Gout Busting Out!: Gout Crystals Breaking Though The Skin Of The Big Toe

#gout #dcfootdoctor #toenailfungus #takecareofyourfeet #callus #podiatry #top10 #sheabutter #washingtondc #nailfungus #howto #myfeetarekillingme #feet #ingrowntoenail #doctors #best #dcdoctors #pimple #toenails #kevinhart
A patient with gout for many years comes in with gout crystals (tophi) breaking through the skin of the big toe. His diabetic neuropathy prevents the severe pain that is usually associated with the condition. Gout arthropathy is due to a high level of uric acid in the bloodstream. Over time the uric acid that collects in joints can crystallize, causing an extremely painful inflammatory reaction. As years go by, tophi, a pasty collection of uric acid crystals can form. In this video you will see this formation.
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Kevin E. Jefferson, DPM
Metropolitan Podiatry Associates, PLLC
7603 Georgia Avenue NW, Suite 100
Washington, DC 20012
202-882-9682
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[@lilitheden748]

I’m so sorry for the patient. Diabetes, neuropathy and gout is not a laughing matter. He can’t feel the excruciating pain the gout should be giving this means he also can’t feel any ulcer that can be growing on his big toe. It’s a smart thing he did by coming to see you. Now he can be assured to be healed, if he follows your instructions. I hope he will get better soon. Thanks for this educational case.

[@3peanpod]

I’ve not seen gout like that! Bless his heart. I pray that there’s no infection/bone erosion.

[@brucemarsh1145]

I worked in a laboratory and these gout crystals are like microscopic double pointed needles and it was easy to see why they are so painful!

[@vanessashaw6912]

I am totally fascinated by gout. The fact that such a drastic restrictive life style (bathing... eating and exercising (sweating) is required makes it even more challenging than diabetes. I'm baffled that in the twenty first century there hasn't been more progress in controlling it.

[@AmandaTroutman]

Wow. Diabetes is no joke when it comes to foot health; it can impede effective care. Thank you for caring for this gentleman and for educating us here on youtube!

[@ilonakathyrowbottom3218]

It doesn't happen to diabetics cuz I'm not diabetic n have severe gout due to weight gain after spinal cord injury. Paralyzed from waist down n got gout n that's so painful

[@MrsDauphinee]

Gout and diabetes are two different conditions.

[@sunshinelula28]

@@ilonakathyrowbottom3218 the patient says he has diabetes, and it's in the video description that he has diabetic neuropathy, which is why he hadn't felt pain. it's why the doctor didn't want to make a longer incision- the possibility of infection is greater with diabetics.

[@platinumdiva75]

I grew up on the water and a lot of my family members had gout. My auntie said that the pain was worse than giving birth! Ugh! I feel for this gentleman but man, I love his personality! He is hilarious!

[@Irishguy075]

I can’t believe he’s not in pain, when I get a flare up in that same spot I literally am almost bed ridden. If you squeeze it like you were I would most likely pass out. Glad he’s not in pain but he’s got some other serious things going on. You’re the best Doc.

[@priscillarobinson7740]

You have the best patients Doctor Jefferson. Not only was this gentleman well educated in Gout Crystals but he had a good sense of humor too. It’s good to hear he’s ready to be aggressive in the the treatment of his Gout but also wants to listen to the various options to take care of his foot. It sounds like he and his wife make a great team and together they will make all the right choices when it comes to his Gout 👣

[@fuzzylop9164]

I love that you explain things in simple terms that anyone can understand. 💓

[@sparklepurple24]

I really appreciate the way you take the time to educate your patients. You don't sugarcoat the truth. They need to understand what's happening and you definetly help with that. I enjoy your channel and the variety of patients you show. I am an RN. Your channel is educational and easy for people to understand too! (Whether people know it or not they are learning along the way!)

[@tanyamanna8407]

This doctor has such a calming voice with a caring bedside manner.. his patients are very lucky ☺️

[@Drawkcabi]

As a sufferer of gout flare ups, I've been taking tart cherry extract OTC supplements every day and also if I have them on hand, eat cherries during flare ups. It amazes me how much it has helped since I started this regimen and better for the body than continued daily medicines like allopurinol.

[@1maybeline]

Cherry is great! A glass of water with a quarter teaspoon of baking soda and some line/lemon juice on an empty stomach also helps.

[@markhassan6203]

1maybeline I agree with both of you as I do both.

[@belindamiller7808]

Just started! Glad to know it works.

