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The Guardian - UK
The Guardian - UK
Daniel Lavelle

At 35, I found out I had gout. Imagine having to give up everything you like to eat and drink

Friends having vegetarian feast
‘It turns out even superfoods can lead to crutches.’ Photograph: Katarzyna Bialasiewicz/Alamy

I wake to searing pain in my right foot, the worst pain I’ve ever felt. Worse than the time I broke my back after plummeting 16ft from a cricket practice net, worse than when a rusty nail, jutting out from a rickety armchair, bored into my soft infant arm and worse than any grief from my teeth over the years. I switch on the light, gently remove the covers and discover an angry red lump, the size and shape of a golf ball, pulsing on the big toe of my right foot. I have no idea how this happened. It’s like I’ve been sucked into a cartoon overnight, and Daffy Duck has whacked me with an Acme hammer.

In my non-expert opinion, the toe looks broken. I think I should go to a hospital, but I reason that the NHS is too busy and what can they do about a broken toe except say “you have a broken toe” and send me on my way with crutches and painkillers. Also, I’m too lazy. In fact, that’s the real reason I don’t go; the NHS bit was to make me look good in your eyes. Soz.

Anyway, after much malarkey and desperate calls to the hotel I’m staying at, a kindly receptionist collects some crutches from an Argos next door and delivers them to my room. Somehow, I manage to collect my effects and hobble with my new sticks to Euston station.

When I return home, my mum torpedoes my plan to just let the toe heal itself. She tells me my foot could be sore and disfigured for life, or I could end up like Bob Marley, who, she says, famously dismissed a sore toe and died of cancer soon after. The Marley story inspires enough sense of peril in me, and I let Mum drop me off at the Royal Oldham hospital.

After a surprisingly short wait in A&E, I get to tell a triage nurse about the mystery. “Do you think I knocked it during the night?” I ask her, hopefully. The nurse glances at my toe, “No, it’s gout,” she says. “Gout!?” I say. “That’s right,” she says, a bit too gleefully, as she taps away on her desktop keyboard. I don’t believe it. Gout is a condition I associate with elderly rich gluttons or ancient bigamist Tudors, but apparently I’ve managed to cram a lifetime of greed into just 35 years.

Painting of First meeting of Henry VIII and Anne Boleyn, 1835 by Daniel Maclise
‘Gout is a condition I associate with elderly rich gluttons or ancient bigamist Tudors.’ First meeting of Henry VIII and Anne Boleyn, by Daniel Maclise. Photograph: Heritage Images/Getty Images

Gout occurs because the kidneys can no longer efficiently filter uric acid out of the body. The acid eventually crystallises in the joints and can lead to severe inflammation.

All the nice things in life can trigger it: foods rich in purines – chemical compounds that form uric acid when metabolised – such as red meat, seafood, booze and cake. It’s why it’s called the rich man’s disease because, for centuries, only a king like Henry VIII could afford to live like that. Now, anyone with a Just Eat app can order their way to an early death. Or, at least, a very painful foot.

If I don’t want this to happen again, I have to quit almost everything I like, and it’s high time, too. This shouldn’t be too difficult, as I don’t dislike healthy food, but cooking is something I did in the noughties when I was skint, long before I could get a meal with just my fingertips. I don’t even have to hand over cash any more; all I have to do is raise my head slightly from my cushion like a tardy tortoise poking its head from its shell, make eye contact with my camera and facial recognition does the rest.

If only it was as simple as switching to healthy food, though. It turns out that oily fish such as sardines and mackerel – universally recognised as being good for your heart due to all the omega-3 they have – may as well be hydrofluoric acid for my gouty kidneys. The fact that red meat and offal risk causing flare-ups is not surprising, but broccoli, spinach? It turns out that even these superfoods can lead to crutches.

I’m doing all right, though. This was the wake-up call I needed. At least the first major warning was an excruciating toe rather than feeling like an elephant had sat on my chest.

  • Daniel Lavelle writes on mental health, homelessness and social care

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