Gout used to be called the disease of kings, but now it affects more than 8 million Americans from all walks of life. It’s a form of arthritis that can be very uncomfortable and a little tricky to diagnose because its symptoms are similar to several other joint conditions. It is characterized by too much uric acid in the bloodstream and joints causing it to be crystallized and deposited in the joints. 

Gout Relief

Gout can flare up commonly at night. It is a flare-up. It is very common in the base of the big toe. It is very painful and can cause a very painful gait, difficulty wearing shoes,. Most patients describe it as a sharp, throbbing pain especially with standing up for a long time or walking.

Men are 3 times more likely to develop gout than women, and you could also be at high risk depending on your family history, drinking habits, and other factors.  

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Gout usually responds well to medication and lifestyle changes. While most attacks will run their course in a few days to a few weeks, proper treatment can also relieve many of the most troubling symptoms and reduce joint damage.

Learn how to live more comfortably with gout. Understanding your medical options and recommended lifestyle changes can help you to manage your condition.

 Medical Care for Managing Gout:

Understand the causes. Your body usually removes excess uric acid when you urinate, but sometimes it can accumulate in your blood and start to form needle-like crystals in your joints. This can be due to your diet or to your body making too much uric acid on its own.
  1. Spot the symptoms. Many gout patients notice tingling or other sensations before an attack during which the affected joint becomes red, swollen, and painful. In some cases, your joints can be so sensitive that even the pressure of a bed sheet or a breeze can be irritating.                                                                                                                                    👉👉👉Powerful Pain Relief Through Meditation
  2. See a specialist. To develop your treatment plan, your doctor may refer you to a rheumatologist. That’s a doctor who specializes in diseases that affect joints, muscles, and bones.
  3. Get diagnosed. Your doctor may order several tests, but a joint fluid test is the most conclusive. By drawing fluid from your joint and looking at it under a microscope, they’ll be able to tell if the urate crystals associated with gout are present.
  4. Take medication. There are numerous drugs now available that can treat gout attacks, relieve pain and complications, and help prevent future attacks. Your doctor may also adjust your medication over time if your symptoms change.
  5. Apply ice. If you want to try managing your pain without medication, it may help to apply ice or cold compresses to sore joints. Keep a cloth or other barrier between the ice and your skin. Foot soaks with Epsom salts have relieved some of my patient’s symptoms. There are commercial portable foot baths now available in drug stores and pharmacies. Some have a whirlpool-like function that is quite soothing to inflamed joints of the foot and even ankles. You can add ice cubes to the water for cooling.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     👉👉👉SAUNA VS. ICE BATH: Which One Works Better?
  6. Continue monitoring. Measuring uric acid levels is an important part of managing gout. Ask your doctor to set up a schedule of regular appointments, so you can stay on track.

Lifestyle Changes for Managing Gout:

  1. Limit alcohol. Beverages and foods high in a substance called purine can trigger gout attacks. That includes alcohol, especially beer. 
  2. Avoid certain foods. Foods rich in purine include organ meats, red meats, game meats, and some seafood. Some fishes such as tuna, mackerel, anchovies, sardines have a high purine content and should be taken in less quantity and frequency.   
  3. Even salmon is also in this category. Scallops, beer, sugary drinks, high-fat dairy products are also some that have to be avoided. Even some vegetables have a high purine content: asparagus, cauliflower, and spinach. Some fruits that also have a high purine content are dates, prunes, lychees, plums, cherries, and pears.-  Check labels for high fructose corn syrup and other sweeteners too. While they’re not high in purine, they can trigger gout attacks.
  4. Eat healthily. Most of the foods that may help lower uric acid levels are suitable for any balanced diet. That includes vegetables, fruits, nuts, seeds, whole grains, dairy products, and eggs.   


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  1. Drink water. Staying well-hydrated can also help your body to remove uric acid more efficiently. Drink water with meals and carry a bottle around with you.


  1. Lose weight. Obesity and related conditions like diabetes greatly increase your risk for gout. Shed pounds gradually with a lower calorie diet and regular exercise.

