Thursday, August 16, 2012

Gout Outta Here


Gout Outta Here

The other day I had to refill my prescription for my high blood pressure.  The medication had no refills left so it required a call to my physician.  He refused the refill saying he needed to see me first.  I had just been there last month so I did not see the need.  Anyway, I had to make an appointment before he would offer his assistance.  It made me think back to a time when he fought me on a daily medication that might have made my life a bit easier.

It was late spring of 1990.  A new tradition was in its infancy.  We already had a house down the Jersey Shore for the 4th of July holiday.  Now, I would be a part of another friend’s Garden State offering.  His parents had a house at Barnegate Light on Long Beach Island.  I had spent many a summer during college on that island, but usually the south end…the partying end.  This area was more residential, and the beautiful two-story house sat right on the bay.  We were given the week right after Drexel’s classes ended to invade…usually the 3rd week in June.  I had been working my new job for about 6 months and was looking forward to a couple of days off.  A few days before I was to leave, I woke with a shooting pain in the middle of my foot.  I had played hockey the night before, so I just assumed it was something I had done in the game.  The pain did not subside, nor did a bruise form in the area.  I had never experienced anything like this before.  I went to the doctor to get it x-rayed to make sure there was no break.  After a few snapshots and a few tests the doctor returned.  “Mr. Walsh, you have Gout.”  Huh?

Gout was something I had heard of, but I thought that ailment went by the way of the dinosaur.  People got Gout in the olden days, along with Scurvy, Beriberi and Rickets.  I was given medication and told not to drink alcohol for the next two weeks.  Excuse me?  I am heading down the shore…not drinking alcohol would be akin to not breathing.  Not yet being familiar with my new foe, I obeyed the doctor’s orders.  What a boring week that was.  For three years the monster would not return.  During that time I chalked it up to a quack of a Doc who obtained his degree from the bottom of a Cracker Jack box.  I may have mocked him too soon.  In the summer of 1993 the Gout would return with a vengeance.

Gout 
Definition
Gout is a form of acute arthritis that causes severe pain and swelling in the joints. It most commonly affects the big toe, but may also affect the heel, ankle, hand, wrist, or elbow. Gout usually comes on suddenly, goes away after 5-10 days, and can keep recurring. It is different from other forms of arthritis because it occurs when there are high levels of uric acid circulating in the blood, which can cause urate crystals to settle in the tissues of the joints.

Urate crystals to settle in the tissues of the joint…hmmm…let me put that in layman’s terms.  It is like shards of glass imbedded in the joint.  You can’t rub it, you can’t touch it…it constantly throbs like a cartoon character who stubbed his big toe.  While sleeping, even the slightest movement of a blanket can awaken you in excruciating pain.  My demon would settle in the knuckle of the big toe.  It would be the most intense pain I would ever have in my life.  As stated, it does come on suddenly…so once you feel it, preventive medication is already too late.  I was recommended to a podiatrist, whom I must say was very sympathetic to my plight.  I would get to know him very well.  The treatment would be a whirlpool for the foot.  Warm water would get the blood circulating to the area and the flow would help to clear the crystallization.  After this was done, an ultrasound machine was used to try and break down the remaining crystals in the joint.  I was given anti-inflammatory pills too.  While this sped up the recovery process, time seemed to be the only real remedy.   I went to my primary physician and asked for a long term solution.  He mentioned there was preventive medication, but felt I was too young to start a daily med.  He suggested diet and exercise, and drink plenty of fluids…and not the alcoholic type.  Believe it or not I took his advice.  I was helped along with a perk at my job of having a gym and personal trainer.  I avoided the foods on the “Gout List” and cut back on the beer intake.  I was now 28 and in the best shape of my life.  However, the almost monthly visits from the Gout remained.  My own personal period.

Over the years I would do my best to manager the monster.  I would even play hockey while in the midst of an attack.  You think putting the skate on was an adventure in pain…imagine taking it off after the game.  The next day I would be back at the podiatrist…and the whole process would begin again.  I tried not to miss out on things, but inevitably there were times I would have to give in to the pain.  I would offer other excuses why I would be missing out.  I never shared my ailment with anyone.   The name in itself is enough to have people turn away.  Not since the days of Kings has the word Gout been commonly used.  I would suffer in silence.

In late 2000 the monster must have has his fill with my big toe.  He branched out to my ankle.  While attacking my big toe, I was always able to walk…albeit painful.  But when the Gout expanded its route, the ankle would be my Achilles’ heel.  The ankle joint is larger than the toe so more crystallization can form…hence harder to remove.  The big guns would have to come out.  My podiatrist would have to clear the joint by inserting a needle in it and flushing out the joint.  How delightful.  I struggled through these procedures for the next few months.  My doctor still did not relent on the daily drugs, feeling my youthfulness should be able to fight off this Old Man ailment.  I did understand where he was coming from.  Certain medications can have long-term side effects.  He felt it was not worth the risk.  However with the attack on the ankle, he now was starting to soften his stance…especially when I barely had one.

It finally culminated in October of 2001.  The Yankees were in the World Series and they were going for four in a row.  I went to Game 3 at the Stadium and what a grand spectacle it was.  The world would see that even though New York City had be brought to her knees on 9/11…she would not break.  The President would throw out the first pitch.  After a night of partying the payment ensued.  Mr. Gout came a knockin’.  It was worse than ever.  That night after I watched an amazing Game 4 on the television, I received a call from my friend.  “You want to go to Game 5 tomorrow?”.  Yes, I most certainly did.  But there was no way I could go, the pain was too great.  I made up an excuse for my absence.  Alone in my apartment I would watch Scott Brosius, with two outs in the 9th, hit a 1–0 pitch over the left field wall to tie the game. Yankee Stadium erupted after the home run.  For the second straight night, the game went into extra innings following a ninth inning home run.  The Yankees would win it in the 12th when Alfonso Soriano knocked in Chuck Knoblauch.  To top it off, in the ninth inning, with the Yankees down 2–0, Paul O'Neill, retiring after the series, was serenaded by Yankees fans chanting his name in unison.  My favorite player since Lou Piniella.  This was the last straw.  The following day I went to the doctor and demanded the daily medication.  He thought my youth could defeat the monster, yet it was taking too much of it away.

One of the early side effects of the preventive medication was inducing an immediate acute flare up of the Gout itself.  Great.  But I figured I could muddle through it one last time.  Of course, nothing is ever that simple for me.  You may recall from the definition above it may also affect the heel, ankle, hand, wrist, or elbow.  This time it chose the hand.  Well, it would go away in 5-10 days…however I had a wedding to attend, and I was in the wedding party.  It was filled with friends I had not seen in several months.  Each greeted me with a hearty handshake.  Each time I smiled as I almost crumbled in pain.  One last parting shot by the monster.

For over 10 years I have been on the medication.  Gout is now just a painful memory.  As my friends and I have gotten older, we discuss the certain ailments and medication we now take.  They are surprised when I say I am on Gout medication.  “We didn’t know you had Gout?”

Not anymore.

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