By Jared Fiel
By the time I turned 50, I had come up with a number of ways of causing myself pain. I have broken my foot, been in a car crash and had a soccer collision that caused another player’s tooth to get lodged in my leg. I’ve even listened to ABBA.
But in all that time, there is nothing that has hurt worse than gout.
Yes, gout. If you have never had it, you might think (like I did in those blissful days before my first flare-up) that gout was some old-timey ailment like scurvy or cholera. But for older guys like me, especially guys like me who enjoy a good burger and beer, gout is a very painful reality.
I talked to Dr. Laura Howe of the UCHealth Rheumatology Clinic in Greeley who said gout is a growing problem—mostly for older men—brought about by really tasty food.
The reason gout sounds like an old-timey disease is because it is. It’s been around since, well, really tasty food. When humans stopped simply surviving on whatever we could grow and were able to create fatty, sugary goodness, there has been gout. In fact, it used to be called the Rich Man Disease.
But unlike most rich people problems, gout spread to the rest of us who can still afford a Big Mac and a large milkshake.
“Now this is the Western Diet Disease,” says Dr. Howe. “Our diet, with processed foods and sugars, it’s delicious and killing us.”
Dr. Howe has lots of big words to describe what happens to cause a gout flare up, but I am going to try to translate: Essentially, there are foods that are high in purines (see Gout Diet). Purines may sound like something George Lucas came up with, but when your kidneys try to process these purine-rich foods, one of the byproducts is uric acid. The acid finds its way into your joints, especially colder joints typically in the extremities, like your big toe. If the acid sits there long enough, it starts to crystallize into needle-like bits that cause the kind of pain that makes grown men cry.
My first flare up started innocently enough. My big toe felt like I had stubbed it on a coffee table. Of course, I couldn’t remember hitting my toe on anything, but after 50, I had grown accustomed to having minor scrapes, bruises and pains of mysterious origins.
But the pain got worse. After a short while, it hurt just to put a sock on. Then it became painful to walk on. That night, I woke up at 3 a.m. with blinding pain because the weight of my bed sheet was excruciating on my foot (this is no exaggeration).
The next morning, a smart person would have called their doctor to get an appointment as soon as possible. I am not a smart person. But I was having lunch with a friend that day and I mentioned this problem to him.
“Dude, that’s gout and it sucks!”
My friend is a smart person. He had gone to a doctor for this a few years before. The doctor had told him to change his diet and see if it went away. If it didn’t, the doc would give him medication. My friend said the pain was so terrible that he didn’t eat red meat or drink beer for a year just to make sure he never experienced it again.
Dr. Howe says diet, exercise and hydration are the first lines of defense. But genetics also factor in; genetics may predispose you to gout but the flare-ups stem from diet. Either way, Howes says, “By the time most patients see me, they are well past that, and they need serious help.”
“Serious help,” according to Dr. Howe, means either medication to help rid the body of the extra uric acid or medication to relieve the pain. Or, really, both.
Things can get even more serious with gout. Dr. Howe used to work at a VA hospital where she saw some patients who had put off treatment for so long, they couldn’t walk. When the uric crystals build up even more, they can cause nodules on the foot that may deform the joints and eventually break through the skin and become infected.
Fortunately, she says, she doesn’t see a lot of that now because people are reaching out for help before things get that bad.
At this point, I need to remind you, kind reader, that I am not a smart person. I didn’t see a doctor. I decided to rely on my friend’s advice and the internet. And like most people reading on the internet, I read only the stuff I wanted to hear.
I read that red meat was bad. So, instead of grilling a big steak on a lovely Sunday afternoon, I grilled a gorgeous stuffed mushroom. It was delicious, and it caused an even worse flare up the next day.
I read that if I bought this foot roller thing, I could rub my foot over the bumpy bits and it would break up the crystals in my toes and eliminate my pain. When I showed this wonder device to Dr. Howe, she looked at me like I was presenting her with magic beans to create a beanstalk. “Well, heat is good. And if you rub your foot, I guess that creates heat,” she says, clearly trying to make me not feel like a moron for purchasing this.
The one thing I read that actually might have helped was tart cherry juice and extract. Dr. Howe says she has heard that this can help rid the body naturally of excess uric acid. Since I have two large bottles of extract and a vial of juice in my fridge, I felt moderately vindicated and maybe a little smarter.
At this stage, my gout flares up every so often (usually after steak), and I keep it at bay for now through diet, but Dr. Howe warned me that most people who have gout will eventually need medication.
Gout Diet
Pretty much everything you like to eat or drink contains purines, but here are some foods that you should enjoy only in moderation if you are worried about gout (or kidney stones), and avoid completely during a flare-up.
AVOID:
Red meat and organ meat • Alcohol • Seafood (except the ones listed below) • Sweetened beverages (yes, sugar is not good) • Mushrooms (the food kind…not sure about the other kind) • Asparagus • Cauliflower • Spinach and green peas • Fried foods and rich desserts
EAT:
Eggs • Nuts and legumes • Any fruit and veggies (except the ones listed above) • Crab, salmon and herring • Low-fat dairy • Bread • Pasta • Rice and potatoes (see, there are some good things!) • Coffee and tea (whew!)
