Ivor

Age at interview: 69

Brief Outline: Ivor’s first attack of gout occurred when he was abroad on holiday. He has chosen to manage attacks with diclofenac rather than taking preventative medication. Ivor has about three or four attacks a year but does not feel that these impact on his day to day life.

Background: Ivor is married and lives with his wife. He has two sons. He is semi-retired and works part time as an accountant. Ethnic background/nationality: White English/Jewish.

More about me...

Ivor was abroad on holiday in 1978 when he felt a pain in his big toe. He remembers the pain initially feeling like a sprain, but then it got worse and worse. About four days later, Ivor was lying in bed in the middle of the night and was experiencing excruciating pain. He could not bear to have a sheet over his foot. Ivor’s wife called a doctor, who came to see him. The doctor told Ivor that he had gout. Ivor did not think that this was the correct diagnosis because he was 35 and believed that this was too young to have gout. He also believed at that time, that the main causes were eating red meat and drinking port – neither of which he had been doing. The doctor prescribed anti-inflammatories that Ivor remembers took a long time to work. Ivor’s foot was very swollen and he could not wear shoes. It was about four weeks before the swelling and pain had subsided enough for him to walk properly and wear his usual shoes.
 
When Ivor returned from his holiday, his GP checked his uric acid levels and found that they were high. The GP suggested that Ivor could take a tablet every day for the rest of his life to prevent him from having attacks. Ivor does not like taking pills because he is concerned about potential long-term side effects, so he decided not to use preventative medication and to deal with attacks as they occurred.
 
After his first attack, Ivor experienced attacks three or four times a year for about six years. He tried modifying his diet but he did not find anything that appeared to cause or improve his gout so he did not make any long-term changes.
 
Ivor was surprised to discover how many people had gout. He had previously thought that it was a very rare condition. He was concerned that he might not be able to continue playing sports such as football and squash, but felt reassured once he learnt that the symptoms could be controlled.
 
Attacks of gout impact less on Ivor’s day to day life now than they did when he was first diagnosed. He believes that this is because he is able to recognise when an attack is starting and can then take diclofenac quickly to control the symptoms.
 
Ivor still experiences symptoms about three or four times a year, but as long as he controls them by taking diclofenac, he feels that gout does not have any impact on him at all. 

Ivor’s first attack happened on holiday. He could not bear the bed sheet touching his foot.

The first time I suffered and I didn't even know what it was at the time, not initially anyway. I was overseas, we were on holiday, and I felt a sort of a pain in my big toe which just felt like I'd sprained it initially, but it just got worse and worse and eventually after about four days I was lying in bed and it was in the middle of the night and it was absolutely excruciating pain and I couldn't even put a sheet over my foot, it really was bad. At which point my wife called the doctor. So he came and made a quick assessment and told me it was gout and I immediately rebuffed him, I said, “It can't” - at that age having gout, because I was only what 45 or whatever, 45 years old. So, no 35, sorry, and he was absolutely insistent that it was gout and he gave me some anti-inflammatories which actually took a long time to take effect so - and my foot was really very, very swollen, I couldn't wear shoes, and that situation pertained for about almost four weeks before it eventually subsided that I could walk properly again with a regular pair of shoes. And thereafter I suffered from time to time, I think for about five or six years it happened three or four times a year. 

Ivor read a lot about gout and diet. He tried changing his diet but found that it made no difference.

Well we went to the library, I don’t think in those days we had internet, [laughs] you know, and I got various publications on gout, from time to time there are articles in newspapers which we picked up on. In more recent years I've looked up online information relating to gout and the causes of it. And I think for as many articles that are written there's a different identifier and you know if I were to - I just get the impression that if I were to follow all the advice that’s in all the articles that I've read, I wouldn't eat or drink anything ever again [laughs]. Because there just seems to be such a wide array of possible causes. And I'm sort of a bit nonplussed by it all really. 

And have you ever noticed any links between anything you’ve eaten and the onset of symptoms?

From time to time I thought I had done, so for example I thought it might have been beer, but I've never been a really big beer drinker, and then I thought maybe it was just bottled beer as opposed to draft beer. And then I went through a phase where I thought it might be wine, then there was a phase where it was foods with high protein like liver or whatever, so from time to time over the years I've cut out one or other of these particular - particular foods and drinks and it's never really had any effect whatsoever. 

So I've not actually found anything that either seems to be the particular cause for my condition or a particular remedy for it either. So some years ago I just gave up with all this experimentation and just carried on.

Ivor was relieved to find out that gout could be managed. He was pleased he could continue playing football and squash.

What was important was that I was told and soon figured out that it could be controlled, because at that time I was still playing football actively, so you know I was a bit fearful that if - if this was something really unknown that I wouldn't be able to do any active sport again, so knowing that it could be controlled, that was really helpful. Yeah, so I carried on playing football after a while and squash and whatever. So that was okay. Because I - I think if I'd have been told then that it was a really serious condition that was not really treatable, then I'd have been - I think I'd have been really upset about that. 

Ivor was surprised to find that gout was more common than he thought.

It was just surprising the number of people who also commented that they’d suffered from it. It was a bit of a revelation because I didn't - I just assumed that it was a very rare condition and it obviously wasn’t. Most people who had experienced it, or knew of other people who had experienced it were really very sympathetic because they'd all said they'd had real problems. So there you go, that was a bit encouraging I suppose. 

Ivor did research about gout and diet but found that there was no agreement about particular foods that might trigger attacks.

Well we went to the library, I don’t think in those days we had internet, [laughs] you know, and I got various publications on gout, from time to time there are articles in newspapers which we picked up on. In more recent years I've looked up online information relating to gout and the causes of it. And I think for as many articles that are written there's a different identifier and you know if I were to - I just get the impression that if I were to follow all the advice that’s in all the articles that I've read, I wouldn't eat or drink anything ever again [laughs]. Because there just seems to be such a wide array of possible causes. And I'm sort of a bit nonplussed by it all really.