The Pharmaceutical Journal
Vol 268 No 7186 p251
23 February 2002

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Gout

Pharmacists, who are also patients, describe in their own words what it is like to have to take a medicine for life

Living with gout: practical knowledge is useful

For most of my life I have enjoyed good health and until I was 59 years old I was a regular distance runner. However, from the age of 55 I had developed problems of an arthritic nature in my feet. It did not cause much trouble because it responded to doses of ibuprofen. The episodes, however, were occurring more often as time went by. In August 2000, I had to attend hospital and also see my GP because of a broken ankle. During this period my doctor suspected that I might be prone to gout and he sent me for a test to have my blood checked for urates.

The result of this blood test came back showing a level of 0.45, which is just above an acceptable level. The first step on the road to recovery was to be given a diet sheet. Nothing too drastic: some of the items listed were things that I do not like anyway but certain sacrifices have had to be made. Crab, mackerel, kippers and shrimps are things that I miss; kidney I can do without and liver pâté is lethal. Fortunately, the well-known notion about red wine being contraindicated in gout is a fallacy. All alcohol needs to be controlled but seven or eight units in the evening is acceptable and half a bottle of red wine is well inside this level.

My drug treatment involves taking 200mg of allopurinol each morning immediately after breakfast. After about three months I had another blood test and the urate level was found to be 0.32, which is well within the acceptable range. I was also given a supply of piroxicam 10mg and I found that in the early days a flare-up could be cut short by taking 20mg morning and night for one day only.

Water intake important

The most important aspect of my treatment is my intake of water. By restricting the purines in my diet, taking allopurinol and keeping any uric acid formed in solution with copious amounts of water, I can keep problems at bay. Fluid intake consists of orange juice at breakfast and a cup of tea after my evening meal. In between I consume 2.5 litres of chilled water a day. I increase that to 3.5 litres on the days when I work out in the gym,usually once or twice a week. I have found that on the rare occasions I eat any of the forbidden foods or exceed my limit on alcohol consumption, increasing my intake of water to 3.5 litres per day for two days will avoid any problems. During a recent trip to Florida, the temperature and humidity were at their usual high levels and I found it necessary to take at least 4 litres of water daily.

Better understanding

Having been diagnosed with gout and having to manage the condition has given me a better understanding of the life of a gout sufferer. It is all right learning the theory of illnesses, but it is much more useful having the practical experience to manage the condition. I am now in a position to pass on my knowledge and experience to patients. This can be done on a one-to-one basis or by talking to a group. Having a little more knowledge than the next person gives the impression that one is an expert on the subject.

Patient packs have been a great help to me because they ensure that I do not miss doses of my medication. Missing doses, careless eating and dehydration bring a heavy penalty. A simple mistake can immobilise me or reduce me to being a cripple on a temporary basis and it is just not worth it. My success can be gauged by the fact that I have not had any problems for over a year now.

It is an ambition of mine to attempt road-running once more; whether I can achieve this or not only time will tell. At the age of 64 my best days are undoubtedly behind me.