Great progress has been made in treating gout in recent years. Talk with your doctor about your options and control your symptoms by adjusting your diet, limiting alcohol, and losing any excess weight.

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A Quick Guide to Joint Surgery

A Quick Guide to Joint Surgery

 When joint pain is too much, 

A Hip and Knee Replacement or other surgeries can be a lifesaver…..Working closely with an orthopedic surgeon who is exceptional in performing knee and hip surgeries, I came up with a quick guide that can prove helpful to persons who are facing the possibility of a knee or hip replacement.

 More than 7 million Americans are living with an artificial knee or hip, according to the American Academy of Orthopaedic Surgeons, and those figures are likely to keep growing. Total knee replacements more than doubled between 2000 and 2009, and total hip replacements increased almost as much.

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Severe Osteoarthritis is the common reason why a knee replacement or a hip replacement is indicated. Arthritis causes degeneration and erosion within the joint that erodes the soft tissues including the meniscus. 


This causes both the bone of the thigh and the lower leg to rub against each other, resulting in a bone-to-bone contact between these two structures that can be very painful. This can also cause severe inflammation, stiffness, and pain. The result can be very debilitating making standing, walking difficult, so with the inability to tolerate simple tasks of daily living.

 Hip and knee replacements can provide a new lease on life for patients who experience severe arthritis pain that doesn’t respond to conventional treatments, medication, or lifestyle adjustments. Surgery often restores joint function and makes many daily activities possible once again.

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 However, what you do before and after surgery will play a big role in the outcomes you experience.Read this guide before you decide on joint surgery.

 Steps to Take Before Your Joint Surgery:

 1.      Explore other alternatives. While surgery can be very beneficial, it’s a major undertaking. Try less intensive treatments first, including drugs, physical modalities such as heat or cold packs, and exercise. You may also want to ask your doctor about cortisone injections.

 Cortisone injections work by treating the inflammation that can cause knee painswelling, stiffness, and warmth. The effects of a cortisone injection can last from three weeks to three months. I have had patients who report relief for up to a year. Arthritis sufferers who want quick, temporary relief from knee arthritis pain may choose to have a cortisone shot. Ask your primary physician or orthopedic surgeon.

2.      Understand your options. If surgery is indicated, your doctor may recommend total or partial joint replacement or other types of operations. That may include arthroscopy, which often takes as little as one hour, or joint fusion surgery, which can be used when joint replacement isn’t feasible.

3.      Consider your timing. Deciding when to act can be tricky. You want to have joint surgery as soon as necessary but as late as possible to minimize additional damage and the need for replacement procedures.

4.      Lose weight. Your doctor may suggest you take off excess weight to make surgery safer and put less strain on your knees and hips. Maintaining your new figure will also be important.

5.      Work out. Exercise plays a big role before and after you’re in the hospital.

Being fit will speed up your recovery and increase your mobility.


6.      Review your medications. Let your doctor know about any drugs or supplements you use. Substances like glucosamine can interfere with anticoagulants that reduce the risk of blood clots.

7.      Plan your finances. While insurance will probably cover your surgery, it may not extend to other expenses like home health care and medical supplies. Ensure you budget for the total cost.

Steps to Take After Your Joint Surgery:

1.      Prevent infection. You can reduce your risk of infection by keeping wounds clean and taking antibiotics as recommended. Contact your doctor if you see warning signs like fever, redness, or drainage from a wound.

It is common to experience swelling days after surgery. Cryotherapy, or using cold packs regularly throughout the day can help ease discomfort and pain. It also keeps the swelling or edema, under control. If left alone, the leg can swell up all the way to the ankles as gravity tends to pull fluids down when we are up on our feet.

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Patients always ask how long do they have to apply ice packs each time. Orthopedic surgeons have their specific protocols regarding icing schedules. I recommend for the first 3 days to hourly as feasible, then every two hours once swelling and pain are more controlled. About 20 to 30 minutes should do it, but always check your skin to make sure you don’t freeze your knee or hip! No frostbites!

