Things seem like they're about to get bad

[trophy33]

No I also have gout, that'd make things worse
and last time I tried fasting, it caused a flareup.

Diet I don't think is going to help me here much, I already adhere to a low purine diet, and avoid sugar and artificial sweeteners, just avoiding things I know will start a gout flareup, but the psoriasis, that's its own beast where my own body hates itself. I think this most recent flareup may have been triggered by covid.

But this is just a lot of "coincidence" of losing medications that I used to control it, and delaying any medical intervention so I just have to suffer the disease. I don't know what God is doing but it's making me more bitter. Chronic pain doesn't build up it tears down.

The lion diet (just beef, water, salt) is for anti-inflammatory purpose. Similarly with fasting - ketones are anti-inflammatory.

Never blame God for anything. Blame it on American Standard Diet, alcohol and medication, damaging your metabolic health for decades.

 

[Jamdoc]

The lion diet (just beef, water, salt) is for anti-inflammatory purpose. Similarly with fasting - ketones are anti-inflammatory.

Never blame God for anything. Blame it on American Standard Diet, alcohol and medication, damaging your metabolic health for decades.

red meat is high purines and usually triggers gout flareups within the time it takes to digest.
I don't drink alcohol.
I haven't drank more than 1 alcoholic drink in a year in.. 15 years, and last drink I had was.. 3 years ago? Just a shot of lemoncello that my uncle made just to taste it.

and the reason I point to God is all the "coincidences" of multiple medications being taken away due to circumstances within a short period of time, combined with "coincidence" of getting Covid right before a Rheumatologist appointment that made me reschedule about 2 months later.
All that happening at the same time is not something human caused or controlled, but God sovereignly causing, or allowing, these things to happen from non human agents. Think Job.
and yes, Job did also point to God as the source of his calamities and Job similarly did not know what God was doing with it.

It would be a slight on God's own sovereignty to claim that God had nothing to do with this.

as for the second video though, I mainly eat pork and chicken. It's the only 2 things that don't directly cause a flareup,
if I eat a steak, I'm probably going to have a flareup unless I'm totally clear for a few weeks it's the one "cheat" I can do on my diet to have a steak, have some roast beef, something like that,
sugar intake is 1 tablespoon per 12oz glass of cold brew coffee, so two times a day and before I dropped my medication I hadn't actually had a solid gout flare in over a year, I got some "warnings" that were usually connected to something like not getting enough sleep or stress - which is usually psoriasis rather than gout. Psoriasis is always accompanied by rashes or lesions on the skin, gout is almost always the same night as a triggering food gets eaten, but sometimes it might take multiple "doses". For example if I drink orange juice 4 days in a row 1 glass a day, I will get a flare. The same thing if I drink soda (so I cut it out), even diet soda, or use one of those like ensure drinks or something where it's using an artificial sweetener.

average for me is I'll eat bacon or pork sausage and eggs for breakfast 2 glasses of cold brew coffee with about 1oz of 4% milk and 1 tbsp of sugar per glass, Lunch I usually skip or I'll just have a slice or two of ham lunchmeat, no bread or anything like that. Dinner I might have pasta or a potato or rice or corn, so my only real source of carbs, and 95% of the time it's either something with pork or chicken.
Turkey, fish, beans or legumes are almost instantaneous flares, like I'll feel it that very night.
Beef, is a rare thing I have to be careful about it but I can handle it maybe once every 10 days if I'm totally clear.
no deserts, maybe once a week I might have popcorn for a snack so my only other source of carbs just plain popcorn.

When I was on my medication and in a medical cannabis state? I could go years mostly in remission.
But since I left? it's been walking on a razor's edge no beef at all.
and since I got covid? constant psoriasis flare.

 

[Gidgx]

Try to eat only organic fatty red meat (beef), just boiled in salted water. Nothing else and drink only water. If you cannot find fatty beef, add ghee or butter to it. It takes several weeks for your body to slowly heal, sometimes months, so its not a diet for just few days, its a long term diet.

