By Henrylito D. Tacio
DON’T dismiss gout as just another heath problem. To be a gout patient is no joke. Listen to the words of one sufferer: “Today, I am home and probably be home for the whole week or more. The gout has attacked again and this time it is really painful. I didn’t know I had one until I went to see my doctor last month. At first, I thought I was just over working or I was putting a lot of pressure on my toe therefore it hurts. For me, I literally could not stand for as much as a sheet to touch my feet and walking is impossible.”
Once known as the “king’s disease” because it almost always afflicted the well heeled, this form of arthritis is an equal opportunity deployer: It delivers a royal pain to the toe, knee and other joints. American statesman Benjamin Franklin described gout as an enemy which “would not only torment my body to death, but ruin my good name.”
Aside from Franklin, other famous of the arthritic condition include numerous Charles Dickens characters along with real-life sufferers Henry VIII, George IV, Charles V, Alfred Lord Tennyson, Immanuel Kant, Samuel Johnson, John Milton, Isaac Newton, Nostradamus, and Thomas Jefferson.
Gout is also mentioned in the following books: Jane Austen’s ‘Lady Susan,’ Herman Melville’s ‘Moby Dick,’ Jonathan Swift’s ‘Gulliver’s Travels,’ Robert Louis Stevenson’s ‘Kidnapped,’ Nathaniel Hawthorne’s ‘From Twice Told Tales,’ George Eliot’s Middlemarch, Wilkie Collins’ ‘Law and the Lady,’ Anne Bronte’s ‘The Tenant of Wildfell Hall,’ H.G. Wells’ ‘The War of the Worlds,’ and Victor Hugo’s ‘Notre-Dame de Paris.’
Gout is caused by very plebeian uric acid. We all have it in our bloodstream. But if you suffer from gout, “either you produce too much or you produce a normal amount and don’t excrete enough,” says Dr. Branton Lechman, a clinical assistant professor of pharmacy at the University of Southern California School of Pharmacy. Either way, the excess turns into tiny, troublemaking crystals that inflame your joints.
The onset of gout is usually quick and unexpected. Often, people who develop gout will do so during the night while sleeping, after having gone to bed in good health. During the night, they are awakened by acute pain in the big toe or, more rarely, in the heel, ankle or instep. This pain has been described as feeling at first like a bucket of cold water has been poured over the affected area, with the pain increasing to a violent stretching, tearing sensation. There is also a pressure and tightness around the area, and the pain becomes unbearable.
“We’re talking about pain so intense that the weight of the bed sheet feels excruciating,” explains Dr. Paul Caldron, a clinical rheumatologist and researcher at the Arthritis Center in Phoenix, Arizona.
The soft tissues, such as the muscles and tendons, around the joint can become hot, red and swollen, and wearing of a regular shoe may become impossible. This megagrief can last for hours or days, but a gout bout can vanish almost as swiftly as it comes, leaving the person totally pain-free until the next episode.
Why are some people more susceptible to gouty attacks? For some, it may due to hereditary in nature. For others, it may be due to some risk factors, among these are obesity and sudden weight gain, abnormal kidney function, and certain types of cancer.
Alcohol is a double whammy for those with gout, because it boosts the production of uric acid, says rheumatologist John G. Fort, clinical associate professor of medicine at Thomas Jefferson University Hospital in Philadelphia. Beer is particularly bad, because it has an even higher purine content than wine or other spirits.
A study of nearly 50,000 men has found those who over-indulge in beer, in particular, are at heightened risk. Men who drank two or more beers per day were 2.5 times more likely to develop gout than those who did not drink. The research, published in ‘The Lancet,’ was carried out by a team at Massachusetts General Hospital.
But it’s not only alcoholic beverages that make a person more susceptible to gouty attacks but drinking sugar-sweetened soft drinks as well, according to another study published online by the ‘British Medical Journal.’ Those least likely to develop gout are men who drink less than one serving per month. Compared with that group, men who drank five to six servings a week were 29 percent likelier to develop gout. This probability rose to 45 percent among those who had one serving per day, and to 85 percent among those who drank two servings or more.
If you have high blood pressure (hypertension) in addition to gout, you have double trouble. That’s because certain drugs prescribed to lower blood pressure – such as diuretics – actually raise uric acid levels, says Dr. Lachman. His advice: Try to control your blood pressure naturally by decreasing sodium intake, exercising regularly, reducing excess weight and controlling stress.
Some foods that are rich in purines can lead to attacks. Purine-rich foods include organ meats and all meat products. (In an episode of ‘King of the Hill,’ the leading character develops gout in the big toe as a result of eating chopped liver on a daily basis.) “You can’t get away from purine, because it’s in most foods,” says Dr Caldron. “But it’s useful to avoid red meat, especially organ meats and some types of fish.”
If you have gout, you should also avoid tea, coffee, cocoa, and chocolate. Some dark, green leafy vegetables, asparagus, cauliflower, mushroom, and those rich in protein (like dry beans and peas) may also present a problem.
Despite the advance of science, people are still suffering from gout. However, there are some traditional solutions which can lessen pains. One of these is the virgin coconut oil (VCO). Multi-awarded Filipino columnist Conrado de Quiros is one of those who believe in the therapeutic value of VCO.
“Taking virgin coconut oil has not made my gout disappear, or lessened its visits,” de Quiros wrote in his widely-read column. “But it has made walking much easier, something I’ve been at pains to do for some time now, my left knee in particular having become a little stiff. A rheumatologist once explained to me that gout attacks deplete the joints of fluids, which makes for stiffness. The equivalent, he said, is motor oil slowly drying up on a car engine, which causes friction among the pistons. Who knows? Maybe the virgin coconut oil is replenishing the lost fluids on my knee? That is pure speculation, of course. But I personally don’t care; I like what I’m feeling right now.”
Another traditional solution is eating mangosteen. The Chinese have used this fruit for thousands of years to help heal inflammation, parasites, wounds, burns, pain, diarrhea, bacteria and fungal ailments, and fever and headaches, among others. Recently, some practitioners are recommending mangosteen to those suffering from muscle problems and gout. It is currently being studied by medical experts as it contains xanthones, which are the highest concentration of antioxidants found in nature. Since mangosteen is a fruit, it is touted to be a safer alternative. As one old saying goes, “Why use a drug when a food will do the same thing?”
But one best solution is drinking lots of water. Large amounts of fluid can help flush excess uric acid from your system before it can do any harm. Dr. Robert H. Davis, a professor of physiology at Pennsylvania College of Podiatric Medicine, recommends plain old water. “Most people just don’t drink enough water,” he points out. “For best results, have five or six glasses a day.”
As a bonus, lots of water may also help discourage the kidney stones that gout patients are prone to. — ###
Gout: Invasion of crystal attackers
By Henrylito D. Tacio