I don't know about you, but when I hear the word "gout" I think old-timey, rich old dude disease. I had no idea what caused it, or how to treat it, or even what the symptoms were.
Now I know. And not in my usual "I read it somewhere" way, but in a more practical sense.
Last Monday as I went about my day I got a cramp in my right foot, at the joint where my big toe is attached to my foot. I tried to work it out by stretching and walking through it, but it got progressively worse through the day. It got a little swollen, but not as much as I would expect from a fracture. That big joint became painful to the touch, and I started to lose flexibility in my foot. At the end of the day, I got a ride home because I could not stand the thought of walking to and from the bus. When I got home, I went to bed, took some Tylenol, and tried to sleep. That didn't go so well, since my foot was only comfortable when not being touched by anything and resting at a comfortable angle. I couldn't find a comfortable angle, and I live in a universe that is chock full of matter, so my foot was constantly touching something. It was a lousy night.
The next morning, my father-in-law, Youngsoo, took me to a clinic. They took x-rays and drew blood for testing, and made me walk around with one bare foot in their office, which made me grateful that it was early in the morning.
(Side note: every x-ray technician I have encountered in this country has inspired an incomparable blood lust in me. Apparently they believe that foreigners feel no pain, probably because we are not very good at expressing ourselves when some ass-hat grabs an injured limb and twists it into position for that perfect angle. And while I am aware that in Korean culture laughter is a very common way to show discomfort, it is difficult to set aside the fact that in American culture laughing at someone else's pain is considered a sign of being a super-villain. Fortunately, my Korean is not good enough to say, "I wonder what sort of x-ray picture we would get if I were to forcibly insert the x-ray projector into one of your body cavities?" I really need to take more Korean lessons. But I digress.)
The doctor was guessing gout, and gave me a prescription that he said would help if it was. I went to school that with a cane borrowed from Youngsoo and medicine to take after lunch. I was walking like a gimp, trying to figure out how best to use the cane, and how to avoid flexing my right foot. It was a long day, and I was exhausted from trying to avoid pain.
So here are some things I learned about gout. I do not know if they are generally true, or just in my case, and some of them are a bit speculative. I do not recommend quoting me in a research paper.
- gout happens when uric acid crystals form in the joints, most often the big toe.
- it is very much driven by diet, and can often be avoided by changing one's diet.
- the big toe does not, in fact, go to market, nor is it a piggie.
- crystals in general are kind of cool, but they have sharp edges, like a thousand little knives.
- flexing the joint with the crystals in it applies pressure to the crystals, breaking them into millions of tinier, newer, sharper crystals.
- uric acid is highly concentrated in organ meats, so I need to avoid liver, gizzards. No problem.
- and red meat in general. Dammit.
- and some seafood. Well poop.
- Including mackerel, a fish which I could not have picked out of a lineup before moving to Korea, but is now easily my favorite: cheap, flavorful, with so much natural oil you can cook it in a dry pan, big bones that are easy to remove, and full of the purines that lead to high concentrations of uric acid in the bloodstream so GOUT GOODBYE MACKEREL I WILL REMEMBER YOU FOREVER!
- It is removed from the bloodstream by the kidneys, unless they are busy processing alcohol, so I am going completely dry for the next month. Maybe longer.
- Oh yeah, sugary drinks interfere too. I didn't want my weekly Pepsi that bad anyway.
- The doctor said it is aggravated by stress, so if giving up everything you enjoy eating stresses you out, TOO BAD YOU GET GOUT ANYWAY! HA HA! - sincerely, your body.
- Once you announce that you have gout on Facebook, you quickly find out who else does as well.
- Just like every other medical condition, you are likely to do better if you are not overweight.
- But hey, if I'm taking everything fun out of my diet, that shouldn't be a problem.
- The medicine works, and fairly quickly.
By Wednesday night I had no trouble sleeping. I was walking more carefully, and my foot only hurt when I flexed it too much. But at least I could flex it, and it was no longer painful to the touch.
Thursday I was walking slowly, with short steps, and without the cane. Occasional pain when I forgot what I was doing, but nothing like earlier in the week.
Friday I was mostly back to normal.
Except that I'm no longer sure what normal is. Even now, a full week after I had trouble sleeping because of the pain, I feel something when I flex my foot. Not exactly pain, but the memory of pain. A sense that that pain is lurking just out of sight, and ready to come back any time. I have medicine to take, and I'm pretty sure I'll recognize it the next time I have an attack. Taking the medicine early and being gentle with my foot should make a second attack much more manageable, but...
It's a reminder that even though we pay attention to how our age is counting up, our remaining days on Earth are also counting down. It's a reminder that the body is a wondrous machine, but like any machine it requires maintenance. It's a reminder that going to America and eating your weight in meat has a downside.
I'm not going to claim that this has turned my life around. But I'm paying more attention to what I eat now. I'm trying to be more active.
And I am seriously hoping that research into the human microbiome leads to that Woody Allen future where you eat whatever you want and remain healthy and fit without even trying.