It helps many people. In addition, you can also try some fasting for a day or two, once a month.

Changing your diet in the beginning stages will help slow down the disease . Problem is that most people don't get diagnosed until later on. By than the damage has already been done.
When I finally saw a rheumatologist the xray revealed alot of damage. It was only a matter of time before my hands and feet started to deform.
Being put on medication now is to stop serious complications like organ damage.

 

[Jamdoc]

Changing your diet in the beginning stages will help slow down the disease . Problem is that most people don't get diagnosed until later on. By than the damage has already been done.
When I finally saw a rheumatologist the xray revealed alot of damage. It was only a matter of time before my hands and feet started to deform.
Being put on medication now is to stop serious complications like organ damage.

yeah.. in my case I have bone spurs in my feet, knees, elbows and shoulders that xrays have revealed and like I said the toe is so deformed with a fusing joint that they are going to have to remove it. I didn't get diagnosed with gout until 26 but had been having attacks since I was 18 (basically after the first time I drank beer), and the gout attacks were getting worse and worse and Doctors couldn't figure it out until I went to a Rheumatologist who found that Psoriasis was also involved and the 2 conditions were feeding off of each other.

 

[Gidgx]

With gout, changing your diet will help. Getting your uric acid levels down will help. It will lower the chances of getting another flare.
As for me, I have rheumatoid arthritis and Hashimoto Thydritis. So diet does help a lot. Fortunately,for me medication does help with the rest.

 

[Jamdoc]

With gout, changing your diet will help. Getting your uric acid levels down will help. It will lower the chances of getting another flare.
As for me, I have rheumatoid arthritis and Hashimoto Thydritis. So diet does help a lot. Fortunately,for me medication does help with the rest.

yeah this current flare isn't gout it's psoriatic arthritis. I just brought up gout because the other poster said to eat beef, I was just clarifying for him that'd be a bad idea, it'd make it worse. Like okay great for that one youtube video the guy could eat red meat and not have flareups but I know for me, if I eat beef twice in a week, I'm going to regret it for weeks after.

The psoriatic arthritis triggers are a lot harder to identify and that's why I'm thinking covid might have been the trigger this time but I can't be 100% sure.

 

[Gidgx]

Yeah it's possible with covid. Lots of people who had it are now being diagnosed with an auto immune diseases.

As for my diet, don't seem to have any problems with meat in general. Mostly processed food and fried foods seem to be problematic for me.

 

[trophy33]

Changing your diet in the beginning stages will help slow down the disease . Problem is that most people don't get diagnosed until later on. By than the damage has already been done.
When I finally saw a rheumatologist the xray revealed alot of damage. It was only a matter of time before my hands and feet started to deform.
Being put on medication now is to stop serious complications like organ damage.

Yes, unfortunately, we people commonly wait with the proper human diet and lifestyle till its "late" (its never late to live well, but it may not solve as many issues as taken early, because, as you say, the damage is already done). However, damage can be frequently undone, body has amazing healing abilities, if fed and treated properly.

As the doctor in the first video pointed out, its not just one problem like gout people have, their metabolism is having problems also in other areas. We must immediately study any health issue we have, experiment, fix our lifestyle after the first problem, first pains, first low energy, first higher weight, first bad sleep, first allergic reactions, first anxiety attacks etc. Instead, we try to live with that, continue doing what harms us and accept it as normal.

 

[trophy33]

It would be a slight on God's own sovereignty to claim that God had nothing to do with this.

Permissive will. Also, there are frequently (maybe always) some paths in front of us, some ways, how to solve our issues, how to exit our trials. We just do not try them or for the needed period of time.

 

[trophy33]

As for my diet, don't seem to have any problems with meat in general. Mostly processed food and fried foods seem to be problematic for me.

Processed food, fried food, alcohol, sugar, coffee, cocoa, many nuts, plants... harm everybody. Some just have not noticed it, yet.