Most hospitals will send you home with special ice packs, and some even send you with an ice device such as Game Ready, Aircast Cryocooler, Don Joy iceman, or Polar active ice device. There are many available in the market. Basically, it is a device for an ice circulation system. These products are available on the market, even Amazon that can cost anywhere from $75 to $2,700 plus on the high end.

For home use, if one does not have access to these fancy ice devices, here’s a real homemade ice pack you can use that is very effective, just as cold as expensive ice packs and you can make it yourself!

CORN SYRUP COLD PACK: Buy the KARO brand LIGHT (not the dark) corn syrup at your grocery.

Place syrup in an airtight largest freezer ziplock bag you can find. Make sure you double bag it to avoid any leakage. Once frozen the syrup solidifies but is moldable over the joint. Use a pillowcase as a cover, not a towel to ensure maximum coldness needed for symptom relief. 
If preferred, check Amazon and search for “Cold Packs”. You will find an array of cold packs with different sizes and shapes. Read the reviews and find one that does not harden and gets stiff once frozen. I have found that some of these cold packs actually harden once frozen and are hard to mold over the hip or knee.

2.      Do physical therapy. Of course, I am impartial to this, being one. Your surgeon will surely refer you for Physical therapy that will start at your home for a few weeks. You will then be referred to outpatient Physical Therapy soon after, where you can work on an advanced therapeutic activities program. 

Expect to work a little harder with your outpatient PT who will help with you regaining more knee flexion and strengthening the hip or knee. This will allow you to progress towards being able to walk again on your own, or with the least restrictive walking device like a cane. Plan to start physical therapy before you leave the hospital. Some orthopedic clinics provide a pre-op consult or even therapy itself for a few visits to prepare you for surgery. 

A Physical Therapist can teach you the appropriate Pre-Op exercises or Anti-embolic exercises (Simple exercises that are aimed at preventing blood clots common after any surgical procedure) right after surgery. A home exercise program can be prescribed by your physical therapist which you can probably perform safely on your own at home once you receive proper instructions.

3.      Prepare your home. Be ready for departure day. Clear away clutter and area rugs that could lead to falls. Install grab bars in the bathroom and move your sleeping arrangements to the ground floor if necessary. Stairs can be tough to manage early on after your surgery. 

4.      Dress comfortably. Select loose garments. When doing physical therapy, it is easier for your therapist to access your knee or hip for manual therapy if the therapist so prefers. Elastic waist pants and pull-on tops will save time. Wear slip-on shoes until you can bend your legs.

5.      Bathe carefully. Keep your incision dry until the stitches, sutures, or staples are removed. Some surgeons use Aquacel dressings for knee and hip replacements. This is a sterile dressing with an inner non-woven pad made of Hydrofiber technology and ionic silver. 

Take sponge baths or use a stool and shower hose. Keep the surgical site dry. If Tegaderm, a transparent dressing is used, you can take a shower without having to cover the area as it is waterproof. Tegaderm is a sterile, breathable, waterproof, germ-proof barrier dressing commonly used in surgical procedures due to its stated qualities.

6.      Buy assistive devices. Your physical therapist, medical supply stores, and online catalogs can help you find various items to aid in your recovery. Crutches and walkers can be delivered to the hospital or your home. The use of a walker may be temporary as many of my patient s can pretty much walk on their own once outpatient therapy has started.

TIP: Check your local thrift shops including Goodwill and Salvation Army. I seem to always find barely used walkers in these places for about $8 to $15. Ask your physical therapist to adjust and check it for you for your ideal fit.

Ideally, the walker height should be about the level of your wrist joint when your hand hangs on your side. A good fit can save your back from having to slouch so much forward while walking. Practice the heel/toe walking pattern even before your surgery. This allows better gait patterns and avoids excessive loading on just the surgery side.  Ask your physical therapist.

7.      Arrange for help. Ask a family member or close friend to bring you home from the hospital and stay with you for the first few days. It is safer for you when there is someone else who can help you while you are recovering and unable to move around well just yet. That knee or hip will feel heavy, stiff, and uncomfortable making walking difficult.  If no one is available locally, see if your church has a homebound ministry.

