Alan

Age at interview: 73

Brief Outline: Alan and his wife, Sue, have both had gout. Alan gets attacks around three times a year, and manages these by taking colchicine. Gout usually affects the joints in his foot, but he has also had attacks in his knee.

Background: Alan lives with his wife and has one child. He is now retired. He previously worked as a Civil Servant. Ethnic background/nationality: White English.

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Alan’s gout attacks tend to occur in his foot, but he sometimes has attacks in his knee. When Alan feels an attack of gout developing, he describes the sensation as being similar to stubbing his toe, but the affected joint also becomes red, and much hotter than the surrounding areas. During an attack of gout, Alan experiences pain all the time, but the pain becomes much sharper if he walks and puts pressure on the affected joint.

When Alan initially developed pain in his toe, he thought that he had maybe stubbed his toe and broken it, although he did also wonder if gout was a possibility. He then visited his GP who diagnosed him with gout and prescribed colchicine.

When Alan was in hospital for four weeks waiting to have an operation, he got what he describes as ‘quite severe’ gout, but remembers being told that the hospital did not have any tablets to give him to manage his gout.

Alan believes that gout does not impact much on his relationship with his wife Sue because both of them have had gout and are therefore more understanding and sympathetic towards each other. When Alan told friends that he had gout most of them found it amusing, although people he spoke to who had gout themselves were very understanding about the pain. Alan believes that there is still a perception that gout only affects people who over indulge in food and alcohol. He does not feel embarrassed about having gout, but sometimes feels embarrassed about the fact that he is limping, or that gout stops him doing things for other people that he would generally do, such as carrying a bag or helping someone up stairs. 

When Alan has an attack of gout he finds it difficult to walk, and finds using a walking stick helpful. However, he has found that riding a bicycle is the easiest way of getting around because he can use one foot to move the pedals round which reduces the pressure on his other foot. This has been particularly useful to him when he has to go to see his GP, which would usually involve walking to the bus stop and catching a bus.

The pain of gout stops Alan from doing his usual activities, such as digging in the garden, but he tries to remain active to ensure that gout does not prevent him from doing what he wants to. The pain of gout also often stops Alan from sleeping at night, so he gets up and goes downstairs to read or watch TV. Alan’s gout started after he had retired, but he believes that it would have been quite problematic if he had been working – even in terms of the physical effort of getting to work.
 
Alan feels that he has learnt how to manage his gout more effectively over time by learning to recognise an attack earlier, and beginning treatment quickly. For example, he has found that if he takes colchicine as soon as he notices symptoms of gout developing, the attack does not get as bad, and goes within a few days, whereas if he leaves it until later to begin taking colchicine, the attack is more severe and lasts for longer. He takes colchicine tablets with him if he goes on holiday in case he gets an attack while he is away.
 
At the moment, Alan is getting attacks of gout two or three times a year. He believes that his GP is monitoring his health in terms of gout as well as his other health conditions. He has blood tests every six months, and his GP checks his uric acid levels at the same time. Alan’s GP has mentioned the possibility of him taking long-term medication to prevent attacks of gout, but does not believe that this is necessary yet. Alan thinks that this might be because he is already taking several other tablets for other health issues, such as his heart condition. Alan is not keen to start taking another daily tablet for gout, but would be happy to do so if his attacks of gout became more frequent. 

Alan found it amusing that he enjoyed drinking alcohol and had now been diagnosed with gout. He thought that his friends would see it as his own fault.

And how did you feel when you discovered you'd got gout?

Alan: Well, slightly amused I’ll be honest because, everybody says, “Ah gout, it’s all to do with drinking” and of course, I must admit that I do drink [laughs], so I thought I know what my mates are going to say, “Aye serves you right” you know [laughs], “It’s come to you”, but I mean, it isn’t really a lot to do with drinking, because one of the most ironic things is, I was in hospital for four weeks waiting to have a procedure done and of course with not a spot of any alcohol at all, and this was the four weeks I got quite severe gout [laughs], so I thought, “Ah there we are, that’s proved that wrong, it’s nothing to do with drinking”, well at least it wasn’t that time.

Alan found it hard to visit his GP during an attack because of the severe pain. He has now been prescribed tablets to keep at home in case he needs them.