[@capricer3817]

Hello my husband did both. But he's got so bad he takes the medicine everyday. It's been 8 years since his last flare we all do what's best for us God bless.

[@jannyendsley9877]

Hey Doc! That was a great explanation regarding gout. Just watching you squeeze the tophi out of your patients’s foot made me cringe and also aware of how serious neuropathy of the feet due to diabetes is. He should have been screaming in pain. All I can say is, “WOW!” I love watching you work! Thank you for another great video!

[@basbleupeaunoire]

My father has had gout a couple of times, and he talked about how incredibly painful it is. That this guy walked around with it so long is amazing.

[@jessicahughes4639]

Ah, the Rich Man's disease. Great job Dr. J as usual. Always great to hear your conversations with your patients.

[@iris-nx1wt]

That's what my mom calls it.

[@amazinggrace3207]

I never saw crystals poking out like that before. You do learn something new every day.

[@katherinecalderon50]

Oh my...I am so sorry for this patient. Prayers for healing.

[@couchdetectivesunite]

Doc, you are essential to those patients! Teaching goes such a long way!

[@rd4454]

I love watching your channel. You are so patience and respectful to your patients. You treat them like your best friend and not little children. My God continue to bless and keep you in his Grace.

[@stephaniefields4743]

What a nice patient....And taking the time to teach the patient and answer his questions is refreshing to see I'm a physician these days!

[@rd4454]

I wish I could take my brother and my mom to see you. Your wings are under your scrubs. You give people such respect. You build the end not belittle them. God bless you sir.

[@correjck]

I was hoping for a big squirt of crystals. Oh well, maybe next time. How did his X-ray turn out?? Hoping there’s no bone damage..

[@pamcoleman6502]

My daddy had gout in his big toe. When he first got his attack he was in horrific pain. My daddy had a high pain tolerance, but that pain took him down. Once he was on the right medication which he took religiously, he never had another attack.

[@aqualibra961]

I've always wanted to learn more about gout. I've got several family members that have endured the severe pains issues related to gout. Thank you Dr. Jefferson for providing this case. Very interesting and informative. :)

[@joykiser6673]

Amazing. I never knew it could break through the skin.

[@kathrynphillips5206]

I’ve watched other practitioners miss some of the cues that you seem to pick up on naturally... especially the stomach upset part. A lot of people have a hard time discussing their gi even with their doctors. Thoroughly enjoyed this video.

[@cubbi2789]

Does gout get worse as you age as well besides diet? I do hope that this patient gets help with both diet and his gout

[@pants6416]

I got the stupidest thing running through my head just now. You know the song 'Shout' by Tears for Fears? Gout Gout Let it all out These are the things I can do without Come on I'm talking to you Come on

[@joylumley6858]

🤣😂🤣😂🤣😂

[@gwendalyntaggart2242]

Awesome 😂😂😂

[@rachelbrad6436]

LMAO😂😂😂

[@pinklady4772]

😂😂 good one

[@halloween482]

Hahahahaha that's hilarious

[@sandrapass4787]

Dr.Jefferson, you are always so concerned about your patients. Even when the situation looks crucial you always make them feel at ease and give them hope and comfort. Thank you Dr. Again I will say, "we need you here in Gadsden, Al."------Thank you.

[@oldstuffbethtx8052]

Interesting. Never knew gout could break through the skin.

[@TheGrungy1]

I learned it could about 4 days ago. Now this. Yuck

[@melissabrown8594]

Henry VIII had terrible gout. Seeing this, I can imagine how hard it would have been to keep it clean, let alone hygienic. Apparently one leg was wrapped from knee down, and the smell notably horrendous. So if physicians tried to ‘bleed’ his leg, that wouldn’t have really cleaned the crystals out. And the care of surface skin back then, wouldn’t even be half of today. I understand why it was described as covered in pustules and rotting.

[@jewellerylove]

@@melissabrown8594 Henry VIII had an accident as a young man whilst on horseback. I believe it was whilst he was out hunting, and he received a bad injury to his leg. It was this open wound that would never heal and caused regular bouts of the infection to flare up to the point where his doctors thought he might die. This unhealed open wound weakened him significantly and he was never the same man again. He suffered constant pain, and an oozing infection that never fully went away. This was also rather off-putting for the women in his life who were repulsed by the smell and sight of the wound, but couldn’t say anything for fear of offending the King. You’re right that he also suffered badly with gout in his later years. This was thought to be a result of the very rich diet he enjoyed and his very large appetite, but I don’t think it was the cause of his wound which never healed.

