Month: August 2017

Gout in Real Life

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I was 30 when I was diagnosed with gout.  I remember seeing the doctor because I initially believed I had somehow walked on my foot incorrectly, or maybe I’d sprained my toe.  I described the symptoms and the doctor nodded and said, casual as a cat lying in the sun, “You have gout.”

I was a little taken aback.  “Gout is for old people,” I said.

The doctor shrugged.  “Actually, a man entering his 30s is a prime candidate.  Welcome to aging.”

Back then, gout was a peripheral part of my life.  Always my big toe, always a day or two of discomfort.  Tolerable.  Now, at 42, gout has become a part of my day-to-day life.

And I hate it.

For the first several years after the diagnosis, I lived with the occasional flare-up.  It didn’t bother me too much.  The only concern I really had was work: as someone who worked on his feet, a flare-up was not a happy experience.

It wasn’t until a few years ago that my life was truly becoming affected by the onslaught of gout.

For the uninitiated, gout is caused by a simple process.  Purines found in every day foods are metabolized into uric acid.  Uric acid is expelled from the body through urine.  The uric acid that remains – if there is an abundance – crystalizes and crowds into a joint, usually the big toe (because, let’s face it, gravity).  Depending on the amount of crystalized uric acid, a flare-up can go from discomfort to extreme pain.


I’d like to take a look at those two words: extreme pain.  I think we’ve desensitized ourselves to those words.  We hear them so often, see them on commercials.  “Do you suffer from extreme pain?” the concerned actor in a doctor’s coat might ask.  But the words are really lost when used as a description.  Yes, my gout causes extreme pain.  The kind I can’t begin to describe.  It is…hellish.

I want you to imagine your worst toothache, perhaps a migraine that begged you to be in a dark room without sound.  Now imagine that in a joint.  Now imagine that you can’t move that joint for the life of you.  It is so swollen that the skin is shiny-smooth, wrinkle free.  The slightest touch or – God forbid – movement is enough to make you faint.  Or, even better, remember the last sprained ankle or wrist you had – and multiply it by five.

In the beginning it was my big toe.  Then my ankle.  Then my knees.  I’ve suffered from flare-ups now in both elbows and both wrists.  As I write this my left wrist is healing from a two-week bout, and my knee is currently the size of a baseball.  I once had a flare-up so horrendous, so crippling, I could not get up off the couch to go to the bathroom; I peed into a water bottle because I feared trying to get up.  Yes, it gets that bad.

Gout, too, can cause depression.  You begin to wonder – selfishly – Why Me?  How can I afford to live when I can’t even go to work?  How long with this flare-up last?  Friends and family, as sympathetic as they can be, don’t truly understand what you’re going through, so cancelling on plans or calling out sick from work appears to be laziness more than anything.  It’s frustrating.

“Well, Sean, I do know gout is caused by lifestyle choices, so perhaps you should be making some changes.”

Oh, I’m way ahead of you.  I’ve done it all.  I’ve stopped drinking for long periods.  I’ve tried vegan diets.  I exercised, drank tons of water.  I’ve been on allopurinol, but I had allergic reactions.  I’ve Done Everything.  And guess what?  During these processes, I still had gout flare-ups.  There seems to be nothing I can do but live with it.

But what frightens me the most is this: if gout has progressed this far in the past 12 years, what will the next 30 years of my life be like? The idea of being bed-ridden for long periods is not a good thought.  Will my joints get gnarled and lumpy?  Will I be hunched over using a walker at 50?

A lot of this is selfish complaining, I know.  But really I wanted to get it out there, the experience, what it’s like to sit on the couch and dread getting up to go to the bathroom or, god forbid, outside.  I do know it boils down to making severe changes now: all those foods high in purines, all those foods I enjoy to no end – red meats, poultry, seafood, and beer – will no longer need to be taken in moderation, but they’ll have to be removed for good.

It feels like such a sacrifice.  It feels – again, selfishly – like another pathetic episode of Why Me?