Gary M. is a 48-year-old senior vice president of marketing at a hospital on the East Coast. Though it was only three years ago when he found himself nearly crippled by the painful swelling of gout, today he has the chronic condition nearly under control. Gout is recurrent attacks of joint inflammation caused by a build-up of uric acid crystals. The father of three talks with fellow sufferers regularly and works with his doctor to minimize symptoms as he continues to live an active life with his wife of 18 years.
What was your first sign that something was wrong? What symptoms did you experience?
I had a stereotypical onset of gout three years ago, right after Christmas. I had been eating a ton of crabmeat, shrimp, and fine foods at holiday parties. One night, I was in a meeting with doctors, working late. All of the sudden, it felt like I pulled a tendon in my right foot. Over the course of two days, I was hobbled. It was absolute torture that happened overnight.
The pain settled into the ball of my right foot. Even the pain of a bed sheet lying on my foot was intolerable. I tossed and turned all night. My foot swelled up and got red hot. It looked cherry to the touch.
What was the diagnosis experience like?
When I went to work in the morning, I called one of our podiatrists. I said, "I did something to my foot and I have no idea what it is." After I described my symptoms, the doctor asked me if I'd ever heard of gout. I told him my younger brother has it and my father had it when he was alive. The doctor said he thought I had it too; I saw him later that day and he confirmed the diagnosis.
What was your initial and then longer-term reaction to the diagnosis?
At first, I was kind of depressed because it's a chronic condition. It's with you all the time. Alcohol, red meat, beer, and crabs can trigger a gout attack. I love all those things. Since my father died of heart disease when he was 45, I was already on long-term, low-dose aspirin therapy, but I had to stop that because aspirin can trigger gout attacks.
How do you manage gout?
That first attack was so bad I had to have a cortisone shot so that I could walk. I felt like Jeff Goldblum in "The Fly," dragging my worthless appendage behind me. To clear up the symptoms, I take anti-inflammatory drugs.
Once the excess uric acid is out of your system and you're gout-free, you can go on a maintenance drug (allopurinol) to purge your body of uric acid. I haven't gotten to the point where I'm comfortable taking a drug for the rest of my life, so I try to manage it with dietary changes.
Did you have to make any lifestyle or dietary changes in response to gout?
I knew the gout wasn't going to go away and I would have to adopt lifestyle changes. So, it just became a matter of trying to do things to fend off having it recur. I try to stay away from alcohol, red meat, and seafood, but get tired of eating chicken every day. I haven't had another full-scale gout attack. I do have days when I'm feeling "gouty," and I know my body is ripe for it to develop. Sometimes it's really simple. If I eat a fast-food burger, I'll start feeling sore all over.
Did you seek any type of emotional support?
Gout is like the Rodney Dangerfield of diseases, it gets no respect. But once somebody gets gout, they are more than happy to talk to you about it. Four guys from our finance department came to talk to me before I was officially diagnosed. They all have gout and keep little stashes of home remedies that work for them, herbs and dried fruits, in their offices. There's this underground gout group out there that has helped me.
Does gout have any impact on your family?
My wife has been pretty supportive in terms of being aware of things that will trigger an attack. Sometimes it affects the activities I'm interested in doing. When you're feeling gouty, you do not feel like getting out and walking.
What advice would you give to anyone living with gout?
I offer a lot of sympathy. It helps to commiserate with others who have it and get tips from them. Try to find out which foods are your poisons and stay away from them, which is easier said than done.
I think more people should feel free to talk about it, because with social acceptance comes raised awareness. And that helps drive better maintenance and control.
Interviews were conducted in the past and may not reflect current standards and practices in medicine. Talk to your doctor to learn more about how this condition is diagnosed and managed today and what treatment approaches are right for you.