Monday, February 8, 2010


My mother, an avid reader with a lively imagination, had a habit of colorfully describing ailments for her doctors. "It feels just like somebody has stuck a fork in my ear," she would say to report an earache. Or "It's like somebody has put out a Cuban cigar on my arm" to depict an infected wart. It was unfortunate because doctors generally do not care for this sort of thing. They would prefer to have a clinical approach.

Maybe they find this kind of thing too subjective but then, how can a patient not feel subjective? As a teenager, I warned her against this habit and told her it was best merely to point and wait for questions and moan a bit to motivate the staff. She never learned the lesson and eventually, unfairly, her various physicians, after running inconclusive tests, began to think of her as a bit of a "crank," or a hypochondriac or as one doctor said, "a hysterical personality type."

"Me? Hysterical?" she would shout, hysterically.

So with this in mind, I will relate my own recent health problem.


I believe I had read about gout in the Jane Austen or Thackeray books. It's usually the fat slightly prissy brother or sour cantankerous father.  I think Oliver Hardy had it one time in a film. In any case,  I couldn't have, for the life of me- told you what the disease entailed. I'd probably have got it confused with a goiter.

Gout is, however, much more similar to arthritis. Unlike arthritis, however, gout is a strangely specific disease. In most cases, it strikes the joint of the big toe. (But I have also had it appear in the heel too.)

As my mother would have said, basically it feels like some very naughty person has take a sledgehammer and has given your foot a firm whack one or two times every a day. The toe doesn't swell- not nearly as much as it feels like it should- but it feels warm  and looks rather pinkish. During the attack, which can last about a week, the throbbing pain in the joint makes walking or even resting next to impossible. A blanket resting ever so gently on the toe can become unbearable. Putting any weight on it? Forget it. Just lifting the foot to take a step is painful.

It was once called "the king's disease" because a diet rich in red meats, internal organs, yeast, and oily fish is a contributing factor. These foods are loaded with a substance called "purines." In order for the body to metabolize purines, the body produces uric acid. When the body produces too much, or can not eliminate the normal levels, it ends up collecting in certain areas of the body, namely the joints. Uric acid forms crystals and those crystals are perceived by the immune system to be foreign bodies and launches an attack. There comes the inflammation and the pain.

Incidentally, high levels of uric acid in the body can also lead to a form of kidney stones.

It is important to consider lifestyle changes ( what AGAIN??!!) because, even if a person with gout can somehow endure the chronic cycles of the disease, over time the attacks can occur more frequently and last longer. (cheery news) And at the initial stages of this disease, only one or two joints are involved, over time it can spread to other areas.

I have given up most alcohol- which except for the rare glass of beer or wine- and I do mean rare and not occasional. I have changed my lifestyle so many times already for this problem or that problem. I quit smoking two years ago. Began eating more fruits and vegetables. Reduced the level of stress in my life. However, like a bit of slapstick confusion at the coat check, I am starting to think I might have walked away with somebody else's lifestyle. A monk's maybe or an elderly Mormon's.

I have some medicine which tends to shorten the cycle. Until that kicks in, I hobble around with a cane- "there was a crooked man and he walked a crooked mile " style. Aspirin should be avoided as it can actually make it worse. Ice packs can be helpful in relieving pain and reducing inflammation. And drinking copious amounts of water to flush out the system. Can that hurt anyway? Except it forces you to drag yourself- crab-like to the bathroom.

This last attack was brought on by taking a cold medication, which contained a strong diuretic to relieve symptoms of the cold. However by eliminating the water from my body, the uric acid level rose accordingly. That's my latest theory anyway. That's the last thing I would tell my doctor, of course, because, even without a diagnosis, I already know I am a hysterical personality.


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  1. I had my very first gout attack last week. After the attack has completely subsided I took Zyloric to get rid of the excess uric acids. I first took Tramadol to relieve the pain. You can see the complete drug study of these medicines at

    Be sure to drink plenty of water or fluids to flush out the uric acids. Gout really Is a hassle. But if you know how to counter attack it once it appears your in the right track of taking care of yourself.

  2. I started taking Zyloric (actually the name of the stiff they call it here but the same) yesterday. It seems better today but the prospect of having to take it all the time is hardly uplifting. This attack seems to have gone on longer than the last ones. I was taking some anti-inflammatory medicine which didn't do much good but allowed me to sleep. What an underrated ailment! Thanks for your comments and a kind suggestions.


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