John Z

Age at interview: 43

Brief Outline: John experienced pains in various joints and wondered if he might have gout. His GP did a blood test that showed that his uric acid levels were high. John now takes 300mg of allopurinol every day.

Background: John is married and lives with his wife. He is studying part-time for a PhD. Ethnic background/nationality: White English.

More about me...

John had been experiencing pains in various joints for a while, including his knees and ankles. He was working as a doctor at the time and wondered if he might have gout. He went to see his GP who did a blood test. John’s uric acid levels were high, so his GP prescribed allopurinol. John was slightly surprised by the diagnosis because of his age and the fact that he did not have any family history of gout, but he was relieved to have a condition that was easy to treat.

John wondered if he needed to modify his diet. He began to drink more water, and stopped drinking port and eating game. He also tried eating cherries for a while, but did not notice that any of these changes made much difference to his symptoms.

John takes 300mg of allopurinol every day. He does not often think about having gout now, and occasionally questions whether he does have it. He wonders if he should have tests to get a more definitive diagnosis. 

John Z did not feel embarrassed by the diagnosis because of his medical background and knowledge that he had not done anything to cause gout.

I didn’t kind of feel any negative connotation myself, as such. Because at that stage I wasn’t overweight like I am now. So that didn’t bother me too much. So yeah, I mean - and I think, I think when you’re medical, I think you’re - I don’t think you view risk factors in the same sort of stigmatising way. You think ‘well that’s just what causes that’ you know, and you just have to address that. People can make the lifestyle choice, put it that way. And it’s up to them to make the choice, and if it’s something that they can’t help, then you know, there’s no point stigmatising them for it.

John says gout is easily managed, and most people won’t need to make any major changes to their diet.

Well there’s not really - for most people there’s not anything to worry about, and it’s very easily managed. And, don’t get too stressed about the aspects of diet, really. You don’t need to make any drastic changes - unless you’ve got a very strange diet. So yeah, just don’t believe in the mythology that it’s all about - must be living life rather extravagantly because most of the time it’s not true. So that would the main advice.

I think the most useful thing is knowing that actually diet doesn’t make that much difference. Because I think if you, if you try and make too many changes that are unnecessary then that’s probably going to be, kind of, the worst side effect really. So I think that, that it actually doesn’t make that much difference. Because, I do like to have a bit of game every now and then, for example.

John said doctors need to find out what patients know so that they can explain things to them in the best way.

When you’ve got the knowledge, you don’t realise what the lay person’s knowledge is. And I think it’s really easy to forget. So I think partly personal experience and professional experience as well - while at medical school. Because, it’s so easy. You just go, “Oh this is what the condition is” and you completely forget what you knew and thought about these particular things before you’d entered medical training. 

Make sure that you address the myths really. Make sure they have a proper understanding. Because, unless you elicit what people already believe about gout, you won’t necessarily be able to address those things. So yeah, find out what people think first – then go through the education process.