 

[Gidgx]

Yes, unfortunately, we people commonly wait with the proper human diet and lifestyle till its "late" (its never late to live well, but it may not solve as many issues as taken early, because, as you say, the damage is already done). However, damage can be frequently undone, body has amazing healing abilities, if fed and treated properly.

As the doctor in the first video pointed out, its not just one problem like gout people have, their metabolism is having problems also in other areas. We must immediately study any health issue we have, experiment, fix our lifestyle after the first problem, first pains, first low energy, first higher weight, first bad sleep, first allergic reactions, first anxiety attacks etc. Instead, we try to live with that, continue doing what harms us and accept it as normal.

Unfortunately I have what as known as ulnar drift or ulnar deviation. The ulnar nerve was damaged because the treatment wasn't administered early. Surgery could help, doctors are leary about it because it could make things worse.

 

[Jamdoc]

Permissive will. Also, there are frequently (maybe always) some paths in front of us, some ways, how to solve our issues, how to exit our trials. We just do not try them or for the needed period of time.

The Sovereign is ultimately responsible. By permitting something God is still sovereign over it and makes the decision for it to happen.

Isaiah 45

7 I form the light, and create darkness: I make peace, and create evil: I the Lord do all these things.

Job 1

11 But put forth thine hand now, and touch all that he hath, and he will curse thee to thy face.
12 And the Lord said unto Satan, Behold, all that he hath is in thy power; only upon himself put not forth thine hand. So Satan went forth from the presence of the Lord.

It was not just Satan acting on his own and the Lord permitting it. For Satan or another agent to negatively affect a believer's life, God has to declare that they have permission to do so, and while they may mean it for evil, God means it for good.

21 And said, Naked came I out of my mother's womb, and naked shall I return thither: the Lord gave, and the Lord hath taken away; blessed be the name of the Lord.
22 In all this Job sinned not, nor charged God foolishly.

It is not sin to acknowledge that God is sovereign even over your calamities in life. I am not cursing God for doing this, I am simply saying I don't understand the purpose of it. I know there is one. I just don't understand it.

Job 2

4 And Satan answered the Lord, and said, Skin for skin, yea, all that a man hath will he give for his life.
5 But put forth thine hand now, and touch his bone and his flesh, and he will curse thee to thy face.
6 And the Lord said unto Satan, Behold, he is in thine hand; but save his life.

again, God is responsible, He allows evil to be done by an agent, but places limitations when it is on a believer.

Job 6

1 But Job answered and said,
2 Oh that my grief were throughly weighed, and my calamity laid in the balances together!
3 For now it would be heavier than the sand of the sea: therefore my words are swallowed up.
4 For the arrows of the Almighty are within me, the poison whereof drinketh up my spirit: the terrors of God do set themselves in array against me.

So yes, even the old testament archetype of saintly suffering attributed his suffering to God sovereignly doing it to him, and he did not curse God, nor say God was out of line for doing it.
But many people try to say Job was patient, didn't complain, and didn't blame God. That's wrong. He complained, and he attributed the suffering to being caused by God. In neither case was he considered sinning by doing so.

 

[returntosender]

I guess by now I should learn to recognize these things aren't happening at the same time by coincidence. It's not the first time God has visibly moved his hand in my life.... to hit me.

I completely understand where you're coming from where my life is for the most part is a duplicate. I see mj sold on line all the time and wonder?

I've never bought but it must be possible. I'm not sure why VA is letting you down unless you are not harassing them. Maybe you should do that. They,we, owe you. I can know your sadness in relying on you family. There's agency's out there. Many many. Hit the books. It can be done. I've always been in my own with no let up of pain. No help from family. I do get help from agency's. If your elder or not they're out there. I don't have transportation either. God mostly does small miracles for me like keeping me on my feet and so i wait on him. There's hope. Keep the faith! God loves you

 

[Jamdoc]

I completely understand where you're coming from where my life is for the most part is a duplicate. I see mj sold on line all the time and wonder?

