Gout – The 4-1-1

I bet you thought that no one got gout anymore. That it was just in the history books, right? Not true.
Gout is still around and it seems that as people get heavier the more gout invades life. I use that word invade because generally one’s first gout attack is an attack. It is sudden and very painful. 

“I just kind of woke up one morning, stepped out of bed, took one stride toward the bathroom and ended up giving a high falsetto scream, like a six-year-girl, flopping to the floor, [and] grabbing my left big toe.”

David Wells, major league baseball pitcher
What is Gout?
 
Gout is actually a form of arthritis. Arthritis is actually the overall name for over 100 diseases of the joints, bones, muscles, cartilage and other connective tissues.
Gout usually attacks the big toe but it can be found in the feet, ankles, knees, hands, wrists or elbows. It will usually attack only one joint at a time but if left untreated it can become chronic and attack other joints.
Gout is an unusually painful form of arthritis. Attacks can last anywhere from a few days to two weeks. The attacks can get worse if the disease is not treated and will cause not only cause pain but will lead to a degeneration of the joint.
What causes gout?
 
Gout is caused by a high level of uric acid in the body. We all have uric acid in our bodies. Uric acid is created when purines are chemically broken down in the body. Part of the uric acid in your body comes from the breakdown of cells in your body and part of the uric acid comes from food. For people without gout, most of the uric acid dissolves in the blood and travel to the kidneys and is expelled in the urine. For people with gout, the uric acid is not expelled and will build and will create uric acid crystals in the joints. It is the collection of these crystals in the joints that cause the pain of gout. Unfortunately, unless the uric acid levels are reduced, the crystals can continue to grow.
What are Purines?
 
Purines are found in in the cells in our body and in most foods. Foods that contain high levels of purines are meat (bacon, beef, pork, lamb), anchovies, sardines, herring, mackerel, scallops, and beer. In general, the suggestion is to limit eat a more plant based diet, drink plenty of water, and choose low-fat or fat-free dairy products.
Since not all the uric acid in your body is produced from eating, there is some debate about how much your diet will affect the lowering of uric acid in your body. But as is ALWAYS said, maintaining a healthy weight and exercising will help.
How do they determine that you have gout?
 
There are some key elements that indicate gout.
1.       Sudden onset of pain
2.       Severity of the pain
3.       Which joint is affected
4.       How many joints are affected
5.       Medical history
6.       Eating and drinking habits
The doctor can order a blood test that will indicate if you have a high level of uric acid in your blood. This will be an indication but not everyone with high levels of uric acid develops gout. The only foolproof way is to look at the fluid (called the synovial fluid) that is found between the joints under a microscope to see the uric acid crystals.
I think I have gout. Why go to the doctor?
 
I know, right? It goes away, why go to the doctor. Yes, there has to be a catch. Gout is a progressive disease. You don’t just get it once and then it is gone. The high uric acid in your body will continue to cause joint damage – even when you aren’t in pain. Each bout of pain will be worse and can cause permanent problems.
So, yes, you need to go see your friendly local podiatrist. If you are in pain, they can recommend the use of over the counter pain relief medicines. There are medicines to help your body release the excess uric acid and you and your doctor can discuss the use of those medicines.
 
Famous people with gout
Just because we are all a bit nosy…
Ben Franklin
Henry the VIII
David Wells
Maurice Cheeks
Sir Isaac Newton
Jared Leto
Have a great week!

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