Joint replacement or other surgeries can be the start of an active and fulfilling new life. Being prepared will help you work with your health team to find the appropriate options for your condition.

Feel free to ask me more about joint surgeries and exercises you can do to help feel better and recover faster.

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The Rheumatoid Arthritis and Fatigue Connection: What you should Know

The Rheumatoid Arthritis and Fatigue Connection: What you should Know

I came across a patient who we see for joint pains. This prompted this article to also hopefully reach those with the same condition: Rheumatoid Arthritis. 

Rheumatoid Arthritis or RA: When your immune system attacks your own joints. Individuals with RA know the impact of this affliction on daily living. Waking up with swollen, painful, and stiff joints making even the most menial task of dressing, getting out of bed, tedious. 

When it comes to rheumatoid arthritis, sore fingers, hands, knees, and stiff hips and legs may be the first thing that comes to mind. There are invisible symptoms however that can be just as troubling. About 75% of patients say they experience fatigue, weakness, and insomnia. Restlessness and waking up at night from pain can lead to sleepless nights having one wake up already tired and dreading the day ahead.

Rheumatoid arthritis is a systemic condition that affects the whole body and not just the joints. Left untreated, it can lead to permanent joint damage such as crooked hands and fingers, nodules on the joints of the fingers and wrist making gripping, grasping, lifting painful and difficult. Patients also report this condition heightens stress levels which can even affect relationships due to limited ability to perform tasks of daily living.

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Patients report fatigue which experts believe is caused by antibodies that circulating through the blood and triggers inflammation.

A troubling cycle is triggered where physical discomfort interferes with sleep. Lack of sleep makes daily activities more difficult to bear. Patients report feeling “dense” in the head, sluggish, or drowsy during the day. This often results in fatigue where an individual is less likely to do daily chores and become sedentary. As we know, a sedentary life further causes weakness which ultimately results in poor balance and inability to walk better or far. In a worst-case scenario, this is another major cause of falling in older adults.

 Do not let Rheumatoid Arthritis hold you back, however. There are ways to take care of yourself despite this progressive condition. As I always tell my patients, it is your health. Take charge!

  Learn more about lifestyle changes and medical treatments that can boost your energy.

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Lifestyle Changes

Simple lifestyle changes can make rheumatoid arthritis easier to deal with.

Self-care can help you manage pain, fatigue, and other symptoms:

  1. Regular Exercise. Many dislike exercise. How can you motivate yourself to work out when it’s a struggle just to stand up? Remember that physical training provides long-term relief as you strengthen your muscles, extend your range of motion, and brighten your mood.
A simple walk daily around your neighborhood or simple stretches before getting out of bed can make a difference. Here are a few easy tips you can do easily:
A. Heel and Toe Raises – Hold on to your kitchen counter, dresser, back of the chair, or anywhere to steady yourself. Go up on your toes. Hold this for 5 seconds. Then go on your heels and raise your toes up and hold the same for another 5 seconds. Repeat this move 10 times, or more as you are able. You can do these exercises as many times as you can throughout the day.
B. Seated Marching –Sit towards the edge of a chair with good upright posture. Begin by raising up one arm and the opposite side leg as shown. Lower arm and leg back down and then raise the opposite sides as you alternate back and forth. 

C. Hand Exercises. Hand movements are very important for daily tasks. We use our hands so much in everything we do. With RA or rheumatoid arthritis, if left alone, finger and hand joints can become very stiff especially early morning upon waking up. These hand exercises can help move the fingers of the hands to alleviate stiffness.