I've never bought but it must be possible. I'm not sure why VA is letting you down unless you are not harassing them. Maybe you should do that. They,we, owe you. I can know your sadness in relying on you family. There's agency's out there. Many many. Hit the books. It can be done. I've always been in my own with no let up of pain. No help from family. I do get help from agency's. If your elder or not they're out there. I don't have transportation either. God mostly does small miracles for me like keeping me on my feet and so i wait on him. There's hope. Keep the faith! God loves you

Well, regarding online stuff, I figure a lot of that is really shady and it is illegal not only federally but state as well.
Like in a legal state, you can kinda go with the fact that the Department of Justice was unofficially deferring to state laws regarding it. But it was always a murky area as far as obeying the law of the land vs treating the disease. The jump to include medical marijuana was kind of like a last ditch option at the time because multiple DMARD's, and Biologics weren't cutting it. Mind you it wasn't a perfect solution, it did nothing for the skin psoriasis (nothing did) and when I had to drop Methotrexate, the Humira and MJ in combination was barely keeping things from getting too hot. Like my body would still warn me from time to time like if I missed a day of using MJ (because honestly, I don't like using it so frequently), almost as if my body was saying to me "just a reminder that I hate you and want to kill you if only you give me a chance, and I'll do it slowly and painfully". It's not something I did lightly and now that I'm in a state that doesn't allow it it's kind of out of my hands. I don't have that "it's a grey area" to work with I have black and white law.

I was able to do it in my previous state partially because I could just walk into a store and buy it like any other product, the store was clean, the staff was courteous and professional and not high, it didn't feel like "drug dealing" it felt like buying any other product at a store outside of using cash and presenting a medical card and veteran's card (because most dispensaries offer veteran discounts). I suppose it'd be closest to being between a pharmacy and a liquor store in experience. Kinda like if you go to a pharmacy and want to buy the actual sudafed that works which is always behind the counter and you have a monthly limit or something.

I really don't like the idea of shady business and sneaking around. There's just sinful conviction if you're having to hide your activities from others you know?

So I just pray
and suffer
and pray more
and suffer more.

and just.. grow weary, and wonder what the point of it is.

 

[The Righterzpen]

So I just pray
and suffer
and pray more
and suffer more.

and just.. grow weary, and wonder what the point of it is.

I understand on the "no end to this" and no solution. I have a 21 year old son with refractory epilepsy. He can't hold down a job, can't go to school, can't work, can't drive. We've been to some of the best hospitals on the planet and they just don't have the medical technology to help him. He's not in pain; but he is asking "What the... f..lip am I suppose to do for the next 60 years?"

And I don't have an answer for him either. The suffering is hard to watch. I'm actually in a VA mental health group program because of.... a lot of things. And I too am a firm believer in the sovereignty of God. Still though, it's hard to watch.

I don't know if any of this will help you; or if you've tried any of these things. (You said medical cannabis helped. CBD oil had some limited affect on my son.) I'm "service connected" for "Gulf War Syndrome". (Chronic Fatigue, Fibromyalgia, migraines and PTSD). I had Alpha variant and Omicron Covid. And Alpha was like a bad resurgence of "Gulf War Syndrome". I had a lot of inflammatory reactions and was suddenly "allergic" to weirs things like Creeping Charlie (a benign plant that grows in my garden). I first got sick in February of 2020 and it took most of that year to recover from "long haul Covid". My son got "post covid multi system inflammatory disorder" in October of 2021 and we both left the Ronald McDonald House in Philly with Omicron in July of 2022.

We've been taking high doses of plant based vitamin C, D, zinc, Quercetin (works like ivermectin), and NAC (N-acetyl cytosine = stopes immune system cytokine storm.) And that's seemed to help. I'm not on any pharmaceutical meds and the only pharmaceutical my son takes is Vimpat for his seizures. Neither of us have had any of the covid shots though either. I know I was exposed to biological weapons back during the war. (Which I think Covid was also a bio weapon.) So my symptoms have been similar.

