Runibunar

Age at interview: 38

Brief Outline: Runibunar had pain for a number of years, which was diagnosed as gout when he moved to the United Kingdom from the Philippines. He takes 900mg of allopurinol, but still has some attacks, which affect his job, working in a warehouse.

Background: Runibunar is married and lives with his wife and three children. He works in a warehouse at a distribution centre. Ethnic background/nationality: Asian British.

More about me...

Runibunar has been having pain in his ankles since the age of 25, which was diagnosed as gout when he moved to the United Kingdom from the Philippines. He was given various different medications from his GP but these did not work so he was referred to a rheumatologist. The rheumatologist gave him allopurinol and he now takes 900mg. He also sees the rheumatologist for regular check-ups. He has changed his diet, trying to reduce the amount of purine-rich food he eats.
 
When he has an attack of gout, Runibunar finds it very difficult to do his job, which is in a warehouse. His employers have been supportive but the nature of the work makes it difficult, for example, needing to put on safety boots. He sometimes takes pain relief before he goes to work, to ensure that he can do the job. He is currently working part time, as a way of managing the attacks. He also feels that the gout affects his role as a husband and father inside the house and he sometimes feels ‘useless’.
 
He has some leaflets on gout and has also used the internet to find information. He thinks that some of his relatives in the Philippines may also have gout, as they have similar symptoms to him.

Runibunar first had symptoms when he was living in the Philippines. He took painkillers but was not diagnosed until he moved to the UK and visited his GP.

First when I experienced this kind of illness I thought it was just a simple you know, muscle pain or joint pain, with my foot. That was a long time ago as well because I - I experienced this when I was single, I wasn’t married yet at the time. By the time that I felt this kind of pain that I suffered was really worse, but the thing is not really stay quite a long time and then there were - there were several attacks that happened to me as well, which I consider it's really worse because l couldn't even walk, I couldn't even go to the toilet, I couldn't even do anything that I usually do, then. But the thing is, I just only taking those kind of pain relievers because in our place - because back home (Philippines) we don’t really go to the specialist right away, I just only found out that this kind of illness is considered as gout when I was here (UK), since I - since I went to my GP and then the GP told me that that it was suspected that I have gout, so they told me to - give my - to have a blood test and then at the time they found out that my uric acid was really high. 

Runibunar was reassured by his rheumatologist that the treatments he was taking were safe. He also has regular checks to monitor his kidney function.

I probably was a bit worried at the time because you know for loads of medicines that I was taking, I was thinking that there would be an effect on my body as well, so I asked them really that, “For all these kind of medicines that I am taking is it still safe?” then they told me that, “Yeah, it's still safe because we are giving you very safe medicines for your illness”. And that’s why they just - every time that I went to - every time I go to them, they always check my - check my - my liver functions, my kidney functions, so that they will make sure that - because even the rheumatologist gave me a joke that, at the moment you’re still doing okay [laughs].

Runibunar felt ‘useless’ because he could not perform his duties as a father and husband during attacks.

It really affects my life, not only my job but inside the house as well with my family, with my kids and with my wife. I can't really perform the duties of a father and a husband, because I only lie down in the bed, I can't even go to the toilet, I really have to ask my wife to assist me, and just a little bit things like - I'm quite irritable, or just like I - because of the pain that I can't handle really.

I can't do the usual way that I was doing it with my kids, I can't - I can't play with them, I can't teach them, with their studies, you know. And with my wife I cannot do the usual husband what they are doing, you know what I'm saying, then you see you can really just only a useless person inside of the house, yeah. That’s what I can say if I have an attack. Yeah. 

You feel like a useless person?

Yeah, yeah. A useless person really because you can't do anything. Yeah. And you know all the people inside the house are really affected as well because they can't - they can't - what I mean they can't do anything in their usual ways as well because they have a sick person inside the house. Yeah. Because the pain that you're experiencing during the attack of gout is really, really worst

Runibunar forces himself to put his protective shoes on so that he can work. He dislikes his colleagues knowing why he is limping in case they think he cannot do his job properly.

Do you find you have any problems with footwear, because obviously at the moment round the house you can wear…?

Yeah wearing flip flops, yeah. 

Flip flops, but when you go to work…

Yeah because we are using the safety shoes, protective shoes, quite… because if I have an attack it's really - the thing is I think if you're only going to touch the part that - the part that affected it's really worse, it's really painful. So… but the thing is I really have to force myself to - to put it on because you cannot go to work without those things, so…it's just a matter of sacrificing yourself to do that. Yeah. 

So that’s very painful? 

Yeah it is really, yeah. It was really painful, very, very painful. I don’t - I don’t even bother to - because sometimes they're telling me, “Why are you limping?” I just only, you know, sometimes I'm telling them not really the reason why because sometimes if you really tell them they're - that I have an - I have gout they will think that, you know…especially with your boss, you know, they might you know…they might think that you cannot do your job properly. But the thing is I still handle to reach what they required of me, so I really work hard. Yeah.

When he needs time off work, Runibunar worries that his GP will not believe how intense and limiting his pain is.

I find a lot of support with my rheumatologist but sometimes, you know, I cannot - I cannot take away from me that sometimes if I had an attack and go to the GP and ask for an off sick note, sometimes - which is I really don’t want because I really treasure my job as well - sometimes you’re a bit worried that they're just thinking that you're not really in pain, you know. Because there's people, I know that they know, but the thing is I'm not - I'm not…it's just like I'm quite worried as well that getting some, those kind of things that they consider me not fit to work, I really have to explain it to them always, every time I go to them, every time I went to them, I really need to explain them that, “I can't really handle to go to work so I need an off”. I don't know what they will think of me but the thing is, it’s the real thing, yeah, because I'm not only working - I'm not working at a table, in a - in a job that involves you only going to sit, but I need to work which I really have to do physical things inside a warehouse, so…it's quite - affecting me as well. Yeah.

So you worry that your GP doesn't…

Won't believe me. 

…doesn't believe you? 

Yeah, yeah. I always think of that, that my GP won't believe me, that I was really in pain, that I was only making an alibi or something like that.