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 to 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 later the flare-up is gone. Usuall, 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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20 thoughts on “Men and Gout: Our silent reality

  1. Had one of the worst timings of gouts ever yesterday. Deadline of my college stay extension submission, and last day before finals submission which I haven’t worked on a single bit which meant I just had to go to school that day. The first hour alright, paying my extension fee, walking around with crutches. Felt embarassing tho. Next hour felt like HELL. Man I felt EXHAUSTED. Over the course of an hour I had to go down a floor(used an elevator but I was just getting worn out) and up again using crutches. I’m 5’10 175ish so not exactly a lightweight. The look on my face when I was asked to GO GET MY DOCUMENTS PHOTOCOPIED when the photocopying station was 2 floors above. When I had gout + a sprained ankle(yeah timing was great, forgot to mention I also sprained my ankle the day I forgot to resist hotdogs that triggered my gout). Sure there was an elevator but getting to the elevator was already a chore since this was pretty much end to end, then the photocopyer was at the other end of the building. Amazing first 2 hours. Wasn’t done yet, since college stay extensions require a shit ton of signatures from different offices. Fuck me. Had to go up 3 floors again after going down to submit the photocopied docs. Great. At this point thankfully my friend already arrived, so I had some assistance. Got to the deans office, I was then told he’d arrive after lunch; it was about 9am at that time. Awesome. So went to the lab to work on my project(programming) which I was just totally incapable of because of the exhaustion. Ended up browsing shit for about 1 hr before I gave in and dozed off for about an hour and a half. Woke up expecting to feel better but I just felt worse. 2 hours of moving around in crutches just takes a toll on you so hard. Had to go down a floor to the deans office; it was an end to end journey again to make it to the elevator. Fuckin awesome. I was still exhausted at this point no to mention woozy from just waking up. Thank goodness for my friend that was in the pep squad that assisted me. 2 times almost fell over from the stairs dude caught me. Assisted me 3 steps upwards(didn’t take the PWD ramp since I was just spent. The steps were a shortcut to the office) and damn dude easily got me up the stairs with one arm. Was tempted to ask him to just piggyback me during my entire stay. Those pep dudes are strong af holy cow. So got my final signature, and thank goodness too for my other friend who was dealing with the same college extension, he submitted my forms and was an exemplary individual enough to return to me and resubmit my form because of a couple of clearance issues. Of course those clearance issues meant I had to go down again and back up. Even with the elevator the problem was the trek to and fro the elevator. I was so unfortunate to have all my destinations at the other end from the elevator. On the way up I decided to grab a bite with my friends since the cafeteria was near the elevator and I was starving from all the crutching. It was while we made our way to the cafeteria that I may have experienced the most excruciating pain I’ve ever felt. I accidentally hit my crutch on his foot which unbalanced me and caused me to use my gout foot instinctively and unconsciously to catch myself. It was for only about half a second that I put my full weight on my foot before I recovered with my crutches. That half a second felt like the entire multiverse dumped the solar system on my foot. Waves of unbelievable pain. I wasn’t even aware pain that extreme was possible due to gout. I tried to play it off so as not to make him feel bad but the pain was so severe I had to fake losing breath to take a short break. Man the pain just took so long to subside. It decreased gradually but because of how intense the pain was it took a while for it to be tolerable. 15 minutes of torture. Fortunately that was my final torment since after we ate and went back up I was replenished enough to work on my project enough before going home couple hours later. Never has the thought of cutting my ankle off occur so frequently till that day. Will try cherry juice when I’m able to get my hands on some for sure

    1. Wow man, you did have a bad time of it and what shit timing my friend. I’m 6’4 and about 330 so I totally understand what uncomfortable pain in the ass crutches are. It must have been the been the week for since I had a particularly bad gout attack combined with planters fascitis on my heel that same week. Usually with a boot and can bear through it but I actually had too miss a few days of work over it this time. It’s been a few years since I have had a gout attack and associated ailments to this degree which is confusing since I’m basically 90% vegetarian. Like you I ate one thing and set it off. I’ve had a lot of things happen to me but I swear, the gout pain this the most debilitating pain I have ever dealt with. Usually, I buy cherry juice at Walmart. Just make sure its straight cherry juice and not concentrate or mixed with something else like cranberry. I don’t know why it makes a difference but it does. Then cut it with water I usually keep the ration 10% juice and 90% water for a 12oz cup.

  2. I had my first experience with gout last year. I have been fighting high blood pressure since I was a kid, and now in my 40s, I’m experiencing side effects of it. One of those side effects has been poor kidney function. Because my kidneys don’t work as well anymore, I have begun to get uric acid build up, causing swelling in my ankles and on my Achilles tendons.

    My first sign of gout was when the tendon in my left foot partially tore because the uric acid crystals weakened it. I did nothing to tear the tendon, so my doctor didn’t even believe it was torn. I wore a boot for 2 months because walking became excruciating, then 2 days after I got out of the boot, the tendon tore again with no provocation. My doctor finally came around, and sent me for an MRI and it showed a lot of little spots on the tendon, caused by uric acid.

    So I got to spend another month in the boot.

    I didn’t have another flare up until January this year and nothing my doctor did worked for it. Here we are in March, and I went to Walmart last week for iron pills since I also have anemia. As I got the pills, I looked up and saw Tart Cherry Extract supplements a few shelves above. I’d often heard that Tart Cherry juice worked to relieve gout symptoms, so I got them to see if they worked for my problem. It was almost instant relief. I took a capsule about every 3 hours the first day, and the next day I was walking without a limp. I did still have some pain, but I attribute that to walking funny and irritating my ankle while I was limping around from the gout symptoms.

    For the last week, I’ve continued to take the Tart Cherry capsules, usually about 3 a day unless I feel pain creeping back into my tendon, then I might take a few extra. The capsules are supposedly equivalent to eating over a pound of cherries each. They are far less than the $15 juice you mentioned, I think they were less than $7 for a bottle of 60. You might want to give these a shot Michael, and anyone else that is suffering from gout.

    Thank you for this post!

    1. Hey, thank you, Brent, so much for reading, sharing your story and leaving such an awesome reply. I’ve had the tendon issue also with gout but never figured out how they were connected. What is your doctor planning on or suggestion to help the problem? The boot is such a pain to wear and I can’t even imagine wearing it as long and as often as what you have. I will look up those pills for sure and see if those work, as well as the juice, does for me. Thanks for the suggestion! Good luck my friend.

  3. I’m 170lbs and in my 20s and have had gout recently. Well I still do as I type this. My foot is swollen with a nice angry red color and walking? Well that’s just a test of mental fortitude. Holy hell the pain gout gives you, it’s ridiculous. Especially when putting a shoe over that foot. I needed too for a doctors appointment, the entire time my foot was just throbbing like crazy. I have a high pain threshold generally but this was just ridiculous.
    I’ve been pretty much limping along when I needed too. I’ve reached a point where I’ll probably just spend the next 3-4 days indoors and not bother moving around much.
    Reading your post, I get it, I really do. I hope your Gout flares when they come, pass quickly. Same for any other sufferers out there.

  4. 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. Yes, the boot helps me walk during an attack. I had one from a stress fracture, thought I’d try it out and was really pleased at the result. Give it a try, you can buy them online cheaply.

      Linda G.

  5. 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.

  6. 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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