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November 03, 2003
If I were a horse, they'd have shot me

Sorry for the lack of bloggery. I have a note from my doctor.


Gout?!? That's something out of a Charles Dickens novel, right? No one gets that in the 21st Century, right?

Right? Right? Right?!?

Right. Well, I got it.

I already knew of one other guy who has it... but to my surprise, I discovered in conversation that a couple of the guys on my street have it, too. I'm just a year or so over 40, so I guess I shouldn't be too surprised that my body is beginning to show signs of wear, but these guys are as much as 10 years younger than me.

Now, I've talked in the past about pain. Back pain of the kind I occasionally experience - due to a herniated disc - can be debilitating because of the widespread effects it can cause. When I have an "incident," I feel it from my back all the way down the legs. The slightest movement is painful, as are standing or even sitting still. But I can lie down and the pain subsides. Bed rest is good.

Gout, though... this is different. Different bad, not or different unusual.

Last Monday morning I woke up feeling some discomfort in my foot. Not pain, just a sense that there was something wrong. During the day, the discomfort turned to an ache, and then to distracting pain in the ball of the foot. Monday being a telecommute day for me, I was able to elevate it and keep ice on it. No luck. Aspirin wasn't helping much, if at all. The whole day sucked, but a good night's sleep would take care of it, I hoped.

Not quite.

Tuesday dawned, and the pain was still there. And I had a meeting to be at. A three-hour meeting. No telecommute for Russ. It was bearable, but getting worse. As soon as the meeting was over, I went home to ice my foot down. On the way, I called my doctor for an appointment - but nothing was available until late Wednesday afternoon. Dang. More ice, more aspirin. I didn't get much work done at all. Come bedtime, Unisom was needed. It didn't help much.

Wednesday... I said then:

given the opportunity, I'd have cheerfully removed my own foot with a hacksaw.
That is not an exaggeration. The only thing that kept me out of the Emergency Room that day was my inability to negotiate the steps down into the garage to get a power tool. I know, I know, it sounds silly - but the pain was truly mind-altering.

My foot had swollen and started to bruise, and the pain was pounding, almost pulsing up my leg. I knew I hadn't broken anything - I'd have remembered that. I was more concerned than ever.

The previous statement, by the way, is my official submission for The Understatement Of The Year competition.

I'd have done almost anything to be rid of the pain. And, unlike a back injury, there was no "comfortable position" I could get into that would make the pain stop. Elevating the foot seemed to take some of the pressure off, but the difference was inconsequential.

I called my doctor, to try to get an earlier appointment. "Hahahahahaha! Get lost," the receptionist said.

"Bite me. I'm in serious agony here," I replied, nonplussed.

"Suffer, foolish mortal," she quipped gleefully.

"Get bent. Need I remind you of my gold-plated insurance?" quoth I.

"Uh... OK, we can bump you up to 1:30," she relented.

After exchanging cheerful expletives, I rang off and got ready to go to work.

I had a little difficulty putting on a shoe. A lot of difficulty, actually. A lot of gasping-in-pain eye-watering cursing-out-loud difficulty. But I managed it, mainly because I can wear sneakers to work, and laces are un-laceable. And because going to the office barefoot is frowned upon.

I had a 10:00 a.m. meeting - a big important meeting with my manager. To miss it would be a severe CLM. And another meeting immediately thereafter. No telecommuting for this guy that day. So, I made it to my manager's office.

My manager, on the other hand, didn't. Dang.

Praying for sweet, sweet unconsciousness, I hobbled to the next meeting. I don't remember a minute of it. My foot was on fire. After 40 minutes, I could take no more, made my manners, and left for home and an icepack. I implied earlier that getting a shoe on was tough. It was nothing compared to getting it off a couple hours later.

Nothing, but nothing, relieved the pain. I considered using some of my leftover Vicodin, but I was thinking clearly enough to know I didn't want to do that. Knowing that my appointment was soon helped me avoid the painkillers, I think.

  • 1:30 p.m. - I hobble into the doctor's office.

