My foot hurt so terribly that I went to the emergency room. I waited in pain for more than an hour before my name was called.
I explained to the nurse that my foot started hurting two days earlier. I did not feel pain after the initial scream from the radio falling on my foot. I thought I would be fine. “But here I am,” I told her.
The doctor came in and I explained that it hurt when I put weight on my foot and that the swelling and discoloration was new that day. The doctor felt the area just below the big toe of my left foot, which was very tender. He decided “I don’t really feel anything, but we will do an x-ray just to be sure.”
“There is nothing wrong with your foot that shows up on x-ray,” he explained. “You have gout.” He explained that gout is a form of arthritis that usually appears around the big toe and is characterized by pain, stiffness, swelling and tenderness. It is caused by excessive uric acid crystals, he said. He prescribed a moderately high dose of a common anti-inflammatory medication and sent me on my way.
Over the next few months, the swelling and pain would come and go. The anti-inflammatory medication did little to relieve the pain. Over-the-counter pain relievers provided minimal relief. I missed work several days because of the swelling and pain. I just could not walk on my gout-affected foot.
It was six months later that everything changed. I woke up to sunshine peeking through the mini-blinds. It was going to be a “gorgeous” day, the weatherman predicted the night before. So I hopped out of bed, only to fall straight backwards as soon as my left foot hit the floor. I was writhing in pain. I looked at my foot and discovered that my big toe and most of my foot was varying shades of purple, red and brown and was badly swollen.
“Hmm- according to your old x-ray, your foot was fractured six months ago when you were here in emergency; let me find out who you saw then.”
“It was you; you told me I had gout, that there was nothing wrong on the x-ray. You are the doctor who prescribed the anti-inflammatory for the gout you diagnosed me with!” I replied in anger as I was seething at the fact that I did not have gout, but had been walking on a fractured foot for six months!
Needless to say, he left the room and another doctor took over. My foot was put in a cast and I was referred to an orthopedic surgeon. I had a cracked sesamoid bone in my left foot and had to have surgery to remove the small bone, due to the fracture being so old.
My experience with gout was bittersweet. I did not have the condition that can be difficult to deal with for many patients suffering from gout. Yet I was misdiagnosed by a doctor with the apparent inability to see the clearly fractured bone the first time. I suffered needlessly, then had to suffer through surgery and recuperation.
Gout can mimic other conditions. If you are diagnosed with gout, ask questions. Why does the doctor think you have gout? What are the differentials? A differential is a medical tem that describes another potential diagnosis that may be causing the symptoms. Demand an x-ray and ask for a second opinion, particularly if you had a recent foot injury, as I did. If you do not have risk factors, which the Mayo Clinic describes as diabetes, untreated hypertension, hyperlipidemia, family history of gout, over age 40, ask what criteria was used in the gout diagnosis. If I had known the risk factors, I would have asked for a second opinion. I was under 30, had none of the other risk factors. If you do indeed have gout, follow your treatment plan; gout can get progressively worse, especially when treatment is not followed diligently.