[@roseprince7842]

Does drinking water flush out uric acid?

[@judywalker2849]

Drinking cherry juice by R.W. Knudson helps too.

[@leeannjohnson1808]

@@judywalker2849 I've bought that for my 84 year old sister in law, she swears by it.

[@kimwhitehead9096]

Theoretically yes...but most kidney stones are also due to high Uric acid. Water is key. But genetics are also at play.

[@conniecrawford6429]

That was really interesting. Doctor, if you don't mind. What causes uric acids? Great video. Thank you for sharing. I always like your videos. Take care and God bless you and your loved ones...

[@sharonbeckett721]

Obviously I have heard of gout but I have never seen it burst out like that! Will you be filming the next appointment with this man to show us how he is doing please.

[@pfadiva]

Ouch! That hurts me just to see it. Good thing he came to see you.

[@jdiscovered6686]

Love the "water mark" great video

[@hestiaa9354]

Gout and Diabetes is a very bad combination. Add neuropathy, and it’s absolutely critical that you are vigilant about managing your diabetes, avoiding foods that can cause a gout flare up, taking your gout medication and checking your feet. I would be very scared.

[@mollyhudson161]

Hestia A -- u giv good info for gout/ diabetes/ neuropathy for peopl who dont kno the importance of diligent careI have all 3.

[@vanessahinds8320]

EXACTLY!!! My Step Dad is in the hospital now with diabetes, neuropathy and gangrene in his big toe. They are amputating it on Monday Morning unless it gets worse. It would help if he would listen to his Doctors and Me!!!! And Mom when she has to get on to him for doing stupid stuff!!!!!

[@offduty170]

THAT was super interesting. I’ve never seen that before. Thanks so much for sharing - I really enjoy your channel !!!

[@frenchtoast7742]

Love this Dr . Love how he makes his patients comfortable. 🙏🥰

[@col.231]

I had this years ago (am on tablets for it now) the pain was crazy. I had to have a kidney removed so, maybe having only one kidney caused the back up of urea acid. Could you show more on Gout because I am getting a showing of Topei only this week. Still on tablets? Thank you.

[@agoddessadiva]

Wow, I've heard of gout but have never seen it until today. I hope everything turns out okay for this gentleman.

[@lkrachal5120]

He sounds like he is a very nice and pleasant person to have as patient.😊

[@Hope2seeU]

Never clicked so fast, and the patient is hilarious. Lol

[@janieloujohnson4015]

Does eating cherries and drinking water help prevent gout?

[@pooddescrewch8718]

Does gout ecver cause auto-amputation due to erosion of joint surface and blood vessels ?

[@iaintnobody9694]

Gout! Gout! Squeeze it all out These are the crystals that make me shout! C'mon! I'm screaming at you! C'mon! --Tophi for Toe I

[@irisadams7639]

Once uric acid has built up to the point of breaking through the skin, can that lead to liver or kidney damage or is it strictly a joint problem?

[@cheriajohnson]

I literally just said..out loud.."😳 GOUT!! I love gout!!" Why am I like this?! 😂😂

[@jennilang721]

I cry, you cry, we all cry, for TOPHI!!!😊 Whenever my father-in-law would come stay w us for a visit, he would always say that my rich cooking was gking to give him the gout, lmao!!! He was a WII vet, and any sore, lump, or minor irritation, was always becayse "you gave me the gout!!!".😄😄😄

[@siobhanoliver3767]

My dad had gout in his toe and said it was the most painful thing he’s ever experienced and he had every manner of werido ailments lol grate video thanks for the uploaded

[@ercly9382]

Your dad is telling the truth. It is like a knife in the joint. No pain relief no matter what you do. When in full flare up, it is more painful than kidney stones passing.

[@Phatarse]

Can we get a "DC Foot Docter's Foot Reveal" at 100k subs?

[@pattysdaughter5639]

So true!

[@pambaars7685]

Wow I’ve never seen gout crystals before. Omg poor man.

[@brandynicholson1499]

Could your patient use a waterproof barrier like Tagaderm to put over the open area and shower?

[@MrRetepyesmar]

I have similar symptoms neurophy in the feet with nerve degeneration in ankles and feet. Boy are those gout attacks painful! They are caused by crystal accumulation. I am hart patient suffering HOCM and taking medicine for this.which is under conttol. I dont smoke or frink controldrink any alcohol, i dont smoke at all

[@belindamiller7808]

You are so wonderful with your patients. Have learned a lot from you.