  • 1:31 p.m. - Doctor: "That's gout."

  • 1:40 p.m. - I finally believe he's serious.
Sure, sure, he gave himself a way out by suggesting it might possibly be tendonitis or arthritis. But the first thing he said was gout. And the whole time he's explaining the whys and wherefores, I'm thinking he could be actually doing something about it. Finally, I was given some kind of injection, a prescription for Colchicine (which has been used for over 100 years for gout), and a lab slip for a blood test to make sure of the diagnosis.

The doc's injection (a kind of steroid, I think - I wasn't paying particular attention at the time) and the Colchicine had their effects moderately quickly - the swelling began to subside and the pain eased that afternoon.

A word about Colchicine, or more specifically about the side effects: ouch. The nausea knocked me onto my butt for three or four days, which was a convenient place to have been knocked onto, since the other side effect had me in the littlest room in the house most of Wednesday night, Thursday, Friday, and Saturday. All things considered, though, I'll take the side effects over the gout symptoms, any day.

It's Monday - and I can walk almost normally for the first time in a week. And I have a meeting I have to be in the office for later this afternoon.

Normality is resuming... but I'll have to keep an eye on my foot for the rest of my life. I hate getting older... but it beats the alternative.

OK, I said I was sorry for the lack of blogging. I guess this post makes up for it.

UPDATE: Aspirin and ice are exactly the wrong things to use for a gouty foot. It just figures, doesn't it?

Posted by Russ at 11:39 AM, November 3, 2003 in Personal Stuff

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You've almost inspired me to get one of those blog "collectives" going for guys (OK, gals too Indigo!) over 40 who could swap tales of health problems and how it sucks to get old. GIT: Grouches In Training. Only that would take too much effort, and give me another excuse to neglect my own blog.

Glad to hear you're getting vertical again.

Posted by: MarcV at November 3, 2003 01:15 PM

Ouch! Sure am glad you're feeling better.

Posted by: Psycho Dad at November 3, 2003 01:53 PM

Over 40? Bwahahahahaha. Galloping decrepitude will soon set in as more systems begin to fail. Got your bifocals yet?

Glad to hear you are up and around again.

Posted by: Kirk at November 4, 2003 07:48 AM

Lay off the ice, that may make the uric acid crystals form faster, making the gout worse. The blood tests probably won't be of any help. The uric acid levels drop as the body uses them to form the crystals that are causing the pain. Gout is often a diagnosis of exclusion. Its not cellulitis so it must be gout.

Good luck


Posted by: azygos at November 5, 2003 03:52 AM

My brother had gout in his ankle and had identical symptoms you describe. They gave him Piroxicam 10mg as needed. He said it had no side effects, but he is on some other medication that causes nausea. You can look all that kind of stuff up at www.medlineplus.com - a National Health Institute site of some sort per my brother. It will tell you everything you want to know about any drug prescribed.

Hope that helps you out some. Get better so you don't have to feel like a one-legged man in an ass-kickin contest!

Posted by: The Bartender at November 7, 2003 02:51 AM

I feel for you. I'll be stopping my colchicine treatment in another day or so. Don't worry though, after about ten years the effects aren't quite as bad. :)

Posted by: charles austin at November 12, 2003 10:32 PM

A couple more things. I think colchicine has been around for a couple thousand years. Just be glad your doctor didn't believe he had to extract crstals from your foot to validate his diagnosis. One doctor I saw when I was traveling was reluctant to believe me when I told him it was gout and that I needed colchicine to deal with it unless I'd let him try and extract the crystals from my foot. Bastard. He finally relented, but because of his delay, by hat evening my foot had all the other tell-tale signs of redness and swelling he wanted to see before he would concur with what I already knew about my body. Who exactly would want to abuse colchicine anyway? Jeez.

Finally, gout is transitory. I've had it in my toes, my metatarsals, my ankles, my knees, and my elbow. They only thing they have in common is that they all suck.

Posted by: charles austin at November 12, 2003 10:57 PM