It was week after we came back from our honeymoon when my husband woke up with tenderness and inflammation on his right toe. It was very sudden and we could not think of anything that had caused it, no strenuous exercise or injury. My husband took ibuprofen and hoped it would go away, but it did not. As the days went by, it kept getting worse, and his toe was even more swollen and bright red. He describes the pain as having a thousand little needles poking under the skin and jammed into the joint. We made an appointment with his primary care doctor and was diagnosed with gout.
Gout is caused by high levels of uric acid in the blood. The uric acid becomes little crystals, creating deposit in the joints and causing the acute attack. The first one my husband had was so painful that he had to soak his foot on a tub full of ice to get some relief. There are genetic and lifestyle components to the disease. Foods like red meat, seafood and beer can trigger a gout attack. My husband immediately cut red meat and beer from his diet, but we have found that it does not make much of a difference in his case. Treatment for gout includes a strong anti-inflammatory and steroids and, once the attack is over, medication to reduce the levels of uric acid in the blood. While the anti-inflammatories are only taken during an acute attack, the rest of the medications have to be taken continuously. If there is something we learned about gout is that it is a chronic disease, and has to be managed. Gout cannot be cured . This became apparent a few years after my husband’s first attack.
After having a few attacks here and there, some that were so bad that it took us to the ER, it seemed like the gout had “gone away.” My husband had months free of pain, which led him to a horrible mistake, he stopped taking his medication. Last summer, he had his worst gout attack to date, affecting his elbow.
This time there were some warning signs, his whole body ached and was extremely tired the week before the attack. Before this attack, we did not know that gout can affect any joint in the body, although elbows, fingers and toes are the most common. My husband’s elbow was the size of a baseball, it was red, tender and incredibly painful to the touch. He immediately went to the doctor and was put on anti-inflammatories once again.
I want to point out that, along with the pain caused by the attack, my husband had to endure incredibly uncomfortable digestive issues and severe stomach pain caused by the medications. Anti-inflammatories are incredibly harsh on the stomach, after prolonged use they can cause severe heartburn and ulcers. So on top of the anti-inflammatories, my husband had to take Omeprozole to deal with the side effects of his medication. The pain on his elbow was gone within a few days, but this time the swelling took much longer to go down, almost a month. This is because, when left untreated, gout can result in something called tophi, which is a hard deposit of uric acid. In some cases the tophi dissolves, but in others it can cause joint damage and limit joint function. My husband was incredibly lucky, because even though it was painful and uncomfortable for more than a few weeks, the tophi on his elbow eventually went away.
It has been almost 10 years since my husband was diagnosed with gout, and we have learned a lot along the way. Most importantly, we have learned that he will always have gout and that regardless of the time it has been since his last attack, he cannot stop medication. He will always be on it, even if at a reduced doses. If you think you have gout, go to see the doctor immediately, your joints and your family will thank you for it.