by Henry Tham
(Silver Spring, Md)


Hello Joshua,

I think you are a "terribly" good man! I just had this "terrifying compulsion" to blurt an urge. Enough with my spurt.

I am a recent retiree enjoying my senescent 67 years doing "eat, sleep, and play pool" three hours daily, five days a week. Of two months late, my left wrist started to hurt sporadically. I wondered if it was my gout extending geography. I postulated, could it be from playing pool with my left hand forming a robust, stable bridge repeatedly with my thumb pressing firm on my fore finger? My most recent attack, today, is debilitating. There is also a hint of a swell. I took a Bayer NSAID 325mg and there certainly was a measure of comfort, alas, as you say, only temporary. Prospect promised daunting days ... I cannot be ingesting NSAID on a regular basis ...it's bad for my health ... what with incipient renal artery stenosis.

I read about your "Ice Pack" and will follow advice. I did not think an unstrenuous manipulation of the fingers for a "pool bridge" could collapse a good hand. Can you explicate?

Thanking my good man Joshua,



Joshua Answers:

Hi Henry.

Yeah, Anti-inflammatory drugs like Ibuprofen are fine to get you through the day, but definitely not a long term tendonitis relief solution.

And don't blame the pool bridge, it's more than just playing pool or any one specific movement. Your Tendonitis dynamic has been in the works for years and decades. For whatever reason, you'be just started to feel it now.

See: What Is Tendonitis

If you have gout etc, then that's a big clue for nutritional and system issues.

With your heart issues you may definitely want to check out 'The Great Cholesterol Lie' found on this page: http://www.side-effects-site.com/statin-drugs-muscle-weakness.html (opens a new page)

You said you checked out my 'ice pack'. I'd be far more interested in you checking out the ice dipping as described on the How To Reduce Inflammation page.

Also, stop ALL gluten intake for 2 months.

Also, see: Magnesium For Magnesium For Tendonitis

It sounds like you went from 'no wrist pain' to 'debilitating wrist pain' in a span of two months. That's not abnormal. Your body kept it at bay as long as it could, but then it started losing the battle, and when that happens, the mechanism showballs.

It's not that things went from fine to bad all of a sudden, it's that things were already 'bad', you just weren't feeling any pain. And then your body delivered the pain messages to your conscious brain, and the pain mechanism kicked in.

Along those lines, make sure to understand the Pain Causing Dynamic


1. Have you ever had any wrist/forearm/hand pain issues before?

2. Hand or wrist injury?

3. Say more about the gout.

4. What's a normal day in your diet look like?

5. Anything else interesting.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.

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Feb 09, 2013
Gout in Guise
by: Henry Tham

Hello Joshua,

Thank you very much for your reply. To ad rem your queries, I have not had previous injury or pain on my wrists. My gout on my feet has been with me for over ten years; on attacks, the pain is comfortably manageable with Indomethacin. My doctor says the gout will be with me always (?). He now refuses to prescribe for me Indomethacin because of my unfledged renal stenosis -- i.e. my kidney is not happy with me. (What am I doing wrong?) (I miscommunicated in my initial letter when I wrote "renal artery stenosis.)

I now take Colchicine only on a needed basis as was with Indomethacin. I dread ingesting regular dosage of the medicine, because prudence and common sense suggest temperance from (any) drug. I have taken liberty with the prescribed dosage despite the caution label, but favoredly, I have deferred no ill effects.

My gout attacks are not as painful and frequent as was several (6) years back. My most recent "painful" attack was about six months prior when I felt an urgent need to take a tablet a day for two days. Other days, my foot (only one foot, left or right) twitch in response to the acid crystallization and I take a tablet. These "baby" episodes prompt me to trumpet a triumphant tune (compared to years past).

Rice is staple daily diet with roughly 50% meat (chicken, fish, pork, shrimp, beef), 50% miscellaneous vegetables. Very low sodium intake because of my hypertension, which incidentally, is in control because of medications. My blood pressure readings have been in the 120/80 plus, minus (mostly minus) range for two years. My doctor dissents when I suggested to reduce my intake of medications.

On a diabetic note, it's been four years since I 've stopped taking Actos with my doctor's tacit countenance; my triglyceride is 148 vs. < 150 MG/DL. The shivering of torso and going weak all over, a symptom of Type 2 Diabetes, has not visited me since. Once in a while (a month), I indulge in a beer or two or three, every morning an egg or two for a week. I am aware my my gout will not tolerate too much protein nor the purine in the beer.

On the note of interest, when my wrist tendonitis was swollen, I tried dipping in ice the whole evening and then some in the morning. The swell did not wax nor wane, but the constant pain was unbearable and depressing. I relented a visit to my physician and he prescribed for me hydrocodone and prednisone which brought relieve as long as the medicines lasted. Some analgesic oil squelch the nagging pain until such time a second visit to the doctor was sine qua non. He referred me to an orthopaedist in favor of a more thorough analysis of my condition and maybe a cortisone shot for long-term relief.

