This past weekend I developed a condition in my left big toe (why don’t we have a special word for it, as we do for thumbs?). This condition involved swelling, a rise in temperature, and a pain as great as I have ever experienced.
The odd thing about this odd joint pain is that it was as great when I and my toe were motionless as it when I walked with all my weight on it. It emerged early Sunday night when I was asleep and prevented any further sleep that night. Monday morning I went to the local clinic. The medical assistant who came in to check my temperature and blood pressure before the doctor arrived, looked at my toe and said, “It looks like gout.”
“Gout!??!” Surely you jest! Nobody gets gout any more. That was an almost jocular disease that attacked fat, lazy, rich people who overindulged in rich foods back in the 18th and 19th centuries (see illustration—that’s not me, by the way). You read about it in the novels of that period. Surely middle-class US-ers in the 21st (!) century don’t come down with the gout!
The attending physician came in, looked at the toe and said, “It looks like gout.” “How could I have gout?” I responded. “What causes it?”
“Animal organs, shellfish, and wine,” he replied.
That was the menu for my dinner Saturday night! At last I’ve reached the point where I can enjoy liver patê, lobster, and a glass or two of excellent wine. I have a meal like that once, maybe twice, rarely thrice a month. Now you tell me I have to pay and even greater price for the education of my palate than what the restaurant charged!?
“Gout is not that uncommon,” the doctor told me. “You are not the only person in the world able to afford good food.”
So, what is gout? He explained that uric acid as is normally found in urine, makes its way to the toe joint where it forms crystals in the joint of the big toe. (Are we sure there is not word for it like thumb?)
Wha-a-a-a-t!? What is the connection between urine and—of all the joints in the body—the big toe? Well, rarely other joints are affected. No, no, no! That is not my point. What is the uric acid-big toe connection? Well, researchers are working on that question. All they know is that hyperuricemia, too much uric acid in the bloodstream, leads to gout and gout naturally gravitates to the big toe. That is all we need to know since several drugs cure or control it: colchicine and corticosteroids like prednisone.
After two of the pills prescribed by the attending physician (my doctor was away on vacation), the symptoms vanished—even more quickly than they occurred. Now, I need to reduce my weight by a few pounds, continue my exercise routines, drink plenty of water every day, and avoid overindulging in shellfish, dried beans, anchovies, animal organs (foie gras, patê, haggis!), and drinking too much wine, at least, all at the same time.