HTV talk-show: “Gout’s Complication & Treatment”

In recent years, along with the socioeconomic development of the country, the incidence of Gout grows rapidly in Vietnam. However, what we know about Gout is too little.

Especially, we do not know much about its dire consequences to human body. Today, in this talk-show, I would like to introduce you a short video clip about devastation of Gout to human body.

we have already watched some images of Gout patients who have to suffer and live in desperation with diabolic complications caused by Gout. Those are some typical images of thousand of Gout patients who have been at risk of suffering from its complications. To address this situation, today we will have a talk with two scientists of medicine and some Gout patients to exchange information about complications of Gout and its treatment.

Firstly, with respect, we would like to introduce Associate Professor and Doctor Phan Van Cac, the deputy director of Ho Chi Minh City Institute of Gout. Secondly, we would like to introduce Professor and Doctor Hoang Khai Lap, experts of Epidemiology. In addition, with respect, we’d like you to meet some Gout patients who are being treated at Ho Chi Minh City Institute of Gout.

Ladies and Gentlemen, we have a question for Professor and Doctor Hoang Khai Lap

- Nhu Quynh: Professor, Please tell us what are the usual complications of Gout and why do they happen?

- Professor and Doctor Hoang Khai Lap: Usually we see that kidney suffers from Gout’s complication. One important function of kidney is eliminating many unnecessary substances for the body including Urat and Uric acid which are created during the eating process. When these substances increase, our kidney will have to work much leading to renal failure which is the first problem we usually meet. The second problem which is also common is complications in arthrosis. The manifested swell such as Tophi will cause consequences later, that means when swells are too big you will find difficult to travel and finally, you cannot travel anymore. The more serious consequence is that Tophi can be bursted leading to the infection. We have already known that, along with these above complications, a body can suffer from manifestations of other diseases.     

The third complication we can meet is complication in liver such as liver failure and hepatitis.

The forth complication of Gout is always related to dyslipidemia with the increasing tendency.

The forth problem also being found with Gout is the symptom of heart failure.

 The usual causes of Gout complications are as follows:

 Firstly, because of Gout is a chronic disease which happen gradually so people do not go to medical facilities for early treatment. The late treatment always causes complications.

Second cause: during treatment process, patients buy medicine in the market by themselves or through the suggestion of relatives or acquaintances as long as this medicine helps them release paint. Using medicine in this way is not effective and the disease is more serious without the awareness of patients.

The third problem: although patients go for treatment but they do not associate closely with doctor, or while using medicine of a medical facility patients use other drugs according to the suggestion of other people. That also causes complications later.

-          Nhu Quynh: In general, we have already known the common causes and complications of Gout. In particular, what is the situation of Gout’s complication inVietnam? Professor and Doctor Phan Van Cac, can you please tell us about the situation inVietnam?

-          Professor and Doctor Phan Van Cac: We can say that, the situation of Gout in the world is familiar to that in Vietnam. We still do not have a specific statistic figure for Gout. However, through the operation of Institute of Gout in the past nearly 4 years, with more than 20,000 patients, we find that 20% of the patients are suffering from complications with the level from mild to severe.

-          Nhu Quynh: Professor and Doctor Hoang Khai Lap, can you please tell us that currently, in Vietnam and in the world, whether there are treatment methods for Gout patients who suffer from its complication or not?

-          Professor and Doctor Hoang Khai Lap: In fact, the treatment method for Gout patients has appeared for a long time. Firstly, in term of Western medicine, Colchicine is mainly used for Gout treatment. This method is mainly for the treatment of symptoms such as paint relief, reduction of fever, but not for the causes. I think that it’s difficult to have treatment for causes. However, recently, in Ho Chi Minh City Institute of Gout there are some cases of patients who are treated to recover from chronic Gout. I think that this will open a new direction and viewpoint in treatment for chronic Gout patients, especially to patient who suffers from many diseases. And I am sure that during the treatment for those patients, some certain progess can be made. They have certain association and experience in organizing and implementing this problem.

-          Nhu Quynh: Before meeting and learning about the exchange of treatment method presented by Professor and Doctor Phan Van Cac, we will meet some patients first to understand about the complications and how they experience through stages of treatment. Ladies and Gentlemen, this is the image of The, one of patient who seriously suffers from Gout when coming to Ho Chi Minh City Institute of Gout. At the time when you took this photo, do you know what disease you have contracted?  

-          Ms.The: When taking examination, doctor said that I had contracted with arthrosis disease; however, the more I took medicine, the bigger my swell was. So I went to Can Tho for treatment, and the doctor here examined and let me drink Dexa. I took 30 Dexa tablets per day in 3 months and found that my face swelled up and I fell sick immediately. I could not imagine that I was swelled up like that. I could not stretch and bend, because of the swell I could not eat anything.

-          Nhu Quynh: How are you today?

-          Ms. The: The first month drinking the medicine, I felt my hand less painful,  and I was very happy. Now it can stretch and bend. In general, I feel muchstronger. Everytime, after getting off the bus it takes me 30 minutes to come here, but today it takes me only 9 minutes.

