John Y

Brief Outline: John’s first attacks of gout were in his knee. He could not take allopurinol because it made his skin itch. John then saw a specialist who suggested that he took a low dose of allopurinol and gradually increased it to 300mg. John has not experienced any itching and the frequency of his attacks has decreased.

Background: John is married and lives with his wife and granddaughter. He has two children. John is retired and previously worked as a Police Officer. Ethnic background/nationality: White English.

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John had visited his GP a few times because he was experiencing pain in his left knee. He had been sent for x-rays but no diagnosis was made. John was still experiencing pain so he had made another appointment, but the day before he was due to visit his GP, he woke up to find that his leg was swollen, bright red and very painful. John went straight to his GP, who thought that he might have septicaemia and sent him to the hospital. A doctor at the hospital took a sample from his leg with a needle. A few hours later, they told John that he did not have septicaemia, but that he did have gout. John felt strange about being diagnosed with gout because he thought of it as being an older man’s condition. His leg was put in plaster for a month, and he was told to visit his GP again.
 
John’s GP prescribed allopurinol, but John found that it made his skin itch so he stopped taking it. He tried taking it again a few times over the years, but each time his skin became itchy. Every few months John had an attack of gout. The attacks were mainly in his left knee, but he also had them in his ankles, toes, elbow, wrist and thumb. He took diclofenac to manage the pain, and also found that cold compresses helped. He noticed that beer sometimes triggered an attack so was careful about how much of that he drank. He read on the internet that cherries might help, so he often has them for breakfast.
 
John had to have time off work following his first major attack. When he returned to work his leg muscles were weak from being in plaster, so he had to gradually build up his strength before he could cover all his usual duties. When he had an attack he was unable to do anything and he found that the pain made him a bit grumpy. He used to get up and watch television in the middle of the night because he could not sleep and it was too uncomfortable to lie in bed. He sometimes used to wear a knee brace to reduce the movement of his knee. He also used a walking stick if he needed to walk anywhere.
 
A few years ago, John went back to see his GP about gout. The GP sent him to see a specialist, who started John on a very low dose of allopurinol which was then gradually increased. He also prescribed colchicine for him to take during an attack. John is now taking 300mg of allopurinol and has not experienced any itching. His levels of uric acid have also decreased. He has been taking allopurinol for 18 months and his attacks are getting less frequent. The last major attack he had was over six months ago. He now has no worries about the future in terms of gout. 

John Y’s GP thought he might have septicaemia. He went to the hospital. A sample from his knee confirmed that he had gout.

I just could hardly get out of bed. My leg was so swollen and very, very painful, and bright red. And so the wife rang into work, and said I shouldn’t be coming into work. So I, the second house as you turned into this road, but, I couldn’t walk to the doctors which was on that, if you past it, there’s like a Co-op, and a few shops there, which is what 300 yards. So, I could, I couldn’t walk that far. So, I just managed to put the car into gear, and drove there. And, I went to the doctor and, he thought I’d got septicaemia. So, he said, “Can you get to the hospital?” So I said, “Yes”. So, I managed to get back home again. 

My dad took me to the hospital, and I sort of went to the desk, sat down, and I, first I sat down again, they called me through, and they said, they took a sample from me knee, and said that it will be sort of an emergency. Because, they thought it was septicaemia, by the looks of it. So, they took an emergency blood sample, and sort of, to do that, I’d be on the ceiling. So, they come at me with a needle that big, literally, and, but I didn’t feel anything, they’d deadened it. And, they took this gungy, yellowy brown stuff away, and. And about an hour and half later, two hours later, they came back, and said, “It isn’t septicaemia”, thankfully. 

John’s had attacks less often in the last 18 months since he has been taking 300mg of allopurinol.

Since I’ve been properly on the allopurinol which is probably 18 months now - I would have thought, it’s got to be, the full dose - the attacks have been getting less and less and less, thankfully, and less. And, like I say, it was last year, when I had a really nasty attack. Perhaps in October time, will it be? I think it’s probably October time. You get the odd twinge, you know, like I say this little finger, hurts now and again, but, that’s, and the knee will ache a little bit. But, whether it’s the gout, I don’t think it is, or my knee. 

John Y found that he was more likely to get an attack if he drank more beer than usual.

Well I felt strange, because it’s, like I said, it’s an old man’s, or you think it as being an old man, I mean Henry VIII had it, didn’t he, or George IV had it and they were, I suppose perhaps even a bit younger than me. And, you know, you sort of think, “Well it’s a strange thing to have really”. You think it’s your own fault. Something you’re doing. I know, you know, you sort of look then, you can’t have different foods. Well, I didn’t like offal, you know, so I didn’t have none of that. I did like a beer, a pint of beer. And, I think, beer does, you know, it does affect it. So, I’m careful, that way. Because, I know if I’ve been a party or something like that, and I have had a few more beers, than I normally have, you know, I have had an attack.

Allopurinol made John’s skin itchy and tingly. A specialist prescribed a very low dose and then increased it. He’s had no problems since.

Allopurinol used to make me, sort of tingle, and itch, and so, I couldn’t take it. 

Anyway, they tried me on a couple of things, and what they said they’d do they’d start off with a tiny, tiny 0.5 I think it was, allopurinol again, and build it up, which they did do. And, I’m on it, and I’ve no great problems with it now. And, so, that has sort of brought my reading down, from something like 12, or more sometimes, down to three, two or three. And he, he said he didn’t want me seeing him again, I think it was September last year, or somewhere around that time, you know, unless I had any problems. He didn’t want to see me again. So, that’s me, although he’s a nice chap, you know I was quite happy.

John Y felt strange being diagnosed with gout in his 40s when he thought of it as being an older person’s condition.

So can I take you back to when you were first told that it was gout that you’d got. 

Yeah. 

How did you feel about that?

Well I felt strange, because it’s, like I said, it’s an old man’s, or you think it as being an old man, I mean Henry VIII had it, didn’t he, or George IV had it and they were, I suppose perhaps even a bit younger than me. And, you know, you sort of think, “Well it’s a strange thing to have really”.

Until he took daily medication, John Y used to go for months without any symptoms then would suddenly get an attack. He noticed they became more frequent over time.

It was strange really because you would, you would have an attack, like I had, which it was pretty severe, and then you’d go ages, and months with, nothing. You know, nothing would happen. And then, suddenly it would come again. So, you think, “Well is it, have I got gout or…” you know, because you would think you would have it all the time. But, of course, as the years go on, you do get, you do get it more regularly. And, like I said you feel it sort of, it’s like having a little wind up, one of them little wind up, record players, you know, where it sort of starts off and then it gets, you know, slower and slower and then, you know, before you know where you are, it’s in agony.