Getting out the gout

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Several terminal gout patients have recovered after being treated with a combination of western and traditional medicines at the Gout Institute in Ho Chi Minh City

  Nguyen Van Manh, 38, has a tophus in his elbow and a tophus on his left foot that have been reduced by 60 percent after getting treatment at the HCMC Gout Institute for six months

Gout does not receive as much attention as other joint diseases, explains Dr. Nguyen Hong Thu, director of the Ho Chi Minh City Gout Institute.

It is a curable disease but is typically mistreated and can be fatal in extreme cases.

Gout is a metabolic disease caused by high levels of uric acid in the blood, the main symptom of which is recurring bouts of inflammatory arthritis. Chronic and acute gout patients may develop kidney stones and other kidney problems, tophi (monosodium urate crystal deposits in joints), liver problems, lipid disorders, diabetes, hypertension and coronary artery disease.

Most healthcare facilities, both in Vietnam and more developed countries, do not have departments which specialize in the treatment of gout. Most of its sufferers are treated by general physicians, rheumatologists or orothpedists.

Dr. Thu said, "The medicines commonly used to treat gout are still anti-inflammatories, painkillers, waste-discharge medications or those which help reduce the synthesis of uric acid in order to prevent the reappearance of the spasms of gout.

"If the disease is discovered and treated in its early stage and patients adjust their lifestyles, they can keep the disease under control and prevent it from worsening."

Lifestyle is one of the main components which complicate the treatment of gout. Many Vietnamese gout patients, who do not have a balanced diet, depend upon over-the-counter anti-inflammatory medicines and painkillers, which can cause the disease to become chronic, tophi to appear and destroy or disfigure the joints and lead to other health problems, according to Dr. Thu.

Dr. Thu stressed that the long-term abuse of corticoid (Dexamethason), which contains painkillers of an unidentified origin, may cause edema, infection, osteoporosis and kidney failure. Many patients become immune to commonly used medicines due to overuse.

According to Associate Prof. Vu Dinh Hung, chairman of the Ho Chi Minh City Rheumatology Society, the European League Against Rheumatism (EULAR) concluded in June that gout was "the most curable disease," but "the worst treated."

A new approach

Many patients went to the Gout Institute considering it their last resort.

More than 60 percent of the patients at the institute are chronic sufferers and more than 5 percent of them have serious complications, making them likely to die soon unless dramatic steps are taken.

Treating chronic gout patients is difficult without worsening their condition due to unwanted side-effects of some medicines, said Dr. Thu.

The Gout Institute has taken a new approach that combines western and traditional medicines. It employs the strength of western drugs to reduce the gout spasms quickly and the safety and effectiveness of traditional medicines made from herbs.

The Gout Institute studied remedies used by ethnic minority people from northern Vietnam and placed orders with pharmaceutical companies to replicate their herbal medicines in order to treat gout and other related diseases.

To increase the effectiveness of treatment, doctors at the institute call or visit their patients often to give them advice and encourage them to try to follow the physicians' guidance, Dr. Thu explained.

"Many patients have recovered and the institute has stopped treating them, but they still stop by to visit."

Making the miraculous commonplace

The Gout Institute has effectively treated thousands of patients, more than 200 of which were suffering from severe complications and who have now recovered and returned to normal life.

Nguyen Van Manh, who is a primary school teacher in the Mekong Delta province of Hau Giang and has been receiving treatment at the institute for six months, said, he began to feel pain about five years ago.

"At first, it was not serious and I just bought painkillers at pharmacies to treat the acute spasms."

Medical tests showed that Manh was suffering from complications typically associated with gout such as failing kidneys and liver, as well as a lipid disorder which arose from the long-term abuse of painkillers.

"It got worse about two years ago and big tophi began to appear on my feet and on my elbows. Spasms appeared continually and I could not even walk very well. About a year ago, my relatives and I thought I was going to die."

Manh, 38, said several people told him he was probably suffering from gout, so he got on the Internet and found the Gout Institute. Now he said he feels he has recovered 70 percent and the tophi have decreased in size by more than 60 percent.

"I had to pee three to four times a night, but now I don't pee at night. I sleep soundly now. I have started teaching again," he told Vietweek.

Huynh Cong Tam, 57, a motorcycle washer from Tay Ninh Province, suffered from gout for 12 years. He had been to different hospitals and had used different medicines before his family took him to the Gout Institute.

His arms and legs had atrophied and he suffered from anemia due to the weakness of his coronary artery, hypertension and continuous pain, as well as high fevers. He had been relegated to a sickbed for several months and neighbors thought he was going to die.

After more than two months of treatment at the institute, the spasms became fewer and fewer and he began to be able to move his arms and legs better, as well as hold things with his hands again.

After more than five months of treatment, Tam began to recover. His liver and kidneys started to function normally and his weight rose from 42 to 51 kilograms. Soon he began washing motorbikes again.

Tam's wife, Nguyen Kim Hue, said, "Tam's family and friends feel as though he has returned from death. We are so happy. We don't know what to say anymore."

"Now, I've recovered by about 90 percent and I do my job normally; and am taking less medicine," said Tam.

The treatment at the Gout Institute is not particularly inexpensive, but patients say the cost is well worth it, as the cost of treatment reduces dramatically once the healing process has begun.

"When I first came to the Gout Institute, I paid about 3.1 million dong for some medical tests and medicine for the first months. Later, the medicine cost less and less. Now, it is just about one million dong a month. That's not expensive," said patient Nguyen Van Cuong.

"I've gotten better and no longer suffer from unbearable pain.

"More importantly, I feel happy and confident. The doctors at the Gout Institute are very friendly and have taken very good care of me."

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