When Elmer (not his real name) tells people he suffers from gout, they often react in two ways. They might express surprise that people still get it, assuming it is an 18th-century thing – a “rich person’s disease” afflicting only kings and the affluent.
Otherwise, they might say: “Been drinking too much port, have you?”
Now 75 and retired, Elmer has had a long history with gout, and can still recall his first attack. After several nights of eating out with friends, he woke up with his foot on fire. His toe and the whole side of his foot were red, and he couldn’t even get out of bed.
His family history made it easy for Elmer to recognise the disease; both his brothers suffer from it, too.
The warmth and redness are common symptoms of gout. Others include swelling and stiffness in the affected joint, which can affect the ankles, knees, wrists or hands, but happens most commonly in the big toe.
Elmer has learnt to keep the condition in check through medication, pain-management strategies, and diet modification. He uses over-the-counter pain relievers and has a prescription for colchicine that he takes at the first sign of an attack.
In most cases, a case of gout lasts several days, during which the patient should avoid eating certain foods to reduce intake of purines. When he gets a flare-up, it keeps Elmer off his feet for about a week. He has limited his seafood intake and stopped consuming alcohol.
Purines, a natural substance found in some foods, are not entirely bad, but one to avoid it in high amounts. When the body digests purines, it produces a waste product called uric acid. A build-up of uric acid crystals in the joints causes gout.
High-purine foods include:
- red meat such as beef or lamb;
- shellfish such as clams, mussels, scallops, prawns, oysters and crabs;
- offal such as liver, intestine, stomach and kidney;
- oily fish such as anchovies, herring, sardines, trout and mackerel;
- asparagus, fava beans, lentils, peas, spinach and cauliflower;
- alcohol such as beer, or fortified spirits such as port and brandy.
Common treatments for gout include:
- bed rest;
- ice packs;
- non-steroidal anti-inflammatory drugs (NSAIDs);
- steroids, for patients who can’t take NSAIDs;
- colchicine, taken in the first hours of an attack.
There are other medications that can lower the risk of a gout attack, such as allopurinol, which controls levels of uric acid in the blood. But since some patients have infrequent attacks – some only suffer one attack a year – these are not always needed.
Elmer says he is lucky as he has not suffered a gout flare-up in a long time. He is sharing his story as proof that a balanced diet, regular exercise, and maintaining a healthy body weight are important aspects of gout management.
TELEME Healing Life Stories is a collection of inspirational stories of how ordinary people triumph over their health conditions and recover to lead a healthier life. Email [email protected] to share your story.
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