provided are for informational use only and do not confer patient-provider relationship. My name is ***** ***** I will do whatever I can to try to help you.

Treatment for current gout attacks is the NSAIDs (Advil, Motrin, Aleve), colchicine, and even perhaps a short burst of corticosteroids. Once the acute attack has passed, your provider may consider putting you on a medication to prevent future attacks like allopurinol or febuxostat that blocks uric acid production or a drug like probenicid that improves the ability of the kidneys to remove uric acid so it cannot build up and cause gout. Since probenicid can lead to increased levels of uric acid in the blood (and kidney stones), it isn't used as much as allopurinol to prevent the formation of uric acid in the first place.

You would need to talk to your provider about a referral to a psychotherapist for cognitive behavioral therapy for the panic attacks, or your provider may prescribe an anti-anxiety drug to be taken for a short time to help you get the panic attacks under control as you learn the behaviors in psychotherapy that will help you. Since this may be situational (your father in the hospital) you may only need help for a short time. There are anti-anxiety drugs meant for very short-term use (2-3 weeks at most, like Xanax) and other drugs that can be used long term for anxiety-related issues. The two of you would need to determine if this is a long-term problem or a result of the concern for your father along with the pain and lack of sleep.

On your own you can take over-the-counter supplements like melatonin to help with sleep.

Please let me know if you have questions.

All the best,