-          Nhu Quynh: Lady and Gentlemen. A patient, named Duong Van Hai bearing a serious complication. He has suffered from liver failure, renal failure, being puffed with oedema, water storing. It is more serious than Miss The have ever thought. It has prolonged years, had Tophi clots having been broken along with articulation degeneration, osteomalcia, chest pains, hoop vessel, etc. Many times, Mr Hai said: “I want to die” right? How do you feel now after receiving periods of treatment?

-          Mr Hai: I have treated Gout for more than 2 years. At first, I could not walk, my brother took me to hosptal, then had a blood test. Doctors diagnosed and gave me medicines to drink. After drinking those medicines, I can come to hospital by myself. Now, tophi clots have reduced 70% since I drank those medicines.

-          Nhu Quynh: We have one more patient who have a complication and have been treated at Institute of Gout. He is Nguyen Quang Lieu. Now how are your disease and your health?

-          Nguyen Quang Lieu: I have had arthritis since 2005. But the Gout Hospital had not founded, I only drank pain-killers and went to any place where people told me but it could not be treated totally.

-          Nhu Quynh: So, How long have you treated here and how do you feel about the result?

-          Nguyen Quang Lieu: This month is the fifth month I have treated here. The result is that more than 50% has been reduced. I would like to ask 2 professors. As my situation, after the treatment, whether tophi clots could dissapear totally or not?

-          Professor and Doctor Phan Van Cac: We completely believe that after using the medicines some periods, these clots will dissapear.

-          Nguyen Quang Lieu: If so, this makes me more belief. After treating 5 months in here. Now, every afternoon I can walk about 2 kilometers. And I can eat and sleep well.

 -          Nhu Quynh: With the Gout, the World has known this disease for 2700 years. Of course, we have not found out any effective treatment method. That is a general and big challenge of Vietnam as well as of the World.

-          Professor and Doctor Phan Van Cac: Previous Gout treatment methods were simple; they only focused on resisting inflammation, reducing pains, increasing Acid Uric elimination, controling eating and drinking, limiting it at low level to control recrudesence of pernicious Gout outburst. By this method, we could only treat temporarily symptom of pernicious Gout outburst and some phases in disease mechanism but we ignored so many important factors needed to solve and treat the Gout. After consulting documents of the World, we have drawn a diagram of the Gout. On the basis of this diagram, we don’t treat the Gout according to normal method but we treat totally the Gout and accompanied diseases.

-          Nhu Quynh: With the Gout Hospital’s treatment methods as Professor and Doctor Phan Van Cac has said and with patients’ confidences, Professor Hoang Khai Lap, do you have any comment?

-          Professor and Doctor Hoang Khai Lap: Associate Professor Phan Van Cac has said that Gout Hospital’s treatment method is total. With the method, the treatment is not only applied for the Gout but also applied for other accompanied diseases or complications. I believe that that is a new opinion in treating a chronic disease as the Gout. This is an important opinion in treatment which we need to develop it. We need to support and develop this opinion. The second time going to this Hopital, I found that beside examination and treatment, there is a valuable thing. At the first or the second time, patients will have been propagandized about the Gout. This is what we didn’t do in the past. And today, being listened to patients’ confidences, I feel so wonderful.

-          Nhu Quynh: Ladies and Gentlemen. So far, we have listened to many patients’ confidences. Nhu Quynhh would like to ask again Associate Professor and Doctor Phan Van Cac: “Can you say something with our patients and community?

-          Associate Professor anđ Doctor Phan Van Cac: In treatment, the Gout Hospital has appriciated both two sides. The first is about western medicine, we only select and use some peremptory medicines to kill pain, and to resist the initial inflammation. In total process of treatment, we focus on exploiting best advantages of Vietnam medicinal herbs according to greatly famous physician’s  principle – Buddist priest Tue Tinh,  meaning “Vietnamese medicine treat Vietnamese disease”. Because Gout patients receive non-resident treatment, so we are concerned particularly about controling the treatment. However, with Gout patients, we are also concerned particularly about accompanied diseases, especially a hoop vessel disease. When patients suffer from the Gout and the hoop vessel disease, Gout medicines must be combined appropriately to medicines of the hoop vessel disease, such as: coagulation resisting medicines, platelet aggregation resisting medicines. And our Gout Hospital has carried out, linked and solved effectively the relationships between the Gout and the hoop vessel disease effectively.

-          Although we have catched many patients with serious complications but I would like to introduce other patient who is not at here. We have treated for that patient. He is Le Hong Dan, in Vinh Bao – Hai Phong. He has suffered from the Gout since more than 20 years and now has very serious complications and his complete body’s oedema. Tophi clots have appeared on his total arms, abdoment, thigh and leg part. His hand and foot are 4 weights which he cannot lift. He only lies and thinks his dealth. Previous one month and half, we saw Mr. Dan was completely pessimistic, 3 days ago, I visited and saw him totally different. He could sit himself. Although his hand and foot is too heavy and could not recover, he has a confidence in life and said to us that he has a future and his wife and children are so happy.

-          Nhu Quynh: Ladies and Gentlemen, we have listened much about the Gout but it is difficult to foresee its damage level on human body. Therefore, through patients’ pictures, datas along with scientist statement and patients’ exchanges here. Through this talk-show, we wish that it and the Gout Hopital’s activities in general would have impact on community’s concern on this disease as well as approaching to total treatment which the Gout Hopital is applying and innitially has great success. Ladies and Gentlemen, our talk-show will be ended now. Goodbye, see you again!

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