Diet wise; many years ago, I went on several different detoxification diets and currently we eat primarily organic food. That seems to have helped too.

It's really hard to be chronically ill!

 

[Jamdoc]

I understand on the "no end to this" and no solution. I have a 21 year old son with refractory epilepsy. He can't hold down a job, can't go to school, can't work, can't drive. We've been to some of the best hospitals on the planet and they just don't have the medical technology to help him. He's not in pain; but he is asking "What the... f..lip am I suppose to do for the next 60 years?"

And I don't have an answer for him either. The suffering is hard to watch. I'm actually in a VA mental health group program because of.... a lot of things. And I too am a firm believer in the sovereignty of God. Still though, it's hard to watch.

I don't know if any of this will help you; or if you've tried any of these things. (You said medical cannabis helped. CBD oil had some limited affect on my son.) I'm "service connected" for "Gulf War Syndrome". (Chronic Fatigue, Fibromyalgia, migraines and PTSD). I had Alpha variant and Omicron Covid. And Alpha was like a bad resurgence of "Gulf War Syndrome". I had a lot of inflammatory reactions and was suddenly "allergic" to weirs things like Creeping Charlie (a benign plant that grows in my garden). I first got sick in February of 2020 and it took most of that year to recover from "long haul Covid". My son got "post covid multi system inflammatory disorder" in October of 2021 and we both left the Ronald McDonald House in Philly with Omicron in July of 2022.

We've been taking high doses of plant based vitamin C, D, zinc, Quercetin (works like ivermectin), and NAC (N-acetyl cytosine = stopes immune system cytokine storm.) And that's seemed to help. I'm not on any pharmaceutical meds and the only pharmaceutical my son takes is Vimpat for his seizures. Neither of us have had any of the covid shots though either. I know I was exposed to biological weapons back during the war. (Which I think Covid was also a bio weapon.) So my symptoms have been similar.

Diet wise; many years ago, I went on several different detoxification diets and currently we eat primarily organic food. That seems to have helped too.

It's really hard to be chronically ill!

"What am I supposed to do for the next 60 years?" Oh boy.. yeah.. that feeling of being useless is just.. really hard. Like people, especially online assume you work, assume you have resources so they always say I'm supposed to be helping others and doing all this ministry stuff and it's like.. I haven't been able to leave the house! I'm broke, with what resources am I supposed to bless others with? That sort of thing. I get pointed to like Joni Tada or some guy with no arms and no legs doing things and I'm like that's great, but they're not actively in chronic pain and yes that does make a huge difference in what you're able to do. Not having a leg that doesn't cause pain well you can find workarounds to be able to do activities to get above and around what people see as a limitation, but if that leg is still attached bug is causing you pain any time it gets moved, you can actually do less than what the person without a leg can do, because that pain itself is the limiter.

That's why I'm okay with losing a toe, rather than just trying to live with the "intact" foot. When gone the toe will no longer be a potential limiter of activity because of pain and swelling so I can't put on shoes.

 

[The Righterzpen]

"What am I supposed to do for the next 60 years?" Oh boy.. yeah.. that feeling of being useless is just.. really hard. Like people, especially online assume you work, assume you have resources so they always say I'm supposed to be helping others and doing all this ministry stuff and it's like.. I haven't been able to leave the house! I'm broke, with what resources am I supposed to bless others with? That sort of thing. I get pointed to like Joni Tada or some guy with no arms and no legs doing things and I'm like that's great, but they're not actively in chronic pain and yes that does make a huge difference in what you're able to do. Not having a leg that doesn't cause pain well you can find workarounds to be able to do activities to get above and around what people see as a limitation, but if that leg is still attached bug is causing you pain any time it gets moved, you can actually do less than what the person without a leg can do, because that pain itself is the limiter.

That's why I'm okay with losing a toe, rather than just trying to live with the "intact" foot. When gone the toe will no longer be a potential limiter of activity because of pain and swelling so I can't put on shoes.