Continued ...

Feb 09, 2013
Gout in Guise part 2
by: Henry Tham

Page 2

And lo, the specialist said it was my gout claiming new territory. After some consultation, he did give me a cortisone shot, assuring me the injection would not be painful. He was right -- skillful! I suspected, from previous acquaintance, the cortisone shot would not purge the pain; and so the pain brooded around my wrist. Two days in, my pain did start to subside ever, ever so gradually until today I have regained complete wringing-a-wet-towel-"dry" power. Vestigial pain sensations brush my wrist in staccato runs. I can live with that, can I!

On your advice of two months sans gluten intake I could not have hoped to succeed such a regimen. My learning on this nutritional segment is a pair of I's: ignorant and immature. Provisionally, I beheld the road I was about to travel, alas, I shuddered and heaved and faltered when I looked straight the boulevard. In retract, I am the wiser gluten will a flame a flare.

Again, on your advice, I am taking 250 mg (sometimes 500 mg) of magnesium a day. Just before you emailed me, my lower legs, at night, ran rife with cramps. Serendipitous timing indeed. Although the spasms seem enervated, occasionally at odd hours in night a twinge come. I understand my constitution might need to shore up on the element before unmitigated efficacy prevail.

Thank you for your tendonitis emails. It was especially painful to read Geraldean's I Had Endoscopic-Bi-Lateral Plantar Fasciitis Surgery Nightmare agonizing, heartbreaking episode with Plantar Fasciitis. I wonder if it would help anyone if I relate my one year reclamation of the use of both my plantar fasciae.

In 2004, getting out of bed one morning, I was stricken with fright when a piercing pain spiked the heel of my foot. In days to come, the affliction from one foot progressed to two. Now, I'm a walking puppet caricature. Fortunately, one foot was more manageable than the other. I tried several kinds of generic orthotic devices, but it was pro tempore.

My doctor ordered x-ray (no spur) and referred me to a podiatrist, where upon he injected corticosteroid on one foot and gave me an instruction sheet for stretching exercise for the lower leg and heel. My God, what on earth was that infusion to the heel of my foot. It hurts the devil -- I yelped!

Before my second visit I rummaged information on foot problems and ordered a night splint through the net for $60. As well, since the foot doctor on the second visit solicited me for a generic, bulky looking splint for $200. I certainly was fortuitous. Lamentably, the night splint accorded the least of benefit, but a continual and continuous awareness of stretched muscles and uneasiness. Less I not mention, the second injection to the other foot also did not significantly mitigate the pain.

Continued ...

Feb 09, 2013
Gout in Guise part 3
by: Henry Tham

Page 3

The exercise sheet from the podiatrist looked unprofessional with untidy hand drawings and notes, a motion in passing, I would as soon let lay wayside. Dishearten at my condition, why not avail and give it a go! With arms outstretched on window sill supporting a bending body at about 45 degrees, I started to throw my stretched legs and lower body forward in a rhythmic go: throw ... recoil ... throw ... recoil. A side view in right angle triangle, the floor and the wall (window) a right angle, your body the hypotenuse distend ... straighten ... distend ... straighten. The exercise pull taut the calves' muscles and the heels' fasciae, giving it a strengthening workout and fostering resiliency. I did this for about half an hour total, spacing equal time impelling both legs forward; one leg stepped forward with knee bent, and thrusting forward the other outstretched leg giving the bent leg a breather; then switch leg. During and after my first workout, although my lower legs ached somewhat, there was a perceptible vigor flooding a recent dull sinews. This perked my spirit. Somewhere in my addled brain I began to sense an inchoate merit to the process. I did this for about a year and then I stopped. The interim and absence of foot pain were "so long ago," one day, I suddenly realized my heels do not hurt. A little caution, you know your own body's pain threshold, as with all exercises, start out slow and rev apropos. Incidentally, I do not wear shoes with stiff leather soles or upper anymore.


Henry Tham


Joshua Comments:

Hi Henry.

1. As long as you have functioning kidneys, magnesium is ok. Your body may (certainly) be needing more than 500mg/day (anything other than Magnesium Oxide).

2. Exercise is a great thing for the body, absolutely.

3. If you're diabetic, why in the world are you eating rice? Only meat, fat, and vegetables for you, good sir!

That whole gout/protein thing isn't the whole truth. It's less about the protein/meat and more about the OTHER things you're eating. Try meat/fat/vegetables only for a while and see what happens.

4. I sympathise with you about your doctor. Doesn't sound like he knows a thing about medicine.

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