Men and Gout: Our silent reality

 

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You know us guys aren’t supposed to talk about health stuff right? At least that’s how my generation was brought up. Granted, things have gotten easier over the years since things like Facebook have caused a massive amount of over-sharing in our world. Who knows whether that’s a good or bad thing? Anyways, I don’t know that I’ve ever blogged about health stuff and things that are wrong with me so I figured why not now. Considering the circumstances, it’s a good time to share.

I have gout. Do you know what gout it? Gout is a buildup of uric acid which forms urate crystals which build up in your joints. Gout is a complex form of arthritis. Often this buildup happens around the big toe. Gout affects Men more often than women. Look at your big toe…now imagine your big toe and the area around it 2-3 times bigger than normal. This is often the reality for those of us with gout.

gout2

 

What causes gout?

This is what the Mayo clinic says about it:

Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body, as well as in certain foods, such as organ meats, anchovies, herring, asparagus, and mushrooms.

Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes your body either produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needle-like urate crystals in a joint or surrounding tissue that cause pain, inflammation, and swelling.”(Mayoclinic.org)

Now, what does this feel like in English? Have you ever dropped a bar of soap on your foot in the shower? Of course you have, we all have. It doesn’t’ bother you does it? Well for those of us who are in the middle of a Gout flare up it feels completely different. Dropping that bar of soap on our foot feels like we are being stabbed in the foot over and over again. Something as light as a sheet on our feet at night is excruciating. Walking at a normal pace without limping is impossible. And wearing a sneaker, boot or anything except sandals is nearly impossible. Even something as necessary as sleeping is a battle. When you have a gout flare-up its nearly impossible to get comfortable in bed, you might get 2-3 hours of sleep after tossing, turning and praying to find a comfortable spot for your foot. This happens for 3-4 hours before you actually manage to fall asleep. Walking up the stairs takes 2 minutes and sometimes going down you have to sit on your ass and scoot down every step. You just can’t bear the weight. You have almost no balance and no center of gravity.

not my foot right now
not my foot right now

I have been suffering from Gout for almost 15 years. I had my first flare-up when I was about 21 and I am 35 now. It wasn’t until my mid 20’s that I even found out what it was let alone what I could do about. For those of us without insurance getting medicine for it isn’t easy and is very expensive. Typically I have a flare-up once a year and as many as 3 times. The last few years I have been lucky and only had 1 flare-up a year. Right now I am in the middle of what I thought at first was a mild flare-up which turned into what experience has proven to be moderate to low level severe flare up. I spend a lot of time on my feet whether walking around campus or at the diner where I work. Being on your feet a lot makes the flare-ups worse. The crap thing about gout is that the flare-ups get worse the older you get and recovering from them takes even longer. I know this for a certainty. A flare up now at 35 is 10 times more devastating than it was when I was in my mid 20’s

 

 

Order of events

When I start to feel the pain coming on in my feet (any pain) I start drinking cherry juice just in case. Cherry juice has proven to help break down the crystals that build up in the joints. I read this online a few years back and it really does help. I do this whether I have meds or not. The 2 problems with cherry juice are 1. It doesn’t work fast. 2. Cherry juice is expensive. You need pure, tart cherry juice, no concentrate, no mixes with other fruit juices. You need the real deal and just the real deal. Generally a 24oz bottle of cherry juice costs about 15 dollars and goes up from there with size. Typically I go through 24oz in a day or 2. It’s not just the Gout which causes the problems but everything else that comes with it.

Here is a list of how things typically happen for me when I get a moderate to severe gout flare up.

I feel Flare-up beginning to happen, toe/s becomes inflamed.

-I begin walking funny, usually on the heel of the affected foot. I start limping, trying to compensate for the fact my first 3 toes and the top of my foot nearest them will not bend without excruciating pain and often they won’t at all. I am 6’4” and weigh about 300 lbs. I am a sexy guy, but I cannot limp in a safe and sexy way.

– I get a sprained ankle in the affected foot from limping and walking funny (almost always).

– I can’t wear normally wear closed-toe shoes or boots. I can barely walk without the assistance of my cane.

-My knee on the leg of the gout flare-up starts to hurt. (I have bad knees already)

-Anywhere from 5 days to 2 weeks late the flare-up is gone. Usually after 1 week it has subsided enough where I can squeeze into my shoes again with some discomfort (but not always). Keep in mind this whole time I am still limping and walking funny.

-The opposite foot sometimes has its own flare-up which historically is less severe for me. I have come to call this the aftershock. The aftershock happens about 80% of the time.

– The opposite foot of the original flare up gets a slight ankle sprain and/or uncomfortable knee pain from walking putting more weight on that leg during the gout flare up.

