John X
Age at interview: 57
Brief Outline: John has been experiencing attacks of gout for about 10 years. He has had about 15 attacks in the last 12 months. Gout attacks, combined with a recent stroke, have had a big impact on his everyday life. His GP recently suggested that he starts taking allopurinol.
Background: John is divorced and lives with his partner. He has three children. He is not currently working due to health reasons, and previously worked as a Sales Rep. Ethnic background/nationality: White English.
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John’s gout attacks started in 2004. He noticed when he was walking to his local swimming pool that his toe was painful, and found the cold water at the swimming pool was soothing.
He then experienced no symptoms for a while, but in 2005 he began to get attacks again, this time in his knees, ankles and hands. By 2009 he was also having attacks in his elbows and shoulders and fingers, and on some occasions had attacks in both arms at once.
John found the attacks debilitating. He had been prescribed colchicine by his GP, but found that it took three or four days to work. Colchicine also upset his stomach. John decided to try managing his gout by changing his diet. He tried to find out whether certain foods were causing the attacks by cutting them out of his diet, but this did not stop him from having gout attacks. He also found that the dietary information he came across was often contradictory, but believes that cherries are beneficial.
In 2012, John was having attacks of gout about every ten days. He developed a blood clot on his leg and was taken into hospital, where he had another attack of gout. He was prescribed prednisolone for the gout, which reduced his symptoms within about four hours.
After John came out of hospital, he continued to get attacks of gout. He had a blood test that showed that his uric acid levels were high, and he then developed a severe attack of gout in his foot. He was admitted to hospital and prescribed colchicine, but it was not effective in reducing the pain. John was then prescribed prednisolone and was able to walk by the next morning.
John was in hospital for a week, and unfortunately had a stroke while he was there. Three days after John had the stroke, he had another bad attack of gout in his ankle which – combined with the effects of the stroke – meant that John could not get out of bed. He was admitted to hospital where he was given colchicine. John’s GP then prescribed prednisolone for him, which stopped the pain and reduced the swelling.
When John has gout in his feet or knees it prevents him from driving. If he has attacks in is arms he finds it best to sleep sitting up in a chair, and also struggles to eat and drink because he cannot bend his arms. During attacks he often finds it difficult to get to the toilet. John is not working at the moment since he had the stroke, but in the past he has had to have time off work because of gout.
About six months ago John’s GP suggested that he started taking allopurinol. John has been waiting for a clear period with no attacks of gout to begin taking the medication. He has had between 12 and 15 attacks in the last 12 months.
He then experienced no symptoms for a while, but in 2005 he began to get attacks again, this time in his knees, ankles and hands. By 2009 he was also having attacks in his elbows and shoulders and fingers, and on some occasions had attacks in both arms at once.
John found the attacks debilitating. He had been prescribed colchicine by his GP, but found that it took three or four days to work. Colchicine also upset his stomach. John decided to try managing his gout by changing his diet. He tried to find out whether certain foods were causing the attacks by cutting them out of his diet, but this did not stop him from having gout attacks. He also found that the dietary information he came across was often contradictory, but believes that cherries are beneficial.
In 2012, John was having attacks of gout about every ten days. He developed a blood clot on his leg and was taken into hospital, where he had another attack of gout. He was prescribed prednisolone for the gout, which reduced his symptoms within about four hours.
After John came out of hospital, he continued to get attacks of gout. He had a blood test that showed that his uric acid levels were high, and he then developed a severe attack of gout in his foot. He was admitted to hospital and prescribed colchicine, but it was not effective in reducing the pain. John was then prescribed prednisolone and was able to walk by the next morning.
John was in hospital for a week, and unfortunately had a stroke while he was there. Three days after John had the stroke, he had another bad attack of gout in his ankle which – combined with the effects of the stroke – meant that John could not get out of bed. He was admitted to hospital where he was given colchicine. John’s GP then prescribed prednisolone for him, which stopped the pain and reduced the swelling.
When John has gout in his feet or knees it prevents him from driving. If he has attacks in is arms he finds it best to sleep sitting up in a chair, and also struggles to eat and drink because he cannot bend his arms. During attacks he often finds it difficult to get to the toilet. John is not working at the moment since he had the stroke, but in the past he has had to have time off work because of gout.
About six months ago John’s GP suggested that he started taking allopurinol. John has been waiting for a clear period with no attacks of gout to begin taking the medication. He has had between 12 and 15 attacks in the last 12 months.
John was worried about the idea of allopurinol triggering an attack. He is waiting for a few clear weeks without an attack before he starts taking it.
John was worried about the idea of allopurinol triggering an attack. He is waiting for a few clear weeks without an attack before he starts taking it.
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[Laughs] I think he frightened me when he said it’d give me a bout of gout first. Taking allopurinol apparently kicks in a gout attack and then from then on it’s gone, or so they say. But yeah I’d give it a go. I’ve actually had a prescription for it, but then I had a gout attack. The week I got – the day I got a prescription for it, on a Wednesday, but then on Thursday I was laid up in bed with damned gout. So I thought, “Well, there’s no point in taking it. This is just wasting money.”
Is that what the doctor told you to do?
No, I decided – I went back to the doctor and said, “Look, I won’t take it because I’ve got an attack. I don’t want to waste the money.”
John found it better to sleep sitting up. He found it hard to eat and drink.
John found it better to sleep sitting up. He found it hard to eat and drink.
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So were there things that it stopped you doing then?
Well, it stops you driving, stops you – I would say, Yes, it would stop you doing your full day’s work, because you’ve won’t put up with that all day. Psychologically you won’t, you want to do things to ease pain problems. Yeah, it does definitely. Yeah, gout would stop me walking. If you get it in the shoulders and the arms, phew, my friend had to cut my food up a couple of – quite a few days, so that I could eat.
John X felt like he would rather tear his fingernails out than have the pain of gout. He feared touching the affected joint and could not even bear a sheet over it.
John X felt like he would rather tear his fingernails out than have the pain of gout. He feared touching the affected joint and could not even bear a sheet over it.
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Can you describe what the pain is like at all?
It’s a severe – a very severe ache – a sharp ache. Ooh, a sharp ache. You can’t – you don’t – I think even mentally the thought of touching it hurts. It’s one of those kinds of things. It’s a fear factor. It’s more of fear factor than a pain. But a sheet – you couldn’t put a sheet on it. You couldn’t lie a sheet over it in the winter. I’d move the sheet and pull the sheet back without it being – and, as I say, sore, very sore. There is – and the pain is very particular and if it’s in the knee – if it’s in the ankle then it’s in the ankle and that’s it. It’s there and that’s it and that’s all I can say about it. No, I don’t know, I don’t complain with things very often, but that is the one thing that really does get me.