Is your pain a case where you can actually remove a body part to be rid of the pain?

Part of the "lesser function" of my foot and leg is that physical alterations were made to them to make them less painful. Of course this has made them less stable. (We were in a catastrophic car accident in 2010 and I had a lot of injuries to my lower body. Broken bones and torn out ligaments and tendons - lot of hardware in my leg). One of the things is that they later removed screws that they'd put in my foot to make it more stable. If I step on it wrong; it hurts. Which is part of the reason I still use crutches. Reducing the weight bearing on that foot reduces the pain.

I too live with a certain degree of chronic pain; but sometimes it's worse than others. My pain runs from .5 to about a 4 on average days. If I really overdue it; I'm at about a 5 to 6 and am spending the next 3 days sitting on the couch with minimal activity and sleeping as much as I can. Sleep helps a lot. One of the things that happened in the accident is that I lost the functional site in my right eye. And when I'm tired or stressed out; I'm quite light sensitive and my eye ball actually hurts. I have varying power of sunglasses, prescription sunglasses and sunglasses I can put on over sunglasses; as well as a black eye patch. Currently, I think my eye problems are the most difficult to deal with; although the mobility issues are the most physically limiting.

I also go to a chiropractor about once a month; which helps with back pain and headaches. But as far as my legs; not much more can be done to make them better. Certain physical therapy exercises that would strengthen my muscles and make my one leg more stable only exacerbate the pain. So I do what I can and let my body tell me when it needs to sit down and rest.

But I also have a wheelchair that if I need to go somewhere (like an appointment or to the store) and am too uncomfortable to just use my crutches (foot hurts / knee hurts; or the weather is really wet); I'll use the chair. Which at least that doesn't totally quench my ability to get stuff done.

One day at a time.

But if you can get surgery to remove / alter painful parts; I'd do it. I'm getting to that point with my eye. I think I've had 4 to 5 eye surgeries and we're getting to the point where eventually, they'll just have to remove it and give me a prosthetic eye.

 

[Jamdoc]

Is your pain a case where you can actually remove a body part to be rid of the pain?

Part of the "lesser function" of my foot and leg is that physical alterations were made to them to make them less painful. Of course this has made them less stable. (We were in a catastrophic car accident in 2010 and I had a lot of injuries to my lower body. Broken bones and torn out ligaments and tendons - lot of hardware in my leg). One of the things is that they later removed screws that they'd put in my foot to make it more stable. If I step on it wrong; it hurts. Which is part of the reason I still use crutches. Reducing the weight bearing on that foot reduces the pain.

I too live with a certain degree of chronic pain; but sometimes it's worse than others. My pain runs from .5 to about a 4 on average days. If I really overdue it; I'm at about a 5 to 6 and am spending the next 3 days sitting on the couch with minimal activity and sleeping as much as I can. Sleep helps a lot. One of the things that happened in the accident is that I lost the functional site in my right eye. And when I'm tired or stressed out; I'm quite light sensitive and my eye ball actually hurts. I have varying power of sunglasses, prescription sunglasses and sunglasses I can put on over sunglasses; as well as a black eye patch. Currently, I think my eye problems are the most difficult to deal with; although the mobility issues are the most physically limiting.

I also go to a chiropractor about once a month; which helps with back pain and headaches. But as far as my legs; not much more can be done to make them better. Certain physical therapy exercises that would strengthen my muscles and make my one leg more stable only exacerbate the pain. So I do what I can and let my body tell me when it needs to sit down and rest.

But I also have a wheelchair that if I need to go somewhere (like an appointment or to the store) and am too uncomfortable to just use my crutches (foot hurts / knee hurts; or the weather is really wet); I'll use the chair. Which at least that doesn't totally quench my ability to get stuff done.

One day at a time.

But if you can get surgery to remove / alter painful parts; I'd do it. I'm getting to that point with my eye. I think I've had 4 to 5 eye surgeries and we're getting to the point where eventually, they'll just have to remove it and give me a prosthetic eye.