-Three to four weeks after the gout flare up life is back to normal…Usually.

 

Often when I get a Gout flare up I do my best to stay off of it, keep it elevated and alternate heat and ice. I drink the juice and take ibuprofen. This current attack of gout has been worse than ones in years past. The reason is because I work at a diner and I am on my feet A LOT. When my I felt my flare up begin in my left foot on Tuesday 18th I attempted to work on it the next night (Wednesday night). That night I wasn’t hosting, I was working back of the house and carrying heavy things and walking faster than what I should have. I was limping, walking on my heel and just putting too much weight on it. I had no chance to really rest it for over 8 hours. I had to work so I didn’t feel I had a choice. When I got home I knew the worst was coming.

Gout foot is on the left, this my foot today and its a little better
Gout foot is on the left, this my foot today and its a little better

I ended up getting a second-degree sprain in my left ankle (same foot as the gout flare-up). This rendered me nearly immobile. Not only were my toes swollen because of gout but now my ankle was swollen. I looked like I had some mini version of elephantiasis in my foot. I began wearing a walking boot to help give some protection and support in my ankle (which for a time hurt worse than the gout flare-up). Wearing normal shoes, even sandals on the left foot was impossible. I wanted to use the boot so I could at least attempt to go on with my day to day life and responsibilities since I have a lot on my plate right now despite the fact I was in so much pain. I tried working last Saturday but couldn’t make it the full shift since everything hurt. I haven’t worked since.

Side view comparison. Far foot is the Gout foot. Near foot is normal
Side view comparison. The far foot is the Gout foot. Near foot is normal

The thing about working in restaurants is that you have to wear nonslip shoes. It’s one of those OSHA and insurance liability rules which I understand but don’t agree with. Guess what are not slip resistant? The medical walking boot like I am wearing. So because of the Gout and associated the ankle sprain I was wearing a boot and wasn’t allowed to work with the boot on. I haven’t been able to NOT wear the boot and because of the swelling and sprain I could not wear my normal shoes.

IMG_20140330_102938_803[1]

Today, this morning, in fact, was supposed to be my first day back at the diner since last weekend. The ankle sprain has subsided into a dull, but acceptable ache that I could deal with. The gout had been slowly getting better…or so I thought. I was ready to go without the plastic walking boot and felt my ankle was well enough that as long as I was careful I would be fine without it. However, I woke up today with more pain around the toe than I have had in 2-3 days. I didn’t think much of it as I have gotten used to tenderness and stiffness in the morning with this whole ordeal. Anyways after getting dressed I went to put on my boots for work only to find the area around my toe was so swollen I could not even get my normal work boot on my left foot. I frantically tried every single shoe I had. I needed to work, I needed to be there. There are things going on at my work and it will look bad if I am not there yet again after telling people I would be. Every shoe, boot and combination I tried was matched with excruciating pain and defeat.

I called work, talked to the supervisor and explained to her what happened that morning. I don’t know if she could understand me since I was crying at the same time. I don’t cry often but between the pain, feeling completely stressed and now defeated…I was crying. I’m not ashamed of saying it. I told her I couldn’t come in even though I wanted too and I felt like an asshole for not being able to come in. I haven’t worked in a week and won’t have a paycheck this coming week; I didn’t need that either not with a baby on the way. Did I mention I had to shell out 100 bucks yesterday on new tires since some asshole ran me off the road 2 nights ago making me hit a curb and destroying a tire and its wheel? Yea it was awesome….prick!

I wrote this blog not to bitch really (even though venting is nice) but so people understand that gout is a real thing. It’s not some made up craziness, it’s not something we can just walk off and it’s not fucking funny. It’s painful, hard and messes your life up in more way than just the physical pain it causes. I wrote this so that other people out there might read it and relate if they have gout or know someone who does. So they might feel better and not so alone. This really is something men often suffer through in silence. I tell people when I have a gout flare-up (I can’t really hide it) but I feel they just roll their eyes and don’t really get it. It’s not just a sore foot; it goes beyond that, far beyond that.

Stacey called me from her work this morning and talked me to since I left her a crying voice mail as well after I called work. I don’t think she’s ever heard me cry. She reassured me that things would be OK. But that’s my job to say that to her not her to me right? At least that’s how it feels. I’m supposed to be doing the reassuring and being positive since she is pregnant. I love her so much for saying it. But I worry they won’t be, we have so much going on right now and this is the last fucking thing I/we needed. I can handle a lot of stress, but I feel like things are building up. I won’t lie, I do worry about what I’m going to do when a flare-up happens after my son is born.