[@anna-lisagirling7424]

I have a friend who has gout and years ago he and his wife bought an old house in Vancouver, BC for a small fortune and ambitiously began to fix it up themselves. He dropped a screwdriver on his big toe (wearing flip-flops that day) and he nearly passed out! This man survived many years in refugee and POW camps during the Viet Nam war and was one tough fellow. I learned about gout when he told me about that!

[@jodierichardson7986]

WOW! I've never seen tophi coming through ones skin! That looks so painful! Diabetic neuropathy is never good but this guy doesn't know how painful this would be if he didn't have it! It almost hurts to watch! Great video though! I hope you taped his follow-up appointment if you had to cut it! BTW AREN'T THERE CERTAIN FOODS THAT AGGRAVATE this condition?

[@lauraclay8006]

This poor man has to be in SEVERE pain! I’ve had gout before. It’s no joke. This man is in my prayers poor guy.

[@zoeelauren4649]

Thank you dr. That was very informative!

[@traceybeerling4776]

Bless this patient and you Doc xxxx

[@courtneymore4315]

Are the crystals hard or soft ?

[@smrttgrl]

Omg, I can't imagine how painful this should be. My husband has got and didnt imagine this would be a thing. I'll watch it

[@stephaniehall2552]

Small blessings he can't feel the pain ,would be severe

[@twanany]

He said get it all out. 😂😂😂😂 I'm like yes, get it out. I can't stop watching 😰😰

[@Yepthatsme0038]

Ouch! This poor guy must be in soooo much pain. Thanks doctor for educating me! Knowledge is power!

[@miriamgonzalezsiegel6478]

The human body never stops surprising me.

[@chriskee6919]

Can these form between the toes as well?

[@vtriplej8334]

My husband had that nasty medication for uric acid and oh my it messed his stomach up... he is taking 3 lopramide every single day some days more...but it was kidney stones all the time it's no joke!! This poor fella with gout and diabetes wow...you are so very passionate with your patients your so lovely bless you xoxox need more doctors in the world like you 😉😍💯

[@aia1229]

Oh my. So glad he had you to help him.

[@loumorrell61]

Great job Dr. Jefferson👏👏

[@jeffcarroll1990shock]

I can honestly say I have never seen this happen before Dr. Jefferson.

[@annbebbington952]

My husband suffered with gout for years, before being put on preventive medication, there was no way on this earth, that you’d get anywhere near his toe.😱

[@jessicasance2357]

Did he say “I don’t do sweaty”? That was so cute!

[@onyx1864]

you inspire me and i’m glad that i found your account

[@greggorsantonio4542]

How does one alliviate gout from the body?

[@duvalledwards8977]

Hey doc cherry tart juice is tremendous for gout

[@jasonwickens0813]

DC Foot Doc. Outstanding Dr. One can tell he has compassion and a caring demeanor. Dr. are hard to come by now days who truly care and want to help. NOT about what insurance demands from the Doctors these days. Let a Doctor be a doctor.

[@laracroft1063]

Omg...how is that not hurting him?! Like doc said gout is excruciating!!!! I had a flare and took Allopurinol for it (30 days) and didn’t add it to my daily regimen UNTIL my second flare and that sent me to the ER, that one was worse than the first, because it was in my ankle instead of my toe. When it’s in your toe (at least for me) I could at least put pressure on my heel to walk, but that ankle isn’t no joke, I couldn’t even bend my ankle. You better believe that Allopurinol is apart of my daily regimen now.

[@juliahaynie2910]

That looks so painful. I can’t believe that it isn’t hurting him.

[@ilonakathyrowbottom3218]

Its frozen but don't show it

[@Shawn-ho6de]

I think it is because he has neuropathy and can't feel his toes....man...this video is a good wakeup call for me.

[@kimwhitehead9096]

ilona kathy rowbottom No way that stuff would even ease this pain. He has diabetic neuropathy. He literally is not feeling one of the most painful conditions known to man.

[@Bettina8987]

Excellent work doctor

[@EllBeeCUSoon]

Well, here I am at 1240am CST, catching another awesome video from Dr. Jefferson! I’m learning something new 🙂.

[@jasoncreamer5747]

How come he was not feeling any pain?

[@lin8148]

I take gout med every day but have had crystals begin to come to the surface of my toe. It's REALLY horrible painful.