Finger Walking (Hand OA/RA Exercise)
Place the hand flat with the fingers spread.  Start by moving the thumb outwards.  Then move each finger towards the thumb, joining the fingers together one at a time.  The palm can come off the table.
There are many more exercises that a Physical Therapist or Occupational Therapist can help you with exercises. Ask your primary physician for a referral to any of these professionals.
(If you want me to send you more of the Rheumatoid exercises by email, message me at:
  1. Healthy eating. Choose foods that have anti-inflammatory effects. Green leafy vegetables such as spinach, collards, kale, etc. Tomatoes, olive oil are also good to have in your diet. Almonds and walnuts are also known to fight joint pain and inflammation. Fatty fish (tuna, salmon, sardines, mackerel). That also includes most fruits like strawberries, blueberries, oranges, cherries, and others. WHAT TO AVOID: Processed meats, sodas, fried foods, refined carbs, and lard.

  2. Stay hydrated. Fatigue is a common sign of dehydration. It’s especially important to drink enough water. (Rule of thumb is 8 x 8 rule,  eight 8-ounce glasses, which equals about 2 liters, or half a gallon a day. This is called the 8×8 rule and is very easy to remember. when you have a condition like rheumatoid arthritis that can worsen such symptoms.                                                                 
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  4. Reorganize your home. Energy can be conserved by making your living space more efficient where you can easily access things when you need them.  These are called energy conservation strategies. By making your home and office more user-friendly and accessible, you are able to do your daily tasks with less exertion. Place items that you use frequently within reach. Get a small cart with wheels for moving supplies from one room to another. You can also use your walker with a seat, or a rolling office chair where items can be placed instead of carried. Be creative and innovative within your home environment.                                                                                👉👉👉  6 Quick Stress Relief Tips With Reflexology

  5. Make time for your ZZZ’s.  Sleeping more may not eliminate fatigue, but it can help. Aim to go to bed and wake up at the same time each day. Keep your bedroom dark and quiet. If you are a music lover, lull yourself to sleep listening to peaceful, meditative type music or instrumentals. Youtube has many collections which can play for hours. If you are the techie type, have Alexa do your music selection. 

Psychological Changes

“Choosing to be positive and having a grateful attitude is going to determine how you’re going to live your life. – Joel Osteen

 ***Your attitude also plays a major role in how rheumatoid arthritis affects your life.***

See how transforming your outlook can boost your energy levels:

  1. Lighten up. Treat yourself with compassion. You may need to cut back on your responsibilities so you can protect your health. Focus on your own abilities instead of trying to keep up with others.

  2. Prepare for setbacks. The road of a person with rheumatoid arthritis is a rollercoaster ride. It is ups and downs. No day is the same as the previous day. Make the most of it. Take it easy on days that you have more pain or fatigue. On good days, make the most of it. Be flexible and accepting of your limitations. Frequent and dramatic fluctuations are typical with rheumatoid arthritis. You’ll probably have easy days and times that are much more challenging. Give yourself permission to rest when you’re feeling under the weather.                                                          👉👉👉4 Easy Tips for Stress Relief   

  3. Avail of support. Even your closest family and friends may find it difficult to understand your fatigue. Look for support groups or online forums where you can meet others who share similar experiences. 

Medical Treatment

 There are new and more effective options for treating rheumatoid arthritis that has been introduced during the past two decades. Consult with and follow your doctor’s recommendations to help you to reduce the inflammation that causes fatigue.

Strategies to Consider

  1. Review and Change your prescription. Definitely have your physician or rheumatologist review your medications. There are now several categories of drugs for rheumatoid arthritis. Discuss the side effects with your doctor and ask about trying a different medication if you experience excessive fatigue.
  2. Increase mobility. Physical therapy can increase your strength and overall fitness. Your doctor may be able to provide a referral, or you can find someone who specializes in rheumatoid arthritis through the American Physical Therapy Association. 
  3. Manage depression. Rheumatoid arthritis doubles your risk for depression. This is a fact. Let your doctor and loved ones know if you need help. Medication and counseling have a high success rate.

 While there is no current cure for rheumatoid arthritis, appropriate self-care and medical treatment can increase the quality of your life. Reduce fatigue so you can feel happier and return to doing the activities you love. Hope this helps! I would love to hear from you!

Write any questions at the comments section below or reach me at primemotionz@gmail.com.

Until the next issue!


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