Why did none of my grandfather's doctors think of this?

Why did none of my grandfather's doctors think of this?My grandfather has gout, and starting about ten years ago, symptoms that caused him to miss entire nights of sleep. He has been to see eleven different doctors in three different states, eight of whom were specialists either in elderly health or sleep disorders. He was- over and over again- diagnosed with restless leg syndrome, and put on medications to help treat it. When the medications started causing side effects of their own, he was put on more meds to control the symptoms of his primary medications. Enter Google. Since he didn't seem to be having any long-term relief (at most, he got two or three hours of sleep a night, and was always exhausted), I looked up some of his symptoms, and they seemed to square more with gout that RLS. I checked my grandpa's joints on his toes, fingers, knees, and elbows (all the places where he couldn't stand being covered with a blanket), and he had the telltale uric acid swelling. I brought this to my Mom's attention, and she made an appointment with a rheumatologist for him. The rheumatologist first said, too, that he had RLS, and when my Mom brought up the possibility of MSU, said that, yes, all of his symptoms (spasmodically kicking at a blankets/sheets covering his feet and knees was the biggy) could be attributed to gout as well as RLS. They tried Probenecid, and my grandfather's symptoms decreased significantly over the next two weeks. He's been sleeping regularly for at least five hours since. I'm really pretty upset that none of his prior physicians, or even the rheumatologist, thought to connect the rather obvious symptoms of gout elsewhere on his body to his sleeping patterns, and prescribed him medications that did only minimal good, and caused- on the other hand- severe hallucinations and anxiety.

Liam
Most of the doctors just want to finish the day, instead of actually think.
Being a doctor is a hard job, and most of them are tired all day long and just want some sleep...diagnose by the book, the faster you get to sleep.
There's no other reason than that...

Pangolin
Gosh. Maybe they're human, and not perfect?

UNCOLA
His presentation is not typical. I also seems he may not have been communicating his symptoms well. I am not trying to place blame, but it is very hard to make a diagnosis without a full and accurate history.

swordfish
first off, let me say GOOD FOR YOU for pointing out the signs of gout to his doctor. in this day and age, you must become an advocate for yourself and your family. and the way to do that is to educate yourself, which you obviously have done. bravo.
what people don't realize about the medical field, and yes, this is STUPID, is that you have to rule out everything it could be before making a diagnosis, and that the simplest answer is almost always the correct one. it cuts costs for unnecessary testing. but there is still no excuse for your grandfather to continuously get diagnosed with the same problem with the same treatment that hasn't worked. doctors as a rule don't really talk to each other. their communication is done by forwarding charts.
your grandfather finally getting relief is 100% because of you, and because your mother actually said it to the rheumatologist instead of just blindly following instructions. you must MUST MUST educate yourself when it comes to medicine. and SAY SOMETHING. say it loud, don't quit until someone listens. they want you happy and to get the hell out of the office, trust me, nobody wants to go to court because a patient was unhappy with care and sued. the patients who are the most verbal get the best treatment. fact.

greydoc6
You didn't say whether any of the doctors checked your grandfather's uric acid level, a key indicator of gout. It is not screened in many standard comprehensive metabolic panels. It is understandable, but not very excusable, that a sleep disorders specialist was too narrowly focused to consider other conditions.

Doctors are human. Sometimes an atypical symptom leads us down the wrong path. Good that your grandfather had you as an advocate.

Add your own answer in the comments! Gout - information, symptoms and treatments. Googout.info health information factsheet - advice on gout and its symptoms, causes and treatment, plus prevention through diet.

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