Alan: It starts off with a twinge, but basically, within a day it is very difficult to actually walk, you know, the only way you can really walk is with a walking stick so that you don’t actually put any weight on the foot and it’s nearly always the left foot, it’s very occasionally the right but; and the other thing of course, it is very, very painful, it’s, you know, it’s there throbbing and hurting the whole time, but it tends to go after what, well, it will take a week if I don’t take any tablets, but if I take the three a day tablets, basically it’s gone in about three days, but whilst it’s there, it does curtail a lot of what you can do and I mean one of the most ironic things about it is, when it comes, in order to get the tablets, you can’t just, you’ve got to do the physical effort of getting all the way to the Doctor’s surgery in order for him just to go, “Yes is it gout, yes” and write the - whereas you say, “Well I knew that to start with [laughs], couldn’t you have just written a prescription and given it to me?” but, no they won’t do it, but I have got them to actually now, they give me more than the prescribed amount, they tend to give me 100 which tend to last a couple of years, which is very useful to be honest [laughs] otherwise you keep having to go up there.

Alan and Sue found walking painful. Alan finds the easiest way to get around during attacks is to ride his bicycle.

Sue: The most difficult thing I found was actually walking, because you couldn’t put, can’t put any pressure on your toes or on the big toe, which was where it was mainly, so even just walking around indoors, let alone trying to walk to the end of the road, it was absolute agony, and even with a walking stick, because you just couldn’t put any pressure, and again at night, because you couldn’t have the bedclothes on you because the pressure of bedclothes was absolute agony, and it is the pain. I think a lot of people don’t realise just how painful gout is, it’s absolutely horrendous.

Alan: Because I think I would say, mobility, the easiest way I found, and still do find if it’s there is to ride a bike. You’re not putting the same amount of pressure on it, because you can use the other foot to sort of get it going round so it’s - because that’s, I mean - about a fortnight ago it came on and I went up, had to go to the Doctor and I just jumped on my bike and rode up there which was a lot easier than having to sort of hobble round to the bus stop, get the bus, hobble to the bus there, so a recommendation for other gout users if it’s there, ride a bike [laughs]

Alan and Sue felt that sometimes it was better to go out and socialise because it helped to take their mind off the pain.

Alan: It curbs it to some extent, like for example I mean like, we very often used to go down to the pub on a Friday night; if you’ve got gout or something you’d probably say, “Oh I won’t bother tonight”, but I mean, if was other sort of, and things like, if you were going out for dinner or something like that, you’d, I’d still make the effort and go because it, it would be worse if you were just sat around at home doing nothing and thinking well I could have gone out and had a nice meal, at least that’s taken my mind off other things you know [laughs]. 

Sue: Well yes, I agree with you. I think you try to carry on as much as you can, because it’s just one of those things that you know what it is, but is absolute agony and you think, “well I’ve got to try”.

Alan and Sue don’t let it affect them when people make jokes about gout.

Sue: A lot of people see it as a joke, without realising the implications of the pain, the pain and torture really that you go through with it. It still is the Dr Johnson type of attitude when you have these swollen limbs and bandages and, you know, it’s too much Port, too much Claret etc. Most people have very little understanding of gout and the way it can affect somebody’s body because we’re quite lucky in the fact that it doesn’t affect us that much, but I worked; I had one or two clients when I was working for Social Services who had gout in every single joint, which was red and swollen and for a lot of people, they got very little understanding so it does become a stereotype jokey, “Oh you’ve got gout ha ha ha ha” type of approach, so there tends to be a lot more understanding, particularly I think if you’ve got families who don’t understand it, who might think, “Oh Dad’s been on the bottle” or whatever, which I think could happen.

Alan: Yes, I think there is, there still is quite a perception that it only comes to those who over indulge, both in food and alcohol.

And how does that make you feel?

Sue: I think we’re very resilient really [laughs] so we don’t take any notice of it. We would just make some quip back I think and sort of say, “Well, you obviously don’t know what it’s like then don’t you” or something like that, words to that effect. And when they start to say; we would say, “Oh Alan was in hospital for five weeks and got gout; no rich food and no alcohol”, and we don’t eat a rich diet either, do we, we eat a fairly low fat, high fibre, lots of fresh fruit and vegetable type diet.