This toe in specific has a really bad tophi that's been getting hit a lot it was like a magnet for things hitting it during the move including dropping a tv stand directly on it., it's always swollen, always inflamed, always itching, burning, and painful, and the joints in that toe have fused into kind of a hook, like I can't bend or flex the end joint because the bones fused together, so it's actually an impedement just by the way it's shaped at this point.

Basically I just need the opinion of the Rheumatologist regarding the healing process cause you don't want to amputate and then have a really nasty infection that never heals.

 

[The Righterzpen]

This toe in specific has a really bad tophi that's been getting hit a lot it was like a magnet for things hitting it during the move including dropping a tv stand directly on it., it's always swollen, always inflamed, always itching, burning, and painful, and the joints in that toe have fused into kind of a hook, like I can't bend or flex the end joint because the bones fused together, so it's actually an impedement just by the way it's shaped at this point.

Basically I just need the opinion of the Rheumatologist regarding the healing process cause you don't want to amputate and then have a really nasty infection that never heals.

Risk of infection post amputation depends on a lot of factors.

1. Overall health of the patient. If one has circulation issues or diabetes; they run higher risk of infection than someone who doesn't.
2. Amputating fingers and toes is generally less risk of infection than amputating arms and legs.
3. The type of injury causing the amputation matters. "guillotine" type injuries (or intentional amputation) run less risk of infection than crushing wounds.
4. How well the patent is able to care for the wound is another factor. As is how fast / well they heal. How fast one heals too depends on whether they are deficient in vitamin D, C, magnesium or zinc etc. Stuff like that plays a role in overall health too.

They can fix and straiten joints. They do it all the time. I know several people who've had bunions removed and their toe joints fixed.

Also, do you have gout? (Common cause of tophi.) Gout is a manageable disease. Generally, (like type 2 diabetes) managed with diet. And the flair ups with medication. Gout is an issue with the thyroid. My son had odd thyroid readings; but simply giving him a seaweed supplement (contains natural iodine) changed that.

 

[Jamdoc]

Risk of infection post amputation depends on a lot of factors.

1. Overall health of the patient. If one has circulation issues or diabetes; they run higher risk of infection than someone who doesn't.
2. Amputating fingers and toes is generally less risk of infection than amputating arms and legs.
3. The type of injury causing the amputation matters. "guillotine" type injuries (or intentional amputation) run less risk of infection than crushing wounds.
4. How well the patent is able to care for the wound is another factor. As is how fast / well they heal. How fast one heals too depends on whether they are deficient in vitamin D, C, magnesium or zinc etc. Stuff like that plays a role in overall health too.

They can fix and straiten joints. They do it all the time. I know several people who've had bunions removed and their toe joints fixed.

Also, do you have gout? (Common cause of tophi.) Gout is a manageable disease. Generally, (like type 2 diabetes) managed with diet. And the flair ups with medication. Gout is an issue with the thyroid. My son had odd thyroid readings; but simply giving him a seaweed supplement (contains natural iodine) changed that.

yeah I mentioned it earlier, I had it since I was 18, didn't get diagnosed till 26 (cause doctors don't really look for gout in patients who are younger and under 200 pounds), couldn't get it managed with diet or medications until we also found that I had psoriatic arthritis and we targeted treating that and then the gout became managable as well.
I got the tophi at about 30, so I've had it for about 13 years, and it progressively got worse, and really took off after I had to drop the 2 medications that were helping with the psoriatic arthritis. The uloric I take gets my uric acid under 7 which I know under 6 is the goal but nothing has been able to get there except the IV recombinant uricase enzyme which worked for a couple of treatments and then I developed antibodies to it so it was no longer effective, uric acid shot back up to almost 11.

When not trying to manage the gout at all my uric acid is over 12, especially during attacks. With diet changes or medications I can get it down to 8-10. With both, somewhere between 6-8.