Attack of the Gout

I’m in the throes of a gout attack. At Hong Kong airport. Hobbling around. The big toe joint on my right foot is inflamed. Swollen. Red. Every step is agony. Dragging my right foot behind me. Can’t walk normally. Can’t flex it. Too painful. Putting a shoe on or taking it off makes me want to scream. Glad they didn’t ask me to remove my shoes at security.

It’s been like this for a few days. It’s Wednesday now. Felt the first twinge walking around Macao on Friday. Worsened by Sunday. In full force. Sleeping has been tough. Can’t cover it, even a sheet is painful. Throbbing, intense pain.

Anti-inflammatories help. Ibuprofen. Except I think the ones I carry in my toiletries bag have expired. Naproxen is better but prescription only and don’t have any with me on the road.

What is gout? For the uninitiated, from Wikipedia:

Gout (/ɡaʊt/ GOWT) is a form of inflammatory arthritis characterised by recurrent attacks of a red, tender, hot and swollen joint,caused by the deposition of needle-like crystals of uric acid known as monosodium urate crystals. Pain typically comes on rapidly, reaching maximal intensity in less than 12 hours. The joint at the base of the big toe is affected (Podagra) in about half of cases.

This might be the worst gout attack I’ve ever had. Get two or three a year. I’m usually pretty sensible with food and drink choices. All comes down to that. There are genetic factors too but I’m not sure if I’m predisposed.

It’s purines. Foods that are high in purines raise levels of uric acid. Uric acid crystallises and wham! A gout attack. Surprise motherfucker.

What foods? There’s a good guide here but really it’s red meat, offal, most shellfish and alcohol. Alcohol, beer particularly, is bad news. So a big surf ’n’ turf of steak and lobster washed down with a few beers is a ticking time bomb.

I usually know exactly where I’ve gone wrong when an attack occurs. I didn’t always. In my early thirties when I had my first one I didn’t know what it was. Woke up one morning to find my big toe joint swollen and in pain. Assumed I’d hurt myself somehow and not noticed. Got worse then subsided. Forgot about it until the next time. Then the next. Finally looked into it and went to the doctor. Gout. Didn’t know anything about it. Someone called me “Henry VIII” at work.

Allopurinol is a medication that can be used to lower levels of uric acid but since my attacks were minor and infrequent this wasn’t advised.

It is manageable. Make sensible choices and avoid gout attacks. Two or three minor ones a year have been acceptable.

I’ve been running for the last eight years or so. I love running. I’ve been running around the world. I think this and my other workouts help. The running particularly stops crystals from forming in major ways. I usually run three times a week, averaging 30–40 km a week. I walk a lot too.

Recently due to a slight quad strain I’ve had to take a few weeks off running. I’ve also slipped on some of those sensible food and drink choices. Beers in Bali. Barbecue platter of brisket and sausage on my last night. Roasted pork and goose in Hong Kong, several times. Cured meats, chinese pork jerky. Cocktails.

There are no surprises here. This attack was inevitable. Imminent. I just wasn’t prepared for how severe it would be. Been in my hotel room for most of the last day or so. Now hobbling around the airport before flying to Taipei. Hoping it eases in a day or two.

This is a wake up call. It’s almost the end of the year. I don’t make New Year’s resolutions. But I am resolute in a few things here:

I love running. It’s a part of my life now.

I really don’t enjoy drinking anymore. A cider, cocktail or whisky every now and then. Fine.

I can eat more vegetables. None of us need to eat as much meat as we do. I certainly don’t.

Everything has consequences. Like the Christmas lunch I had a few days ago. Beef Wellington. Delicious. It will have to be paid for.

I am actually thankful for this gout attack. The changes I will make will have far reaching benefits to all areas of my life.

Thank you gout.

For now I’ll just pop another Ibuprofen.