So now I’m sitting at coffee chop feeling completely shitty and useless.

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11 thoughts on “Men and Gout: Our silent reality

  1. i get one or two flareups every year, I am actually going through one right now which started christmas eve and this one is the most painful one yet as it is deep in my ankle joint. I just turned 41 and I too am staying away from being medicated by trying to lose weight and eat right, which to a certain extent has worked. Unfortunately I also have sleep apnea which i recently discovered can largely contribute to flareups… I wanted to find out, has anyone here actually used a walking boot and if so did it help the pain? I am thinking of getting one but I want to make sure it actually helps before doing so…thoughts???

    1. Thanks for the reply. I actually do have a walking boot that use for bad flare ups. Sometimes, I use is when my toe is swollen and can’t get a shoe on my foot. Other times I’ll use it for, when like you it’s in my ankle and can barely walk. It does help to some degree. I will caution that the walking boot does throw off your normal gate of walking. It may also throw off your balence and can put strain on the the opposite leg and especially the knee causing issues like sprains and sore knees. It’s worth it though since it rarely happens

  2. Reading this helped me so thank you for venting. My left foot has gout. Guess what, I am a door to door interviewer and I have to walk for long periods a few days a week. I now have a walking boot which helps a lot. I do not eat meat or fish or drink alcohol so I don’t know why I have this beastly problem. I also like to wear pretty shoes so it makes me upset too. I am sitting here at 3 in the morning unable to sleep.

    1. Tania,

      First, thank you so much replying to this and adding to the talk. I know gout affects more men than women so I really appreciate a woman’s perspective on this. For a few years, I worked in a restaurant and was on my feet all the time. When I had an attack it was so unbearable that I usually had to call into work even though I could not afford since I wasn’t allowed to wear my walking boot at work. Have you cut meat out of your diet completely? I am curious about the fish since my doctor said fish was actually good for gout sufferers over meat.

      If I may ask how often are you gout attacks? Do you keep a log of what you eat? I ask about the log because my doctor had me do that so we could narrow down what was or might be causing the attacks.

  3. Sounds like you’re already on something, but if you have gout attacks relatively frequently, you should ask your dr about a drug called Allopurinol (I think that’s how it’s spelled). It’s basically a maintenance drug that you take that prevents the flare-ups. Reviews I’ve seen on it have been overwhelmingly positive. The only thing that steered my dr away from recommending it to me is the fact that I only suffer from 1-2 flare-ups per year, and Allopurinol is a maintenance drug that your liver has to process, so it’s something that requires periodic blood tests to ensure your body’s taking it well. In the end, she was willing to prescribe it to me if I wanted, but recommended I hold off unless flare-ups get more frequent. I’m 35, so figured I can probably hold off on the meds for a bit longer.

    As a good substitution, she recommended (and prescribed) a 6 day dose of oral steroids, and prescribed an additional refill to keep on hand. She said to basically just keep it on hand, and if I feel a flare up is starting, I should begin taking them, which will cut the inflammation down drastically.

    Cortisone shots also work well from what I’ve heard, but they’re excruciating from a pain perspective, and with every injection, they become slightly less effective from what I’ve heard. They also only work well if given during the early stages of the flare-up (going in a week later probably won’t do much), and the thought of someone shoving a wide-ass needle into my toe joint at the height of my pain threshold does not sound enticing.

    Anyway, just figured I’d add my two cents. I’ve been suffering through my gout attack and recovery for 7 weeks now (2 weeks of horrible pain, and 5 weeks of sprained ankles, subtle soreness, and shoes that are laced up half way up the tongue.) I’d like to say it gets better, but I’m still waiting…..

    1. Hey, thanks for responding it’s always nice knowing I am not the only one in this boat and that this post might help other people. My doctor did suggest Allopurinol but we decided against it since, like you I only suffer a few attacks a year of varying degrees and I’m only 37. I feel I am too young for an everyday pill regimen.

      I have some slight damage to my liver from a medication I took for acne as a teen so I have to be careful about how I treat that which is why I rarely drink. I have been taking a pill now and I can’t remember the name but I’ve been taking it for about a year and if you’re interested ill update with the name. I only take in 3 times a day and only when I feel an attack comming on (you know what I mean) and it works very very well and quick.

      Another thing that I found works very well is dried cherries. They are easier to take and less bitter then straight cherry juice and also make a nice snack. As of now, I am not sure what’s worse; the actual gout attack or the sprained ankles and sore knees.

    1. I appreciate that Eric. It’s nice hearing from others out there who have the misfortune of dealing with this. It reminds me that I should update this post. I’ve been taking a medication when I feel an attack coming and it works amazing.

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