[@AliMacDonald1]

Wowzers! I can’t believe he couldn’t feel that! He must have some serious neuropathy going on. Hope it heals ok.

[@SixtyOne-es6tj]

WOW Great Video! I and my husband are Diabetic, along with my youngest son who is 34 years old, I'm 64 years old, and my husband is 61years old. Both my husband and son have episodes of Gout, and when they do the conversation goes like this.... Me: What's wrong why are you limping? Husband: Nothing is wrong. Son: I don't have anything wrong. Me: Really, I think your Gout is back. They just look at me and say nothing, because they both know what's coming their way. I actually go and look to see if the Gout medication has been taken, be it at my house or my son's house. His wife will always rat him out to me. They will hear from me and now my son's wife: 'If you took your Gout medication like you are supposed to you would not get sever attacks, but you don't so all I have to say is you did it to yourself, no pity party for you! I am not heartless I will be the one who reminds them to take the medication, and if it is a open wound, I am the one who puts the dressings on, makes sure they make it to the doctor, and to the follow ups. I do it coz I love them. Now I am going to show them this video and maybe they will get a clue!

[@mollyhudson161]

Very interestg to WATCH but AUDIO not good. Iv had gout attacks so this is helpf but i ddnt kno crystals could break thru skin.

[@bbuunnyycc]

Thank you.

[@Chromia1]

You can't use a vacuum type thing to remove them in the office?

[@sabratierney2193]

Why scrape it instead of cutting in and removing all of it?

[@jacobsladderpa]

I’m late to the party but glad to be here. Hello Dr Jefferson! I fear some binge watching is about to happen.

[@aeonfluxcapacitor77]

I know it's wrong, but when my mom was alive and she asked me to do something or go somewhere I didn't really really want to, I'd say - it'll give me THE gout, Ma! To which she'd say - you're not helping Sarah. And to close it out I'd say - I won't tryin to help! Ahhh I dunno which was worse, won't or it'll give me THE gout. On it serious note, do pain meds work for this?

[@hoodoo.hillbilly]

Hell no, I have had flare ups where these little blisters come up and next thing you know gout crystals are pouring out, there is no pain medication that can even come close to touching the pain! I was on the verge of getting in a bath of warm salt water and cutting my off with a pair of pruning sheers!

[@heatheremar]

Wow! That was interesting! Would be interested in seeing the x-ray.

[@mindyvaughn8217]

Is a curette too large for this job?

[@lorij6796]

Good job D C Doctor 👏 👍 👌 🙌

[@cynthiaWalker5226]

WoW! I have never seen that before! Glad he got to the Doc before it got worse!

[@deniseatkins9407]

Wow my brother had gout and the crystals developed as kidney stones which he has had removed. He is on medication for life. His was caused by drinking too much cheap coke

[@dewdlee]

Google fructose gout, and decide if it's worth sharing to your brother. Bless you both!

[@kimwhitehead9096]

Gout is all about Uric acid. It isn’t cheap coke. It’s his body’s metabolism. It’s pure science. The Uric acid needs to be less than 6 to keep crystals from forming. It has nothing to do with diet. That’s why he takes daily meds. The diet thing has been proven false.

[@jacquelinejackson1358]

Hopefully he doesn't drink alcohol because that can really make it worse. My Uncle had it and it was extremely painful. The doctor would touch his knee and he would scream! I love the information that you give your patient! Thanks for the great video!

[@ginnycross6840]

Nice thumb shots, Doc!

[@wanttruth3876]

I'm learning that there's more to your profession than the obvious. Wow, I didn't know as much about Gout before this video. It's a learning experience. Thanks.

[@ForbiddenFruitToS]

Can blister under the nail cause ingrown hair and fungus bacteria growth from ulcer or fissure that is unseen.. in stead of pulling of nail or shaving it down can the virus be cleaned out from corner of nails like callus see you tube channel podogical integrel

[@margieb9502]

So happy to see your video Dr. Jefferson! I can’t sleep. ❤️ Very interesting! ❤️

[@chippyl3331]

Wow, gout, diabetes, and neuropathy, that's a bad combo! I hope this gentleman has some help at home, or wherever he lives taking care of it all! I am a CNA and work in an assisted living/retirement facility and have cared for people with diabetes and neuropathy, but thankfully haven't seen any gout. Can't imagine how painful this is. I hope his scans came out okay and there is no bone damage.